Gastro-entérites en milieux des réfugiés au Tchad

Les réfugiés et déplacés de guerre sont des personnes vulnérables. C’est pourquoi, nous avons entrepris une étude des gastro-entérites dans leurs milieux au Sud et à l’Est du Tchad. Cette étude a concerné 53 patients dans les camps du Sud dont 28,30% sont des enfants de 0 à 5 ans. Elle a été couplée d’une enquête sur l’état nutritionnel de 205 réfugiés dans les deux zones. L’isolement et l’identification des entéropathogènes dans les selles ont été réalisés au laboratoire de l’Hôpital Général de Référence Nationale (HGRN), en utilisant les milieux Hektoen, Mueller-Hinton, EMB, Saboraud Chloramphénicol et la galerie API® 20 E. La microscopie, les tests de filamentation et biochimiques ont permis de caractériser et de déterminer les taux des infestations parasitaires, fongiques et d’infections bactériennes qui sont respectivement de 18,86%, 11,32% et 24,52%. La caractérisation de la sensibilité des agents bactériens Salmonella, Shigella et Escherichia coli a montré une résistance de 85% aux bêta-lactamines. En revanche, 98% des germes sont sensibles aux fluoroquinolones. Cette étude nous a permis non seulement de connaître les caractéristiques des diarrhées liées à l’état nutritionnel des réfugiés, mais également, de mettre en évidence une antibiothérapie efficace permettant la mise en place d’un programme de prévention contre les maladies diarrhéiques et d’amélioration de leur état nutritionnel dans les milieux confinés. L’amélioration de l’état nutritionnel des enfants pourrait comporter : la distribution régulière et complète des aliments riches en vitamines ; l’extension des programmes d’alimentation d’appoint et le logement adéquat pour les réfugiés.Mots clés: Diarrhée, entéropathogènes, nutritionnel, antibiotique, HGRN

ETIOLOGIES DES PLEURESIES DU SUJET AGE AU TOGO

Objective: The aim of this study was to review the current aetiologic profile of pleurisies in the elderly people. Materials and method: We carried out a retrospective study based on the data of 126 patients, old of at least 55 years, hospitalised from January 2007 to December 2011 for pleurisy in the pneumology department of Sylvanus Olympio teaching hospital of Lome. Results: Pleurisies represent 23,11 % of elderly people’s hospitalisation motives. The Sex-ratio was 1 and the average age of the patients 65 ± 09 years old. The clinical aspect was dominated by thoracic pain (88,88 %) and cough (69,84 %). The chest X-ray revealed pleural effusion at the left side in 48,41 %, at right side in 46,83% and of medium abundance in 57,93 %. The liquid was citrine in 53,97 %, haematic in 30,95% and purulent in 15,08% . Pleurisies were of cancerous origin in 32,54 %, tubercular in 17,46 % and bacterial not tubercular in 14,58%. No aetiology had been found in 33,33 %. The mortality was 27,78 % and due to cancers and idiopathic pleurisies in 86 % during three months’ follow up. Conclusion: Cancers are the first aetiology of pleurisies followed by tuberculosis in elderly people. The acquisition of the new means of pleural exploration is important to reduce the proportion of idiopathic pleurisies

ETIOLOGIES DES PLEURESIES DU SUJET AGE AU TOGO

Objective: The aim of this study was to review the current aetiologic profile of pleurisies in the elderly people. Materials and method: We carried out a retrospective study based on the data of 126 patients, old of at least 55 years, hospitalised from January 2007 to December 2011 for pleurisy in the pneumology department of Sylvanus Olympio teaching hospital of Lome. Results: Pleurisies represent 23,11 % of elderly people’s hospitalisation motives. The Sex-ratio was 1 and the average age of the patients 65 ± 09 years old. The clinical aspect was dominated by thoracic pain (88,88 %) and cough (69,84 %). The chest X-ray revealed pleural effusion at the left side in 48,41 %, at right side in 46,83% and of medium abundance in 57,93 %. The liquid was citrine in 53,97 %, haematic in 30,95% and purulent in 15,08% . Pleurisies were of cancerous origin in 32,54 %, tubercular in 17,46 % and bacterial not tubercular in 14,58%. No aetiology had been found in 33,33 %. The mortality was 27,78 % and due to cancers and idiopathic pleurisies in 86 % during three months’ follow up. Conclusion: Cancers are the first aetiology of pleurisies followed by tuberculosis in elderly people. The acquisition of the new means of pleural exploration is important to reduce the proportion of idiopathic pleurisies

Essential Medicines at the National Level : The Global Asthma Network's Essential Asthma Medicines Survey 2014

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013-2020 sets an 80% target for essential NCD medicines' availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013-2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system's capacity to address NCDs.Peer reviewe