Intellectuels africains, patriotisme et panafricanisme : à propos de la fuite des cerveaux

Under the guise of a simple sociological description, the concept of brain drain hides a value judgement on the duties of intellectuals towards their homelands. We would not talk about ‘drain’ if every intellectual was not primarily considered as attached to a specific country, a specific continent, and as having some ‘patriotic duty’ to contribute, with all his/her intellectual capacity, to the development,prosperity and influence of their homeland. The intellectuals who havechosen emigration could be accused of prioritizing their interests, and shamefully dissociating themselves from the destiny of their countries, their continents and their peoples. Those intellectuals could be blamed for having failed to make a contribution, however modest it could be, to the construction of fair, democratic and prosperous African societies and to help in the implementation of those nationalist and pan-Africanist projects that were envisioned around the earlypost-independence period. Yet, is patriotism (as well as nationalism) to be considered as a virtue, and should brain drain be regarded as a vice? Aren’t there situations where brain drain itself could be regarded as a virtue, at least in the sense that it could help to put at the service of humankind and its own society (through states that recognize and value it) talents that otherwise would have been left untapped? These are some of the questions, which in fact implicitly contain our assumption, guiding the reflection that we have developed in this article

Anomalies de l’électro-encéphalogramme en neurologie pédiatrique: à propos de 500 enregistrements à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (Cameroun)

Introduction: Cette étude dont le but était d'évaluer la contribution de l'électroencéphalogramme (EEG) en neurologie pédiatrique et de déterminer les indications pertinentes chez l'enfant de 0 à 15ans. Méthodes: Il s'agit d'une étude rétrospective et descriptive réalisée au laboratoire d'électroencéphalographie de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé du 1er novembre 2011 au 15 mars 2012.Résultats: L'âge moyen des patients était de 70.2 mois avec des extrêmes de 0 et 180 mois. Le sexe ratio était de 1.04. Cent quatre vingt treize des 500 tracés de veille étaient anormaux 41 des 114 tracés de sommeil étaient anormaux et 78 des 500 tracés réalisés présentaient un rythme de fond ralenti pour l'âge. Cent cinquante tracés présentaient des anomalies épileptiques dont 81 focales, 35 multifocales et 34 des anomalies généralisées. Sur les 137 patients dont l'EEG était compatible avec une épilepsie, le lobe temporal était le plus souvent le siège d'anomalies épileptiques avec des épilepsies temporales et des épilepsies à pointes centro-temporales, venaient ensuite le lobe frontal, les épilepsies généralisées, les épilepsies du lobe occipital et l'hypsarythmie. Chez 13 des 150 patients avec des anomalies épileptiques à l'EEG, les anomalies retrouvées ne rentraient pas dans le cadre d'un syndrome épileptique particulier. Lorsque l'épilepsie était connue, la probabilité d'avoir un tracé EEG anormal était 1,44 fois plus élevée (OR=1.44 (0.83-2.52) même si la corrélation n'était pas statistiquement significative (p=0.1). En revanche lorsque l'épilepsie était suspectée, il y avait 3.43 fois plus de risques d'avoir un tracé anormal (OR=3.43 (2.27-5.18) avec une corrélation statistiquement significative (p< ;0.05). Les convulsions fébriles, les mouvements anormaux, le retard psychomoteur, les troubles déficitaires de l'attention avec hyperinésie, la perte de connaissance et les troubles du langage n'étaient pas significativement corrélés avec un risque accru d'avoir un EEG anormal. Conclusion: L'EEG a un rôle aussi bien dans la confirmation et la caractérisation de divers syndromes épileptiques et suspicions d'épilepsie que dans la discrimination des manifestations paroxystiques non épileptiques chez l'enfant. Les renseignements cliniques sont indispensables pour une lecture optimale du tracé.Key words: Enfants, épilepsies, électro-encéphalogramme, Camerou

Epilepsie chez les Enfants Atteints d’Infirmité Motrice Cérébrale : à Propos de 412 Observations à Yaoundé, Cameroun

Une étude prospective, descriptive et consécutive réalisée à l’Unité de Neurologie Pédiatrique de l’hôpital gynéco-obstétrique et pédiatrique de Yaoundé (Cameroun) du 1er janvier 2004 au 31 Décembre 2008 a permis de retenir 412 patients admis pour infirmité motrice cérébrale (IMC). L’IMC représentait 20,39% des pathologies neuropédiatriques. L’âge moyen des patients était de 31,7 mois. Les étiologies anténatales étaient de (5,51%), périnatales (65,25%), postnatales (29,22%) ; elles étaient dominées par l’asphyxie néonatale (43,68% de cas). L’épilepsie était l’une des principales affections associées à L’IMC. Elle était retrouvée chez 41,5% des patients. L’épilepsie était plus fréquente dans la tétraplégie spastique et l’hémiplégie cérébrale infantile. Par ailleurs 68,72% de patients ont fait la première crise épileptique au cours de leur première année de vie. Les convulsions néonatales, l’asphyxie néonatale et les infections néonatales ont été les facteurs de risque prédisposant les enfants avec IMC à faire l’épilepsie.Mots Clés enfants ; infirmité motrice cérébrale ; épilepsie ; Camerou

Neonatal mortality in a referral hospital in Cameroon over a seven year period: trends, associated factors and causes.

Background: The fourth Millennium Development Goals targets reduction by 2/3 the mortality rate of under-fives by 2015. This reduction starts with that of neonatal mortality representing 40% of childhood mortality. In Cameroon neonatal mortality was 31‰ in 2011.Objectives: We assessed the trends, associated factors and causes of neonatal deaths at the Yaounde Gynaeco-Obstetric and Pediatric Hospital.Methods: The study was a retrospective chart review. Data was collected from the hospital records, and included both maternal and neonatal variables from 1st January 2004 to 31st December 2010.Results: The neonatal mortality was 10%. Out-borns represented 49.3% of the deceased neonates with 11.3% born at home. The neonatal mortality rate followed a downward trend dropping from12.4% in 2004 to 7.2% in 2010. The major causes of deaths were: neonatal sepsis (37.85%), prematurity (31.26%), birth asphyxia (16%), and congenital malformations (10.54%). Most (74.2%) of the deaths occurred within the first week with 35% occurring within 24hours of life. Mortality was higher in neonates with birth weight less than 2500g and a gestational age of less than 37 weeks. In the mothers, it was high in single parenthood , primiparous and in housewives and students.Conclusion: There has been a steady decline of neonatal mortality since 2004. Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of neonatal deaths. Neonatal sepsis remained constant although at lower rates over the study period.Key words: mortality, neonates, referral hospital, Cameroo

Neonatal mortality in a referral hospital in Cameroon over a seven year period: trends, associated factors and causes.

Background: The fourth Millennium Development Goals targets reduction of the mortality rate of under-fives by 2/3 by the year 2015. This reduction starts with that of neonatal mortality representing 40% of childhood mortality. In Cameroon neonatal mortality was 31% in 2011.Objectives: We assessed the trends, associated factors and causes of neonatal deaths at the Yaounde Gynaeco-Obstetric and Pediatric Hospital.Methods: The study was a retrospective chart review. Data was collected from the hospital records, and included both maternal and neonatal variables from 1st January 2004 to 31st December 2010.Results: The neonatal mortality was 10%. Out-borns represented 49.3% of the deceased neonates with 11.3% born at home. The neonatal mortality rate followed a downward trend dropping from 12.4% in 2004 to 7.2% in 2010. The major causes of deaths were: neonatal sepsis (37.85%), prematurity (31.26%), birth asphyxia (16%), and congenital malformations (10.54%). Most (74.2%) of the deaths occurred within the first week with 35% occurring within 24hours of life. Mortality was higher in neonates with birth weight less than 2500g and a gestational age of less than 37 weeks. In the mothers, it was high in single parenthood , primiparous and in housewives and students..Conclusion: There has been a steady decline of neonatal mortality since 2004. Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of neonatal deaths. Neonatal sepsis remained constant although at lower rates over the study period.Key words: mortality, neonates, referral hospital, Cameroo

A Study of Brain Networks Associated with Swallowing Using Graph-Theoretical Approaches

Functional connectivity between brain regions during swallowing tasks is still not well understood. Understanding these complex interactions is of great interest from both a scientific and a clinical perspective. In this study, functional magnetic resonance imaging (fMRI) was utilized to study brain functional networks during voluntary saliva swallowing in twenty-two adult healthy subjects (all females, 23.1±1.52 years of age). To construct these functional connections, we computed mean partial correlation matrices over ninety brain regions for each participant. Two regions were determined to be functionally connected if their correlation was above a certain threshold. These correlation matrices were then analyzed using graph-theoretical approaches. In particular, we considered several network measures for the whole brain and for swallowing-related brain regions. The results have shown that significant pairwise functional connections were, mostly, either local and intra-hemispheric or symmetrically inter-hemispheric. Furthermore, we showed that all human brain functional network, although varying in some degree, had typical small-world properties as compared to regular networks and random networks. These properties allow information transfer within the network at a relatively high efficiency. Swallowing-related brain regions also had higher values for some of the network measures in comparison to when these measures were calculated for the whole brain. The current results warrant further investigation of graph-theoretical approaches as a potential tool for understanding the neural basis of dysphagia. © 2013 Luan et al

Sequelae due to bacterial meningitis among African children: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>African children have some of the highest rates of bacterial meningitis in the world. Bacterial meningitis in Africa is associated with high case fatality and frequent neuropsychological sequelae. The objective of this study is to present a comprehensive review of data on bacterial meningitis sequelae in children from the African continent.</p> <p>Methods</p> <p>We conducted a systematic literature search to identify studies from Africa focusing on children aged between 1 month to 15 years with laboratory-confirmed bacterial meningitis. We extracted data on neuropsychological sequelae (hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delay/impairment, and seizures) and mortality, by pathogen.</p> <p>Results</p> <p>A total of 37 articles were included in the final analysis representing 21 African countries and 6,029 children with confirmed meningitis. In these studies, nearly one fifth of bacterial meningitis survivors experienced in-hospital sequelae (median = 18%, interquartile range (IQR) = 13% to 27%). About a quarter of children surviving pneumococcal meningitis and <it>Haemophilus influenzae </it>type b (Hib) meningitis had neuropsychological sequelae by the time of hospital discharge, a risk higher than in meningococcal meningitis cases (median = 7%). The highest in-hospital case fatality ratios observed were for pneumococcal meningitis (median = 35%) and Hib meningitis (median = 25%) compared to meningococcal meningitis (median = 4%). The 10 post-discharge studies of children surviving bacterial meningitis were of varying quality. In these studies, 10% of children followed-up post discharge died (range = 0% to 18%) and a quarter of survivors had neuropsychological sequelae (range = 3% to 47%) during an average follow-up period of 3 to 60 months.</p> <p>Conclusion</p> <p>Bacterial meningitis in Africa is associated with high mortality and risk of neuropsychological sequelae. Pneumococcal and Hib meningitis kill approximately one third of affected children and cause clinically evident sequelae in a quarter of survivors prior to hospital discharge. The three leading causes of bacterial meningitis are vaccine preventable, and routine use of conjugate vaccines could provide substantial health and economic benefits through the prevention of childhood meningitis cases, deaths and disability.</p

Itineraire Therapeutique Des Patients Epileptiques A Yaounde: A propos de 149 observations

En Afrique, très peu d\'études ont été consacrées aux problèmes liés au retard de la prise en charge de l\'épilepsie. Cette étude prospective, transversale et descriptive effectuée à l\'Unité de Neurologie Pédiatrique et d\'Epileptologie de l\'Hôpital Gynéco- Obstétrique et Pédiatrique de Yaoundé et au Service de Neurologie de l\'Hôpital Central de Yaoundé, Cameroun du 10 Octobre 2006 au 27 Février 2007 a permis de retenir 149 patients âgés de 0 à 73 ans répondant à nos critères d\'inclusion. Au Cameroun, l\'épilepsie est un problème de santé publique avec une prévalence 5,8 %. De nombreuses croyances entourent cette affection avec des différences notables d\'une région à l\'autre. Ces croyances sont responsables d\'un retard important à la prise en charge, voire une absence de prise en charge, les traitements traditionnels constituant le premier recours. A Yaoundé, les patients se sont majoritairement orientés vers les structures sanitaires modernes en raison de la proximité des structures sanitaires avec le lieu d\'habitation (69% des cas) ; mais environ la moitié de nos patients ayant consulté en première intention les structures sanitaires modernes, a consulté parallèlement un tradipraticen alors que 25,5% de ces patients se sont adressés directement à un tradipraticien en première intention, ceci entraînant un retard sur la prise en charge globale. En raison des causes organiques multiples des épilepsies, les auteurs proposent une collaboration entre tradipraticiens et formations sanitaires modernes ainsi qu\'une mise à la disposition des patients des médicaments anti-épileptiques génériques essentiels de bonne qualité dans toutes les formations sanitaires du pays.In Africa, few studies have been carried out on the causes and consequences of late management of epilepsy. This prospective, cross sectional and descriptive study done in the Epilepsy and Pediatric Neurologic Unit of the Yaounde Gynaeco-Obstetric and Pediatric Hospital and the Neurologic Unit of the Central Hospital Yaounde, Cameroon from 10th October 2006 to the 27th of February 2007 reviewed 149 patients aged 0-73 years. In Cameroon, epilepsy is a major health problem with a prevalence of 5.8%. Many beliefs surround this disorder with variations from one region to another and resulting in late consultations and management, with most patients first seeking traditional treatment. This study showed that in Yaounde, most patients (69%), first go to modern health facilities because they live close vicinity to these health structures. About half of the patients who consulted in health facilities also sought concomitant treatment with traditional healers, while 25% of patients only sought treatment with traditional healers. The end result is that appropriate management is delayed. Given that epilepsy can have many organic causes, the authors recommend that a broad collaboration should be established between traditional healers and modern health facilities, and that good quality generic anti-epileptic drugs be made available to patients at affordable prices in all health facilities in the country.Keywords:Epilepsy-Anti epileptic drugs-Traditional healers.Clinics in Mother and Child Health Vol. 5 (2) 2008: pp. 893-89

Théories de la justice Justice globale, agents de la justice et justice de genre – Séminaires doctoraux de Yaoundé Yaoundé PhD seminars 2012-2014 (Global justice, officers of justice and gender justice - doctoral seminars of Yaoundé Yaoundé PhD seminars 2012-2014)

Le Yaoundé PhD Seminar-Theories of Justice est un séminaire international et pluridisciplinaire qui se tient depuis 2012 à Yaoundé (Cameroun). Il réunit des professeurs et des doctorants africains et non africains ainsi que des professionnels et des représentants de la société civile autour de questions de justice sociale et de politique publique. À l'initiative de doctorants africains et non africains, il a été mis en place conjointement par la Chaire Hoover de l'Université catholique de Louvain (UCL) et par le Centre d’études et de recherches sur la justice sociale et politique de l’Université catholique d’Afrique centrale (UCAC) dans le but de bâtir une véritable solidarité entre le Nord et le Sud dans le domaine de la formation académique et de la recherche. The Yaoundé PhD Seminar-Theories of Justice is an international and multidisciplinary seminar which is held since 2012 in Yaoundé (Cameroon). It brings together teachers and African and non-African doctoral students as well as professionals and representatives of civil society around issues of social justice and public policy. At the initiative of African and non-African students, it has been implemented jointly by the Hoover Chair of the Catholic University of Louvain (UCL) and the Centre of studies and research on social justice and political of the Catholic University of Central Africa (UCAC) in order to build a genuine solidarity between the North and the South in the field of academic training and research

Evaluation of the efficacy and the safety of parenteral sulbactam/ampicillin folllowed by oral sultamicillin for paediatric infections.

The efficacy and the safety of parenteral sulbactam/ampicillin followed by oral sultamicillin* has been evaluated in 41 children aged between 0.5 and 15 years presenting with various infections.Overall clinical and bateriologial success was achieved in 92% of evaluable cases; 97% of 22 pathogens isolated in these patients were eradicated. Adverse reactions were pain at the intramuscular injections site (7%) which was minimized by concurrent injection of lidocaine. Gastro-intestinal disturbances with soft stools were common during oral sultamicillin therapy. Laboratory tests remained normal. Parental sulbactam/ampicillin followed by oral sultamicillin is useful therapy for the treatment of serious non-life-threatening paediatric infections