Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads ...Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.展开更多
Introduction: COVID-19, an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typically presents with mild clinical manifestations in pediatric populations. As in many ...Introduction: COVID-19, an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typically presents with mild clinical manifestations in pediatric populations. As in many other regions of the Democratic Republic of the Congo (DRC), the COVID-19 pandemic affected children in Haut-Uélé, a province bordering South Sudan and Uganda. This study aimed to describe the epidemiological profile of COVID-19 in pediatric population in this area. Materials and Methods: This descriptive cross-sectional study was conducted over a 6-month period from August 1, 2021 to February 7, 2022. It included all patients aged 0 to 19 years with confirmed COVID-19 using RT-PCR and managed at the COVID-19 Treatment Centers (CTCO) in ISIRO and WATSA. Data were collected from patient records supplemented by the dataset from the service of Health Information System (SNIS) and the Epidemiological Surveillance Commission of the Provincial Health Division (DPS). Epidemiological and clinical profiles were analyzed. All statistical analyses were performed using SPSS software, Version 18. Results: During the 4th wave of the pandemic, 5 out of 13 health zones in Haut-Uélé province were affected, with a total of 569 recorded cases;45 of them were children aged 0 to 19 years (7.9%). Asymptomatic cases accounted for 33.3% (15 cases). The mean age was 9.88 ± 5.49 years, with the most affected age group being 10 - 14 years (44.45%). There was a predominance of males (73.3%), with a male-to-female sex ratio of 2.75. Half of the patients (53.3%) were from Watsa Health Zone. A seasonal peak was observed between December and January. Comorbidities were present in 10% of infected patients, and nearly half of participants were contacts of infected individuals. The primary reasons for admission were fever (66.66%), followed by rhinorrhea (57.77%) and cough (31.11%). All patients responded favorably to treatment. Conclusion: The proportion of pediatric COVID-19 cases at the CTCO centers in Haut-Uélé was low, with adolescent males being the most affected group. More than half of the cases were asymptomatic. The most common reasons for consultation were fever, rhinorrhea, and cough.展开更多
<strong>Introduction</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> During childbirth by Caesarean, several types...<strong>Introduction</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> During childbirth by Caesarean, several types of anesthesia can be used. The Caesarean, the most practiced surgical delivery technique in obstetrics, has a risk for complications for both </span><span style="font-family:Verdana;">the pregnant</span><span style="font-family:Verdana;"> women and newborns. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To evaluate the importance of the complications due to Caesarean in the Teaching hospital Gabriel Toure. </span><b><span style="font-family:Verdana;">Patient and Methods: </span></b><span style="font-family:Verdana;">We conducted a </span><span style="font-family:Verdana;">cross sectional</span><span style="font-family:Verdana;"> survey in the departments of </span><span style="font-family:Verdana;">intensive</span><span style="font-family:Verdana;"> care unit and gyneco-obstetric from January to August 2017 in the University hospital Gabriel Touré of Bamako. Our study population was pregnant women who gave birth to children by Caesarean. We included all cases of preventive and emergent Caesarean under loco-regional or general anesthesia. Data were compiled from the obstetrical files of the patients, the anesthetic consultation registry </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the </span><span style="font-family:Verdana;">databasis</span><span style="font-family:Verdana;"> of the department of gyneco-obstetric. The test of khi</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of Pearson was used for the comparison of our results with a value of p < 0.05 considered as statistically significant. </span><span style="font-family:Verdana;">The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During the study period, 1875 childbirths have been recorded of which 633 were by Caesarean (33.7%). We collected and analyzed 524 files of Caesarean. The mortality rate was 1.5% in pregnant women and 15% in newborns. The average age was 26.6 ± 6.9 </span><span style="font-family:Verdana;">ans</span><span style="font-family:Verdana;">. Pregnant women were referrals in 59.4% of the cases. The most frequent motive of referrals was high blood pressure and pregnancy in 66.6%. The Caesarean was indicated in most of the cases on </span><span style="font-family:Verdana;">previously</span><span style="font-family:Verdana;"> operated uterus in 22% and eclampsia was present in 14%. The maternal mortality had occurred in </span><span style="font-family:Verdana;">a context</span><span style="font-family:Verdana;"> of hemorrhage in 50% of the cases. The factors of maternal </span><span style="font-family:Verdana;">morbi-mortality</span><span style="font-family:Verdana;"> were the mode of admission, iterative Caesarean, t surgeon, context of the Caesarean, realization of the anesthetic consultation </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the technic of anesthesia (p = 0.05). The factors of fetal mortality were the realization of </span><span style="font-family:Verdana;">endo-tracheal</span><span style="font-family:Verdana;"> intubation, technic of anesthesia, </span><span style="font-family:Verdana;">realization</span><span style="font-family:Verdana;"> of the anesthesia consultation, </span><span style="font-family:Verdana;">context</span><span style="font-family:Verdana;"> of the Caesarean, iterative Caesarean </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the mode of admission (p</span></span><span style="font-family:""><span style="font-family:Verdana;"> ≤ </span><span><span style="font-family:Verdana;">0.05). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> is associated with a high risk of maternal complications and a very important fetal mortality. The anesthesia consultation in the follow-up of pregnancy would reduce this high mortality.</span></span></span>展开更多
Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income coun...Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income countries, the risk factors for hip disease are numerous, but the means for its management, such as total hip prostheses, are not. The aim of this work was to determine the morbi-mortality of total hip prostheses in the short and medium term in our department and to review the literature. Patients and Method: This was a prospective and descriptive study over a period of 9 years. It involved 50 THPs performed on 45 patients. Patients who had received a THP and were followed up for at least two years were included. We excluded patients who were lost to follow-up. The Moore-type posterolateral minimally invasive approach was used. Complications were investigated from the immediate postoperative period and in the medium term. The final functional results were evaluated according to the Postel Merle d’Aubigné score. Results: We performed 50 THPs out of 750 procedures, i.e. , 6.6%. The indications were: primary coxarthrosis 60%, necrosis of the femoral head 26%, post-infectious balloon hip 4%, and pseudarthrosis of the femoral neck 10%. The average time to the consultation was 2.4 years with extremes of 1 and 5 years. According to the terrain, sickle cell disease represented 18%, tuberculosis 12%. Postoperative complications were lameness 12%, dislocation 6%, suppuration 6%, death 4%, peri-prosthetic fracture 8%, loosening 2%, peri-articular ossification 2%, and paralysis of the external popliteal nerve 2%. Conclusion: Whoever performs a THP is obliged to monitor the patient as long as he/she is alive. Complications are possible at any time and can negatively change the assigned goal and force the surgeon to be expensive and sometimes inconclusive secondary interventions.展开更多
文摘Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.
文摘Introduction: COVID-19, an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typically presents with mild clinical manifestations in pediatric populations. As in many other regions of the Democratic Republic of the Congo (DRC), the COVID-19 pandemic affected children in Haut-Uélé, a province bordering South Sudan and Uganda. This study aimed to describe the epidemiological profile of COVID-19 in pediatric population in this area. Materials and Methods: This descriptive cross-sectional study was conducted over a 6-month period from August 1, 2021 to February 7, 2022. It included all patients aged 0 to 19 years with confirmed COVID-19 using RT-PCR and managed at the COVID-19 Treatment Centers (CTCO) in ISIRO and WATSA. Data were collected from patient records supplemented by the dataset from the service of Health Information System (SNIS) and the Epidemiological Surveillance Commission of the Provincial Health Division (DPS). Epidemiological and clinical profiles were analyzed. All statistical analyses were performed using SPSS software, Version 18. Results: During the 4th wave of the pandemic, 5 out of 13 health zones in Haut-Uélé province were affected, with a total of 569 recorded cases;45 of them were children aged 0 to 19 years (7.9%). Asymptomatic cases accounted for 33.3% (15 cases). The mean age was 9.88 ± 5.49 years, with the most affected age group being 10 - 14 years (44.45%). There was a predominance of males (73.3%), with a male-to-female sex ratio of 2.75. Half of the patients (53.3%) were from Watsa Health Zone. A seasonal peak was observed between December and January. Comorbidities were present in 10% of infected patients, and nearly half of participants were contacts of infected individuals. The primary reasons for admission were fever (66.66%), followed by rhinorrhea (57.77%) and cough (31.11%). All patients responded favorably to treatment. Conclusion: The proportion of pediatric COVID-19 cases at the CTCO centers in Haut-Uélé was low, with adolescent males being the most affected group. More than half of the cases were asymptomatic. The most common reasons for consultation were fever, rhinorrhea, and cough.
文摘<strong>Introduction</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> During childbirth by Caesarean, several types of anesthesia can be used. The Caesarean, the most practiced surgical delivery technique in obstetrics, has a risk for complications for both </span><span style="font-family:Verdana;">the pregnant</span><span style="font-family:Verdana;"> women and newborns. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To evaluate the importance of the complications due to Caesarean in the Teaching hospital Gabriel Toure. </span><b><span style="font-family:Verdana;">Patient and Methods: </span></b><span style="font-family:Verdana;">We conducted a </span><span style="font-family:Verdana;">cross sectional</span><span style="font-family:Verdana;"> survey in the departments of </span><span style="font-family:Verdana;">intensive</span><span style="font-family:Verdana;"> care unit and gyneco-obstetric from January to August 2017 in the University hospital Gabriel Touré of Bamako. Our study population was pregnant women who gave birth to children by Caesarean. We included all cases of preventive and emergent Caesarean under loco-regional or general anesthesia. Data were compiled from the obstetrical files of the patients, the anesthetic consultation registry </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the </span><span style="font-family:Verdana;">databasis</span><span style="font-family:Verdana;"> of the department of gyneco-obstetric. The test of khi</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of Pearson was used for the comparison of our results with a value of p < 0.05 considered as statistically significant. </span><span style="font-family:Verdana;">The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During the study period, 1875 childbirths have been recorded of which 633 were by Caesarean (33.7%). We collected and analyzed 524 files of Caesarean. The mortality rate was 1.5% in pregnant women and 15% in newborns. The average age was 26.6 ± 6.9 </span><span style="font-family:Verdana;">ans</span><span style="font-family:Verdana;">. Pregnant women were referrals in 59.4% of the cases. The most frequent motive of referrals was high blood pressure and pregnancy in 66.6%. The Caesarean was indicated in most of the cases on </span><span style="font-family:Verdana;">previously</span><span style="font-family:Verdana;"> operated uterus in 22% and eclampsia was present in 14%. The maternal mortality had occurred in </span><span style="font-family:Verdana;">a context</span><span style="font-family:Verdana;"> of hemorrhage in 50% of the cases. The factors of maternal </span><span style="font-family:Verdana;">morbi-mortality</span><span style="font-family:Verdana;"> were the mode of admission, iterative Caesarean, t surgeon, context of the Caesarean, realization of the anesthetic consultation </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the technic of anesthesia (p = 0.05). The factors of fetal mortality were the realization of </span><span style="font-family:Verdana;">endo-tracheal</span><span style="font-family:Verdana;"> intubation, technic of anesthesia, </span><span style="font-family:Verdana;">realization</span><span style="font-family:Verdana;"> of the anesthesia consultation, </span><span style="font-family:Verdana;">context</span><span style="font-family:Verdana;"> of the Caesarean, iterative Caesarean </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the mode of admission (p</span></span><span style="font-family:""><span style="font-family:Verdana;"> ≤ </span><span><span style="font-family:Verdana;">0.05). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> is associated with a high risk of maternal complications and a very important fetal mortality. The anesthesia consultation in the follow-up of pregnancy would reduce this high mortality.</span></span></span>
文摘Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income countries, the risk factors for hip disease are numerous, but the means for its management, such as total hip prostheses, are not. The aim of this work was to determine the morbi-mortality of total hip prostheses in the short and medium term in our department and to review the literature. Patients and Method: This was a prospective and descriptive study over a period of 9 years. It involved 50 THPs performed on 45 patients. Patients who had received a THP and were followed up for at least two years were included. We excluded patients who were lost to follow-up. The Moore-type posterolateral minimally invasive approach was used. Complications were investigated from the immediate postoperative period and in the medium term. The final functional results were evaluated according to the Postel Merle d’Aubigné score. Results: We performed 50 THPs out of 750 procedures, i.e. , 6.6%. The indications were: primary coxarthrosis 60%, necrosis of the femoral head 26%, post-infectious balloon hip 4%, and pseudarthrosis of the femoral neck 10%. The average time to the consultation was 2.4 years with extremes of 1 and 5 years. According to the terrain, sickle cell disease represented 18%, tuberculosis 12%. Postoperative complications were lameness 12%, dislocation 6%, suppuration 6%, death 4%, peri-prosthetic fracture 8%, loosening 2%, peri-articular ossification 2%, and paralysis of the external popliteal nerve 2%. Conclusion: Whoever performs a THP is obliged to monitor the patient as long as he/she is alive. Complications are possible at any time and can negatively change the assigned goal and force the surgeon to be expensive and sometimes inconclusive secondary interventions.
