Analyse du coût économique direct du cancer du sein en Côte d'ivoire en 2022 / NA

La prise en charge du cancer du sein constitue un fardeau économique important dans les pays àressources limitées. L'objectif était d'estimer les coûts médicaux directs des patientes suivies pour un cancer du sein en côte d'ivoire Une étude transversale a été conçue et réalisée dans les principales structures sanitaires de référence en gynécologie-obstétrique et en oncologie en Côte d'Ivoire. L'étude incluait les patientes avec un cancer du sein confirmé par l'histologie. Les données ont été recueillies à partir des dossiers médicaux et des entretiens avec les patientes. Au total, 102 patientes à différents stades de la maladie ont été incluses dans l'étude. Les coûts augmentent aux stades avancés. La chimiothérapie était le principal facteur de coût (3 121 $ par patiente) avant la radiothérapie (1 714 $). Les femmes atteintes d'un cancer du sein ont dû faire face à un coût moyen estimé à 442 $ (allant de 322 $ à 933 $). Le coût de la radiothérapie était également exorbitant (1 714 $ par patient). La chirurgie était le traitement le moins onéreux (1 416 dollars). Le coût total moyen des examens radiologiques et des tests de laboratoire s'élevait respectivement à 304 et 247 dollars. Les soins de suivi ont été estimés à 631 dollars. Cette étude fournit une analyse perspicace qui servira de base à une évaluation économique plus poussée et pourrait également être utile aux décideurs en matière de santé pour l'inclure dans le plan national de couverture de la santé.

The management of breast cancer is a major economic burden in countries with limited resources. The aim was to estimate the direct medical costs of patients treated for breast cancer in the Ivory Coast. A cross-sectional study was designed and carried out in the main referral health facilities for gynaecology-obstetrics and oncology in the Ivory Coast. The study included patients with histologically confirmed breast cancer. Data were collected from medical records and patient interviews. A total of 102 patients at different stages of the disease were included in the study. Costs increase in advanced stages. Chemotherapy was the main cost factor ($3,121 per patient), followed by radiotherapy ($1,714). Women with breast cancer faced an estimated average cost of $442 (ranging from $322 to $933). The cost of radiotherapy was also exorbitant ($1,714 per patient). Surgery was the least expensive treatment ($1,416). The average total cost of radiological examinations and laboratory tests was $304 and $247 respectively. Follow-up care was estimated at $631. This study provides an insightful analysis that will serve as a basis for further economic evaluation and could also be useful to healthcare decision-makers for inclusion in the national health coverage plan.

A rare case of important and recurrent abnormal uterine bleeding in a post partum woman caused by cavernous hemangioma: a case report and review of literature.

The cavernous hemangioma is a rare benign vascular tumor. About 50 cases of this disease were found in the literature over the last century and only 9 cases of cavernous hemangioma on the pregnant uterus were published it comes into cavernous or capillary form. The symptomatology is not unequivocal and when it occurs during pregnancy or postpartum, it causes life-threatening cataclysmic hemorrhage. Antenatal diagnosis is difficult and requires a multidisciplinary approach with pathologists, radiologists and gynecologists to avoid these complications or unnecessary hysterectomies. The diagnosis is histological. Hysterectomy is possible after failure of conservative treatment means. We report a rare case, a novel mixed cavernous hemangioma of the body associated with a capillary hemangioma of the cervix in a patient of 28 years 5th visors with recurrent genital bleeding in the postpartum period leading to a hysterectomy.

Cervical Cancer Screening Program by Visual Inspection: Acceptability and Feasibility in Health Insurance Companies.

Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company. Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA) or Lugol's iodine (VILI). Results. Among the 800 identified women, 640 (82%) have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases. Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program.