[Socio-Anthropological Determinants of the High Prevalence of Obstetric Fistula in Guinea]. / Déterminants Socio-Anthropologiques de la Prévalence Élevée des Fistules Obstétricales en Guinée.

Objective: The purpose of this study was to analyse the socio-anthropological determinants (representations, beliefs, practices and perceptions of health services) of the high prevalence of obstetric fistulas in Guinea. Patients and methods: From January 15 to February 15, 2018, we carried out a qualitative study in three health centres (one urban and two rural). The study focused on biological mothers who attended the centres to get vaccinated their children. The data were collected by semi-structured individual interview. Results: None of the 42 respondents could link the occurrence of obstetric fistulas and obstructed labour. Participants at all three study sites believed that obstructed labour and obstetric fistula have a mystical origin. In Kissidougou, the respondents thought that obstructed labour and obstetric fistulas are caused either by soubaya, sorcery in Malinké or the evil spell korte in Malinké cast by an enemy, or the bad behaviour of the parturient which means either she practices adultery or if she behaves disrespectfully towards elders. In Dubréka, the respondents linked the occurrence of labour dystocia and obstetric fistula to witchcraft koromikhi in Sousou. In Labé, some respondents thought that obstructed labour and obstetric fistula are due to divine punishment in local dialect lette Allah when the woman does not respect her husband or has contracted the pregnancy out of the legal union. Others deemed that childbirth is difficult because of the narrowness of the delivery route in Fulani lawol ngol no faadhi in parturients who do not have sex during pregnancy or when the woman had not adequately had female circumcision, in local dialect o suuwaaki laabhi which means, part of the clitoris was left in place during the excision. The majority of respondents had a poor perception of health services (male staff, lack of privacy, poor hygiene, abuse). Several cultural practices (early wedlocks, genital mutilations, dietary restrictions, home deliveries) also induce obstetric fistulas. Conclusion: Respondents' cultural beliefs and practices regarding childbirth limit women's attendance at maternity hospitals during childbirth and favour obstetric fistulas.

[Erectile Dysfunction In Chronic Hemodyalized Patients, Clinical And Epidemiological Aspects In Nephrologic Department Of Point "G" Hospital Teaching Center]. / Aspect Epidemiologique Et Clinique De La Dysfonction Erectile Chez Les Hemodialyses Chroniques, Dans Le Service De Nephrologie Et D'Hemodialyse Du CHU Du Point G.

Erectile dysfunction is a common pathology in the general population. The frequency of these erectile disorders is increased in some particular populations such as patients with renal impairment in which it is estimated between 50% and 70% depending on the stage of renal failure. AIMS: Our study aims to study erectile dysfunction in chronic hemodialyzed male patients. METHOD: This is a descriptive prospective study carried out during the period from April 3 to August 31, 2017 having covered 65 chronic hemodialyzed patients for more than 12 months. RESULT: In our study the prevalence of DE was 70.8% and moderate in 13.8%, severe in 30.8%, mild in 26.2%. Testosteronemia was normal in 83.1% of cases and significantly lower in patients with sexual disorders p = 0.030. Libido disorders were observed in 57% of our patients and significantly related to a decrease in testosteronemia p = 0.001. Vascular nephropathy was the most common etiology, i.e. 50.8% of cases followed by chronic Glomerulonephritis 24.6% and in 13.8% of cases no underlying etiology was found.

la dysfonction érectile est une affection fréquente dans la population générale. La fréquence de ces troubles de l'érection est majorée dans certaines populations particulières comme les patients insuffisants rénaux chez qui elle est estimée entre 50% à 70% selon le stade de l'insuffisance rénale. BUT: Notre étude a pour objectif d'évaluer la prévalence la dysfonction érectile chez les patients hémodialysés chroniques de sexe masculin. MÉTHODE: Il s'agit d'une étude prospective descriptive réalisée durant la période du 3 Avril au31 Aout 2017 ayant porté sur 65 patients hémodialysés chroniques depuis plus de 12 mois. RÉSULTAT: Dans notre étude la prévalence de la dysfonction érectile était de 70,8 %. Elle est modérée dans 13,8 %, sévère dans 30,8 %, et légère dans 26,2%. La testosteronémie était normale dans 83,1 % des cas et significativement plus basse chez les patients présentant des troubles sexuels p = 0,030. Les troubles de la libido étaient observés chez 57 % de nos patients et significativement liés à une diminution de la testostéronémie p = 0,001. La néphropathie vasculaire était l'étiologie la plus fréquente soit 50,8 % des cas puis la glomérulonéphrite chronique 24,6% et dans 13,8 % des cas aucune étiologie sous-jacente n'a été trouvée.

[Comparative Study of Induced Pregnancies and Spontaneous Pregnancies in a Level II Hospital in Bamako District Mali]. / Etude Comparative Des Grossesses Induites Et Grossesses Spontanees Dans Un Hopital De Niveau II Du District De Bamako Mali.

The aim of this work was to compare the prognosis of induced pregnancies and spontaneous pregnancies received in the service. PATIENTS AND METHODS: We performed a retrospective study of Ca / Witnesses (1 case for 2 controls) with age and parity matching. This study was conducted at the maternity ward of the Reference Health Center of Commune V District Bamako (CSREF CV) over a period of 10 years from January 1, 2007 to December 31, 2016 for all patients meeting our criteria of 'inclusion. We called cases, induced pregnancies, and witnessed spontaneous pregnancies. The data was entered and analyzed on the Epi-Info software version 6.04 according to the formula applicable to the Case / Witness study. RESULTS: We included in this study, (due to a case for two controls), 1611 induced pregnancies (cases), and 3222 spontaneous pregnancies (controls). The average age was 35.4 years (25 years-43 years) with an average parity of 2.7 (1-5). Hypertensive disorders, preterm birth, intrauterine growth retardation (IUGR), caesarean section, poor perinatal prognosis were found with a statistically significant difference (OR> 1) in patients with induced pregnancies. CONCLUSION: Induced singleton pregnancy is a high-risk pregnancy.

L'objectif de ce travail était de comparer le pronostic des grossesses induites et des grossesses spontanées reçues dans le service. PATIENTES ET MÉTHODES: Nous avons réalisé une étude rétrospective Ca/Témoins (1 Cas pour 2 Témoins) avec appariement de l'âge et la parité. Cette étude s'est déroulée la maternité du Centre de Santé de Référence de la Commune V du District de Bamako(CSREF CV) sur une période de 10ans allant du 1er janvier 2007 au 31 Décembre 2016 portant sur toutes les patientes répondant à nos critères d'inclusion. Nous avons appelé Cas, les grossesses induites et témoins les grossesses spontanées. Les données ont été saisies et analysées sur le logiciel Epi-Info version 6.04 conformément à la formule applicable à l'étude Cas/Témoins. RÉSULTATS: Nous avons inclus dans cette étude, (en raison d'un Cas pour deux Témoins), 1611 grossesses induites (Cas), et 3222 grossesses spontanées (Témoins). L'âge moyen était de 35,4 ans (25 ans-43ans) avec une parité moyenne de 2,7 (1-5). Les troubles hypertensifs, l'accouchement prématurité, le retard de croissance intra-utérin(RCIU), la césarienne, le mauvais pronostic périnatal ont été retrouvés avec une différence statistiquement significative (OR>1) chez les patientes avec grossesses induites. CONCLUSION: La grossesse singleton induite est une grossesse à haut risque.

Biology of two larval morphological phenotypes of Aedes aegypti in Abidjan, Côte d'Ivoire.

Since 2008, several outbreaks of yellow fever and dengue occurred in Abidjan, the economic capital of Côte d'Ivoire. A better knowledge of the biology of Aedes aegypti populations, the main vector of yellow fever and dengue viruses, is necessary to tailor vector control strategies implemented in the city. This study was designed to determine some biological parameters, occurring during the life cycle of two morphological phenotypes of Ae. aegypti larvae. Mosquitoes were sampled in a suburb of Abidjan (Treichville) using the WHO layer-traps technique. Biological parameters were studied in laboratory under standard conditions of temperature (27°C ± 2°C) and relative humidity (80% ± 10%). Our results indicated that the mean eggs laid by females from 'brown larvae' (BL) (85.95, 95% confidence interval (CI 95%) 78.87-93.02) was higher than those from 'white larvae' (WL) (64.40%, CI 95% 55.27-73.54). The gonotrophic cycle was 3 and 4 days in females from BL and WL, respectively. The overall yield of breeding mosquitoes from BL (63.88%, CI 95% 62.61-65.14) was higher compared with those of mosquitoes from WL (59.73%, CI 95% 58.35-61.12). The sex ratio (male/female) was 0.95 and 1.68 in Ae. aegypti populations from BL and WL, respectively. Females from BL lived slightly longer than those from WL (t = -2.332; P = 0.021). This study shows that Ae. Aegypti populations from BL and WL present different biological parameters during their life cycle. This could have an implication on their ability to transmit human disease viruses such as dengue and yellow fever. Further molecular studies are needed to determine genetic divergence between these Ae. aegypti populations.

[Epidemiological baseline situation before the construction of a small dam in five villages of Bouaké, central Côte-d'Ivoire]. / Situation épidémiologique avant la mise en eau du barrage hydroagricole de cinq villages de Bouaké, centre Côte-d'Ivoire

Abstract From June 2007 to June 2008, entomological, malacological and parasitological investigations were carried out in five villages in close proximity to a small dam of Raf-fierkro in Bouaké, central Côte-d'Ivoire. The objective of the study was to identify vectors and intermediate host snails of parasitic diseases related to water, and to assess the prevalence of malaria, schistosomiasis and soil-transmitted helminthiasis before dam construction. Mosquitoes were caught by human landing catches, snails were collected in water bodies, and microscopic analyses of blood, stool and urine samples were carried out. Two malaria vector species were identified:Anopheles gambiae and Anopheles funestus. The average infective rate of An. gambiae ranged between 3.1 and 4.5 %. The infective rate of An. funestus was 1 % in all sites. The entomological inoculation rate ranged between 343.1 and 427.1 infective bites per person per year (ib/p/y)for An. gambiae and between 14.6 and 40.1 ib/p/y for An. funestus. Three species of were found: Plasmodium falciparum (predominant species), Plasmodium ovale and Plasmodium malariae. There were no intermediate host snails of schistosomiasis with the exception of Biomphalaria pfeifferi,intermediate host snail of Schistosoma mansoni in Ahougui. The prevalence of urinary and intestinal schistosomiasis and soil-transmitted helminthiasis was low. Our studies revealed important transmission of malaria, with the presence of three plasmodial species, whereas schistosomiasis and soil-transmitted helminthiasis were present, but only at low frequencies.