ABSTRACT
Calmette is a national university hospital with 220 adult beds. It has emergency, surgical, medical and gynecology and obstetrics departments, along with a radiology unit, a laboratory for medical analyses, a central pharmacy and an outpatient clinic. This hospital has an unusual statute, with managerial autonomy and a system of cost recovery that currently provides 64% of the hospital's income. Since 1994, it has benefited from a French cooperation program. The French NGO, Médecins du Monde, has been present at Calmette since 1990, providing support for <
Subject(s)
Hospital Information Systems , Hospitals, General , Adult , Cambodia , Female , France , Humans , International Cooperation , Male , Medical Records Systems, ComputerizedABSTRACT
The obstetrical referral patients admitted to the Sanon Souro hospital in Bobo-Dioulasso (Burkina Faso) during 1991 were retrospectively reviewed. During the study period 741 women were admitted. The median distance between the referring centre and Bobo-Dioulasso was 33 km. Median age was 22 years and median parity was 3. Indications for referral were dominated by obstructed labour, haemorrhages and infections. The proportion of maternal mortality in the study was 5.4% and was not related to maternal age or parity. However, there was a linear trend of increasing mortality according to the distance between the referring centre and Bobo-Dioulasso (X2 for trend: 7.56; p = 0.006). The perinatal mortality rate of 420 p. thousand was not related to maternal age, but a parity exceeding 4 was a risk factor for the occurrence of perinatal death (relative risk: 1.4; 95% C.I.: 1.2-1.7). As for maternal mortality, there was a linear increase of perinatal mortality with the distance from the referring centre (X2: 20.8; p = 0.00001). There was no marked seasonal variation in the number of referrals nor in the mortality rates per month.
Subject(s)
Infant Mortality , Maternal Mortality , Adult , Burkina Faso , Demography , Female , Hospitalization , Humans , Infant, Newborn , Obstetric Labor Complications/epidemiology , Obstetric Labor Complications/mortality , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/mortality , Referral and Consultation , Transportation of PatientsABSTRACT
The 1986-87 outbreak of paralytic poliomyelitis in Senegal, with 676 reported cases, provided an opportunity to evaluate the efficacy of an enhanced-potency inactivated poliovirus vaccine (N-IPV) in the Kolda region, where this vaccine has been used since 1980. 89 cases, confirmed to have poliomyelitis with residual paralysis, were enrolled in a case-control study, up to 5 matched controls being obtained for each case. The clinical efficacy for one dose of N-IPV was 36% (95% confidence interval 0%, 67%) and for two doses was 89% (95% CI 62%, 97%).