ABSTRACT
Background: Healthcare-associated infections (HAIs) are increasing in health facilities in Mali, due to health disparities and growing costs. Twenty to fifty percent of HAIs in the surgery department can be prevented with appropriate measures. Objectives: This study aimed to determine the burden of HAI and its risk factors. Materials and Methods: This was a prospective cohort study from January to June 2021 at the CHU Gabriel TOURE, Bamako, Mali. The sample size was determined based on the CDC Atlanta criteria, used to confirm HAI in surgical settings. Demographic, clinical, and biological parameters were determined. For the confirmed case of infection, the incriminated bacteria were isolated and tests were performed for the choice of drugs. Results: Of the total 1001 patients included in this study, 195 patients (19.48%) have HAIs. The types of infections were as follows: 70 cases of surgical site infections, 54 infections on burns victims, 40 urinary tract infections, and 31 cases of bacteraemia. Germs such as Escherichia Coli, Klebsiella pneumoniae, and Acinetobacter were often isolated. We found increasing hospital stays as well as some postoperative mortality related to infections. At the end of this study, corrective efforts were implemented to prevent HAI. Among them are improvements in sterilisation techniques as far as surgical materials were concerned. In addition to a surgical checklist, locally used drapes were replaced with single-use surgical supplies. Advanced training of the surgical team on things such as bladder catheterisation was also conducted in the department. It is important to put in place a committee, to prevent nosocomial infection in our hospital. The selected committee will be responsible for planning and implementing diverse strategies to prevent infections. Conclusions: The prevention of HAIs will reduce health costs and improve the quality of surgical care.
ABSTRACT
The upsurge and the impact of stroke in terms of mortality and morbidity in Africa are well documented. But their current stroke management modalities remain to be evaluated. METHODS: This study investigated the modalities of healthcare practitioners working in structures involved in stroke management in seven of the eight regions and the capital city of Bamako. A questionnaire was sent out to all potential participants identified in the designated areas, whereas the relevant medical personnel were systematically enrolled to take part. 149 practitioners (90%) including 68 general practitioners, 12 specialists, and 69 residents responded to the questionnaire. Six CT-scan, 15 echocardiographs, and 21 electrocardiographs were available. The team directly involved in patient management included six neurologists, seventeen cardiologists, six neurosurgeons, 86 physical therapists, three orthophonists, and two ergotherapists. Hemiplegia was the revealing symptom of stroke in 61.1% of cases. Almost all infrastructures and the personnel are located in a geographic area representing less than 10% of the country, where only 14 % of the population live. These findings emphasize the lack and unequal distribution of resources allocated to stroke management. CONCLUSION: Problems related to stroke in Mali need a re-organization of patient management networks. An initial and continued training of health practitioners should be implemented.
La haute incidence des AVC en Afrique et leur gravité en termes de mortalité est bien documentée. Mais les modalités actuelles de leur prise en charge restent à évaluer. L'objectif de ce travail était d'analyser les modalités de prise en charge et l'offre de soins pour les AVC, au Mali. Il s'agissait d'une enquête de santé publique auprès des prescripteurs exerçant dans des structures impliquées dans la prise en charge AVC dans 7 des 8 régions existantes et du district de Bamako. Un questionnaire a été adressé à tous les intervenants potentiels recensés de ces territoires, tandis que les plateaux techniques et les personnels ont été systématiquement recensés.Au cours de ce travail 149 prescripteurs sollicités ont répondu au questionnaire (90%). Il s'agissait de 68 médecins généralistes, 12 médecins spécialistes, 69 internes. Sur le plan de la logistique, la presque totalité de ce plateau technique et du personnel se trouvent sur une aire géographique qui représente moins de 10% du territoire national et n'abrite que 14% de la population. Ces données témoignent de l'insuffisance et de l'inégale répartition des ressources allouées à la prise en charge des AVC.
Subject(s)
Death, Sudden/epidemiology , Death, Sudden/etiology , Adolescent , Adult , Africa/epidemiology , Aged , Aged, 80 and over , Autopsy , Female , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
La haute incidence des AVC en Afrique et leur gravite en termes de mortalite est bien documentee. Mais les modalites actuelles de leur prise en charge restent a evaluer. L'objectif de ce travail etait d'analyser les modalites de prise en charge et l'offre de soins pour les AVC; au Mali. Il s'agissait d'une enquete de sante publique aupres des prescripteurs exercant dans des structures impliquees dans la prise en charge AVC dans 7 des 8 regions existantes et du district de Bamako. Un questionnaire a ete adresse a tous les intervenants potentiels recenses de ces territoires; tandis que les plateaux techniques et les personnels ont ete systematiquement recenses. Au cours de ce travail 149 prescripteurs sollicites ont repondu au questionnaire (90). Il s'agissait de 68 medecins generalistes; 12 medecins specialistes; 69 internes. Sur le plan de la logistique; la presque totalite de ce plateau technique et du personnel se trouvent sur une aire geographique qui represente moins de 10du territoire national et n'abrite que 14 de la population. Ces donnees temoignent de l'insuffisance et de l'inegale repartition des ressources allouees a la prise en charge des AVC
