[Blood exposure accidents: knowledge and practices of hospital health workers in Mali]. / Les accidents d'exposition au sang : connaissances et pratiques des personnels de santé d'un hôpital du Mali.

This is a prospective study conducted in December 2012 among 128 at the Nianankoro Fomba Hospital in Segou in order to assess their knowledge and practices on Blood Exposure Accidents (BEA). The average age of caregivers was 35.4 ± 9 years (range: 22-59 years). The nurses were predominant with 37.5%. The definition of BEA was mastered by 43.8%. The main transmissible infectious agents (HIV, HBV and HCV) were ignored by 76.6%. Questioning revealed that during the treatment, 78.9% wore gloves and 36.0% recapped needles after use. The concept of washing and disinfection after BEA was known by 68.8%. The disinfectant applied was correct for 21.9% of the cases, the time of application for 69.5%. Consulting a referring physician after BEA was mandatory for 32% of them. The time limit of 48 hours delay for the declaration of BEA was experienced by 51.3%. Among staff interviewed 82 caregivers (64.1%) experienced at least one BEA. Students and nursing students were most at risk. Needle pricks were the most frequent (73.2%). BEA is a major problem in the Segou Nianankoro Fomba Hospital. Compliance with standard precautions is not of common practice. Post-exposure care is not widely known. The experienced cases show poor management of BEA in the structure.

[Epidemiological, clinical and therapeutics' data of HIV-infected patients placed on ART in the Segou hospital in Mali (2004-2011)]. / Données épidémiologiques, cliniques et thérapeutiques des patients infectés par le VIH sous traitement antirétroviral à l'hôpital de Ségou au Mali (2004-2011).

This is a retrospective study on a cohort of 811 adult patients placed on ART between January 2004 and December 2011 at the hospital Nianankoro Fomba Segou in Mali, to describe their epidemiological, clinical and developmental profile for 48 months. The average age of patients was 35.2±9.4 years. The sex-ratio was 0.6. Approximately 58.3% of the patients were from rural areas. HIV1 represented 95.8%. Prolonged fever, weight loss and chronic diarrhea were the main reasons for testing. The majority of patients (64.5%) had stage III WHO. The mean CD4 cell count was 144±135.8/mm³ at screening. The evolution was favorable under immunological antiretroviral therapy. The survival rate at 48 months follow-up was 78% [64.1%-81.3%]. Patients followed in the structure are predominantly rural, female and young aged. They are diagnosed with advanced HIV infection. Antiretroviral therapy has led to the strengthening of the immune system and improved the clinical outcomes with a survival rate of 78%.

[Seroprevalence of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among blood donors in Segou, Mali]. / Séroprévalence des virus de l'immunodéficience humaine et des hépatites B et C chez les donneurs de sang à Ségou (Mali).

The purpose of this retrospective study, which examined data collected from January 2007 through September 2010, was to evaluate the seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among 2946 new blood donors at the Nianankoro Fomba Hospital (NFH). The overall seroprevalence of HIV was 0.88%, of HBV 5.3%, and of HCV 0.55%. Donors infected with HIV and HBV were younger than healthy donors, while those infected with HCV were older. These findings at the NFH show that HIV, HBV, and HCV remain major public health problems in Mali.

Problematique de la prise en charge de l'infarctus du myocarde a L'Hopital Desegou (Mali)

INTRODUCTION: Myocardial infarction is a major emergency involving life-threatening in the absence of appropriate treatment. The aim of this study was to analyze the problem of management of myocardial infarction in a second reference hospital in Mali. PATIENTS AND METHODS : This was a prospective descriptive study over a period of six months from January to June 2010. It concerned all patients admitted for myocardial infarction in intensive care.The diagnosis was suspected in chest pain or the occurrence of complications (PAO, cardiogenic shock) and electrocardiogram signs on at least two precordial leads. The parameters studied were: age,reason for admission, risk factors, hemodynamic parameters, the deadline for completion of the ECG, the topography of lesions and electrical changes within 15 days. RESULTS: A male was found with a mean age of 54.62 years. Chest pain was the main reason for admission (6 cases) followed by cardiogenic shock (1 case) and acute pulmonary edema (1 case). The electrocardiogram was performed in 7 patients more than 24 hours after admission. The anterior territory was the most affected. On admission three patients had a systolic pressure below 90 mmHg.The evolution was marked by occurred heart failure (3 cases) and death (2 cases). CONCLUSION: The lack of diagnostic and therapeutic method in our heath facility helps to increase morbidity and mortality associated with myocardial infarction.

[Problems with the management of myocardial infarction at the Desegou Hospital]. / Problematique de la prise en charge de l'infarctus du myocarde a L'Hopital Desegou (Mali)

INTRODUCTION: Myocardial infarction is a major emergency involving life-threatening in the absence of appropriate treatment. The aim of this study was to analyze the problem of management of myocardial infarction in a second reference hospital in Mali. PATIENTS AND METHODS: This was a prospective descriptive study over a period of six months from January to June 2010. It concerned all patients admitted for myocardial infarction in intensive care.The diagnosis was suspected in chest pain or the occurrence of complications (PAO, cardiogenic shock) and electrocardiogram signs on at least two precordial leads. The parameters studied were: age,reason for admission, risk factors, hemodynamic parameters, the deadline for completion of the ECG, the topography of lesions and electrical changes within 15 days. RESULTS: A male was found with a mean age of 54.62 years. Chest pain was the main reason for admission (6 cases) followed by cardiogenic shock (1 case) and acute pulmonary edema (1 case). The electrocardiogram was performed in 7 patients more than 24 hours after admission. The anterior territory was the most affected. On admission three patients had a systolic pressure below 90 mmHg.The evolution was marked by occurred heart failure (3 cases) and death (2 cases). CONCLUSION: The lack of diagnostic and therapeutic method in our heath facility helps to increase morbidity and mortality associated with myocardial infarction.