[Management of suspected cases of malaria before admission to a district hospital in Burkina Faso]. / Chemin de soin des cas présomptifs de paludisme admis dans un hôpital de district au Burkina Faso.

After widespread use and misuse of antimalarial drugs led to the emergence of resistance, new guidelines for malaria treatment with artemisinine-based combination therapy (ACT) were introduced in Burkina Faso in 2005. To describe the management (drug therapy and other practices) of patients with suspected malaria before their admission to the district hospital of Dô, seven years later. This cross-sectional study was conducted during admission to the district hospital, during the low season for malaria, from December 2010 to May 2011. It included all patients aged 6 months or older diagnosed with suspected malaria according to the criteria of the national malaria control program, excluding those with severe comorbidities. The study included 476 suspected cases, 422 (88.7%) uncomplicated and 54 (11.3%) complicated. They accounted for 7.9% of all admissions. Their mean age was 14.4 years, and 35.3% (n = 168) were younger than 5 years. Only 23 (4.8%) had first consulted in a primary health care facility; 346 (72.7%) had used initial self-medication (or, more precisely in some cases, parental administration of medication without medical consultation). Overall, 435 (91.4%) came directly to the district hospital, 331 (76.1%) of them after self-medication; 10 (2.1%) had first consulted a traditional healer. The practice of self-medication did not differ according to age, gender, or complications (p>0.05). The drugs used for self-medication were mainly antipyretics (94.5%) and antimalarials (16.8%); the latter included ACT (39.6%), quinine (19.0%), and non-recommended antimalarial agents (41.4%). During the malaria low season, the treatment itinerary of suspected malaria cases is marked by equal use of ACT and non-recommended antimalarials for self-medication and minimal use of the primary level of care. A study underway of this management and these itineraries during the epidemic season may provide more data about use of ACT, the last armament against malaria in drug-resistant areas such as Burkina Faso.

[Solitary ulcer of the rectum. Report of two cases treated by the Orr-Loygue technique]. / L'ulcère solitaire du rectum. A propos de deux cas traités par la technique d'Orr-Loygue.

We report two cases of solitary ulcer of the rectum treated by Orr Loygue rectopexy technique in a ten-year period at the Surgery Department of Aristide Le Dantec. The first case is about a 39 year-old female who was constipated since approximately seventeen years and had a rectal prolapse associated later to bloody stools. In 1990, she underwent haemorrhoids surgery operation with unsatisfactory results. After the recurrence of the disease, she was admitted at Aristide le Dantec Teaching Hospital, rectoscopy revealed a solitary ulcer. Orr Loygue rectoplexy technique was performed by laparotomy. In the follow up, there was no complication. The second case is about a 43 years old female who suffered from rectal syndrome since twenty years and had pelvis pains with bleeding and phlegmatic diarrhoeas. The physical examination and biologic analysis showed no particularity. Rectoscopy has revealed a solitary ulcer of the rectum which was confirmed by biopsy. Orr Loygue rectoplexy technique was performed. In the follow-up, there was a recurrence and this was confirmed by rectoscopy. The rectopexy alone does not summurize the therapeutic. A final dyskesia or an associated perineal insufficiency must be integrated in a total therapeutic strategy.