Corps étrangers chroniques dans l'œsophage chez l'enfant / Chronic foreign bodies in the oesophagus in children

Les ingestions de corps étrangers sont des accidents fréquents en pédiatrie. La plupart sont sans grande conséquence sauf ceux qui sont enclavés dans l'œsophage. Nous rapportons 2 cas de pile bouton intraœsophagienne chez 2 enfants âgés de: 4ans de sexe masculin et 2 ans de sexe féminin. Le motif de consultation dans les deux cas était la dysphagie aux solides. La fibroscopie broncho-oesophagienne a été effectuée dans les 2 cas avec échec d'extraction conduisant à une extraction chirurgicale par voie de thoracotomie chez le garçon et de cervicotomie chez la fille. Une sténose œsophagienne est survenue à 2 mois dans les suites opératoires chez le garçon. L'évolution a été favorable après dilatation aux bougies de Rehbein modifiées. Chez la fille en postopératoire un œdème laryngé est survenu et a nécessité des séances de nébulisations. L'évolution a été favorable chez les 2 enfants avec un recul de 5 ans et de 2 mois. Conclusion: Les piles boutons sont des corps étrangers particuliers qu'il faut extraire en urgence. L'oesophagoscopie reste le moyen le plus fréquemment employé mais la chirurgie reste le dernier recourt avec des possibilités de complication.

Ingestion of foreign bodies is a common accident in paediatrics. Most of them are of little consequence except for those that are enclosed in the esophagus. We report 2 cases of intraesophageal button stacks in 2 children aged 4 years' male and 2 years female. The reason for consultation in both cases was solid dysphagia. Bronchoesophageal fibroscopy was performed in both cases with failed extraction leading to surgical extraction by thoracotomy in boys and cervicotomy in girls. Esophageal stenosis occurred at 2 months of age in the postoperative period in boys. The development was favourable after expansion at the modified Rehbein candles. In the postoperative girl, laryngeal edema occurred and required nebulization sessions. The evolution was favorable in the 2 children with a follow-up of 5 years and 2 months. Conclusion: Button batteries are special foreign bodies that need to be removed urgently. Esophagoscopy remains the most frequently used method, but surgery remains the last resort with the possibility of complications.

[Medical responsability for compensation: opinion of practitioners and users of the hospital, case of Burkina Faso]. / Responsabilite medicale a visee indemnitaire : avis des praticiens et des usagers de l'hopital, cas du Burkina Faso.

INTRODUCTION: Any doctor, during his practice is involved in medico-legal acts. The purpose of this work was to study the opinions of practitioners and users on medical responsibility for compensation, in the case of Burkina Faso. MATERIAL AND METHOD: This is a cross-sectional study on Medical Liability for Compensatory Purposes: Advice from Practitioners and Users of the Hospital, was conducted from April 1 to June 30, 2017 with the help of a anonymous individual questionnaire, among 271 practitioners and users of Yalgado Ouedraogo University Hospital. RESULTS: The study population was young. The mean age of hospital users was 38.68 years, that of practitioners was 32.26 years. Hospital users think in 56.1% of cases (152) that a practitioner can be sued. Of these, administrative responsibility was cited in 79% of responses. Users who felt that they had been the victim of medical malpractice numbered 36 or 13.3%. None of these 36 users had filed a lawsuit complaint. Practitioners who cited both compensatory responsibilities to which they could respond were 65 or 24%. Practitioners who assume to have been at the origin of a medical malpractice numbered 3 (1.1%). Continuing education is the most suggested solution by practitioners (196 times cited). CONCLUSION: Medical liability for compensation is not known by all practitioners, let alone by the users of the hospital. The College of Physicians should emphasize the continuing education of medical practitioners with respect to compensatory medical responsibility.

INTRODUCTION: tout médecin, lors de sa pratique pose des actes médico-légaux. Le but de ce travail était d'étudier les avis des praticiens et des usagers en matière de responsabilité médicale à visée indemnitaire, cas du Burkina Faso. MATÉRIEL ET MÉTHODE: Il s'agisait d'une étude transversale portant sur la Responsabilité médicale à visée indemnitaire : avis des praticiens et des usagers de l'hôpital. Elle a été réalisée du 1er Avril au 30 Juin 2017 à l'aide d'un questionnaire individuel anonyme, auprès de 271 praticiens et usagers du CHU Yalgado Ouédraogo. RÉSULTATS: la population d'étude était jeune. L'âge moyen des usagers de l'hôpital était de 38,68 ans, celui des praticiens était de 32,26 ans. Les usagers de l'hôpital pensent dans 56,1% des cas (152) qu'un praticien peut être poursuivi en justice. Parmi ces derniers, La responsabilité administrative était citée dans 79% des réponses. Les usagers qui estimaient avoir été victime d'une faute médicale étaient au nombre de 36 soit 13,3%. Aucun de ces 36 usagers n'avait déposé une plainte pour poursuite judiciaire. Les praticiens qui ont cité à la fois les deux responsabilités à visée indemnitaire auxquelles ils pouvaient répondre, étaient au nombre 65 soit 24%. Les praticiens qui assument avoir été à l'origine d'une faute médicale sont au nombre de 03 soit 1,1%. La formation continue est la solution la plus proposée par les praticiens (196 fois cités). CONCLUSION: la responsabilité médicale à visée indemnitaire n'est pas connue par tous les praticiens, encore moins par les usagers de l'hôpital. L'ordre des médecins devrait mettre un accent sur la formation continue des praticiens en matière de responsabilité médicale à visée indemnitaire.

Meningitis trends in Niger 2008-2015: a secondary data analysis.

INTRODUCTION: Niger, located in the meningitis belt, faces recurrent epidemics of magnitudes that vary with the year. The objective of this study was to describe the trends in meningitis and identify the profile of the microbes implicated in meningitis epidemics in Niger. METHODS: We conducted a descriptive study (a secondary analysis) of meningitis data from 2008 through 2015. The study population comprised patients with suspected and confirmed meningitis. We conducted an exhaustive sampling of all suspected and confirmed meningitis cases reported in Niger from 2008 to 2015. RESULTS: A total of 6167 (40.6 %) confirmed cases of meningitis were identified. Among them, 5,507 (89.3 %) were attributable to Neisseria meningitidis, 593 (9.6 %) to Streptococcus pneumoniae, and 66 (1.1 %) to Haemophilus influenzae respectively. Among the Neisseria meningitidis cases, 2,984 (54.2 %) were caused by serogroup A, 1,333 (24.2 %) by serogroup W, 1,165 (21.1 %) by serogroup C, 23 (0.4 %) by serogroup X, and 2 (0.03 %) by the serogroup B. CONCLUSION: This study enabled us to describe meningitis trends and identify the profile of the bacteria implicated in its epidemics in Niger. We observed the emergence of Neisseria meningitidis C and recommend vaccination against this serogroup.

[Prevalence of mental disorders in the general population of Burkina Faso]. / Prévalence des troubles mentaux en population générale au Burkina Faso.

OBJECTIVES: To determine, with the use of the Mini-International Neuropsychiatric Interview (MINI), the prevalence of mental disorders in the general population of Burkina Faso; To identify the factors associated with the occurrence of these disorders. METHODS: We conducted a cross-sectional descriptive and analytical survey of a representative sample of the general population aged 18 years and over (n=2587). The only non-inclusion criterion was absence from the place of residence during the investigation period for whatever reason. This approach allowed us to select at random 840 households with a total number of 2587 persons aged 18 years and over. The data collection tools we used were a written questionnaire, developed by ourselves, and the Mini International Neuropsychiatric Interview or MINI questionnaire. On the ethical level, the protocol of this research and its appendices have received the prior approval of the Ethics Committee for Health Research of Burkina Faso as well as support from local customary and administrative authorities. RESULTS: The surveyed population consisted of 1 479 women (57.17 %) and 1108 men (42.83 %). Of the 2 587 people surveyed, 1 072 or 41.43 % met the criteria for at least one of the mental disorders. The prevalence rate was significantly higher among women than men (46.24 % versus 35.01 %). The depressive episode was the most frequent disorder in the surveyed population (11.60 %). Gender, place of residence and marital status were the main factors significantly associated with the occurrence of mental disorders. CONCLUSION: This first national survey revealed a high prevalence of mental disorders. Considering the importance of mental disorders in the general population, it is important to train and involve more nurses and general practitioners in the identification and management of these disorders as there are very few specialists in the field at present.

Brewery wastewater treatment using MBR coupled with nanofiltration or electrodialysis: biomass acclimation and treatment efficiency.

Breweries release significant amounts of wastewater loaded with various organic and mineral materials. Prior studies of membrane bioreactor (MBR) wastewater treatment have been conducted with very little interest granted to the conditions of biomass acclimation. This study displays biomass behavior during brewery wastewater treatment by an aerobic MBR. In addition, nanofiltration and electrodialysis have been studied as potential post-treatment to decrease mineral concentrations and permit further water reuse for agriculture. An anoxic/aerobic laboratory MBR, associated with a flat sulfonated polyether membrane was used for synthetic brewery wastewater treatment. Biomass acclimation was performed using a feeding substrate. Organic concentrations in the MBR influent varied from 700 mg COD/L to 10,600 mg COD/L (COD: chemical oxygen demand) for 110 days. The results indicate a good acclimation to effluent with high salts and organic matter loads. Steady evolution of biomass concentration and activities was achieved after 90 days of operation. A reduction of COD of around 95% was obtained with MBR and up to 99% with nanofiltration post-treatment for the reconstructed brewery effluent with an organic loading rate of 7 g COD/L·d and a solid and hydraulic retention time of 30 days and 36 hours. A good reduction of the salt content was also recorded primarily with the nanofiltration and electrodialysis processes.

Fipronil 1% pour-on: further studies of its effects against lab-reared Glossina palpalis gambiensis.

In order to assess the residual effects of fipronil 1% on tsetse fly survival, male Glossina palpalis gambiensis were released on non-treated and treated cattle, with 0.1 ml of fipronil/kg b.w. as a pour-on formulation. In a second trial, the female fecundity performances were evaluated by feeding teneral females on the same cattle. These females were then mated and their production parameters monitored, as well as the survival of freshly emerged flies. Fipronil had a significant effect on tsetse fly survival (p < 0.001). Over a period of 30 days, up to 40% of tsetse fly mortality was observed within 72 h after tsetse were released. The residual effects ranged between 51 and 74 days when tsetse flies were released twice within a 15-day interval in the presence of a treated animal. When tsetse flies were fed on treated cattle through a parafilm membrane, 92 days after the treatment, no significant effect of fipronil was observed on the reproductive performance of females, i.e., as well as on fecundity (p = 0.948) and emergence rates (p = 0.743), or puparial weight (p = 0.422). This was also the case for the survival of young flies, with no difference observed between the two groups. After this study, it is confirmed that fipronil is highly effective against tsetse flies. Its efficacy in controlling ticks is already known but other externalities such as the control of biting insects add value to its use.

[Parasitological profile of urinary schistosomiasis of the Sourou hydroagricultural complex of Burkina Faso]. / Profil parasitologique de la schistosomose urinaire du complexe hydroagricole du Sourou au Burkina Faso.

In the Sourou area of Burkina Faso, parasitological and malacological surveys of urinary schistosomiasis have been carried out in the constructed sites of Guédougou, Niasan and Débé dating respectively from 1967, 1986 and 1996. The investigations covered also the traditional villages of Lanfiera, Di, Poro, Tiao and Mara situated in the middle of the hydroagricultural planning for the first, very close to the lake for the second and about twenty kilometres distant for the three last. These towns represent the main sites in the Sourou area. The results of the parasitological surveys showed that urinary schistosomiasis was present in all sites. The levels of prevalence varied considerably: 70.3% in Guiédougou, 40.8% in Niassan, 8.5% in Débè in the irrigated zone, 55.6% in Lanfiéra, 56.8% in Di, 13.2% in Poro, 83.3% in Tiao and 64.7% in Mara. Concerning the malacological investigation, two species (Bulinus senegalensis and B. truncatus) were shown to be intermediate hosts of Schistosoma haematobium. The first was endemic to the area while the second was compatible with S. haematobium from the Sourou and other zones. Compared to the results of earlier investigations, the endemic had worsened with differences according to sites. This disparity of prevalence levels which has already been observed in other hydroagricultural area results from many factors, among which the impact of irrigation activities, the aquatic biotope system (irrigation canals, natural lake, pools and temporary rivers) and the type of contact of human communities with water rank high. Schistosomiasis expansion is amplified by the intermediate host dynamics and the introduction of new schistosomes carried by the new workers arriving from all over the country. In these conditions, in order to reduce rapidly prevalence levels, preventive measures should be centred on chemotherapy for the population. The treatment should be administered during a period of weak intermediate host density and be directed towards in-coming workers. Such an approach should be able to check the spread of schistosomiasis naturally occurring with the irrigation of new sites.

[Comparative study of 3 Schistosoma haematobium foci in Burkina Faso]. / Etude comparative de trois foyers bilharziens à Schistosoma haematobium au Burkina Faso.

The comparative study of the three most common schistosomiasis foci in Burkinabé villages shows a great disparity both in parasitological and malacological results. Parasitological investigations by reagent strips and urine filtration conducted on school children indicated respective prevalence rates of 85% at Thion, 37.5% at Donsin and 10.5% at Djerma. Malacological prospections found two species (Bulinus senegalensis and Bulinus truncatus) of intermediate hosts of schistosomiasis in the water biotopes in Thion and Donsin, and only one species (B globosus) at Djerma. We speculate that this situation could be related to initial levels of endemicity, to the distance between living quarters and sites of transmission, to sociological practices as well as to the mollusc vector species. Given the large distribution of these foci throughout the country, the Burkinabé medical authorities should recognise their importance with regard to the disease on a public health level and support the current orientation of the national schistosomiasis control programme which is coordinated around district health services.

Transmission in utero of microfilariae of Onchocerca volvulus.

Skin snips from newborn children and biopsy material from the umbilical cord and placenta of their mothers were examined. Microfilariae of O. volvulus were found in the skin of 2 out of 11 babies and in the umbilical cords of 2 out of 11 babies born to ten mothers infected with O. volvulus in Bawku Hospital, Ghana.