RESUMO
Introduction : La médecine communautaire/famille reste un champ encore mal exploré en matière de recherche scientifique comme le cas du Mali. Objectif de cette étude était de déterminer les motifs de consultation afin de connaitre les types de pathologies rencontrées, les examens réalisés et le devenir des patients dans le centre de santé communautaire et universitaire (CSCOM-U) de Konobougou. Méthodologie : Il s'agissait d'une étude descriptive, rétrospective et déroulée du 1ier janvier au 31 décembre 2018 dans le CSCOM-U de Konobougou/ Mali. Les dossiers des malades ont été tirés au hasard soit tous les dixièmes patients des consultations externes réalisées par deux médecins. Les données ont été collectées sur un questionnaire puis saisies et analysée par SPSS22. Résultats : Le premier motif de consultation était la fièvre avec 25,39% suivi de céphalée 13,69%, algies abdominales 12,95%, troubles digestifs 11,66% et la toux 6,48%. Le paludisme était le plus représenté avec 46,28% suivi des infections respiratoires aigües avec 10,82%, des infections uro-génitales 5,56%, des pathologies gastriques et plaies liées aux accidents 4,77% chacune et en fin des lésions musculosquelettiques 3,1%. Les patients guéris représentaient 90,8% et l'état des patients était amélioré/stabilisé dans 5,6%. Les références/ évacuations représentaient 3,6% et 0,1% de décès. Conclusion : Les motifs de consultations sont divers, variés en première ligne et concernent toutes les spécialités de la médecine d'où l'intérêt d'une bonne démarche diagnostique pour une meilleure prise en charge
Assuntos
Mali , Enfermagem de Atenção PrimáriaRESUMO
This was a cross-sectional, descriptive study lasting 8 months from 20 January to 20 September 2013, carried out in the Department of Dentistry of the Bamako IHB Military Hospital. Thus, out of 263 children surveyed, 178 cases of tooth decay were recorded, ie 67.68%. Females accounted for 97 cases or 54.49% with a sex ratio of 1.2; the 3- to 6-year age group accounted for 72 cases, or 40.45%. School children accounted for 85.39% of cases. The children who brushed represent 168 cases or 94.38%. Those who brushed once were the most represented with 145 cases or 86.30%. Almost all patients had consulted for swelling and pain. The group of lower right and left lower temporal molars were the most represented with respectively 24.71% and 28.09%. Temporary teeth were 103 (71.0%) were mainly the most affected. Stage 3 caries known as pulp according to the classification of early childhood caries represented 145 cases, ie 81.46%. The lower jaw represented 142 cases, ie 77.76%. Oral health plays an important role in children to maintain oral functions. It is necessary for eating, developing speech and a positive self-image. It is therefore time to focus on education campaigns, information for behavioral change in oral hygiene and the use of anti-caries adjuvants in children.
Il s'agissait d'une étude transversale, descriptive d'une durée de 8 mois allant du 20 Janvier au 20 Septembre 2013 réalisée dans le service d'Odontologie de l'Infirmerie Hôpital Militaire de Bamako IHB. Ainsi, Sur 263 enfants enquêtés 178 cas de carie dentaire ont été recensés soit une prévalence de67,68 %. Le sexe féminin a représenté 97 cas soit 54,49 % avec un sexe ratio de 1,2. La tranche d'âge de 3 à 6 ans a représenté 72 cas soit 40,45 %.Les enfants scolarisés ont représenté 85,39 % des cas. Les enfants qui se brossaient représentent 168 cas soit 94,38 %. Ceux qui se brossaient une fois ont été les plus représentés avec 145 cas soit 86,30%. La quasi-totalité des patients avaient consulté pour tuméfaction et douleur.Le groupe des molaires temporaires inferieures droite et gauche ont été les plus représentées avec respectivement 24,71% et 28,09 %.Les dents temporaires soient 103 (71,0%) ont été principalement les plus affectées. La carie du stade 3 dite pulpaire selon la classification de la carie de la petite enfance a représenté 145 cas soit 81,46 %. Le maxillaire inferieur a représenté 142 cas soit 77,76%.La santé bucco-dentaire joue un rôle important chez les enfants pour maintenir les fonctions orales. Elle est nécessaire pour manger, développer la parole et une auto-image positive. Il est donc temps de mettre l'accent sur les campagnes d'éducation, information pour un changement de comportement face à l'hygiène bucco-dentaire et à l'utilisation des adjuvants anti carieux chez les enfants.
RESUMO
INTRODUCTION: One of the weak points in the strategy for eliminating leprosy is the poor quality of screening. To overcome this, the World Health Organization (WHO) encourages endemic countries to run campaigns for the elimination of leprosy by circulating educational messages and mobilizing the medical community for early screening of cases. The aim of our study was to identify the motives for consultation with high predictive value for the diagnosis of leprosy and to determine the late diagnosis factors and hence assist the staff on site to improve the results of their leprosy elimination campaigns. PATIENTS AND METHODS: The study consisted, during the second trimester of 1999, in interviewing all the patients consulting for the first time the Marchoux Institute or the units screening for leprosy in the Bamako area. The interview recorded the motives for consultation, the delay before consulting and the reasons for late consulting. To assess their positive predictive value, the motives for consultation were related to the diagnosis retained (leprosy or not). RESULTS: One thousand one hundred and seventy seven patients were interviewed. The motive for consulting, "suspected leprosy", scored the highest positive predictive value (PPV) (80 p. 100): 12 cases of leprosy were diagnosed by 15 consultants having suspected leprosy. Neurological problems were the second motive for consultation (PPV=61.9 p. 100). The most frequent motive for consultation was spots or "macules" (20 p. 100 of consultations), but only provided a positive predictive value of 19 p. 100. Prior consultations and non-specialized treatments were identified as factors of delay in diagnosing leprosy (P<0.001). CONCLUSIONS: Diagnosis of leprosy cannot be based on the motives for dermatological consultation alone. The macules are the most apparent signs, but of low predictive value. Nevertheless, they are an early but non-specific sign of leprosy and are often neglected by the patient. Other than macules, attention must be paid to the neurological signs (dysesthesia, motor disorders) when screening for leprosy. These signs may appear early on, or be observed at a late stage in the progression of the disease.
Assuntos
Hanseníase/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Interpretação Estatística de Dados , Diagnóstico Diferencial , Humanos , Lactente , Recém-Nascido , Hanseníase/prevenção & controle , Mali , Pessoa de Meia-Idade , Fatores de Tempo , Organização Mundial da SaúdeRESUMO
INTRODUCTION: One of the weak points in the strategy for eliminating leprosy is the poor quality of screening. To overcome this, the World Health Organization (WHO) encourages endemic countries to run campaigns for the elimination of leprosy by circulating educational messages and mobilizing the medical community for early screening of cases. The aim of our study was to identify the motives for consultation with high predictive value for the diagnosis of leprosy and to determine the late diagnosis factors and hence assist the staff on site to improve the results of their leprosy elimination campaigns. PATIENTS AND METHODS: The study consisted, during the second trimester of 1999, in interviewing all the patients consulting for the first time the Marchoux Institute or the units screening for leprosy in the Bamako area. The interview recorded the motives for consultation, the delay before consulting and the reasons for late consulting. To assess their positive predictive value, the motives for consultation were related to the diagnosis retained (leprosy or not). RESULTS: One thousand one hundred and seventy seven patients were interviewed. The motive for consulting, "suspected leprosy", scored the highest positive predictive value (PPV) (80 p. 100): 12 cases of leprosy were diagnosed by 15 consultants having suspected leprosy. Neurological problems were the second motive for consultation (PPV=61.9 p. 100). The most frequent motive for consultation was spots or "macules" (20 p. 100 of consultations), but only provided a positive predictive value of 19 p. 100. Prior consultations and non-specialized treatments were identified as factors of delay in diagnosing leprosy (P<0.001). CONCLUSIONS: Diagnosis of leprosy cannot be based on the motives for dermatological consultation alone. The macules are the most apparent signs, but of low predictive value. Nevertheless, they are an early but non-specific sign of leprosy and are often neglected by the patient. Other than macules, attention must be paid to the neurological signs (dysesthesia, motor disorders) when screening for leprosy. These signs may appear early on, or be observed at a late stage in the progression of the disease.
