[Early Screening Of Sickle Cell Disease: Knowledge And Behaviors Of Pregnant Women And Health Workers In Burkina Faso]. / Depistage Precoce De La Drepanocytose : Connaissances Et Attitudes De Femmes Enceintes Et d'Agents De La Sante Au Burkina Faso.

OBJECTIVE: Early detection of sickle cell disease significantly reduces sickle cell mortality, but it is not practiced in Burkina Faso where the disease is responsible for significant early mortality. The objective of the study was to analyze the relationship between this finding and the knowledge and attitudes of pregnant women with hemoglobinopathy and health workers. MATERIALS AND METHODS: the study was cross-sectional and conducted in three health districts of Ouagadougou, Burkina Faso, from June 17 to July 31, 2019. Data were collected using a structured individual interview guide. RESULTS: 200 pregnant women with hemoglobinopathy and 50 active health workers had participated in the study. Most women defined sickle cell disease as a bone disease, did not know its transmission mode or the hemoglobin type of their child (ren); 95,4% had never heard of neonatal screening for sickle cell disease. Health workers had limited knowledge of sickle cell disease (16-87%), and only 30% offered neonatal screening to pregnant women with hemoglobinopathy. CONCLUSION: the awareness of the population and training health workers on sickle cell disease, supported by a policy of good access to screening tests, would improve the prognosis of sickle cell disease in Burkina Faso.

OBJECTIF: le dépistage précoce, stratégie ayant amélioré la survie des drépanocytaires, n'est pas pratiquée au Burkina Faso où la maladie est responsable d'une mortalité précoce importante. L'objectif de l'étude était d'analyser la relation entre ce constat et les connaissances et attitudes de femmes gestantes porteuses d'une hémoglobinopathie et des agents de santé. MATÉRIELS & MÉTHODES: l'étude était transversale et conduite dans trois districts sanitaires de Ouagadougou au Burkina Faso, du 17 juin au 31 juillet 2019. Les données étaient recueillies à l'aide d'un guide d'entretien individuel structuré. RÉSULTATS: 200 femmes enceintes porteuses d'une hémoglobinopathie et 50 agents de santé en activité avaient participé à l'étude. La majorité des femmes enquêtées définissait la drépanocytose comme une maladie des os, ne connaissaient pas son mode de transmission, ni le type d'hémoglobine de leur(s) enfant(s) ou n'avaient jamais entendu parler de dépistage néonatal de la drépanocytose. Les agents de santé avaient pour 16 à 87%, des connaissances limitées sur la drépanocytose, 30% seulement proposaient un dépistage néonatal aux femmes enceintes porteuses d'une hémoglobinopathie. CONCLUSION: l'information de la population et la formation des agents de santé sur la drépanocytose, soutenues par l'accès aux tests de dépistage améliorerait le pronostic de la drépanocytose au Burkina Faso.

Dépistage précoce de la drépanocytose: connaissances et attitudes de femmes enceintes et d'agents de la santé au Burkina Faso / Early screening of sickle cell disease: knowledge and behaviors of pregnant women and health workers in Burkina Faso

Objectif : le dépistage précoce, stratégie ayant amélioré la survie des drépanocytaires, n'est pas pratiquée au Burkina Faso où la maladie est responsable d'une mortalité précoce importante. L'objectif de l'étude était d'analyser la relation entre ce constat et les connaissances et attitudes de femmes gestantes porteuses d'une hémoglobinopathie et des agents de santé. Matériels & Méthodes : l'étude était transversale et conduite dans trois districts sanitaires de Ouagadougou au Burkina Faso, du 17 juin au 31 juillet 2019. Les données étaient recueillies à l'aide d'un guide d'entretien individuel structuré. Résultats : 200 femmes enceintes porteuses d'une hémoglobinopathie et 50 agents de santé en activité avaient participé à l'étude. La majorité des femmes enquêtées définissait la drépanocytose comme une maladie des os, ne connaissaient pas son mode de transmission, ni le type d'hémoglobine de leur(s) enfant(s) ou n'avaient jamais entendu parler de dépistage néonatal de la drépanocytose. Les agents de santé avaient pour 16 à 87%, des connaissances limitées sur la drépanocytose, 30% seulement proposaient un dépistage néonatal aux femmes enceintes porteuses d'une hémoglobinopathie. Conclusion: l'information de la population et la formation des agents de santé sur la drépanocytose, soutenues par l'accès aux tests de dépistage améliorerait le pronostic de la drépanocytose au Burkina Faso

Objective: Early detection of sickle cell disease significantly reduces sickle cell mortality, but it is not practiced in Burkina Faso where the disease is responsible for significant early mortality. The objective of the study was to analyze the relationship between this finding and the knowledge and attitudes of pregnant women with hemoglobinopathy and health workers. Materials and Methods: the study was cross-sectional and conducted in three health districts of Ouagadougou, Burkina Faso, from June 17 to July 31, 2019. Data were collected using a structured individual interview guide. Results: 200 pregnant women with hemoglobinopathy and 50 active health workers had participated in the study. Most women defined sickle cell disease as a bone disease, did not know its transmission mode or the hemoglobin type of their child (ren); 95,4% had never heard of neonatal screening for sickle cell disease. Health workers had limited knowledge of sickle cell disease (16-87%), and only 30% offered neonatal screening to pregnant women with hemoglobinopathy. Conclusion: the awareness of the population and training health workers on sickle cell disease, supported by a policy of good access to screening tests, would improve the prognosis of sickle cell disease in Burkina Faso.

[Platelet count in the steady state phase and clinical severity of sickle cell disease in a reference centre for sickle cell disease in Mali]. / Taux des plaquettes sanguines en phase intercritique et expressivité clinique de la drépanocytose dans un centre de référence de la drépanocytose au Mali.

Risk factors associated with complications occurring in sickle cell disease are not fully elucidated. The purpose of this study was to evaluate the existence of an association between the clinical severity of sickle cell disease and platelet count in the steady state phase in patients with sickle cell disease followed up at the Center for Research and Control of Sickle Cell Disease in Bamako, Mali. We conducted a retrospective review of 40 medical records of patients aged 5 to 42 years with sickle cell disease at the Center for Research and Control of Sickle Cell Disease in Bamako, Mali. Clinical severity of sickle cell disease was assessed according to the criteria of VOC and/or hospitalizations < 2 or ≥ 2 per year. Data entry was carried out using the Excel 2013 version. The statistical tests used were the Chi2, Student and Mac Nemar tests. Of the 40 patients, 82.5% had haemolytic phenotype and 17.5% hyperviscous phenotype; complications of sickle cell disease were more frequent in the haemolytic phenotype group (p < 0.05). There was a significant association between mean platelet count ≥ 450 G/L in the steady state phase and the annual number of CVOs ≥ 2 (p = 0.002). This study shows that mean platelet count ≥ 450 G/L in sickle cell patients in the steady state phase could be a risk factor for the frequent occurrence of CVO. It underlines the importance of conducting prospective studies focusing on both hyperplateletosis and platelet activation markers in larger sample sizes, as well as therapeutic trials involving platelet activation inhibitors, such as Crizanlizumab, a humanised anti-P-selectin monoclonal antibodies.

Estimating the risk of child mortality attributable to sickle cell anaemia in sub-Saharan Africa: a retrospective, multicentre, case-control study.

BACKGROUND: Many children with sickle cell disease living in sub-Saharan Africa die before reaching age 5 years. We estimate the child mortality associated with sickle cell anaemia using an indirect approach to overcome the absence of systematic screening at birth. METHODS: We did a retrospective, multicentre, case-control study in five countries in sub-Saharan Africa (Burkina Faso, Democratic Republic of the Congo, Côte d'Ivoire, Mali, and Senegal). Women with at least one child with a confirmed SS haemoglobin phenotype (sickle cell anaemia) and who had at least three (alive or deceased) children from the same father born more than 5 years ago were recruited at an outpatient consultation in a sickle cell disease care centre. Women who had children without sickle cell disease (control group) were recruited from the same area, with inclusion criteria of being a neighbour or relative of one of the mothers included in the study who had a child with sickle cell anaemia, having no child or other first-degree relative with major sickle cell syndrome, having at least three children (alive or deceased) born more than 5 years ago, and having a confirmed haemoglobin AA phenotype. During the mothers' interview, we collected data concerning the mortality of siblings from the same father of a child with sickle cell anaemia and characteristics of the family, such as age at the time of the survey and the level of education of both parents. Mortality rates were calculated for children younger than 1, 5, and 10 years using the Kaplan-Meier method after excluding the index children. We assumed, as per Mendel law, that in families who have a child with sickle cell anaemia and healthy heterozygous parents, 25% of children born on average have sickle cell anaemia. A multivariate Cox model was used to describe socioeconomic and geographical factors associated with mortality. FINDINGS: Between Sept 1, 2017, and Nov 30, 2020, 1563 women who had at least one child with sickle cell anaemia and 4972 women from the same neighbourhood who had children without sickle cell disease were assessed for eligibility. Of 1563 women, 248 were excluded because the genotype of the index child was SC or S ß-thalassaemia. 1315 families with cases of sickle cell anaemia and 1243 control families were included in the study. The median age of children (alive) was 14 years (IQR 8-20) in control families and 13 years (8-19) in families with cases of sickle cell anaemia. 5532 [50·6%] of 10 924 children were male. Mortality rates were 15·3% (95% CI 13·3-17·3) for children with sickle cell anaemia younger than 1 year, 36·4% (33·4-39·4) for those younger than 5 years, and 43·3% (39·3-47·3) for those younger than 10 years. Multivariate Cox survival analysis showed that belonging to a family with sickle cell anaemia (hazard ratio [HR] 2·23, 95% CI 1·96-2·54), living in the Democratic Republic of the Congo (HR 1·64, 1·34-2·01), having an older parent (father or mother age had similar effect; HR 1·12, 1·05-1·19 per 10 years of age), or a significantly higher global Multidimensional Poverty Index (HR 1·09, 1·03-1·14), independently increased the risk of mortality. Whereas, living in Senegal (HR 0·70, 95% CI 0·57-0·86) or having a mother with higher education (high school HR 0·66, 0·55-0·80 or advanced HR 0·41, 0·28-0·61) independently decreased the risk of mortality. INTERPRETATION: Although higher than in high-income countries and affected by non-specific socioeconomic factors, the estimated mortality in children with sickle cell anaemia living in sub-Saharan African cities was substantially lower than previous estimates, suggesting an improvement of sickle cell anaemia care in this setting. FUNDING: Fondation Pierre Fabre. TRANSLATION: For the French translation of the abstract see Supplementary Materials section.

Degree of anemia, indirect markers of hemolysis, and vascular complications of sickle cell disease in Africa.

The hyperhemolysis paradigm that describes overlapping "hyperhemolytic-endothelial dysfunction" and "high hemoglobin-hyperviscous" subphenotypes of sickle cell disease (SCD) patients is based on North American studies. We performed a transversal study nested in the CADRE cohort to analyze the association between steady-state hemolysis and vascular complications of SCD among sub-Saharan African patients. In Mali, Cameroon, and Ivory Coast, 2407 SCD patients (1751 SS or sickle ß-zero-thalassemia [Sß0], 495 SC, and 161 sickle ß+-thalassemia [Sß+]), aged 3 years old and over, were included at steady state. Relative hemolytic intensity was estimated from a composite index derived from principal component analysis, which included bilirubin levels or clinical icterus, and lactate dehydrogenase levels. We assessed vascular complications (elevated tricuspid regurgitant jet velocity [TRV], microalbuminuria, leg ulcers, priapism, stroke, and osteonecrosis) by clinical examination, laboratory tests, and echocardiography. After adjustment for age, sex, country, and SCD phenotype, a low hemoglobin level was significantly associated with TRV and microalbuminuria in the whole population and with leg ulcers in SS-Sß0 adults. A high hemolysis index was associated with microalbuminuria in the whole population and with elevated TRV, microalbuminuria, and leg ulcers in SS-Sß0 adults, but these associations were no longer significant after adjustment for hemoglobin level. In conclusion, severe anemia at steady state in SCD patients living in West and Central Africa is associated with elevated TRV, microalbuminuria, and leg ulcers, but these vascular complications are not independently associated with indirect markers of increased hemolysis. Other mechanisms leading to anemia, including malnutrition and infectious diseases, may also play a role in the development of SCD vasculopathy.

Gene copy number variations in breast cancer of Sub-Saharan African women.

The goal of this study was CGH array profiling of breast cancer from Malian women in order to define differences with those from USA. CGH array was performed in 28 samples, 17 with a triple negative phenotype. The profiles were compared to those of 106 tumors from USA. 6 chromosomal regions (6p21, 9q34, 11q13, 12q24, 17q25 and 22q12.1-22q13.1) were identified with a significant higher rate of copy number alterations. These regions contain several genes of interest including BCR. FISH and IHC confirmed that BCR was amplified and overexpressed particularly in triple negative tumors. Finally, 5 regions presented a high level of amplification in two or more samples, including 2 regions located between 9p22.3-9p23 and 9p23-9p24.1. This study confirms that breast cancers from African women present biological differences with those from USA. Larger studies are needed to go further in the identification of therapeutic targets that would be specific to African women.

[Reference values of neonatal erythrocyte and leukocyte count in Bamako, Mali]. / Valeurs de Référence érythrocytaires et leucocytaires chez le Nouveau-né à Bamako, Mali.

Reference values for blood cell count are not established at birth in Mali. This study aimed to determine reference values for erythrocyte and leukocyte at birth in Bamako. Blood was collected from the umbilical cord immediately following its clamping and studied for complete blood cell count in 481 newborns with a birth weight > 2500g, Apgar score ≤ 7 at 5 or 10 minutes, without abnormal hemoglobin mutations and whose mothers were willing in Bamako, Mali. Other than the median and mean values, 2.5 and 97.5 percentiles were calculated. The findings suggest that the normal reference values following a timely clamping of the umbilical cord were (mean ± 1SD and range): RBC = 4,00 ± 0,46.1012/L (3,13 - 4,89), Hb = 14,12 ± 1,49 g/dL (11,20 - 17,00), Hct = 40,27 ± 4,71% (31,62 - 50,18), MCV = 101 ± 5 fl (91 - 112), MCHC = 35,37 ± 2,16 pg/cellule (30,70 - 39,59), MCH = 35,06 ± 0,93 g/dL (33,40 - 36,90), RDW = 17,79 ± 7,33% (15,50 - 20,39), Reticulocytes (109/L) = 133,081 ± 29,95 (66,62 - 200,86), GB (109/L) = 13,24 ± 7,23 (7,20 - 23,70), PMN (109/L) = 7,16 ± 4,70 (3,07 - 14,22), PME (109/L) = 0,28 ± 0,26 (0 - 0,98), PMB(109/L) = 0,05 ± 0,09 (0 - 0,31), Lymphocytes (109/L) = 4,49 ± 2,45 (1,96 - 9,42), Monocytes (109/L) = 1,06 ± 0,73 (0,21 - 2,54), myelocytes = 1.43 ± 1.51%, erythroblasts = 4.52 ± 7.83%. It should be noted that male babies had a lower neutrophil count than female newborns. By taking into account these results when interpreting the blood cell count in Malian newborn infants, costly misdiagnoses should be considerably decreased in a population struggling with low incomes.

Les valeurs de référence de l'hémogramme ne sont pas établies à la naissance au Mali. Cette étude détermine les valeurs de référence érythrocytaires et leucocytaires du nouveau-né à Bamako. Le sang du cordon ombilical a été prélevé après clampage sans délai et étudié pour les paramètres érythrocytaires et leucocytaires chez 481 nouveau-nés à terme avec un poids de naissance > 2500g, un score d'Apgar ≥ 7 à 5 ou 10 minutes, sans mutant de l'hémoglobine et dont les mamans étaient consentantes, à Bamako, Mali. Outre les valeurs médianes et moyennes, les percentiles 2,5 et 97,5 ont été calculés. Les valeurs considérées comme normes de référence locales après un clampage sans délai du cordon ombilical (moyenne ± 1SD et extrêmes) sont : GR = 4,00 ± 0,46.1012/L (3,13 ­ 4,89), Hb = 14,12 ± 1,49 g/dL (11,20 ­ 17,00), Ht = 40,27 ± 4,71% (31,62 ­ 50,18), VGM = 101 ± 5 fl (91 ­ 112), TCMH = 35,37 ± 2,16 pg/cellule (30,70 ­ 39,59), CCMH = 35,06 ± 0,93 g/dL (33,40 ­ 36,90), IDR = 17,79 ± 7,33% (15,50 ­ 20,39), Réticulocytes (109/L) = 133,081 ± 29,95 (66,62 ­ 200,86), GB (109/L) = 13,24 ± 7,23 (7,20 ­ 23,70), PNN (109/L) = 7,16 ± 4,70 (3,07 ­ 14,22), PE (109/L) = 0,28 ± 0,26 (0 ­ 0,98), PB (109/L) = 0,05 ± 0,09 (0 ­ 0,31), Lymphocytes (109/L) = 4,49 ± 2,45 (1,96 ­ 9,42), Monocytes (109/L) = 1,06 ± 0,73 (0,21 ­ 2,54), myélocytes = 1,43 ± 1,51%, érythroblastes = 4,52 ± 7,83%. A noter un taux des polynucléaires neutrophiles plus bas chez le garçon que chez la fille. Ces valeurs diffèrent de celles rapportées pour d'autres populations. La prise en compte de ces résultats dans l'interprétation de l'hémogramme du nouveau-né au Mali, devrait éviter des erreurs de diagnostic et des explorations par excès chez une population à faibles revenues.

[Epidemiological and Clinical features of colorectal cancer at the hematology and oncology ward of Point G in Bamako, Mali, from 2005 to 2011: 113 cases]. / Particularites epidemiologiques et cliniques du cancer colorectal dans le service d'hematologie oncologie medicale du Point G de Bamako au Mali de 2005 a 2011: 113 cas.

AIMS: Epidemiological, clinical and biological characteristics of colorectal cancer vary across continents probably because of different risk factors that are not yet fully listed in countries with limited resources. This study describes the epidemiological and clinical features of colorectal cancer at a University hospital in Bamako, Mali. PATIENTS AND METHODS: A retrospective study that concerned the period from 2005 to 2011 was carried out. It included records of patients with colorectal cancer histologically documented in the service. Were analyzed epidemiological, clinical and biological data stored in files. RESULTS: One hundred-thirteen (113) cases of colorectal cancer were diagnosed representing 15% of all cancers documented over the 7 years. The number of cases increased year by year. The cases of colorectal cancer are not uncommon in young patients (23% under 30 years of age, 60% under 50). The male is significantly more represented in this population of colorectal carriers with a sex ratio M / F = 2. The time between first the symptom and care is long and the diagnosis is made in 85% of cases at a metastatic stage. Localization of the cancer is more frequent in the colon (56%) than in the rectum (44%). Cancer is an adenocarcinoma in 97% of cases. CONCLUSION: These epidemiological and clinical features invite practitioners to reconsider the concept of rarity of colorectal cancer in Africa and vigilance in front of a digestive disorder, even the patient is young, they also emphasize the need to conduct prospective studies to identify specific risk factors and develop appropriate strategies for the prevention and treatment of colorectal cancer in Mali.

BUT: Les caractéristiques épidémiologiques, cliniques et biologiques du cancer colorectal sont variables selon les continents, probablement à cause de facteurs de risque différents et non encore complètement répertoriés dans les pays à faibles moyens. Cette étude décrit les particularités épidémiologiques et cliniques du cancer colorectal dans un service hospitalier de référence spécialisé de Bamako au Mali. PATIENTS ET MÉTHODES: L'étude rétrospective a concerné la période de 2005 à 2011. Elle a inclus les dossiers des patients atteints de cancer colorectal documenté histologiquement. Ont été analysés, les données épidémiologiques, cliniques et biologiques enregistrées dans les dossiers. RÉSULTATS: Cent-treize (113) cas de cancer colorectal ont été colligés et représentaient 15% de l'ensemble des cancers diagnostiqués sur 7 ans. Ces cas étaient en augmentation d'année en année et s'observaient chez une population souvent jeune (23% avant 30 ans, 60% avant 50 ans). Le sexe masculin était significativement plus représenté, soit 2 hommes pour une femme. Le délai entre le premier symptôme et la prise en charge du malade était long avec dans 85% des cas, un diagnostic porté à un stade métastatique. La localisation était plus souvent colique (56%) que rectale (44%). Le cancer était un adénocarcinome dans 97% des cas. CONCLUSION: Ces particularités épidémiologiques et cliniques invitent à reconsidérer le concept de rareté du cancer colorectal en Afrique et à la vigilance de la part des praticiens devant un trouble digestif même chez un sujet jeune, ils soulignent aussi la nécessité de conduire des études prospectives pour identifier des facteurs de risque particuliers et élaborer les stratégies les mieux adaptées pour la prévention et la prise en charge du cancer colorectal au Mali.

Valeurs de reference des erythrocytes et des leucocytes chez le nouveau-ne a Bamako; Mali

Les valeurs de reference de l'hemogramme ne sont pas etablies a la naissance au Mali. Cette etude determine les valeurs de reference erythrocytaires et leucocytaires du nouveau-ne a Bamako. Le sang du cordon ombilical a ete preleve apres clampage sans delai et etudie pour les parametres erythrocytaires et leucocytaires chez 481 nouveau-nes a terme avec un poids de naissance 2500g; un score d'Abgar ? 7 a 5ou 10 minutes; sans mutant de l'hemoglobine et dont les mamans etaient consentantes; a Bamako; Mali. Outre les valeurs medianes et moyennes; les percentiles 2;5 et 97;5 ont ete calcules. Les valeurs considerees comme normes de reference locales apres un clampage sans delai du cordon ombilical (moyenne _///} 1SD et extremes) sont : GR = 4;00 _///} 0;46.1012/L (3;13 - 4;89); Hb = 14;12 _///} 1;49 g/dL (11;20 - 17;00); Ht = 40;27 _///} 4;71 (31;62 - 50;18); VGM = 101 _///} 5 fl (91 - 112); TCMH = 35;37 _///} 2;16 pg/cellule (30;70 - 39;59); CCMH = 35;06 _///} 0;93 g/dL (33;40 - 36;90); IDR = 17;79 _///} 7;33 (15;50 - 20;39); Reticulocytes (109/L) = 133;081 _///} 29;95 (66;62 - 200;86); GB (109/L) = 13;24 _///} 7;23 (7;20 - 23;70); PNN (109/L) = 7;16 _///} 4;70 (3;07 - 14;22); PE (109/L) = 0;28 _///} 0;26 (0 - 0;98); PB (109/L) = 0;05 _///} 0;09 (0 - 0;31); Lymphocytes (109/L) = 4;49 _///} 2;45 (1;96 - 9;42); Monocytes (109/L) = 1;06 _///} 0;73 (0;21 - 2;54); myelocytes = 1;43 _///} 1;51; erythroblastes = 4;52 _///} 7;83. A noter un taux des polynucleaires neutrophiles plus bas chez le garcon que chez la fille. Ces valeurs different de celles rapportees pour d'autres populations. La prise en compte de ces resultats dans l'interpretation de l'hemogramme du nouveau-ne au Mali; devrait eviter des erreurs de diagnostic et des explorations par exces chez une population a faibles revenues

High incidence of triple-negative tumors in sub-saharan Africa: a prospective study of breast cancer characteristics and risk factors in Malian women seen in a Bamako university hospital.

OBJECTIVE: Few studies have been conducted on breast cancer in Sub-Saharan Africa and their results have been suspected to be impaired by artefacts. This prospective study was designed to determine tumor and patient characteristics in Mali with control of each methodological step. These data are necessary to define breast cancer treatment guidelines in this country. METHODS: Clinical and tumor characteristics and known risk factors were obtained in a consecutive series of 114 patients. Each technical step for the determination of tumor characteristics [histology, TNM, grade, estrogen (ER) and progesterone receptors (PR), HER2, and Ki67] was controlled. RESULTS: Patients had a mean age of 46 years. Most tumors were invasive ductal carcinomas (94%), T3-T4 (90%) with positive nodes (91%), grade III (78%), and ER (61%) and PR (72%) negative. HER2 was overexpressed in 18% of cases. The triple-negative subgroup represented 46%, displaying a particularly aggressive pattern (90% grade III; 88% Ki67 >20%). CONCLUSION: This study demonstrates the high incidence of aggressive triple-negative tumors in Mali. Apart from a higher prevalence of premenopausal women, no significant difference in risk factors was observed between triple-negative tumors and other tumors. The hormonal therapy systematically prescribed therefore needs to be revised in light of this study.

[The malignant hemopathies in children: epidemiologic aspects in the Haematology and Medical Oncology Ward of Point G Hospital, Bamako, Mali (1996-2003)]. / Les hemopathies malignes de l'enfant: aspects epidemiologiques dans Le Service D'Hematologie Oncologie Medicale de L'Hopital Du Point G, Bamako, Mali (1996-2003).

Data from developed countries place the malignant hemopathies among the most frequent cancers in children. The epidemiologic and prognostic aspects of these diseases are not well known in developing countries notably in Africa sub-Saharan countries because of lack of registry and clinical collaborative studies. Nevertheless, the good progress in the management of paediatric diseases that were a big concerns in former times authorize to think that in future, these countries will be engaged in programs to fit malignant diseases as major health problems in children. A good knowledge of epidemiologic aspects of these diseases must be therefore an important concern. This study describes epidemiologic and prognosis particularities of malignant hemopathies in children diagnosed in a last referral hospital ward, Bamako, Mali (West Africa) during height years. Fifty-nine cases of malignant hemopathies were diagnosed by January 1996 to December 2003 in 19 females and 40 males. Data were analysed retrospectively with SPSS 11.0. These children were aged from 4 to 15 years and the modal class of age was 6-10 years. The mean recruitment of cases per year was 7.37. Lymphomas were more frequent (70%) particularly the Burkitt lymphoma. The Hodgkin's lymphoma was not observed under 5 years of age but represents 24% of cases over this age and was more frequent in male. This study emphasizes the need to put in place strategies for a better understanding of epidemiological aspects of malignant hemopathies in children and for developing policies to improve management and prevention of cases in Mali.