[Haemorrhagic Stroke after Snakebite Envenomation Resulting in Irreversible Blindness in a 6-Year-Old Child in Mali]. / Hémorragie Cérébrale Post Envenimation par Morsure de Serpent Responsable D'une Cécité Irréversible Chez Un Enfant de 6 Ans au Mali.

Introduction: Snakebite envenomation can cause serious damage. Here, we report the case of a six-year-old male child bitten by a snake. Clinical description: The child presented a gingivorrhagia, abdominal pain, bloody vomiting and severe headache from a snakebite. Neurological examination showed paralysis of the III cranial nerve associated with bilateral blindness and mydriasis, unreactive on the right. The brain scan revealed a left frontal hematoma. The course on antivenom was marked by the disappearance of clinical signs except blindness which remained 18 months after discharge. Discussion - Conclusion: The hemorrhagic syndrome evoked viper bite. Blindness is rarely seen as a result of viperine envenomation. In our case, the presence of intracranial hypertension, absence of ocular lesions and scanner were in favor of compression of the optic nerves which resulted in permanent blindness.

Place of malaria in the etiologies of febrile attacks in children in a conflict area zone: Case of department of pediatric regional hospital of Timbuktu

Introduction: Malaria, a public health problem in tropical countries, depends on several factors, some of which are social and environmental. In Mali in the Sahel zone, a socio-security crisis has prevailed in recent years. It was therefore interesting to study the epidemiology of this condition in situation. Objective: To determine the frequency of malaria among febrile syndromes in children aged 1 to 59 months in the pediatric ward of the Regional Hospital of Timbuktu. Material and methods: the study was longitudinal retrospective descriptive for a period from January 1 to December 31, 2015. The data were collected with fact sheets and consultation records. They were captured and analyzed on the Statistical Package for Social Scientist (SPSS) software version 21. Results: a total of 789 children hospitalized, 276 children had a febrile syndrome (35%). During the study period, we collected 180 cases of malaria, with a positive biological examination. The hospital frequency of malaria was 22.8% (180/789) and a frequency in febrile syndromes of 65.2% (180/276) of malaria cases. Of these 180 cases, 147 cases of uncomplicated malaria (81.7%) and 33 cases of severe malaria (18.3%) were found. In 34.8%, the etiology of febrile syndromes was other than malaria. Seasonal variation in malaria was found in terms of months of the year, peaking in September. The hospital lethality was 1.1% in our series. Conclusion: Malaria was the leading febrile syndromes among children under 5 in hospitals in Tombouctou

[Role of men in family planning decisions in Mali]. / Implication des hommes dans la prise de decision concernant le planning familial au Mali.

The birth control program was in place and functional since 1970, and it was integrated with maternal and infant health activities in 1978: knowledge about contraception is increasing among women and men respectively 75.6% and 87.6% according to EDSM II, 2001. Nevertheless, only 5.7% of women and 10% of men reported the use of one of the modern contraceptive methods. This is a transversal descriptive and analytic study which included men of 14 years old and above residing in Kayes, Koulikoro, Mopti, Sikasso and Bamako. We used a random choice of 6 out of the 9 regions in Mali (Bamako and the 5 regions supported by partners funding the present study) followed by a non-random choice at different degrees. Data were uniformly collected from One thousand and four men. The mean age was 37.6 +/- 15.6 years, 44.7% of the men were monogamous whereas 23.1% were polygamous and 30.6% were either single or had a fiancé. Most of the men in the study group had more than 2 children compared to 34.2% without children and 19.9% with either one or two children. Among them, 89.1% reported to have heard about birth control program and 70.3% had listed Planned Parenthood as an objective of birth control. The most used methods of birth control the most used are contraceptives (66.7%), condoms (60.5%) and injections (30.8%). However, only 30.6% of men used one birth control method with their partners; among those studied in the cohort, 40.8% used birth control method with their wives. Condom was the main method used by 86% of the men compared to utilization of contraceptive pills and injections respectively 66.7% and 25.6%. Birth control methods were used mainly to protect against sexually transmitted diseases (20.7%), then maternal and infant health respectively 6.0% and 5.8%. 60.7% of men think that the decision to use birth control method should be made by them whereas 25.7% think that the decision should be made by the couples. Many strategies are being proposed to involve men in the wider implementation of birth control program; these strategies will be more efficient when the age group 20-29 and 30-44 are targeted nationwide including rural areas, as well as couples especially those polygamous and illiterate.