[Writing quality of medical prescriptions at the Social Security System of Ouagadougou]. / Etude de la qualité rédactionnelle des ordonnances médicales à la Caisse de sécurité sociale de Ouagadougou.

A medical prescription may sometimes include errors which might have a negative impact on the patient's health. The objective of this study was to analyse the key elements of medical prescriptions given to patients covered by the Ouagadougou social security health insurance system. The population of practitioners included in the study comprises all of the medical doctors practicing in Ouagadougou. The study consisted of a review of all prescriptions registered by the family benefits and professional hazards service branches dating from January 1st to December 31st 1997. The identification of the doctors and patients was satisfactory in more than 97% of the prescriptions. However, certain errors were frequent such as the omission of the treatment's duration, the medication's dosage, and the form. The oversights observed were comparable to those described in the literature. Repeating similar periodic evaluations with a systematic feedback relayed to the practitioners will bring about an improvement of medical prescriptions.

[Features of hysterosalpingography performed in Burkina Faso]. / Particularités des hystérosalpingographies réalisées en milieu Burkinabé

PURPOSE: The goal of this study was to describe the distinctive hysterosalpingographic features of women with infertility in Burkina Faso. MATERIALS AND METHODS: We performed a retrospective study of 1019 women who were referred for infertility between January 1996 to June 1997 at the National Hospital Centre of Ouagadougou. Clinical and radiological features were reviewed and statistical data analysed on the software EPI Info 5.0. RESULTS: The mean age of the patients was 28+/-0,3 years. Primary infertility was found in 34.4% and secondary infertility in 65.6%. Abnormalities on plain film were present in 6.9% of the cases. Hysterosalpingography was abnormal in 62.1% of the cases. Tubal abnormalities were found in 62% and uterine lesions in 38.3%. The main hysterosalpingographic abnormalities were tubal obstructions, hydrosalpinx, uterine fibromas, and trauma sequelae in 25,9%, 25,3%, 16,5% and 10% of cases respectively. Seventy one percent of tubal and uterine lesions represent outcomes of chronic infections and underground abortions. CONCLUSION: In Burkina Faso, hysterosalpingographic abnormalities are characterized by the predominance of infectious and traumatic sequelae. Such a frequency could be reduced by active politics against underground abortion and information about genital infections.

[Fetal weight gain curve for a cohort of 126 pregnant women at Ouagadougou, Burkino Faso]. / Courbe foetale de croissance pondérale à Ouagadougou (Bukina Faso). A propos d'une cohorte de 126 gestantes.

We carried out a prospective study at Ouagadougou, from March 1 1997 to April 30 1998, in which we plotted curves of fetal weight gain, estimated by ultrasound biometry, with the aim of comparing our results to those of other authors and establishing a local chart. We established a growth curve from 936 fetal weights estimated during the follow up of 126 pregnant women. The mean age of the women included was 26 +/- 0,8 years and 52.4% were of the mean socioeconomic level. We identified significant differences between our weight gain curve and those of other authors. The factors involved in this difference are unclear but may be nutritive, ecological and ethnic in nature. Further work is required to produce local charts, to optimize the estimation of fetal weight.

[Ultrasound foetal biometry in the town of Ouagadougou, Burkina Faso. Report of a cohort of 126 pregnant women]. / Biom¿etrie foetale ultrasonore dans la ville de Ouagadougou, Burkina Faso. A propos d'une cohorte de 126 gestantes.

PURPOSE: This inquiry on the ultrasound fetal biometry in the town of Ouagadougou aimed to study the fetal growth through the ultrasound biometry in order to compare it with other authors's works and to lay down a local chart. PATIENTS AND METHODS: This prospective study led from March 1997 to April 1998 The follow-up of 126 pregnant women allowed to lay down the graphs of following elements: biparietal diameter, cephalic circumference, transverse abdominal diameter, abdominal circumference and femur. RESULTS: The average age of the subjects was 26 years old+/-0.8 and 52.4% of them belonged to an average socio-economic level. All the studied parameters were closely connected with the age of pregnancy. The DAT and the abdominal circumference presented the greatest correlation (0.998). The comparison of our growth graphs with those of others authors led to notice significant differences as well as with African, European and American graphs. CONCLUSION: There is a need to lay down local charts in order to have a best estimation of the pregnancy age and the fetal growth.

[Intrapartum hemorrhages in the maternity ward of the Yalgado Ouédraogo University Hospital Center of Ouagadougou, Burkina Faso]. / Les hémorragies de la délivrance à la maternité du Centre Hospitalier National Yalgado Ouédraogo de Ouagadougou (Burkina Faso).

On 12,175 childbirth registered in 4 years, 200 cases of delivery haemorrhage have been observed giving a rate of 1.6% of these accumulated childbirth. 60 patients (30.5%) have been evacuated from region of the country. The main etiology were: placental retention (54.5%), uterine inertia (24.5%) and coagulation disorders (21%). Blood was not available for emergency transfusion of 72 patients (54.1%) 26 deplorable cases of death raised the rate of lethality by 13%. Instant research of risk factors on all parturients, recycling of all personal on elementary first aid and life saving, also an improvement of sanitary references will enable to lower incidences related to haemorrhage by delivery.

[Evaluation of the pre-introduction of contraception by means of subcutaneous levonorgestrel implants in Burkina Faso]. / Evaluation de la pré-introduction de la contraception par les implants sous-cutanés de levonorgestrel au Burkina Faso.

It is a prospective study based on the pre introduction evaluation of Norplant implants conducted from September 92 to September 93 in the city of Ouagadougou. 197 women were selected for the study. Based on unemployed women with an average age of 31 years old. The average parity was of 5.47% of patients were multiparas. A gain of weight of an average of 2.43 kg was observed. The main side effects observed was cycle disorders and headache. The continuing rate after 12 months was 96.5%. Conclusion from this study is that Norplant Implants are well tolerated and accepted by women.

PIP: According to the 1989 census, Burkina Faso has a fertility rate of 7.1%. In 1992, the rate of contraceptive use was 8.2%. In an effort to expand the selection of contraceptive methods available in the country, the government of Burkina Faso worked with the Population Council to introduce the Norplant subcutaneous implant method of contraception. Norplant is a long-term, reversible, hormonal contraceptive method employing levonorgestrel. A prospective study based upon the preintroduction evaluation of Norplant was conducted from September 1992 to September 1993 in Ouagadougou. 197 women aged 18-47 years were chosen for the study. They were of mean age 31.9 years with 67% aged 30-39 years. Their mean parity was 5 children with the extremes of 1-11 children. 47% were multiparous, and 69% had already ever used a contraceptive method. The women weighed 42-91 kg, of mean weight 60 kg upon Norplant insertion and 62.43 kg 12 months later. Main secondary effects were cycle disorders and cephaly. The continuation rate of Norplant use after 12 months was 96.5%. These data indicate that Norplant is well accepted and tolerated by women in this setting.

[Human parasitoses in Burkina Faso. Histopathologic approach]. / Parasitoses humaines au Burkina Faso. Approche histopathologique.

The aim of this first study was to assess parasitic diseases encountered in histological practice in Burkina Faso. An examination of 3410 pathological specimens showed 138 cases of parasitic diseases which represented 4% of the results observed for 5 years in the laboratory of YALGADO OUEDRAOGO National Hospital. The parasitic diseases diagnosed were in decreasing order Schistosomiasis 53.6%, Cysticercosis 13.1%, Mycetoma 12.3%, Cutaneous Leishmaniasis 8%, Amebiasis 6.6%, Filariasis 4.3%, and Histoplasmosis 2.1%. We recommend better data collection for integration of these diseases into the health policy of Burkina.

[Gynecology-obstetrics at the Yalgado-Ouédraogo (Ouagadougou) National Hospital Center. Cancer of the cervix uteri: epidemio-clinical and anatomopathologic aspects]. / Gynécologie-obstétrique au centre hospitalier national Yalgado-Ouédraogo (Ouagadougou). Cancer du col utérin: aspects épidémio-cliniques et anatomopathologiques.

We report the findings of a 3-year retrospective study aimed at describing the epidemiological, clinical, anatomical and pathological profile of cervical cancers in an African country. We studied 46 cases of invasive cervical cancer. This type of cancer accounts for 31.7% of female genital cancers. The mean waiting time for a consultation was 7 +/- 2.4 months. The average age of the patients was 48 +/- 3.7 years. They were mostly women who had had several pregnancies without paid work. The main reasons for seeking medical help were metrorrhagia (95.6%), pelvic pain (58.7%) and purulent discharge (45.6%). In 89.1% of the cases, the cancer was inoperable. Pathology results were available in 37 cases. We found 36 cases (97.3%) of epidermoid carcinoma and a single case (2.7%) of adenocarcinoma. There were associated condylomatous lesions in 21.6% of cases. These results demonstrate the importance of making cervical smear tests a routine part of medical examination and of making the public aware of the importance of screening for cervical cancer.

[Gynecology-obstetrics at the Yalgado-Ouédraogo National Hospital Center. Eclampsia: epidemiologic, clinical and prognostic aspects]. / Gynécologie-obstétrique au centre hospitalier national Yalgado-Ouédraogo. Eclampsies: aspects épidémiologiques, cliniques et évolutifs.

We present the results of a retrospective study carried out between 1992 and 1995 aimed at describing the epidemiological, clinical and developmental profile of eclampsia in an African maternity unit towards the end of the 20th Century. The incidence of eclampsia was 108 cases in 12,175 births (0.89%), mostly in young patients during their first pregnancy. 40.7% of the patients were less than 20 years old and 59.3% were expecting their first child. Eclampsia occurred between the 28th and 37th weeks of amenorrhea in 37% of cases. Thirty four patients (31.5%) had had at least three episodes of eclampsia prior to admission. Diastolic arterial blood pressure was higher than 120 mmHg in 25.9% of cases. Eclampsia occurred before labor in 30.6% of cases, during labor in 38% of cases and after giving birth in 31.5% of cases. Postpartum episodes occurred an average of 67 +/- 18.7 hours after the birth. There were complication with infection in 7 cases, renal insufficiency in 14 cases and one case of retro placental hematoma. Seventeen patients died, giving a death rate of 15.7%. During the same period, 3.4% of maternal deaths were due to eclampsia. The perinatal mortality rate was 23.1%. A quantitative and qualitative improvement in prenatal consultations should make it possible to reduce the incidence of eclampsia. Measuring arterial blood pressure daily for at least 14 days after the birth appears to be necessary for diagnosis and treatment of all cases of hypertension.