Sante (Montrouge, France)

Publisher: John Libbey Eurotext

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A global approach to health and development. Aids and parasitosis in tropical Africa, malaria in Vietnam, the cost of treating measles in Burkina Faso, Aids information and prevention in France - the Cahiers/Santé provide a unique platform for teams in the field to exchange scientific information. They report on practical experiences and provide health professionals with a remarkable diversity of input. They are also an excellent tool for educators and trainers. The archives of Cahiers/Santé from Volume 6 are available on the site of the Agence Universitaire de la Francophonie.

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  • Website
    Cahiers d'Études et de Recherches Francophones / Santé website
  • Other titles
    Santé (Montrouge, France: En ligne), Cahiers d'études et de recherches francophones., Santé: cahiers d'études et de recherches francophones, Cahiers / Santé
  • ISSN
    1157-5999
  • OCLC
    61121513
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

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John Libbey Eurotext

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: In 1995, 2005 and 2011, cross-sectional studies of 611 parturients at the Centre Hospitalier de Libreville in Gabon assessed the prevalence of maternal malaria and anaemia; two indicators of poor pregnancy outcomes. The prevalence of Plasmodium falciparum infection in maternal peripheral blood decreased from 25% in 2005 to 6% in 2011. Parasite density was significantly lower in 2005 (31 p/μL) than in 1995 (1,240 p/μL) or 2011 (35,055 p/μL). Anaemia prevalence was high (>50%) in 1995 and in 2005, but fell by more than 50% (24%) in 2011. After implementation of new malaria prevention strategies during pregnancy, the prevalence of both maternal peripheral P. falciparum infection and anaemia fell. Studies are necessary to assess the efficacy of these strategies and to seek other causes of anaemia.
    Sante (Montrouge, France) 02/2012; 21(4):199-203.
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    ABSTRACT: Despite progress in the control of malaria, it remains a serious public health problem. Substantial declines in malaria transmission, morbidity and mortality have nonetheless been reported in several countries where new malaria control strategies have been implemented. We conducted this molecular and epidemiological analysis of malaria in the pediatric department of the Chinese-Gabon Friendship Hospital (HCGC) in Franceville in 2010. Franceville is the third largest town in Gabon, and malaria transmission is high year-round. We included 945 children, 756 of them febrile. Malaria was diagnosed based on the detection of P. falciparum in thick blood films, with Lambarene's method. Malaria prevalence among the febrile children included in this study was 17.9% (n=135). The burden of malaria is thus lower than in the past; it is now the second leading cause of pediatric hospital visits, rather than the leading cause as it was in 2004. The children's mean age was 48.5 ± 3.9 months, older than in 2004 (p<0.05). We also analysed the molecular drug resistance marker, Pfmdr1. The prevalence of the wild-type genotype N86 of Pfmdr1 was 47.4% (n=64), higher than in 2004 (p<0.001). The increased prevalence of codon 1246 was not significant. Socio-economic factors and known malaria risk factors were analysed. We found that the use of Insecticide-treated mosquito nets and the provision of information (education or communication) to parents and guardians about malaria were protective factors against the disease. In conclusion, a larger study of the entire region over a longer period is necessary to characterise malaria in Franceville today. Transmission factors must also be studied.
    Sante (Montrouge, France) 02/2012; 21(4):193-8.
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    ABSTRACT: Painful sickle cell crises are among the principal manifestations of sickle cell disease. Their treatment routinely requires the use of non-steroidal anti-inflammatory drugs (NSAIDS). These drugs also, however, inhibit the cyclooxygenase cycle in arachidonic acid metabolism, promoting the synthesis of leukotrienes, which have bronchoconstrictive effects. This study took place from March through August, 2007, and included 100 patients of both sexes, aged 2 to 59 years, with any sickle cell phenotype (SS, SC, AS, SFA2, or SAFA2) and treated by NSAIDs in the Immunology and Haematology department of the University Hospital of Cocody. We analysed the characteristics of the respiratory events induced by taking NSAIDs to identify potential risk factors for their occurrence. We found that 5% of these patients presented respiratory symptoms linked to NSAIDs. These appeared within 30 minutes of drug intake for 80%; in 60% of these cases, only corticosteroid and antihistamine treatment resolved these symptoms. The occurrence of respiratory events did not differ by sex; however, younger subjects were more exposed to these respiratory events. All patients with family or individual history of atopy-like hypersensitivity type I events presented these respiratory symptoms when taking NSAIDS for sickle-cell crises.
    Sante (Montrouge, France) 02/2012; 21(4):187-91.
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    ABSTRACT: To review the pathologic, diagnostic and therapeutic aspects of the cranioencephalic complications of bacterial sinusitis. This retrospective study included children who underwent diagnostic imaging at the Omar Bongo Ondimba military hospital between January 2006 and December 2010 and treatment of cranioencephalic complications of sinusitis. During the study period, 58 children were hospitalized with sinusitis, and eight (13.8%) had cranioencephalic complications for an annual incidence of 1.6% and a sex ratio of 5 boys to 3 girls. Their mean age was 13 years. Symptoms developed over a mean duration of 14 days (range: 3-45 days). The clinical picture was dominated by febrile headaches and neurologic signs. Palpation of the sinus pressure points was painful in all cases. Disorders of consciousness were found in five cases, with a mean Glasgow score of 9 (range: 7-13). Seven children had multifocal sinusitis and one frontal sinusitis. Five children had a subdural empyema, two associated with thrombophlebitis of the sagittal sinus, one with a brain abscess with thrombophlebitis of the sagittal sinus, and another with meningitis and thrombophlebitis of the sagittal sinus. Two children had osteomyelitis of the frontal sinus table, including a frontal lobe abscess for one. Another had multiple cerebral abscesses. Five children had sinus and neurosurgical drainage, two sinus drainage only, and one neurosurgical drainage only. Microbiology was positive for microbes in four cases: Streptococcus eqinus (one case), Staphylococcus aureus (one case), both S. pneumoniae and Haemophilus influenzae (one case), and Aerococcus viridans (one case). Outcome was favourable in seven cases, including four without sequelae. Two children had recurrences, and one died. Diagnosis of the cranioencephalic complications of sinusitis rely on medical imagery. Early multidisciplinary therapeutic management is essential.
    Sante (Montrouge, France) 02/2012; 21(4):215-20.
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    ABSTRACT: The international community is increasing concerned about obesity, which it has become one of the most common noninfectious pandemics worldwide and affects a growing number of children. We conducted an analytic cross-sectional study from May 25 to June 16, 2010, among a sample of 435 randomly selected students in secondary schools in the city of Ouagadougou to identify the factors contributing to obesity and overweight. The main factors significantly associated with obesity and overweight were family history of obesity (OR = 7.4), higher socioeconomic level (OR =  3.8), snacking on candy (OR = 5, 3), pastry (OR = 3.5), and chocolate (OR = 12.6), frequent consumption of sweets (OR = 2.2), lack of physical activity (OR = 4.4), and conflictual family relationships (OR = 3.9). Dealing with these factors in prevention activities should help to reduce the prevalence of overweight and obesity and their morbid consequences later on.
    Sante (Montrouge, France) 11/2011; 21(4):227-31.
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    ABSTRACT: To determine the causes of neonatal deaths and their contributing factors. We used the "three-delay model" to conduct an audit of the neonatal deaths that occurred between January 2006 and December 2010 at the Charles de Gaulle University Pediatric Hospital, in Ouagadougou. The neonatal mortality rate was 12.3%. The main direct causes were infections (70%), cerebral distress (10%), respiratory distress (7%), congenital malformations (5.5%), prematurity (4.5%) and hemorrhagic syndromes (3%). All three delays were found: in decision making in 64.4% of cases, in access to health services in 77%, and in receiving appropriate care in 66.9%; they multiplied the risk of death by a factor of 4, 3 and 5, respectively. To reduce deaths of newborn babies, it is necessary to overcome the three delays that contribute to it, pending the improvement of socioeconomic conditions of populations. This combat requires optimizing the implementation of the subsidies for obstetric and neonatal emergency care and strengthening the involvement of all stakeholders, specifically, policy makers, the community and health professionals.
    Sante (Montrouge, France) 11/2011; 21(4):209-14.
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    ABSTRACT: In 1998, the isolation of Staphylococcus aureus resistant to methicillin (MRSA) from a sample taken from a post-caesarean surgical site infection (SSI) led the obstetrics department to call upon the hospital hygiene team for assistance. A retrospective investigation of incidence in the files of 24 women with caesarean deliveries showed a SSI rate of 24%. These abnormally high figures led to an audit of hygiene practices during these deliveries. To reduce the incidence of post-caesarean SSIs at Dreux Hospital Centre. From 1999 through 2005, SSIs have been monitored according to the methods of the western France Coordinating Centre for Nosocomial Infections and the guidelines of ANAES in France and the U.S. CDC. The data were analysed by Epi Info 6, retrospectively. Files of 1972 caesareans performed over a 6-year period were analysed. The SSI rate was 24% in 1999; it fell to 7.4% in 2000 and stabilized from 2003 through 2005 in the neighbourhood of 2.6%. More than 70% of our patients are re-examined within 2 weeks of delivery. Close cooperation between the Obstetrics and Hospital Hygiene departments led to a dramatic reduction in SSI rates, to 2.6% (similar to the national rate), and its maintenance over a 3-year period. Implementation of the caesarean hygiene protocol has continued since 2006.
    Sante (Montrouge, France) 11/2011; 21(4):205-8.
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    ABSTRACT: The aim of this study is to describe the epidemiological and microbiological characteristics and outcome of children with septicemia at the Charles de Gaulle University Pediatric Hospital of Ouagadougou to help improve probabilistic antibiotic therapy in this type of infection. This retrospective descriptive study covered all the children from 0 to 15 years old seen over a period of 7 years in any hospital department with suspected bacteriemia and for whom the bacteriology laboratory performed a blood culture. During the study period, the laboratory received 842 requests for blood cultures and found 154 (18.3%) of them to be positive. Files for 81 of the 154 patients could be found and examined. The distribution according to age showed septicemia was most frequent among those aged 6-15 years (61.7% of the cases). Microbial identification showed the dominant species to be Salmonella enterica (serovars paratyphi and typhi) (58%) followed by Staphylococcus aureus (12.3%). The salmonella isolates had a high rate of resistance to amoxicillin, chloramphenicol and cotrimoxazole. Staphylococci were always sensitive to the antibiotics with which they were tested, although to a lesser extent for penicillin G. All patients routinely received antibiotic treatment, and 81.5% (n=66) were cured (5 children died and 10 left the hospital against medical advice). This study shows that the bacterial epidemiology of septicemia in our setting is dominated by salmonella. Trends in bacterial resistance to antibiotics showed that common antibiotics such as amoxicillin and cotrimoxazole are no longer acceptable as probabilist therapy here. They should be replaced in this type of infection by injectable third generation cephalosporin alone or combined with aminoglycosides.
    Sante (Montrouge, France) 11/2011; 21(4):221-5.
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    ABSTRACT: The objective of this study was to determine the sociodemographic characteristics of cannabis users, their consumption patterns, and effects. Our cross-sectional, descriptive study included 205 subjects (191 men, 14 women, mean age = 25.9 ± 7.9 years). The consumption of psychotropic drugs and/or cannabis was confirmed by toxicological analysis. In our study population, 61% were cannabis users. Consumption was significantly higher in males (94.4%) than in females. Consumers were young adults, aged 25.8 ± 8.8 years, single (81.6%), had primary school educations (62.4%), were employed (72%) and lived in urban areas (77.6%); 28.8% had a personal history of psychiatric disorders. The mean age of first cannabis use was 20 years. Cannabis use was frequently associated with consumption of alcohol and tobacco (72%). Forty percent of consumers used cannabis daily. Most of those who had used drugs had done so with friends. In most cases, cannabis was regarded as a means of escape from problems (29.3%), relaxation (20.2%), experimentation (18.2%) and a source of pleasure (16.7%). These data suggest the importance of primary prevention of early use and rapid treatment of young users.
    Sante (Montrouge, France) 11/2011; 21(4):233-9.
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    ABSTRACT: this study aims to assess the frequency, complications and advantages of each of the three principal approaches to hysterectomies: abdominal, vaginal, and laparoscopic. this prospective study analyses a consecutive series of 78 hysterectomies for benign disease (myomas and precancerous lesions of the cervix) in the gynaecological surgery department of Libreville Hospital Centre from March 1, 2006, to November, 2010. We excluded cases of genital prolapsus, invasive uterine cancer, and hysterectomy during pregnancy or delivery. Data were collected from the surgical registers and reports and from patients' files. the frequency of abdominal hysterectomy was about 39% (31 cases), and that of vaginal hysterectomy 61% (31 cases); laparoscopic assistance was involved in 20.58% (14 cases). The women's mean age was 46  years (range: 45 to 60  years). Mean parity was 5.5 (range: 0 to 9). Overall, 30% of the patients had previously undergone pelvic surgery by the abdominal route. Two wounds, one of the bladder and the other of the uterus, comprised the surgical morbidity. No deaths occurred. the surgeon's experience with the vaginal route, sometimes with laparoscopic assistance, resulted in limited use of the abdominal route.
    Sante (Montrouge, France) 09/2011; 21(2):79-81.
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    ABSTRACT: Ewing sarcoma is a primary malignant bone tumor rarely observed in black populations. We report a case of Ewing sarcoma in a 12-year-old boy, manifested by pain in the lower limbs and pelvis, limping while walking, with functional disability and visual disorders developing over a 2-year period, from 2005 through 2007. The child was transferred for care to South Africa where a biopsy bone was taken and analyzed. The histological slices showed clusters of small round cells, sometimes with indistinct or eosinophilic cytoplasm, oval vesicular nuclei, and fine chromatin. These images were compatible with neoplastic proliferation of small round cells of the Ewing tumor type. We use this case to review the literature and discuss the circumstances of onset and methods of diagnosis.
    Sante (Montrouge, France) 09/2011; 21(2):93-5.
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    ABSTRACT: the nutritional intake required for normal growth and development is similar among children with diabetes and healthy children. Nonetheless, for children with diabetes, food intake must also be correlated with their insulin treatment plan and level of physical activity. The objective of this work was to identify the eating habits of the children and adolescents followed in the National Diabetes Center in Libreville. this prospective survey was conducted from November 1, 2008, through January 30, 2009, at the National Diabetes Center of the Libreville Hospital Center. during the study period, 21 children and adolescents were treated at our center. The sex ratio was 1:1, and the mean age was 14.7 years. The mean body mass index (BMI) was 18.5 kg/m(2). Mean age at diagnosis was 9.6 years. All the children received insulin; two had two injections daily and the other 19 (90.4%), three a day. Three children never ate breakfast; 17 "often" drank some milk, and 18 ate some bread. Twenty children "often" ate a starch and chicken at lunch, five others "often" had vegetables then. Healthy planned snacks were not eaten by 57% of the subjects, although 24% reported "nibbling" between meals "sometimes". In addition to water, 67% of the patients drank diet Coke. few children complied with the diet strictly, because their families could not afford to buy all the recommended food. Effective access to appropriate local food is essential. All patients should discuss their preferred foods with the doctor or dietician, so that their insulin treatment can be adapted appropriately to the food.
    Sante (Montrouge, France) 09/2011; 21(2):83-7.
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    ABSTRACT: Still disease is an inflammatory rheumatism occurring predominantly in children and adolescents, but which is sometimes diagnosed in adults. A combination of fever, arthralgia, transient dermatological lesions, hyperleucocytosis predominantly neutrophilic, and ferritinaemia greater than 1,000 μg/L is suggestive of this disease, but infectious, haematological, immunological, and tumor diseases must first be ruled out. Accordingly, patients' financial limitations keep this disease from being diagnosed often in sub-Saharan Africa. We report four cases of Still disease with favourable outcome after corticosteroid therapy.
    Sante (Montrouge, France) 08/2011; 21(2):97-101.
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    ABSTRACT: the aim of this study was to evaluate the management of HELLP syndrome at Josephine-Bongo Maternity Hospital. the retrospective study included all women admitted to the intensive care unit of our hospital from 1 January 2004 through 30 December 2007 with HELLP syndrome. The characteristics studied included: age, parity, number of previous pregnancies, antenatal monitoring, term at onset, clinical and laboratory signs, treatment, complications, perinatal and neonatal mortality and duration of intensive care unit admission. nine patients, mainly primiparas with an average age of 29.7 ± 6.5 years were admitted to intensive care. HELLP syndrome was diagnosed at a mean term of 33 ± 2.7 weeks. The clinical signs noted included the following: jaundice (100%), headaches (100%) and epigastric pain (67%). The laboratory analysis showed: a mean haemoglobin level of 8.7 ± 1.2 g/dL, an average platelet level of 70,900 ± 27,052.9/mm(3), and mean transaminase levels of 120 ± 60 UI/L for aspartate aminotransferase (AST) and 99 ± 41.1 UI/L for alanine aminotransferase (ALT). Hypertension was treated by continuous intravenous administration of nicardipine. The fetal pulmonary development was ensured with betamethasone. Delivery was by caesarean for four women (44%) and vaginal for the other five (56%). One maternal death was noted, related to a rupture of a subcapsular haematoma of liver. in view of the extent of perinatal morbidity and mortality associated with HELLP syndrome, abdominal ultrasonography to detect any subcapsular haematoma of liver should be performed to determine the need for immediate delivery. It would be appropriate to provide the Josephine-Bongo Maternity Hospital with a neonatal intensive care unit of high quality.
    Sante (Montrouge, France) 08/2011; 21(2):67-71.
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    ABSTRACT: In the rural communities of Côte d'Ivoire, malaria control is guided by the sociocultural etiology or perception of this disease, as we can see by studies conducted in the Baoulé and Gouro communities. These studies show that these communities establish a link between the sun, excessive oil consumption, agricultural activities, disease, and lack of hygiene. Mosquitoes, however, are not identified as the cause of malaria but rather as an insect noxious by their noise and painful bites. These populations use both traditional and modern means to move mosquitoes away from their homes. Analysis of this social reality shows that the battle against malaria in rural areas is not simply a problem of health education. It is thus important in developing malaria control programmes to adopt a strategy that links community participation and health education.
    Sante (Montrouge, France) 08/2011; 21(2):107-10.
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    ABSTRACT: to describe and to analyze the results of our experience in inducing labor with the misoprostol, 50 μg, administered orally. this descriptive prospective study took place at the Josephine-Bongo Maternity Hospital, in Libreville, in Gabon, from 1st January 2007 to 31st December 2009. It included pregnancies with a gestational age greater or equal to 29  weeks of singletons in cephalic presentation. The induction consisted in the administration of one quarter of a misoprostol tablet (that is, a dose of 50 μg) at 6 in the morning, fasting, and repeated every 4 h up to a maximum of five doses. The principal study indicators were epidemiologic characteristics, dose received, duration of labor, and outcome. the study included 91 patients, with a mean age of 26  years. On average, women received 1.6 doses of 50 μg of misoprostol, for a mean dose of 78.5 μg. A single dose of 50 μg was sufficient to induce labor for 61 patients (67%), as well as for 69% of patients (34/49) with a parity less than or equal to 1. Delivery occurred within 24 h for 80 patients (88%). Vaginal deliveries accounted for 86% of the births (n = 78 patients). There were five failures (5.5%), no adverse effects, and no maternal complications. our series confirms the effectiveness and good tolerance of 50-μg misoprostol, administered orally. This route has a period of rapid action, is easy to use, and requires no invasive procedures.
    Sante (Montrouge, France) 08/2011; 21(2):73-7.
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    ABSTRACT: We present the clinical aspects of avascular osteonecrosis in children with sickle-cell disease and emphasize the need for early detection of this necrosis of the femoral head, which is often nearly or totally asymptomatic. This retrospective descriptive study covers the 10 years from January 1989 through December 1999 and includes 22 homozygous (Hb-SS) children and adolescents with sickle-cell disease, all presenting pain in the hip and/or limping. The sex ratio was 2.6 (72% boys). Epiphyseal infarction in these children can concern the femoral as well as the humeral head. Femoral osteonecrosis is disabling and often has severe complications, involving not only functional prognosis but also growth potential. Patient and family education is essential to facilitate early diagnosis and treatment and avoid severe consequences in adulthood.
    Sante (Montrouge, France) 08/2011; 21(2):89-92.
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    ABSTRACT: An adequate uncontaminated blood supply is an essential element of an effective health care system. A regional blood transfusion policy was defined in 2004 by the Direction of Health in Bamako, Mali. The objective of this study is to analyse the coverage of transfusion needs at the Fifth District health Center in Bamako after the implementation of this policy. This prospective study, conducted from December 2006 through May 2007, included 134 patients for whom transfusion orders were recorded in the laboratory. The coverage rate of transfusion needs was estimated by dividing the number of units transfused by the number of units that health professionals requested. The blood supply was regular (46 units per month, on average) and consistent with demand (59 units per month on average). Overall, 75% of the transfusions were required for obstetric complications. All patients received at least one 450-mL unit of whole blood. The coverage of transfusion needs has reached 65% of the total number of units required (95% CI = 60-70%). The implementation of a functioning system of blood transfusion is complex. In Bamako, a system based on a centralized transfusion center met a high proportion of the needs in a reference hospital where demand was high while ensuring a high level of patient safety. Further studies are needed to guide the implementation of feasible and sustainable strategies for providing sufficient quantities of safe blood in other contexts and to assess the impact of these different strategies on global health, and on maternal health in particular.
    Sante (Montrouge, France) 06/2011; 21(1):33-40.
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    ABSTRACT: Tuberculosis is a major public health problem in our country. Abdominal tuberculosis ranks third among the extrapulmonary localisations and account for 3% of the various topographic forms in Morocco. The pancreas and peripancreatic locations are much rarer than peritoneal and intestinal lesions. They present a pseudotumoral appearance that creates a diagnostic emergency. We report a case of pancreatic tuberculosis observed in the general surgery department of the 5th Military Hospital.
    Sante (Montrouge, France) 06/2011; 21(1):61-3.

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