Luc Hervé Samison

• MD, MSBM, Prof
• Past Dean at University of Antananarivo

Introduction: the indication for pancreatic necrosectomy arises in a context of seriousness. Several factors can influence postoperative outcomes. Our objective is to identify the clinical and paraclinical factors which would influence the occurrence of complications after pancreatic necrosectomy. Patients and methods: it is a retrospective stud...

Despite the numerous articles published on the clinical characteristics and outcomes of COVID-19 with regard to high-income countries, little is known about patients in low- and middle-income countries (LMIC) in this context. The objective of this observational, prospective, hospital-based multicentric study was to describe clinical features and ou...

To estimate the prevalence of IgG antibodies against six arboviruses in people living with HIV-1 (PLWHIV) in Madagascar, we tested samples collected between January 2018 and June 2021. We used a Luminex-based serological assay to detect IgG antibodies against antigens from Dengue virus serotypes 1–4 (DENV1–4), Zika virus (ZIKV), West Nile virus (WN...

Background In Madagascar, no study has reported the impact of COVID-19 on people living with HIV (PLHIV). The present work aimed to analyze the seroprevalence of SARS-CoV-2 in Malagasy PLHIV before and during the three waves of COVID-19 pandemic.This is a retrospective study. Materials and Methods We conducted a retrospective serological survey in...

Severe abdominal trauma represents an absolute surgical emergency. The objective of our study is to report the surgical management of severe abdominal trauma in a low-resource center. This was a 31-month observational study from January 2018 to August 2020. We have 44 cases of severe abdominal trauma. The sex ratio was 4.5. The mean age of patients...

Background: The management of gastric cancer is a major challenge in low-income countries. The aim of this study was to describe the epidemiological, clinical and therapeutic aspects of gastric cancer in the Visceral Surgery ward of the Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona in Antananarivo. Materials and Method: This was...

Background: Antimicrobial resistance is a major public health threat, affecting not only humans but also animals and the environment. Although the "One Health" dimension of resistance is well recognized, data are lacking on the circulation of resistance, particularly in low-income countries. The World Health Organization has proposed a protocol cal...

Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries...

Ostomy feeding remains a reference approach for enteral nutritional assistance. In Madagascar, the techniques are still conventional surgical procedures due to the lack of adequate endoscopic equipment. This study aims to evaluate the benefits and risks of enteral nutrition with a two-week follow-up. Included patients who had benefited from enteral...

Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries...

Antimicrobial resistance is a major public health concern worldwide affecting humans, animals and the environment. However, data is lacking especially in developing countries. Thus, the World Health Organization developed a One-Health surveillance project called Tricycle focusing on the prevalence of ESBL-producing Escherichia co li in humans, anim...

Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This internati...

Background Sub‐Saharan Africa faces the highest relative need for health care workers in the world and the emigration of physicians significantly contributes to this deficit. Few studies have explored development of these patterns during medical education. This study investigates career aspirations of medical students in two African nations with si...

Résumé Introduction Plusieurs applications dédiées à la douleur sont actuellement accessibles. L’utilisation des outils intelligents est de plus en plus développée en Afrique. L’objectif est d’analyser le téléchargement des applications de la douleur dans le monde et l’évolution des outils intelligents en Afrique afin de voir son utilisation en ta...

Aim This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicio...

Background 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on...

p>Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications...

Introduction Les plaies pénétrantes du thorax sont fréquentes et nécessitent une prise en charge spécifique. Les objectifs de cette étude sont de décrire les aspects épidémiologiques, cliniques, thérapeutiques et évolutifs des plaies pénétrantes par arme blanche. Méthodes C’est une étude rétrospective portant sur 73 patients ayant une plaie thorac...

Résumé Objectif Déterminer les facteurs de dénutrition et le grade nutritionnel des patients en chirurgie viscérale dans un centre hospitalier universitaire malagasy. Cet objectif découle du fait que la dénutrition pré-opératoire, facteur de risque indépendant de complications postopératoires, aggrave la morbi-mortalité et devrait être recherchée...

Background Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. Methods This international cohort study included adult patients undergoing elective surge...

Post-traumatic hemothorax is common in young adults in the context of road accidents. Explorations of the lesions may be limited by the technical platform. The objective of our study is to discuss the difficulty of managing post-traumatic hemothorax in a limited-medium structure. This was a 20-month retrospective study (01 May 2018-31 December 2019...

During the period of total containment during the Covid-19 pandemic; our department became the sole treatment center for all surgical emergencies. The influx of many patients made the task very difficult for the surgeon. This is a 3-month descriptive prospective study in the visceral surgery department at the Analankininina Toamasina University Hos...

Acute appendicitis was often diagnosed at the complication stage during the Covid19 pandemic at CHU Analankininina Toamasina. Our objective was to discuss the particularity of the management of appendicitis during the pandemic. Our study was prospective, descriptive for 6 months and took place in the general surgery department of the Analankininina...

Introduction: Digestive hemorrhage on peptic ulcer is one of the major digestive emergencies. Therapeutic progress in recent years has been based on the removal of risk factors. Our objective was to evaluate the impact of diet and hygiene on digestive haemorrhage in peptic ulcer disease. Patients and method: Our study was prospective, monocentric,...

Introduction: L’incidence du cancer de sein bilatéral synchrone varie selon les auteurs de 1.5 à 3.5 %. Sa prise en charge reste limitée dans les pays à revenu faible comme Madagascar. L’objectif de notre étude était de caractériser la prise en charge du cancerdu sein bilatéral à Madagascar et d’en déterminer les particularités cliniques et pronost...

Introduction: Les plaies pénétrantes du thorax sont fréquentes et nécessitent une prise en charge spécifique. Les objectifs de cette étude sont de décrire les aspects épidémiologiques, cliniques, thérapeutiques et évolutifs des plaies pénétrantes par arme blanche. Matériel et méthodes: C’est une étude rétrospective portant sur 73 patients ayant une...

We report a case of a digestive haemorrhagic complication from portal segmental hypertension secondary to chronic pancreatitis, discovered During an abdominal CT-scan. Our objective is to describe the Contribution of CT-scan in digestive hemorrhage by portal segmental hypertension secondary to chronic pancreatitis.

Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. They are generally considered as solitary tumors. Here we report the case of a 66-year-old man with familial history of digestive cancers, admitted after a 2-months history of gastrointestinal bleeding. Colonoscopy showed a circumferential ulcerate...

Résumé Introduction. La dénutrition préopératoire reste un facteur de risque indé-pendant des complications postopératoires, en chirurgie digestive. Une des clés de voûte de cette prise en charge reste l’anticipation de l’assistance nutritionnelle. Objectif. L’objectif était de déterminer le profil évolutif des patients, sous assistance nutrition-n...

The diagnosis of a right diaphragmatic defect is difficult to establish. The authors report a series of real cases of right diaphragmatic defect, the particularities of which are based on the late discovery with the possibility of an abdominal surgical cure in both cases. This work deals with four clinical cases, including one case of congenital di...

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who ha...

Background: We describe the clinical aspects and surgical management of soft tissue infections with a three-step procedure: antibiotherapy-debridement, negative pressure aspirating dressing. Method: A retrospective case series of fourteen patients with necrositing fasciitis and myonecrosis of the chest wall who underwent operated at the unit of tho...

Résumé L’adolescentologie constitue un volet très important en santé reproductive. En effet, répondre aux besoins physiques et cognitifs des adolescents nécessite beaucoup d’habilité et d’expérience. La dysménorrhée est l’un des symptômes les plus fréquemment rencontrés à cette tranche d’âge. La tolérance de la douleur, les troubles du cycle et les...

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort stu...

Résumé Introduction: Le néfopam est souvent utilisé dans le cadre de l’analgésie postopératoire multimodale. Les effets indésirables qui lui sont associés sont fréquents, mais l’imputabilité à son mode d’administration n’est pas précise. L’objectif de cette étude a été de comparer la survenue des effets secon-daires du néfopam selon son mode d’admi...

The authors describe the case of intrathoracic appendiceal abscess associated with right diaphragmatic hernia (hiatal hernia) discovered in a 52 years old woman. The surgical treatment consisted of conventional laparotomy appendectomy after reduction of paraoesophagal hernia into the abdominal cavity in the fist time. In second time, we realised a...

Introduction To describe the epidemiology of joint pains and document analgesics usage in an African context. Methods Patients suffering from joint pain were recruited from nine sites located in Antananarivo, Madagascar, including 6 hospital services and 3 clinics. Doctors collected information on the etiology and characteristics of the patients’...

The pseudosyndrome of Meigs is caracterised by a triad, which associates a solid benign tumor of the ovary, an ascitis and a pleural effusion. Surgical extraction of the tumor entails disappearance of the symptomatology. The authors report in this study a case of an ovarian goitre revealed by this syndrom. Copyright © 2014. Published by Elsevier SA...

Nous rapportons le cas d'un homme de 29 ans admis pour une masse hypogastrique très douloureuse. La laparotomie exploratrice réalisée en urgence permettait de mettre en évidence l'origine et la localisation iléale de la masse tumorale. Le traitement chirurgical consistait en une tumorectomie complète avec respect des marges carcinologiques. Les sui...

Introduction Simple hepatic cysts must be differenciated from cystadenoma and from cystadenocarcinoma. The treatment is different and surgical indications are restricted. We want to enhance the superiority of fenestration in the management of simple hepatic cysts through clinical cases and review of the literature. Observation We report two cases o...

Introduction La rupture de varices œsophagiennes liée à une hypertension portale d’origine bilharzienne reste l’étiologie majeure d’hémorragie digestive non ulcéreuse à Madagascar. Le cavernome portal est parmi les autres étiologies possibles mais rares. Nos objectifs sont de mettre en exergue l’intérêt de connaître cette pathologie et de discuter...

Introduction Breast cancer is the most common malignancy tumor amongst Malagasy women registered at the pathology unit of the “Institut Pasteur de Madagascar”. In Madagascar, there is no laboratory practicing hormone receptors' status on these tumors. Until now no study about hormone receptors' status of Malagasy women with invasive breast cancer w...

Objective To describe the epidemiological and clinical aspects, to report the cures and the evolutions of the post-ulcerous gastroduodenal stenosis diagnosed in the university hospital of Antananarivo (Madagascar). Methods Retrospectively, the files of the patients presenting a post-ulcerous gastroduodenal stenosis and admitted in period of January...

Il est actuellement recommandé de stratifier les hémorragies digestives hautes, en fonction de leur risque, par des scores pronostiques. L'objectif de cette étude a été d'appliquer ces scores en vue de les comparer, dans un centre hospitalier malgache. Etude prospective sur 419 patients, sur une période entre janvier et décembre 2011, au Centre Hos...

La fasciite nécrosante est une infection sévère, rapidement progressive, mutilante, souvent fatale du tissu sous cutané et du fascia profond. Les auteurs rapportent et discutent un rare cas de fasciite nécrosante de la paroi thoracique antérieure secondaire à une pleurésie purulente chez un diabétique. Un diagnostic précoce avec incisions multiples...

INTRODUCTION: La dénutrition péri-opératoire est une des complications qui peut entraver la réhabilitation postopératoire et augmenter la morbi-mortalité dans les chirurgies digestives. Il est actuellement recommandé d'évaluer l'état nutritionnel, notamment pré-opératoire des patients. L'objectif de cette étude était d'évaluer l'état nutritionnel p...

La prise en charge d'un aspergillome pulmonaire, dans le cas des lésions limitées accessibles, est une des activités courantes en chirurgie thoracique dans les pays endémique à la tuberculose comme Madagascar. Sur une période allant de janvier 2005 en mars 2010, 15 patients, ancien tuberculeux, atteints d'une aspergillome pulmonaire sont traités pa...

Introduction : La morphine intrathécale (MIT), dans le cadre de l’analgésie balancée postopératoire procure une analgésie efficace, mais est grevée de risques. Patients et méthodes : Quarante-cinq patientes de 22 à 74 ans, opérées d’hystérectomies, ont été suivies dans une étude prospective. Les patientes étaient divisées en trois groupes: le gr...

Low income countries seldom possess adequate means to effectively carry out rigorous epidemiological studies in the fight against infectious diseases such as Tuberculosis and Acute Lower Respiratory Infections. To do so, they require solid health infrastructures and qualified researchers trained in the latest laboratory techniques. Where internatio...

Objectif : L'achalasie est une pathologie rare mais aux complications graves. Notre objectif est de présenter les aspects cliniques des cas d'achalasie observés dans des services de gastroentérologie à Madagascar. Matériels et méthodes : Il s'agit d'une étude rétrospective, descriptive multicentrique des dossiers des patients ayant présenté une ach...

To analyze the frequency, clinical and therapeutical aspects of paratesticular tumors encountered in Universiatry Teaching Hospital Ravoahangy-Andrianavalona. This a retrospective study carried out on 12 patients with paratesticular tumor seen in UTH Ravoahangy-Andrianavalona between January 1997 and December 2007. Studied parameters were: age, dis...

We report herein an aggressive endometriosis with multiple localisations. Ms RAH, a 41 year-old Malagasy woman, is consulting for cutaneous ulceration and abdominal mass. She is nullipara. Ten years ago, she had an umbilical endometriosis treated by omphalectomy. A recurrence two years later motivated a second operation followed by monthly injectio...

Pasini type albupapuloid dystrophic epidermolysis bullosa is an exceptional form of hereditary dystrophic epidermolysis bullosa. It concerned a 37 year-old Malagasy man who had onycholysis and diffused scar lesions secondary to bullas eruption starting from childhood. In his family, 19 persons in paternal side presented the same lesions. Pathologic...

The authors report the case of a 14-year-old boy with complete isthmic rupture of a horseshoe kidney after a bicycle accident. The imaging diagnosis was difficult because of the presence of a massive retroperitoneal haematoma. However, sonography and CT should be sufficient to detect associated signs, such as malrotation of the renal hila and low-l...

Breast tuberculosis is rare. It usually involves young women of childbearing age. The purpose of this report is to describe two cases of breast tuberculosis observed in Madagascar with focus on epidemiological, clinical, and therapeutic features. Infection of the breast is usually secondary by lymphatic, contiguous, or, more rarely haematogenous sp...

Gastric perforation in the neonate is rare. The authors report a 3-day-old male infant, born through a normal delivery after an uncomplicated pregnancy, who presented with a sudden gross distention of the abdomen followed by respiratory distress. Abdominal X-ray examination showed a massive pneumoperitoneum. After a brief resuscitation, an isolated...

Gastric perforation in the neonate is rare. The authors report a 3-day-old male infant, born through a normal delivery after an uncomplicated pregnancy, who presented with a sudden gross distention of the abdomen followed by respiratory distress. Abdominal X-ray examination showed a massive pneumoperitoneum. After a brief resuscitation, an isolated...

Centromedullary nailing without locking using a Kuntscher nail remains a routine practice in developing countries for the treatment of leg fractures. We observed a distal transplantar migration of this type of nail which had not been removed and report here the etiopathogenic factors involved as well as the clinical evolution. In our patient, trans...

Burkitt non hodgkin lymphoma affects children and young adults. It is endemic in tropical Africa and it has especially facial and abdominal localisations. We report a case of anal localisation in a 22 years-old man, human immunodeficiency virus (HIV), negative aiming to show clinical, therapeutical and evolutive particularities of this exceptional...

Burkitt non hodgkin lymphoma affects children and young adults. It is endemic in tropical Africa and it has especially facial and abdominal localisations. We report a case of anal localisation in a 22 years-old man, human immunodeficiency virus (HIV), negative aiming to show clinical, therapeutical and evolutive particularities of this exceptional...

Female genital tuberculosis is relatively frequent in developing countries. Most cases occur in young women of childbearing age. The most common locations are the tubes, endometrium, and ovaries. Bartholin gland involvement is rare. The purpose of this report is to present a case of Bartholin gland tuberculosis in a 50 year-old woman and to describ...

We report two cases of giant calculus in two male farmers in 1999. They were operated on in the urologic ward by lithocystotomy. Infrared spectrophotometric analysis, carried out in Bordeaux, gave us the main components of the stones. These stones weighed respectively 350 g and 450 g. Research of common aetiology such as vesical neck stricture, pro...

We report two cases of giant calculus in two male farmers in 1999. They were operated on in the urologic ward by lithocystotomy, infrared spectrophotometric analysis, carried out in Bordeaux gave us the main components of the stones. These stones weighed respectively 350 g and 450 g. Research of common aetiology such as vesical neck stricture, pros...