Introduction: Covid-19 is defined as a pandemic disease by WHO, in November 2023, WHO recorded 772.1 million confirmed cases and 6.9 million deaths, including 68,382 confirmed cases and 1426 deaths in Madagascar. The ...Introduction: Covid-19 is defined as a pandemic disease by WHO, in November 2023, WHO recorded 772.1 million confirmed cases and 6.9 million deaths, including 68,382 confirmed cases and 1426 deaths in Madagascar. The management of severe cases of Covid-19 remains a challenge for the healthcare system in a resource-limited country, due to the consumption of human resources, the shortage of medical resources and the lack of capacity in resource-limited countries. Prone position (PP) improves survival in acute respiratory distress, and numerous studies have shown that during Covid-19, it reduces mortality rates at 28 and 90 days, and increases the number of days without mechanical ventilation. However, data on the beneficial effects of PP remain limited in low-income countries. In this context, our study aims to evaluate the benefits of the prone position for severe Covid-19 patients in a referral center in Madagascar. Method: This is a retrospective cohort study, during the 2<sup>nd</sup> and 3<sup>rd</sup> waves of COVID-19, over a period of 11 months in two wards managing COVID-19 cases. We included all patients aged 15 and over with severe forms of COVID-19 who required 6 l/min of oxygen therapy. Results: We enrolled 123 patients, including 40 in the prone position and 83 in the supine position, with a mean age of 60.5 ± 12 years. The prone position (DV) reduced the risk of probable complications of COVID-19 with a strong association in terms of use of respiratory assistance (OR = 0.15;95% CI = 0.05 - 0.47), respiratory deterioration (OR = 0.22;95% CI = 0.09 - 0.58), shock (OR = 0.30;95% CI = 0.11 - 0.79) and hemodynamic instability (OR = 0.33;95% CI = 0.12 - 0.95). Univariate analysis of the effect of prone position on SpO<sub>2</sub> showed improvement with significant associations with SpO<sub>2</sub> at Day 1- Day 3, D4 - D7, D8 - D14, and persisting even at D15 - D21, D3 and D2 before discharge, and at discharge. In the overall population, the mean length of hospital stay was 22.8 ± 22.1 days, with extrem展开更多
Spot Them All,is the first localization software developed by the Laboratoire de Seismologie et Infrason Madagascar.The objective of this study is to validate results obtained from the software by comparing them with ...Spot Them All,is the first localization software developed by the Laboratoire de Seismologie et Infrason Madagascar.The objective of this study is to validate results obtained from the software by comparing them with bulletin published by GFZ and the revised event bulletin of the CTBTO from April 2018 to November 2019.On May 15th,2018 around 15:48,an unusual seismic event of magnitude 5.9 was detected in northwest of Madagascar with thousands of aftershocks.The program Spot Them All collects data from IRIS,GEOFON,DASE,IMS,Africa Array network on request.Results showed that earthquake location obtained using STA is consistent with the other two international bulletins.Moreover,199 earthquakes of magnitude greater than 4 were detected by the IMS,39 by the GEOFON network while 937 by STA.Depth is fixed at 10 km in the GFZ’s bulletin and at 0 km in the CTBTO’s REB.STA’s bulletin shows more constrain on events’depth,ranging from 0 to 135 km and they are located between latitudes 11.84°S and 14.18°S,and longitudes 44.8°E and 46.78°E.Information collected from different researches showed that a magma is propagating from Moho depth to the surface.Consequently,a new mountain of about 800 m high and 5 km wide is raising above the seafloor.展开更多
文摘Introduction: Covid-19 is defined as a pandemic disease by WHO, in November 2023, WHO recorded 772.1 million confirmed cases and 6.9 million deaths, including 68,382 confirmed cases and 1426 deaths in Madagascar. The management of severe cases of Covid-19 remains a challenge for the healthcare system in a resource-limited country, due to the consumption of human resources, the shortage of medical resources and the lack of capacity in resource-limited countries. Prone position (PP) improves survival in acute respiratory distress, and numerous studies have shown that during Covid-19, it reduces mortality rates at 28 and 90 days, and increases the number of days without mechanical ventilation. However, data on the beneficial effects of PP remain limited in low-income countries. In this context, our study aims to evaluate the benefits of the prone position for severe Covid-19 patients in a referral center in Madagascar. Method: This is a retrospective cohort study, during the 2<sup>nd</sup> and 3<sup>rd</sup> waves of COVID-19, over a period of 11 months in two wards managing COVID-19 cases. We included all patients aged 15 and over with severe forms of COVID-19 who required 6 l/min of oxygen therapy. Results: We enrolled 123 patients, including 40 in the prone position and 83 in the supine position, with a mean age of 60.5 ± 12 years. The prone position (DV) reduced the risk of probable complications of COVID-19 with a strong association in terms of use of respiratory assistance (OR = 0.15;95% CI = 0.05 - 0.47), respiratory deterioration (OR = 0.22;95% CI = 0.09 - 0.58), shock (OR = 0.30;95% CI = 0.11 - 0.79) and hemodynamic instability (OR = 0.33;95% CI = 0.12 - 0.95). Univariate analysis of the effect of prone position on SpO<sub>2</sub> showed improvement with significant associations with SpO<sub>2</sub> at Day 1- Day 3, D4 - D7, D8 - D14, and persisting even at D15 - D21, D3 and D2 before discharge, and at discharge. In the overall population, the mean length of hospital stay was 22.8 ± 22.1 days, with extrem
基金We thank the staff of the Laboratoire de Seismologie et Infrason for providing constructive comments and suggestions in their review of the present document.We would like to acknowledge the GFZ,the CTBTO,DASE,IRIS,Africa Array,for supplying the resource needed in order to complete this work.We are very grateful to all IOGA(NDC Madagascar)staff for giving a productive environment.
文摘Spot Them All,is the first localization software developed by the Laboratoire de Seismologie et Infrason Madagascar.The objective of this study is to validate results obtained from the software by comparing them with bulletin published by GFZ and the revised event bulletin of the CTBTO from April 2018 to November 2019.On May 15th,2018 around 15:48,an unusual seismic event of magnitude 5.9 was detected in northwest of Madagascar with thousands of aftershocks.The program Spot Them All collects data from IRIS,GEOFON,DASE,IMS,Africa Array network on request.Results showed that earthquake location obtained using STA is consistent with the other two international bulletins.Moreover,199 earthquakes of magnitude greater than 4 were detected by the IMS,39 by the GEOFON network while 937 by STA.Depth is fixed at 10 km in the GFZ’s bulletin and at 0 km in the CTBTO’s REB.STA’s bulletin shows more constrain on events’depth,ranging from 0 to 135 km and they are located between latitudes 11.84°S and 14.18°S,and longitudes 44.8°E and 46.78°E.Information collected from different researches showed that a magma is propagating from Moho depth to the surface.Consequently,a new mountain of about 800 m high and 5 km wide is raising above the seafloor.
