Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases...Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.展开更多
Land tenure is a major determinant of the types of land use in a region or area and, by extension, affects its conservation. Most of the land that falls under public or communal land-tenure systems in developing count...Land tenure is a major determinant of the types of land use in a region or area and, by extension, affects its conservation. Most of the land that falls under public or communal land-tenure systems in developing countries such as Mali faces numerous challenges among them being natural resource overexploitation. This is mainly because the land is openly accessible to all people around it, and thus the tendency to overexploit the land resources leading to degradation, and food and environmental insecurity. In Mali, land ownership falls under three categories: Public or Government, Communal and Private. This study was undertaken to assess the land ownership types in Yanfolia District, Mali, a gold-mining area that lies some 170 km southern east of capital district of Bamako and upstream of Selingué dam on Sankarini River. A social survey of 200 households was done using a structured questionnaire. Additional research instruments were focus group discussion, key informant interviews and observation check-lists. The data was analyzed using both descriptive and inferential statistics. The study findings indicated that most of the land under gold-mining was owned by the government followed by community and finally private. There were significant associations between size of land under gold-mining and land tenure types: communal land (<em>χ</em><sup>2</sup> = 30.52;p = 0.000);private land (<em>χ</em><sup>2</sup> = 65.09;p = 0.000) and public or government land (<em>χ</em><sup>2</sup> = 177;p = 0.000). Gold-mining takes place mostly on lands classified under public/government and communal compared to that which takes place on lands classified as private. It is recommended that the relevant Malian governmental regulatory and enforcement agencies implement and enforce existing environmental laws with respect to land and environment. These agencies should adopt participatory and sustainable approaches to land and natural resources management for improved food and environmental security.展开更多
In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-opera...In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the Gabriel Touré University Hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify any cases of scar stenosis of meatoplasty. Hea展开更多
Introduction: Post-intubation tracheal stenosis (STPI) is a complication of ventilatory assistance by intubation and/or tracheotomy. Her frequency is estimated between 10% to 20%. The treatment of choice remains surge...Introduction: Post-intubation tracheal stenosis (STPI) is a complication of ventilatory assistance by intubation and/or tracheotomy. Her frequency is estimated between 10% to 20%. The treatment of choice remains surgery. It is based on tracheal resection-anastomosis which guarantees satisfactory and reliable long-term results. Objectives: To determine the frequency of post-intubation tracheal stenosis, to specify the diagnostic and therapeutic methods, to determine the complications and the evolution. Material and methods: This was a study carried out in the ENT and head and neck surgery department of the University Hospital Center Gabriel TOURE. Our study focused on two (02) cases of post-intubation tracheal stenosis (STPI) collected during a period of 1 year (January 2021 to December 2021). Results: They are all acquired, secondary to an intubation. The two (02) cases benefited from a tracheal anastomosis resection, the indications of which were specified and the results and complications evaluated. Conclusion: Our results show that resection anastomosis remains the reference treatment for STPI.展开更多
文摘Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.
文摘Land tenure is a major determinant of the types of land use in a region or area and, by extension, affects its conservation. Most of the land that falls under public or communal land-tenure systems in developing countries such as Mali faces numerous challenges among them being natural resource overexploitation. This is mainly because the land is openly accessible to all people around it, and thus the tendency to overexploit the land resources leading to degradation, and food and environmental insecurity. In Mali, land ownership falls under three categories: Public or Government, Communal and Private. This study was undertaken to assess the land ownership types in Yanfolia District, Mali, a gold-mining area that lies some 170 km southern east of capital district of Bamako and upstream of Selingué dam on Sankarini River. A social survey of 200 households was done using a structured questionnaire. Additional research instruments were focus group discussion, key informant interviews and observation check-lists. The data was analyzed using both descriptive and inferential statistics. The study findings indicated that most of the land under gold-mining was owned by the government followed by community and finally private. There were significant associations between size of land under gold-mining and land tenure types: communal land (<em>χ</em><sup>2</sup> = 30.52;p = 0.000);private land (<em>χ</em><sup>2</sup> = 65.09;p = 0.000) and public or government land (<em>χ</em><sup>2</sup> = 177;p = 0.000). Gold-mining takes place mostly on lands classified under public/government and communal compared to that which takes place on lands classified as private. It is recommended that the relevant Malian governmental regulatory and enforcement agencies implement and enforce existing environmental laws with respect to land and environment. These agencies should adopt participatory and sustainable approaches to land and natural resources management for improved food and environmental security.
文摘In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the Gabriel Touré University Hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify any cases of scar stenosis of meatoplasty. Hea
文摘Introduction: Post-intubation tracheal stenosis (STPI) is a complication of ventilatory assistance by intubation and/or tracheotomy. Her frequency is estimated between 10% to 20%. The treatment of choice remains surgery. It is based on tracheal resection-anastomosis which guarantees satisfactory and reliable long-term results. Objectives: To determine the frequency of post-intubation tracheal stenosis, to specify the diagnostic and therapeutic methods, to determine the complications and the evolution. Material and methods: This was a study carried out in the ENT and head and neck surgery department of the University Hospital Center Gabriel TOURE. Our study focused on two (02) cases of post-intubation tracheal stenosis (STPI) collected during a period of 1 year (January 2021 to December 2021). Results: They are all acquired, secondary to an intubation. The two (02) cases benefited from a tracheal anastomosis resection, the indications of which were specified and the results and complications evaluated. Conclusion: Our results show that resection anastomosis remains the reference treatment for STPI.
