Epidemioclinical Profile of Premature Infants at the Neonatology Unit of the Mali Hospital 2012-2015

Introduction: A newborn is preterm when it is born before 37 weeks of amenorrhoea. Preterm births account for 11.1% of live births worldwide, 60% of which are in South Asia and sub-Saharan Africa. Preterm birth is the leading cause of neonatal mortality and the second leading cause of mortality in children under 5 years of age. The aim of this study was to investigate prematurity in the neonatology unit of the Mali Hospital. Materials and Methods: This was a cross-sectional, descriptive study from January 2012 to December 2015 of premature newborns from 28 to 36 weeks of amenorrhea in the neonatology unit of Mali Hospital. Results: From January 2012 to December 2015, we recorded 1692 inpatient newborns, including 614 preterm newborns, a frequency of 36.29%. The sex ratio was 1.43 in favor of boys. The average age of the mothers was 23.9 years with a minimum of 15 and a maximum of 47 years. The majority were housewives (92.7%). The pregnancy was poorly monitored in 51.8% of the mothers. The average gestational age was 32.9 days with extremes of 25 and 36 days. The most frequent mode of delivery was vaginal delivery (93.2%), with late prematurity in 51.5%, moderate prematurity (24.4%), extreme prematurity (18.7%) and very premature (5.4%). The mean birth weight was 1464 g with a standard deviation of 485 g and 2751 g. Prematurity was associated with neonatal infection in 49.4% of newborns, perinatal anoxia (13.9%) and hypotrophy (2.6%). The most frequent maternal risk factors were fever (83.4%), twinship (38.9%) and high blood pressure (8.6%). The average length of hospitalization was 9.75 days with extremes of 0 and 68 days. We recorded a cure rate of 57.7%, a death rate of 35.7% and a dropout rate of 6.7%. Conclusion: Prematurity is frequent in the neonatology unit of the Mali Hospital. We observed a high frequency among women of extreme age and low socio-economic and educational level. In our study we also noted a high mortality rate proportional to gestational age.

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.