In Mali, the low utilization of reproductive health services in general and family planning (FP) in particular contributes strongly to illnesses or deaths of women during and/or after childbirth and of children under ...In Mali, the low utilization of reproductive health services in general and family planning (FP) in particular contributes strongly to illnesses or deaths of women during and/or after childbirth and of children under the age of one year. This situation is, among other things, the logical consequence of harmful practices, including closely spaced pregnancies, early pregnancies, clandestine abortions, access difficulties and the lack of adequate obstetric and neonatal care. Objective: The objective of our study was to study the difficulties of access to contraception in the health district of commune IV. Methodology: This was a descriptive and multicenter prospective cross-sectional study, carried out in the reference health center of commune IV in the district of Bamako, in the ten (10) CSCOMs and the RENEE CISSE maternity hospital (MRC). Study appalled from June 1 to December 30, 2019. Two subgroups of the study population were involved in the study: Service providers;Users (clients) made up of women of childbearing age (13 - 45 years old). The premises of the FP units, the service providers, the clients who answered our questionnaires constituted our sample;the interviewed providers were also evaluated for their capacity in Counseling with the different methods used. The variables retained for the analysis concerned: the provision of contraceptive products;as well as user files and their characteristics. Results: The result of our survey reveals that the method most used at the time of our survey was Norplant 49.5% and the least used is the pill 1.8;some products, such as the diaphragm, cervical cap, female condom and spermicide, are not available in the various FP units. Side effects were the cause of discontinuation for 17.9% of our clients;50% against the husband;10.7% for no reason;21.4% for desire for children. 87.2% of clients are satisfied with the service delivery compared to 12.8%. 79.8% of clients say that the cost of contraceptive products is affordable compared to 20.2%. Clients who attend the FP unit with their partner’s consent accounted for 21.1% versus 78.9%. All providers were female. They only resort to Doctors in case of tubal ligation and resection. The preference of the female provider was explained by: Religion: “For Muslims, it is preferable to have one provider”;Personal convenience: “some women don’t want to be examined by a man”;Convenience: “Women feel more comfortable with each other”. Providers who thought that the opposition of the husband prevents women from practicing FP were 50%;33.4% of the providers attribute it to the high cost of the products;8.3% of them attribute it rather to religion.展开更多
In Mali, breast cancer remains a real health problem in the absence of an adequate and adapted health policy for their early diagnosis and their often late or even non-existent treatment. Objectives: This study aimed ...In Mali, breast cancer remains a real health problem in the absence of an adequate and adapted health policy for their early diagnosis and their often late or even non-existent treatment. Objectives: This study aimed to study the epidemiological, diagnostic, and therapeutic aspects of breast cancer to write the clinical aspects of breast cancer in the gynecology-obstetrics department of the CHU Gabriel Touré from 2020 to 2022. Methodology: This was a retrospective and descriptive study of 219 cases of breast cancer that were diagnosed in the gynecology and obstetrics department of the CHU Gabriel Touré in Bamako, from 2020 to 2022. Results: The annual frequency was 77.2 cases per year, the average age 45.55 years with extremes of 16 to 85 years;housewives represented 92.7%;multiparas were reported at 57%. Considering the history, the personal history of benign breast pathology was 55.6%. Regarding the localization, the left breast was the most affected with 53.9%, and the tumor was found in the supero-external quadrant in 53.9%. The cancer was metastatic in 81.28%. The diagnosis biopsy + histology contributed to 98.6%. The histological type was invasive carcinoma of non-specific type in 95%. As for the histoprognostic grade of SBR studied, grade II was predominant at 46%, grade III at 34.95%. The therapeutic strategy was chemotherapy in 83.1%. Neoadjuvant chemotherapy followed by surgery in 10%, primary surgery in 6.4%, radiotherapy in 0.5%. Conclusion: The major challenges in the fight against breast cancer in Mali remain a better organization of the system for early diagnosis, the establishment of a screening program, early diagnosis in women from the age of 40 and also adequate care.展开更多
The community diagnosis is an essential approach to the resolution of health problems with the involvement of the communities concerned who become object and subject. Improvingmaternal and child health is a health pri...The community diagnosis is an essential approach to the resolution of health problems with the involvement of the communities concerned who become object and subject. Improvingmaternal and child health is a health priority for many developing countries, including Mali. The objective was to study the role of community-based diagnosis in improving maternal and child protection in a vulnerable urban community in a developing country. Methodology: This was a research-action integrating a community diagnosis conducted in March 2023. The involvement of several stakeholders, including social actors including ASACO, membership card holders, district chiefs, neighborhood delegates, local authorities, and health professionals, made it possible to provide curative, preventive and promotional care. The ASACOSEKA Health Area was used as a setting for the study. The methodology was the indicator approach, contact, document review, interview of CSCOM patients, observation of the structure, prioritization of problems, development of an action plan and restitution of the report. Results: The monograph consisted of describing the characteristics of the study setting. Indeed, the ASACOSEKASI area is located on the left bank of the Niger River, with a population of 34,497 inhabitants. The CSCOM presented to describe a medical unit, a maternity unit, a laboratory unit, an ultrasound room and a medication storage room. The main pathologies found were confirmed simple malaria (45.08%), high AKI: 20.43%, confirmed severe malaria: 19.85%, suspected diarrhoea: 3.43%, trauma related to road accidents: 3.36%, pregnancy-related disorders (1%). BCG, Penta3, VAR, and yellow fever vaccination rates were above 100%. It reflects the fact that the doses administered were higher than the target population. This was related to out-of-area vaccination and lost doses. CPN1, CPN4, tetanus vaccination (VAT2) and family planning (FP) consultations all have a proportion above 100%. Maternal care is increased by out-of-area patients, particularly from Guinea. NPC3 and CPON have a proportion of less than 100%. The target population did not follow policies, standards and procedures. Postpartum, women rarely came to the CPON. Local actions to combat malaria included cleaning up plots and neighbourhoods, weeding families and streets, cleaning gutters, spraying the roosts of the female Anopheles Beetle, sleeping in LLINs, organising chemoprophylaxis days, promoting the use of MS, and using curtains against vectors. Conclusion: The community was involved at all stages of this diagnosis, from design to implementation, as well as to the restitution of local solutions. Indeed, the community diagnosis has led to a resolution plan related to reproductive health.展开更多
Appendicitis bilharzia is a very rare condition and we report 3 cases of this pathology that sense clinical and biological similarities with bacterial appendicitis. The etiological diagnosis was exclusively histopatho...Appendicitis bilharzia is a very rare condition and we report 3 cases of this pathology that sense clinical and biological similarities with bacterial appendicitis. The etiological diagnosis was exclusively histopathological, this allowed to highlight eggs of Schistosome in the appendicular wall in the three patients. The surgical treatment was supplemented by a specific medical treatment based on praziquantel. The surgical suites were simple for 2 patients, complicated by superficial parietal suppuration in a patient.展开更多
文摘In Mali, the low utilization of reproductive health services in general and family planning (FP) in particular contributes strongly to illnesses or deaths of women during and/or after childbirth and of children under the age of one year. This situation is, among other things, the logical consequence of harmful practices, including closely spaced pregnancies, early pregnancies, clandestine abortions, access difficulties and the lack of adequate obstetric and neonatal care. Objective: The objective of our study was to study the difficulties of access to contraception in the health district of commune IV. Methodology: This was a descriptive and multicenter prospective cross-sectional study, carried out in the reference health center of commune IV in the district of Bamako, in the ten (10) CSCOMs and the RENEE CISSE maternity hospital (MRC). Study appalled from June 1 to December 30, 2019. Two subgroups of the study population were involved in the study: Service providers;Users (clients) made up of women of childbearing age (13 - 45 years old). The premises of the FP units, the service providers, the clients who answered our questionnaires constituted our sample;the interviewed providers were also evaluated for their capacity in Counseling with the different methods used. The variables retained for the analysis concerned: the provision of contraceptive products;as well as user files and their characteristics. Results: The result of our survey reveals that the method most used at the time of our survey was Norplant 49.5% and the least used is the pill 1.8;some products, such as the diaphragm, cervical cap, female condom and spermicide, are not available in the various FP units. Side effects were the cause of discontinuation for 17.9% of our clients;50% against the husband;10.7% for no reason;21.4% for desire for children. 87.2% of clients are satisfied with the service delivery compared to 12.8%. 79.8% of clients say that the cost of contraceptive products is affordable compared to 20.2%. Clients who attend the FP unit with their partner’s consent accounted for 21.1% versus 78.9%. All providers were female. They only resort to Doctors in case of tubal ligation and resection. The preference of the female provider was explained by: Religion: “For Muslims, it is preferable to have one provider”;Personal convenience: “some women don’t want to be examined by a man”;Convenience: “Women feel more comfortable with each other”. Providers who thought that the opposition of the husband prevents women from practicing FP were 50%;33.4% of the providers attribute it to the high cost of the products;8.3% of them attribute it rather to religion.
文摘In Mali, breast cancer remains a real health problem in the absence of an adequate and adapted health policy for their early diagnosis and their often late or even non-existent treatment. Objectives: This study aimed to study the epidemiological, diagnostic, and therapeutic aspects of breast cancer to write the clinical aspects of breast cancer in the gynecology-obstetrics department of the CHU Gabriel Touré from 2020 to 2022. Methodology: This was a retrospective and descriptive study of 219 cases of breast cancer that were diagnosed in the gynecology and obstetrics department of the CHU Gabriel Touré in Bamako, from 2020 to 2022. Results: The annual frequency was 77.2 cases per year, the average age 45.55 years with extremes of 16 to 85 years;housewives represented 92.7%;multiparas were reported at 57%. Considering the history, the personal history of benign breast pathology was 55.6%. Regarding the localization, the left breast was the most affected with 53.9%, and the tumor was found in the supero-external quadrant in 53.9%. The cancer was metastatic in 81.28%. The diagnosis biopsy + histology contributed to 98.6%. The histological type was invasive carcinoma of non-specific type in 95%. As for the histoprognostic grade of SBR studied, grade II was predominant at 46%, grade III at 34.95%. The therapeutic strategy was chemotherapy in 83.1%. Neoadjuvant chemotherapy followed by surgery in 10%, primary surgery in 6.4%, radiotherapy in 0.5%. Conclusion: The major challenges in the fight against breast cancer in Mali remain a better organization of the system for early diagnosis, the establishment of a screening program, early diagnosis in women from the age of 40 and also adequate care.
文摘The community diagnosis is an essential approach to the resolution of health problems with the involvement of the communities concerned who become object and subject. Improvingmaternal and child health is a health priority for many developing countries, including Mali. The objective was to study the role of community-based diagnosis in improving maternal and child protection in a vulnerable urban community in a developing country. Methodology: This was a research-action integrating a community diagnosis conducted in March 2023. The involvement of several stakeholders, including social actors including ASACO, membership card holders, district chiefs, neighborhood delegates, local authorities, and health professionals, made it possible to provide curative, preventive and promotional care. The ASACOSEKA Health Area was used as a setting for the study. The methodology was the indicator approach, contact, document review, interview of CSCOM patients, observation of the structure, prioritization of problems, development of an action plan and restitution of the report. Results: The monograph consisted of describing the characteristics of the study setting. Indeed, the ASACOSEKASI area is located on the left bank of the Niger River, with a population of 34,497 inhabitants. The CSCOM presented to describe a medical unit, a maternity unit, a laboratory unit, an ultrasound room and a medication storage room. The main pathologies found were confirmed simple malaria (45.08%), high AKI: 20.43%, confirmed severe malaria: 19.85%, suspected diarrhoea: 3.43%, trauma related to road accidents: 3.36%, pregnancy-related disorders (1%). BCG, Penta3, VAR, and yellow fever vaccination rates were above 100%. It reflects the fact that the doses administered were higher than the target population. This was related to out-of-area vaccination and lost doses. CPN1, CPN4, tetanus vaccination (VAT2) and family planning (FP) consultations all have a proportion above 100%. Maternal care is increased by out-of-area patients, particularly from Guinea. NPC3 and CPON have a proportion of less than 100%. The target population did not follow policies, standards and procedures. Postpartum, women rarely came to the CPON. Local actions to combat malaria included cleaning up plots and neighbourhoods, weeding families and streets, cleaning gutters, spraying the roosts of the female Anopheles Beetle, sleeping in LLINs, organising chemoprophylaxis days, promoting the use of MS, and using curtains against vectors. Conclusion: The community was involved at all stages of this diagnosis, from design to implementation, as well as to the restitution of local solutions. Indeed, the community diagnosis has led to a resolution plan related to reproductive health.
文摘Appendicitis bilharzia is a very rare condition and we report 3 cases of this pathology that sense clinical and biological similarities with bacterial appendicitis. The etiological diagnosis was exclusively histopathological, this allowed to highlight eggs of Schistosome in the appendicular wall in the three patients. The surgical treatment was supplemented by a specific medical treatment based on praziquantel. The surgical suites were simple for 2 patients, complicated by superficial parietal suppuration in a patient.
