Bacteriological Profile and Antimicrobial Susceptibility Pattern of Cervico-Facial Cellulitis at the Regional Teaching Hospital of Ouahigouya (Burkina Faso)

Context and Objective: Cervicofacial cellulitis is a lethal infection without treatment. The aim of this study is to establish the bacteriological and antimicrobial susceptibility profile of cervico-facial cellulitis at the Regional Teaching Hospital (RTH) of Ouahigouya, in order to guide practitioners in the development of effective probabilistic antibiotic therapy protocols. Subjects and Methods: This was a transversal descriptive study with prospective data collection from July 1 to December 31, 2021 at the RTH of Ouahigouya. All cases of suppurative cervicofacial cellulitis that had been the subject of pyoculture were retained. Results: A total of 63 patients were chosen including 41 men, with 40.91 years as the average age and the sex ratio was 1.86. In 90.48% of cases, the front door was dental. All patients took antibiotics before their admission. Pus culture was positive in 34/63 subjects (53.97%) and showed monomicrobial infection. The isolates were Gram-negative bacilli for 20.59% and Gram-positive cocci for 79.41%. These isolates were all resistant to certain beta-lactams (such as amoxicillin, amoxicillin + clavulanic acid). However, some isolates were susceptible to cefoxitin, ceftazidime and ceftriaxone. All isolates were sensitive to amikacin for aminoglycosides. As for macrolides, erythromycin had excellent activity (100%) against Gram-positive cocci. Indeed, some isolates were susceptible and others resistant to ciprofloxacin for quinolones. Conclusion: Bacteriological profile and antimicrobial susceptibility knowledge of cervicofacial cellulitis may propose an effective probabilistic antibiotic therapy protocol.

Obstetrical Emergencies in Ouahigouya Regional Teaching Hospital (Burkina Faso) in the Context of Insecurity Linked to Armed Groups: A Comparative Study between Patients from Precarious Security Zones and Those from Safe Areas

Introduction: Insecurity can be an obstacle to access to emergency obstetric and newborn care, that is why we proposed to study obstetrical emergencies in Ouahigouya Regional Teaching Hospital, a referral hospital in a region plagued by insecurity linked to armed groups. Method: This was an analytical cross-sectional study with prospective data collection over a 4-month period, from June 10 to October 10, 2020. Patients from precarious security areas were compared to those from safer areas. The Chi squared and Fisher tests were used for comparison of variables. Results: Obstetric emergencies accounted for 38.62% of admissions, from which 25.59% came from precarious security zones. Age was similar in both comparison groups. However, patients from unsafe areas were more likely to reside in rural areas (p 0.001) and more likely to be in unpaid occupations (p 0.001). Prenatal visits were less frequent (p 0.01) and women were more often multigravidae (p 0.01) in the precarious security group of patients. Apart from the more frequent uterine rupture (p = 0.02) in the group from precarious security zones, diagnosed complications and maternal mortality were similar in the 2 groups, while perinatal mortality was higher in the group of patients from precarious security zones (p 0.01). Conclusion: The precarious security situation has negative consequences on maternal and perinatal morbidity and mortality. Further studies are needed for better understanding of these consequences, and improvement of health system resilience strategies, to reduce related maternal and fetal morbidity and mortality.

Adherence to Physical Measures during the SARS-COV2 Pandemic by Haemodialysis Patients in a Burkina Faso Tertiary Hospital: A Cross-Sectional Survey

Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.

Obstetrical Vacuum Deliveries: Clinical Aspects and Fetal Prognosis in Regional Teaching Hospital of Ouahigouya

Objective: To determine the frequency of obstetrical vacuum deliveries in the service of obstetrics and gynecology of regional teaching hospital of Ouahigouya and then to assess fetal outcomes. Patients and Methods: It was about a cross sectional and descriptive retrospective data collection from 1st January 2014 to 31st December 2016 in the service of obstetrics and gynecology of regional teaching hospital of Ouahigouya. Patients who had vacuum delivered in the service with single pregnancy, at least 34 weeks gestation age and summit presentation and had a useful medical folder were included in our study. The data were collected and the analysis used epi-info software 7.2.1.0. version, 2010 Word and excel. The results were presented in percentage for qualitative variables and in means standard deviation for quantitative variables. Results: We have collected 6233 deliveries from 1st January 2014 to 31st December 2016, out of which 312 were done by using obstetrical vacuum giving a frequency of 5.0%. The mean age of patients was 23.5 ± 6.4 years. The average parity was 1.3 ± 0.7 women per delivery and 73.1% of our patients were pauciparous. 90.1% of patients were referred. The main indications were maternal weakness (43%), fetal distress (36.5%), prolonged expulsive phase (6.1%), stopping progression (4.8%) and the scar uterus (4.5%). Fetal prognosis was dominated by the caput in 13 cases (4.2%) and excoriations of the scalp in 5 cases (1.7%). Conclusion: Vacuum extractions are very limited in low setting countries. Its popularization is essential to reduce maternal and fetal mortality.

Epidemiological, Clinical, Therapeutic and Prognostic Aspects of Puerperal Infections within the Gynecology Obstetrics Department of Yalgado Ouedraogo University Teaching Hospital (CHU-YO), Burkina Faso

Objective: Conduct a study about the epidemiological, clinical, therapeutic and prognostic aspects of puerperal infections within Gynecology Obstetrics department of CHU-YO during the study period. Patients and Methods: This was a cross-sectional and descriptive study. The study period was from January 1st to December 31st, 2019. Data collection was retrospective. The exhaustive sample included all female patients having a puerperal infection. Results: Our study included 65 patients. The frequency of puerperal infections represented 1% of deliveries, the average age of patients was 27 ± 7.26 years. Housewives represented 64.4% of the patients. Hyperthermia and abdominal-pelvic pain respectively occurred in 63.8% and 21.3% of patients. The patients had given birth by caesarean section in 83.1% of cases. Endometritis represented 76.9% of cases of puerperal infections. The patients were treated with antibiotics, uterotonics and symptomatic therapy. Maternal death occurred in 13.9% of cases. Conclusion: A focus should be put on preventive measures in front of any high-risk puerperal infection situation.

Maternal Mortality in the Obstetrics and Gynecology Service of Regional Hospital Center of Ouahigouya: Epidemiological, Etiological Aspects and Contributing Factors—About 151 Cases Collected in Three Years from 1st January 2013 to 31 December 2015

The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.

Low Birth Weight at Term: Risk Factors and Perinatal Prognosis in the Teaching Hospital Yalgado Ouédraogo, Burkina Faso

Objective: The objective of our study was to study the risk factors of low birth weight at term in the Teaching Hospital Yalgado (CHU-YO) Ouédraogo. Patients and Methods: This dealt with a comparative and analytical control case study. The group of cases was made up of female patients who gave birth to newborns with low birth weight at term and that of control cases included female patients who delivered a normal-weighted newborn at term. Results: The frequency of low birth weight at term was therefore estimated at 4.4%. The average age of the parturients was 25 ± 6.36 years. Female patients living in a marital setting accounted for 93.1% of cases and 64.4% of them had no income-generating activities. A maternal underweight, a height below 155 cm, passive smoking, and malaria during pregnancy have been identified as the factors associated with a low birth weight. Conclusion: Quality prenatal care could reduce the incidence of low birth weight at term.

Surgical Activities in the Gynecology-Obstetrics Department of the Teaching Hospital Yalgado-Ouédraogo of Ouagadougou: Assessment of One Year of Practice from January 1^st, 2015 to December 31^st, 2015

Objective: The objective of our study was to study the surgical activities carried out in the gynecology-obstetrics department of the CHU-YO (Teaching Hospital Yalgado Ouédraogo) from January 1st 2015 to December 31st, 2015. Patients and Methods: This dealt with a cross-cutting descriptive and analytic study with retrospective data collection. Our study has included the female patients who underwent surgery in the operating room and whose medical records were usable. Results: 45% of female patients admitted in the concerned department underwent a surgery. The average age of patients was estimated at 28.02 years ±7 years with extremes of 13 years and 80 years. Obstetrical surgery has involved 89.9% of cases. Female patients have received a loco-regional anesthesia in 92.7% of cases. Emergency surgical operations accounted for 88.8% and caesarean section was the main surgical operation carried out in 87.1% of cases. The mortality rate of the overall surgical operations was 1.04%. Conclusion: A better availability of labile blood products is more likely to reduce the mortality rate of surgical operations under the threshold of 1%.

Emergency Cesarean Section for Teenagers at Yalgado Ouedraogo Teaching Hospital (YOTH), Ouagadougou, Burkina Faso: Frequency, Indications, Maternal and Perinatal Prognosis

Objective: To study emergency cesarean section in teenagers with the goal of reducing morbidity and maternal-fetal mortality. Methods: This was a descriptive cross-sectional study with prospective collection of data on 248 cases collected from July 1st to December 31st, 2016. Results: The incidence of cesarean section in teenagers was 56.4%. The average age was 18 ± 0.4 years old. The vast majority were primiparous (92.7%). The main indications for emergency Caesarean section were: pre-eclampsia and its complications (20.2%), acute fetal distress (18.5), pre-rupture syndrome (14.1%) and bone dystocia (11.7%). The maternal mortality rate was 1.6% and perinatal mortality was 134 per 1000 live births. Conclusion: The rate of caesarean section is high at Yalgado OUéDRAOGO Teaching Hospital of Ouagadougou. Postoperative complications are sometimes serious and compromise the maternal and fetal outcome. There is a need for increased surveillance of all pregnant and recently delivered women to reduce maternal and perinatal mortality in teenagers.

Factors for Postponement or Cancellation of Operating Programs Set in the Orthopedics-Traumatology Department of Yalgado Ouédraogo University Teaching Hospital in Ouagadougou (Burkina Faso)

Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.

Place of Autologous Intraoperative Blood Transfusion in the Treatment of Broken Ectopic Pregnancy (EP) at the Chiphra Hospital of Ouagadougou, Burkina Faso

Objective: To describe the role of autologous regenerative intraoperative bleeding of recent intra-cavity losses over the ectopic pregnancy ruptured at the Schiphra Hospital of Ouagadougou. Methodology: It has been a cross-sectional descriptive study over a period of 18 months from January 1st 2014 to June 30th 2015 in the obstetrics and gynecology department at the schiphra hospital of Ouagadougou. In our study, we included all pregnant women having received emergency with a diagnosis of broken ectopic pregnancy complicated by a significant array of clinical haemoperitoneum and who have consented to participate in the survey. Results: During the study period, we recorded 322 cases of ectopic pregnancy, among which 106 were broken. Autotransfusion was performed in 59 patients, that is to say 18.3%. The average age of patients was 27 years (18 - 40). The average rate of childbirth was 5.25 (0 - 11). The general condition of the patients was pretty good at 8.5% and poor in 91.5% of cases. The average amount of blood transfused per patient was 935 ml with a range of 400 and 1600 ml. After autotransfusion, 62% of patients had greater improvement in hemoglobin 10 g/dl. Maternal prognosis was marked by a case of fever with a morbidity rate of 1.9% and a death post autotransfusion case fatality rate of 1.9%. Conclusion: In the context of shortage of blood products, autologous transfusion could be an alternative in the treatment of ruptured ectopic pregnancy in developing countries.

Vaginal Bleeding in the Nonpregnant Patient Received in Emergency at Yalgado Ouedraogo University Hospital of Ouagadougou, Burkina Faso

Objective: To describe the epidemiological, clinical and therapeutic aspects of cases of vaginal bleeding in the nonpregnant patient received in emergency at Yalgado OUEDRAOGO University Hospital. Materials and Methods: It was a retrospective and descriptive study that involved the clinical records of 326 patients collected from January 01, 2009 to December 31, 2013. Results: The average age of women was 47 years old with extremes at 12 and 82 years old. Women of childbearing age accounted for 61.6% and postmenopausal women 18.7%. 70.7% of women were pauciparous or nulliparous. Menorrhagia and pelvic pain were the main signs associated. This symptomatology required hospitalization in 85.2% of cases. The main aetiologies were uterine myomas 49.69%, cervical cancer 23% and functional metrorrhagia 11.04%. Progestin was the most used drug in 67.1% of cases. Total abdominal hysterectomy and abdominal myomectomy were the most commonly used surgical methods with 22.3%, 44.4% of cases. Eleven death cases were observed. Conclusion: Gynecological metrorrhagia is more common in women of childbearing age than in menopausal women. The main causes are fibroma, cervical cancer and functional metrorrhagia.

Acute Intussusception of the Adult in Burkina Faso, a Tropical Area: Our Experience about 30 Cases

Objective: To describe the etiological, clinical and therapeutic aspects of adults’ intussusception at Yalgado Ouedraogo University Hospital in Ouagadougou (CHU-YO), Burkina Faso. Patients and method: This descriptive cross-sectional study was conducted between May 2011 and April 2016 at CHU-YO. All patients with 16 years of age and older operated on for intussusception were included. Results: Thirty patients were identified, 15 men and as many women. Their average age was 37.3 years. A higher frequency was noted between 30 and 39 years. The installation of the symptomatology was insidious in 22 cases and brutal in 8 cases. The reasons for consultation were abdominal pain (30 cases), vomiting (19 cases), intestinal transit stop (18 cases) and rectorrhagia (9 cases). Physical examination noted an abdominal mass in 11 cases and a localized abdominal tenderness in 7 cases. An intussusception coil was identified on ultrasound in 9 cases. All patients underwent surgery under general anesthesia and the approach was laparotomy. Intraoperatively, the intussusception was ileocolic in 15 cases;a right hemi-colectomy was performed. It was colo-colic intussusception in 10 cases and the treatment thus consisted of a left hemi-colectomy. In other 5 cases, intussusception was ileal, requiring ileal resection. The average hospital stay was 11.7 days. Pathologically, the examination was normal in 2 cases. A colic tumor was found in 14 cases and an ileum tumor in 6 cases. In the other 8 cases, it was an inflammatory aspect of the intestine. Conclusion: In tropical Burkina Faso, adult intussusception often occurs on an intestinal tumor. The symptomatology is atypical.

Septic Chronic Multifocal Osteomyelitis in Children: A Challenging Presentation of Osteomylitis in a Low Income Country

Background: The aim of this study was to describe the clinical, biological and x-ray presentation of Septic Chronic Multifocal Osteomyelitis (SCMO) and discuss the therapeutic difficulties of this pathology in an African Sub-Saharan teaching hospital. Patients and Methods: A retrospective study was conducted in the Orthopedics and Trauma department of the university teaching hospital of Bobo-Dioulasso (Burkina Faso). Over a period of two years, we selected all cases of chronic osteomyelitis. We studied the epidemiological, diagnostic and therapeutic aspects of SCMO cases. Results: Eleven cases of SCMO were identified. The mean age of the patients was 11.8 years and the sex ratio was 1.75. There were 7 rural patients. The mean time to visit the hospital was 158 days. The most common reasons for consultation were pain (10 cases), swelling (9 cases), and fever (7 cases). Two were sickle cell patients. The most affected bones were the femur (10 cases), the tibia (9 cases) and the fibula (6 cases). The most frequent specific radiological lesions were sequestra (6 cases) followed by pandiaphysitis. Staphylococcus aureus was the most common aetiology. Treatment combined antibiotherapy and surgery (sequestrectomy and/or bone curettage and/or fistulectomy). Hip dislocations, pathological fractures and bone defect complicated the course of this disease. The therapeutic results was good in 3 patients and bad in 5 patients;the other 3 patients were lost to follow-up. Conclusion: Septic chronic multifocal osteomyelitis is a rare but formidable form of osteomyelitis in children. Therapeutic outcomes are often poor in hospitals with limited resources. The best strategy is prevention through early diagnosis and aggressive treatment of acute osteomyelitis.

Placental Abruption in the Obstetrics and Gynecology Service of Regional Hospital Center of Ouahigouya: Epidemiological, Clinical Ant and Therapeutic Aspects about 89 Cases Collected from 1^stJanuary 2013 to 31^stDecember 2015

Objective: To study epidemiological, clinical ant therapeutic aspects of placental abruption in the service of obstetrics and gynecology of regional hospital center of Ouahigouya. Methods: We conducted a cross-sectional study scheduled for 3 years, from 1st January 2013 to 31st December 2015. Data were collected from patients’ folder, theater register and maternity delivery register. Results: We recorded 5791 deliveries, out of which 89 were placental abruption cases giving a rate of 1.54% of deliveries. The women most affected were whose with age ranging 25 - 30 years (30.33%), the nulliparous women (32.58%), the married women (83.52%) and whose with bad antenatal clinic attendance (54.6%). The clinical aspect was most often complete: nil fetal heart rate (82.00%), hypertony uterine (79.90%) and vaginal bleeding (74.20%) were the most signs found. Spontaneous vaginal delivery has been made in 64.04%. Maternal prognosis was dominated by a morbidity linked by an anemia in 53.90%. Maternal lethality was 2.20%. Fetal newborn-death was 88.80%. Conclusion: Placental abruption represents an obstetrical and medical emergency by its start of brutal installation, its unforeseeable character and its materno-fetal consequences. Only a tacking of risk populations, precocious of diagnosis and a speed management in surgical and medical unit allow improving the prognosis of this disease.