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Aims: To identify the predictive factors and reduce the mortality of COVID-19 in the Tambacounda region. Materials and methods: An analytical cross-sectional study was conducted on confirmed COVID-19 individuals. Sampling was exhaustive with 303 cases. Data were collected by literature review, secondary data extraction and interviews. A data extraction form and an Epi Info®7.4.2.0 input mask were used. Medians, numbers, proportions were calculated and odds ratios were estimated. Statistical analysis was performed using Epi Info®7.2.4.0, SAS®9.4 and Excel®2019. Results: Of the confirmed cases, 58 (19.1%) were deceased. The median age was 59 years (43-69 years). The sex ratio (male to female) was 1.6. Factors independently associated with mortality in COVID-19 were diabetes (ORa=9.34, CI95% [2.15-40.63]); hypertension (ORa=6.51, CI95% [1.85- 22.93]); acute respiratory distress (ORa=6.22, CI95% [2.89-13.37]); male sex (ORa=6.44, CI95% [2.22- 18.65]) and age ≥ 60 years (ORa=2.62, CI95% [1.14-6.02]). Conclusion: Prevention strategies targeting diabetics, hypertensives, males, and those at least 60 years old would reduce mortality from COVID-19 in the Tambacounda region. [ABSTRACT FROM AUTHOR]

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Burns in diabetics are quite frequent and serious in relation to diabetic neuropathy, which is common in this population, delaying healing and predisposing to the risk of infection. The objective of this study was to describe the characteristics of burns in diabetics hospitalized at the CTB of Tunis over 18 months. During the study period, 891 patients were hospitalized, including 43 diabetics (5%). The average age of our patients was 57 years old with a male predominance (65%). Type 2 diabetes was present in 86% of cases and type 1 diabetes in 14% of cases. Degenerative complications were reported in 10 cases (23%), such as diabetic retinopathy (n=6), diabetic nephropathy (n=4) and diabetic neuropathy (n=6). The circumstances of burns were related to a domestic accident in 2/3 of the cases (76.7%). Thermal burns were involved in 83.7% of cases. 86% of the patients had decompensated their diabetes during their hospitalization. Sepsis marked the evolution of the patients in 55.8% of cases. In our study, poor prognostic factors were: a glycosylated haemoglobin >13%, an extent of burns greater than 20%, and a delay in consultation greater than 6 hours. The mortality rate was 18.6%. [ABSTRACT FROM AUTHOR]

Introduction. Il existe peu de recherches sur les décès liés à une intoxication aiguë due à une substance chez les aînés (60 ans et plus) au Canada. Cette étude vise à explorer et à décrire les caractéristiques sociodémographiques, les antécédents en matière de santé et les circonstances des décès en ce qui concerne les décès accidentels liés à une intoxication aiguë chez les aînés. Méthodologie. À la suite d'une analyse descriptive rétrospective de tous les dossiers des coroners et des médecins légistes sur les décès accidentels liés à une intoxication aiguë due à une substance chez les aînés au Canada de 2016 à 2017, les pourcentages de décès et les taux de mortalité issus des données des coroners et des médecins légistes ont été comparés aux données sur les aînés de la population générale tirées du recensement de 2016. Dans la mesure du possible, nous avons réalisé des tests du chi carré pour les variables nominales. Résultats. En 2016 et 2017, 705 décès accidentels liés à une intoxication aiguë chez les aînés ont été documentés. Dans 61 % des cas, ce sont plusieurs substances qui ont contribué au décès. Le fentanyl, la cocaïne et l'éthanol (alcool) sont les substances les plus souvent en cause. Les maladies du coeur (33 %), la douleur chronique (27 %) et la dépression (26 %) ont souvent été documentées. Environ 84 % des aînés avaient pris contact avec des services de soins de santé au cours de l'année précédant leur décès. Le décès a eu lieu en présence d'un témoin dans 14 % des cas seulement. Conclusion. Nos constatations permettent de mettre en lumière les facteurs sociodémographiques, contextuels et les antécédents médicaux pouvant avoir une incidence sur les décès liés à une intoxication aiguë due à une substance chez les aînés et d'ainsi proposer des aires clés de prévention. [ABSTRACT FROM AUTHOR]

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Introduction: to help reduce neonatal mortality in Burkina Faso, we identified the prognostic factors for neonatal mortality at the Sourô Sanou University Hospital. Methods: we conducted a cross-sectional and analytical study in the neonatal department from July 25, 2019 to June 25, 2020. Patients' medical records, consultation and hospital records were reviewed. Prognostic factors for neonatal mortality were identified using a Cox model. Results: data from 1128 newborn babies were analysed. Neonatal mortality was 29.8%. Most of these deaths (89%) occurred in the early neonatal period. The mean weight of newborns at the admission was 2,285.8 ± 878.7 and 43.6%. They were at a healthy weight. Four out of five newborns had been hospitalized for infection or prematurity. The place of delivery (HR weight <1000g = 5.45[3.81 -7.79]) and the principal diagnosis (HR asphyxiation= 1.64[1.30-2.08]) were prognostic factors for neonatal mortality. Conclusion: improving technical facilities for the etiological investigation of infections and an efficient management of low-weight newborns suffering from respiratory distress would considerably reduce in-hospital neonatal mortality in Bobo-Dioulasso. [ABSTRACT FROM AUTHOR]

Objectives: to study risk factors for mortality in SAM children within the first 72 hours of hospitalization. Methods: We conducted a retrospective study on data from 0-59-month-old SAM children hospitalized from June 1th, 2016, to May 31th, 2019, at CHUSourô Sanou of Bobo-Dioulasso. A logistic regression was performed to determine risk factors for death. Variables with odds ratio (OR) > 1, and p <0.05 were predictors of death. Results: Of 646 SAMs included, most were 12-23-monthyearold (34.83%). Death rate was 19.04%. Deep coma [OR :27.2, 95%IC: 9.62-91.1], OAP [OR :16.3, 95%IC: 1.58-383], Signs of in particular low pulse volume [OR :5.45, 95%IC: 1.74-17. 1], cold extremities [OR :4.66, 95%IC: 1.03-20.8], capillary refilling time (CRT) >3seconds [OR :3.55, 95%IC: 1.50-8.27], sepsis[OR :3.39, 95%IC: 1.33-8.50]were the risk factors predictive of mortality. Conclusion: Training and ongoing supervision of healthcare staff in the management of paediatric emergencies, the use of the WHO SAM management protocol and the availability of emergency kits could improve SAM management. [ABSTRACT FROM AUTHOR]

Extremely low birth weight infants are a public health problem in developing countries. The objective of this study was to evaluate the prognosis of extremely low birth weight newborns hospitalized at Saint Camille Hospital in Ouagadougou (HOSCO). Method: This was a descriptive and analytical study with retrospective data collection on newborns with birth weight <1000g, in the neonatology department from January 2017 to December 2021. Results: A total of 319 newborns were admitted giving a hospital frequency of 8.62%. Male sex was predominant with a sex ratio of 1.02. The mean age was 0.18 ± 0.71 days. The main signs on admission were hypothermia 88.40% and respiratory distress 92.16%. The evolution was marked by 92.79% of deaths of which 90.20% occurred during the early neonatal period. Hypothermia, birth outside HOSCO and maternal age less than 20 years were the factors associated with mortality. Conclusion: The management of low birth weight remains difficult because of the very limited resources in our countries. Simple and inexpensive interventions can considerably improve the survival of these newborns. [ABSTRACT FROM AUTHOR]

Liver transplantation has become the treatment of choice to increase survival and quality of life of patients with end-stage chronic liver disease, acute liver failure and other liver diseases including hepatocellular carcinoma without any other effective curative therapeutic option. Advances in immunosuppressive therapy, improved surgical expertise, and early diagnosis and management of complications after liver transplantation have led to a gradual improvement in survival rates, especially in the short and medium term, however the long-term survival rate, after 10 years, remains stable since two decades, around 60%. Long-term survivors are at increased risk of morbidity due to other than classic complications of transplantation such as graft dysfunction, rejection, or recurrence of liver disease. De novo malignancies, metabolic disorders, cardiovascular diseases and renal failure have emerged as causes of late death after liver transplantation. Long-term post-transplant care is complex and requires specialized and regular follow-up to detect, treat and prevent the above-mentioned complications. [ABSTRACT FROM AUTHOR]

Many questions remain unanswered regarding the so-called “Spanish” influenza pandemic of 1918. This article addresses three of them and describes the state of knowledge for each of them: Where did the pandemic start? How many people died? And why was it so deadly?

Au Congo, la nécessité d’un cadre juridique protecteur de la femme enceinte est une préoccupation. En effet, le risque que court une femme de mourir ou de devenir invalide durant la grossesse et l’accouchement est en rapport étroit avec son statut social et économique, les normes et valeurs de la culture à laquelle elle appartient et le fait de résider dans un lieu géographique reculé. De manière générale, plus une femme est pauvre et marginalisée, plus son risque de mourir est grand. En fait, les taux de mortalité maternelle reflètent les inégalités entre pays riches et pays pauvres dont fait partie le Congo, plus qu’aucune autre mesure d’ordre sanitaire. Ici, le risque d’une femme, calculé sur la durée de vie, de mourir du fait de la grossesse ou de l’accouchement est de 1 sur 39 contre 1 sur 4 700 dans les pays développés.

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Aims: To describe the clinical and evolutionary aspects of the primary closure of exstrophy at the CHU Gabriel Touré. Materials and Methods: This was a retrospective and prospective study carried out from January 2014 to December 2019 in all the children admitted and operated on for bladder exstrophy at the CHU Gabriel Touré. Results: We collected 35 cases of exstrophy, ie25 boys and 10 girls. The mean age at diagnosis was 4.8 months. The bladder plate was both normal and budded, ie 28.6% of cases. Plaque infection was found in 45.7%. A malformation was associated in 34.3% of cases. Primary plaque closure was achieved in all of our patients. Postoperative morbidity was 28.6% of cases and mortality 11.4% of cases. Conclusion: Bladder exstrophy is a rare malformation of the urogenital sphere, its management is complex and its mortality is not null. [ABSTRACT FROM AUTHOR]

Many questions remain unanswered regarding the so-called "Spanish" influenza pandemic of 1918. This article addresses three of them and describes the state of knowledge for each of them: Where did the pandemic start? How many people died? And why was it so deadly?. [ABSTRACT FROM AUTHOR]

Contexte : Malgré les premiers rapports sur les déterminants sociaux de l’infection par le coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) et de la maladie à coronavirus 2019 (COVID-19), les analyses sur les inégalités attribuables à la COVID-19 au niveau national ont été limitées. L’objectif de cette étude est de décrire les inégalités en matière des décès attribuables à la COVID-19 au Canada en utilisant des données préliminaires obtenues dans le cadre de l’Initiative pancanadienne sur les inégalités en santé. Méthodes : Deux intégrations des données provisoires de la Base canadienne de données sur les décès de la Statistique de l’état civil ont été utilisées. Les données sur les décès survenus entre le 1er janvier et le 4 juillet 2020 parmi les résidents de logements privés ont été liées aux données, au niveau individuel, provenant du questionnaire abrégé du Recensement de 2016. Cette intégration a permis de ventiler les données de mortalité selon le sexe et la situation de faible revenu, le type de logement, le type de ménage et la taille du ménage. Les données sur les décès survenus entre le 1er janvier et le 31 août 2020 ont été liées aux données du Profil de Recensement au niveau local, du Recensement de 2016. Cette intégration de données a permis de ventiler des données de mortalité selon le sexe et les caractéristiques des quartiers, dont les ont été ventilées par sexe et par quintiles de composition ethnoculturelle (déterminés en fonction de la proportion de personnes ayant immigré récemment, appartenant à une minorité visible, étant nées à l’extérieur du Canada, ne connaissant ni l’anglais ni le français), par quintiles du revenu et par résidence dans une région métropolitaine. Les différences et les ratios des taux de mortalité liée à la COVID-19 normalisés selon l’âge (pour 100 000 habitants) entre groupes ont été estimés. Résultats : En juillet/août 2020, les résidents d’appartement, des grands centres urbains, des quartiers ayant la plus forte concentration de composition ethnoculturelle ou des quartiers ayant les plus faibles revenus ont connu 14 à 30 décès liés à la COVID-19 pour 100 000 habitants de plus comparativement aux groupes de référence (résidents d’une maison individuelle non attenante, ceux qui se trouvent en dehors des centres urbains, ceux résidant dans des quartiers avec la concentration de composition ethnoculturelle la plus faible ou ceux détenant les revenus les plus élevés, respectivement). Les inégalités entre les sexes étaient également plus importantes dans ces quatre groupes (11 à 18 décès chez les hommes de plus que chez les femmes pour 100 000 habitants) que dans les groupes de référence (2 à 4 décès chez les hommes de plus que chez les femmes pour 100 000 habitants). Conclusion : Ces résultats reflètent le fardeau global de mortalité plus élevé que subissent les populations défavorisées au niveau socioéconomique. Les domaines d’études futures sont abordés dans l’optique de guider une réponse à la pandémie axée sur l’équité en santé.

Copyright of LHB: Hydroscience Journal is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To analyze the main causes and risk factors of death in intensive care. Patients and method: Prospective observational study in the intensive care units in Hospital Principal of Dakar from July to December 2018 including all patients who died 24 hours after admission. Demographic, clinical, severity (IGSII, APACHE II, MPM) and organ failure (SOFA, LODS) scores were collected.A multiparametric comparison was made between deceased and surviving patients. Results: The overall mortality was 25.86% correlated with the probability of death (MPM): 26.4%. The mean age was 50.98 [8-94 years] with a sex ratio of 1.15. The majority of deaths (79.26%) occurred outside of duty hours and 70.7% had at least one medical history. The mean severity scores were for IGSII 40.12 +/- 17.25 and for APACHE II 18.31 +/- 8.49. The mean visceral failure scores were for SOFA 7.02 +/- 4.44 and for LODS 5.73 +/- 3.35. Complications were dominated by nosocomial infections (48.78%) and are responsible for 37.8% of deaths. The mean length of stay was 7.30 days +/- 7.46. Age, the existence of organ failure, the use of vasopressors, the occurrence of nosocomial infections and the absence of a senior doctor were correlated with mortality. Conclusion: The intensive care unit mortality rate is 25.86%. Advanced age, the existence of organ failures and the occurrence of a nosocomial infection are factors in the occurrence of death. [ABSTRACT FROM AUTHOR]

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Affichée comme une priorité de la gestion du risque d’inondation, la sécurité des populations est rarement évaluée dans les bilans des catastrophes naturelles en France. Plus que les bilans humains, ce sont les dommages socio-économiques qui sont mis en avant comme indicateurs de la prévention. Cet article présente un recueil de données sur les décès liés aux inondations dans le sud de la France (BD Vict-In). 328 victimes ont étérecensées entre 1980 et 2020. L’article présente le profil des personnes décédées et une analyse des circonstances et des lieux de décès. Il ressort que les victimes sont majoritairement des hommes (61%) de la classe d’âge 40-70 ans. 35% des décès sont liés à l’automobile et 31 % ont lieu au domicile. Parmi les comportements dangereux, le franchissement de cours d’eau en véhicule ou à pied (50 cas recensés) ou les refus d’évacuation (24 cas) sont les plus représentés. 29 décès ont eu lieu dans des campings. La cartographie du taux de mortalité montre la forte exposition des arrière-pays méditerranéens qui associent fréquence des épisodes pluvieux, fortes pentes et urbanisation croissante. L’évolution temporelle montre une diminution du nombre de décès par événement mais une augmentation du nombre d’inondations meurtrières.

Introduction: the purpose of this study was to describe the clinical and epidemiological features of COVID-19-related deaths in Tunisia notified at the ONMNE (National Observatory of New and emerging Diseases) between 2nd March 2020 and 28th February 2021 and to compare COVID-19-related deaths recorded in Tunisia with the international data. Methods: we conducted a national prospective longitudinal descriptive study of data collected from the National Surveillance System of SARS-CoV-2 infection of the ONMNE, Ministry of Health. All COVID-19-related deaths that occurred in Tunisia between March 2020 and February 2021 were included in this study. Data were collected from hospitals, municipalities and regional health departments. Death notifications were collected from multiple data sources (triangulation): The Regional Directorate of Basic Health Care, the ShocRoom (Strategic Health Operations Center), public and private health facilities, the Crisis Unit of the Presidency of the Government, the Directorate for Hygiene and Environmental Protection, the Ministry of Local Affairs and the Environment, as part of the followup of confirmed cases by the ONMNE team, positive RT-PCR / TDR post mortem results. Results: during this study, 8051 deaths were recorded, corresponding to a proportional mortality of 10.4%. The median age was 73 years, with an interquartile range of 17 years. Sex-ratio (M/F) was 1.8. The crude death rate was 69.1/100 000 inhabitants and fatality rate was 3.5%. The analysis of the epidemic curve showed 2 peaks of deaths on 29th October 2020 and 22nd January 2021, with 70 and 86 deaths notified respectively. The spatial distribution of mortality showed that the southern Tunisian region had the highest mortality rate. Patients aged 65 and over were most affected (73.7% of cases) with a crude mortality rate of 570.9/100,000 inhabitants and a fatality rate of 13.7%. Conclusion: prevention strategy based on public health measures must be reinforced by the rapid deployment of anti-COVID-19 vaccination, especially for people at risk of death. [ABSTRACT FROM AUTHOR]

Copyright of Algerian Journal of Arid Environment (AJAE) is the property of University of Kasdi Merbah Ouargla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The prognosis of cerebral venous thrombosis (CVT) is much better than that of cerebral artery (CAI) infarct. The purpose of this study is to describe intra-hospital and three-month outcomes of patients with CVT in the Department of Neurology of Befelatanana as well as the role of anticoagulants in the management of patients with CVT, without and with haemorrhagic suffusion. We conducted a retrospective cohort study of patients with CVT from January 01, 2014 to December 31, 2019 (72 months). Patients' clinical characteristics and their intra-hospital and three-month outcomes data were collected. Data were analyzed using the R software, by comparing data of patients with CVT, with and without haemorrhagic suffusion and with a significant p = 0.05. We recorded 21/4227 (0.49%) cases of CVT, of whom 11 (52.38%) had CVT with haemorrhagic suffusion. The average age of patients was 38.05 years. The age group 18-34 years (47.62%) was most represented. Women were the predominant gender (76.19%; n=16). On admission, NIHSS score < 10 was found in 85.71% of patients (n=18) and mRS score < 3 was found in 61.90% of patients (n=13). All patients were receiving anticoagulants. Upon discharge from hospital, NIHSS score < 10 was stable (90.47% (n=19)) with an increase in patient with mRS score < 3 (85.71% (n=18)), of whom 3 were in the haemorrhagic suffusion group. The average hospital stay was 16.04 days. One patient in the group without haemorrhagic suffusion died during hospitalisation. At 3 months after discharge, only 9 patients were reachable. Their neurological status improved (NIHSS score < 10 in 100% (n=9) of patients, mRS score= 0 in 88.89% (n=8) of patients). No statistically significant differences were found between the two groups in terms of disability (p=0.757), with a relative risk (RR) of 0.91 CI [0.04; 6.55] and of death (p=0.282) (0 deaths in a group) between the two groups receiving and not receiving anticoagulants. Mortality and disability in patients receiving anticoagulants during the evolution of CVT are very low. The availability of a low-cost brain CT angiography could allow better management of CVT in our Neurology Department. [ABSTRACT FROM AUTHOR]

Résumé: Le SARS-CoV-2, responsable de l'épidémie de Covid-19, de par sa contagiosité et sa mortalité chez les patients les plus vulnérables et les plus âgés a conduit à la mise en place de mesures de prévention majeures avec l'instauration d'un confinement national en France le 17 mars 2020 afin de limiter la propagation du virus et en particulier au sein des Ehpad. Ces mesures qui visaient principalement la limitation de la transmission de la Covid-19 au sein de ces établissements ont aussi pu avoir des conséquences indirectes. Quel fut l'impact sur la mortalité ? SARS-Cov-2, responsible for the Covid-19 epidemic, due to its contagiousness and its mortality in the most vulnerable and oldest patients has led to the implementation of major preventive measures with the establishment national confinement in France on March 17, 2020, in order to limit the spread of the virus and in particular within nursing homes. These measures, which were mainly aimed at limiting the transmission of Covid-19 within these establishments, may also have had indirect consequences. What was the impact on mortality? [ABSTRACT FROM AUTHOR]

Introduction: Pericarditis is a commun cause of hospitalisation in cardiology and internal medicine wards. Objective: We aimed to describe the epidemiological profile of effusive pericarditis at the Department of cardiology of the National Referral Teaching Hospital of N'Djamena, Chad. Methods: We undertook a descriptive cross-sectional study from January 2017 to December 2019. Patients presenting with effusive pericarditis and who consent to participate were consecutively enrolled during the study period. Results: Overall, 1805 patients were hospitalized at the department of cardiology during the study period with effusive pericarditis accounting for 4.3% of all cases (n = 78). Patients' mean age was 35.84 ± 14 years, [range 16 and 73 years]. The sex ratio was 0.89. Exertional dyspnea, chest pain, poor general condition and fever were main symptoms reported in 90%, 89%, 81% and 51% of the cases respectively. Pericardial rub was found in 51% of the study patients. Eighteen patients (26%) were HIV positive and 97% of the study patients had cardiomegaly. ECG demonstrated low QRS voltage (97%) and diffuse abnormalities of repolarisation (96%). Pericardial effusion was found abundant in 57% of the cases. Etiologies of effusive pericarditis were mainly tuberculosis (47%), idiopathic (21%) and HIV infection (13%). Thirty patients (43%) benefited from pericardiocentesis. The in-hospital mortality rate of the disease was 17%. Conclusion: Effusive pericarditis is frequent and associated with poor outcome. Treatment depends on etiology dominated by tuberculosis in Chad. [ABSTRACT FROM AUTHOR]

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Aims/Objectives/Assumption: In Mali, malaria is the leading cause of death and consultations in health facilities. The objective of this study was to examine trends in morbidity and mortality among children aged 0 to 15 years and to establish accurate mapping of the distribution of cases in health areas of the Sélingué health district. Materials and method: A retrospective analysis of hospital records at the Sélingué district reference health center from 2010 to 2013 was conducted. Trend Chi2 and logistic regression were used, respectively, to compare changes in trends between health areas and to identify risk factors associated with malaria mortality. Results: Among the 1282 cases of malaria, the incidence of severe malaria gradually decreased from 96.75 ‰ (671 cases) in 2010 to 34.23 ‰ (291 cases) in 2011, 19.76 ‰ (168 cases) in 2012 and 19.43 ‰ (152 cases) in 2013. From 2010 to 2013, there was an average monthly variation in October of 26, 6% cerebralmalaria and 23.3% malaria anemia by the month of July of the same year. Spatial variation of anemic forms of malaria between health areas (p < 0.001) was observed from 2010 to 2013. From 2012 to 2013, there was an overall decrease in the frequency of hospitalizations, incidence and death rate for severe malaria. In multivariate analysis, in the final model, malaria lethality was associated with the duration of hospitalization for more than three days (OR = 0.124); the year of hospitalization from 2010 to 2012 (OR = 0.813); the absence of blood transfusion of the patient (OR = 0.282); at the age of the patient in children under one year (OR = 0.356) and at the emergency anti-malarial treatment instituted with artemether (OR = 3.006) adjusting for the form of malaria. On the other hand, malaria lethality was not related to the form of malaria (p = 0.072), sex (p = 0.390), residence (p = 0.308), prior treatment before hospitalization (p = 0.949). at fever in children (p = 0.153) adjusting for other variables in the model. Conclusion : Hospital case fatality remains high with a drop in the incidence of morbidity and mortality; a monthly variation in morbidity and mortality with two peaks, July - August and October- November and the emergency treatment instituted with artemether, the length of hospital stay could be identified as associated factors. [ABSTRACT FROM AUTHOR]

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Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The early neonatal mortality rate is a good indicator of the quality of care and the level of economic and social development of a population. The purpose of this work was to determine the prevalence, etiological profile, and risk factors of early neonatal mortality. Methods: It was a retrospective descriptive study conducted in the neonatal medicine and resuscitation department of the maternity and neonatal center of Tunis over a period of 9 months from January to September 2017. During this period 3,560 newborns were hospitalized in the neonatal resuscitation department. Among them 150 early neonatal deaths occurred. Results: The incidence of early neonatal mortality was 15 per 1000 live births. The very early neonatal mortality rate occurring during the first 24 hours of life was 15%. Sixty percent died after 48 hours of life. The rate of premature babies was 68%. The leading causes of early neonatal deaths were an infectious cause in 38.6% of cases with a maternal-fetal infection in 25% of cases and healthcare-associated infections in 14% of cases, congenital malformations in 18.7% of cases, and perinatal asphyxia in 12.7% of cases. The main risk factors for early neonatal mortality were unregulated pregnancies, socio-economic status, prematurity, low birth weight, perinatal asphyxia, cardiac malformations and central nervous system malformations. Conclusion: Early neonatal mortality is still high. To try to reduce it we insist on the monitoring of pregnancies, the prevention of prematurity and the improvement of the neonatal infrastructures. [ABSTRACT FROM AUTHOR]

Nosocomial bacteremia (NB) is one of the most severe infections in burns in intensive care units. Their prognosis is worsened with the emergence and spread of multidrug resistant bacteria (MDR). Our retrospective study aimed to investigate clinical and bacteriological characteristics of NB occurring in patients hospitalized in the Trauma and Burn Center's Burn Unit (TBC-BU) in Tunisia, during a 3-year period (2016-2018). We found 261 NB in 216 patients, for a prevalence of 25.7% and an incidence density of 13.4‰ days of in-patient stay. The vast majority (88.9%) of NB occurred during the first 2 weeks of hospitalization. The catheterrelated bacteremia rate was 11.1%. P. æruginosa (20.2%) and A. baumannii (16.8%) were the 2 species most frequently isolated when S. aureus represented only 7.5% of isolates. Resistance rates were high, with 71% of P. æruginosa resistant to ceftazidime, 64% of S. aureus being MRSA, 69,5% of resistance to 3rd generation cephalosporins among Enterobacteriaceae, and colimycin remaining the only regularly active antibiotic (98%) on A. baumannii. The MDR rate was 44%, represented mainly by A. baumannii, ESBL-E and P. æruginosa. The mortality rate due to NB was 25%, with a significantly higher rate of MDR in fatal NB compared to that in NB with favorable outcome (p = 0,000019). [ABSTRACT FROM AUTHOR]

Copyright of Population & Sociétés is the property of Institut National d'Etudes Demographiques and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the absence of interventional endoscopy the treatment of upper digestive hemorrhage a the brazzaville university hospital is only medicinal. Objective of this work was to identify risk factors for upper gastrointestinal bleeding by conducting a retrospective case-type study conducted over a period of 2 years. The 180 patients included for upper digestive hemorrhage were divided into 2 groups accordind to their progressive modality: deceaded patients (cases) and non-deceased patients (controls). Risk factors for mortality were studied by logistic regression. The mortality linked to upper gastrointestinal bleedind was 36.6%, the risk factors for death were age between 30 and 60 with an OR of 9.79; male (OR of 2.03); late hospitalization over 24 hours (OR of 6.30); blood transfusions (OR of 3.5). The protective factors were hemoglobin greater 7 g/dL (OR of 0.28); treatment by proton pump inhibitors (OR of 0.36). In conclusion, reducing the still high mortalty rate in our country requires taking into account the identified risque factors and aquiring endoscopic hemostasis equipement. [ABSTRACT FROM AUTHOR]

Introduction: The "Programme d'Accompagnement du retour à Domicile" (PRADO) COPD is a home discharge support program dedicated to organizing care pathways following hospitalization for COPD exacerbation. This study aimed at assessing its medico-economic impact., Methods: This was a retrospective database study of patients included in the PRADO BPCO between 2017 and 2019. Data were extracted from the National Health Data System. A control group was built using propensity score matching. Morbi-mortality and costs (national health insurance perspective) were measured during the year following hospitalization., Results: While the proportion of patients with a care pathway complying with recommendations from the National Health Authority was higher in the PRADO group, there was no significant effect on mortality and 12-month rehospitalization. In the PRADO group, the rehospitalization rate was lower when the care pathway was optimal. Healthcare costs per patient were 670 € higher in the PRADO group., Conclusions: The PRADO COPD improves quality of care but without decreasing rehospitalizations and mortality, although rehospitalizations did decrease among PRADO group patients benefiting from an optimal care pathway., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Objectif : déterminer les facteurs associés aux décès chez les patients atteints de tétanos, hospitalisés au service des Maladies Infectieuses du CHU du Point-G. Matériels et méthode : il s'agit d'une étude rétro-prospective chez les malades atteints de tétanos, hospitalisés dans le service de Maladies Infectieuses du CHU du Point G de janvier 2013 à avril 2015. Les dossiers de tous les cas de tétanos âgés de 18 ans et plus répondant aux critères d'inclusion ont été inclus. Les données ont été saisies sur Word et analysées sous le logiciel SPSS. Le test X² a été utilisé pour la comparaison des variables qualitatives avec un seuil de significativité p≤0,05. Résultats : trente-cinq cas de tétanos ont été colligés sur 972 hospitalisations soit une prévalence de 3,6%. La totalité des patients était des hommes. Aucun patient n'avait un calendrier vaccinal à jour. La majorité des portes d'entrée tégumentaires était causée par des accidents de la voie publique (soit 31,7%). Les cultivateurs étaient les plus exposés avec 37,1%. Les comorbidités (15 cas) étaient le paludisme, l'hypertension artérielle et le diabète avec respectivement 53,3% ; 33,3% ; et 13,3%. La létalité du tétanos était de 25,7%. Les facteurs associés de façon significative à la mortalité était l'hypertension artérielle, les complications pulmonaires et les fausses routes. Conclusion : Cette étude montre que les comorbidités et les complications ont majoré la létalité du tétanos. La prise en charge rapide et correcte des complications et des comorbidités pourra avoir un impact positif sur le pronostic des patients atteints de tétanos.

L’objectif de l’étude a été de caractériser les performances reproductives (fertilité, prolificité, mortalités) et pondérales des lapines de la souche synthétique algérienne « ITELV 2006 », conduites en insémination artificielle (IA) avec un rythme semi-intensif (intervalle mise bas – IA de 12 jours). Durant deux années consécutives (2017 et 2018), un suivi de la conduite de reproduction de 73 lapines, faisant l’objet de 327 IA, a été mené à l’animalerie de l’Université de Chlef (Algérie). Durant la durée de l’étude, les IA ont été réalisées à partir d’une semence récoltée chez des mâles du même type génétique et analysée localement. Les données relatives à l’IA, à la palpation, à la mise bas et au sevrage ont été enregistrées pour l’ensemble des femelles. L’effet de la saison sur les critères de poids et les performances de reproduction des lapins a été analysé. Toutes les données ont été soumises à une analyse de variance. Les femelles ont montré une bonne prolificité de 9,5 ± 2,4 nés totaux dont 8,4 ± 2,9 nés vivants par mise bas et 7,4 ± 2,6 sevrés par sevrage, avec des taux de fertilité de 85,6 ± 35,1 % à la palpation et 69,7 ± 45,9 % à la mise bas. Le poids adulte des femelles à l’IA était de 3584 ± 391 g. Le lapereau pesait en moyenne 63 ± 13 g à la naissance et 490 ± 81 g au sevrage. Un effet très significatif de la saison a été enregistré sur la fertilité et la prolificité des lapines, et sur le poids et la mortinatalité des lapereaux avec les plus faibles valeurs enregistrées en saison chaude (63 % de fertilité). Cependant, les femelles sont restées productives durant cette période de grande chaleur.

La section traumatique du cholédoque est un phénomène extrêmement rare surtout lorsqu´elle est isolée. Habituellement, elle survient suite à une chirurgie des voies biliaires notamment laparoscopique. Cette lésion est souvent associée à une ou plusieurs lésions des organes de voisinage. Nous rapportons un cas de section isolée du cholédoque suite à un traumatisme abdominal chez un enfant âgé de 5 ans pris en charge dans notre service au Centre Hospitalier Mère et Enfant de Nouakchott. L´exploration radiologique n´était concluante. Une laparotomie exploratrice faite devant un tableau chirurgical a révélé une péritonite généralisée d´origine biliaire secondaire à une plaie du bas cholédoque. Le traitement d´urgence était une toilette avec une dérivation biliaire externe suivie à un mois après par une dérivation bilio-digestive. La complication la plus redoutable de section de cholédoque est la péritonite biliaire. La morbidité postopératoire précoce est de l´ordre de 20 à 30% dans la littérature alors que la mortalité est de 0 à 2%. La section traumatique isolée du cholédoque chez l´enfant est une lésion dont le tableau clinique et la conduite thérapeutique doivent être connus afin de diminuer la morbi-mortalité. La prise charge doit être multidisciplinaire impliquant le chirurgien pédiatre, le radiologue et le réanimateur anesthésiste.

INTRODUCTION: l´accident vasculaire cérébral (AVC) constitue un problème majeur de santé publique, tant par le nombre de personnes atteintes, que par ses conséquences médicales, sociales et économiques. L´objectif était de dégager les facteurs de mauvais pronostic vital à la phase aiguë de l´AVC artériel. METHODES: il s´agit d´une étude prospective durant quatre mois portant sur les patients présentant une symptomatologie évocatrice d´AVC aux deux CHU de Sfax, Tunisie. Le suivi a été de un mois. RESULTATS: nous avons colligé 200 patients. Après un mois de suivi, la mortalité était de 19,9%. Les facteurs de mauvais pronostic vital étaient: le sexe masculin, la consommation de tabac, l´antécédent d´AVC, le score de Glasgow bas, le NIHSS élevé, les céphalées, les crises épileptiques symptomatiques aiguës, le signe de Babinski, la mydriase, l´aphasie, la déviation conjuguée de la tête et des yeux, les chiffres élevés de pression artérielle systolique (PAS), pression artérielle diastolique (PAD) et pression artérielle pulmonaire (PAP), l´hyperthermie, l´hyperglycémie, l´hyperleucocytose, l´augmentation des CRP, créatinine, urée et la troponine Tc, la nature hémorragique de l´AVC, l´œdème péri lésionnel, l´effet de masse, l´engagement, la topographie sylvienne totale de l´ischémie, la présence de signes précoces d´ischémie, l´hémorragie méningée, l´inondation ventriculaire, l´hydrocéphalie, le recours à une assistance respiratoire, au traitement anti-œdémateux et antihypertenseur, la transformation hémorragique, l´épilepsie vasculaire, les complications infectieuses, métaboliques et de décubitus. CONCLUSION: l´identification des facteurs prédictifs du devenir vital permet d´optimiser les procédures thérapeutiques et mieux organiser les filières de prise en charge. Une étude comparative sera envisagée afin de mesurer l´impact des mesures correctives.

La néphrologie au Burkina Faso est confrontée à de nombreux défis dont l'insuffisance de données épidémiologiques. But: Notre étude a pour but de décrire les caractéristiques épidémiologiques et cliniques des patients en hémodialyse chronique dans un nouveau centre. Méthode: Il s'est agi d'une étude transversale, descriptive, monocentrique, menée dans l'unité d'hémodialyse du CHU de Tengandogo du 1er février 2018 au 31 janvier 2019. Résultats: Nous avons enregistré 94 patients pris en charge en hémodialyse pour insuffisance rénale chronique terminale, dont 63 patients incidents en hémodialyse contre 31 patients qui nous ont été transféré à partir d'autres centres. L'âge moyen était de 43,7 ans [4-85 ans]. L'âge moyen de mise en hémodialyse était de 42,5 ans [4-85 ans]. La durée moyenne en dialyse était de 1,2 ans [0-12 ans]. Le sexe ratio était de 2,48. La principale comorbidité était l'hypertension artérielle avec 63.8%. Dans 43,6% des cas, la cause de la maladie rénale chronique n'a pas pu être déterminée. La néphropathie vasculaire d'origine hypertensive et la glomérulonéphrite chroniqueétaient retrouvés respectivement avec 27,6% et 12,7%. Le taux de mortalité étaitde 23,4 pour cent personnes années. Dans 82% des cas, le décès est survenu dans le premier mois suivant la mise en hémodialyse. Le jeune âge, les difficultés de diagnostic, le taux de mortalité élevé, révèlent les insuffisances de notre système sanitaireet affectent négativement le développement socio-économique. Conclusion: Ces données montrent la nécessité de la mise en place d'un programme de prévention des maladies rénales. [ABSTRACT FROM AUTHOR]

Hypoalbuminemia as seen in major burn injury results in widespread endothelial dysfunction. Base deficit provides the best estimate for degree of tissue anoxia. Acute blood loss describes anemia present in burn patients. Controversy focuses on the administration of protein-based colloids: whether to provide them, which solutions to use, and when to begin? The aim of this study was to determine whether alteration of gas exchange, excess base deficit, hypoalbuminemia and anemia could predict mortality in major burn patients, whether to provide protein-based colloids, and when to begin fluid resuscitation. The prospective study included 42 major burn patients. All the patients were admitted to the burn intensive care unit at Menoufia University Hospital. Serum albumin level, hemoglobin concentration, arterial blood gases and base deficit were measured at admission, third day and after one week. Average serum albumin on admission was 3.33 ± 0.44, after 3 days 2.85 ± 0.54 and after 1 week 2.46 ± 0.67 gm./dL, while hemoglobin concentration was 14.79 ± 2.13, 12.25 ± 1.99, and 10.24 ± 2.47 gm./dl respectively. However, base deficit was 5.75 ± 2.40, 5.24 ± 2.05 and 5.45 ± 2.76 respectively, with significant statistical difference (p<0.001) between the death and survivor groups. Binary logistic regression analysis for independent predictors of mortality declared that base deficit, albumin and hemoglobin serum levels were independent predictors for mortality with an odds ratio of 2.23, 95% CI, 1.66-16.75 for base deficit, 3.56, 95% CI, 1.88-12.59 for albumin and 2.21, 95% CI, 1.56-13.54 for hemoglobin. Hypoalbuminemia, anemia and excess base deficit can be used as prognostic factors for mortality in major burn patients. [ABSTRACT FROM AUTHOR]

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Population (00324663) is the property of Institut National d'Etudes Demographiques and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Population (00324663) is the property of Institut National d'Etudes Demographiques and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Our objective was to describe the surgical neonatal visceral emergencies (SNVE) morbidity and mortality in the paediatric surgery department of the National Hospital of Lamordé in Niamey, Niger. It was an observational, prospective and descriptive study conducted over 2 years (from 1 March 2014 to 29 February 2016). Data included age at admission and sex of newborns, patient and familial medical history, diagnostic, therapeutic, and evolutive aspects of conditions. Chi-square and Student's t tests were used to compare the data of deceased and living patients. A value of p< 0.05 was considered statistically significant. SNVE accounted for 12.8 % of admissions (n = 106). The mean patient age at admission was 5.8 days (range, 0-28 days). Male predominance was observed (n = 69, 6 %). The mean birthweight was 3000 g (range, 1700-4200 g). Omphalocoele (n = 36, 33.9 %) and anorectal malformations (n = 32, 30.1 %) were the most common pathologies. Surgery was performed for 58 patients (54.7 %). The morbidity rate was 34.5 % (n = 20). The overall and postoperative mortality rates were 46.2 % (n = 49) and 46.5 % (n = 27), respectively. Septicaemia was the most common cause of death (n = 27, 55.1 %). Factors determining mortality were prematurity (P = 0.0427), low birthweight (P = 0.0185), anaemia (P = 0.0233), leucopaenia (P = 0.0004), and morbidity (P = 0.0016). Surgical neonatal visceral emergencies are frequent. Their mortality was high and favorised by prematurity, low birthweight, anaemia, leucopaenia. An antenatal and early perinatal management would improve the outcome of neonatal visceral emergencies. [ABSTRACT FROM AUTHOR]

Traumatic injury of the common bile duct is extremely rare, especially when it is isolated. It usually occurs after laparoscopic biliary tract surgery. This lesion is often associated with one or multiple lesions of the neighborhood organs. We report a case of isolated injury of the common bile duct following abdominal trauma in a 5-year old child treated in our Department at the Mother-Child Hospital in Nouakchott. Radiological exploration didn't provide a conclusive diagnosis. Exploratory laparoscopy was performed because surgery had revealed diffuse biliary peritonitis secondary to a lesion at the bottom of the common bile duct. Emergency treatment was based on lavage with external biliary drainage followed, after a month, by bilio-digestive anastomosis. Life-threatening complication of common bile duct injuries is biliary peritonitis. In the literature, early postoperative morbidity is 20-30% while mortality rate is 0-2%. Isolated traumatic injury of the common bile duct in children is a lesion whose clinical course and therapy should be known in order to decrease morbi-mortality. Treatment is based on a multidisciplinary approach involving the pediatric surgeon, the radiologist and the resuscitating anaesthesiologist. [ABSTRACT FROM AUTHOR]

Introduction: cerebrovascular accident (stroke) constitutes a major public health problem due to the number of people affected and to its medical social and economic consequences. This study aims to identify poor vital prognostic factors for survival in patients with acute arterial stroke. Methods: we conducted a prospective study of patients with symptoms suggestive of stroke at the two University Hospitals of Sfax, Tunisia over a period of 4 months. Patients were followed-up for a period of 1 month. Results: we collected data from 200 patients. After one month of follow-up, mortality was 19.9%. Poor prognostic factors were: male sex, consumption of tobacco, a history of stroke, low Glasgow score, high NIHSS, headaches, acute symptomatic epileptic seizures, Babinski's sign, mydriasis, aphasia, combined deviation of the head and the eyes, high PAS, PAD and PAM, hyperthermia, hyperglycaemia, leukocytosis, high concentration of CRP, creatinine, urea and troponin T, haemorrhagic stroke, perilesional oedema, a mass effect, commitment, total middle cerebral artery topography of ischemia, early signs of ischemia, meningeal hemorrhage, ventricular flood, hydrocephalus, the recourse to respiratory support, to anti-edematous treatment and to antihypertensive therapy, hemorrhagic transformation, vascular epilepsy, infectious, metabolic complications, complications of bed sores. Conclusion: the identification of the predictive factors for survival allows for optimisation of therapeutic procedures and better implementation of patient' management. A comparative study will be considered to measure the impact of the corrective measures. [ABSTRACT FROM AUTHOR]

What could be the specificity of a Mediterranean essay? Far from discussing the essay as the expression of essentialist ideas of the south and of a supposed vitality of the Mediterranean culture Georg Lukács groundbreaking study "Über Wesen und Form des Essays" underlines instead a particular constellation: conceiving the South as a symbolic order is linked to the mortality of man. Practices and a certain attitude towards the world, considered as characteristic of the essayist, can be identified through a reading of Eugen Winkler’s texts, a German author and literary critic who develops his poetics by reflecting upon his experiences of the South. His essay on the island of Torcello is by no means a Mediterranean one, but, turning his back to essentialism and idealism at the same time, he develops a paradigmatic example of the "Writing of the South" within the context of literary modernity. Decentered on the planetarian scale, the South is not essentially opposed to the North, but a construction that serves the European way of thinking man and that has traditionally been orientated towards a certain, classical, idea of the Mediterranean.

L'insuffisance cardiaque (IC) est une affection chronique, complexe et grave, dont la symptomatologie est susceptible d'affecter fortement la qualité de vie des patients atteints avec une létalité élevée. Elle constitue un problème important de santé publique. Elle représente la première cause d'hospitalisation des plus de 60-65 ans. Il s'agissait d'une étude rétrospective descriptive transversale faite au service de cardiologie de l'hôpital national Ignace Deen CHU de Conakry. Les données ont été recueillies à partir de dossiers de patients hospitalisés pour insuffisance cardiaque pendant la période allant du 01 Janvier 2018 au 30 Juin 2019. La mortalité de l'IC a été déterminée à partir des dossiers de tous les patients décédés admis pour insuffisance cardiaque durant période d'étude. Cette étude nous permis de connaitre la mortalité liée à l'insuffisance cardiaque qui était de 9.6% au service de cardiologie de l'hôpital national Ignace Deen. Ce taux était inférieur aux résultats de certains travaux africains notamment au Gabon avec 10.3% à Lomé avec 11.86% et au Nigéria avec 10.1%. Cependant notre résultat est superposable à celui de Yaoundé qui était de 9.03%. Il reste supérieur à celui du Maroc avec 6.1%. La mortalité de l'insuffisance cardiaque reste non négligeable. Celle ci devrait être dépistée aussi précocement que possible et prise en charge correctement.

INTRODUCTION : l'Insuffisance Cardiaque Aiguë (ICA) correspond à une entité syndromique spécifique, regroupant plusieurs tableaux cliniques hétérogènes; fréquemment rencontrées aux urgences. L'objectif de cette étude a été de décrire les caractéristiques épidémiologiques, cliniques, thérapeutiques et pronostiques des patients admis aux urgences pour ICA.Méthodes: nous avons mené une étude prospective descriptive dans un service d'accueil des urgences qui a inclus tous les patients admis pour ICA. Nous avons étudié les caractéristiques épidémiologiques, cliniques, thérapeutiques et pronostiques chez ces patients.Résultats: nous avons inclus 180 patients pour ICA ayant entrainé une hospitalisation dans le service d'urgence. Le sexe ratio a été de 1,27. L'âge moyen a été de 66±12 ans. Quatre vingt deux pour cent des patients étaient hypertendus et 69% étaient diabétiques connus. Les étiologies de décompensation étaient essentiellement une poussée hypertensive chez 61,7% des patients, un syndrome coronaire aigu chez 24%. Le support respiratoire a été assuré essentiellement par la CPAP (Continuous Positive Airway Pressure) dans 73,3% des cas. Le traitement pharmacologique a été à base de dérivés nitrés dans 70% et de diurétique dans 40,5% des cas. Le taux de récidive de l'insuffisance cardiaque aiguë à un mois a été de 21,7% (n=39 patients), et celui de la mortalité à 3 mois a été de 13,3%.Conclusion: l'ICA vue au niveau des urgences est essentiellement sous forme hypertensive. Le traitement est basé essentiellement sur la CPAP, les vasodilatateurs et les diurétiques. Le taux de récidive était important, et la mortalité était aussi élevée.