Search

Oxidative stress represents an imbalance between the endogenous antioxidant defenses and the production of pro-oxidant molecules. The present study describes oxidative stress markers (oxidant and antioxidant) metabolic disturbances in diabetic and non-diabetic patients at the Internal Medicine and Endocrinology ward of hospital of Mali.We conducted a descriptive case / control study involving 30 diabetic and 30 non-diabetic patients. Studied markers were Glutathione erythrocyte peroxidase (GPX), intra erythrocyte Superoxide dismutase (SOD), plasmatic uric acid, direct and total bilirubins, albumin and markers for diagnosis and monitoring of diabetes.Non-diabetic patients (9%) had higher glutathione peroxidase levels compared diabetics (3%) (p = 0.005). An increase in superoxide dismutase was observed in 73.3% of diabetics versus 40% of nondiabetics (p = 0). The albumin, uric acid and bilirubin levels were identical in both populations. Glycated hemoglobin was significantly correlated with microangiopathies (p = 0.0058) and macro angiopathies( p=0,0007) in diabetics.The study showed an increase in antioxidant defenses in diabetics by the elevation of superoxide dismutase and a relative normalization of glutathione peroxidase.Le stress oxydant est un déséquilibre entre les défenses antioxydantes endogènes et la production de molécules pro-oxydantes. L'objectif principal était d'étudier les différents marqueurs du stress oxydatif (oxydant et antioxydant) chez les sujets diabétiques et non diabétiques au niveau du service de médecine interne et d'endocrinologie de l'hôpital du Mali à Bamako.l'étude était transversale avec comparaison entre 30 sujets diabétiques et 30 sujets non diabétiques. Les marqueurs étudiés : Glutathion peroxydase érythrocytaire (GPX), la Superoxyde dismutase (SOD) intra érythrocytaire, l'acide urique plasmatique, Les bilirubines directes et totales, l'albumine ainsi que quelque marqueur de diagnostic et de suivi du diabète.Trois pour cent de nos diabétiques avaient un taux de glutathion peroxydase élevé contre 9% des non diabétiques (p =0,005) ; augmentation de la Superoxyde dismutase des diabétiques 73,3% contre 40% des non diabétiques (p =0). Taux d'albumine, acide urique et la bilirubine identiques dans les deux populations ; hémoglobine glyquée était corrélée significativement aux complications dégénératives micro angiopathies (p=0,0058) et macro angiopathies (p=0,00017) chez les diabétiques.l'étude a montré une augmentation des défenses antioxydantes chez les trente diabétiques par l'élévation de la Superoxyde dismutase et normalisation relative du glutathion peroxydase.

Introduction : La schistosomiase constitue un enjeu de santé publique d'envergure mondiale, affectant le plus souvent les enfants, elle semble être liée au développement et l'augmentation des réseaux d'irrigation. L'efficacité des traitements de masse (TDM) ciblant les schistosomiases reste compromise par la non compliance au Mali. L'objectif était d'étudier les facteurs associés à la non compliance au TDM dans trois districts sanitaire : Bougouni, Bankass, et Tominian. Matériel et méthodes : Il s'agissait d'une étude transversale avec analyse secondaire des données de 2277 participants âgés de 5 - 14 ans et/ou leurs parents issues de l'enquête réalisée de juin à décembre 2017 dans les districts sanitaires de Bankass, Bougouni et Tominian. La non compliance a été évaluée en utilisant une analyse uni et multi variée (régression logistique) avec le logiciel STATA version13. Résultats : La religion (p=0,0001), la profession du père (p=0,006), la peur des effets secondaires (p=0,001) et la présence d'hématurie terminale (p=0,001) ont été trouvées statistiquement associées à la non compliance. En terme de contribution au model, la religion explique plus la non compliance, suivie de la peur des effets secondaires avec respectivement 43,79%, 18,79%, le sexe contribue moins avec seulement 1,09%. Conclusion : La religion, la profession du père, la peur des effets secondaires et la présence d'hématurie terminale étaient des facteurs statistiquement associés à la non compliance. Une intervention basée sur l'éducation sanitaire serait nécessaire afin de minimiser le taux de non compliance au TDM ciblant les schistosomiases.

Background Schizophrenia is a relatively common disease worldwide with a point prevalence of around 5/1000 in the population. The aim of this present work was to assess the demographic, clinical, familial, and environmental factors associated with schizophrenia in Mali. Methods This was a prospective descriptive study on a series of 164 patients aged at least 12 years who came for a follow-up consultation at the psychiatry department of the University Hospital Center (CHU) Point G in Mali between February 2019 and January 2020 for schizophrenia spectrum disorder as defined by DSM-5 diagnostic criteria. Results Our results revealed that the male sex was predominant (80.5%). The 25–34 age group was more represented with 44.5%. The place of birth for the majority of our patients was the urban area (52.4%), which also represented the place of the first year of life for the majority of our patients (56.1%). We noted that the unemployed and single people accounted for 56.1 and 61% respectively. More than half of our patients 58.5% reported having reached secondary school level. With the exception of education level, there was a statistically significant difference in the distribution of demographic parameters. Familial schizophrenia cases accounted for 51.7% versus 49.3% for non-familial cases. The different clinical forms were represented by the paranoid form, followed by the undifferentiated form, and the hebephrenic form with respectively 34, 28 and 17.1%. We noted that almost half (48.8%) of patients were born during the cold season. Cannabis use history was not observed in 68.7% of the patients. The proportions of patients with an out-of-school father or an out-of-school mother were 51.2 and 64.2%, respectively. Conclusion The onset of schizophrenia in the Malian population has been associated with socio-demographic, clinical, genetic and environmental characteristics.

The practice of excision in girls poses a significant risk to their health. The objective of this study was to determine the immediate acute complications associated with this practice.This was a retrospective descriptive study over a period of 15 months including all girls aged 0-15 years hospitalized for acute complications related to excision within 7 days of the practice in the pediatric department of the University Hospital Gabriel Toure.We collected 17 patient files. The median consultation time was 43 h. The main reason for consultation was post-excision bleeding in 76.4% of the cases. Pallor associated with respiratory distress was found in almost all cases. On admission, four girls (23.5%) were comatose and five girls (29.4%) showed signs of shock. The reasons for hospitalization were hemorrhage associated with post-excisional sepsis (52.9%), complicated shock anemia (23.5%), and severe post-excision anemia (23.5%). The average hemoglobin level was 5.5 g/dL; there was severe anemia in 94.1% of the girls (Hb7g/dl). All the girls received blood transfusions with red blood cell concentrate. The other treatments received were local care (100%), administration of analgesics (100%), antibiotic therapy (82.4%), and oxygen therapy (41.2%). The outcome was unfavorable in two patients (11.8% deaths).This study shows the seriousness of the immediate complications associated with the practice of excision.

Background: Early screening is crucial for early autism spectrum disorders (ASD) diagnosis and intervention. ASD screening tools have mostly been constructed based on the Western cultural context. We hypothesized that their use in Mali may require a prior validation. Objective: To validate the modified checklist for autism in toddlers-Revised (M-CHAT-R) and the social communication questionnaire (SCQ) in the Malian sociocultural context for ASD screening. Study design: We administered M-CHAT-R and SCQ in 947 toddlers aged 16–30 months old at the district and community health centers in Bamako and 120 patients (60 autistic and 60 age and sex matched controls) aged ≥4 years old at the psychiatry department in Bamako. Toddlers at moderate to high risk of ASD underwent M-CHAT-R/F and clinical evaluation by an ASD multidisciplinary team. M-CHAT-R and SCQ were evaluated for cultural appropriateness by Malian anthropologists. The sensitivity, specificity, PPV, NPV were determined for both M-CHAT-R and SCQ. Health professionals have been trained during ASD seminary on how to use M-CHAT-R and SCQ for ASD screening in Bamako. Results: We found for the M-CHAT-R a sensitivity of 50%, a specificity of 100%, a PPV of 100% and a NPV of 87%. The SCQ had a sensitivity of 71%, a specificity of 72%, a PPV of 73% and a NPV of 70%. We have found four out of 20 items on the M-CHAT-R that were culturally inappropriate in the Malian context. Discussion: M-CHAT-R and SCQ can be used for early autism screening in Mali. In the future, we plan to train a descent number of Malian physicians in chief and pediatricians at the district hospitals across the country to integrate the early ASD screening into the national health system. Conclusion: M-CHAT-R has a perfect specificity and SCQ a fair diagnostic accuracy for ASD in Mali. Keywords: M-CHAT-R, SCQ, NPV, PPV, Mali

Introduction: Spinal muscular atrophy (SMA) and sporadic amyotrophic lateral sclerosis (SALS) are both motor neuron disorders. SMA results from the deletion of the survival motor neuron (SMN) 1 gene. High or low SMN1 copy number and the absence of SMN2 have been reported as risk factors for the development or severity of SALS. Objective: To investigate the role of SMN gene copy number in the onset and severity of SALS in Malians. Material and Methods: We determined the SMN1 and SMN2 copy number in genomic DNA samples from 391 Malian adult volunteers, 120 Yoruba from Nigeria, 120 Luyha from Kenya and 74 U.S. Caucasians using a Taqman quantitative PCR assay. We evaluated the SALS risk based on the estimated SMA protein level using the Veldink formula (SMN1 copy number + 0.2∗SMN2 copy number). We also characterized the disease natural history in 15 ALS patients at the teaching hospital of Point G, Bamako, Mali. Results: We found that 131 of 391 (33.5%) had an estimated SMN protein expression of ≤2.2; 60 out of 391 (15.3%) had an estimated SMN protein expression

Autism is a global and early developmental disorder that appears before the age 3 years old. It is characterized by a triad of symptoms affecting the following domains: social interaction, verbal and non-verbal communication, imagination and behaviors. This work aimed to determine the frequency of autism and to identify its risk factors in Malians aged 0-17 years old.In a cross sectional and prospective study, we reviewed clinical data in 2068 medical charts dating from 1992 to 2012 from all the mental health care centers in Bamako.We found a frequency of 7.8% (162/2068). The age range 0-5 years old was the most represented. The sex ratio was 1.7. The autistic child was issued from a consanguineous marriage in 25.4% (41/162) of the cases. To have parents in divorce, being the first child, and male gender were associated with autism with statistical significance. Our data suggest an elevated number of autism cases in Mali. We plan to carry out a larger prospective study to determine other autism risk factors and importantly to identify autistic families for a molecular genetic study.L'autisme est un trouble global et précoce du développement qui apparait avant l'âge de 3 ans. Il se caractérise par une triade de symptômes affectant les domaines d'interaction sociale, la communication verbale et non verbale, l'imagination, et les comportements. Le but de ce travail était de déterminer la fréquence de l'autisme et d'identifier les facteurs favorisants chez les sujets maliens de 0–17ans.Il s'agissait d'une étude transversale rétrospective de dossiers médicaux de 1992 à 2012 à partir des données cliniques dans les structures de prise en charge en santé mentale dans le district de Bamako au Mali.Sur les 2068 dossiers constitués durant la période d'étude, nous avons colligé 162 dossiers de troubles autistiques (de janvier à décembre 2012), soit une fréquence de 7,8% (162/2068). La tranche d'âge de 0 – 5 ans était la plus représentée. Le sex-ratio était de1,7. La consanguinité entre les deux parents était présente dans 25,4% (41/162) des cas. Avoir les parents en divorce, être le premier enfant, et surtout du sexe masculin étaient associés de façon statistiquement significative à la présence de l'autisme. Nos données témoignent du nombre de cas élevé d'autisme au Mali. Une étude prospective plus élaborée pour déterminer les autres facteurs favorisants de l'autisme et surtout d'identifier les familles autistes pour une étude génétique moléculaire est à planifier.

Background Systemic lupus erythematosus (SLE) is an autoimmune disease with genetic, hormonal, and environmental influences. In Western Europe and North America, individuals of West African descent have a 3–4 fold greater incidence of SLE than Caucasians. Paradoxically, West Africans in sub-Saharan Africa appear to have a low incidence of SLE, and some studies suggest a milder disease with less nephritis. In this study, we analyzed sera from African American female SLE patients and four other cohorts, one with SLE and others with varying degrees of risk for SLE in order to identify serologic factors that might correlate with risk of or protection against SLE. Methods Our cohorts included West African women with previous malaria infection assumed to be protected from development of SLE, clinically unaffected sisters of SLE patients with high risk of developing SLE, healthy African American women with intermediate risk, healthy Caucasian women with low risk of developing SLE, and women with a diagnosis of SLE. We developed a lupus risk index (LRI) based on titers of IgM and IgG anti-double stranded DNA antibodies and levels of C1q. Results The risk index was highest in SLE patients; second highest in unaffected sisters of SLE patients; third highest in healthy African-American women and lowest in healthy Caucasian women and malaria-exposed West African women. Conclusion This risk index may be useful in early interventions to prevent SLE. In addition, it suggests new therapeutic approaches for the treatment of SLE.