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Introduction Thyroid pathology is frequent in Mali, which is an endemic zone for goiter. But this pathology rarely occurs in children. The purpose of our study was to characterize this illness among children in Mali. Methods We report on patients aged less than 15-year old who presented with clinical signs and symptoms with hyperthyroidism at the medicine service at Hospital de Point G from January 1999 and December 2005 to determine the characteristics of hyperthyroidism. Results The frequency was 9.6‰ (38/3972), with an average age of 12.5 ± 3.34-year. The sex ratio was 3 girls/1 boys. The most common symptoms were tachycardia (n = 30, 78.9%), palpitations (n = 15, 34.4%). 31 patients (81.5%) presented with exophthalmoses, 93.5% being bilateral. Weight loss was present in 31.5% (n = 12). Goiter was present in 37 patients (97.4%). The goiter was diffuse in 27 patients (73%) and nodular in 10 (27.%). The presence of goiter caused signs of compression in the neck in half of the cases: dyspnea and dysphonia were the most common consequences. TSH less than 0.05 μUI/1 was used to confirm the diagnosis. Graves's disease was the most common cause (n = 32, 84.2%), followed by toxic adenoma (n = 4, 10.5%). Other causes included toxic multinodular goiter and thyroiditis. Etiologies were independent of sex and age: (p = 0.95). All patients were started on medical therapy upon diagnosis. 7 patients (18.4%) were lost to follow-up during the 6 months of treatment. Remission was obtained in 26 patients (83.9%), and relapse occurred in 5 patients (16.1%). Conclusion The frequency of hyperthyroidism in children in Mali is a problem in a goiter endemic zone like Mali. Poor general health in children and signs and symptoms of neck compression are markers of progressive disease.

Thyroid pathology is frequent in Mali, which is an endemic zone for goiter. But this pathology rarely occurs in children. The purpose of our study was to characterize this illness among children in Mali.We report on patients aged less than 15-year old who presented with clinical signs and symptoms with hyperthyroidism at the medicine service at Hospital de Point G from January 1999 and December 2005 to determine the characteristics of hyperthyroidism.The frequency was 9.6 per thousand (38/3972), with an average age of 12.5+/-3.34-year. The sex ratio was 3 girls/1 boys. The most common symptoms were tachycardia (n=30, 78.9%), palpitations (n=15, 34.4%). 31 patients (81.5%) presented with exophthalmoses, 93.5% being bilateral. Weight loss was present in 31.5% (n=12). Goiter was present in 37 patients (97.4%). The goiter was diffuse in 27 patients (73%) and nodular in 10 (27.%). The presence of goiter caused signs of compression in the neck in half of the cases: dyspnea and dysphonia were the most common consequences. TSH less than 0.05 microUI/1 was used to confirm the diagnosis. Graves's disease was the most common cause (n=32, 84.2%), followed by toxic adenoma (n=4, 10.5%). Other causes included toxic multinodular goiter and thyroiditis. Etiologies were independent of sex and age: (p=0.95). All patients were started on medical therapy upon diagnosis. 7 patients (18.4%) were lost to follow-up during the 6 months of treatment. Remission was obtained in 26 patients (83.9%), and relapse occurred in 5 patients (16.1%).The frequency of hyperthyroidism in children in Mali is a problem in a goiter endemic zone like Mali. Poor general health in children and signs and symptoms of neck compression are markers of progressive disease.

In order to reduce the prevalence of goiter in a village of Mali liable to iodine deficiency, an iodized product (Lipiodol® Ultra Fluide) was orally administered to their inhabitants. Taking into account a series of demographic variables and goiter types, a protocol was conducted using Lipiodol at three different dosage levels. Six months after the treatment, the hormone levels regained normal values, whereas only the smallest dose reduces the volume of goiters significantly.

In 1990, a study was made in the district of Diré, North Mali in West Africa, to determine the prevalence of pulmonary tuberculosis and HIV infections in general population. From 1,814 subjects tested, 1.1% (n = 20) have active pulmonary tuberculosis and 0.2% (n = 4) were seropositive with HIV1 or HIV1 + 2. No relation was made between the two diseases.

Results of a study about mother-infant transmission of hepatitis B virus (HBV) confirm the high degree of positivity of HBV markers in Bamako, Republic of Mali. Among 372 sera of mother-newborn pairs, seroprevalence of HBs Ag has been around 11% in mothers. The lack of anti HBc IgM in all sera agree probably with a relative old contamination. Pre-S2 epitope marker has been found in more than 70% of HBs Ag positive mothers and 50% of their children. Large discordance has been noted between the prevalence rate of this marker and the HBe Ag and viral DNA, other markers of HBV replication. Further studies are necessary for the clear understanding of HBV transmission systems in our country.

A new method for iodine deficiency disorders prevention is tested during one year in a rural area of Mali. Silicone and sodium iodide made diffusers are set up inside 2 villages' drillings. Their efficiency is compared with a placebo. Supervision criteria are evolution of goiter, rates of iodine in water and ioduria of the population, specially women and children. In the treated villages a decrease of goiters' size of the younger people is observed. Iodine rates in treated drillings water stay during 12 months between 150 and 300 micrograms/l with a minimum intake of 150 micrograms/day/person. The means of ioduria rates from less than 25 micrograms/l before treatment (severe deficiency) increase to more than 100 micrograms/l after six months of treatment (no deficiency).

ANTHROPOLOGY AND MEDICAL BIOLOGY, APPLICATION TO THE ENDEMIC GOITER AND ENDEMIC CRETINISM, BWA REGION (MALI) Summary. — The study is concerned with the dispersion, the importance and the causes of the endemic goiter and cretinism in a village of Mali. The methods which are used there, relied on a very accurate definition of the population, on the precision of the diagnosis, on the measuring out of the serum, of the urine and of the food, on blood tests, bringing to the fore all the genetic markers known. The prevalence of the goiter is of 71,21 % for the men and of 89,09 % for the women. Moreover the hormones TSH and T4 playing a very discriminant role between goitrous and non goitrous. The genetic factor appears here very probable. As for the cretinism its prevalence is certainly of 1%., Résumé. — L'étude porte sur la dispersion, l'importance et les causes du goitre et du crétinisme endémiques dans un village du Mali. Les méthodes utilisées se sont appuyées sur une définition très précise de la population, sur la rigueur des diagnostics, sur les dosages sériques, urinaires et alimentaires, sur les analyses sanguines mettant en évidence l'ensemble des marqueurs génétiques connus. La prévalence du goitre est de 71,21 % chez les hommes et de 89,09 % chez les femmes, les hormones TSH et T4 jouant par ailleurs un rôle très discriminant entre goitreux et non goitreux, le facteur génétique apparaît ici très probable. Quant au crétinisme, sa prévalence est vraisemblablement de l'ordre de 1 %., Bellis G., Chaventré André, Roux F., Bisset J.-P., Chastin I., Rhaly A. Ag, Margotat A., Malthiery Y. Anthropologie et biologie médicale, application au goitre et au crétinisme endémiques, pays Bwa (Mali). In: Bulletins et Mémoires de la Société d'anthropologie de Paris, XIV° Série. Tome 5 fascicule 1-2, 1988. pp. 47-60.