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9415 ressources

  • Article libreArticleEn anglais

    Examination of adolescent and youth modern contraceptive users’ perceptions on how religion influences contraceptive use and their rationale and circumstances of use: qualitative evidence from Burkina Faso, Kenya and Niger

    Ilene S. Speizer, Fiacre Bazie, Amelia Maytan-Joneydi, John A. Mushomi, Sanoussi Chaibou, Kindo Boukary, Balki Ibrahim Agali, Julius Rwenyo

    While religion is a key determining factor of contraceptive use, few studies examine how religion influences adolescent and youth contraceptive attitudes, beliefs, and use. We use recently collected (August–November 2022) qualitative data from Burkina Faso, Kenya, and Niger among young users of modern contraception who practice Christianity or Islam. In-depth interviews with married and unmarried young women ages 18–24 years were conducted in two sites in each country to obtain a mix of religions and method users. In each country, many young Christian and Muslim women perceived that their religion is not supportive of contraceptive use. Some nuances around perceived acceptability of use were identified in Niger and among Muslim women in Kenya particularly for married women for spacing or health reasons. Reasons given for using related to realities of life, personal choices, and that use is their prerogative and God will forgive them. Most married women felt there would be few consequences if their religious community learned of their use whereas unmarried young women feared more consequences from their religious and broader community. These findings demonstrate that while religion is important in all three study contexts, decisions around contraceptive use among the young women included were not necessarily influenced by their religious beliefs and practices. As a greater number of young people adopt contraception, with or without perceived religious support, social norms are likely to change leading to increased access to contraception for all young women, married and unmarried, when or if they need it.

    Biologie cellulaire et moléculaireGénétiqueSanté publiqueLicence : Open Access http://creativecommons.org/licenses/by/4.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original autho
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  • Article libreArticleEn anglais

    Examination of factors impacting spitting or vomiting among children under 5 years of age during seasonal malaria chemoprevention: a quantitative study in Burkina Faso, Chad, Nigeria and Togo

    Chen Gao, Sikai Huang, Taiwo Ibinaiye, Benoît Sawadogo, Adama Traore, Cheick Saïd Compaoré, Fantche Awokou, Chukwudi A. Nnaji, Kevin Baker, Duoquan Wang, Sol Richardson

    BackgroundSince 2012, the World Health Organization has recommended seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine plus amodiaquine (SPAQ) for children aged 3–⁠59 months in regions where malaria transmission is seasonal. Full ingestion of SMC medicines without spitting or vomiting during a complete 3-day course is critical to ensure effectiveness of SMC medicines and to avoid development of antimalarial resistance. Although evidence suggests that spitting or vomiting is not rare, there is limited analytical evidence on potential factors associated with spitting or vomiting in SMC campaigns.MethodsWe utilized data from SMC coverage surveys conducted in Burkina Faso, Chad, Togo and Nigeria between 2020 and 2022. Episodes of spitting or vomiting were defined as SMC-eligible children spitting out most of the dose or vomiting the entire dose within 30 min of SPAQ administration as reported by primary caregivers. We conducted a cross-sectional study using mixed-effects logistic regression with variables including household socioeconomic variables and caregiver knowledge of SMC, to identify factors associated with spitting or vomiting.ResultsThe proportion of SMC-eligible children spitting or vomiting SPAQ doses ranged from 1.81% in Nigeria to 4.36% in Chad. The odds of spitting or vomiting were lower among children administered medicines under community distributor (CD) supervision, and whose primary caregivers had a high degree of knowledge of SMC. Spitting or vomiting were negatively associated with caregiver adherence to AQ administration and caregiver reporting of children’s adverse reactions to SMC medicines. Over half of the children experiencing a spitting or vomiting episode did not receive a replacement dose from CDs. Redosing was positively associated with caregiver educational attainment, caregiver knowledge of SMC, and directly supervised medicine administration.ConclusionsCD-supervised administration of SPAQ can strengthen community eng

    Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)Parasitologie et mycologieLicence : Open Access http://creativecommons.org/licenses/by/4.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original autho
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  • Lien vers la sourceArticleEn anglais

    Examining multiple funding flows to public healthcare providers in low- and middle-income countries — results from case studies in Burkina Faso, Kenya, Morocco, Nigeria, Tunisia and Vietnam

    Fahdi Dkhimi, Ayako Honda, Kara Hanson, Rahab Mbau, Obinna Onwujekwe, Hoang Thi Phuong, Inke Mathauer, El Houcine Akhnif, Imen Jaouadi, Joël Arthur Kiendrébéogo, Nkoli Ezumah, Evelyn Kabia, Edwine Barasa

    AbstractProvider payment methods are traditionally examined by appraising the incentive signals inherent in individual payment mechanisms. However, mixed payment arrangements, which result in multiple funding flows from purchasers to providers, could be better understood by applying a systems approach that assesses the combined effects of multiple payment streams on healthcare providers. Guided by the framework developed by Barasa et al. (2021) (Barasa E, Mathauer I, Kabia E et al. 2021. How do healthcare providers respond to multiple funding flows? A conceptual framework and options to align them. Health Policy and Planning 36: 861–8.), this paper synthesizes the findings from six country case studies that examined multiple funding flows and describes the potential effect of multiple payment streams on healthcare provider behaviour in low- and middle-income countries. The qualitative findings from this study reveal the extent of undesirable provider behaviour occurring due to the receipt of multiple funding flows and explain how certain characteristics of funding flows can drive the occurrence of undesirable behaviours. Service and resource shifting occurred in most of the study countries; however, the occurrence of cost shifting was less evident. The perceived adequacy of payment rates was found to be the strongest driver of provider behaviour in the countries examined. The study results indicate that undesirable provider behaviours can have negative impacts on efficiency, equity and quality in healthcare service provision. Further empirical studies are required to add to the evidence on this link. In addition, future research could explore how governance arrangements can be used to coordinate multiple funding flows, mitigate unfavourable consequences and identify issues associated with the implementation of relevant governance measures.

    Biologie cellulaire et moléculaireGénétiqueSanté publiqueLicence : https://creativecommons.org/licenses/by/3.0/igo/ This is an Open Access article distributed under the terms of the Creative Commons Attribution 3.0 IGO License(), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
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  • Article libreArticleEn anglais

    Examining Social Media User Types and the Impact on a Reproductive Health Web-Based Intervention for Young People in Francophone West Africa: Randomized Factorial Design Using Latent Class Analysis

    AbstractBackgroundWeb-based interventions present an opportunity for addressing reproductive health outcomes among young Francophone West Africans, but little is known about how social media use impacts such interventions.ObjectiveThis study aimed to identify social media use patterns among young French-speaking West Africans and assess the impact on a reproductive health intervention delivered on Facebook.MethodsFrench-speaking social media users (aged 15‐24 years) were recruited from Senegal, Côte d’Ivoire, and Burkina Faso via social media advertisements. Using a factorial design for a multiarm parallel study, participants were randomly assigned via block randomization to 4 conditions: comparison (standard content), peer role models (personal narratives from similarly aged peers), online influencers (popular online figures), and a mixed peer role model and online influencer strategy. Participant blinding was implemented. Respondents completed pre- and post- self-administered online surveys between December 2023 and February 2024. Latent class analysis using maximum likelihood estimation was used to examine social media use patterns and related outcomes: contraceptive knowledge, provider awareness, and online service use.ResultsIn total, 353 participants were randomized to each group, with a final analytic sample of 262 participants. Two social media user types were identified from the completed study: selective users (daily use of WhatsApp and Facebook) and multiplatform users (daily use of WhatsApp, Facebook, Instagram, YouTube, and TikTok). Being 20-24 years old, compared with 15‐19 years, was associated with increased odds of multiplatform use (odds ratio [OR] 3.61, 95% CI 1.46‐9.36; P=.008). Furthermore, residing in Senegal was associated with a greater likelihood of multiplatform use, compared with Côte d’Ivoire (OR 0.27, 95% CI 0.08‐0.88; P=.03) and Burkina Faso (OR 0.23, 95% CI 0.07‐0.76; P=.02). Among selective users (daily users of WhatsApp and Facebook)

    Biostatistiques et épidémiologieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ https://formative.jmir.org This is an open-access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published
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  • Article libreArticleEn anglais

    Examining the human infectious reservoir for Plasmodium falciparum malaria in areas of differing transmission intensity

    Bronner P. Gonçalves, Melissa C. Kapulu, Patrick Sawa, Wamdaogo M. Guelbéogo, Alfred B. Tiono, Lynn Grignard, Will Stone, Joel Hellewell, Kjerstin Lanke, Guido J. H. Bastiaens, John Bradley, Issa Nébié, Joyce M. Ngoi, Robin Oriango, Dora Mkabili, Maureen Nyaurah, Janet Midega, Dyann F. Wirth, Kevin Marsh, Thomas S. Churcher, Philip Bejon, Sodiomon B. Sirima, Chris Drakeley, Teun Bousema

    A detailed understanding of the human infectious reservoir is essential for improving malaria transmission-reducing interventions. Here we report a multi-regional assessment of population-wide malaria transmission potential based on 1209 mosquito feeding assays in endemic areas of Burkina Faso and Kenya. Across both sites, we identified 39 infectious individuals. In high endemicity settings, infectious individuals were identifiable by research-grade microscopy (92.6%; 25/27), whilst one of three infectious individuals in the lowest endemicity setting was detected by molecular techniques alone. The percentages of infected mosquitoes in the different surveys ranged from 0.05 (4/7716) to 1.6% (121/7749), and correlate positively with transmission intensity. We also estimated exposure to malaria vectors through genetic matching of blood from 1094 wild-caught bloodfed mosquitoes with that of humans resident in the same houses. Although adults transmitted fewer parasites to mosquitoes than children, they received more mosquito bites, thus balancing their contribution to the infectious reservoir. Heterogeneity in the transmission potential of individual hosts is an important feature of malaria. Here, the authors perform a multi-regional study of the human infectious reservoir in malaria-endemic regions of Burkina Faso and Kenya.

    Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : Open Access http://creativecommons.org/licenses/by/4.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original autho
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  • Article libreArticleEn anglais

    Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso

    Bernard Brabin, Sabine Gies, Stephen A. Roberts, Salou Diallo, Olga M. Lompo, Adama Kazienga, Loretta Brabin, Sayouba Ouedraogo, Halidou Tinto

    BackgroundIron supplementation before a first pregnancy may improve the future health of mother and baby by reducing maternal anaemia. Iron supplementation could, however, increase malaria infections, notably in primigravidae who are most susceptible. The pathogenicity of other iron-utilizing pathogens could also increase, causing inflammation leading to increased risk of adverse birth outcomes. This paper reports pre-specified secondary birth outcomes from a safety trial in Burkina Faso in an area of high malaria endemicity. Primary outcomes from that trial had investigated effects of long-term weekly iron supplementation on malaria and genital tract infections in non-pregnant and pregnant women.MethodsA double-blind, randomized controlled trial. Nulliparous, mainly adolescent women, were individually randomized periconceptionally to receive weekly either 60 mg elemental iron and 2.8 mg folic acid, or 2.8 mg folic acid alone, continuing up to the first antenatal visit for those becoming pregnant. Secondary outcomes were ultrasound-dated gestational age, fetal growth, placental malaria, chorioamnionitis and iron biomarkers. Seasonal effects were assessed. Analysis was by intention to treat.Results478 pregnancies occurred to 1959 women: 258/980 women assigned iron and folic acid and 220/979 women assigned folic acid alone. Malaria prevalence at the first antenatal visit was 53% (iron) and 55% (controls). Mean birthweight was 111 g lower in the iron group (95% CI 9:213 g, P = 0.033). Mean gestational ages were 264 days (iron) and 269 days (controls) (P = 0.012), with 27.5% under 37 weeks compared to 13.9% in controls (adjRR = 2.22; 95% CI 1.39–3.61) P < 0.001). One-third of babies were growth restricted, but incidence did not differ by trial arm. Half of placentae had evidence of past malaria infection. C–reactive protein > 5 mg/l was more common prior to births < 37 weeks (adjRR = 2.06, 95% CI 1.04–4.10, P = 0.034). Preterm birth incidence during the rainy season was

    Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provid
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  • Article libreArticleEn anglais

    Exchanging and using research evidence in health policy networks: a statistical network analysis

    Jessica C Shearer, Michelle Dion, John N Lavis

    BackgroundEvidence-informed health policymaking is a goal of equitable and effective health systems but occurs infrequently in reality. Past research points to the facilitating role of interpersonal relationships between policy-makers and researchers, imploring the adoption of a social network lens. This study aims to identify network-level factors associated with the exchange and use of research evidence in policymaking.MethodsData on social networks and research use were collected from seventy policy actors across three health policy cases in Burkina Faso (child health, malaria, and HIV). Networks were graphed for actors’ interactions, their provision of, and request for research evidence. Exponential random graph models estimated the probability of evidence provision and request between actors, controlling for network- and individual-level covariates. Logistic regression models estimated actors’ use of research evidence to inform policy.ResultsNetwork structure explained more than half of the evidence exchanges (ties) observed in these networks. Across all cases, a pair of actors was more likely to form a provision tie if they already had a request tie between them and visa versa (θ = 6.16, p < 0.05; θ = 2.87, p < 0.05; θ = 2.31, p < 0.05). The child health network displayed clustering tendencies, meaning that actors were more likely to form ties if they shared an acquaintance (θ = 2.36, p < 0.05). Actors’ use of research evidence was positively associated with their centrality (i.e., connectedness).ConclusionsThe exchange and use of research evidence in policymaking can be partly explained by the structure of actors’ networks of relationships. Efforts to support knowledge translation and evidence-informed policymaking should consider network factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0126-8) contains supplementary material, which is available to authorized users.

    Parasitologie et mycologieImmunologieMaladies infectieuses et tropicalesLicence : http://creativecommons.org/licenses/by/4.0 http://creativecommons.org/publicdomain/zero/1.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original
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  • Article libreArticle

    Exérèse curative d'une tumeur stromale extra gastro intestinale (EGIST) localement avancée et fistulisée dans le grêle après traitement par Imatinib: à propos d'un cas

    Abdesslam Bouassria, Ouadii Mouaqit, Elbachir Benjelloun, Hicham Elbouhaddouti, Abdelmalek Ousadden, Khalid Mazaz, Khalid Ait Taleb

    Les tumeurs stromales extra-gastro-intestinales (les EGIST) sont des tumeurs rares qui se développent en dehors du tractus digestif. Bien que l'exérèse curative est acceptée comme un traitement de EGIST non invasive, la stratégie thérapeutique pour EGIST localement avancées et/ou métastatiques n'a pas encore été établie. Nous rapportons un cas rare de tumeur stromale extra gastro intestinale (EGIST) localement avancée et fistulisée dans le grêle qui a pu faire l'objet d'une résection curative après traitement par l'imatinib, avec une bonne évolution post opératoire. Le traitement préopératoire avec le mésylate d’ imatinib suivie par une exérèse complète (R0) est une option thérapeutique réalisable pour guérir les EGIST invasives.

    Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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  • Lien vers la sourceArticle

    Exérèse du jabot chez le pigeon mondain : une approche chirurgicale innovante

    Ibrahim Maman Laminou

    Problématique : La ptose du jabot est une affection fréquente chez le pigeon. Elle est due à une colibacillose chronique ou une indigestion ingluviale. C’est aussi une caractéristique chez les pigeons ibériques : gorguero et gaditano. Cet important développement du jabot peut être pris en charge chirurgicalement au risque d’une perforation mortelle. Objectif : Cette étude décrit une technique chirurgicale innovante pour réaliser une exérèse chirurgicale du jabot chez le pigeon souffrant d’une colibacillose chronique au cabinet « la maison des éleveurs » à Niamey au Niger. Méthodologie : Les étapes de cette opération sont : la préparation du champ opératoire par déplumage de la zone d’intervention, un nettoyage-désinfection à la polyvidone iodée du site et une contention de l’oiseau. Aucune anesthésie locale ou générale n’est nécessaire car les oiseaux ne supportent pas les dérivés morphiniques comme la lurocaïne ou la xylocaïne. Deux pinces à coprostase sont ensuite posées pour délimiter à partie atteinte. Une exérèse de la partie inférieure du jabot ou de la partie perforée est réalisée à l’aide d’une paire de ciseau. Une synthèse en deux plans sera réalisée : un surjet simple avec un catgut résorbable sur la membrane du jabot et des points simples séparés sur la peau au moyen d’un fil non résorbable. L’opération se termine par un pansement médicamenteux de la plaie chirurgicale. Principaux résultats : Cette chirurgie est une intervention à très haut risque septique. Le taux de succès est 90%. La rémission se fait en une semaine et on retire les points de sutures. Conclusion : L’exérèse du jabot est une technique chirurgicale innovante, facile à réaliser, qui sauve des pigeons, qui rapporte un revenu substantiel et qui trouvera rapidement une place de choix dans les services proposés par les vétérinaires.

    PharmacologieSémiologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/licenses/by/4.0/
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  • Article libreArticle

    Exophtalmie de l’œil gauche en faveur d'un carcinome adénoide kystique orbitaire: à propos d'un cas

    Adil Bouzidi, Said Iferkhass, Zine El Abidine Hansali, Mohammed Elmallaoui, Abdelkader Laktaoui

    Le Cylindrome orbitaire (carcinome adénoide kystique) est une tumeur maligne d'agressivité locale et d’évolution lente. Sa localisation orbitaire aux dépens des glandes lacrymales est exceptionnelle. Nous rapportons le cas d'un patient de 51 ans consultant pour une exophtalmie gauche non axile irréductible, douloureuse; avec ptosis modéré et baisse d'acuité visuelle. Une biopsie de la tumeur par voie palpébrale supérieure a été faite, en faveur d'un un carcinome adénoïde kystique cribriforme de la glande lacrymale. Après trois mois d'un traitement conservateur chirurgical, une exentération totale a été effectuée suivie d'une radiothérapie complémentaire. Le patient a été revu tout les 3 mois en consultation durant la première année. Sur un recul de six ans, le patient ne présente pas de signe en faveur d'une récidive.

    Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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  • Article libreArticle

    Exophtalmie inflammatoire révélant un kyste hydatique orbitaire

    Zouheir Hafidi, Rajae Daoudi

    Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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  • Article libreArticle

    Exophtalmie pulsatile révélant une agénésie sphéno-orbitaire dans la maladie de Von-Recklinghausen

    Imane Ait Belaid, Safouane Khairallah, Soumaya Alj, Mariem Ouali Idrissi, Najat Cherif Idrissi El Ganouni

    Les manifestations ophtalmologiques au cours de la maladie de Von Recklinghausen sont rares. Seulement quelques cas ont été rapportés dans la littérature internationale. Nous rapportons un cas d'exophtalmie pulsatile révélatrice d'une agénésie sphéno-orbitaire au cours de la maladie de Von Recklinghausen.

    Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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  • Article libreArticle

    Exophtalmie tardive révélant une fistule carotido-caverneuse post traumatique: à propos d’un cas

    Khaoula Boukili, Loubna Elmaaloum, Bouchra Allali, Asmaa Elkettani

    La fistule carotido-caverneuse est une communication anormale entre le système artériel carotidien et le sinus caverneux. L´origine la plus fréquente est congénitale en raison des malformations artério veineuses, mais elle peut être aussi post traumatique. C´est une pathologie rare, pouvant mettre en jeu le pronostic visuel et vital du patient. Nous rapportons ici les cas d´une jeune patiente âgée de 34 ans, qui était victime deux ans avant son admission d´un accident de la voie publique avec impact crânio-facial et au niveau des membres inférieurs, et qui a présenté un an après une exophtalmie gauche d´évolution lentement progressive sans autres signes associés, révélant une fistule carotido-caverneuse gauche. La particularité de notre cas est le délai relativement long entre le traumatisme, l´apparition de l´exophtalmie et le diagnostic de la fistule carotido-caverneuse post-traumatique.

    Licence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
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  • Article libreArticle

    Exophtalmie unilatérale révélant un géant anévrysme intra caverneux rompu de la carotide interne

    Qariani Hajare, Aachak Meriem

    Giant aneurysm of the intracranial carotid artery is a relatively rare disorder which can lead to life-threatening consequences. Ophthalmologic symptoms, mainly oculomotor nerve palsies, usually reveal lesions of the cavernous sinuses. We report the case of a 39-year old female patient presenting with rapidly progressive unilateral exophthalmos (A,B) and binocular diplopia associated with tension headaches causing a single episode of vomiting evolving in a context of apyrexia and general state preservation. Ophthalmologic examination found isolated palsies of the right lateral rectus muscle (abduction deficit). Static and dynamic assessment of the eyelids was normal. Corrected visual acuity was 5/10. Slit lamp exam showed dilation of the conjunctival vessels(C), clear cornea that didn’t take up fluorescein, preserved direct and consensual pupillary light reflex, intra-ocular pressure 15 mmhg and venous tortuosities at the back of the eye without papillary abnormalities (D). Neuroradiological assessment, such as magnetic resonance angiography, showed compressive aneurysms of the intracavernous portion of the right internal carotid artery with grade III exophthalmos. Cerebral angiography objectified right giant ruptured saccular carotid-cavernous aneurysm in the cavernous sinuses (E).with anterior and posterior venous drainage associated with aneurysm of the left carotid syphon (F).

    Biologie cellulaire et moléculaireGénétiqueLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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  • Article libreArticle

    Exophtalmie unilatérale révélant un grand anévrysme de la carotide interne: à propos d´un cas

    Khaoula Boukili, Loubna Elmaaloum, Bouchra Allali, Asmaa Elkettani

    L´anévrysme de l´artère carotide interne intra caverneuse est une pathologie rare, pourvoyeuse de complications majeures. Le tableau clinique typique est une ophtalmoplégie avec des céphalées intenses. Le diagnostic est suspecté cliniquement, l´angiographie cérébrale confirme le diagnostic et guide la prise en charge thérapeutique. Le traitement de référence est l´embolisation artérielle par voie endo vasculaire. Nous rapportons le cas d´une femme de 80 ans qui consulte aux urgences pour une exophtalmie droite et des céphalées brutales évoluant depuis 2 semaines avant sa consultation. Le diagnostic d´un anévrysme de l´artère carotide interne fissuré dans le sinus caverneux est retenu chez elle.

    Licence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
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  • Article libreArticle

    Exostose géante de l'extrémité inférieure du femur

    Younes Ouchrif, Issam Elouakili

    Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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  • Article libreArticle

    Exostose sous-unguéale: à propos d’un cas et revue de la littérature

    Mohamed Ben Jemaa, Hedi Chaabouni, Mohamed Ghorbel, Ameur Abid, Wassim Zribi, Mohamed Zribi, Moez Trigui, Kamel Ayedi, Mourad Aoui, Hassib Keskes

    L´exostose sous-unguéale est une tumeur ostéocartilagineuse bénigne, peu fréquente et à tendance récidivante. Nous rapportons un cas chez un garçon de 17 ans. La notion de traumatisme était retrouvée. Le traitement est chirurgical par un abord direct. La tumeur a été excisée complètement. Les suites opératoires sont simples sans récidive.

    Licence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
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  • Article libreArticleEn anglais

    Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries

    Anna Stout, Siri Wood, George Barigye, Alain Kaboré, Daouda Siddo, Ida Ndione

    Nearly half a million doses of DMPA-SC were administered over 2 years in Burkina Faso, Niger, Senegal, and Uganda, with 29% of doses provided to first-time family planning users and 44% (in 3 countries) to adolescent girls and young women under age 25. Switching from intramuscular DMPA (DMPA-IM) was not widespread and generally decreased over time. Community health workers provided a higher proportion of DMPA-SC than DMPA-IM injections. Stock-outs in 2 countries hindered product uptake, highlighting the need to strengthen logistics systems when introducing a new method. PATH partnered with the United Nations Population Fund (UNFPA) and country ministries of health (MOHs) to coordinate pilot introductions of subcutaneous depot medroxyprogesterone acetate (subcutaneous DMPA or DMPA-SC, brand name Sayana Press) in Burkina Faso, Niger, Senegal, and Uganda from July 2014 through June 2016 in order to expand the range of methods available to women, particularly in remote locations. The pilot introductions aimed to answer key questions that would inform decisions about future investments in DMPA-SC and scaling up product availability and service-delivery innovations nationally. These questions included the extent to which DMPA-SC would appeal to first-time users of modern contraception, as well as adolescent girls and young women; whether DMPA-SC would add value to family planning programs or simply replace DMPA-IM or other modern methods; and the trends in injectables use when introducing DMPA-SC (or any injectable) at the community level for the first time. We implemented a multicountry monitoring system to track key indicators, including the number of doses administered by category of user (e.g., new users, by client age group) or delivery channel. Providers generally collected these data using their national programs' standard family planning registers. Data were analyzed for cumulative information and to examine trends over time using Microsoft Power Query for Excel a

    Santé publiqueLicence : http://creativecommons.org/licenses/by/4.0/ https://doi.org/10.9745/GHSP-D-17-00250 This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, prov
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  • Article libreArticleEn anglais

    Expanding the Single-Visit Approach for Cervical Cancer Prevention: Successes and Lessons From Burkina Faso

    Yacouba Ouedraogo, Gahan Furlane, Timothee Fruhauf, Ousmane Badolo, Moumouni Bonkoungou, Tsigue Pleah, Jean Lankoande, Isabelle Bicaba, Eva S. Bazant

    The single-visit approach was implemented with strong attention to systems in 14 health facilities. In the 2 largest facilities, nearly 14,000 women screened for cervical cancer over 4 years. Of approximately 9% who screened positive, about 66% received same-day cryotherapy. Attention is needed to ensure local technicians can repair cryotherapy equipment, supplies are consistently in stock, and user fees are not prohibitive to accessing care. ABSTRACTBackground:Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso were limited to temporary screening campaigns.Program Description:Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.Methods:Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.Results:Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day s

    Santé publiqueLicence : http://creativecommons.org/licenses/by/4.0 https://doi.org/10.9745/GHSP-D-17-00326 This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provi
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  • Article libreArticleEn anglais

    Expansion of Neisseria meningitidis Serogroup C Clonal Complex 10217 during Meningitis Outbreak, Burkina Faso, 2019

    Joann F. Kekeisen-Chen, Felix T. Tarbangdo, Shalabh Sharma, Daya Marasini, Henju Marjuki, Janelle L. Kibler, Heather E. Reese, Seydou Ouattara, Flavien H. Ake, Issaka Yameogo, Issa Ouedraogo, Emmanuel Seini, Robert L. Zoma, Issa Tonde, Mahamoudou Sanou, Ryan T. Novak, Lucy A. McNamara

    During January 28–May 5, 2019, a meningitis outbreak caused by Neisseria meningitidis serogroup C (NmC) occurred in Burkina Faso. Demographic and laboratory data for meningitis cases were collected through national case-based surveillance. Cerebrospinal fluid was collected and tested by culture and real-time PCR. Among 301 suspected cases reported in 6 districts, N. meningitidis was the primary pathogen detected; 103 cases were serogroup C and 13 were serogroup X. Whole-genome sequencing revealed that 18 cerebrospinal fluid specimens tested positive for NmC sequence type (ST) 10217 within clonal complex 10217, an ST responsible for large epidemics in Niger and Nigeria. Expansion of NmC ST10217 into Burkina Faso, continued NmC outbreaks in the meningitis belt of Africa since 2019, and ongoing circulation of N. meningitidis serogroup X in the region underscore the urgent need to use multivalent conjugate vaccines in regional mass vaccination campaigns to reduce further spread of those serogroups.

    Biologie cellulaire et moléculaireGénétiqueMicrobiologie (bactériologie, virologie)Licence : Emerging Infectious Diseases is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
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    Expérience d´intégration de la santé mentale en première ligne de soins en Guinée

    Abdoulaye Sow, Bart Criel, Bernard Branger, Michel Roland, Myriam De Spiegelaere

    Introductionla faible couverture des services spécialisés et la pénurie en ressources humaines en santé mentale représentent d´immenses défis pour les systèmes de santé en Afrique. L'intégration de la santé mentale dans les soins de santé primaires constitue un complément substantiel et faisable aux services spécialisés. Cette étude rassemble et analyse les données générées dans 5 Centres de santé (CS) ayant intégrés ce paquet de soins en Guinée.Méthodesl'étude descriptive porte sur les nouveaux cas de santé mentale entre 2012 et 2017. Les motifs de consultations et les diagnostics posés ont été répertoriés et analysés sur la base des registres de consultation et des dossiers médicaux individuels.Résultatsau total 4995 patients ont consulté pour un problème de santé mentale, ce qui représente 2,8% des consultations générales (de 0,5 à 7,7% selon les centres). La moyenne d'âge des patients était de 27,9 ans (± 16,1). Les motifs de consultations les plus fréquents étaient les insomnies: 44,4% (n = 2081), les crises convulsives: 39% (n = 1827), les troubles du comportement: 31,9% (n = 1263) et les hallucinations: 26,1% (n = 1224). Les diagnostics les plus fréquemment posés étaient l'épilepsie : 36,8% (n = 1773) et les troubles psychotiques: 33,5% (n = 1613). 88,4% (n = 4418) des patients ont reçu un traitement médicamenteux, le plus souvent combiné avec un soutien psychologique.Conclusionl´étude montre que dans le contexte guinéen où l´accès aux soins spécialisés en santé mentale est très limité, les malades mentaux, même atteints de pathologies lourdes, peuvent être suivis dans des Centres de santé par un personnel non spécialiste mais formé en santé mentale.

    PharmacologieLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
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    Expérience de réorganisation d'une maternité de troisième niveau face à la pandémie de la COVID-19: étude du cas de la maternité de l´hôpital universitaire de Marrakech

    Hajar Ouahid, Latifa Adarmouch, Abderraouf Soummani, Mohamed Cherkaoui, Majda Sebbani, Mohamed Amine

    Introductionla pandémie de la COVID-19 a entraîné des pressions sans précédent sur les services de soins en gynéco-obstétrique. Les maternités devaient se préparer à fournir des soins de qualité tout en empêchant la transmission de l'infection. Cette étude avait pour objectif de décrire les éléments clés de la réponse à la COVID-19 au sein de la maternité du CHU Mohammed VI de Marrakech.Méthodesun plan d'étude de cas a été adopté. Les données ont été collectées à travers l´exploitation des différents documents administratifs intéressant l´activité de la maternité du CHU Mohammed VI, durant la pandémie. Nous avons également mené des entretiens semi-structurés avec des professionnels au niveau de la maternité. Une méthode d'analyse thématique qualitative a été utilisée pour l'analyse des données retranscrites et la triangulation avec l´analyse des données documentaires.Résultatsl´étude a mis en exergue les étapes de conception et d´organisation de deux circuits d´accès de la maternité. Un nouveau circuit pour les patientes suspectes ou confirmées COVID-19 a permis d´assurer l´accès à une prise en charge de qualité des patientes en garantissant leur isolement. Le circuit habituel est resté fonctionnel pour consolider le droit d´accès aux soins gynéco-obstétricaux tertiaires tout en appliquant les mesures de protection contre la COVID-19.Conclusionil est nécessaire de s´inspirer de l´expérience de préparation des autres établissements de santé, de contextualiser les actions locales et d´anticiper l´organisation du travail face aux crises sanitaires.

    Gynécologie-obstétriqueLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
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  • Lien vers la sourceMémoire

    Expérience du TIPS dans les complications de la Maladie Vasculaire Porto Sinusoïdale : étude multicentrique rétrospective

    Marie Vandois

    Introduction : la maladie vasculaire porto-sinusoïdale (MVPS) peut évoluer vers une hypertension portale non-cirrhotique. En cas d’hémorragie digestive récidivante ou d’ascite réfractaire, la place du TIPS et le pronostic restent incertains. Nous rapportons l’expérience du TIPS chez des patients MVPS dans une étude multicentrique rétrospective. Patients et méthodes : 122 patients atteints de MVPS ayant reçu un TIPS dans 23 centres Français et Belge de 2010 à 2025 ont été rétrospectivement inclus, et comparés à 363 patients atteints de cirrhose ayant eu un TIPS pour les mêmes complications d’hémorragie récidivante, d’ascite réfractaire, ou autres indications. La survie globale et les survies sans récidive ont été comparées sans ajustement, puis ajustées avec un score de propension (critères d’âge, sexe, bilirubine, albumine, TP, indication du TIPS pour ascite, encéphalopathie hépatique, MELD et antécédents d’hémorragie sur HTP), puis en analyse de sensibilité excluant les indications préemptives du TIPS. Résultats : les patients MVPS ou cirrhotiques avant ajustement étaient respectivement des hommes dans 66% vs. 83% (p&lt;0.001), d’âge médian 57 vs. 58 ans (p=0.3), TP à 75% vs. 53% (p&lt;0.001), albuminémie 33 vs. 28 G/L (p&lt;0.001), bilirubinémie 14 vs. 33 µmol/L (p&lt;0.001), et 73% d’affections extra hépatiques associées à la MVPS. Le TIPS était mis pour hémorragie, ascite ou autres indications respectivement dans 52%, 30% (4% mixte) et 13% (dont 82% en vue d’une chirurgie) pour les patients MVPS vs. 67%, 31% et 1.1% pour les patients Cirrhose (p&lt;0.001). Avant ajustement le taux de mortalité globale était de 20% dans le groupe MVPS (suivi médian 48,6 mois) contre 41% dans le groupe cirrhose (suivi médian 31,5 mois) (p&lt;0.001). Après ajustement, la survie globale était meilleure dans le groupe MVPS-TIPS (HR=0.42 (IC95% : 0.21-0.85), p=0.0159) avec des taux de survie à 1, 2 et 5 ans de 89, 87 et 84% et de 88, 76 et 49% dans le groupe cirrhose-TIPS, ainsi qu’en

    SémiologieMaladies infectieuses et tropicalesMédecine interne (cardiologie, endocrinologie, néphrologie…)Licence : https://creativecommons.org/licenses/by/4.0/
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