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Rajaa Elhannati, Hicham Tahri
Najia Ilham El Makrini, Badredine Hassam
Anastasie Nicole Alima Yanda, Jobert Richie N. Nansseu, Hubert Désiré Mbassi Awa, Sandra A. Tatah, Judith Seungue, Charlotte Eposse, Paul Olivier N. Koki
BackgroundAlthough sickle cell disease (SCD) children are highly susceptible to bacterial infections (BIs), there is a dreadful lack of data related to the burden and spectrum of BIs in sub-Saharan Africa (SSA), the highest affected region with SCD. This study aimed to determine the burden and spectrum of BIs among SCD children hospitalized in a pediatric reference hospital in Cameroon, a SSA country.MethodsWe conducted a retrospective analysis of records of children hospitalized from November 2012 to August 2015 in the SCD unit of the Mother and Child Centre of the Chantal Biya Foundation, Cameroon. We enrolled all known SCD children aged 15 years or less, hospitalized for a suspicion of BI and who presented a positive culture of a body specimen.ResultsA total of 987 SCD children were hospitalized during the study period. Cultures were positive for 96 patients (9.7%) among whom 60.4% males. Ages ranged from 6 to 192 months with a median of 53 (Interquartile range (IQR) 21–101) months. For children no more covered by the Expanded Programme on Immunization, only 13 (18.8%) had received the Pneumo 23® and Meningo A&C® antigens, and 12 (17.4%), the Typhim vi® and the Haemophilus influenzae type b antigens; 58 children (84.1%) had received no vaccine. The specimen yielding positive cultures were: blood (70.7%), urine (13.1%), pus (9.1%), synovial fluid (4.1%), cerebrospinal fluid (2.0%), and bone fragment (1.0%). The different types of infection included: urinary tract infections (13.5%), myositis (8.3%), arthritis (6.3%), osteomyelitis (4.2%), and meningitis (2.1%); the site of infection was unidentified in 65.6% of cases. The main bacteria included: Salmonella sp. (28.1%), Staphylococcus sp. (18.8%), Klebsiella pneumoniae (17.7%), Escherichia coli (10.4%), Enterobacter sp. (5.2%), Acinetobacter sp. (4.2%), Streptococcus sp. (4.2%) and Serratia sp. (4.2%).ConclusionThis retrospective analysis revealed 9.7% cases of BIs, mainly caused by Salmonella sp. (28.1%), Staphylo
Saeid Safiri, Ali-Asghar Kolahi, Maryam Noori, Seyed Aria Nejadghaderi, Nahid Karamzad, Nicola Luigi Bragazzi, Mark J. M. Sullman, Morteza Abdollahi, Gary S. Collins, Jay S. Kaufman, Jessica A. Grieger
BackgroundAnemia is a common disease which affects around 40% of children and 30% of reproductive age women and can have major health consequences. The present study reports the global, regional and national burden of anemia and its underlying causes between 1990 and 2019, by age, sex and socio-demographic index (SDI).MethodsPublicly available data on the point prevalence and years lived with disability (YLDs) were retrieved from the global burden of disease (GBD) 2019 study for 204 countries and territories between 1990 and 2019. The point prevalence, YLD counts and rates per 100,000 population were presented, along with their corresponding 95% uncertainty intervals.ResultsIn 2019, the global age-standardized point prevalence and YLD rates for anemia were 23,176.2 (22,943.5–23,418.6) and 672.4 (447.2–981.5) per 100,000 population, respectively. Moreover, the global age-standardized point prevalence and YLD rate decreased by 13.4% (12.1–14.5%) and 18.8% (16.9–20.8%), respectively, over the period 1990–2019. The highest national point prevalences of anemia were found in Zambia [49327.1 (95% UI: 46,838.5–51,700.1)], Mali [46890.1 (95% UI: 44,301.1–49,389.8)], and Burkina Faso [46117.2 (95% UI: 43,640.7–48,319.2)]. In 2019, the global point prevalence of anemia was highest in the 15–19 and 95+ age groups in females and males, respectively. Also, the burden of anemia was lower in regions with higher socio-economic development. Globally, most of the prevalent cases were attributable to dietary iron deficiency, as well as hemoglobinopathies and hemolytic anemias.ConclusionsAnemia remains a major health problem, especially among females in less developed countries. The implementation of preventive programs with a focus on improving access to iron supplements, early diagnosis and the treatment of hemoglobinopathies should be taken into consideration.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13045-021-01202-2.
Background: Malaria is a parasitic infection transmitted by mosquito vectors, commonly found in tropical regions, and characterized by high morbidity and mortality. It causes a heavy disease burden in Sao Tome and Principe (STP), an island country in West Africa which at one time had a high incidence of malaria. Objective: This study aims to analyze the trend of disease burden of malaria in STP. Methods: The crude and age-standardized incidence, mortality, and disability-adjusted life years (DALYs) rate data of malaria were extracted from GBD 2019. Joinpoint 4.9 software was used to calculate the annual percentage change (APC) and the average annual percentage change (AAPC), which were also used to indicate the change in disease burden by different stages. Results: In general, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) of malaria presented a decreasing trend between 1990 and 2019, with an average annual decrease of 5.6%, 6.2%, and 10.7%, respectively, in STP. Specifically, all indicators first presented an increasing trend from 1990 to about 2000, followed by a decreasing trend until 2019, although the incidence rebounded slightly after 2015. Overall, the ASIR, ASMR, and ASDR of malaria reduced by 77.08%, 87.84%, and 82.21%, respectively, in 2019 as compared to 1990. No significant differences in disease burden were found between males and females between 2005 and 2019. Children who were under 5 years old showed a relatively small decrease in the rate of DALYs as compared to other age groups, but remained the group with the highest disease burden of malaria in the country. Conclusions: The disease burden of malaria in STP showed a significant decrease between 1990 and 2019, but it will still be challenging to achieve the goal of eliminating malaria by 2025. The government and relevant authorities should aim to strengthen the prevention and surveillance of malaria and tailor population-sp
Nancy S. Green, Deogratias Munube, Paul Bangirana, Linda Rosset Buluma, Bridget Kebirungi, Robert Opoka, Ezekiel Mupere, Philip Kasirye, Sarah Kiguli, Annet Birabwa, Michael S. Kawooya, Samson K. Lubowa, Rogers Sekibira, Edwards Kayongo, Heather Hume, Mitchell Elkind, Weixin Peng, Gen Li, Caterina Rosano, Philip LaRussa, Frank J. Minja, Amelia Boehme, Richard Idro
BackgroundChildren with sickle cell anemia (SCA) are highly susceptible to stroke and other manifestations of pediatric cerebral vasculopathy. Detailed evaluations in sub-Saharan Africa are limited.MethodsWe aimed to establish the frequency and types of pediatric brain injury in a cross-sectional study at a large SCA clinic in Kampala, Uganda in a randomly selected sample of 265 patients with HbSS ages 1–12 years. Brain injury was defined as one or more abnormality on standardized testing: neurocognitive impairment using an age-appropriate test battery, prior stroke by examination or transcranial Doppler (TCD) velocities associated with stroke risk in children with SCA (cerebral arterial time averaged mean maximum velocity ≥ 170 cm/second).ResultsMean age was 5.5 ± 2.9 years; 52.3% were male. Mean hemoglobin was 7.3 ± 1.01 g/dl; 76.4% had hemoglobin < 8.0 g/dl. Using established international standards, 14.7% were malnourished, and was more common in children ages 5–12. Overall, 57 (21.5%) subjects had one to three abnormal primary testing. Neurocognitive dysfunction was found in 27, while prior stroke was detected in 15 (5.7%). The most frequent abnormality was elevated TCD velocity 43 (18.1%), of which five (2.1%) were in the highest velocity range of abnormal. Only impaired neurocognitive dysfunction increased with age (OR 1.44, 95%CI 1.23–1.68), p < 0.001). In univariate models, malnutrition defined as wasting (weight-for-height ≤ −2SD), but not sex or hemoglobin, was modestly related to elevated TCD (OR 1.37, 95%CI 1.01–1.86, p = 0.04). In adjusted models, neurocognitive dysfunction was strongly related to prior stroke (OR 6.88, 95%CI 1.95–24.3, p = .003) and to abnormal TCD (OR 4.37, 95%CI 1.30, p = 0.02). In a subset of 81 subjects who were enriched for other abnormal results, magnetic resonance imaging and angiography (MRI/MRA) detected infarcts and/or arterial stenosis in 52%. Thirteen subjects (25%) with abnormal imaging had no other abnormalities detected
Sanata Bamba, Adama Zida, Ibrahim Sangaré, Mamoudou Cissé, David W. Denning, Christophe Hennequin
Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the national demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.
BackgroundShigella is a leading cause of childhood diarrheal disease and a priority target for vaccine development, particularly in low-resource settings where its true burden is often underestimated. A clear understanding of local Shigella epidemiology and risk factors is essential for guiding control strategies and vaccine introduction.Methodology/Principal FindingsWe conducted a 12-month longitudinal cohort study enrolling 750 children under five years of age in a peri-urban area of Ouagadougou, Burkina Faso, from December 2020 to March 2021, with follow-up through March 2022. Active and passive surveillance captured both symptomatic and asymptomatic infections. Stool samples (n = 2,401), including 236 from diarrheal episodes, were analyzed by conventional microbiological methods with species confirmation using the BD Phoenix M50 system. Shigella was isolated from 56 incident cases, yielding an incidence rate of 6.8 cases per 1,000 child-months (95% CI: 5.3-8.9). Shigella flexneri predominated (58.9%), followed by S. boydii (23.2%), S. sonnei (14.3%), and S. dysenteriae (3.6%). Incidence among diarrheal cases was 39.2 per 1,000 child-months (95% CI: 24.7-62.2), alongside substantial asymptomatic carriage (4.9 per 1,000 child-months). Shigellosis was strongly associated with diarrhea, predominantly mucoid rather than bloody stools. Young age was a significant predictor, particularly at 12–23 months (aHR = 2.68; 95% CI: 1.11-6.47) and 36–47 months (aHR = 2.81; 95% CI: 1.08-7.33), while use of a public water source was independently protective (aHR = 0.52; 95% CI: 0.29-0.94).Conclusions/SignificanceThis study provides foundational incidence and serotype data for Shigella among young children in peri-urban Burkina Faso, informing future vaccine development and targeted public health interventions. The findings highlight the need to strengthen water, sanitation, and hygiene programs, improve diagnostic capacity, and enhance antimicrobial resistance surveillance to red
IntroductionSickle Cell Anemia (SCA) is a significant genetic disorder in Africa; however, comprehensive data on its prevalence and geographic distribution remain limited. We aimed to estimate the pooled prevalence of SCA (HbSS) in African populations and examine regional, demographic, and temporal variations from 1994–2024.MethodsWe systematically searched PubMed, Scopus, Google Scholar, and BASE databases for studies reporting SCA prevalence in African populations. Screening and quality assessments were performed using JBI tools. A random-effects meta-analysis with logit transformation was performed, with subgroup analyses by region, age, sex, and study design. Meta-regression explored heterogeneity sources, including geographic region, age category, diagnostic method, study design, and publication year.ResultsFrom 115 studies with 1,203,839 participants and 17,458 confirmed HbSS cases, the pooled prevalence was 1.43% (95% CI: 1.08%–1.88%), with substantial heterogeneity (I2 = 99.1%) and a prediction interval of 0.21%–8.91%. Central Africa showed the highest prevalence (1.99%), and Southern Africa showed the lowest (0.59%). Children exhibited a higher prevalence (1.65%) than adults (0.45%), while sex differences were non-significant (males 2.71%, females 1.74%; p = 0.694). The prevalence has remained stable over three decades despite a six-fold increase in research output, although wide prediction intervals indicated substantial between-study variability. Electrophoretic techniques predominated (86.4% of cases). Diagnostic method (χ² = 16.73, p = 0.033) and age category (χ² = 33.66, p < 0.0001) significantly moderated the prevalence. The multivariable meta-regression was marginally significant (χ² = 29.01, p = 0.066), but substantial residual heterogeneity persisted (I2 = 98.6%). Leave-one-out sensitivity analysis showed that no single study significantly impacted the pooled estimates.ConclusionSCA represents a substantial and geographically variable public health
Eugenia V. Asare, Ivor Wilson, Amma A. Benneh-Akwasi Kuma, Yvonne Dei-Adomakoh, Fredericka Sey, Edeghonghon Olayemi
In Africa, sickle cell disease (SCD) is a major public health problem with over 200,000 babies born per year. In Ghana, approximately 15,000 (2%) of Ghanaian newborns are diagnosed with SCD annually. A retrospective review of medical records of all SCD patients aged 13 years and above, who presented to the sickle cell clinic at Ghana Institute of Clinical Genetics (GICG), Korle-Bu, from 1st January 2013 to 31st December 2014, was carried out, using a data abstraction instrument to document their phenotypes, demographics, attendance/clinic visits, pattern of attendance, and common complications seen. During the period under review 5,451 patients were seen at the GICG, with 20,788 clinic visits. The phenotypes were HbSS (55.7%) and HbSC (39.6%) with other sickle cell phenotypes (4.7%). Out of the 20,788 clinic visits, outpatient visits were 15,802 (76%), and urgent care visits were 4,986 (24%), out of which 128 (2.6%) patients were admitted to the Teaching Hospital for further management of their acute complications. There were 904 patient referrals (out of 5,451 patients) for specialist care; the 3 specialties that had the most referrals were Obstetrics and Gynaecology (168 patients), Orthopaedics (150 patients), and Ophthalmology (143 patients). In 2014, complications seen at KBTH included 53 patients with avascular necrosis (AVN) and 61 patients with chronic leg ulcers. Our centre has a large number of patients living with sickle cell disease. From our experience, early recognition and referral of sickle cell related complications can reduce morbidity and mortality associated with this disease. A multidisciplinary approach to care of SCD patients is therefore important.
Annicet Bopda Negueu, Samuel Nambile Cumber, Layu Donatus, Claude Ngwayu Nkfusai, Bestina Forkwa Ewang, Fala Bede, Terrence Epie Beteck, Joyce Shirinde, Vincent de Paul Djientcheu, Benjamin Alexandre Nkoum
IntroductionLe burnout ou syndrome d'épuisement professionnel des soignants est un problème de santé publique au Cameroun. Il se manifeste par un épuisement émotionnel, une dépersonnalisation et une diminution de l'accomplissement personnel du sujet. Il touche la plupart des personnels soignants et les conséquences sont nombreuses. Au Cameroun en général et à l'Hôpital Central de Yaoundé (HCY) en particulier, toutes ces dernières années, les soignants n'ont cessés d'exprimer leur mécontentement face à leurs conditions de travail à travers des grèves et menaces de divers ordres. La prise en charge des patients se fait de façon impersonnelle et on assiste à des conséquences dramatiques et des problèmes déontologiques.MéthodesNotre étude transversale analytique avait pour objectif de déterminer les facteurs qui sont associés au burnout dans cette population des soignants de l'HCY. Pour ce faire, pendant un mois, nous avons administré auprès de ces soignants notre questionnaire conçu selon les modèles théoriques de Maslach et Siegrist. Nous avons pu obtenir des informations recherchées auprès de 104 personnels soignants; la saisie et l'analyse des données se sont faites avec SPSS 20.RésultatsLes résultats montrent auprès des soignants de quatre unités de soins de l'HCY des manifestations similaires à celles trouvées dans la littérature et une prévalence du Burnout (BO) de 63% parmi ces soignants. Sept facteurs y ont été associés de façon statistiquement significative: il s'agit du pavillon d'exercice (OR= 3.93; 1.16-13.24; p-value=0.027); le statut matrimonial (OR: 2.56; 1.22 - 5.39; p-value=0,049); le ratio effort/récompenses déséquilibré (OR: 2.31; 1.10 - 4.84; p-value=0.026 ); avoir été menacé physiquement ou verbalement (OR: 3,75; 1,49 - 9,41; 0,005); le maintien de l'équilibre entre vie privée et vie professionnelle (OR: 3,41; 1,19- 10,7; p-value=0,038); la fréquence des oublis (OR: 4,25 -1,33; 7,91; p-value=0,002) l'attribution des erreurs aux conditions de travai
Aurélia Rakotondrainibe, Harifetra Mamy Richard Randriamizao, Noro Seheno Ratsimbazafy, Yvon Mong-Gine, Catherine Nicole Rakotoarison, Felantsoa Auberlin Rakototiana, Marie Lydia Agnès Ravalisoa
La profession médicale est un métier stressant, pouvant engendrer un syndrome d'épuisement professionnel ou burnout syndrom (BOS). Le but de cette étude était de déterminer les degrés du BOS (faible, moyen, élevé) de par ses dimensions et les facteurs liés à l'activité professionnelle du médecin qui lui étaient corrélés. Il s'agit d'une étude transversale, en 2012, par auto-questionnaire, auprès des médecins du Centre Hospitalier de Soavinandriana et du Centre Hospitalier Universitaire, Joseph Ravoahangy Andrianavalona. Des tests de corrélation et de régression linéaire ont été effectués (SigmaStat® 3.5). Le taux de réponse à l'enquête a été de 47,1% sur 138 médecins hospitaliers. Le nombre de dossiers retenus était de 48. La population de l'étude était à prédominance masculine (sex ratio: 1,8) avec un âge médian de 37 [25-59] ans. Les internes de spécialité et les médecins assistants représentaient 56,3% de la population. Selon l'ancienneté 16,7% étaient dans le métier depuis moins d'un an. Le burnout syndrom a été observé dans 51,2 % des cas avec un degré élevé pour 4,2% des médecins. Le titre avait une corrélation significative avec le syndrome d'épuisement professionnel et son degré (p=0,0142 et p=0,0362), notamment l'épuisement émotionnel (p=0,0414). L'apparition du BOS n'était ni corrélé avec l'ancienneté du médecin ni avec le secteur d'activité. Le BOS existe en milieu hospitalier, surtout lié au titre du médecin. Il est essentiel de le diagnostiquer au plus tôt pour en éviter ses conséquences délétères.
Mohamed Ben Jemaa, Wassim Zribi, Emna Elleuch, Wajdi Bouaziz, Ameur Abid, Soumaya Yaich, Mourad Aoui, Kamel Ayedi, Mounir Ben Jemaa, Mohamed Zribi, Hassib Keskes
La tuberculose de l'épaule est rare. Elle regroupe toutes les atteintes tuberculeuses des tissus articulaires et péri-articulaires de l'épaule. Son évolution insidieuse mimant les pathologies inflammatoires et dégénératives, explique la fréquence de son retard diagnostique. Nous rapportons un cas rare d'une bursite tuberculeuse de l'épaule chez une femme de milieu rural, insuffisante rénale et traitée pour une tuberculose péritonéale et du psoas. Des signes d'imprégnation tuberculeuse ont été notés à l'anamnèse. L'examen clinique trouvait une tuméfaction douloureuse de l'épaule avec raideur. L'IRM de l'épaule était en faveur d'une bursite infectieuse. L'origine tuberculeuse était confirmée par l'examen histologique d'une biopsie synoviale écho-guidée. Un traitement antituberculeux lui a été instauré avec bonne évolution. Au recul de 9 ans, elle retrouve une fonction articulaire satisfaisante avec absence de récidive infectieuse.
Guillaume Broc
Constat. Les paradigmes de la Global & One Health sous-tendent que la santé n’est pas un état, mais une propriété émergente des interactions entre les systèmes vivants humains, animaux, végétaux et leur environnement (Raphael et al., 2024 ; Topolski, 2009). Cette évolution marque une rupture décisive avec une conception strictement biomédicale et anthropocentrique de la santé. Toutefois, la Santé Globale demeure à ce jour une ambition encore largement peu opérationnalisée (Chen et al., 2020 ; Ding et al., 2024 ; Guzmán, 2022 ; Ridde et al., 2022 ; Salm et al., 2021). En l’absence de cadre et de méthodologie structurant la gouvernance et l’action au niveau structurel, populationnel, organisationnel et clinique, les initiatives demeurent sectorialisées et reproduisent les silos disciplinaires et institutionnels (Ding et al., 2024 ; Guzmán, 2022 ; Kleinman, 2010). Objectif. Dans ce contexte, l’objectif de cette synthèse était de faire émerger —à la lumière de mes travaux— un cadre épistémologique et méthodologique susceptible d’accompagner les transitions en Santé Globale. Contribution. Le cadre Dynamique et Écosystémique d’Adaptation par Allostasie [DEA-A] formalise cette réponse. Il s’appuie sur une épistémologie intégrative, à la croisée des théories évolutionnistes, développementales et intersectorielles de l’adaptation en santé humaine, animale, végétale et organisationnelle (p. ex., Gorban et al., 2021; Gross & Thompson, 2007; Halfon & Forrest, 2018; Hassani et al., 2018; Leconstant & Spitz, 2022; Marks, 2018; Rothermund & Brandtstädter, 2019; van de Guchte et al., 2018) opérationnalisée dans le paradigme des Systèmes Adaptatifs Complexes (Bircher & Hahn, 2016; van Geert, 2019). Le cadre DEA-A est outillée par des méthodes participatives centrées-agents, evidence-based et réalistes. Il s’inscrit dans le protocole d’Intervention Mapping et vise: 1/ un diagnostic fonctionnel écosystémique; 2/ l’identification de fonctionnements-cibles par (c
Women’s fear and uncertainty about vaginal delivery and lack of empowerment in decision-making generate decision conflict and is one of the main determinants of high caesarean section rates in low- and middle-income countries (LMICs). This study aims to develop a decision analysis tool (DAT) to help pregnant women make an informed choice about the planned mode of delivery and to evaluate its acceptability in Vietnam, Thailand, Argentina, and Burkina Faso. The DAT targets low-risk pregnant women with a healthy, singleton foetus, without any medical or obstetric disorder, no previous caesarean scarring, and eligibility for labour trials. We conducted a systematic review to determine the short- and long-term maternal and offspring risks and benefits of planned caesarean section compared to planned vaginal delivery. We carried out individual interviews and focus group discussions with key informants to capture informational needs for decision-making, and to assess the acceptability of the DAT in participating hospitals. The DAT meets 20 of the 22 Patient Decision Aid Standards for decision support. It includes low- to moderate-certainty evidence-based information on the risks and benefits of both modes of birth, and helps pregnant women clarify their personal values. It has been well accepted by women and health care providers. Adaptations have been made in each country to fit the context and to facilitate its implementation in current practice, including the development of an App. DAT is a simple method to improve communication and facilitate shared decision-making for planned modes of birth. It is expected to build trust and foster more effective, satisfactory dialogue between pregnant women and providers. It can be easily adapted and updated as new evidence emerges. We encourage further studies in LMICs to assess the impact of DAT on quality decision-making for the appropriate use of caesarean section in these settings.
Wiem Feki, Amin Bahloul, Slim Bouaziz, Imen Haddar, Emna Daoud, Leila Abid, Salma Charfeddine
La calcification caséeuse de l'anneau mitral est une entité rare et souvent méconnue des cliniciens, y compris des radiologues. Son diagnostic peut s'avérer difficile en échocardiographie, avec un risque de confusion avec des tumeurs ou pseudomasses cardiaques. Dans ce contexte, nous rapportons le cas d'une patiente de 40 ans, aux antécédents médicaux notables d'hypertension artérielle et d'insuffisance rénale chronique, hospitalisée pour une pneumopathie infectieuse compliquée de douleurs thoraciques droites. Une échocardiographie réalisée dans le cadre du bilan a révélé un rétrécissement aortique serré, une calcification de l'anneau mitral, une insuffisance mitrale modérée et une insuffisance tricuspide sévère. En vue d'une évaluation préopératoire, un coroscanner a été effectué, mettant en évidence une formation hypodense au niveau du trigone aortomitral, compatible avec une calcification caséeuse de l'anneau mitral. Ce cas illustre la complexité diagnostique en présence d'anomalies valvulaires multiples associées à des facteurs de risque cardiovasculaires et métaboliques. Il souligne également l'intérêt crucial d'une imagerie multimodale pour affiner le diagnostic différentiel et optimiser la stratégie thérapeutique. Ce cas contribue ainsi à enrichir la littérature médicale sur la prise en charge des calcifications annulaire et caséeuse.
Eitel Igor Kouamo, Merouane Nour, Jean Marie Gennar, Jean Marc Guillaume, Elie Choufani, Thierry Merrot, Jean Pierre Alessandrni, Kathia Chaumoitre, Michel Panuel, Namane Doumbouya, Patrice Guemaleu
Les calcifications discales sont le plus souvent révélées chez l'enfant, par des crises douloureuses rachidiennes. Leur localisation cervicale, semble être la plus fréquente. Cependant, les autres localisations sont moins symptomatiques et pourraient ainsi passer inaperçues. Nous rapportons deux observations d'enfants hospitalisés pour des calcifications discales cervicales symptomatiques. Il s'agit : du cas d'une fillette âgée de quatre ans et demi ayant présenté un torticolis, révélateur de la migration d'une calcification discale jusque-là asymptomatique ; et de celui du garçon âgé de 05 ans venu pour cervicalgie aigue et chez qui une calcification discale a été retrouvée. Leur traitement était essentiellement conservateur. Les calcifications discales intervertébrales de l'enfant sont une pathologie rare dont l'étiopathogénie reste inconnue. Leur diagnostic ne doit pas se faire sans un examen neurologique attentif et une imagerie devant des douleurs rachidiennes inexpliquées chez l'enfant.
Haykel Abdelhedi, Naziha Khammassi
Samia Ait Faqih, Béfa Noto-Kadou-Kaza, Lalla Meryam Abouamrane, Naoufal Mtiou, Selma El Khaya, Mohamed Zamd, Ghislaine Medkouri, Mohamed Gharbi Bengahanem, Benyounes Ramdani
IntroductionLes calcifications valvulaires constituent une des complications cardiovasculaires majeures de l'hémodialysé de par sa prévalence et son caractère prédictif de morbidité et de mortalité. De nombreux facteurs de risque sont à l'origine de ces calcifications. Le but de notre étude est d’évaluer à la fois la prévalence des calcifications valvulaires chez nos patients hémodialysés ainsi que leurs facteurs de risque.MéthodesIl s'agissait d'une étude transversale monocentrique, descriptive et analytique, ayant inclus 111 patients adultes hémodialysés depuis plus de 6 mois au centre d'hémodialyse du CHU Ibn Rochd de Casablanca et qui ont eu à bénéficier d'une ETT durant l'année 2013.RésultatsL’âge moyen de nos patients était de 44 ± 14 ans. L'ancienneté moyenne en hémodialyse était de 146 ± 80 mois. La pression artérielle moyenne était de 123 ± 23 mmHg pour la systolique et de 72 ± 13 mmHg pour la diastolique, la PTHi moyenne de 529±460 pg/ml, la calcémie moyenne de 86±10 mg/l et la phosphatémie moyenne de 40±15 mg/l. La CRP moyenne était de 11±19,8 mg/L. Sur le plan thérapeutique, 96% des patients étaient sous carbonate de calcium, 11% sous 25 OH vitamine D, 55,5% sous 1 hydroxy-vitamine D3. La prévalence des calcifications valvulaires était de 15% avec une localisation valvulaire aortique dans 41,2% et valvulaire mitrale dans 41,2%. En analyse univariée, seule la durée d'hémodialyse semble être associée à la survenue des calcifications avec p = 0,09 proche du seuil de significativité.ConclusionLa prévalence des calcifications valvulaires chez nos patients hémodialysés reste élevée même si elle parait relativement moindre comparée aux données de la littérature. Aucun facteur de risque connu n'est apparu significativement associé à ces calcifications.
Nadia Kabbali, Tarik Sqalli
Abdoulaye Diallo Harouna, Karima Atarraf, Abderrahmane My Afifi
La calcinose pseudo-tumorale est une tumeur bénigne relativement rare, elle se caractérise par un dépôt de matériel calcique dans les tissus mous péri-articulaires. Nous rapportons un cas de calcinose tumorale primitive de la hanche gauche découvert chez un enfant de 15 ans avec une revue de la littérature. La patiente a été opérée avec une exérèse totale de la masse, les suites postopératoires étaient simples. 6 mois après l’intervention il n’y a pas de récidive tumorale.
Manel Jellouli, Tahar Gargah
Ghita Belmaati Cherkaoui, Ayat Allah Oufkir
Tumoural calcinosis rarely occurs in adolescents and young adults. It is characterized by a deposit of calcium in the periarticular soft tissues. We here present two characteristics and original clinical and radiographic images of sporadic left iliac cutaneous tumoural calcinosis causing non-painful swelling in an elderly woman. The study involved a 66-year old female patient with no particular past medical history who presented with polylobal erythematous mass, hard to palpation, that had evolved for 2 months (A). The diagnosis was evoked on the basis of standard frontal X-ray results (B) and biopsy results, and confirmed after histological examination of the surgical specimen. The diagnosis was made after all other possible differential diagnoses of soft tissue calcifications: calcinosis secondary to imbalances in calcium and phosphate levels, post-traumatic calcinosis and others.
Abdou Ahlam, Badreddine Hassam