Sante (Montrouge, France)最新文献

{"title":"[Evaluation of the lifetime of nail markings during polio vaccinations in Chad].","authors":"Huong Quoc Cuong,&nbsp;Martin Schlumberger,&nbsp;Salomon Garba Tchang,&nbsp;Dah Ould Cheikh,&nbsp;Marianne Savès,&nbsp;Barah Mallah,&nbsp;Jacques Demtilo Attilo,&nbsp;Ndeikoundam Ngangro Mosurel,&nbsp;Youssouf Gamatié","doi":"10.1684/san.2010.0201","DOIUrl":"https://doi.org/10.1684/san.2010.0201","url":null,"abstract":"<p><strong>Background: </strong>SID (Supplemental Immunization Days) is a special strategy intended to accelerate eradication of poliomyelitis in countries where it is still endemic (India, Afghanistan, and Pakistan in Asia, and Nigeria in Africa). This strategy is also applied in Nigeria's neighbours (Cameroon, Chad, Niger and Benin). Since the poliomyelitis virus was imported from Nigeria in 2001, Chad has reported cases of poliomyelitis every year. After 30 SIDs in Chad and the inaccurate or false attribution of side-effects to polio vaccines, some groups persistently refuse polio vaccination. To ascertain the true coverage of SID, the Ministry of Health and several partners (WHO, UNICEF and Rotary) conduct external coverage evaluations, to identify the under-vaccinated areas where population may be refusing immunization. The nails of the children receiving vaccinations are marked with indelible ink and those markings are the best indicator of the area's actual SID coverage. When coverage investigators arrive and propose vaccination to all children not immunized during SID, mothers who wish to refuse vaccination may claim that the children's markings disappeared after a few days, due to bathing. WHO experts have found that markings applied to their own nails with the WHO-recommended markers persist a few weeks, but others suggested that the markings may disappear much faster among children living in a traditional tropical environment. Until now, the lifetime of these markings has not been tested among children in Africa.</p><p><strong>Objectives: </strong>To determine the lifetime of the fingernail markings after SID and factors that influence this lifetime in children young than 5 years old in Chad.</p><p><strong>Materials and methods: </strong>This prospective cohort study of 200 children (aged 0 to 59 months) took place from March to May 2009 in Milezi, a health zone north of Ndjamena, the capital of Chad, in central Africa. These children received nail markings on their left little finger with an indelible marker pen provided by WHO. The finger was monitored for 35 days, visually and by photographs, to determine the factors associated with the lifetime of the markings. Kaplan-Meier and log-rank methods were applied to estimate their survival curve and the variables significant for their lifetime; the Cox proportional hazard model was used to determine multivariable-adjusted hazard ratios.</p><p><strong>Results: </strong>Of the 184 children surveyed through the end of the study, the markings disappeared after 35 days of follow-up for 35% of them. The average lifetime of markings on these children was 28 days (SD: 4.95) and was associated, according to the Cox model, with 3 variables: the quality of the marking (RR = 0.335, 95% CI: 0.182-0.617, p < 0.001), playing with soil or mud (RR = 0.38, 95% CI: 0.208-0.697, p = 0.002), and living in different blocks, after stratification for the variable of application of chemical products on the nail.","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"143-8"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How the financial resources of health centre management committees in Burkina Faso can be used to improve equity of access to health care].","authors":"Yamba Kafando,&nbsp;Valéry Ridde","doi":"10.1684/san.2010.0208","DOIUrl":"https://doi.org/10.1684/san.2010.0208","url":null,"abstract":"<p><p>With the advent of cost-recovery system in the 1990s in Burkina Faso, patients contribute to the financing of health centres (CSPS), which are managed by management committees (COGES). Asking patients to pay, however, erects a financial barrier to treatment for the poorest. The aim of this paper is to study how the financial resources from cost recovery can be used to improve equity of access to health care. The study took place in the health district of Ouargaye and documents the financial position of 17 COGES over a period of 12 months, with their accounting data. The results show that COGES spent an average of 7 million francs CFA, 65% for the purchase of medicines, 15% for operating costs, 7% for staff salaries and bonuses to COGES and 3.4% for discounts for health workers. Average revenue per COGES was 7.3 million FCFA. The sale of generic drugs accounted for 82% of revenue and fees for medical care to 10%. The average profit was 300,000 FCFA. The cost recovery rate averaged 104% and the profit margin on the sale of drugs 31%. Discounts to health workers represented 30% of the revenues from medical fees. The average cash position of a COGES was 3.1 million FCFA. The financial standing of the COGES is thus good. They could improve access to care and provide the standards discount to employees (20%) by removing fees for services, reducing the margins on the sale of drugs, or by using a portion of profits to exempt the poorest from payment.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"153-61"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29509026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Audit of medical records].","authors":"Ad Some,&nbsp;S Ouattara,&nbsp;S Barro,&nbsp;M Bambara,&nbsp;B Dao","doi":"10.1684/san.2010.0199","DOIUrl":"https://doi.org/10.1684/san.2010.0199","url":null,"abstract":"<p><strong>Objective: </strong>TO assess the quality of medical records in a university teaching hospital in Africa.</p><p><strong>Material and methods: </strong>We conducted a retrospective study at the Souro Sanou University Teaching Hospital of Bobo Dioulasso in Burkina Faso, by randomly selecting 480 medical records from 4 clinical departments (internal medicine, obstetrics & gynaecology, paediatrics and surgery). Items recorded were based mainly on those used by the French agency for the evaluation of health services (now the HAS). Ten physicians were also interviewed about medical file ergonomics file. Descriptive statistics were compiled from the data collected.</p><p><strong>Results: </strong>Only 368 of the 480 records could be found. Two of the four departments had an adequate record room. Assessment of the overall quality of the files noted that: i) 95 to 100% of the records were in good physical condition; ii) the handwriting in the files was legible in 94 to 100% of the cases; iii) the identity of the staff members making file entries could be determined in 73 to 92% of the cases. A detailed examination of the content of the files revealed that: i) the patient's social and demographic characteristics (name, sex, age, residence, occupation, marital status and religion) were available in 26 to 99% of the cases; ii) the mode of admission was noted in 52 to 88%; iii) the reason for admission was stated in 83 to 100%; iv) the main diagnosis was reported in 68 to 100%; v) surgery notes were found for 93 to 100% of patients who underwent surgery; vi) the disposition on discharge was not found in 31% of the records; vii) the circumstances of death were not recorded for 77% of the patients who died.</p><p><strong>Conclusion: </strong>The quality of medical records at Souro University Teaching Hospital must be improved, through improving staff awareness and regular audits.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"167-71"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Childhood ocular tumors: epidemiological and histopathological aspects at the Yaoundé gynaeco obstetric and pediatric hospital].","authors":"Lucienne Assumpta Bella,&nbsp;Ted Afetane Evina,&nbsp;André Omgbwa Eballe","doi":"10.1684/san.2010.0198","DOIUrl":"https://doi.org/10.1684/san.2010.0198","url":null,"abstract":"<p><strong>Unlabelled: </strong>The ocular tumours encountered in ophthalmologic consultations affect all age groups. The purpose of our study is to help improve knowledge of ocular and orbital tumours in children in Cameroon, by analysing the epidemiologic and histopathologic aspects of these tumours at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (HGOPY). We therefore conducted a retrospective descriptive cross-sectional study examining files of cases treated from 2003 through 2009. We found that tumours accounted for 0.36% of all consultations of children aged from 0 to 15 years in the HGOPY and affected an average of three children a year, mainly those younger than 10 years (90% of the cases) and 65% boys. Overall, 75% of the tumours were retinoblastomas (75%), 15% conjunctival naevi, 5% epidermoid carcinomas of conjunctiva (5%) and angioneurofibromas of the optic nerve (5%).</p><p><strong>Conclusion: </strong>Ocular tumours are rare in children attending hospitals in Cameroon. They are mainly retinablastinomas and affect boys more often than girls.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"139-41"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Utility of the viral load measurement after one month of antiretroviral treatment].","authors":"O Kra,&nbsp;B Ouattara,&nbsp;Yt Aba,&nbsp;Pm Roger,&nbsp;P Dellamonica","doi":"10.1684/san.2010.0205","DOIUrl":"https://doi.org/10.1684/san.2010.0205","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the therapeutic utility of the viral load (VL) measurement after one month (M1) of antiretroviral (ARV) treatment.</p><p><strong>Patients and method: </strong>A retrospective study of HIV patients included in the NADIS database from 1998 to 2006 and followed at Nice University Hospital. We included ARV-naive patients who received ARV (3-drug combination) for at least 3 months and ARV-experienced patients beginning a new ARV after virologic failure.</p><p><strong>Results: </strong>The NADIS database included 1065 patients from 1998 to 2006. We included 262. In all, 234 of them had VL measured at M1 and are considered in this analysis. Their mean age was 44 years, and 174 were men, for a sex ratio of 9.1. ARV-naïve patients accounted for 35% of the sample (n = 81) and previously treated patients 65% (n = 153). All the naive patients had a VL decrease at M1 > 1 log, as did all but 14 of the previously treated patients (9%). This virological result was followed by a medical action 21 times for the naive patients and 97 times for the previously treated patients (p < 0.004).</p><p><strong>Conclusion: </strong>The VL measurement at M1 indicates a virological objective that was reached for all the naive patients and 91% of the previously treated patients. Moreover, the medical actions taken at M1 for a new ARV treatment appear to be associated with the patient's treatment history and not the virological results.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"149-52"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29509029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Frequency and causes of blindness and visual impairment in schools for the blind in Yaoundé (Cameroon)].","authors":"Christelle Domngang Noche,&nbsp;Assumpta Lucienne Bella","doi":"10.1684/san.2010.0202","DOIUrl":"https://doi.org/10.1684/san.2010.0202","url":null,"abstract":"<p><strong>Aim/objective: </strong>To determine the causes of blindness and visual impairment in students attending schools for the blind in Yaounde (Cameroon) and to estimate their frequencies.</p><p><strong>Materials and methods: </strong>This study examined all 56 students at three schools for the blind in Yaoundé from September 15 through October 15, 2006. We collected data about their age, sex, medical and surgical history. Visual acuity was measured to determine their vision status according to the World Health Organization categories for blindness and visual impairment. All subjects underwent an ocular examination. Epi Info 3.5.1. was used for the statistical analysis of age, sex, visual acuity, causes of blindness and visual impairment, and etiologies.</p><p><strong>Results: </strong>Fifty six people were examined: 37 men (66.1%) and 19 women (33.9%). Their mean age was 21.57 ± 10.53 years (min-max: 5-49), and 48.2% were in the 10-19 years age group (n = 27). In all, 87.5% were blind, 7.14% severely visually impaired, and 1.78% moderately visually impaired. The main causes of blindness and visual impairment in our sample were corneal disease (32.14%), optic nerve lesions (26.78%), cataract and its surgical complications (19.64%), retinal disorders (10.71%), glaucoma (8.92%, and malformations of the eyeball (1.78%). Their etiologies included congenital cataracts (19.64%), meningitis/fever (8.92%), glaucoma (7.14%), measles (5.35%), ocular trauma (5.35%), albinism (3.57%), Lyell syndrome (1.8%), and alcohol ingestion (1.8%). Etiology was unknown in 46.42%. Fifty per cent of these causes of blindness and visual impairment were treatable and/or preventable.</p><p><strong>Conclusion: </strong>Corneal lesions were the main cause of blindness and visual impairment in our sample. Fifty per cent of the causes found were treatable and/or preventable. Thus, substantial efforts are required to ensure access to better quality specialist ocular care. Furthermore, local authorities should create more centers specialised in the rehabilitation of the visual handicapped.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"133-8"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A neglected potential therapy in the treatment of severe Plasmodium falciparum malaria?].","authors":"Jacques Le Mire,&nbsp;Patrick Besnard,&nbsp;Pierre Carnevale","doi":"10.1684/san.2010.0200","DOIUrl":"https://doi.org/10.1684/san.2010.0200","url":null,"abstract":"","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"173-6"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diabetic retinopathy in black Africans: an angiographic study].","authors":"Godefroy Koki,&nbsp;Assumpta Lucienne Bella,&nbsp;Eballe Andre Omgbwa,&nbsp;Emilienne Epee,&nbsp;Eugene Sobngwi,&nbsp;Koumgang Augustine Kouanang,&nbsp;Mvogo Come Ebana,&nbsp;Jean-Claude Mbanya","doi":"10.1684/san.2010.0207","DOIUrl":"https://doi.org/10.1684/san.2010.0207","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus is an important public health issue worldwide. This retrospective and descriptive study took place at the diabetic retinopathy (DR) prevention and management project at the Central Hospital in Yaoundé between November 2007 and December 2008. Our aim was to analyse the characteristics of diabetic retinopathy in black Africans.</p><p><strong>Materials and method: </strong>Our sample included all patients with diabetes, irrespective of age or insulin- dependence, with the results of at least fasting blood sugar test and fluorescein angiography imaging. The images were interpreted according to the Early Treatment of DR Study classification by one of the 3 project ophthalmologists. We used Epi-Info version 3.5.1 for the statistical analysis, comparing results with the Chi-square test (significance set at p < 0.05).</p><p><strong>Results: </strong>Of 472 subjects with diabetes, 274 (58%) did not have DR, and 198 (42%, 393 eyes) did: 113 men (57%) and 85 women (43%). The mean age was 58.6 years with a mean duration of diabetes of 12.8 years. 128 subjects (64.7%) had non-proliferative DR (NPDR) in both eyes; 53 (26.8%) proliferative DR (PDR) in both eyes and 14 (7.1%) were discordant, with NPDR in one eye and PDR in the other. Macula edema was found in 21 angiographies (10.6%). In all, 6.9% of the subjects were blind.</p><p><strong>Conclusion: </strong>Fluorescein angiography is an invasive complementary examination that helps to diagnose retinal pathologies, to perform laser photocoagulation, and to assess its results. It cannot, however, replaced direct or indirect funduscopy with dilated pupil. Every patient with known diabetes must systematically undergo a complete ophthalmologic exam with funduscopy and angiography to prevent the onset or control existing DR.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 3","pages":"127-32"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tuberculosis control programme in Tunisia: efficacy assessment].","authors":"Mohamed Kouni Chahed,&nbsp;Hédia Bellali,&nbsp;Sassia Dhouibi,&nbsp;Nissaf Ben Alaya,&nbsp;Béchir Zouari","doi":"10.1684/san.2010.0191","DOIUrl":"https://doi.org/10.1684/san.2010.0191","url":null,"abstract":"<p><p>The aim of this study was to assess the efficacy of the national Tuberculosis Control Programme in Tunisia, by applying the 8-stage model proposed by Piot (1967). Two retrospective cohorts of tuberculosis cases, including all new smear-positive cases detected by all laboratories in the study area during the study period, were selected at least 2 years after treatment began. The real number of new active cases during the study period was estimated at 142, the case detection rate at 61%. In all, 70% of patients started tuberculosis treatment, and regular use of the home treatment varied from 87% (including irregular use) to 71% (excluding irregular use). The low global efficacy of the program, which ranged from 26 to 31%, indicates the need for improved application of the strategy by programme managers.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29168940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rare localisations of endemic Burkitt lymphoma: about 21 cases observed in the Haematology Department of the University Hospital of Yopougon Abidjan].","authors":"Kouassi Gustave Koffi,&nbsp;Emeraude N'dathz,&nbsp;Aissata Tolo,&nbsp;Danho Clotaire Nanho,&nbsp;N'dogomo Meite,&nbsp;Romeo Ayemou,&nbsp;Paul Kouehion,&nbsp;Ibrahima Sanogo","doi":"10.1684/san.2010.0196","DOIUrl":"https://doi.org/10.1684/san.2010.0196","url":null,"abstract":"<p><p>In this retrospective study, we analysed rare localisations of Burkitt lymphoma observed in the Haematology Department of the University Hospital of Yopougon Abidjan. Over a 10-year study period, we saw 106 patients with Burkitt lymphoma, 21 with unusual localisations. The mean age at onset of symptoms or discovery was 15.48 years, and more patients were female. There were 8 cases of primary Burkitt lymphoma in a rare localisation and 13 cases of unusual localisations of secondary lymphomas. The most frequent of these rare lesions were renal (6), ovarian (4), in peripheral nodes (4), testicular (3), and mammary (3). Still rarer were thyroid, skin, pulmonary, and suprarenal localisations. Clinical manifestations were non-specific and difficult to differentiate from other solid tumours. The CMA protocol produced complete remission in 29% of cases (n=6). Seven patients died. In conclusion, the rare forms of Burkitt lymphoma are non-specific and can be mistaken for other solid tumours. Diagnosis should thus be based on histochemical analysis.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29168944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}