Pseudomonas aeruginosa is generally susceptible to antibiotics of the families of Beta-lactam, am... more Pseudomonas aeruginosa is generally susceptible to antibiotics of the families of Beta-lactam, aminoglycosides and quinolones. The aim of this study was to evaluate the antimicrobial susceptibility of P. aeruginosa strains in Bamako, Mali. P. aeruginosa strains were isolated on Drigalski agar. Antimicrobial susceptibility testing was performed using the disc diffusion method on Mueller-Hinton agar. Among 317 non repetitive strains recovered from 2010 to 2019, there were 246 (77.6%) hospital strains and 71 (22.4%) extra-hospital strains. Colistin (100%), imipenem (98.4%), ceftazidime (89.3%), amikacin (85.2%) and piperacillin (72.3%) were the most active antibiotics against our P. aeruginosa strains. Of the strains 11 (3.5%) were multi-drug resistant (MDR) and 5 (1.6%) were extensively drugresistant (XDR). The extra-hospital P. aeruginosa strains were more susceptible to aztreonam (91.5% vs 60.6%; P = 0.0000018), piperacillin (84.5% vs 68.7%; P = 0.013), gentamycin (84.5% vs 62.2%; P = 0.00071), netilmicin (56% vs 32.5%; P = 0.0045) and ciprofloxacin (79% vs 65.4%; P = 0.0455) than the hospital strains. Colistin, imipenem, ceftazidim, amikacin and piperacillin have a high-level activity against P. aeruginosa in Bamako.
HAL (Le Centre pour la Communication Scientifique Directe), 2011
C ausée par une levure encapsulée, Cryptococcus neoformans (C. neoformans), la cryptococcose est ... more C ausée par une levure encapsulée, Cryptococcus neoformans (C. neoformans), la cryptococcose est connue surtout par sa localisation neuroméningée entraînant une méningo-encéphalite mortelle en l'absence de traitement (1). Cette infection, rare dans la première moitié du vingtième siècle, s'est répandue de façon exponentielle ces dernières années du fait de la pandémie du VIH/ SIDA (2), son incidence atteignant 5 à 10 % des malades sidéens en Europe et aux Etats-Unis et 15 à 35 % en Afrique centrale (1-5). Dans les pays africains à haute prévalence du VIH, elle constitue la principale cause des méningites chez les adultes (6, 7, 8) (tableau 1).
Malaria and HIV are a major public health problem in developing countries. Our study was a prospe... more Malaria and HIV are a major public health problem in developing countries. Our study was a prospective study to find the incidence of malaria during HIV infection in Bamako at the national referral and teaching hospital "Point G" from May 1 st , 2006 to February 28 th , 2007. Among 212 patients hospitalized or followed as patients with HIV positive by rapid tests: Immuno Comb II HIV 1/2 (Organics, Strasbourg, France) and genie II HIV 1/2 (Sanofi Diagnostics Pasteur, France); 46 patients had a positive malaria test (21.6%). Theses coinfected patients (Plasmodium/ HIV) have been enrolled in the study. The age average was 34.4 ± 9.4 years. The sex ratio was 0.7. The patient majority had a CD4 rate less than 200 cells/mm 3. The HIV 1 infection was predominant in 45 patients (97.6%). The risk of exposure to the complicated malaria during HIV infection was higher in patients with the AIDS stage than seropositive patients (p = 0.04 fisher). The risk of exposure to moderate anemia during HIV infection was higher in patients with the AIDS stage than seropositive patients (p = 0.01 fisher). The majority of patients did not use preventive measures which are 71.7%. The hospital case lethality was 34%. We can confirm that Malaria has been relatively frequently during the HIV infection in Mali. Malaria chemoprophylaxy combined to bed nets use by HIV/AIDS patient should improve the morbidity and mortality due to this disease.
Introduction. La prise en charge du pied diabétique passe par une prévention, qui s'articule surt... more Introduction. La prise en charge du pied diabétique passe par une prévention, qui s'articule surtout sur la détection précoce des deux mécanismes impliqués dans la genèse d'un ulcère du pied (atteinte vasculaire et l'atteinte neurologique), appelée évaluation du risque podologique. Ce risque doit être évalué chez tous diabétiques de type 1 évoluant depuis 5 ans ou tous diabétique de type 2 depuis la découverte. C'est dans cette optique que nous avons mené cette étude chez les patients diabétiques hospitalisés. Patients et méthodes. Nous avons mené une étude descriptive, transversale avec recueil prospectif des données. L'étude a eu lieu au service de Médecine et d'Endocrinologie de l'hôpital du Mali du 1er octobre 2017 au 31 mars 2018, soit six mois). Résultats. Parmi 258 patients 111 étaient diabétiques (43,02%). Le sex ratio était de 0,76, l'âge moyen : 54,23± 15,95. Parmi les diabétiques, 80 présentaient un pied à risque (72,1%). Le diabète de type 2 représentait 92%, la durée d'évolution ˂ 5 ans : 47%. À l'examen clinique, la neuropathie a été retrouvée chez 72.5%, tandis que l'artériopathie des membres inférieurs chez 19.8%. La distribution des patients en fonction du grade de l'artériopathie était la suivante : grade 0 : 28% ; grade 1 : 41% ; grade 2 : 10% et grade 3 : 21%. Il existait un lien statistiquement significatif entre la durée d'évolution et le grade. Parmi ceux ayant une durée d'évolution ˃ à 5 ans, 55 étaient au grade 1, 18 au grade 2 et 14 au grade 3. Parmi ceux au grade 1, 65 avaient un mauvais équilibre glycémique (HbA1c ˃ 7%). Tous les patients ont bénéficié de l'éducation podologique et des médicaments suivants: vitamines, antiagrégants plaquettaires et vasodilatateurs. Conclusion. Le pied diabétique demeure un problème de santé préoccupant, c'est l'une des causes majeures de morbidité due à l'amputation de membre. L'un des moyens clés de prévention d'ulcère du pied est l'évaluation du risque podologique.
This prospective study included patients treated for tuberculosis between January 998 and April 1... more This prospective study included patients treated for tuberculosis between January 998 and April 1999 in the pneumology unit of the Point G Hospital in Bamako. The purpose was to analyze chest x-ray and bacteriological findings in HIV+ and HIV- patients. All patients had clinical and radiographic signs suggestive of tuberculosis with one or several sputum samples and HIV serology. Among the 127 patients, 36 were HIV positive (28.3%). There was no sex predominance in the HIV+ patients (p = 0.3). The most common radiographic aspect associated nodules and infiltration irrespective of the immune status (p = 0.014). Characteristic features of the chest x-rays in HIV-positive patients were: frequent military forms and rare cavernous forms (p = 0.007). Sputum tests were positive more often in HIV-negative than HIV-positive patients (p = 0.0003). The diagnosis of tuberculosis was retained in 11.7% of the patients with negative microbiology despite repeated samples. A normal chest x-ray was observed solely in one HIV-negative patient.
L’objectif de ce travail etait d’etudier l’evolution de la circulation du poliovirus sauvage au M... more L’objectif de ce travail etait d’etudier l’evolution de la circulation du poliovirus sauvage au Mali a travers la surveillance active des paralysies flasques aigues. Il s’agissait d’une etude descriptive retrospective du 1er janvier 1998 au 31 decembre 2005 et portant sur 1 002 cas de paralysie flasque aigue (PFA) investigues sur l’ensemble du territoire national Malien. Les enfants de moins de 15 ans atteints de PFA notifies au Centre National d’Immunisation (CNI) dans le cadre de la surveillance epidemiologique ont ete inclus. L’isolement du poliovirus a ete realise a partir des examens de selles a l’Institut Pasteur d’Abidjan. Parmi 1 002 cas de PFA, 156 echantillons de selles etaient positifs pour les enterovirus dont 59 cas de poliovirus (31 cas de poliovirus vaccinal et 28 cas de poliovirus sauvage) soit une frequence de 2,3 %. Les enfants de 0 a 5 ans etaient les plus touches par les PFA soit 59,78 %. La paralysie des membres inferieurs a represente le siege le plus frequent soit 69,56 %. La region de Mopti a ete la plus affectee avec 11 cas sur 28. Les garcons etaient les plus touches soit 71,43 %. Malgre les efforts deployes jusqu’ici dans la lutte contre la poliomyelite, les poliovirus sauvages ont continue a circuler au Mali et dans la sous region Ouest Africaine. Tous les pays de la sous region, voire du continent, doivent arriver a un niveau de couverture vaccinale suffisante pour eradiquer cette souche sauvage a l’image des pays industrialises.
Parasitological, malacological and anthropological studies were performed to assess the prevalenc... more Parasitological, malacological and anthropological studies were performed to assess the prevalence of Schistosoma haematobium and S. mansoni in schoolchildren living in the suburban area of Bamako. A total of 1017 schoolchildren aged 6-14 years were selected in two different areas between September 1997 and December 1999. In Djikoroni, the prevalence of S. haematobium and S. mansoni was 80.7% (339/420) and 22.8% (85/372) respectively. There was no significant difference of prevalence and intensity of infection with S. haematobium between schools, gender and age (p > 0.05), whereas, those of S. mansoni were higher in the vicinity of (+/- 100 m from) major sites where infected Biomphalaria pfeifferi were found (p < 0.001). In Niomirambougou, S. haematobium was prevalent in 46.7% (279/597) and S. mansoni in 28.2% (134/475). Boys and children aged 11-14 years were more infected (p < 0.001). Associated intestinal helminths (Hymenolepis nana, Necator americanus and Ascaris lumbricoides) were relatively scarce (prevalence < 1%). The prevalences of schistosome infected snails intermediate host were relatively high, 49.3% (100/203) in B. pfeifferi, 20.6% (88/138) in B. truncatus and 24.1% (7/29) in B. globosus. We recorded a total of 2514 water contacts about which 1130 in December and 1384 in January. Most of the children, 42.9% (1077/2511) were attracted to water bodies for bathing, swimming and playing, suggesting the lack of recreational facilities in these areas. Developing local control programmes in schools located in the vicinity of water bodies would contribute to break the parasite transmission cycle in Bamako.
A prospective study carried out in Bamako, Mali between July 1998 and January 1999 has assessed t... more A prospective study carried out in Bamako, Mali between July 1998 and January 1999 has assessed the seroprevalence of hepatitis C virus (HCV) in 91 carrier patients of chronic hepatopathy at a cirrhrosis stage (53) or of hepato-cellular carcinoma (38) and to compare with in 92 blood donors as a control population. Only seroprevalence confirmed by a complementary test has been taken into account (RIBA). HCV seroprevalence reached 25% including all hepatopathies, 24% in cirrhrosis and 26% in hepato-cellular carcinomae (HCC) versus 4% in blood donors. Antigen HBs of hepatitis B virus has been found in 55% of patients, versus 25% of the control cases (p = 0.0006). On the whole, the two markers have been notified a little more often in HCC than in cirrhosis and the combination of the two markers has been more frequent during cirrhosis as well. The role of HCV played in cirrhosis and HCC onset in Mali appears to be important.
The aim of this study was to determine the resistance phenotypes and genes involved in antibiotic... more The aim of this study was to determine the resistance phenotypes and genes involved in antibiotic resistance of community uropathogenic E. coli strains in Bamako. E. coli strains were isolated from the urine from September 2011 to June 2012 of external patients who were seen in specialized department of CHU, research of resistance support (integrons and resistance genes) were performed at the Experimental Bacteriology Unit at the Institute Pasteur of Dakar (Senegal). During the study, we have isolated 29 strains of E. coli, the majority produced betalactamase extended-spectrum (55.17%). The resistance was high to amoxicillin, third generation cephalosporins including ESBL (55%), sulfamethoxazoletrimethoprim and fluoroquinolones. Genetic supports detected were bla TEM1 (72%), bla SHV1 (38%), bla OXA1 (52%), bla CTXM1 et bla CMY1 (44%), bla CTXM9 (13%), QnrB (4%) et QnrS (88%). The majority of ESBL-producing strains presented the QnrS gene (88%). Integrons Class 1 (intl 1) were found in 31% of strains and class 2 integrons (intl 2) at 7%. No class 3 integron was detected.The QnrB gene was found in only a single strain. No strain has presented the QnrA gene. This growing increase in resistance to various antibiotics, confirmed by the presence of plasmid genes dictate the strengthening of the surveillance of resistance in our country, through good practice in antibiotic therapy in the hospital and in the community. We must establish a monitoring network antibiotic involving private practice physicians, hospitals and laboratories.
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have been isolated from many... more Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have been isolated from many regions of the world. Epidemiological studies are being conducted in Europe, North America, and Asia. No study has however been conducted in Africa to determine the prevalence and distribution of ESBLs on the continent. This literature review aimed at describing the prevalence of ESBL-producing Enterobacteriaceae isolated from blood cultures, as well as the ESBL genes involved at the international level. Our focus was mainly on Africa. We conducted a literature review on PubMed. Articles related to our study field and published between 1996 and 2014 were reviewed and entirely read for most of them, while we only focused on the abstracts of some other articles. Relevant articles to our study were then carefully reviewed and included in the review. The prevalence of ESBL-producing Enterobacteriaceae differs from one country to another. The results of our literature review however indicate that class A ESBLs prevail over the other types. We took into consideration articles focusing on various types of samples to assess the prevalence of ESBL-producing Enterobacteriaceae, but information on isolates from blood cultures is limited. The worldwide prevalence of ESBL-producing Enterobacteriaceae has increased over time. Evidence of ESBL-producing Enterobacteriaceae can be found in all regions of the world. Studies conducted in Africa mainly focused on the Northern and Eastern parts of the continent, while only rare studies were carried out in the rest of the continent.
Our aim was to study the susceptibility of Staphylococcus aureus to antimicrobial agents and to d... more Our aim was to study the susceptibility of Staphylococcus aureus to antimicrobial agents and to determine the methicillin-resistant S. aureus (MRSA) prevalence in the Point G teaching hospital in Bamako. Methods: Columbia blood agar with nalidixic acid and colistin was used for the isolation of S. aureus strains. The diffusion method was used for antimicrobial susceptibility testing. Results: Of 434 non repetitive strains of S. aureus isolated from 2007 to 2009 in the Point G teaching hospital, 297 (68.6%) were from hospital area and 137 (31.4%) were from extra-hospital area. The hospital strains were more resistant to penicillin than the extra-hospital strains (95% versus 88%; p = 0,016). Tetracycline was more active against hospital clinical isolates than extra-hospital clinical isolates (32% versus 21%; p = 0.024). Among 297 S. aureus clinical isolates, 195 (66%) were MRSA and 102 (34%) were methicillin-susceptible S. aureus (MSSA). The MRSA clinical isolates prevalence was higher in hospital area than in extra-hospital area (66% versus 55.5%; p = 0.0418). The MRSA clinical isolates prevalence was higher in the medical wards than in the surgical wards (74.8% vs 34.3%; p < 10-6). Among 251 MRSA clinical isolates, 169 (67.3%) were from urine, 39 (15.5%) from pus, 30 (12%) from blood culture, 7 (2.9%) from vagina and 6 (2.5%) from other sites. The MRSA clinical isolates prevalence was 46% in 2007, 63% in 2008 and 80% in 2009. The MRSA clinical isolates were highly more resistant to penicillin (p < 10-6), to amoxicillin combined with clavulanic acid (p < 10-6), to aminoglycosides (p < 10-6), to macrolides, lincosamides and streptogramins (p < 10-6), to norfloxacin (p < 10-6), to chloramphenicol (p < 10-6), to tetracycline (p = 0,0042), to sulfonamides (p < 10-6), to trimethoprim (p < 10-6), to fusidic acid (p < 10-6), and to fosfomycin (p = 0,0103) than the MSSA strains. The high level resistance to aminoglycosides, fluoroquinolones, macrolides, lincosamides and streptogramins was more frequent in the MRSA strains than in the MSSA strains. Conclusion: The MRSA clinical isolates prevalence was very high in the Point G teaching hospital in Bamako, in the medical wards especially. The MRSA strains were drugs multiple resistant.
This report analyses the links between violent extremism, illicit activities and local conflicts ... more This report analyses the links between violent extremism, illicit activities and local conflicts in the Liptako-Gourma region. Addressing regional instability in the long term requires empirical data that helps explain the local dynamics that fuel insecurity. This is the first of two reports, and is based on interviews conducted in Burkina Faso, Mali and Niger. The second report assesses the measures aimed at bringing stability to the region.
Cahiers d'études et de recherches francophones / Santé, Apr 1, 2003
Notre objectif etait d’etudier la seroprevalence de l’infection par le CMVH chez les donneurs de ... more Notre objectif etait d’etudier la seroprevalence de l’infection par le CMVH chez les donneurs de sang et les malades infectes par le VIH a Bamako et de chercher un lien entre les manifestations cliniques du sida et le CMVH. La seroprevalence de l’infection par le CMVH a ete de 89 % chez les malades atteints du sida, de 71 % chez les donneurs de sang infectes par le VIH et de 58 % chez les donneurs de sang seronegatifs pour le VIH. La seroprevalence de l’infection a CMVH a ete plus frequente chez les malades atteints du sida que chez les donneurs de sang seronegatifs pour le VIH (p = 0,0000007) ainsi que chez les donneurs de sang infectes par le VIH (p = 0,00146). La seroprevalence de l’infection par le CMVH n’a pas ete plus frequente chez les donneurs de sang infectes par le VIH que chez les donneurs de sang seronegatifs pour le VIH (p = 0,0547). La seroprevalence de l’infection par le CMVH n’est pas statistiquement liee au sexe et a l’âge chez les malades atteints du sida comme chez les donneurs de sang. Les pneumopathies ont ete plus frequentes chez les malades atteints du sida seropositifs pour le CMVH (40 %) que chez les malades seronegatifs pour le CMVH (0 %) : la diffference a ete significative (p = 0,005). Les malades seropositifs pour le CMVH n’ont pas presente plus de candidoses bucco-pharyngees, de dermatoses prurigineuses, de sarcomes de Kaposi et d’atteintes neurologiques que les malades seronegatifs pour le CMVH.
La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit. Article disponible en ligne à l'adresse Article disponible en ligne à l'adresse https://www.cairn.info/revue-sante-publique-2009-3-page-263.htm Découvrir le sommaire de ce numéro, suivre la revue par email, s'abonner... Flashez ce QR Code pour accéder à la page de ce numéro sur Cairn.info.
European Journal of Clinical Microbiology & Infectious Diseases, Jun 23, 2005
... References 1. Odemuyiwa SO, Mulders MN, Oyedele OI, Ola SO, Odaibo GN, Olaleye DO, Muller CP ... more ... References 1. Odemuyiwa SO, Mulders MN, Oyedele OI, Ola SO, Odaibo GN, Olaleye DO, Muller CP (2001) Phylogenetic analysis of new hep-atitis B virus isolates from Nigeria supports endemicity of geno-type E in West Africa. ...
Supracondylar fractures of the humerus are the most common traumatic elbow injury in children. Se... more Supracondylar fractures of the humerus are the most common traumatic elbow injury in children. Several techniques are described in their support. Blount's method is one of the widely used orthopedic means. The objective of our study was to evaluate the results of supracondylar fractures of the humerus treated by this method in our department. This was a descriptive, longitudinal study with the prospective collection over a period of 12 months from May 2018 to April 2019. It focused on children aged 0 to 15 years treated in the Orthopedic Traumatology Department of the CHU of Kati for a supracondylar fracture of the humerus in extension. A minimum follow-up period of 6 months was necessary for inclusion. 12 patients were collected. The sociodemographic, anatomopathologic, therapeutic and evolutionary aspects were studied. The results were evaluated according to Flynn's criteria. The male sex was predominant with a ratio of 2. The average age was 5.5 years. The average admission time was 12.5 hours. Domestic accidents were the main etiology (66.66%) and Type II fracture was the most frequent with 58.33%. The duration of immobilization was 42 days for 11 patients. Complications were 1 case of secondary displacement and 1 case of 12˚ flexion deficit. The average Baumann angle was 72˚. The result was satisfactory for all our patients. Supracondylar fractures of the humerus are common in children, especially boys. The method of Blount when it is well carried out by respecting the indications gives good results.
The aim of this study was to determine the wastewaters antibiotic residues concentration in two h... more The aim of this study was to determine the wastewaters antibiotic residues concentration in two hospitals (CHU Point G and CHU Luxembourg) in Bamako. Methods: The samples of wastewater were collected three times consecutively on three days every week at 9 a.m., 3 p.m. and 9 p.m. in 2016. The samples were stored at 4°C and transferred to the veterinary central laboratory (LCV). The antibiotic residues were detected by High Performance Liquid Chromatography and the antibiotic concentrations were determined by a spectrophotometer UV-Visible Hewlett Packard. Results: The detected and measured antibiotic residues were amoxicillin ((0.066 ± 0.08 µg/l), erythromycin (0.04 ± 0.0 µg/l), co-trimoxazole (sulfamethoxazole 0.06 ± 0.21 µg/l + trimethoprime 0.08 ± 0.006 µg/l) and metronidazole (0.02 ± 0.0 µg/l in the hospital wastewater and in the sewer systems. Amoxicillin and sulfamethoxazole were detected before and after the Point G wastewater treatment. No antibiotic residue was detected in the "Chikoroni" sewer system which discharged the Point G wastewater. Amoxicillin and sulfamethoxazole were also detected in the wastewater of the hospital "le Luxembourg" which doesn't have a wastewater treatment plant and in the "Djafranako" sewer system which discharged the wastewater of this hospital. Erythromycin and metronidazole were detected only in the Point G wastewater. Chloramphenicol, ciprofloxacin and tetracyclin were not detected in the two hospital wastewater. The antibiotic residues concentrations at the different moments show the same high level in the different sites. Conclusion: Hospitals play a role in the antibiotic dissemination into the environment. In Bamako, the wastewater quality is not alarming, but every hospital must get a sewer system.
La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit. Article disponible en ligne à l'adresse Article disponible en ligne à l'adresse https://www.cairn.info/revue-sante-publique-2009-5-page-507.htm Découvrir le sommaire de ce numéro, suivre la revue par email, s'abonner... Flashez ce QR Code pour accéder à la page de ce numéro sur Cairn.info.
Pseudomonas aeruginosa is generally susceptible to antibiotics of the families of Beta-lactam, am... more Pseudomonas aeruginosa is generally susceptible to antibiotics of the families of Beta-lactam, aminoglycosides and quinolones. The aim of this study was to evaluate the antimicrobial susceptibility of P. aeruginosa strains in Bamako, Mali. P. aeruginosa strains were isolated on Drigalski agar. Antimicrobial susceptibility testing was performed using the disc diffusion method on Mueller-Hinton agar. Among 317 non repetitive strains recovered from 2010 to 2019, there were 246 (77.6%) hospital strains and 71 (22.4%) extra-hospital strains. Colistin (100%), imipenem (98.4%), ceftazidime (89.3%), amikacin (85.2%) and piperacillin (72.3%) were the most active antibiotics against our P. aeruginosa strains. Of the strains 11 (3.5%) were multi-drug resistant (MDR) and 5 (1.6%) were extensively drugresistant (XDR). The extra-hospital P. aeruginosa strains were more susceptible to aztreonam (91.5% vs 60.6%; P = 0.0000018), piperacillin (84.5% vs 68.7%; P = 0.013), gentamycin (84.5% vs 62.2%; P = 0.00071), netilmicin (56% vs 32.5%; P = 0.0045) and ciprofloxacin (79% vs 65.4%; P = 0.0455) than the hospital strains. Colistin, imipenem, ceftazidim, amikacin and piperacillin have a high-level activity against P. aeruginosa in Bamako.
HAL (Le Centre pour la Communication Scientifique Directe), 2011
C ausée par une levure encapsulée, Cryptococcus neoformans (C. neoformans), la cryptococcose est ... more C ausée par une levure encapsulée, Cryptococcus neoformans (C. neoformans), la cryptococcose est connue surtout par sa localisation neuroméningée entraînant une méningo-encéphalite mortelle en l'absence de traitement (1). Cette infection, rare dans la première moitié du vingtième siècle, s'est répandue de façon exponentielle ces dernières années du fait de la pandémie du VIH/ SIDA (2), son incidence atteignant 5 à 10 % des malades sidéens en Europe et aux Etats-Unis et 15 à 35 % en Afrique centrale (1-5). Dans les pays africains à haute prévalence du VIH, elle constitue la principale cause des méningites chez les adultes (6, 7, 8) (tableau 1).
Malaria and HIV are a major public health problem in developing countries. Our study was a prospe... more Malaria and HIV are a major public health problem in developing countries. Our study was a prospective study to find the incidence of malaria during HIV infection in Bamako at the national referral and teaching hospital "Point G" from May 1 st , 2006 to February 28 th , 2007. Among 212 patients hospitalized or followed as patients with HIV positive by rapid tests: Immuno Comb II HIV 1/2 (Organics, Strasbourg, France) and genie II HIV 1/2 (Sanofi Diagnostics Pasteur, France); 46 patients had a positive malaria test (21.6%). Theses coinfected patients (Plasmodium/ HIV) have been enrolled in the study. The age average was 34.4 ± 9.4 years. The sex ratio was 0.7. The patient majority had a CD4 rate less than 200 cells/mm 3. The HIV 1 infection was predominant in 45 patients (97.6%). The risk of exposure to the complicated malaria during HIV infection was higher in patients with the AIDS stage than seropositive patients (p = 0.04 fisher). The risk of exposure to moderate anemia during HIV infection was higher in patients with the AIDS stage than seropositive patients (p = 0.01 fisher). The majority of patients did not use preventive measures which are 71.7%. The hospital case lethality was 34%. We can confirm that Malaria has been relatively frequently during the HIV infection in Mali. Malaria chemoprophylaxy combined to bed nets use by HIV/AIDS patient should improve the morbidity and mortality due to this disease.
Introduction. La prise en charge du pied diabétique passe par une prévention, qui s'articule surt... more Introduction. La prise en charge du pied diabétique passe par une prévention, qui s'articule surtout sur la détection précoce des deux mécanismes impliqués dans la genèse d'un ulcère du pied (atteinte vasculaire et l'atteinte neurologique), appelée évaluation du risque podologique. Ce risque doit être évalué chez tous diabétiques de type 1 évoluant depuis 5 ans ou tous diabétique de type 2 depuis la découverte. C'est dans cette optique que nous avons mené cette étude chez les patients diabétiques hospitalisés. Patients et méthodes. Nous avons mené une étude descriptive, transversale avec recueil prospectif des données. L'étude a eu lieu au service de Médecine et d'Endocrinologie de l'hôpital du Mali du 1er octobre 2017 au 31 mars 2018, soit six mois). Résultats. Parmi 258 patients 111 étaient diabétiques (43,02%). Le sex ratio était de 0,76, l'âge moyen : 54,23± 15,95. Parmi les diabétiques, 80 présentaient un pied à risque (72,1%). Le diabète de type 2 représentait 92%, la durée d'évolution ˂ 5 ans : 47%. À l'examen clinique, la neuropathie a été retrouvée chez 72.5%, tandis que l'artériopathie des membres inférieurs chez 19.8%. La distribution des patients en fonction du grade de l'artériopathie était la suivante : grade 0 : 28% ; grade 1 : 41% ; grade 2 : 10% et grade 3 : 21%. Il existait un lien statistiquement significatif entre la durée d'évolution et le grade. Parmi ceux ayant une durée d'évolution ˃ à 5 ans, 55 étaient au grade 1, 18 au grade 2 et 14 au grade 3. Parmi ceux au grade 1, 65 avaient un mauvais équilibre glycémique (HbA1c ˃ 7%). Tous les patients ont bénéficié de l'éducation podologique et des médicaments suivants: vitamines, antiagrégants plaquettaires et vasodilatateurs. Conclusion. Le pied diabétique demeure un problème de santé préoccupant, c'est l'une des causes majeures de morbidité due à l'amputation de membre. L'un des moyens clés de prévention d'ulcère du pied est l'évaluation du risque podologique.
This prospective study included patients treated for tuberculosis between January 998 and April 1... more This prospective study included patients treated for tuberculosis between January 998 and April 1999 in the pneumology unit of the Point G Hospital in Bamako. The purpose was to analyze chest x-ray and bacteriological findings in HIV+ and HIV- patients. All patients had clinical and radiographic signs suggestive of tuberculosis with one or several sputum samples and HIV serology. Among the 127 patients, 36 were HIV positive (28.3%). There was no sex predominance in the HIV+ patients (p = 0.3). The most common radiographic aspect associated nodules and infiltration irrespective of the immune status (p = 0.014). Characteristic features of the chest x-rays in HIV-positive patients were: frequent military forms and rare cavernous forms (p = 0.007). Sputum tests were positive more often in HIV-negative than HIV-positive patients (p = 0.0003). The diagnosis of tuberculosis was retained in 11.7% of the patients with negative microbiology despite repeated samples. A normal chest x-ray was observed solely in one HIV-negative patient.
L’objectif de ce travail etait d’etudier l’evolution de la circulation du poliovirus sauvage au M... more L’objectif de ce travail etait d’etudier l’evolution de la circulation du poliovirus sauvage au Mali a travers la surveillance active des paralysies flasques aigues. Il s’agissait d’une etude descriptive retrospective du 1er janvier 1998 au 31 decembre 2005 et portant sur 1 002 cas de paralysie flasque aigue (PFA) investigues sur l’ensemble du territoire national Malien. Les enfants de moins de 15 ans atteints de PFA notifies au Centre National d’Immunisation (CNI) dans le cadre de la surveillance epidemiologique ont ete inclus. L’isolement du poliovirus a ete realise a partir des examens de selles a l’Institut Pasteur d’Abidjan. Parmi 1 002 cas de PFA, 156 echantillons de selles etaient positifs pour les enterovirus dont 59 cas de poliovirus (31 cas de poliovirus vaccinal et 28 cas de poliovirus sauvage) soit une frequence de 2,3 %. Les enfants de 0 a 5 ans etaient les plus touches par les PFA soit 59,78 %. La paralysie des membres inferieurs a represente le siege le plus frequent soit 69,56 %. La region de Mopti a ete la plus affectee avec 11 cas sur 28. Les garcons etaient les plus touches soit 71,43 %. Malgre les efforts deployes jusqu’ici dans la lutte contre la poliomyelite, les poliovirus sauvages ont continue a circuler au Mali et dans la sous region Ouest Africaine. Tous les pays de la sous region, voire du continent, doivent arriver a un niveau de couverture vaccinale suffisante pour eradiquer cette souche sauvage a l’image des pays industrialises.
Parasitological, malacological and anthropological studies were performed to assess the prevalenc... more Parasitological, malacological and anthropological studies were performed to assess the prevalence of Schistosoma haematobium and S. mansoni in schoolchildren living in the suburban area of Bamako. A total of 1017 schoolchildren aged 6-14 years were selected in two different areas between September 1997 and December 1999. In Djikoroni, the prevalence of S. haematobium and S. mansoni was 80.7% (339/420) and 22.8% (85/372) respectively. There was no significant difference of prevalence and intensity of infection with S. haematobium between schools, gender and age (p > 0.05), whereas, those of S. mansoni were higher in the vicinity of (+/- 100 m from) major sites where infected Biomphalaria pfeifferi were found (p < 0.001). In Niomirambougou, S. haematobium was prevalent in 46.7% (279/597) and S. mansoni in 28.2% (134/475). Boys and children aged 11-14 years were more infected (p < 0.001). Associated intestinal helminths (Hymenolepis nana, Necator americanus and Ascaris lumbricoides) were relatively scarce (prevalence < 1%). The prevalences of schistosome infected snails intermediate host were relatively high, 49.3% (100/203) in B. pfeifferi, 20.6% (88/138) in B. truncatus and 24.1% (7/29) in B. globosus. We recorded a total of 2514 water contacts about which 1130 in December and 1384 in January. Most of the children, 42.9% (1077/2511) were attracted to water bodies for bathing, swimming and playing, suggesting the lack of recreational facilities in these areas. Developing local control programmes in schools located in the vicinity of water bodies would contribute to break the parasite transmission cycle in Bamako.
A prospective study carried out in Bamako, Mali between July 1998 and January 1999 has assessed t... more A prospective study carried out in Bamako, Mali between July 1998 and January 1999 has assessed the seroprevalence of hepatitis C virus (HCV) in 91 carrier patients of chronic hepatopathy at a cirrhrosis stage (53) or of hepato-cellular carcinoma (38) and to compare with in 92 blood donors as a control population. Only seroprevalence confirmed by a complementary test has been taken into account (RIBA). HCV seroprevalence reached 25% including all hepatopathies, 24% in cirrhrosis and 26% in hepato-cellular carcinomae (HCC) versus 4% in blood donors. Antigen HBs of hepatitis B virus has been found in 55% of patients, versus 25% of the control cases (p = 0.0006). On the whole, the two markers have been notified a little more often in HCC than in cirrhosis and the combination of the two markers has been more frequent during cirrhosis as well. The role of HCV played in cirrhosis and HCC onset in Mali appears to be important.
The aim of this study was to determine the resistance phenotypes and genes involved in antibiotic... more The aim of this study was to determine the resistance phenotypes and genes involved in antibiotic resistance of community uropathogenic E. coli strains in Bamako. E. coli strains were isolated from the urine from September 2011 to June 2012 of external patients who were seen in specialized department of CHU, research of resistance support (integrons and resistance genes) were performed at the Experimental Bacteriology Unit at the Institute Pasteur of Dakar (Senegal). During the study, we have isolated 29 strains of E. coli, the majority produced betalactamase extended-spectrum (55.17%). The resistance was high to amoxicillin, third generation cephalosporins including ESBL (55%), sulfamethoxazoletrimethoprim and fluoroquinolones. Genetic supports detected were bla TEM1 (72%), bla SHV1 (38%), bla OXA1 (52%), bla CTXM1 et bla CMY1 (44%), bla CTXM9 (13%), QnrB (4%) et QnrS (88%). The majority of ESBL-producing strains presented the QnrS gene (88%). Integrons Class 1 (intl 1) were found in 31% of strains and class 2 integrons (intl 2) at 7%. No class 3 integron was detected.The QnrB gene was found in only a single strain. No strain has presented the QnrA gene. This growing increase in resistance to various antibiotics, confirmed by the presence of plasmid genes dictate the strengthening of the surveillance of resistance in our country, through good practice in antibiotic therapy in the hospital and in the community. We must establish a monitoring network antibiotic involving private practice physicians, hospitals and laboratories.
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have been isolated from many... more Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have been isolated from many regions of the world. Epidemiological studies are being conducted in Europe, North America, and Asia. No study has however been conducted in Africa to determine the prevalence and distribution of ESBLs on the continent. This literature review aimed at describing the prevalence of ESBL-producing Enterobacteriaceae isolated from blood cultures, as well as the ESBL genes involved at the international level. Our focus was mainly on Africa. We conducted a literature review on PubMed. Articles related to our study field and published between 1996 and 2014 were reviewed and entirely read for most of them, while we only focused on the abstracts of some other articles. Relevant articles to our study were then carefully reviewed and included in the review. The prevalence of ESBL-producing Enterobacteriaceae differs from one country to another. The results of our literature review however indicate that class A ESBLs prevail over the other types. We took into consideration articles focusing on various types of samples to assess the prevalence of ESBL-producing Enterobacteriaceae, but information on isolates from blood cultures is limited. The worldwide prevalence of ESBL-producing Enterobacteriaceae has increased over time. Evidence of ESBL-producing Enterobacteriaceae can be found in all regions of the world. Studies conducted in Africa mainly focused on the Northern and Eastern parts of the continent, while only rare studies were carried out in the rest of the continent.
Our aim was to study the susceptibility of Staphylococcus aureus to antimicrobial agents and to d... more Our aim was to study the susceptibility of Staphylococcus aureus to antimicrobial agents and to determine the methicillin-resistant S. aureus (MRSA) prevalence in the Point G teaching hospital in Bamako. Methods: Columbia blood agar with nalidixic acid and colistin was used for the isolation of S. aureus strains. The diffusion method was used for antimicrobial susceptibility testing. Results: Of 434 non repetitive strains of S. aureus isolated from 2007 to 2009 in the Point G teaching hospital, 297 (68.6%) were from hospital area and 137 (31.4%) were from extra-hospital area. The hospital strains were more resistant to penicillin than the extra-hospital strains (95% versus 88%; p = 0,016). Tetracycline was more active against hospital clinical isolates than extra-hospital clinical isolates (32% versus 21%; p = 0.024). Among 297 S. aureus clinical isolates, 195 (66%) were MRSA and 102 (34%) were methicillin-susceptible S. aureus (MSSA). The MRSA clinical isolates prevalence was higher in hospital area than in extra-hospital area (66% versus 55.5%; p = 0.0418). The MRSA clinical isolates prevalence was higher in the medical wards than in the surgical wards (74.8% vs 34.3%; p < 10-6). Among 251 MRSA clinical isolates, 169 (67.3%) were from urine, 39 (15.5%) from pus, 30 (12%) from blood culture, 7 (2.9%) from vagina and 6 (2.5%) from other sites. The MRSA clinical isolates prevalence was 46% in 2007, 63% in 2008 and 80% in 2009. The MRSA clinical isolates were highly more resistant to penicillin (p < 10-6), to amoxicillin combined with clavulanic acid (p < 10-6), to aminoglycosides (p < 10-6), to macrolides, lincosamides and streptogramins (p < 10-6), to norfloxacin (p < 10-6), to chloramphenicol (p < 10-6), to tetracycline (p = 0,0042), to sulfonamides (p < 10-6), to trimethoprim (p < 10-6), to fusidic acid (p < 10-6), and to fosfomycin (p = 0,0103) than the MSSA strains. The high level resistance to aminoglycosides, fluoroquinolones, macrolides, lincosamides and streptogramins was more frequent in the MRSA strains than in the MSSA strains. Conclusion: The MRSA clinical isolates prevalence was very high in the Point G teaching hospital in Bamako, in the medical wards especially. The MRSA strains were drugs multiple resistant.
This report analyses the links between violent extremism, illicit activities and local conflicts ... more This report analyses the links between violent extremism, illicit activities and local conflicts in the Liptako-Gourma region. Addressing regional instability in the long term requires empirical data that helps explain the local dynamics that fuel insecurity. This is the first of two reports, and is based on interviews conducted in Burkina Faso, Mali and Niger. The second report assesses the measures aimed at bringing stability to the region.
Cahiers d'études et de recherches francophones / Santé, Apr 1, 2003
Notre objectif etait d’etudier la seroprevalence de l’infection par le CMVH chez les donneurs de ... more Notre objectif etait d’etudier la seroprevalence de l’infection par le CMVH chez les donneurs de sang et les malades infectes par le VIH a Bamako et de chercher un lien entre les manifestations cliniques du sida et le CMVH. La seroprevalence de l’infection par le CMVH a ete de 89 % chez les malades atteints du sida, de 71 % chez les donneurs de sang infectes par le VIH et de 58 % chez les donneurs de sang seronegatifs pour le VIH. La seroprevalence de l’infection a CMVH a ete plus frequente chez les malades atteints du sida que chez les donneurs de sang seronegatifs pour le VIH (p = 0,0000007) ainsi que chez les donneurs de sang infectes par le VIH (p = 0,00146). La seroprevalence de l’infection par le CMVH n’a pas ete plus frequente chez les donneurs de sang infectes par le VIH que chez les donneurs de sang seronegatifs pour le VIH (p = 0,0547). La seroprevalence de l’infection par le CMVH n’est pas statistiquement liee au sexe et a l’âge chez les malades atteints du sida comme chez les donneurs de sang. Les pneumopathies ont ete plus frequentes chez les malades atteints du sida seropositifs pour le CMVH (40 %) que chez les malades seronegatifs pour le CMVH (0 %) : la diffference a ete significative (p = 0,005). Les malades seropositifs pour le CMVH n’ont pas presente plus de candidoses bucco-pharyngees, de dermatoses prurigineuses, de sarcomes de Kaposi et d’atteintes neurologiques que les malades seronegatifs pour le CMVH.
La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit. Article disponible en ligne à l'adresse Article disponible en ligne à l'adresse https://www.cairn.info/revue-sante-publique-2009-3-page-263.htm Découvrir le sommaire de ce numéro, suivre la revue par email, s'abonner... Flashez ce QR Code pour accéder à la page de ce numéro sur Cairn.info.
European Journal of Clinical Microbiology & Infectious Diseases, Jun 23, 2005
... References 1. Odemuyiwa SO, Mulders MN, Oyedele OI, Ola SO, Odaibo GN, Olaleye DO, Muller CP ... more ... References 1. Odemuyiwa SO, Mulders MN, Oyedele OI, Ola SO, Odaibo GN, Olaleye DO, Muller CP (2001) Phylogenetic analysis of new hep-atitis B virus isolates from Nigeria supports endemicity of geno-type E in West Africa. ...
Supracondylar fractures of the humerus are the most common traumatic elbow injury in children. Se... more Supracondylar fractures of the humerus are the most common traumatic elbow injury in children. Several techniques are described in their support. Blount's method is one of the widely used orthopedic means. The objective of our study was to evaluate the results of supracondylar fractures of the humerus treated by this method in our department. This was a descriptive, longitudinal study with the prospective collection over a period of 12 months from May 2018 to April 2019. It focused on children aged 0 to 15 years treated in the Orthopedic Traumatology Department of the CHU of Kati for a supracondylar fracture of the humerus in extension. A minimum follow-up period of 6 months was necessary for inclusion. 12 patients were collected. The sociodemographic, anatomopathologic, therapeutic and evolutionary aspects were studied. The results were evaluated according to Flynn's criteria. The male sex was predominant with a ratio of 2. The average age was 5.5 years. The average admission time was 12.5 hours. Domestic accidents were the main etiology (66.66%) and Type II fracture was the most frequent with 58.33%. The duration of immobilization was 42 days for 11 patients. Complications were 1 case of secondary displacement and 1 case of 12˚ flexion deficit. The average Baumann angle was 72˚. The result was satisfactory for all our patients. Supracondylar fractures of the humerus are common in children, especially boys. The method of Blount when it is well carried out by respecting the indications gives good results.
The aim of this study was to determine the wastewaters antibiotic residues concentration in two h... more The aim of this study was to determine the wastewaters antibiotic residues concentration in two hospitals (CHU Point G and CHU Luxembourg) in Bamako. Methods: The samples of wastewater were collected three times consecutively on three days every week at 9 a.m., 3 p.m. and 9 p.m. in 2016. The samples were stored at 4°C and transferred to the veterinary central laboratory (LCV). The antibiotic residues were detected by High Performance Liquid Chromatography and the antibiotic concentrations were determined by a spectrophotometer UV-Visible Hewlett Packard. Results: The detected and measured antibiotic residues were amoxicillin ((0.066 ± 0.08 µg/l), erythromycin (0.04 ± 0.0 µg/l), co-trimoxazole (sulfamethoxazole 0.06 ± 0.21 µg/l + trimethoprime 0.08 ± 0.006 µg/l) and metronidazole (0.02 ± 0.0 µg/l in the hospital wastewater and in the sewer systems. Amoxicillin and sulfamethoxazole were detected before and after the Point G wastewater treatment. No antibiotic residue was detected in the "Chikoroni" sewer system which discharged the Point G wastewater. Amoxicillin and sulfamethoxazole were also detected in the wastewater of the hospital "le Luxembourg" which doesn't have a wastewater treatment plant and in the "Djafranako" sewer system which discharged the wastewater of this hospital. Erythromycin and metronidazole were detected only in the Point G wastewater. Chloramphenicol, ciprofloxacin and tetracyclin were not detected in the two hospital wastewater. The antibiotic residues concentrations at the different moments show the same high level in the different sites. Conclusion: Hospitals play a role in the antibiotic dissemination into the environment. In Bamako, the wastewater quality is not alarming, but every hospital must get a sewer system.
La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit. Article disponible en ligne à l'adresse Article disponible en ligne à l'adresse https://www.cairn.info/revue-sante-publique-2009-5-page-507.htm Découvrir le sommaire de ce numéro, suivre la revue par email, s'abonner... Flashez ce QR Code pour accéder à la page de ce numéro sur Cairn.info.
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