Characteristics and typology of sheep herding systems in the suburban area of Ouagadougou (Burkina Faso)

Abstract. Strong increase in demand for animal products could benefit local producers in developing countries. This development opportunity particularly concerns suburban livestock. In Burkina Faso, the suburban area of Ouagadougou is a place for the setting up of an increasing number of breeders. Due to its importance in religious traditions, spurring its consumption in whole West Africa, mutton is a major part of this suburban production. In order to characterize sheep farming in the suburban zone of Ouagadougou, in terms of motives, practices, and economic performance, and to better understand the dynamic at play in the sheep sector, a survey has been conducted among 80 sheep farmers around Ouagadougou. The results show that suburban sheep keeping is a highly dual sector. Nearly half (42.5 %) of farms may be described as traditional livestock, while 50 % are evolving towards intensification. These two groups essentially differ in terms of animal genetic and feeding management, farm infrastructure, and farmer education level. Economically, the whole sample tends to indicate a lack of profitability of the activity in terms of monetary income. Several factors contributing to this situation are pinpointed, namely feed and animal health constraints, flock and production management, and the market conditions.

[Multiple sites extrapodal actinomycetoma: Favorable outcome to treatment with a combination of cotrimoxazole and NSAI]

Mycetoma is a bacteriological or fungal infectious disease affecting the skin and/or soft tissues, which can be complicated by bone involvement. The most common feature is a tumor of the foot, but extrapodal localizations have been described. We report one case of a 47-year-old man who presented with tumefaction of a leg with multiple skin fistulae. Histopathological examination permitted to confirm the diagnosis of actinomycetoma and TDM showed the degree of bone and soft tissues involvement. Our case was characterized by the very inflammatory aspect of the tumor, its localization to the leg without foot involvement, the modest functional signs compared to the importance of radiological bone involvements, the deep destruction of the fibula while the tibia was apparently intact and the good response to treatment. In spite of its characteristic features, diagnosis of mycetoma is still late in our country, often with bone and/or articular spread. Priority may be given to measures for reduction of mycetoma diagnosis lateness.

[Heller myotomy by transthoracic procedure, a single center experience in Mali with 21 cases]

AIMS

To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the introduction of anti-reflux system by diaphragmatic flap.

PATIENTS AND METHODS

This was a prospective study involved 21 patients (14 women and 7 men) operated for idiopathic megaesophagus during a period of 3 years. All the patients were operated by thoracotomy procedure. An anti-reflux system was performed using a diaphragmatic flap over the entire length of the myotomy.

RESULTS

The mean age was 32 years (range 16 and 68 years). After the surgery we have seen a complete disappearance of dysphagia in 21 patients (100 %) (p <0.001) and a significant weight regain. Short term outcomes were marked by the occurrence of clinical gastroesophageal reflux disease in 1 patient (4.76%) who has received the anti-reflux system (p> 0.05).

CONCLUSION

Oeso-cardio-myotomy of Heller by transthoracic procedure associated with the establishment of an anti reflux system by diaphragmatic flap has goods results.

[Direct cost of traumatic brain management in Hospital of Ségou Mali: What funding for care management in Mali?]

Traumatic Brain Injury (TBI) is the second cause of admission in the emergency department at the Nianankoro Fomba hospital of Ségou. Young adults with low income are the most affected. The objective of this study is to evaluate the direct cost of the management of TBI at the emergency ward and to make a proposal for future financing of this management in Mali. We conducted a prospective study from September 2009 to December 2010 at the Nianankoro Fomba hospital of Ségou. All patients admitted in the emergency ward for TBI for more than 24 hours were included. The age range between 21-40 was the most affected. All socioprofessional categories were affected. The average cost of prescription was 55,392 CFA. Medical evacuation was necessary in 15 cases for an average fee of 60,700 CFA. Due to lack of money, 75% of deceased patients were not evacuated at the third level. The average cost of management was 99,385 CFA [range: 39,115-282,944]. The total cost of services was 7,269,320 CFA. The high cost of the management of TBI is a major determinant of morbidity and mortality of this disease.

Primary unreamed and unlocked intramedullary nailing of femoral shaft fractures

ABSTRACT

In this retrospective study, we present our experience using open Küntscher nailing (K-nailing) which is still performed in developing countries for femoral fractures. Of 157 acute fractures treated between January 2003 and December 2009, 100 were stable (63.7%) and 135 were located within the middle third of the shaft (86%). Comminution was absent or minimal in 135 (86%) cases. Fracture union was achieved at an average of 14 weeks (range, 10 - 25). The duration of follow-up was 17 months (range, 6 - 36). Final evaluation showed that 129 (82.2%) patients had a good result according to modified Kempf's criteria. The predominant complications were infection (n=5; 3.2%), nonunion (n=9; 5.5%), implant failure (n=11; 7%), and malunion (n=27; 17.3%). Open reduction and fixation with a tight fitting Knail can give good results in selected acute femoral shaft fractures but knowledge of potential complications is needed.

KEY WORDS

femoral shaft fracture, Intramedullary nailing, Open reduction.

Closed retrograde multiple intramedullary Kirschner wires fixation for humeral shaft fractures with the limb flexed over an articulated support

OBJECTIVE

To evaluate the results of multiple closed intramedullary Kirschner wiring via a supracondylar entry point for humeral shaft fractures.

PATIENTS AND METHODS

The charts of 37 patients with humeral shaft fractures treated with the Hackethal's technique between January 2007 and December 2011 were reviewed retrospectively. The operation was performed with the patient lying in supine (n = 22) or lateral (n = 15) position. The elbow was flexed over an articulated support with the arm kept in a vertical position. Thirty-three patients were available for final evaluation with a mean follow-up delay of 14 (range, 6-24) months. We were concerned about fracture union, range of motion of the shoulder and the elbow, and complications. Final evaluation used the criteria by Qidwai.

RESULTS

Bone union rate was 94%. Restriction of ranges of motion of the shoulder more than 20° was noticed in two patients due to protruding wires. Three patients developed limitation of elbow extension owing to backing out of the wires. The overall results were excellent (n = 26; 79%), good (n = 4; 12%), and poor (n = 3; 9%).

CONCLUSION

Closed Hackethal's technique using K-wires gives satisfactory results in terms of bone union and elbow and shoulder function in selected humeral shaft fractures. The articulated support precludes the transolecranon traction.

Assessing introgression of Sahelian zebu genes into native Bos taurus breeds in Burkina Faso

A total of 350 samples were analyzed to estimate zebu gene proportions into two different taurine cattle breeds of Burkina Faso (Lobi and N'Dama) using 38 microsatellites and various statistical methodologies. West African and East African zebu samples were sequentially used as reference parental populations. Furthermore, N'Dama cattle from Congo, the composite South African Bonsmara cattle breed and a pool of European cattle were used successively as second parental populations. Independently of the methodology applied: (a) the use of West African zebu samples gave higher admixture coefficients than the East African zebu; (b) the higher zebu proportions were estimated when the European cattle was used as parental population 2; and (c) the use of the N'Dama population from Congo as parental population 2 gave the more consistent zebu proportion estimates for both the Lobi and the N'Dama breeds. In any case, the zebu admixture proportions estimated were not negligible and were always higher in the N'Dama cattle than in the Lobi cattle of Burkina Faso. This suggested that the introgression of Sahelian zebu genes into the taurine cattle of Southern West Africa can follow a complex pattern that can depend on local agro-ecological features. The current research pointed out that the estimation of admixture coefficients is highly dependent on both the assumptions underlying the methodologies applied and the selection of parental populations. Our analyses suggest that either too high or nil genetic identity between the parental and the expectedly derived populations must be avoided.

[Knowledge and practices of hypertension in nursing staff of the Hospital Gabriel Touré and Point G]

OBJECTIVE

This work aimed to study the quality of diagnosis and management of high blood pressure (HBP) by the practitioners of the Gabriel TOURÉ and point G teaching hospitals of Bamako.

MATERIALS AND METHODS

It was a descriptive and analytical, cross-sectional study during the study period from 1st March 2009 to 28 February 2010. It included all physicians and paramedics of the teaching hospital of the Point G and Gabriel TOURÉ in Bamako.

RESULTS

A total of 283 practitioners (physicians and the paramedics) from both teaching hospitals have accepted our questionnaire, including 133 doctors and 185 paramedics. CHU Gabriel TOURÉ accounted for 55.1%, the majority came from the department of cardiology with 18.4%. Doctors accounted for the largest square with 47.0%. The majority of our practitioners (59%) say it takes at least one session during three medical consultations to diagnose the HBP. Only 29,60% define the HBP from 140/90 mm Hg. With a blood pressure goal of 58, 30% and 57.20% of practitioners claimed to retain 140/90 mm Hg, respectively for the diabetic and the renal-insufficient patients. A considerable number of our practitioners (27.9%) still used in pregnant women the triplet diuretic/IEC/diet without salt. The information of patients on some important aspects of the pathology prior to any therapeutic strategy had been conducted in 63.6.

CONCLUSION

The high blood pressure must be a major concern for medical and paramedical staff today.

[Complications of digestive ostomies in pediatric surgery]

AIMS

To determine the frequency and factors of complications of intestinal stomas.

METHODS

This was a retrospective study over a 7 year period from January 2004 to December 2010, covering all children aged 0-15 years, who received a stoma and hospitalized in the period of study. Excluded from this study, alimentary ostomy and urological ostomy, and children whose medical records were incomplete.

RESULTS

We examined 192 cases of stoma or 27 cases/year. We noted a complication in 91 (48%) of our patients. The average age was 3.64 ± 5.03 years ranging from 6 hours and 15 years. The complicating factors were: the indication for surgery, type of stoma, the variety of stoma, surgical technique and equipment.

CONCLUSION

The achievement of good technique and appropriate equipment would be needed to reduce some complications of the stoma.

[Amoebic liver abscess in general surgery at the Gabriel Touré teaching hospital, Bamako, Mali]

The objectives were to determine the frequency, and to describe the clinical and therapeutic aspects of amoebic liver abscess. This was a retrospective study in the general surgery department of the Gabriel Touré teaching hospital from 1 January 2004 to December 2008. Included in this study, were all patients hospitalized and treated for amoebic liver abscess. We collected 53 cases a frequency of 1.3%. This was 45 men (84.9%) and 8 women (15.1%). The sex ratio was 5.6. The average age was 39.5 years. The average consultation time was 3 weeks. The signs observed were fever 96.2% (51 cases), the hepatalgia 94.3% (50 case), hepatomegaly 90.6% (48 cases) and anorexia 88.7% (47 cases). Collections of objectified abscess in abdominal ultrasound were located in the right lobe in 79.2% (42 cases), unique in 92.5% (49 cases) and 100 mm in diameter on average. Pulmonary radiography found an elevation of the right diaphragmatic dome 66.7% (14 cases). Amoebic serology was performed in 60.4% of cases, was negative in 2 cases (6.2%). Medical treatment alone was effective in the majority of cases - 62.7% (32 cases), an ultrasound-guided paracentesis associated with medical treatment was required in 31.4% (16 cases). Surgical methods were very rarely recommended 5.9 % (3 cases). The average amount of pus was 637.6ml. Average duration of treatment was 11 days. We recorded three deaths, including one due to a sepsis on peritonitis from ruptured liver abscess and 2 cases due to HIV.

CONCLUSION

The amoebic liver abscess is uncommon in our service. Negative serology does not exclude the diagnosis. Medical treatment is usually curative in the absence of complications.

[Necrotic ulcer in a general surgery department at Gabriel Tour Hospital]

Our objectives were to determine the frequency, clinical, and therapeutic aspects and to evaluate the cost of care.

PATIENTS AND METHOD

This was a retrospective, analytical study, , carried out in the general surgery department of the teaching hospital Gabriel Touré from 1 January 2000 to December 2008. Were included in this study all patients operated for necrotic ulcer in the service.

RESULTS

Seventy -nine (79) patients were identified which represents 0.6 % of our admissions. There were 48 men (60.8%) and 31 women (39.2%) . The sex ratio was 1.5 . The average age was 33.6 years, with extremes ranging from 31-81 years and the standard deviation = 19.7. The diagnosis was based on clinical and paraclinical investigations in all patients (100 %). The average period of consultation was 1.2 months, with extremes ranging from 1 - 24 months and the standard deviation = 0.8. Traditional medications were given to 38 patients (48.1%). The ulcer was multiple in 20 patients (25.3%). In 57 cases (72.2%) it sat in the lower limb and in 22 cases (27.8 %) in the upper limb. The average diameter was 24.3 cm and the standard deviation = 15.1. Trauma and infection were, respectively, the main causes in 63 patients (79.7 %) and 10 patients (12.6%). The most frequent germs found were the Staphylococcus aureus in 40 patients (50.6%) and Proteus mirabilis in 10 patients (12.7%). The thin skin autograft was performed in 66 patients (83.5 %). Healing was complete in 52 patients (78.8%), with a morbidity of 21.2 % (14 cases) . Infection was observed on graft and edema, 5 cases each (7.6%), graft rejection 4 cases (6.1%). The average hospital stay was 2.3 months. The average cost was 237,450 with a range of 75,000 to 500,000 FCFA.

CONCLUSIONS

Necrotic ulcer is an uncommon pathology in our department. The lack of consultation and the use of traditional medication are the main factors of seriousness.

[Epidemiological profile, clinical and therapeutic cutaneous leishmaniasis in the Department of Dermatology at University Hospital in Ouagadougou, Burkina Faso]

It is a retrospective study in the Service of Dermatology at the University Hospital Center Yalgado Ouédraogo of Ouagadougou (C.H.U.-YO). This study aimed to list the leishmaniasis clinical cases reported in the registers of this department from January 1999 to December 2007. In total, 251 leishmaniasis clinical cases have been reported. The hospital prevalence was 1,1%. Women represented 53% versus 47% men. The average age of patients was 22,78 ans +/- 121. The most frequent clinical forms were those often crusted (40.2%), papulo ulcerative (16.7%) and papulonodular (13.9%). Lesions most often sat on the lower limbs (33%) and thoracic limbs (45%). On the therapeutic level, the first line treatment meglumine antimonite (Glucantime) accounted for only 25.9% of prescriptions.

Lack of mitochondrial DNA structure in Balkan donkey is consistent with a quick spread of the species after domestication

A total of 132 mtDNA sequences from 10 Balkan donkey populations were analysed to ascertain their regional genetic structure and to contribute to the knowledge of the spreading of the species after domestication. The Balkan donkey sequences were compared with those from 40 Burkina Faso donkeys as an African outgroup to account for possible local Balkan scenarios. The 172 sequences gave 62 different haplotypes (55 in Balkan donkey). Virtually all the analysed populations had haplotypes assigned to either Clade 1 or Clade 2 even though the relative proportion of Clade 1 or 2 haplotypes differed across populations. Geographical maps constructed using factors computed via principal component analysis showed that the Balkan donkey populations are not spatially structured. AMOVA confirmed a lack of genetic structure in Balkan donkey mtDNA. Balkan populations were poorly differentiated (ΦST  = 0.071). Differentiation between the Balkan donkey and the African outgroup also was low. The lack of correspondence between geographical areas and maternal genetic structure is consistent with the hypothesis suggesting a very quick spread of the species after domestication. The current research illustrates the difficulties to trace routes of expansion in donkey, as the species has no geographical structure.

[Sickle cell anemia and transfusion safety in Bamako, Mali. Seroprevalence of HIV, HBV and HCV infections and alloimmunization belonged to Rh and Kell systems in sickle cell anemia patients]

Red cell transfusion is one of the main treatments in sickle cell disease. However there are potential risks of blood transfusions. In order to propose strategies to improve blood safety in sickle cell disease in Mali, we conducted a prospective study of 133 patients with sickle cell anemia recruited at the sickle cell disease research and control center of Bamako, November 2010 to October 2011. The study aimed to determine the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections by serum screening and the frequency of red cell alloimmunization before and after blood transfusion. The diagnosis of sickle cell syndrome was made by HPLC, the detection of markers of viral infection was performed by ELISA, and the diagnosis of alloimmunization was conducted by the Indirect Coombs test. Prevalence of viral infections observed at the time of enrolment of patients in the study was 1%, 3% and 1% respectively for HIV, HBV and HCV. Three cases of seroconversion after blood transfusion were detected, including one for HIV, one for HBV and one another for HCV in sickle cell anemia patients. All these patients had received blood from occasional donors. The red cell alloimmunization was observed in 4.4% of patients. All antibodies belonged to Rh system only. Blood transfusion safety in sickle cell anemia patients in Mali should be improved by the introduction of at least the technique for detecting the viral genome in the panel of screening tests and a policy of transfusions of blood units only from regular blood donors.