Risk factors associated with necrotizing fasciitis of the lower limbs: A multicenter case-control study

OBJECTIVE

The aim of this case-control study was to identify risk factors associated with necrotizing fasciitis (NF) of the lower limbs.

PATIENTS AND METHODS

We conducted a prospective case-control study in hospital dermatology departments in 5 sub-Saharan African countries over a 2-year period (April 2017 to July 2019). The cases were patients with NF of the lower limbs and the controls were patients with leg erysipelas. Each case was matched with two controls for age (±5 years) and sex. We analyzed local and general factors.

RESULTS

During the study period, 159 cases (73 females, 86 males) were matched with 318 controls. The mean age was 48.5±15.8 years for cases and 46.5±16.2 years for controls (P=0.24). The main local signs of NF were cutaneous necrosis (83.7%), pain (75.5%) and induration (42.1%). Multivariate analysis showed the following to be independent risk factors associated with NF of the lower limbs: obesity (odds ratio [OR]=2.10; 95% confidence interval [CI]: 1.21-3.42), diabetes (OR=3.97; 95% CI: 1.95-6.13), nicotine addiction (OR=5.07; 95% CI: 2.20-11.70), use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR=7.85; 95% CI 4.60-14.21) and voluntary cosmetic depigmentation (OR=2.29; 95% CI: 1.19-3.73).

CONCLUSION

Our study documents the role of NSAID use at the onset of symptoms as a risk factor for NF of the lower limbs. However, the originality of our study consists in the identification of voluntary cosmetic depigmentation as a risk factor for NF of the lower limbs in sub-Saharan Africa patients. Our results also identified typical overarching factors such as diabetes, obesity and nicotine addiction. Knowing these factors and taking them into account will enable optimization of management strategies for these conditions.

[Compliance's assessment of ultrasound and x-ray requests at Mopti's Sominé Dolo hospital]

OBJECTIVE

To assess the compliance of requests for ultrasound and radiography examinations at Mopti's hospital.

MATERIALS AND METHODS

This was a cross-sectional study from January 2018 to June 2018. The variables analyzed were the different compliance criteria grouped into administrative, clinical and minor.The data analysis was done with SPSS version 20 and Excel 2013 software.

RESULTS

Out of 2000 requests, radiography represented 61.05% compared to 38.95% of ultrasound cases. The administrative criteria were completed in more than 95% of the cases. The purpose of the review was absent in 95% of the requests. The non-compliance rate for the requests was 95.65%. The requests of general practitioners, specialists and medical assistants were respectively non-compliant with 93.62%; 95.68% and 100%.

CONCLUSION

At the end of this study, we observed an insufficiency in the quality of prescriptions for requests for medical imaging examinations with a high rate of non-compliance. This could lead to examination practice not suited to the clinical situation, interpretation errors, complications for the patient and high and unnecessary economic cost.

[Epidemiology of Cutaneous Leishmaniasis in West Africa: a Systematic Review]

Cutaneous leishmaniasis (CL) has been described in West Africa (WA) since the beginning of the 20th century. The incidence of cases has markedly increased during the last decades in several countries of the region. Despite that, data remain scarce and fragmentary. The current incidence and geographic distribution of the disease as well as the involved vectors and reservoirs remain poorly documented. The objective of this review was to collect and analyze available data about CL in WA in order to improve the management of cases and the control of the disease transmission. A systematic literature review was performed using the Pubmed, Google Scholar and Hinari databases. Publications focusing on epidemiological aspects of CL, involved parasite species, sand flies and potential reservoir hosts were searched without any restrictions. Unpublished studies were extracted from Google. Manuscripts without full text or summary available were excluded as well as those whose summaries did not contain any usable data. One hundred and fifteen studies were recorded. Among them, 93 filled selection criteria. CL has been reported in 10 West African countries with outbreaks described in five countries. Burkina Faso, where the average incidence of the disease is around 928 cases per year, and Ghana seem to be the most affected. Cases have been confirmed in the majority of studies by microscopy sometimes associated with culture or histology. The exposure rate to Leishmania infection based on leishmanin skin test was relatively high with an overall average of 30.2%. Leishmania major was the only species identified with a predominance of MON-74 (62%) and MON-26 (30.6%) zymodemes. Phlebotomus duboscqi is retained as the vector whereas Sergentomyia darlingi and Sergentomyia ingrami were found naturally infected. Rodents including Arvicanthis niloticus, Gerbilliscus gambiana and Mastomys spp. are reported as the main reservoir hosts. Additional studies are needed to better characterize CL in WA in order to optimize the management of cases and to organize the control of the disease transmission.

[Caracteristics Of Severe Malaria In Child From 0 To 5 Years At The Hospital Of Sikasso In Mali]

In Mali, malaria is a major public health problem. The region of Sikasso is classified according to the geo-climatic facies as a zone with a long seasonal transmission of malaria greater than 6 months.

OBJECTIVE

To describe the epidemiological, clinical and therapeutic characteristics of children aged 0- 5 years hospitalized for severe malaria in the pediatric ward of the Sikasso hospital. Variables analyzed were epidemiological, clinical, paraclinical, therapeutic and evolutionary.

PATIENTS AND METHODS

This is a retrospective, 12-month (January-December 2014) cross-sectional study of all 0-5-year-olds hospitalized for severe malaria at the Sikasso Regional Hospital.

RESULTS

The hospital frequency of severe malaria was 55.82%. The age group of 12-35 months was the most concerned (45.3%). The peak frequency was in August (21.2%). Anemic, mixed (anemia and neurological) and neurological forms were the most frequent. Artemether and quinine were the antimalarials used. The use of a blood transfusion was frequent (82.8%). The lethality was 10% and the mixed form (anemia and neurology) was the most lethal ((P<10^-6).

CONCLUSION

Malaria remains a national concern in Mali. Improving the quality of care and prevention must be a priority to reduce the lethality that remains high.

[Factors associated to loss of follow-up in patients underwent antiretroviral therapy in an ambulatory HIV treatment center at Conakry]

BACKGROUND

Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry.

METHODS

A retrospective cohort study was conducted in HIV patients aged over 15 years and who receiving antiretroviral therapy. Between August 1, 2008 and July 31, 2015, all patients managed by the ambulatory treatment center of the Guinean Women Association against AIDS and sexually and transmissible infection were included. Loss of follow-up was defined as no follow-up visit within 3 months. Kaplan-Meier curves and multivariate Cox regression models were used to analyze factors associated with loss of follow-up. Analyses were performed by using Stata 13 software.

RESULTS

614 patients aged 36.3±11.2 years, mainly females (68.4%) and living in Conakry (80.5%) were included. Among them, 104 were loss to follow-up, corresponding to a proportion rate of 16.9% (95% CI: 14.2-19.7%) or 5.79/100 person-years. The results of multivariate analyses showed that factors independently associated with loss of follow-up were malnutrition (AHR=7.05; 95% CI: 2.05-24.27; P=0.002) and CD4 cells account at the initiation of AHR (2.35; 95% CI: 1.61-6.39; P=0.016) in patients with 201-350 CD4/μL and 5.83 (95% CI: 2.85-11.90; P<0.001) in patients with less than 150CD4/μL.

CONCLUSION

Despite efforts of health care workers and free antiretroviral therapy, many patients were loss to follow-up. Multivariate analysis showed that malnutrition and low CD4 account were independently associated with loss to follow-up.

The transcription factor XBP1s restores hippocampal synaptic plasticity and memory by control of the Kalirin-7 pathway in Alzheimer model

Neuronal network dysfunction and cognitive decline constitute the most prominent features of Alzheimer's disease (AD), although mechanisms causing such impairments are yet to be determined. Here we report that virus-mediated delivery of the active spliced transcription factor X-Box binding protein 1s (XBP1s) in the hippocampus rescued spine density, synaptic plasticity and memory function in a mouse model of AD. XBP1s transcriptionally activated Kalirin-7 (Kal7), a protein that controls synaptic plasticity. In addition, we found reduced levels of Kal7 in primary neurons exposed to Aβ oligomers, transgenic mouse models and human AD brains. Short hairpin RNA-mediated knockdown of Kal7 altered synaptic plasticity and memory formation in naive mice. Further, reduction of endogenous Kal7 compromised the beneficial effects of XBP1s in Alzheimer's model. Hence, our findings reveal that XBP1s is neuroprotective through a mechanism that engages Kal7 pathway with therapeutic implications in AD pathology.

Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso

INTRODUCTION

Pregnant women are more susceptible to vaginal colonization and infection by yeast. The role of Candida colonization in the occurrence of preterm birth is well established. The knowledge of local epidemiology and identification of risk factors for preterm birth is important for the prevention and management strategies. The purpose of the study was to determine the prevalence of Candida sp. in vaginal swabs of pregnant women.

METHODS

Pregnant women attending routine antenatal visits in three primary health centres in Bobo-Dioulasso (Burkina Faso) were enrolled into a cross-sectional study carried out from February to April 2015. Vaginal swabs samples were taken from participants after obtaining oral consent. The swabs were inoculated into Sabouraud's glucose agar supplemented with chloramphenicol and incubated at 37°C for 24 to 48hours under aerobic conditions in order to perform fungal culture. The identification of the Candida species was done by culture on HiCrome Candida Differential Agar at 35°C for 48h for production of species-specific colors.

RESULTS

A total of 229 pregnant women were included. The prevalence of vulvovaginal candidiasis (VVC) was 22.71%, (95% CI [17.45-28.69]). Candida albicans accounted for 40.39% and non-Candida albicans species for 59.61% of the isolates, with mainly C. glabrata (32.69%), C. tropicalis (15.38%) and C. krusei (11.54%).

CONCLUSIONS

This study revealed a high prevalence of non-C. albicans species. The syndromic management guidelines for VVC in Burkina Faso will be revised to include a specific protocol for pregnant women.

[A case of rhinofacial entomophthoromycosis in Soudano-Sahelian tropical climate in Burkina Faso]

We describe a rhinofacial entomophthoramycosis case in a sexagenarian (65 years old) housewife. She was immunocompetent and resident of Burkina Faso. She consulted both the service of dermatology and the service of stomatology of the Teaching Hospital of Bobo-Dioulasso in February 2016 for a diffuse facial tumefaction evolving over six months. This tumefaction was associated with headaches and a left nasal obstruction. Histological examination of the lesion showed an important and polymorphic inflammatory reaction. Also, a filamentous fungus with wide non-septated hyphae and right-angled fungal branching, consistent with mucormycosis was isolated. Mycological diagnosis based on fungal culture with Sabouraud medium without any antibiotic and cyclohexemide after incubation at 27°C and at 30°C was negative. Furthermore, it was not possible to amplify the DNA extracted from biopsy. Antifungal therapy based on the administration of fluconazole per os at 800mg/day was started allowing clinical improvement. This is the first case of a rhinofacial entomophtharomycosis documented in Bobo-Dioulasso. Rhinofacial entomophthoromycosis is largely unknown, even in tropical regions such as Burkina Faso. This lack of knowledge results in a delay in the diagnosis, and subsequently a bad prognosis. It is therefore urgent to improve knowledge on this disease to guide diagnostic steps, prognosis of outcome, and antifungal therapy.

[Clinical appearance and scalable profile Thiamine deficiency in prison in Guinea: study of thirty-eight observations]

Cardiovascular and neurological manifestations associated with thiamine deficiency in Guinean prisons are common but not reported.We performed a prospective study of 38 cases related to vitamin B1 deficiency over a period of 4 years. In this population, the literature of traditional data gathered: frequency peak after thirty (92.6%) and clear representation male (sex ratio M/F: 18/1). The clinical symptomatology remains essentially dominated by sensorimotor polyneuropathy and pure sensory (52.2%), overall heart failure (31.5%) and to a lesser degree by Gayet Wernicke's encephalopathy (7.8%) and shoshin beriberi with severe evolution (5.2%). The study of nutritional status by body mass index (BMI) of the World Health Organization, by the criteria of Detsky and biological markers including albumin, shows that these patients are severely malnourished.

[Risk factors associated with leg erysipelas (cellulitis) in sub-Saharan Africa: A multicentre case-control study]

BACKGROUND

Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context.

PATIENTS AND METHODS

We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors.

RESULTS

During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5).

CONCLUSION

The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.

[Evaluation of antiretroviral treatment in HIV infected adult in the department of dermatology venereology of the Donka national hospital]

If the use of highly active antiretroviral therapies (HAART) have largely improved survival, morbidity and the quality of life of the people living with HIV in Northern countries as well as Southern countries and particularly in Africa, many obstacles have slowed down their use. Thus the follow-up of the patients under HAART in certain developing countries is still limited even non-existent.

OBJECTIVE

The objective of this work was to bring the therapeutic outcomes obtained after a minimal six months period of follow-up among HIV+ patients admitted in external consultations or following hospitalizations.

MATERIAL AND METHODS

We carried out a retrospective and descriptive study concerning patients followed from January 1st, 2004 to December 31st, 2008 (5 years).

RESULTS

Our study concerned 275 patients including 61.41% women with a sex-ratio (M/W) of 0.62. The average age of our patients was of 36.83 [rage: 18-70]. The initial average weight of our patients was 59.88 kg [range: 30-107] with the majority (66.91%) at the stage III of the WHO clinical classification. The serologic profile was dominated by HIV₁ (97.09%) with a number of average CD4 of 210.99 cells/mm³ at the initiation of the ARV treatment. The evolution under treatment was marked clinically by an average ponderal gain of 7,45kg, with weight increasing from 59.88 kg to 67.33 kg between M0 and M₅₄. Biologically, the number of average CD4 increased from 210.99 to 643 between M₀ and M₄₈ with an average gain of 432.01 cells/mm3. On the virological level, the plasmatic viral load was carried out for 64 patients out of 275. It was undetectable in 31 patients, be it 48.44%.

CONCLUSION

In conclusion, the therapeutic outcomes of the patients under HAART was good at the end of this study with a satisfactory clinical issue, marked by an increase in the average weight which corroborates a good immunological and virological response.

High level of HIV-1 resistance in patients failing long-term first-line antiretroviral therapy in Mali

OBJECTIVES

In resource-limited settings, few data are available on virological failure after long-term first-line antiretroviral therapy. This study characterized the genotypic resistance patterns at the time of failure after at least 36 months of a first-line regimen in Mali, West Africa.

METHODS

Plasma samples from 84 patients who were receiving first-line antiretroviral treatment and with an HIV-1 RNA viral load (VL) >1000 copies/mL were analysed. Genotypic resistance testing was performed and HIV-1 drug resistance was interpreted according to the latest version of the National Agency for HIV and Hepatitis Research algorithm.

RESULTS

At the time of resistance testing, patients had been treated for a median of 60 months (IQR 36-132 months) and had a median CD4 cell count of 292 cells/mm(3) (IQR 6-1319 cells/mm(3)), a median HIV-1 RNA level of 28266 copies/mL (IQR 1000-2 93 495 copies/mL) and a median genotypic susceptibility score of 1 (IQR 1-4). The prevalence of nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations was 78% and 82%, respectively. Viruses were resistant to at least one drug in 92% of cases. Although etravirine and rilpivirine were not used in the first-line regimens, viruses were resistant to etravirine in 34% of cases and to rilpivirine in 49% of cases. The treatment duration, median number of NRTI and NNRTI mutations and some reverse transcriptase mutations (T215Y/F/N, L210W, L74I, M41L and H221Y) were associated with the VL at virological failure.

CONCLUSIONS

This study demonstrated a high level of resistance to NRTIs and NNRTIs, compromising second-generation NNRTIs, for patients who stayed on long-term first-line regimens. It is crucial to expand the accessibility of virological testing in resource-limited settings to limit the expansion of resistance and preserve second-line treatment efficacy.

[Causes and characteristics of patient death under ARV at the Dermatology-Venereology Department of the Donka National Hospital, GUINEA]

INTRODUCTION

The antiretroviral treatments led to a spectacular reduction of morbidity and mortality of HIV-infected patients, transforming it into a chronic infection. HIV infection remains potentially lethal and requires a long term treatment to obtain an immunological and virological control. The goal of this work was to describe the characteristics of the deaths during the ARV treatment.

MATERIALS AND METHOD

We led a descriptive retrospective study of a 4 year period, from July 2004 to August 2007 which looked at 429 patient under ARV followed in the dermatology - venereology department of the Donka national hospital and whose death during hospitalization occurred for the study period. We excluded the patients who suffered loss of sight or who died during the ARV treatment period.

RESULTS

On 429 included patients, recorded death rate was of 27,7%. The mean age of included patients was 42 ± 6.5 years old. Patients at the stage 3 and 4 of the WHO classification recorded the greatest number of death. There was no patient at stage I. More half of the patients were immunosuppressed with a count of CD4 < 200/mm3. In our study 66 patients died with a rate of CD4 < 200/mm3 21 patients with a rate of CD4 ranging between 200 and 499 or 17,6%. Only one patient had a rate of CD4 > 500/mm3 while 31 other patients did not have a CD4 at the time of the death. We recorded 57 deaths in the first 6 months of HAART (among which 32 occurred within the first 3 months) and 24 after. The leading causes of death were tuberculosis (47,05%) including 64,28% of pulmonary localization and 35,71% of extrapulmonary localization, followed by cerebral toxoplasmosis (19,62%) and Kaposi disease (15,12%). The other causes of death found were hepatitis B (4,20%) and neuro-meningeal cryptococcosis (2,52%). A socio-economic unstable situation was found at half of the patients For 14 case the cause of death remained unknown. There no was death due to side effects of the ARV therapy. 89,1% of the patients deceased were under protocol 2 INTI + 1 INNTI which represents the layout of first line in our country.

CONCLUSION

The mortality of the infection by HIV remains high in spite of the introduction of ARV treatment into our service. The patients who passed away were mainly characterized by a low level of CD4 and a very advanced stage of the evolution of the infection to the initiation of the ARV. The leading causes of death were opportunist infections. An early tracking of the infection by HIV and an early and optimal assumption of responsibility of the opportunist infections could contribute to reverse the tendencies in Guinea.

[Epidemiological features of intestinal parasitic infection in Burkina Faso from 1997 to 2007]

A retrospective review of parasitic intestinal infections reported to the Ministry of Health of Burkina Faso from 1997 to 2007 was conducted. Study focused on the results of 904,733 stool examinations performed for parasite detection in public hospital parasitology laboratories. The overall positivity rate for intestinal parasite infection was 54.7%. Protozoa and helminths were identified in 32.0% and 8.0% of stool examinations respectively. The main parasites checked for were amoebas (29.8%), hookworms (5.7%), tapeworms (1.7%) and Schistosoma mansoni (1.6%). Parasites were detected throughout the country and the proportion of positive samples differed significantly from one region to another. These findings highlight the high frequency of laboratory diagnosis of intestinal parasitic infection and demonstrate the need to improve environmental sanitation and provide health education to the population.

[Incarcerated internal hernia through a breach of the broad ligament, a case report]

We report a case of 44-year-old women presented with an acute small bowel obstruction revealated by tomodensitometry. Laparotomy showed an incarcerated internal hernia through the broad ligament. We performed liberation of the ileal segment and closed the hernial orifice. The patient evolution was excellent.

Analgesic efficacy and haemodynamic effects of nefopam in critically ill patients

BACKGROUND

Pain management is challenging in intensive care unit (ICU) patients. The analgesic efficacy, tolerance, and haemodynamic effects of nefopam have never been described in critically ill patients.

METHODS

In consecutive medical-surgical ICU patients who received 20 mg of nefopam i.v. over 30 min, we measured pain, Richmond Agitation Sedation Scale (RASS), respiratory parameters, and adverse drug events at T0 (baseline), T30 (end-of-infusion), T60, and T90 min. Haemodynamic variables were assessed every 15 min from T0 to T60 and T90. Pain was evaluated by the behavioural pain scale (BPS, 3-12) or by the self-reported visual numeric rating scale (NRS, 0-10) according to communication capacity.

RESULTS

Data were analysed for 59 patients. As early as T30, median NRS and BPS decreased significantly from T0 to a minimum level at T60 for NRS [5 (4-7) vs 1 (1-3), P<0.001] and T90 for BPS [5 (5-6) vs 3 (3-4), P<0.001]. No significant changes were detected for RASS, ventilatory frequency, or oxygen saturation. Increased heart rate and decreased mean arterial pressure, defined as a change ≥15% from baseline, were found in 29% and 27% of patients, respectively. For the 18 patients monitored, cardiac output increased by 19 (7-29)% and systemic vascular resistance decreased by 20 (8-28)%, both maximally at T30. Heat sensation, nausea/vomiting, sweating, and mouth dryness were found, respectively, in 6%, 9%, 22%, and 38% of patients.

CONCLUSIONS

A single slow infusion of nefopam is effective in critically ill patients who have moderate pain. The risk of tachycardia and increased cardiac output and also hypotension and decreased systemic vascular resistance should be known to evaluate the benefit/risk ratio of its prescription.

Risk factors associated withSalmonella entericasubsp.entericacontamination of chicken carcases in Senegal

The objective of this study was to identify the risk factors for Salmonella spp. contamination of Senegalese chicken carcases during slaughtering. One hundred and twenty traditional slaughterhouses were studied from January 2000 to December 2002 in and around Dakar. A questionnaire was administered to the slaughterers and samples of breast skin were taken to assess the Salmonella spp. status of chicken carcases. Results showed that 43.3% of the chicken batches were contaminated with Salmonella spp., with Salmonella Hadar and Salmonella Brancaster as the two main serovars. Salmonella spp. contamination of the live birds before slaughtering was related to contamination of the carcases after slaughtering. Feed withdrawal before slaughtering and thorough cleaning and disinfection procedures decreased the risk of Salmonella contamination. One individual worker for each slaughtering stage was also associated with a decreased risk of Salmonella contamination. Using scalding water for plucking increased the risk of contamination. These results will help slaughterers to produce safer products for local consumers.

[Frequency of red blood cell alloimmunization in polytransfused patients at the university teaching hospital of Point G, Bamako, Mali]

This prospective study conducted within 9 months period aimed to determine the frequency of red cell alloimmunization among polytransfused patients of the medical Hematology and oncology ward, and the unit of hemodialysis of the Nephrology ward at the Point-G hospital. Irregular red blood cell antibody screening and identification were performed by gel-filtration method using indirect antiglobulin test and enzymatic treated cells. We did not use saline medium. A total of 78 patients were included in this study. The mean age of the patients was 36.78±14.73 years (range: 11 and 77 years). The sex ratio was of 1.11 in favour of the women. The mean blood units transfused were 12.21±9.99 units (range: 4 and 45 units). The Rhesus phenotypes Dccee, DccEe and DCcee were most predominant, with the respective frequencies of 67.9, 15.4 and 10.3%. Kell antigen was found at a frequency of 1.28%. The total rate of red cell alloimmunization was 10.3%. There was no significant difference between the two wards. All the screened agglutinins were warm antibodies belonging to the Rhesus system: anti-E (7.7%), anti-C (1.3%) and anti-D (1.3%). Only Anti-E was present among hematologic patients. We did not find a significant link between the sex, the age, the number of blood units transfused and the positivity of the antibody screening. We conclude that the frequency of post-transfusional alloimmunization is high among polytransfused patients in Mali. A systematic antibody screening among these patients and the selection of red cells with known Rhesus/Kell phenotypes would allow an optimal blood transfusion safety.