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Profil virologique de l’infection virale B chronique au Service de Médecine Interne de l’Hôpital National Donka de Conakry
Get PDFIntroduction : L’hépatite B est une inflammation du parenchyme hépatique provoquée par un virus hépatotrope. Malgré la disponibilité d’un vaccin efficace, l’infection chronique par le virus de l’hépatite B (VHB) demeure un problème majeur de santé publique en raison de sa forte prévalence, de ses complications et de son impact socio-économique.
Objectif : Décrire le profil virologique de l’infection chronique par le VHB chez les patients suivis au service de Médecine Interne de l’Hôpital National Donka.
Méthodes : Il s’agissait d’une étude rétrospective descriptive menée sur une période de six ans (1er janvier 2017 – 31 décembre 2022). Ont été inclus tous les dossiers médicaux de patients porteurs chroniques du VHB disposant du bilan minimal requis (biochimie, virologie et histologie), conformément aux recommandations de l’European Association for the Study of the Liver (EASL) 2017.
Résultats : Parmi les 1 436 patients porteurs du virus de l’hépatite B recensés, 464 (32,3 %) répondaient aux critères d’inclusion. L’âge moyen était de 36 ± 16,2 ans (extrêmes : 18–74 ans), avec une prédominance masculine (60,1 %, sex-ratio 1,5). Les commerçants constituaient la catégorie socioprofessionnelle la plus représentée (16,6 %), suivis du personnel de santé (7,1 %). Les principaux facteurs de risque étaient liés aux soins médicaux, notamment les extractions dentaires (45 %) et les interventions chirurgicales (24,8 %), tandis que la scarification représentait 8,2 %. Un antécédent familial de portage du VHB a été retrouvé dans 23,3 % des cas, dont une transmission maternelle dans 20,4 %. L’infection était le plus souvent découverte de façon fortuite (80,2 %), traduisant une méconnaissance fréquente de la maladie. La charge virale était détectable chez la majorité des patients (89,4 %), avec des valeurs majoritairement faibles (<2000 UI/mL dans 71,6 % des cas). Cependant, 16,6 % présentaient une virémie supérieure à 10 000 UI/mL, exposant à un risque accru de progression vers des complications hépatiques. Les transaminases (ALAT et ASAT) restaient dans les limites de la normale chez plus de 85 % des patients, ce qui suggère que l’atteinte hépatique peut évoluer silencieusement. Une fibrose significative était néanmoins observée dans un quart des cas, soulignant l’importance du dépistage précoce et du suivi histologique. Sur le plan virologique, le profil prédominant était l’infection chronique HBeAg négative (70 %), suivie de l’hépatite chronique HBeAg négative (18,1 %). Trois cas d’hépatite B occulte (0,6 %) ont également été identifiés. Ces résultats mettent en évidence la forte proportion de patients présentant une infection à bas niveau de réplication mais avec un risque non négligeable de progression, ce qui justifie une surveillance clinique et virologique régulière pour prévenir les complications telles que la cirrhose et le carcinome hépatocellulaire.
Conclusion : L’infection chronique par le VHB touche principalement l’homme adulte jeune et est le plus souvent découverte de manière fortuite. Le profil virologique prédominant est l’infection chronique HBeAg négative, suivie de l’hépatite chronique HBeAg négative. Ces résultats soulignent la nécessité d’un dépistage systématique et d’une évaluation précoce du statut virologique et histologique afin d’orienter la prise en charge et de prévenir l’évolution vers les complications.
Introduction : Hepatitis B is an inflammation of the liver parenchyma caused by a hepatotropic virus. Despite the availability of an effective vaccine, chronic infection with the hepatitis B virus (HBV) remains a major public health problem due to its high prevalence, complications, and socioeconomic impact.
Objective: To describe the virological profile of chronic HBV infection in patients followed up in the Internal Medicine Department of Donka National Hospital.
Methods: This was a retrospective descriptive study conducted over a six-year period (January 1, 2017 – December 31, 2022). All medical records of chronic HBV carriers with the minimum required tests (biochemistry, virology, and histology) were included, in accordance with the recommendations of the European Association for the Study of the Liver (EASL) 2017.
Results : Among the 1,436 patients identified as carriers of the hepatitis B virus, 464 (32.3%) met the inclusion criteria. The mean age was 36 ± 16.2 years (range: 18–74 years), with a predominance of males (60.1%, sex ratio 1.5). Traders were the most represented socio-professional category (16.6%), followed by healthcare workers (7.1%). The main risk factors were related to medical care, particularly tooth extractions (45%) and surgical procedures (24.8%), while scarification accounted for 8.2%. A family history of HBV carriage was found in 23.3% of cases, including maternal transmission in 20.4%. The infection was most often discovered incidentally (80.2%), reflecting a frequent lack of knowledge about the disease. The viral load was detectable in the majority of patients (89.4%), with mostly low values (<2000 IU/mL in 71.6% of cases). However, 16.6% had viremia greater than 10,000 IU/mL, exposing them to an increased risk of progression to liver complications. Transaminases (ALT and AST) remained within normal limits in more than 85% of patients, suggesting that liver damage may progress silently. Significant fibrosis was nevertheless observed in a quarter of cases, highlighting the importance of early screening and histological follow-up. From a virological perspective, the predominant profile was chronic HBeAg-negative infection (70%), followed by chronic HBeAg-negative hepatitis (18.1%). Three cases of occult hepatitis B (0.6%) were also identified. These results highlight the high proportion of patients with low-level replication infection but with a significant risk of progression, which warrants regular clinical and virological monitoring to prevent complications such as cirrhosis and hepatocellular carcinoma.
Conclusion: Chronic HBV infection mainly affects young adult men and is most often discovered incidentally. The predominant virological profile is chronic HBeAg-negative infection, followed by chronic HBeAg-negative hepatitis. These results highlight the need for systematic screening and early assessment of virological and histological status in order to guide management and prevent progression to complications
Dynamiques de l’occupation du sol et du ravinement dans le bassin versant d’un petit affluent du fleuve Niger : kori Ganguel (sud-ouest Niger)
Get PDFL’érosion hydrique est un facteur majeur de la dégradation des milieux sableux au Niger. L’objectif de ce travail est de caractériser la dynamique environnementale sur le bassin de Ganguel. Il s’agit spécifiquement de déterminer les dynamiques de l’érosion hydrique, et de l’occupation des sols. La stratégie de ce travail a été basée sur une cartographie diachronique sous le logiciel ARCGIS et des calculs d’indice de l’agressivité climatique. Il ressort une augmentation du ravinement qui a été de 7 ravins/an entre 1989et 2015, un recul des berges de 7,71m /an entre 2002 et 2017, une augmentation moyenne de 4 noeuds/an entre 2002 et 2017. Une diminution de la végétation de 29% pour la période 1989-2015, une augmentation des surfaces nues et ou encroûtées de 2844 ha entre 1989 et 2015. L’érosivité des pluies à Ganguel entre 1970 et 2017 n’a pas montré une tendance claire et a été régulièrement modérée (100<RI<200). L’accroissement du ravinement a permis le développement de culture de type verger le long des chenaux. En effet la surface des vergers a connu une augmentation de 0,43% entre 2002 et 2015.
Water erosion is a major factor in the degradation of sandy environments in Niger. The aim of this study is to characterize the environmental dynamics of the Ganguel basin. Specifically, the aim is to determine the dynamics of water erosion and land use. The strategy for this work was based on diachronic mapping using ARCGIS software and climatic aggressiveness index calculations. The results show an increase in gullying of 7 gullies/year between 1989 and 2015, bank recession of 7.71m/year between 2002 and 20017, and an average increase of 4 knots/year between 2002 and 2017. A 29% decrease in vegetation for the period 1989-2015, an increase in bare and or encrusted surfaces of 2844 ha between 1989 and 2015. Rainfall erosivity at Ganguel between 1970 and 2017 showed no clear trend and was consistently moderate (100<RI<200). Increased gullying has enabled the development of orchard-type crops along the channels. Indeed, the surface area of orchards increased by 0.43% between 2002 and 2015
The Architecture of Wind: Microclimatic Strategies in Roman Villae Maritimae across the Mediterranean (Case Studies from Tripolitania)
Get PDFThis study examines four maritime villas located in the Tripoli area, aiming to highlight how Roman domestic architecture adapted spatially to local climatic conditions. In particular, it hypothesises that the combination of porticus and cryptoporticus formed an architectural device conceived to exploit the natural direction of the winds in order to ensure the passive cooling of residential spaces. Such interpretations, especially concerning the Tripolitanian villas, were partially advanced by mid-twentieth-century scholars. However, they have never been systematically organised within a comparative, interprovincial framework. The data employed in this study derive from a doctoral project that analyses, through published cartography and relevant scientific literature, the architectural evidence of maritime villas along the coasts of the Roman Mediterranean provinces, with the aim of identifying common architectural typologies. Preliminary findings indicate that these strategies of environmental architecture may represent a regional peculiarity of Tripolitania, rather than a broader pattern within the Roman world
Toward Harmonised Governance of Cultural Routes: Sicilian Industrial Heritage Conservation Without Valorisation
Get PDFSicily represents an emblematic case of industrial heritage governance in Italy. Despite the absence of specific legislation, the region holds a historically significant legacy, particularly linked to the sulphur mining industry. In the absence of a unified legal and policy framework, valorisation increasingly depends on local communities and grassroots initiatives. The study adopted a case study approach, selecting Sicily for its complex governance system and long-standing engagement with cultural heritage policies. Therefore, it combined a multilevel review of national and regional legislation with semi-structured interviews conducted through the key informant method at the Sicilian sites of Trabia-Tallarita and Floristella-Grottacalda. Documentary and interview data have been cross-referenced, highlighting the relationship between European priorities, national policy frameworks and local practices. Findings reveal a misalignment between European valorisation strategies and regional implementation, underscoring the need for cohesive governance, strengthened local capacity, and sustainable funding. Within such a framework, Sicily requires a coordinated national strategy to align local cultural initiatives with European standards and ensure effective heritage valorisation
Geopolitical Aspects of the EU Enlargement Process: Macedonian and Ukrainian Case
Get PDFThis paper compares the integration processes of North Macedonia and Ukraine, which have recently opened EU accession negotiations. The significant disparity in the pace of their integration processes - remarkably slow in the case of North Macedonia and exceptionally fast in the case of Ukraine - serves to examine whether EU enlargement decisions are shaped more by the institutional criteria or by geopolitical interests of member states. Using a comparative approach, the study analyzes the European policies and relations with both countries and the EU role in addressing their internal and external disputes. The study aims to demonstrate how EU enlargement is shaped by EU standards and geopolitical interests, interpreting the findings through intergovernmental and realist perspectives that emphasize state-driven decision-making and security imperatives. The results reveal that North Macedonia’s accession was delayed due to non-criteria political disputes, while Ukraine’s accession process was accelerated for security reasons, demonstrating how geopolitical considerations can outweigh normative standards in EU enlargement
From Immanence to Becoming: Beauvoir, Nietzsche, and the Feminist Monologue in The Patience Stone
Get PDFThe article explores the feminist existentialist dimensions of Atiq Rahimi’s The Patience Stone (2008), situating the unnamed female protagonist’s radical monologue within a broader philosophical lineage that includes Simone de Beauvoir and Friedrich Nietzsche. Drawing on Beauvoir’s The Ethics of Ambiguity (2004) and Nietzsche’s The Gay Science (1974), the study frames the woman’s struggle against immanence and patriarchal silencing as a philosophical revolt. Beauvoir’s humanist existentialism provides a lens for understanding the protagonist’s resistance to passive identity, while Nietzsche’s concept of revaluation of values illuminates her defiant articulation of desire, trauma, and agency. The protagonist’s transformation from passive to self-authoring entity echoes Nietzsche's call to transcend herd morality and affirm the self through creative resistance. By bridging Beauvoir’s ethics with Nietzsche’s radical critique of moral normativity, this study argues that The Patience Stone stages a feminist revolt that is both existential and genealogical - dismantling inherited structures of meaning while forging new modes of becoming. Ultimately, enacts a philosophical drama of voice, vulnerability, and value creation in a context where silence has long been mistaken for virtue
Causes et conséquences de la fluctuation du prix de l’huile de palme dans les marchés d’Edéa-Cameroun
Get PDFLa ville d'Édéa, dans la région du littoral, est un pôle vital pour producteurs, commerçants et consommateurs d’huile de palme, mais les prix y varient fréquemment, sans compréhension locale claire des causes et effets. Cette étude analyse ces fluctuations, leurs origines et leurs impacts, à partir d’une enquête participative auprès de 130 acteurs de la chaîne de valeur, via des questionnaires et guide d’entretiens. Les données ont été traitées avec SPSS (Statistical Package for the Social Sciences) (analyses descriptives, tests de Student, corrélations et tests de khi-deux). Les résultats indiquent que la saisonnalité climatique influence significativement les prix : en saison des pluies, la production baisse (observée par 90% des producteurs), réduisant la disponibilité de 50% à 70%, et entrainant une augmentation des prix de 30% à la production et de 43,3% au détail. Ce phénomène est accentué par un déficit de stockage chez 85% des producteurs et 75% des transformateurs. Les producteurs 75% ont peu d’influence sur les prix, contrairement aux transformateurs et grossistes, dont 80% admettent des pratiques spéculatives. Ainsi, 85% des producteurs subissent une instabilité de revenus. Pour les consommateurs, 75% ressent un fort impact budgétaire, forçant 50% à réduire leur consommation d'huile de palme. Ces fluctuations traduisent un marché déséquilibré nécessitant la mise en œuvre d’une stratégie de stockage régulée de l’huile de palme.
The town of Édéa, located in the coastal region, is a crucial hub for palm oil producers, traders, and consumers. However, prices in the area fluctuate frequently without a clear local understanding of the causes and effects. This study aims to analyze these fluctuations, their origins, and impacts through a participatory survey of 130 value chain actors using questionnaires and interviews. The data were processed using SPSS (Statistical Package for the Social Sciences) for descriptive analyses, Student's t-tests, correlations, and chi-square tests. The results indicate that climatic seasonality significantly influences prices. During the rainy season, production decreases (observed by 90% of producers), leading to a reduction in availability of 50% to 70%. This decrease in supply results in an increase in prices of 30% at the production level and 43.3% at the retail level. This situation is exacerbated by a storage deficit reported by 85% of producers and 75% of processors. Producers have minimal influence (75%) on prices, unlike processors and wholesalers, 80% of whom admit to engaging in speculative practices. As a result, 85% of producers face income instability. For consumers, 75% feel a significant budgetary impact, with 50% being forced to reduce their palm oil consumption. These fluctuations highlight an unbalanced market that necessitates the implementation of a regulated storage strategy for palm oil
Influence of Financial Inclusion on Informal Sector Small and Medium Scale Enterprises’ Employment in Sub-Saharan Africa: Moderating Role of Mobile Money
Get PDFThe informal sector remains a dominant force in Sub-Saharan Africa (SSA), with small and medium-sized enterprises (SMEs) serving as critical engines of employment and livelihood. However, limited access to financial services continues to constrain the growth and sustainability of these businesses. This study investigates the impact of financial inclusion on employment outcomes among informal SMEs in SSA, with a particular focus on the moderating role of mobile money. The study analyzed a panel data from 38 SSA countries between 2000 and 2023 with a two-step System Generalized Method of Moments (GMM). Findings reveal that while financial inclusion has a weak positive effect on employment, mobile money alone also shows a modest direct effect. However, the interaction between financial inclusion and mobile money is negative and statistically significant, suggesting that mobile money may dilute the employment-enhancing impact of broader financial inclusion when both coexist. The results also confirm strong employment persistence and limited influence from macroeconomic control variables. The study implies that policymakers should treat financial inclusion and mobile money not as interchangeable tools but as complementary elements that require careful coordination. Additionally, the findings offer new directions for accounting research, especially in the context of informal financial data and reporting practices. Future work should consider firm-level data, gender-disaggregated analysis, and evolving financial technologies to better understand SME dynamics in Africa’s informal economy
Supply Chain Management Practices in Response to Ecosystem Challenges – Literature Review
Get PDFIn recent years, there has been a widespread awareness of issues affecting the ecosystem, such as climate change. It is in fact a universal reality that affects human life, business activities, and the environment. In this context, companies are required to master operations in a dynamic and risky ecosystem where logistics play a very important role in meeting sustainable development objectives. More specifically, optimizing supply chain performance requires the implementation of various green practices, which leads managers to rethink their decision-making processes related to supply chain management in order to reduce carbon emissions and improve their overall performance (Wang and Sarkis, 2013). This study is therefore a direct continuation of work focusing on sustainable supply chain management. This type of management is now an obligation rather than a choice in the era of climate change, which has major implications in terms of strategic and operational planning. It therefore seems relevant to address the following question: “What supply chain management practices can be adopted to address the challenges of climate change?” The objective of this article is to identify best practices in supply chain management and their impact on the environment and overall performance. Our research methodology consists of a theoretical study based on an analysis of work carried out in this field, the identification of green SCM practices that should be adopted by companies, and an analysis of their impact on overall performance