6 research outputs found
Abcès amibien du foie dans le service de chirurgie pédiatrique du Centre Hospitalière Universitaire Gabriel TOURE
No full textObjectifs généraux : Déterminer la fréquence hospitalière de l'abcès amibien du foie en milieu chirurgical pédiatrique ; - Décrire les aspects cliniques, para-cliniques et thérapeutiques de l'abcès amibien du foie ; - Évaluer le résultat du traitement de l'abcès amibien du foie ; - Evaluer le coût de la prise en charge. Matériels et méthodes : Il s'agissait d'une étude rétrospective de 8 ans, allant du 1er Janvier 2010 au 31 Décembre 2017 effectuée dans le service de chirurgie pédiatrique du Centre Hospitalière Universitaire Gabriel TOURE. Pour 10164 admissions, 50 cas d'abcès amibiens du foie en ont été colligés, ce qui a représenté une fréquence hospitalière de 0,49 p.100 . L'âge moyen de nos patients a été de 6,7 ans. Le sexe masculin a été prédominant avec une sex-ratio de 1,4. Les signes cliniques les plus fréquents ont été la fièvre (100 p.100 ), l'hépatalgie (94,1 p.100 ), l'hépatomégalie (72 p.100 ) et nausées et/ou vomissements (62 p.100 ). Les collections objectivées à l'échographie abdominale étaient localisées dans le lobe droit dans 88,2 p.100, uniques dans 76,5 p.100 . La sérologie amibienne effectuée dans 100 p.100 des cas, a été positive dans 50 cas (100 p.100 ). Le traitement médical a été exclusif dans 6 cas (12 p.100 ), une ponction évacuatrice écho-guidée a été nécessaire dans 88 p.100 des cas. La chirurgie a été pratiquée dans 6 cas de péritonite (12 p.100 ). La morbidité est faible (6 p.100 ). Nous n'avons pas enregistré de décès dans notre série. Une prise en charge multidisciplinaire des abcès amibiens du foie associant le pédiatre, le chirurgien pédiatrique et le radiologue permettrait d'améliorer le pronostic
Entités Territoriales Communales Décentralisées et Gouvernance des Ressources Foncières : L’exemple de l’or dans le Ganadougou/Région de Sikasso au Mali
Get PDFLe Mali est un pays très riche en or. Les orientations économiques des politiques de développement ont contribué à mettre les ressources aurifères au cœur d’une ferveur considérable. Il en résulte des enjeux socio-économiques et politiques à l’œuvre dans la transformation des territoires au plan national et local. Du coup, la question de l’exploitation de l’or, quelle que soit sa forme, présente un intérêt scientifique évident pour les géographes et les économistes. La présente recherche vise certains objectifs. Il s’agit de connaitre l’importance et la nature des pratiques d’exploitation de l’or ; de connaitre les modalités de la gouvernance des ressources foncières aurifères ; de faire une analyse de la traduction spatiale du développement lié à la gouvernance en place. Leur atteinte a nécessité l’observation d’une démarche méthodologique. Celle-ci a été fondée sur l’exploitation de la documentation et les enquêtes de terrain. Fondamentalement les résultats ont permis de comprendre qu’à partir de l’orpaillage traditionnel dont ils assurent la gouvernance, les populations du Ganadougou ont remodelé leur espace en deux types distincts de territoires. Le premier est socialement et économiquement développé. Il s’oppose au deuxième très arriéré sur les mêmes plans.
Mali is a country very rich in gold. The economic policy orientations have contributed to putting the gold resources in the middle of a considerable zeal. This leads to the active socio-economic stakes in the transformation of territories at both national and local level. Consequently, the gold operation issue, whatever its form is, presents an obvious scientific interest for the geographers as well as for the economists. This paper focuses on achieving the following goals: to know the importance and the nature of gold operation practices, to know the governance methods of gold property resources, and to analyze the space manifestation of development due to the setting up governance. A methodological approach was made to reach the goals of this research. It was based on documentation process and field surveys. Basically, the results have made it possible to understand that from traditional mining of which the peoples of Ganadougou ensure the governance, they reshaped their space in two separate types of territories. The first is socially and economically developed, which is opposed to the second that is more backward on the same plans
Bottom-Up Approaches to Policy-making and Aid Effectiveness in the Health Sector: The case of Mali
No full textIntroducing bottom-up approaches into policy-making processes can be a good pathway towards improving aid and development effectiveness. At this regard, the case of Mali is emblematic because health plans are elaborated through decentralised mechanisms: committees at local level elaborate annually their own operational plans; these are then presented at regional level and traduced into regional plans, which are finally aggregated at the central level into the national plan, according to the national policy guidelines. In 2011, the elaboration of the new health programme for the period 2012-2022 enabled to strengthen planning capacities and coherence through the introduction of new bottom-up mechanisms improving stakeholders’ participation and better taking stock of local experiences. Indeed, for policies to be really effective, two key components of the policy-making process are particularly important. Firstly, past experience should be better taken into account and evidence should be used to inform new strategies. This requires the integration of learning dynamics all along the policy process, where stakeholders’ experience and local evidence become essential inputs for planning new strategies and plans. For this evidence to be successfully translated into policies, the influence of individual, organisational and system capacities and resources should be also considered. Secondly, a mindset shift is needed from a linear to a systemic understanding of development. This requests stakeholders to accept that development and health results are multifactorial and that they should be rather expected over the long term. Based on lessons learned from the Malian experience and on literature review, our presentation introduces a framework for action that highlights key determinants and constraints related to the use of bottom-up mechanisms in policy-making in the health sector in a context of aid dependence.info:eu-repo/semantics/nonPublishe
Traitement non chirurgical de l’hématome extradural : expérience du centre hospitalier universitaire Gabriel Toue, au Mali: Non-surgical treatment of intracranial epidural hematoma: experience of Gabriel Toue University hospital, Mali
Get PDFContext and objective. Epidural hematoma (EM) has always been considered a neurosurgical emergency for which surgery was unavoidable. This dogmatic concept has recently been questioned by many authors who report a satisfactory result of non-surgical “conservative” treatment for this pathology. The aim of this study was to describe clinical and therapeutic features and to assess risk factors associated to EM.
Methods. This was a retrospective study on the medical treatment of EM between December 2010 and November 2014 at Gabriel Toue hospital in Bamako. Parameters of interest were epidemiological, clinical and radiological. We used the Pearson chi-square test to look for a possible clinical correlation and to highlight factors related to failure of conservative treatment.
Results. 79 patients were included with an average age of 38 years and a predominance of male sex (88.6%). The road accidents were the main mechanism of head trauma (73.4%) followed by physical assaults (12.7%). About 57% of patients had a Glasgow score of 15 initially. The clinical picture was dominated by headache (92.4%). Thirteen patients had intracranial-associated lesions that consisted of meningeal hemorrhage (3 cases) and oedemato-haemorrhagic contusion (10 cases), which was significantly associated with therapeutic failure (p=0.04). Six patients had been surgically treated for failure of conservative treatment.The evolution was satisfactory in 92.4%. None of our patients had neurological sequelae.
Conclusion. EM remains a neurosurgical emergency; but surgery is not the only option for patients. Conservative treatment based on clinical and radiological criteria is an effective and less aggressive therapy for the patient.
Contexte et objectif. L’hématome extradural a toujours été considéré comme une urgence neurochirurgicale pour laquelle une intervention chirurgicale était inéluctable. Ce concept dogmatique a été récemment remis en cause par de nombreux auteurs qui rapportent un résultat satisfaisant du traitement non chirurgical « conservateur » pour cette pathologie. Les objectifs de la présente étude étaient de décrire les aspects cliniques et thérapeutiques et de rechercher les facteurs associés à l’échec du traitement conservateur.
Méthodes. Dans une étude documentaire, tous les patients admis pour hématome extradural et traités médicalement, au Centre hospitalier universitaire de Gabriel Touré ; entre décembre 2010 et novembre 2014 ont été étudiés. Les paramètres d’intérêts étaient épidémiologiques, cliniques et radiologiques. Nous avons recouru au test de chi-carré de Pearson pour rechercher une corrélation clinique éventuelle et mettre en évidence les facteurs liés un échec du traitement conservateur.
Résultats. 79 dossiers de patients avec hématome ont été colligés. Leur âge moyen était de 38 ans avec une prépondérance masculine (88,6%). Les accidents de la voie publique étaient le mécanisme principal du traumatisme crânien (73,4%) suivi par les agressions (12,7%). Environ 57% de patients avaient un score de Glasgow à 15 initialement. Le tableau clinique était dominé par des céphalées à 92,4%. Treize patients avaient présenté des lésions associées intracrâniennes à type d’hémorragie méningée (3 cas) et de contusion oedémato-hémorragique (10 cas) qui a été significativement associée à l’échec thérapeutique (p =0,04). Six patients (7,6%) avaient été traités chirurgicalement suite à un échec du traitement conservateur. L’évolution était satisfaisante dans 92,4 % des cas. Aucun de patients n’avait présenté de séquelles neurologiques.
Conclusion. Le traitement conservateur de cette série basé sur des critères cliniques et radiologiques constitue une thérapeutique efficace et moins agressive pour certains patients. L’HED demeure certes une urgence neurochirurgicale ; mais la chirurgie n’est pas la seule option à proposer aux patients
AGRHYMET: A drought monitoring and capacity building center in the West Africa Region
No full textThe AGRHYMET Regional Center, a specialized institution of the Permanent Interstates Committee for Drought Control in the Sahel (CILSS), was created in 1974 at the aftermaths of the severe droughts that affected this region in the early 1970s. The mission assigned to the Center was to train personnel, provide adequate equipment for the meteorological and hydrological stations networks, and set up regional and national multidisciplinary working groups to monitor the meteorological, hydrological, crops and pastures conditions during the rainy season. As such, it can be considered as the West Africa drought monitoring center, similarly to its younger counterparts in Eastern and Southern Africa. After 40 years of existence, AGRHYMET’s scope of activities expend now beyond the geographical boundaries of CILSS member states, to include the whole West Africa thanks to several initiatives it has been implementing on behalf of the Economic Commission of West African States (ECOWAS) on food security and environmental issues, including climate change. Throughout the years, AGRHYMET developed, in collaboration with international research organizations, models and methodologies based on ground and satellite observations to monitor rainfall, food crop water requirements satisfaction and prospective yields, the progress of vegetation front and its seasonal and interannual variations. It has trained about 1200 new experts in agrometeorology, hydrology, equipment maintenance, and plant protection, and more than 6000 professionals on topics related to food security, climate change, and sustainable natural resources (land and water) management. As of now, AGRHYMET staff is involved in several international initiatives on climate change, food security, and environmental monitoring that allow them keep abreast of the best available technologies and methods, and also contribute to generating knowledge on those issues
An assessment of interactions between global health initiatives and country health systems
No full textSince 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity value for money, and outcomes in global public health, then these opportunities should not be missed
