Diabetic hand infections in hospital practice in Bamako, Mali.
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Adolescent↗
Biomedical subjects
D Diallo
Publications and source records attributed to D Diallo.
[Feeding pattern of Rift Valley Fever virus vectors in Senegal. Implications in the disease epidemiology].
During the rainy season 2003, an entomological survey was undertaken in the Sahelian bioclimatic zone of the Ferlo area in northern Senegal, in order to evaluate the degree of interaction between Rift valley fever (RVF) virus vectors and domestic animals and to determine the role of natural vertebrate hosts in the transmission and maintenance cycle. The study of vector-host contact was carried out under bed net traps using man, cow, sheep, chicken as bait whereas the RVFV vectors-vertebrate host interactions were studied through the analysis by an ELISA technique of the origin of the blood meals from naturally engorged females collected by aspiration. Blood meals sources were determined using a set of eight antibodies. Overall, the different known RVFV vectors (Culex poicilipes, Aedes vexans and Aedes ochraceus) were opportunistic although the bovine-baited net was, as far the more effective trap with 53.6% of collected mosquitoes. It was followed by the sheep-baited net (16.7%), man-baited net (12.6%) and chicken-baited net (11.6%). The more effectiveness of the bovine-baited net confirms the degree of implication of this host in RVF epidemiology. The study of vector-hosts interactions in nature showed that among the 1,112 mosquito blood meals tested, 701 were identified of which 693 were from Aedes vexans. The percentage of non-reacting blood meal was 36.7% whereas 16.9 % of the blood meals were taken at least on two vertebrate hosts. Overall, 53.2% of the blood meals from Ae. vexans were taken on equine, 18.6% on bovines, 7.1% on sheep and 0.6% on human. No blood meal was taken on rodent. The greatest diversity was observed in August. These host feedings patterns show that although equine is known to play a minor role in RVF epidemiology a thorough attention should be made to this host with regard to the percentage of blood meals taken in this host. The low percentage of blood meals taken on human could probably explain the low human infection rate observed up to now in Senegal. With the high percentage of non-reacting blood meals, our results also underline the necessity of an improvement of ELISA techniques and the use of more reliable tools as molecular markers for an exhaustive identification of vertebrates hosts involved in RVF epidemiological cycle.
Animals↗
Screening of traditional herbal medicine: first, do a retrospective study, with correlation between diverse treatments used and reported patient outcome.
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Humans↗
[Envenomation accidents caused by snakebites in the surgical emergency unit of Gabriel-Touré Hospital, Bamako, Mali (1998-1999)].
This study aimed at assessing envenomations caused by snakebite in the Gabriel Touré hospital between January 1998 and December 1999. We included in total 112 victims of snakebites proved by the identification of the snake, the fangs traces and envenomation signs. The bites concerned 34 women (30.36%) versus 78 men (69.64%) from the Bamako district, while 66.7% were from a rural environment. The farmers were the most affected category (35.1%). The bite concerned the lower limb in 83.3% of the cases. Snakes such as Echis ocellatus, Bitis arietans, Naja nigricollis and N. katiensis caused the envenomations. The viperine syndrome dominated the clinical picture; its severity depended on the bleeding stage and the delay of administration of the antivenom serum (AVS) after the envenomation: 19 hours for Echis sp. and 2 hours for Naja sp. This study shows that the envenomation accidents caused by snakes are frequent with a lethality rate of 9.8%.
Adolescent↗
[Neonatal mortality associated with transfer of low birth weight newborns. Assessment of a neonatal care unit of Dakar].
The aim of this study is to assess mortality rate of low birth weight newborns admitted to a neonatal care unit of Dakar after transfer. This retrospective study include all newborns weighing less than 2500 g transferred to Abass Ndao neonatal care unit between January 1st,1998 and December 31, 1999. Maternal, newborns and transfer related parameters were studied. Data of 180 new-borns were recorded from a sample of 247 babies transferred. The mean weight of these babies were 1452.5 +/- 432 g. An ambulance was used for transport in only 10% of cases. The median time of admission after birth was 3 hours. Median delay of admission and methods of transfer, maternal age and parity, apgar score at 1st and 5th minute were comparable between the newborns deceased and survivors (p > 0.05). To reduce mortality associated with newborns transfer, we insist on a better organisation of neonatal transport in under developed countries by promoting obstetricians and paediatricians collaboration and prevention of low birth weight.
Adolescent↗
Screening of Malian medicinal plants for antifungal, larvicidal, molluscicidal, antioxidant and radical scavenging activities.
A total of 78 different extracts from 20 medicinal plants belonging to 14 plant families from Mali were tested for their antifungal, larvicidal, molluscicidal, antioxidant and radical scavenging activities. Dichloromethane, methanol, water and ethanol extracts were used. TLC autobiography for antifungal activity was run with Cladosporium cucumerinum and Candida albicans. Extracts were also tested on the larvae of the mosquitoes Aedes aegypti, Anopheles gambiae and Culex quinquefasciatus. Molluscicidal activities were established with the snails Biomphalaria glabrata, Biomphalaria pfeifferi and Bulinus truncatus. beta-Carotene and DPPH solutions sprayed on TLC plates were used for antioxidant and radical scavenging assays. Of the extracts investigated, 20% were antioxidant and radical scavengers, 19% fungicidal, 30% were larvicidal and 11% were molluscicidal. Three of the plant extracts, from Cussonia barteri (Araliaceae), Glinus oppositifolius (Aïzoaceae) and Lannea velutina (Anacardiaceae) gave positive responses in all four tests.
Aedes↗
Polysaccharides from the roots of Entada africana Guill. et Perr., Mimosaceae, with complement fixing activity.
Entada africana is a tree used in traditional medicine in Mali. The root is, for example, used for wound-healing. Since polysaccharides from other plants are thought to play a role in the wound-healing process, we wanted to study the polysaccharides present in the root of this species. The polysaccharides were extracted with water at 50 and 100 degrees C and were further separated by anion exchange chromatography. The acidic fractions were finally purified by affinity chromatography on a Con A column. The fraction denoted Ea100 acidic I had the highest activity in the complement fixation test system, while the other acidic fractions had minor activities and the neutral fractions were almost negative. Ea100 acidic I has a structure resembling the arabinogalactan-protein type II polymer, which also was demonstrated by the abilities to precipitate with the Yariv reagent. The biological activity was reduced considerably after removal of arabinofuranoside residues by weak acid hydrolysis. The main core of the other polysaccharides extracted with 100 degrees C were pectins resembling the rhamnogalacturonan type I. These fractions also contain arabinogalactan type II structures, shown by the formation of precipitates with the Yariv reagent.
Amino Acids↗
Hemoglobin C associated with protection from severe malaria in the Dogon of Mali, a West African population with a low prevalence of hemoglobin S.
The malaria hypothesis proposes a survival advantage for individuals with hemoglobin variants in areas of endemic Plasmodium falciparum malaria. Hemoglobin C (HbC) is a possible example in West Africa, where this hemoglobin has a centric distribution with high frequencies among certain populations including the Dogon ethnic group. To test whether HbC is associated with protection from malaria, we performed a case-control study in the Dogon of Bandiagara, Mali. HbC was present in 68 of 391 (17.4%) of uncomplicated malaria control cases, whereas it was detected in only 3 of 67 cases (4.5%) of severe malaria (odds ratio [OR], 0.22; P =. 01). Further, HbC was present in only 1 of 34 cases (2.9%) with cerebral manifestations, the most common presentation of severe malaria in this population (OR, 0.14; P =.03). Episodes of uncomplicated malaria and parasitemias (4800-205 050/microL) were identified in cases of homozygous HbC (HbCC), which indicates that P falciparum parasites are able to efficiently replicate within HbCC erythrocytes in vivo. These findings suggest that HbC does not protect against infection or uncomplicated malaria but can protect against severe malaria in the Dogon population of Bandiagara, Mali. The data also suggest that the protective effect associated with HbC may be greater than that of HbS in this population.
Anemia, Sickle Cell↗
[Heterotopic pregnancy: a report of 5 cases and review of the literature].
Heterotopic pregnancy, also called combined pregnancy, associates extra-uterine pregnancy and intra-uterine pregnancy. We report five cases of heterotopic pregnancy illustrating this condition and reviewed the recent literature from 1994 to 1999. We compared the results of this review with earlier data in the literature from 1971 to 1993. We observed that therapeutic management of the extra-uterine pregnancy and course of the intra-uterine pregnancy have changed little over this period. Conversely, the frequency of heterotopic pregnancy has steadily increased since the development of medically assisted reproduction, although spontaneous cases continue to occur. The diagnosis of heterotopic pregnancy is often difficult as the symptomatology is often misleading. Transvaginal ultrasound generally gives the diagnosis which may be confirmed by laparoscopy, allowing treatment of the extra-uterine pregnancy. Maternal and intra-uterine fetal prognosis depends on early diagnosis which should be made, if possible, prior to termination of the extra-uterine pregnancy.
Adult↗
[Hyperhomocysteinemia and pregnancy: a dangerous association].
Homocysteine results from the demethylation of the essential amino acid methionine. Its metabolism depends primarily on three enzymes and several vitamin cofactors (vit. B6, B9 and B12). Genetic abnormality in these enzymes or deficiency of these vitamins lead to Hyperhomocysteinemia. Hyperhomocysteinemia belongs among the congenital thrombophilies and is a long-known vascular disease risk factor. The discovery that hyperhomocysteinemia may also be responsible for several pregnancy complications has only recently been made. Studies in this area are still scarce and report on limited numbers of patients. It nevertheless appears clear that HHCh is associated with the syndromes of repeated miscarriage, pre-eclampsia, placenta abruptio, thromboembolic events, neural tube defects, and perhaps with fetal death-in-utero and intra-uterine growth retardation. Supplementation with vitamin B9 can reduce plasma HC levels, and is thus recommended in patients with HHCh. The prevention of thromboembolic events during pregnancy by anticoagulant treatment is also desirable in these patients.
Abortion, Habitual↗
Iron deficiency in pregnancy: effects on the newborn.
Iron deficiency during pregnancy affects a significant portion of women in countries with low economic wealth and is not uncommon in pregnant women in industrialized countries. Inadequate intake of iron related to diets poor in bioavailable iron is often responsible for iron deficiency before pregnancy, and metabolic adjustments (such as mobilization of iron stores and increased absorption) are insufficient to meet increasing needs during pregnancy. The effects of iron deficiency on the fetus are still controversial. Numerous measures, including the evaluation of erythrocyte ferritin, favor the hypothesis that the level of iron stores in newborns is related to maternal iron status and that the materno-fetal unit is dependent on exogenous iron, which is necessary to prevent iron deficiency in both mothers and infants. In industrialized countries, iron supplements should be prescribed for pregnant women in the third trimester, when the need for iron is prominent. In developing countries, supplementation should be initiated as soon as possible after conception because of the high prevalence of iron deficiency at the onset of pregnancy. The results of studies comparing intermittent with daily supplementation remain controversial.
Anemia, Iron-Deficiency↗
[Tubal ligation using minilaparotomy under local anesthesia. Apropos of 800 cases at the University Hospital Center in Dakar].
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Adult↗
[The role of Hühner's direct post-coital test in the evaluation of conjugal sterility in the African environment in Senegal. (Apropos of 2593 post-coital tests performed by the clinical cytology, cytogenetic and reproduction biology laboratory at the University Hospital Center in Dakar, Senegal) 1983-1993].
About 2593 post-coïtal tests (PCT) or Hühner direct tests were realised in the laboratory of clinical cytology, cytogenetics and reproductive biology of the University medical Centre of Dakar, Senegal from 1983 to 1993. Analysing the results, the authors showed the importance of the infectious factor in women and also the role of male deficiency in conjugal sterility in black African environment. These realities have been confirmed cytospermiologic test deficient results. These sperm exams have shown among other things, the prevailing number of azoospermia (25%) and of oligo-asthénotératozoospermia (44%) in husbands of sterile women in the black African environment of Senegal. Pap's Tests have been jointly realised at the same time as 1902 PCT. The results have enabled us to track down 120 cervix with precancerous and cancerous cell alterations; 81 condylomas (HPV), 25 CIN1, 11 CIN2 and 3 CIN3 (CIN: cervical intra-epithelial Neoplasia). These facts suggest a cautious technics, and a prudent interpretation of the results and taking into account the competence and the subjectivity of the practitioner. We have learnt from the study that we must give as much as possible to biologists of Reproduction in southern countries, where conjugal sterility and cervix precancerous and cancerous cell alterations are high, a polyvalent training so that they can practise jointly the post-coïtal or Hühner direct test (PCT) and the Papanicolaou Colpocytologic Test (TP), provided that one owes a microscope.
Adolescent↗
[Retroplacental hematoma at the Dakar University Hospital Center].
Abruption placenta has been a principal cause of maternal mortality by hemorragy at Dakar University Teaching Hospital. The incidence is 2.44%. It related with multiparity and age. Etiologics factors such as toxemy (7.01%) and HTA (5.26%) were founded, lack of prenatal care was notified. The complete form is observed in 71.3% and bad hemodynamic conditions in 61%. The death rate is 8.4%: morbidity is dominate by anemia, renal failure and coagulation defect. Perinatal mortality is 87.07%. Cesareans were performed on only 2.25%. The amelioration of the prognostic is linked with depistage of women with high risk of abruption placenta, a good prenatal survey, an early diagnosis and quick evacuation of the uterus.
Abruptio Placentae↗
[Complications of tubal sterilization by minilaparotomy under local anesthesia].
Between January 1, 1991 and June 30, 1996, physicians performed 800 cases of tubal ligation via minilaparotomy under local anaesthesia in the Obstetrics and Gynecology clinic of the Dakar University Teaching Hospital (Senegal). There were complications in 7 (0.87%) cases (bladder and bowel injuries: 6 cases, and post operative infection: 1 case). The most frequent risk factors were: surgeon skill (lack of experience of surgeon in minilaparotomy), type of patients (obesity, previous abdominal surgery). It was concluded, proper training and experience of the surgical team is needed to minimize sterilization related complications.
Adult↗
[Antibiotic prophylaxis à la carte in self-contaminated gynecologic and obstetric surgery: importance of cefotaxime].
Infections represents 5% of our post-operative morbidity and result in the use of expensive antibiotics and longer hospital stays. As a less expensive alternative to systematic antibiotherapy for all patients, the authors propose a prospective and descriptive study of the effectiveness of antibioprophylaxis by administering 1 g of Cefotaxime pre-operatively. The study concerns a continuous series of 103 cases in gynaecology and obstetrics operated in the Dakar University Teaching Hospital, during a 13 months period (April 95-April 96). The average age of the patients is 30 years, the major types of surgery was cesarean sections, laparotomy for extra-uterine pregnancy and myomectomies. The duration of the surgery varied between 40 to 105 minutes with an average of 60 minutes. There was no intolerance to Cefotaxime. No cases of post operative infections were observed. All surgical wounds healed in 6 to 8 days except 2 minor cases of non-union of 1 cm. Antibioprophylaxis with Cefotaxime can therefore be considered as an effective means of preventing post-operative infections in clean surgery. It is easy to administer and also has the advantage of lower cost (4050 Fcfa compared to 29,000 Fcfa for classic antibiotherapy).
Adolescent↗
Different response to Plasmodium falciparum malaria in west African sympatric ethnic groups.
The comparison of malaria indicators among populations that have different genetic backgrounds and are uniformly exposed to the same parasite strains is one approach to the study of human heterogeneties in the response to the infection. We report the results of comparative surveys on three sympatric West African ethnic groups, Fulani, Mossi, and Rimaibé, living in the same conditions of hyperendemic transmission in a Sudan savanna area northeast of Ouagadougou, Burkina Faso. The Mossi and Rimaibé are Sudanese negroid populations with a long tradition of sedentary farming, while the Fulani are nomadic pastoralists, partly settled and characterized by non-negroid features of possible caucasoid origin. Parasitological, clinical, and immunological investigations showed consistent interethnic differences in Plasmodium falciparum infection rates, malaria morbidity, and prevalence and levels of antibodies to various P. falciparum antigens. The data point to a remarkably similar response to malaria in the Mossi and Rimaibé, while the Fulani are clearly less parasitized, less affected by the disease, and more responsive to all antigens tested. No difference in the use of malaria protective measures was demonstrated that could account for these findings, and sociocultural or environmental factors do not seem to be involved. Known genetic factors of resistance to malaria did not show higher frequencies in the Fulani. The differences in the immune response were not explained by the entomological observations, which indicated substantially uniform exposure to infective bites. The available data support the existence of unknown genetic factors, possibly related to humoral immune responses, determining interethnic differences in the susceptibility to malaria.
Adolescent↗
Erythrocyte ferritin in human neonates: maternofetal iron kinetics revisited.
Serum and erythrocyte ferritin concentrations were measured in 369 healthy term neonates and their mothers, with a view to understanding maternofetal iron kinetics. Erythrocyte ferritin concentrations in the neonates were on average 100 times higher than maternal values, while those of serum ferritin were about 10 times higher. Maternal and fetal iron status were correlated in the overall study population. Serum and erythrocyte ferritin values were also correlated with each other in both the mothers and neonates. To study the influence of iron status on these conditions, we formed three groups of mother-child pairs of equal size, based on maternal iron status (serum ferritin). The correlations found in the overall population were not always present in each subgroup. In the infants born to mothers with adequate tissue iron reserves (serum ferritin > 12 micrograms/I), a statistical link was found between serum and erythrocyte ferritin levels. When the mothers had optimal iron status (serum ferritin > or = 22 micrograms/I), there was a correlation between the neonatal and maternal erythrocyte ferritin levels. No such links were found when the mothers had low tissue iron stores (serum ferritin < 12 mg/I). These data point to special iron kinetics during fetal life and the influence of maternal iron status.
Erythrocytes↗