[Gunshot wounds of low urinary tract in period of security crisis at the Sominé Dolo Hospital of Mopti (Mali): Epidemiological and diagnostic aspects]

INTRODUCTION

Firearm injuries to the lower urinary tract are injuries resulting from an energy transfer from a projectile fired by a firearm or a blast from a firearm, to the bladder, prostate, urethra and terminal ureter. Our objective was to describe the epidemiological and diagnostic aspects in the context of a security crisis.

PATIENTS AND METHOD

This was a descriptive cross-sectional study of lower urinary tract firearm injuries at Sominé Dolo Hospital in Mopti from January 2017 to December 2021.

RESULTS

In five years, 29 traumas of the lower urinary tract have been collected, about 6 cases per year. The mean age of patients was 27.48 years, the sex ratio was 13.5/1. The main circumstances of occurrence were intercommunal violence 51.72 %, war wounds 31.03 %. Injuries were inflicted by rifles in 62.1 % and improvised explosive devices in 37.9 %. The main modes of discovery were acute urine retention, hematuria and penoscrotal wounds respectively in 31.03 %, 20.69 %, 17.24 %. The organs affected were the urethra in 58.62 %, the bladder, 37.93 %, the prostate 3.45 %. Associated non-urological lesions present in 68.96 % (n=20) were dominated by intestinal lesions and pelvic fractures.

CONCLUSION

Firearm injuries to the lower urinary tract are rare despite the context of the security crisis. They affect young men, are mostly linked to intercommunal violence, and are dominated by urethral and bladder injuries.

Mothers’ Oral Health Literacy and children’s oral health: study in the department of Pikine, Senegal

Background

Several studies have shown that social conditions in which children are raised and family psychosocial factors affect their oral health. Oral health literacy (OHL) has been shown to be associated with prevalence of dental caries, access to care and prevention of oral diseases. No studies have addressed this issue in Senegal.

Objective: To study the characteristics of the mothers’ OHL and its association with children’s dental health.

Methods

Cross- sectional study in the district of Pikine, a suburb of Dakar including 16 municipalities. Two-stage cluster sampling and a sample comprising 315 children from 3 to 9 years old and their mothers. Data on oral health status were collected from clinical examinations, sociodemographic and OHL (Sistani et al’ OHL-AQ) data were collected during face-to-face interview.

Results

More than half of the mothers (56.5%) had a low OHL, but 68.9% had an adequate score for the communication/interactive dimension. The level of OHL increased significantly with education level, household wealth and dynamism of the social support. Prevalence of dental caries was 64.8%, following a social gradient and significantly associated with the mothers’ OHL level (OR = 5.2) CI[2.2-14.1]. The oral health behaviour of families was significantly associated with the level of OHL and children’s dental health. A structural equation model showed the OHL was a mediating factor between social characteristics and oral health behaviours.

Conclusions

The OHL of mothers is an important variable to be included in the study of social inequalities in oral health. The communication/interactive dimension seems to be decisive in the African context of an oral culture and dynamic social support which makes it possible to provide better knowledge and preventive behaviour.

Key messages

High maternal OHL should be reinforced to lessen oral health inequalities among Senegalese children. The communication/interactive dimension seems to be decisive in the African context of an oral culture and dynamic social to enhance OHL.

[The Ileal Neobladder With The Hautmann Technic At The Urology Depatment Of University Hospital Pr. Bocar S. SALL Of Kati]

Radical cystectomy is the standard treatment for bladder tumors infiltrating the bladder muscle, for patients who have tumors without invasion of neighboring organs and without metastasis. After radical cystectomy, the urinary diversion is a challenge for any urologist. Ileal neo bladder is a rare surgery in our country. The ileal neo bladder is recommended in these patients. We report a case of ileal neo bladder in a 42-year-old woman with a bladder tumor. We discuss the clinical, diagnostic and therapeutic aspects.

[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.

[Evaluation of the need for periodontal treatment in prisons near Dakar, Senegal]

INTRODUCTION

Oral diseases qualify as major public health problems due to their high prevalence and incidence. They usually affect poor and marginal segments of the population. This study focused on the prison population that is characterized by poor living conditions and malnutrition. The aim of study was to assess the need for periodontal care in prisoners serving time in the Dakar region of Senegal.

METHODS

This cross-sectional study included 375 prisoners serving in three facilities, i.e. the penal camp, Liberte VI prison for women, and Rufisque prison for women. Data were collected using a modified WHO information sheet. The community periodontal index of treatment needs (CPITN) was used for scoring. Statistical analysis with stratification by sex and age was performed and tests were considered as significant for p < or = 0.05.

RESULTS

There were 335 men (89.3%) and 40 women (10.7%) with a sex ratio of 8.3. Mean age was 35 years +/- 11.5 (range, 16-88). Mean prison time was 39.29 months +/- 17.73. The proportion of prisoners needing periodontal treatment increased gradually according to prison time with significant differences (p < 0.05) even after stratification.

CONCLUSION

Better management taking into account the environment and prison time would reduce the need for periodontal treatment in prisons in Dakar.

[Prevalence of oro-dental injuries in wrestling in Senegal]

Wrestling is a sport that is deeply-rooted in Senegalese cultural values. It is a popular sport that comes from local traditions but that has been influenced by boxing. This influence has made wrestling evolve to include the practice of boxing without gloves. Howeve, this practice causes many traumas in the mouth and teeth. The general objective of this study is to determine the frequency of the traumas among wrestlers who practice this form of wrestling associated with boxing. The specific objectives are to appreciate the bucco-dental conditions of the wrestlers, to evaluate the frequency and nature of the traumas in the intention to make recommendations and offer perspectives. 63.2% of wrestlers have at least presented a buckle or dental trauma. 28.8% of bucco-dental traumas occur among young wrestlers between 25 and 30 years and, 22.4% relate to the group between 19 and 24 years. 24.8% of bucco-dental traumas occur among wrestlers of the first category, followed by these of the second category with 21.6%, the fourth category with the lowest rate, 4% being last. It has been noted that 60% of buck-dental traumas occur in championship matches. 77.2% of dental and bucco traumas affect the upper jaw while. 22.8% affect the lower jaw. Affect teeth are often the group incisivo-canin. The National committee for the Management of wrestling in Senegal should make mandation the wearing of adapted gloves to attenuate the impact of blows. The Committee could also ban the inclusion of boxing practices in traditional wrestling and make compulsory the wearing of teeth protect in devices to minimize cases of bucco-dental traumas.

Effect of food processing on iron availability of African pearl millet weaning foods

The effects of different cereal precooking process (roasting and extrusion cooking) on iron availability and protein digestibility of four African weaning foods were investigated using in vitro methods. In two weaning foods based on pearl millet, cowpea and peanut, the cereal was extruded (A) or roasted (B). In two other weaning foods having a similar composition, a low proportion of milk powder was added and the cereal extruded (C) or roasted (D). The mean +/- SD iron values (mg/100 g) were: A, 5.56 +/- 0.18; B, 9.12 +/- 0.93; C, 5.89 +/- 0.23; D, 9.04 +/- 0.85. When the pearl millet was roasted, the iron content was higher than in the extruded weaning foods (P < 0.01). However, the percent of available iron of the roasted weaning foods was very low (B, 1.64 +/- 0.01; D, 0.91 +/- 0.02). The iron availability of the extruded weaning foods, A and C, was 3.5 times and 6.5 times higher than the corresponding roasted weaning foods, B and D, respectively. This represented 332.4 +/- 4.4 and 375.1 +/- 5.8 micrograms of available iron/100 g for A and C, respectively versus 149.5 +/- 0.9 and 82.2 +/- 1.8 micrograms of available iron/100 g for B and D, respectively. No significant differences in polyphenol contents were found according to the precooking process of the cereal. The extruded weaning foods showed a higher protein digestibility of approximately 10% than the roasted ones (P < 0.05). A positive correlation was found between in vitro iron availability and protein digestibility (r = 0.976, P < 0.02). Despite a high content of iron, the iron availability of roasted pearl millet weaning foods was quite low. Extrusion cooking of the cereal improved the protein digestibility and iron availability of pearl millet weaning foods; however, the amount of available iron remained insufficient to meet the iron requirements of infants whatever the cereal processing.