Médecine tropicale : revue du Corps de santé colonial
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Epidural analgesia is the most effective method for pain relief during labor. This 10-year exploratory descriptive study on factors underlying women's decisions to request or refuse labor epidural analgesia (LEA) was carried out at a level III maternity hospital in Antananarivo, Madagascar. All patients underwent a pre-anesthesia check-up (PAC) between 32 and 34 weeks of amenorrhea. ⋯ No patient had good knowledge about LEA. Nulliparous women that accepted EA had a higher socio-economic level, expected stronger labor pain, were better informed about EA, and expressed greater confidence in medical care. In addition to economic aspects, the main reasons for refusing EA involved fear and family background.
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Cholera, that had been present in rural areas north of Port-au-Prince, Haiti since October 2010, reached the urban area in November. Due to the novelty of the disease in this region, to the lack of health care, clean water, and waste disposal facilities, and to the extensive damage caused by the earthquake on January 12, 2010, that left a large victim population living in camps, a large-scale health disaster was feared. However, after two months, the disease appeared to be relatively well-controlled and treated with a fatality rate of less than 1% in the urban area. Actions implemented by the Ministry of Health long with its efforts to coordinate the intervention of the many humanitarian partners played a role in this outcome.
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The purpose of this retrospective report is to describe etiologies and therapeutic outcomes of nontraumatic abdominal surgical emergencies in elderly patients. ⋯ The findings of this study indicated that most nontraumatic abdominal surgical emergencies in elderly patients were related to complications of neglected or undiagnosed preexisting disease. Prognosis was related to the stage of the disorder, initial surgical management, and deterioration of the coexisting medical problems.
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This study was based on a retrospective descriptive analysis of all cases of snakebite recorded at the Poison Control and Pharmacovigilance Center of Morocco from 1980 to 2008. A total of 1,761 snakebites, i.e., 61 cases per year, were observed during the study period. Males accounted for 54.5% of victims (sex ratio (M/F) = 1.2) and 70% of cases occurred in rural areas. ⋯ This study demonstrates that management of snakebite is problematic in Morocco. Morbidity was probably underestimated. Restricted access to antivenom is a major problem in rural areas where the population cannot afford the cost.
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The Ebola and Marburg viruses are the sole members of the Filoviridae family of viruses. They are characterized by a long filamentous form that is unique in the viral world. Filoviruses are among the most virulent pathogens currently known to infect humans. ⋯ However, due to their extremely high lethality, association with multifocal hemorrhaging and specificity to the African continent, these hemorrhagic fever viruses have given rise to great interest on the part not only of the international scientific community but also of the general public because of their perceived potential as biological weapons. Much research has been performed on these viruses and major progress has been made in knowledge of their ecology, epidemiology and physiopathology and in development of vaccine candidates and therapeutic schemes. The purpose of this review is to present the main developments in these particular fields in the last decade.