Médecine tropicale : revue du Corps de santé colonial
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The University Hospital Center is the only hospital in Brazzaville, Congo with a pediatric emergency room. The purpose of this prospective study carried out from January 1 to December 31, 2006 was to evaluate nighttime emergency room attendance by comparing children (excluding newborns) admitted between 7 p.m. and 7 a.m. (group 1) to those admitted between 8 a.m. and 2 p.m. (group 2). A total of 5796 emergency room admissions were recorded including 2648 children (45.7%) between 7 p.m. and 7 a.m. and 2209 (38.1%) between 8 a.m. and 2 p.m. ⋯ Nighttime attendance as well as hospitalization and death rates remain high at the pediatric emergency room of the University Hospital Center in Brazzaville. The most frequent reason for attendance was fever. Improving outcomes will require providing better information to parents (reducing admission delay) and upgrading hospital resources in terms of patient assessment and medical intervention (health care personnel and facilities).
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In spite of the high prevalence of schistosomiasis in Mali, few cases involving neurological complications have been described. The purpose of this report is to present a case associated medullary complications. ⋯ Neuroschistosomiasis is a rare but serious complication of the schistosomiasis that can only be made after complete parasite identification and careful differential diagnosis. Treatment with antiparasitic agents in association with corticosteroids is mandatory but must only be initiated in state stage of the parasitic infection, i.e., after maturation of larvae into adults.
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The first use of percutaneous tracheotomy in intensive care was by Sheldon in 1957. Because this technique saves time, costs less, and reduces staff requirements, it is well suited to conditions in underdeveloped countries where resources are often lacking. The purpose of this prospective study conducted in intensive care unit of the Principal Military Teaching Hospital in Dakar, Senegal was to evaluate percutaneous tracheotomy in terms of effectiveness, time and resource management, and perioperative problems while trying to adapt it to resources available in a tropical intensive care setting. ⋯ Two patients had presented esotracheal fistula including one who died after inhalation when feeding was attempted. One patient developed stenosis. Operator experience and training were identified as good prognostic factors.
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Prospective data on management and outcome of stroke in Africa is scarce. The purpose of this prospective descriptive study is to present epidemiologic, clinical and outcome data for a series of patients with hemorrhagic stroke in Djibouti. All patients admitted to the intensive care unit of the Bouffard Medical-Surgical Center in Djibouti for cerebral hemorrhage documented by CT-scan of the brain were recruited in this study. ⋯ Neurologic intensive care techniques provided hospital mortality rates similar to those reported in hospitals located in Western countries. Functional outcome in local survivors appeared to be good despite the absence of functional intensive care. These data argue against the passive, fatalistic approach to management of hemorrhagic stroke and for primary prevention of cardiovascular risk factors.