Médecine tropicale : revue du Corps de santé colonial
-
Venomous animals that are able to innoculate or inject venom and poisonous animals that cannot inject venom but are toxic when ingested belong to all zoological groups. They can be encountered worldwide in any ecosystem on land and at sea but they are more common and more dangerous in tropical areas. This first article of a series to appear in the next issues of Medecine Tropicale presents an overview of species involved in envenomations and poisonings. In addition to a brief reviewing geographic risks and circumstances in which bites, stings or ingestion occur, some information is provided about antivenim therapy, the only etiological treatment.
-
The purpose of this monocentric prospective cohort study was to assess mortality in intensive care unit (ICU) patients requiring more than 6 hours of mechanical ventilation (MV) in a developing country. The study setting was a 10-bed polyvalent ICU at the Centre Hospitalier Régiona1 in El Maarouf, Comoros Islands. The study population included a total of 106 patients requiring MV out of 633 consecutive patients admitted to the ICU over a 10-month period. ⋯ The young age of patients, acute nature of manifestations and reversibility of diseases encountered may explain the favorable outcome observed in this study. The initial diagnosis and associated risk factors (using a severity score if necessary) must be taken into account in deciding the indication for starting and stopping MV. The results of this study show that MV is feasible and effective in a developing country, but requires experience, inventiveness and realism.
-
Health care in sub-Saharan Africa is increasingly financed by direct payments from the population. Mutual health insurance plans are developing to ensure better risk sharing. ⋯ National governments must not forget their responsibility especially for defining and ensuring basic services that must be accessible to all. Will mutual health insurance plans be a stepping-stone to universal health care coverage and can these plans be successfully implemented in the context of an informal economy?
-
Biography Historical Article
[Unpublished letter from Albert Calmette to Marcel Léger. A new mission for China?].
-
Practice Guideline Guideline
[Practical guidelines for the management of Ebola infected patients in the field].
Ebola hemorrhagic fever appears after an incubation of 3 days to 3 weeks. The first symptoms are fever accompanied by general and hemorrhagic signs leading to death in 50 to 90% of cases. During epidemics definition of cases permits prompt diagnosis. ⋯ Persons having been in close contact with patient should be kept under medical surveillance for 21 days. Recovering patients should use condoms for three months. Bodies of deceased patients should be handled by trained teams and buried quickly.