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Objective: To describe the screening for uterine cancer by visual methods. Method: We conducted a prospective and descriptive study over a period of 12 months from January to December 2020. Direct observation of providers and interview of patients were performed for data collection. Results: Out of 3400 patients, 1024 were enrolled for the study, or 30.11%. The average age of the patients was 41 years with the extremes of 17 to 87 years. Women aged 40 to 45 were the most represented with 58.78%, (n = 602). Housewives 85.83% (n = 879), they had a primary education level in 71.09% of cases (n = 728), the vast majority were married 92.28% (n = 945). Multiparous represented 58.78% (n = 602) of the sample, nulliparous 18.26% (n = 187), women living in rural areas 30.17% (n = 309), in urban areas 69.82% (n = 715). The test was positive in 43 patients (4.19%) but squamocylindrical junction was not visible in 17% of cases. The preparation of acetic acid and lugol: good preparation in 100% of cases; the conditions of use are not respected in 27% for acetic acid and 38% for lugol. Conclusion: Routine screening for cervical cancer (SCC) by visual methods is essential to decrease the incidence of invasive cervical cancer.

Land degradation (LD) in Mali is prevalent and leads to an enduring environmental and humanitarian crisis. Farmers' ecological knowledge has proven to be a valuable tool in addressing its challenges. How farmers perceive LD affects how they deal with induced risks, and their responses to these perceptions will shape restoration options and outcomes. Therefore, this study assessed farmers' perceptions of LD along a climatic gradient in three regions of Mali. We interviewed 270 farmers, and we analyzed their responses using descriptive statistics and Spearman rank‐order correlation. We found that the respondents were aware of LD and have identified its key indicators and its impacts on their livelihoods. Moreover, we found that farmers' perceptions are not influenced by gender, age, or education level, but rather by agricultural training, participation in agricultural labor, the practice of fallowing, shortage of firewood, livestock, household size, appearance of some plant species and famine. Additionally, farmers' perceptions of LD vary along the climatic gradient as they correlate to different variables in each agro‐ecological zone. LD's impacts, however, decrease in severity along the north–south gradient, although they are linked to the same variables. As LD is seen through a reduction of ecosystem services provisioning capacity because of the local communities' heavy dependence on natural resources, actions should be geared towards agronomic and vegetative land management options. Such actions should prioritize context‐specific soil and water conservation techniques and proven indigenous practices.

Climate change and variability are significant challenges for the environment and food security worldwide. Development strategies focusing simultaneously on adaptive farming, productivity, and reducing greenhouse gas (GHG) emissions-known as climate-smart agriculture (CSA) strategies-are key to responding to these challenges. For almost a decade, within the framework of Climate Change, Agriculture and Food Security (CCAFS), World Agroforestry (ICRAF), and its partners have been using Participatory Action Research (PAR) to fully engage key stakeholders in co-creating such CSA development strategies. This includes the testing of Agricultural Research for Development (AR4D) CSA scalability options. The multidisciplinary teams include the National Research and Extension Systems (NARES), national meteorological services (NMS), non-profit organizations (NGOs), and local radio programs, among others. The CCAFS-West Africa Program,World Agroforestry-West and Central Africa (ICRAF-WCA), International Union for Conservation of Nature (IUCN), University of Reading, and Centre Regional de Formation et d’Application en Agro-meteorologie et Hydrologie Operationnelle (AGRHYMET) provide technical backstopping to the national teams. Climate information (CI) was used as an entry point to inform the development of CSA technologies and practices within Climate-Smart Villages (CSV). This groundwork has led to a greater understanding of three critical factors for successful CSV implementation: (1) Building strong partnerships to co-design and develop agricultural systems that improve ecosystemand population resilience, (2) Key stakeholders (researchers, farmers, development agents, and students) capacity strengthening through vocational and academic training, and (3) Using CI for livelihood planning at all scales. These three factors support more effective identification and testing of agricultural technologies and practices addressing climate variability and change at plot, community, and landscape levels. This paper discusses the PAR-CSA methodology and parameters for evaluation, including biophysical and social change. Keys to success, including communication, knowledge sharing tools, and scalability are also discussed. Finally, future opportunities for improvement are presented, including knowledge product development, CSA policy and investment planning, capacity building, further engagement of the private sector, and additional research on existing practices and tools.

Cervical cancer remains a major public health problem in Africa, particularly in Mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy center. This was a descriptive study on the retrospective collection of data on patients found in the Radiation Therapy Centre of Bamako, for invasive cervical cancer be-tween April 2014 and April 2017. The average age of our population was 52 ± 12.5 years with extremes ranges from 18 to 95 years. The most represented age group was [50 - 65 years] with 44.2%. The predominant histological type was squamous carcinoma (CE) with 94.2%. Bleeding were found in almost all patients, most often associated with foul smelling hydrorrhea; 80.3% of our patients were stage III and 12.9% of stage IV according to the IFGO classifi-cation. Cervix cancer remains a major public health problem in Mali. The di-agnosis is often late, therefore, resulting in late care and unfavorable progno-sis. Sensitization, vulgarization of vaccination and systematization of screen-ing could be helpful in the fight against this cancer.

We conducted a retrospective study that included patients with erythrocyte and hemolytic pathology justifying a splenectomy and patients presenting splenic trauma for which hemostasis splenectomy is required. We performed 27 total splenectomy in which 26 are by laparotomy (92.86%) and 1 by laparoscopy (3.57%). A partial splenectomy was performed by laparoscopy. The morbidity was marked by 2 cases of infectious syndrome and 1 case severe anemia. The mortality was 7.14% (n = 2). Splenectomy is part of the therapeutic arsenal for benign or malignant hematological disorders that constitute the main indication for elective splenectomy. Splenectomy was one of the most common operations in abdominal surgery. During the past decade, an increased rate of late complications, specially septic and thromboembolic complications are well documented. The risk is related to the indication of splenectomy, and is less than 1% in adults without immunodeficiency. However, these overwhelming postsplenectomy infections are associated with a high mortality rate. The best treatment of these infections is preventive measures which are based on vaccination and education of asplenic patients.

Breast cancer is a major public health problem because of its incidence and mortality. Purpose: To establish the epidemiological and clinical characteristics of breast cancer seen at the radiotherapy center at the Mali Hospital of Bamako. Patients and methods: It was a retrospective, descriptive study of data from patients seen for breast cancer at the Center of Radiotherapy of Mali Hospital between April 2014 and December 2016. The parameters studied were: age, sex, family history of breast cancer, menopausal status, parity, breast tumor location, histological type, histological grade, cancer classification stage. Results: 134 cases of breast cancer were collected, with a frequency of 15%. The sex ratio (H/F) of 0.007. The patient’s mean age was 47 ± 11 years old. The most represented age groups were 33 - 47 years old with 45.5% and 48 - 62 years old with 39%. Three percent (3%) of patients had a family history of breast cancer. Fifty (50%) of the patients were menopausal. The main clinical signs found were : mammary nodules (98%), mastodynia (65%), nodes (67%). Invasive ductal carcinomas were found in 94% of patients, followed by infiltrating lobular carcinomas with 3.7% and metaplastic carcinomas with 1.7%. SBR Grades II and III were mostly found with 37% and 23%. The average tumor size was 87 mm ± 43. Stage III was predominantly represented with 72%, followed by Stage II with 24% and Stages I and IV with 2% each. Conclusion: Breast cancer is common and reaches both before and after 50 years; the diagnosis is usually late; hence it is the importance of raising awareness and screening before the age of 50 and popularizing some complementary tests to better understand the prognosis of this disease and promote more targeted and conservative treatments that will improve survival.

Recently, a new approach to extension and climate information services, namely Participatory Integrated Climate Services for Agriculture (PICSA) has been developed. PICSA makes use of historical climate records, participatory decision-making tools and forecasts to help farmers identify and better plan livelihood options that are suited to local climate features and farmers’ own circumstances. This approach was implemented in 2016 in two sites in Senegal and Mali, with 57 and 47 farmers, respectively. At the end of the growing season, these farmers were surveyed to explore their perceptions on the use of the approach. In Senegal and Mali, respectively 97% and 76% of the respondents found the approach ‘very useful’. The approach enabled farmers to make strategic plans long before the season, based on their improved knowledge of local climate features. Moreover, evidence demonstrates that PICSA stimulated farmers to consider and then implement a range of innovations which included: (i) changes in timing of activities such as sowing dates, (ii) implementing soil and water management practices, (iii) selection of crop varieties, (iv) fertiliser management and (v) adaptation of plans for the season (farm size, etc.) to the actual resources available to them. The study also demonstrated the potential of farmer-to-farmer extension in scaling up the approach, which is of great interest especially in the current context of limited extension services in the West African region. Keywords: Climate change, Climate information services, Climate variability, Food security, Livelihood options, West Africa

Newcastle disease (ND) is endemic in West Africa, which has also experienced outbreaks of highly pathogenic avian influenza (AI) H5N1 since 2006. We aimed to estimate the prevalence and incidence of AI and ND in village poultry in Mali and to identify associated risk factors. A longitudinal serologic study was conducted between November 2009 and February 2011 using ELISA commercial kits to detect antibodies. Sera (5963) were collected from 4890 different poultry. AI was rare, with a seroprevalence of 2.9% (95% confidence interval [CI] 2.3-3.5) and a seroincidence rate of 0.7 birds per 100 bird-months at risk (95% CI 0.4-1.0). AI antibodies were short lived, with a seroreversion rate of 25.4 birds per 100 bird-months at risk (95% CI 19.0-31.7). Risk factors for AI were limited: temporal variation occurred, but proximity to a water body was a risk factor only when large populations of wild waterbirds were present. ND was very common, with seroprevalence of 68.9% (95% CI 61.9-76.0) and a seroincidence rate of 15.9 birds per 100 bird-months at risk (95% CI 11.9-19.8). ND seroreversion rate was 6.2 birds per 100 bird-months at risk (95% CI 3.6-8.9). Regarding risk factors for ND, temporal variations occurred, and ND was more likely to be present in the Sudanian agro-ecological zone than in the Sahelian zone, in chickens than in other species, in flocks with higher numbers of Guinea fowl, and in flocks that had access to a waterbody. Control efforts would benefit from further increasing the ND vaccination coverage of village poultry, although this was already quite high (54.9%) for an African country. Seroconversion seemed satisfactory in vaccinated poultry, since 90.0% (95% CI 87.6-92.4) of these had ND antibodies. Further research should investigate the apparent lack of an epidemiologic role of domestic ducks for AI in Mali (unlike in Southeast Asia) and the potential role of Guinea fowl as a reservoir for ND.

Hypofractionated radiation therapy has proven effective on locoregional control and tolerance in the adjuvant treatment of breast cancer. The aim of this study is to compare the results of hypofractionated radiation therapy versus conventional radiation therapy in terms of local control and tolerance. It was a retrospective study of patients observations collected from January 2007 to December 2008 in Department of Radiation Therapy in Institut National d’Oncologie de Rabat. The treatment results were evaluated by the rate of locoregional recurrence, distant recurrence and research of late toxicities. Radiotherapy was delivered using the same technique in both groups, by gamma photons of cobalt 60 with an energy of 1.25 MeV. They were 2 groups: the first group treated with standard dose rate and the second group treated by hypofractionated radiation therapy. The mean age of the patients was 42.8 ± 6.9 years old in the standard group and 43.22 ± 7.2 years old in the hypofractionation group. We noted a predominance of infiltrating ductal carcinoma. The majority of patients were pT2, pN0 and pN1. The majority of patients had radical surgery and chemotherapy with anthracyclines in both groups. We noted a statistically significant difference in the irradiation of chest wall between the standard (89.2%) and hypofractionated group (70.3%), with p = 0.043. The median duration of radiation therapy was statistically different in both groups: 39 days in the standard and 23 days in the hypofractionated group (p < 0.001). The local recurrences were statistically identical to 12 and 24 months (p = 0.999). Concerning toxicities, the frequency of adverse event was similar in both groups. Hypofractionated radiation therapy with a total dose of 42 Gy at 2.8 Gy per fraction in 5 fractions weekly is comparable to standard radiotherapy in terms of local control and tolerance and is therefore a very good alternative to standard treatment.

Cette étude présente les résultats d’une enquête sérologique qui évalue le statut épidémiologique de la peste des petits ruminants (PPR) d’ovins et de caprins de différentes régions du Mali. Les animaux ont été testés par Elisa de compétition (c-Elisa) afin d’évaluer la séroprévalence par région prospectée, ainsi que par espèce, classe d’âge et sexe. Les résultats indiquent un taux individuel de séroprévalence de 42,6 p. 100 [intervalle de confiance à 95 p. 100 (IC95) : 40,9 - 44,3]. Une variation significative de la séroprévalence a été observée entre les différentes régions allant de 5,5 p. 100 (IC95 : 3,3 - 7,7) à Gao (la région avec la plus faible prévalence) à 55,6 p. 100 (IC95 : 52,2 - 59,1) à Koulikoro (la région avec la plus forte prévalence). Une différence significative (p < 0,05) a été observée entre les prévalences estimées des femelles et des mâles, et entre celles des animaux adultes (> 3 ans) et des plus jeunes (< 3 ans), mais pas entre ovins et caprins. Ces résultats confirment la présence de la maladie à travers tout le territoire, avec une prévalence relativement élevée dans les régions du centre, du sud et de l’ouest. Ils montrent aussi que la maladie sévit probablement à l’état enzootique, soulignant la faiblesse du programme de vaccination contre la PPR au Mali. Ils révèlent l’urgence de mettre en place un plan de vaccination efficace afin de protéger le cheptel contre cette maladie contagieuse.

Our survey aimed to investigate avian influenza (AI) and Newcastle disease (ND) prevalence and risk factors in three areas of Mali at risk for occurrence of H5N1 highly pathogenic avian influenza. Blood samples and cloacal and oropharyngeal swabs were collected from 1470 birds between February 2007 and May 2008 and were tested by commercial enzyme-linked immunosorbent assay to detect antibodies and real-time reverse-transcription (rRT)-PCR to detect virus. Risk factors associated with seropositivity or positive rRT-PCR were identified by random effect logistic regression. AI seroprevalence was significantly lower in birds from commercial farms (0%) than in village backyard birds (3.1%). For backyard birds, no individual risk factors (species, age, sex) were identified, but birds in the Mopti area in the Sahelian zone, where millions of wild birds migrate, were more seropositive than in the Sikasso area in the Sudano-Guinean zone (odds ratio [OR] ?=? 2.0, P ?=? 0.051). Among backyard birds nonvaccinated against ND, ND seroprevalence was 58.4%, and the odds of seropositivity was 2.0 higher in chickens than in ducks, 1.7 higher in females than in males, 3.1 higher in adults than in young birds, and 3.0 higher in poultry from the Sikasso area than from the Mopti area (P < 0.01 in all cases). Prevalence established by rRT-PCR was low for both AI virus (1.1%) and ND virus (2.6%) and was associated with no risk factors for AI but was higher in chickens than in ducks (OR ?=? 5.3, P ?=? 0.05) and in the Sikasso area than in the Mopti area (OR ?=? 3.4, P ?=? 0.027) for ND. For AI and ND, prevalence assessed by serology or rRT-PCR varied over time, although seasonal and interannual variation could not be clearly distinguished. The intracluster correlation coefficient for serologic data was low for AI (0.014) and higher for ND (0.222). These results are useful to optimize surveillance and control strategy for notifiable avian diseases in African countries with similar agroecological and resource-limited contexts.

We aimed at characterizing commercial and traditional village poultry farming in Mali, with a focus on practices influencing the risk of transmission of avian influenza and Newcastle disease. Surveys were conducted in 2009–2011 in a study area covering approximately 98% of the Malian poultry population. Among the 282 commercial farms investigated, of which 64 had not been known by the government authorities, 83% were located within a 50 km radius from the capitals of the country and regions and 54% had low biosecurity standard. Among the 152 randomly selected village household flocks investigated, characteristics were overall similar to those in other African countries but some differences were notable including a large flock size (median 44 poultry), a low presence of ducks and geese (11% and 1.1% of flocks, respectively), vaccination against Newcastle disease being common (49% of flocks), a low proportion of households selling sick and dead birds (0.7% and 0%, respectively) and limited cohabitation between poultry and humans at night. Our recommendations to limit the risk of disease transmission include (1) for commercial farms, to introduce compulsory farm registration and accreditation, to increase technical proficiency and access to credit for farms with low biosecurity, and to support poultry producer associations; (2) for village poultry, to promote better quarantine and management of sick and dead birds. Such detailed knowledge of country-specific characteristics of poultry production systems is essential to be able to develop more efficient disease risk management policies.

To the Editor: In response to influenza outbreaks caused by highly pathogenic avian influenza virus (HPAIV) throughout western Africa as of 2006, the National Veterinary Epidemiologic Surveillance Network of Mali (EPIVET-Mali) started conducting domestic and wild bird surveillance. No HPAI outbreaks were reported to the World Organisation for Animal Health. An evaluation survey conducted in 2009 enabled identification and correction of some weaknesses in the organization and functioning of the network (1). However, no attempt was made to assess how much information on bird health in backyard poultry farms (which account for ≈95% of the total poultry population in Mali) actually reached EPIVET-Mali veterinarians and technicians. Therefore, we quantified reporting of clinical signs of avian diseases, especially those suggesting HPAI, by poultry owners in Mali. We used a pilot-tested standardized quantitative and qualitative questionnaire to conduct face-to-face interviews in 32 randomly selected villages in the southern half of Mali (which accounts for 98% of the poultry population). In each village, we conducted interviews in 4 randomly chosen households. No eligibility criteria were used for household selection because all village households had poultry. Interviews were repeated 6 times (approximately every 3 months) during November 2009–February 2011 in the same villages and whenever possible in the same households. If it was not possible to repeat an interview in a previously interviewed household (absence of the household chief), the neighboring household was interviewed. For each household, data were collected on number of sick and dead birds in the previous 3 months, clinical signs observed, and their notification or lack thereof to veterinary authorities. Households in which birds showed >3 of the following clinical signs (diarrhea, respiratory disorder, nervous signs, cyanosis of the combs or wattles, and mortality rate >50%) were considered as having clinical signs suggesting HPAI. The study was approved by the Direction Nationale des Services Veterinaires and traditional authorities in all 32 villages, and oral consent was obtained from the poultry owners before interviews. A total of 110–128 households were investigated at each study interval, depending on village accessibility and presence or absence of household chiefs (Table). We conducted 738 household investigations in 152 households (80 households were interviewed 6 times, 26 five times, 11 four times, 21 three times, 7 two times, and 7 one time). Observation of sick poultry in the 3 months before the interview was reported in 44.6% of household investigations, and observation of signs suggesting HPAI was reported in 12.2% (Table). Notification of veterinary authorities was reported in 13.5% of household investigations with sick poultry and in 17.4% of household investigations with signs suggesting HPAI (Table). Table Observations and reporting of sick poultry and signs of influenza suggesting HPAI virus infection, Mali, 2009–2011* When we considered the 80 households interviewed 6 times, observation of sick poultry and signs suggesting HPAI varied over time (p = 0.043 and p = 0.018, respectively, by Cochran Q test), whereas variation over time could not be tested for notification because of an insufficient number of observations. When we considered all 738 household investigations as independent investigations, observation of sick poultry and signs suggesting HPAI varied over time (p = 0.008 and p

Nous evaluerons les aspects diagnostiques, therapeutiques et evolutifs du plasmocytome solitaire osseux dans notre structure. Il s'agit d'une revue retrospective portant sur 11 patients suivis et traites dans le Service de Radiotherapie de l'Institut National d'Oncologie de Rabat pour un plasmocytome solitaire osseux entre janvier 1999 et decembre 2009. L’âge moyen de nos patients etait de 53 ans (19-79 ans). La douleur etait le signe revelateur le plus frequent. Le siege des lesions etait rachidien dans 4cas, nasosinusien dans 2cas, orbitaire dans 1 cas, costal dans 1 cas, presternal dans 1 cas, sellaire dans 1 cas et sacre dans 1 cas. Tous les malades ont recu une radiotherapie. Cette irradiation etait delivree seule dans 8 cas (73%) ou associee a la chirurgie (laminectomie) dans 3 cas (27%). La dose moyenne de la radiotherapie etait de 44 Gy (30 a 60 Gy) et celle-ci a ete delivree par un appareil de telecobaltherapie ou un accelerateur lineaire. La duree moyenne de suivi etait de 78 mois (38-118 mois). Le controle local, defini par une stabilite radiologique, a ete obtenu chez 7 des 11 malades (87%). Un patient a evolue vers un myelome multiple apres un delai de 8 mois. La radiotherapie constitue un traitement efficace du plasmocytome osseux solitaire. Le pronostic est affecte par l’evolution vers le myelome multiple, ce qui justifie une surveillance rigoureuse apres traitement et suggere une reflexion sur la place exacte de la chimiotherapie.

L'hemangiopericytomemeninge intracrânien est une tumeur rare qui represente moins de 1 % des tumeurs cerebrales. Son aspect radiologique peut etre trompeur et faire porter a tort le diagnostic de meningiome. Le diagnostic de confirmation est histologique. Le traitement repose sur la chirurgie et la radiotherapie. L'evolution apres traitement est caracterisee par la frequence des recidives et des metastases a distance, imposant un suivi prolonge. Nous rapportons l'observation d'un patient presentant un hemangiopericytome intracrânien dont l'evolution etait marquee par l'absence de recidive a 4 ans de suivi. Key words : Hemangiopericytome meninge intracrânial, chirurgie, radiotherapie, recidive, metastase

L'hémangiopéricytomeméningé intracrânien est une tumeur rare qui représente moins de 1% des tumeurs cérébrales. Son aspect radiologique peut être trompeur et faire porter à tort le diagnostic de méningiome. Le diagnostic de confirmation est histologique. Le traitement repose sur la chirurgie et la radiothérapie. L’évolution après traitement est caractérisée par la fréquence des récidives et des métastases à distance, imposant un suivi prolongé. Nous rapportons l'observation d'un patient présentant un hémangiopéricytome intracrânien dont l’évolution était marquée par l'absence de récidive à 4 ans de suivi.

Congenital Chloride Diarrhoea (CCD) is a form of autosomal recessive disorder which is presented by persistent chloride rich watery diarrhea from birth. Diagnosis of CCD is simple but it needs early prediction and clinical and laboratory evaluation. It can be tentatively made from the typical history of polyhydramnios in antenatal period, prematurity, and watery diarrhea from the beginning and then confirmed by the high fecal concentration of Cl-. Serum electrolyte and pH changes are not reliable diagnostic criteria. Without early intervention most of the children will die in infancy, rest will achieve failure to thrive, and psychomotor developmental delay. .Although congenital chloride diarrhoea has been reported worldwide, but in Bangladesh, we have no reported cases. Here we have discussed two cases of CCD with their diagnostic and management outcome and also discuses about captopril and its effectiveness. Early diagnosis and treatment are essential for normal growth, development, and prevention of other severe complications of congenital chloride diarrhea.