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Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundPolicy makers and practitioners in low- and middle-income countries (LMICs) are increasingly focusing on the effectiveness of digital devices in the delivery of medical and educational services to children under resource constraints. It is widely known that digital literacy can be fostered through exposure to and education regarding digital devices, which can improve children’s academic performance as well as their search and communication skills in the digital era. However, the correlation between the cognitive function of children and exposure and intensity of the exposure to digital devices has rarely been studied, and the association between digital device exposure and the socioeconomic characteristics and cognitive development of children in LMICs is unknown. ObjectiveThis study examines the association among exposure to digital devices, socioeconomic status, and cognitive function in children aged 3 to 9 years in Cambodia. MethodsWe used a survey of 232 children that gathered data on familiarity with digital devices, demographic characteristics, and socioeconomic status, as well as a Cambridge Neuropsychological Test Automated Battery test for cognitive function, to examine the association between possible barriers and factors that may influence the cognitive function of children in 2 Cambodian schools from April 22, 2019, to May 4, 2019. A comparative analysis was performed with and without digital exposure, and an association analysis was performed among the variables from the survey and cognitive function. ResultsSignificant differences were observed in demographic and socioeconomic characteristics such as school location, family type, and family income according to digital device exposure. The results of the Cambridge Neuropsychological Test Automated Battery tests, except for 1 test related to executive function, indicated no significant differences (P>.05) between group A and group B or among the 4 subgroups. Pretest digital device experience and amount of time spent using digital devices during the test had no significant impacts on the cognitive development of the children. Conversely, the multivariate analyses showed that cognitive function was associated with educational expenses per child, school (location), family type, and family income. ConclusionsThese results provide evidence to policy makers and practitioners on the importance of improving socioeconomic conditions, leading to investment in education by implementing programs for children’s cognitive development through digital devices in LMICs.

This paper presents an agent-based modeling framework for affordance-based driving behaviors during the exit maneuver of driver agents in human-integrated transportation problems. We start our discussion from one novel modeling framework based on the concept of affordance called the affordancebased finite state automata (AFSA) model, which incorporates the human perception of resource availability and action capability. Then, the agent-based simulation illustrates the validity of the AFSA framework for the highway-lane-driver system. Next, the comparative study between real driving data and agent-based simulation outputs is provided using the transition diagram. Finally, we perform a statistical analysis and a correlation study to analyze affordance-based driving behavior of driver agents. The simulation results show that the AFSA model well represents the perception-based human actions and drivers' characteristics, which are essential for the design viewpoint of control framework of human driver modeling. This paper is also expected to benefit a designed control for autonomous/self-driving car in the future.

Introduction The aim of this study was to establish if the auricular acupuncture treatment can play a complementary role in enhancing the smoking cessation rate of the smokers receiving conventional therapy, such as NRT and behavioral counseling. Methods This was a retrospective cohort study. Republic of Korea Air Force soldiers who visited the clinic with the intention to quit smoking from September 2016 to March 2017 were reviewed. The smoking cessation program consisted of a 6-weeks treatment period with follow-up at 3 and 6 months from the baseline. Smokers who chose to receive nicotine replacement therapy (NRT) were compared with those who chose to receive auricular acupuncture combined with NRT. Both groups received behavioral counseling. Results A total of 148 subjects were reviewed in the study. Of the 86 smokers who received combination therapy, 41 achieved continuous abstinence (47.7%), while 19 out of the 62 smokers stayed abstinent from the NRT group (30.6%). There was a significant difference between the two groups (p=0.037). Minnesota Nicotine Withdrawal Scale scores significantly decreased after the treatment in both groups, but there was no significant difference between the two groups (p=0.681). No serious adverse events were reported from both groups. Conclusions The results of this study indicate that conventional treatments, such as NRT and behavioral counseling, when combined with auricular acupuncture could be a safer and more effective smoking cessation treatment than conventional treatments alone.

A smartphone-based tidal volume (VT) estimator was recently introduced by our research group, where an Android application provides a chest movement signal whose peak-to-peak amplitude is highly correlated with reference VT measured by a spirometer. We found a Normalized Root Mean Squared Error (NRMSE) of 14.998% ± 5.171% (mean ± SD) when the smartphone measures were calibrated using spirometer data. However, the availability of a spirometer device for calibration is not realistic outside clinical or research environments. In order to be used by the general population on a daily basis, a simple calibration procedure not relying on specialized devices is required. In this study, we propose taking advantage of the linear correlation between smartphone measurements and VT to obtain a calibration model using information computed while the subject breathes through a commercially-available incentive spirometer (IS). Experiments were performed on twelve (N = 12) healthy subjects. In addition to corroborating findings from our previous study using a spirometer for calibration, we found that the calibration procedure using an IS resulted in a fixed bias of −0.051 L and a RMSE of 0.189 ± 0.074 L corresponding to 18.559% ± 6.579% when normalized. Although it has a small underestimation and slightly increased error, the proposed calibration procedure using an IS has the advantages of being simple, fast, and affordable. This study supports the feasibility of developing a portable smartphone-based breathing status monitor that provides information about breathing depth, in addition to the more commonly estimated respiratory rate, on a daily basis.

Objective: This study aimed to assess the prevalence and risk factors for neonatal sepsis among neonates admitted to selected health facilities in the Bamako district and Koulikoro region in Mali., Design: This is a prospective cross-sectional study. Data were analyses using bivariate and multivariate logistic regression., Setting: This facility-based study was conducted in four health facilities consisting of two hospitals and two reference health centres in Mali., Participants: The study participants comprised 795 randomly selected neonates and their indexed mother., Outcome Measures: The primary outcome of the study was the prevalence of sepsis in the considered health facilities. The other variables of interest were risk factors for sepsis., Results: The prevalence of neonatal sepsis among the study population was 21.00%. More than 74% of sepsis cases were early onset (<72 hours). Neonatal age <7 days (AOR=2.79, 95% CI 1.59 to 4.89, p=0.000), low birth weight <2500 g (AOR=2.88, 95% CI 1.41 to 5.86, p=0.003), Apgar score <7 (AOR=4.03, 95% CI 3.09 to 5.24, p=0.000), mother with no education (AOR=2.24, 95% CI 1.15 to 4.33, p=0.02), maternal fever (AOR=2.31, 95% CI 1.53 to 3.53, p=0.000), prolonged rupture of membranes (AOR=1.87, 95% CI 1.01 to 3.54, p=0.04) and prolonged labour (AOR=2, 95% CI 1.03 to 3.88, p=0.04) were significantly associated with neonatal sepsis., Conclusion: The prevalence of sepsis in Mali is still high. Given the country's current security context, the findings in this study can support prevention activities, particularly given the limited resources available. It is essential to facilitate antenatal and postnatal visits, to promote in-facility births and rigorous monitoring of neonates at high risk of sepsis. Furthermore, it would be beneficial for future research on neonatal sepsis to include neonates born at home., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Objectives: This study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa., Methods: This systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger's regression test were used to assess the publication bias., Results: A total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46-26.97) and 36.02% (CI: 26.68-45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6-3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8-4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9-4.1), male sex (OR: 1.2, 95% CI: 1.1-1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5-3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4-5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01-10.9), parity (OR: 0.5, 95% CI: 0.3-0.7), prolonged labor (OR: 3.4, 95% CI: 1.6-6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3-14.3) were significantly associated with maternal sepsis., Conclusion: The prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data. Systematic review registration: PROSPERO (ID: CRD42022382050)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared no conflicts of interest., (Copyright © 2024 Traoré, Sidibé, Diallo, Camara, Sidibé, Diallo, Diarra, Ly, Ag Ahmed, Kayentao, Touré, Camara, Delamou, Sangho and Terera.)

Background: Onchocerciasis control activities in Mali began in 1975 with vector larviciding carried out by the Onchocerciasis Control Programme (OCP), followed by the distribution of ivermectin from 1998 until the closure of the OCP in 2002. At that time, epidemiological evaluations, using skin snip microscopy and O-150 pool screening PCR in black flies, indicated that the disease had been largely controlled as a public health problem. Ivermectin distribution was nevertheless continued after 2002 in 34 of the 75 health districts in Mali as these were known to still be meso- or hyper-endemic for onchocerciasis. In addition, the onchocerciasis sites known to be hypo-endemic for onchocerciasis benefited from the distribution of ivermectin treatment as part of the mass drug administration (MDA) program for lymphatic filariasis. Various entomological and epidemiological evaluations have now indicated that Mali may have achieved successful interruption of onchocerciasis transmission., Methods: A series of cross-sectional surveys to update vector breeding sites throughout the endemic areas, followed by a pre-stop ivermectin mass drug administration (Pre-stop MDA) survey, were undertaken in 2019-2020. Based on breeding site findings, historical epidemiological assessments, and vector collection site maps, 18 operational transmission zones (OTZ) were delineated within which a total of 104 first line villages were selected for evaluation. Dried blood spots (DBS) samples were collected from 10,400 children (5-9 years old) from these 104 first line villages and processed for the presence of OV16 antibody using a lab-based rapid diagnostic test., Results: Within the 544 Simulium damnosum s.l. breeding sites visited in all five endemic onchocerciasis endemic regions of Mali 18.01% (98/544) were seen to be active with the presence of at least one stage of S. damnosum. The overall prevalence of OV16 positive children was 0.45% (47/10,400). However, two hotspots were identified: 2.60% (13/500) seroprevalence in the OTZ number 5 in Kayes Region and 1.40% (7/500) in the OTZ number 1 of Sikasso Region., Conclusion: These data show that onchocerciasis prevalence in the five endemic regions has declined to levels that indicate that Stop-MDA surveys should be now carried out in most of the OTZ except for one in the Kayes Region. This latter site will need additional ivermectin treatment before reevaluation, and an OTZ in the Sikasso Region requires revaluation before possibly reinitiating MDA., Competing Interests: No competing interests, (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Introduction: The health district of Mopti is confronted with factors that influence its vaccination coverage [1]. The aim of the study was to study the factors influencing the low BCG vaccination coverage in VAR1 and Penta3 in children aged 0 to 23 months in the health district in 2021., Methodology: We carried out a descriptive cross-sectional study, collected information from 280 mothers questioned on the services provided by the vaccination service for children before the age of two, the reasons for incompleteness using a questionnaire. Univariate and multivariate logistic regression analysis was done for the variables using SPSS software. An association was significant when p < 0.05., Results: Vaccination completeness was 53.08%, varying from 94% BCG, 79% VAR1 and 83% Penta3. The analysis showed that mothers who spent more time at the vaccination center (P=0.098, Chi-square=18.617), who missed certain sessions (P=0.174, Chi-square=13.371) and who were informed of missed consumables (P=0.278, Chi-square= 7.485) are significantly associated with vaccine incompleteness., Conclusion: Vaccination completeness was insufficient despite good knowledge of the mothers on vaccination., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: Oral hygiene represents all the measures taken to keep the oral cavity clean and healthy by keeping the dental surfaces free of plaque and tartar. The objective of this study was to evaluate the oral hygiene of elite units of the defense and security forces of Mali., Methodology: This was a descriptive cross-sectional study that took place from September 01, 2020 to August 30, 2021 in the odontology department of Bamako Military Hospital. The study population involved soldiers of various Elite Units of the Armed Forces of Mali who came for consultation in the odontology service., Results: In this study, the 30-39 age group was the most represented with 49.2%. NCOs were the most represented with 55.0%. Among Elite Units, the CIR accounted for 34.8%. For tooth brushing, 85.9% brushed their teeth. Regarding the number of brushings per day, 54.7% brushed their teeth once a day. While 48.1% brushed their teeth with a medium brush. For bleeding after brushing, 42.6% had bleeding after brushing., Conclusion: This study showed that the military had knowledge of oral hygiene because they brushed mostly 1 to 2 times a day. However, many soldiers had bleeding after brushing. Faced with this situation, a new orientation of the oral health policy based on preventive odontology is necessary in order to improve the health and quality of life of these soldiers., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: In resource-limited countries, epilepsy prevalence is underestimated and little is known about its risk factors., Objectives: This study aimed to determine the prevalence and risk factors for epilepsy in six health districts (HDs) in Mali., Methods: A community-based cross-sectional and nested case-control study was conducted in 180 villages with the highest number of suspicious epilepsy cases (SECs) in the six study HDs. The SECs were observed as part of a Phase 1 screening conducted by community health workers. For the nested case-control study, one case was matched with at least one control based on residence and age. A case of epilepsy was a person diagnosed with convulsive epilepsy after clinical assessment by a neurologist. A control was a person diagnosed as normal after neurological assessment by a neurologist. Data were collected on sociodemographic characteristics, familial and medical history of epilepsy, consanguinity, place of delivery, preterm birth, length/type of delivery, and history of meningitis and cerebral malaria. A univariate and multivariate binomial logistic regression model was used to analyse factors associated with epilepsy., Results: A total of 1,506 cases of epilepsy and 2,199 controls were enrolled in six HDs. The mean prevalence of epilepsy was 2‰, with the highest in Kenieba (3‰), a previously meso-endemic-onchocerciasis HD, and the lowest in Kadiolo (1.5‰), a hypo-endemic-onchocerciasis HD. Age (adjusted odds ratio [aOR] = 1.02 [95% confidence intervals [CI] 1.02-1.03]), history of cerebral malaria (aOR = 11.41 [95% CI 8.86-14.85]), history of meningitis (aOR = 1.95 [95% CI 1.16-3.29]), living in the HD of Tominian (aOR = 1.69 [95% CI 1.29-2.22]), delayed delivery (aOR = 3.21 [95% CI 2.07-5.07]), and dystocia (aOR = 3.37 [95% CI 2.03-5.73]) were all significantly associated with epilepsy., Conclusion: The prevalence of epilepsy (3‰) in a previously meso-endemic-onchocerciasis HD was much lower than the prevalence (13.35‰) documented in onchocerciasis endemic areas in 2,000. This decrease epilepsy prevalence in the previously meso-endemic region was induced by onchocerciasis, and the reduction was due to an effective community direct treatment with ivermectin programme. Cerebral malaria and obstetrical complications were the main risk factors for epilepsy and interventions improving malaria prevention/treatment and optimizing prenatal and obstetrical care need to be implemented to reduce incidence., (© 2022 S. Karger AG, Basel.)

Introduction: waste electrical and electronic equipment (WEEE), with its health and environmental issues, has become a public health problem exposing workers to toxic compounds causing respiratory problems., Objective: To study the relationship between professional exposure to WEEE and the occurrence of respiratory problems in Bamako in 2019., Material and Methods: This was a 6-month cross-sectional, analytical study carried out in the city of Bamako in 2019 and involved 159 WEEE manipulators. Data were collected using a tablet (2). Univariate and multivariate analyzes were performed using SPSS version 22 with the significance level of 0.05. Odds Ratio (OR) were presented with their 95% confident interval (OR[95%CI])., Results: The overall prevalence of respiratory disorders was 67.3% among WEEE handlers. It was noted that the removal of the coating of electronic wires (OR[95%CI]=25.93[2.30;291.53]), recent weight loss outside of a diet (OR[95% CI]=7,43[1.68;32.85]) and the infrequent hand washing with soap after the toilet (OR[95% CI]=11.50[2.07; 63.89]) represented a higher risk of (2) breathing problems., Conclusion: These results show that D3E handlers have a lot of risky behavior for respiratory problems. This study could be used to implement strategies to reduce the impact of D3E., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: Isolation and quarantine are among the key measures that protect internally displaced people (IDPs) against COVID-19. This study aims to identify the challenges encountered by humanitarian actors, and health, political, and administrative stakeholders in implementing these measures. It also describes the difficulties faced by IDPs when adopting them, and the local initiatives developed to overcome those difficulties., Method: We conducted a qualitative survey consisting of individual interviews and focus groups among IDPs, humanitarian actors, and health, political, and administrative stakeholders. The data was collected between November and December 2020 in the Bamako and Ségou Regions of Mali. Interviews were recorded with audio recorders, then transcribed and thematically analyzed using the NVivo 13 software., Findings: The study involved 36 individual interviews and eight focus groups with 68 participants of whom IDPs represented 72.3%. The main challenges reported on IDP sites included difficulties in contacting positive cases, a lack of facilities for quarantine and isolation, a lack of physical space for building new facilities, and a lack of financial resources to support IDPs during isolation and quarantine. The difficulties reported included: changes in social behavior and practices, fear of stigma, a poor level of literacy, and language barriers. To address those difficulties, the local initiatives developed by IDPs included strengthening the awareness of IDPs on COVID-19, early warning of sites' leaders about positive and suspected cases, and setting up a toll-free number to facilitate access to appropriate information on COVID-19., Conclusion: The findings of this study could be used as evidence to guide policy, adjust current strategies and take into account with more focus IDPs, a group with increased vulnerability, in COVID-19 response, more precisely during the implementation of isolation and quarantine measures. By doing so, they will help improve the response to COVID-19, IDPs health, and population health., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors. Published by Elsevier Ltd.)

Introduction: In response to the COVID-19 pandemic, various candidate vaccines has been approved to be used by WHO. However, there is low adherence to the vaccination campaign, especially in Mali. The goal was to study the perception of fourth municipality's population of the district of Bamako, about the COVID-19 vaccine., Methods: It was a cross-sectional descriptive and analytic study conducted from May to August 2021. A rational selection of two wards of the fourth municipality of Bamako was carried out. The Chi-square test of Pearson was used to test association between variables., Results: In total 179 people from two wards were surveyed. The average age was 37.73 years (SD=13.67), 34.6% (n=62) we'renot in school, and 7.8% (n=62) had received at least the first dose of a COVID-19 vaccine. 37.4% (n=67) did not believe in the existence of COVID-19; while 84.9% (n=152) didn't know at least the name of the vaccine in use in Mali. 65.4% (n=117) didn't trust the vaccine, while 78.1% (n=25) would have preferred other vaccines from AstraZeneca. Knowledge of the vaccine was associated with education level (OR=18.86; 95% CI [7.16-49.64]; p=0.00)., Conclusion: The population of the fourth municipality of Bamako have a few knowledge about the vaccine in use in Mali. So it's necessary to strengthen awareness campaigns., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Background: Countries with scarce resources need timely and high-quality data on coverage of health interventions to make strategic decisions about where to allocate investments in health. Household survey data are generally regarded as "gold standard," high-quality data. This study assessed the comparability of intervention coverage time trends from routine and survey data at national and subnational levels in Mali., Methods: We compared 3 coverage indicators: contraceptive prevalence rate, institutional delivery, and 3 doses of diphtheria, pertussis, and tetanus (DPT3) vaccine, using 3 Mali Demographic and Health Surveys (DHS 2001, 2006, and 2012-2013) and routine health system data covering 2001-2012. For routine data, we used local health information system (HIS) annual reports and an HIS database. To compare time trends between the data sources, we calculated the percentage point change and 95% confidence interval from 2001-2006 and 2006-2012. We then computed the absolute and relative differences between the 2 data sources for each indicator over time at national and regional levels and assessed their level of significance., Results: The direction and magnitude of the time trends of contraceptive prevalence rate, institutional delivery, and DPT3 vaccine from 2001 to 2012 were similar at the national level between data sources. At the regional level, there were significant differences in the magnitude and direction of time trends for institutional delivery and the DPT3 vaccine; contraceptive prevalence trends were more consistent. Routine data tended to overestimate DPT3 coverage, and underestimate institutional delivery and contraceptive prevalence relative to survey data., Conclusion: Routine data in Mali-particularly at the national level-appear to be appropriate for use to inform program planning and prioritization, but routine time trends should be interpreted with caution at the subnational level. For program evaluations, routine data may not be appropriate to draw accurate inferences about program impact., (© Sawadogo-Lewis et al.)

Objective: To identify the factors influencing the implementation of compulsory health insurance in two community health centers (CHC) in the health district of Kalaban Coro in Kati., Material Methods: It was a cross-sectional descriptive study from July 1, 2017 to October 31, 2018 in both CHC of Koulouba and Kalaban Coro central. We conducted a literature review and in-depth interviews with 20 people. A content analysis was done manually using deductive and inductive logic., Results: Out of all the services in 2017, those insured by the compulsory health insurance benefited from 5% of deliveries, 7% of the first antenatal cares and 8% of curative cares at the CHC of Koulouba against 0.1%, 0,3% and 3% respectively in CHC of Kalaban Coro central. The implementation of the compulsory health insurance and the reimbursement mechanisms have been facilitated through the establishment of information and communication channels, the training of members of the Federations of Community Health Associations at national, regional and local levels and other forms of support for CHC. The reimbursement period was 1-3 months in Koulouba against an absence since 2017 in Kalaban Coro central. Governance, monitoring and evaluation and staff motivation systems were weak or nonexistent. They resulted in financial and drug supply difficulties., Conclusion: Among the factors identified, the reimbursement mechanism posed the most problem for CHC and delegated management organizations., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: Côte d'Ivoire's status as a polio-free country requires high quality surveillance of acute flaccid paralysis. Our study aims to determine the prevalence of non-poliovirus enteroviruses found in the surveillance of Acute Flaccid Paralysis (AFP) in Côte d'Ivoire and to study their distribution according to individual characteristics and associated factors., Method: We conducted an exhaustive descriptive and analytical cross-sectional retrospective study on 3597 cases of acute flaccid paralysis notified in the context of surveillance of AFP from 2007 to 2016 in Côte d'Ivoire., Results: The mean annual rate of non-poliovirus enterovirus over the period was 11.3% over the study period with extremes of 9.2% and 15.9%. The absence of fever at the onset of illness and early age were factors associated with the occurrence of acute flaccid paralysis due to non-poliovirus enterovirus., Conclusion: Our study found a downward trend in non-poliovirus enteroviruses detected in AFP surveillance in Côte d'Ivoire, and identified the absence of fever and the age of the subject as being the factors associated with their occurrence. It is therefore necessary to type all cases of non-poliovirus enteroviruses detected in AFP surveillance to assess the risks of vaccine-derived polioviruses.

Objective: The objective was to study the determinants of home delivery in the Commune V Health District of Bamako., Materials and Methods: We conducted an analytical cross-sectional study among women who delivered at home, in two neighborhoodsofSabalibougou and Badalabougou, from March 2015 to February 2016, and who were admitted at the Maternity of the Commune V Referral Health Center during the same period. Two groups of women from two neighborhoods were compared. The data were entered and analyzed using EpiInfo 3.5.3. We presented the Odds Ratios and confident intervals., Results: The frequency of home delivery was 16.18%. The age group 35 years and over were the most represented in both Sabalibougou with 80.75% and Badalabougou with 19.42%.In Sabalibougou, compared to Badalabougou, we found 0.49 times fewer women in school (p = 0.01); 8.92 times more women with gainful occupation (p = 10 -8 ); 3.5 times more partners with non-gainful occupation (p = 10 -6 ); 4.59 times more risk to give birth at home (p = 10 -8 ); 3 times more risk not to perform antenatal care (p = 0.0002); 3.26 times more appreciation of the high cost of delivery care (p = 10 -4 ) and 3.03 times more lack of financial support (p=3*10 -4 )., Conclusion: The frequency of home delivery was higher in Sabalibougou. The determinants of this phenomenon were: the low level of schooling, the low socioeconomic level, the non-use of antenatal care, theperceived high cost of delivery care., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Objective: To study the care of children suffering from severe acute malnutrition with complications at the URENI of the pediatrics of the CHU (University Hospital) Gabriel TOURE., Patients and Method: it was a comprehensive cross-sectional study with a retrospective collection of data on children monitored for the treatment of severe acute malnutrition from January 1st till December 31st, 2014. We, also, conducted a qualitative survey of staff and carers of children under treatment during the survey period., Results: 490 patients were admitted directly to URENI. The 12-23 month age group was predominant (46.5%). The sex ratio was 1.09 in favor of the male sex. The success rate of treatment at the URENI was 51.40%. At the URENAS, the dropout rate was 27.50%. At the URENAM, the dropout rate was 72.70%. Almost all the carers interviewed during the individual interviews and focus groups were satisfied with nutritional care., Conclusion: The lack of autonomous hospitalization rooms at the URENI and the inadequacies noticed at the level of performance indicators have to motivate the creation of an URENI answering the standards at the level of the pediatrics of the CHU (University Hospital) Gabriel TOURE., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)