Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective...Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective of this work is to contribute to the management of OF cases in CAR. Patients and Methods: This was a retrospective, descriptive and analytical study, including data from several OF care services. The study included 245 cases of OF, operated on from 2009 to 2018. The parameters studied were maternal and obstetrical data, sociodemographic data, the specific characteristics of the fistulas as well as the modalities and outcome of surgical treatment. The data collected came from six (6) OF surgical repair campaigns organized by the Ministry of Health and Population with the support of UNFPA. Results: We recorded 245 patients, representing a prevalence of 0.77% of OF per year. Among these patients, almost half (45.3%) were treated at the Sino-Central African Friendship University Hospital Center (CHUASC). The average age of the patients was 30 years (range 14 to 78 years). They were unschooled (53.9%) and primigravidas (35%). The fistulas had an average duration of evolution of 7.58 years. They were vesicovaginal in 25.3%. Types V and I dominated in 17.4% and 9.2%, respectively. In 85.9% of cases, fistulorrhaphy was performed, half of which (50.2%) via the upper route. The cure rate was 83.3%. Note that our study reveals statistically significant links between the evolution after surgery with age (p = 0.04 Conclusion: OF mainly affected women of childbearing age, uneducated, primiparous. Vesicovaginal fistula was the frequently encountered type and was manifested by urine loss clinically with a positive methylene blue test.展开更多
Objective: In the context of increasing cases despite vaccination campaigns, a survey was conducted in the Bangui population from January 17 to 26, 2022, to evaluate the strains of Severe Acute Respiratory Infection C...Objective: In the context of increasing cases despite vaccination campaigns, a survey was conducted in the Bangui population from January 17 to 26, 2022, to evaluate the strains of Severe Acute Respiratory Infection Coronavirus 2 (SARS-Cov-2) circulating in a healthy population. Materials and methods: This study was conducted by taking nasopharyngeal samples from randomly selected volunteers. Antigen detection was performed systematically, and RT-PCR was done on the positive samples. Results and discussion: We collected 2,554 samples. Thirty were found RT-PCR positive (1.2%) and sent for viral genome sequencing. Twenty-eight SARS-Cov-2 strains belonged to the Omicron type, and only 2 to the Delta type. Conclusion: Thus, infections were uncommon in the tested population, but the presence of Omicron and Delta types raises concerns that vaccination may not be effective in fighting the virus, and newly designed vaccines should be implemented to better protect the population at risk of infection and reinfection by these variants.展开更多
Introduction: In many societies, sexuality is still a taboo subject. In the Central African Republic, this topic is rarely discussed outside the context of gynecological consultations and infertility, whereas the sexu...Introduction: In many societies, sexuality is still a taboo subject. In the Central African Republic, this topic is rarely discussed outside the context of gynecological consultations and infertility, whereas the sexual life of couples is often disrupted by the arrival of a child, particularly by the ordeal of childbirth. The aim of the study is to analyze the sexual experience of Central African women after childbirth in order to contribute to improving the health of the population, in particular that of mother and child, and to facilitate harmony within the couple. Methodology: Descriptive and analytical cross-sectional study covering the period from July 1 to August 30, 2023, at the maternity ward of the Center University Hospitalier Communautaire. The study concerned only women who had given birth between the second week and the sixth month postpartum. The sampling was exhaustive. Results: A total of 303 women agreed to take part in our study, aged between 15 and 44, more than half of whom had completed secondary school. The eagerness of the women to take part in the study shows that they are ready to express themselves about their sexuality despite certain biases linked to the method of patient selection. Resumption of sexual relations was initiated by the partners within six weeks in the vast majority of cases. Conclusion: Resumption of sexual intercourse was delayed, often at the partner’s initiative. Further studies are needed to understand the cultural, religious and psychological dimensions of postpartum sexuality in the Central African context.展开更多
Introduction: Fetal macrosomia is a birth weight greater than or equal to 4000 grams. The aim of this study is to determine the frequency of macrosomia, to identify the risk factors, and to evaluate the maternal and p...Introduction: Fetal macrosomia is a birth weight greater than or equal to 4000 grams. The aim of this study is to determine the frequency of macrosomia, to identify the risk factors, and to evaluate the maternal and perinatal prognosis in the obstetrics and gynaecology department of the Community University Hospital Centre (CHUC). Methodology: This was a retrospective case-control study over a period of 24 months in the maternity ward of the CHUC. Results: The frequency of delivery of macrosomic fetuses was 4.1%, and the average age of women with large fetuses was 29.5 years. In 65.7% of cases, they were not engaged in any income-generating activity. Most of them had at least secondary education (65.7%) and were mainly multiparous (78.8%). The risk factors found were maternal age greater than or equal to 35 years, multiparity, previous large fœtus, gestational diabetes, obesity and male sex. Maternal complications were dominated by uterine atony (52.2%), perineal tear (31.9%), and cervical tear (15.9%). In our series, macrosomic newborns were three times more likely to present with a neonatal complication than normal-weight newborns. Neonatal mortality was 2.1%. Conclusion: Reducing macrosomia requires a better understanding of the risk factors, early detection, correct management during vaginal delivery and close monitoring of labour with good control of obstetric manoeuvres.展开更多
Twins are one of the congenital anomalies described as phenomenal or mysterious. It is a rare and specific complication of monochorionic monoamniotic pregnancies resulting either from the late and incomplete splitting...Twins are one of the congenital anomalies described as phenomenal or mysterious. It is a rare and specific complication of monochorionic monoamniotic pregnancies resulting either from the late and incomplete splitting of one embryo into two distinct twins, or from the early secondary fusion of two initially separate embryos. These anomalies are often amenable to early diagnosis by ultrasound in the first trimester, which is still lacking in our community due to the uneven resources available. The aim of our clinical case study was to remind obstetric clinicians and the medical imaging sector that this very rare disease exists, hence the importance of obstetric ultrasound in the first trimester as an essential diagnostic tool to enable a management strategy to be put in place to avoid any surprises that could jeopardise the vital prognosis of the pregnant woman, particularly during parturition.展开更多
Context and objective: The COVID-19 pandemic has become a major public health problem and has mobilized many innovative means of diagnosis. The Central African Republic is not spared. The emergence of variants and the...Context and objective: The COVID-19 pandemic has become a major public health problem and has mobilized many innovative means of diagnosis. The Central African Republic is not spared. The emergence of variants and their impact require health monitoring despite the obligation of vaccination. The purpose of this campaign was to determine the circulation of pending second-wave variants. Patients and Methods: A second mass screening campaign took place from 02 to 22 July 2021 in the main land and river entry points of Bangui (Exit North-PK12, Exit South-PK9, Port Beach) and at the LNBCSP. Antigenic and RT-PCR tests carried out on nasopharyngeal samples made it possible to select strains which were finally sequenced. Results: Of 2687 participants included in the study, 53 (1.97%) were positive for SARS-CoV-2. Thirteen (1.53%) were male and 40 (2.18%) female. The analyses carried out on the LumiraDx analyzer were positive for 109 samples against 53 on the RT-PCR. The prevalence was higher in the most tested age groups (30 to 50 years) with two clusters identified. B.1.617.2 (Delta) variants were predominant (57%). Conclusion: SARS-CoV-2 continues to circulate. The acquisition of automated antigenic tests (LumiraDx®) with sensitivity and specificity close to those of the reference test (RT-PCR) will allow better mass diagnosis for an optimization of the surveillance of COVID-19 in our countries with limited resources. The predominance of the B.1.617.2 (Delta) variant would suggest a third wave in the Central African Republic.展开更多
Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing c...Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing countries. Objective: To identify the determinants that contribute to maternal morbidity and mortality in the Gynaecology and Obstetrics Department of the University Community Hospital. Methodology: We conducted a retrospective study from 1 January 2015 to 31 December 2019 (5 years) in the obstetrics and gynaecology department of the Centre Hospitalier Universitaire Communautaire (CHUC). It focused on the determinants of maternal mortality. Our study population consisted of all women who died during the period and met the World Health Organization (WHO) definition of maternal mortality (MOMA). We used non-probability sampling with the exhaustive choice technique. Results: The study revealed that the number of deaths recorded was 98, while 17,172 live births were registered during the same period. The maternal mortality ratio was 570 per 100,000 live births. The most common age group was 20 to 24, with an average age of 26. The frequency of death among primiparous women was 37.74%, pauciparous women 28.30% and multiparous women 26.42%. Direct causes were dominated by abortion complications (22.41%), followed by infections (9.30%) and haemorrhage (8.19%). Indirect causes were dominated by anaemia with a proportion of 45.16%. The majority of maternal deaths occurred in the post-partum period (34.71%). Most maternal deaths occurred after vaginal delivery, 19 cases (63.33%), while 11 deaths (36.66%) occurred after caesarean section. The occurrence of direct causes was associated with age less than or equal to 25 years, abortion complications and primiparity, with a statistically significant difference. Conclusion: At the end of this study, complications of unsafe abortion and poverty are all factors contributing to the rise in the maternal mortality rate. Emphasis should be placed on promoting family planning, as this would make a major contribution to reducing maternal mortality.展开更多
文摘Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective of this work is to contribute to the management of OF cases in CAR. Patients and Methods: This was a retrospective, descriptive and analytical study, including data from several OF care services. The study included 245 cases of OF, operated on from 2009 to 2018. The parameters studied were maternal and obstetrical data, sociodemographic data, the specific characteristics of the fistulas as well as the modalities and outcome of surgical treatment. The data collected came from six (6) OF surgical repair campaigns organized by the Ministry of Health and Population with the support of UNFPA. Results: We recorded 245 patients, representing a prevalence of 0.77% of OF per year. Among these patients, almost half (45.3%) were treated at the Sino-Central African Friendship University Hospital Center (CHUASC). The average age of the patients was 30 years (range 14 to 78 years). They were unschooled (53.9%) and primigravidas (35%). The fistulas had an average duration of evolution of 7.58 years. They were vesicovaginal in 25.3%. Types V and I dominated in 17.4% and 9.2%, respectively. In 85.9% of cases, fistulorrhaphy was performed, half of which (50.2%) via the upper route. The cure rate was 83.3%. Note that our study reveals statistically significant links between the evolution after surgery with age (p = 0.04 Conclusion: OF mainly affected women of childbearing age, uneducated, primiparous. Vesicovaginal fistula was the frequently encountered type and was manifested by urine loss clinically with a positive methylene blue test.
文摘Objective: In the context of increasing cases despite vaccination campaigns, a survey was conducted in the Bangui population from January 17 to 26, 2022, to evaluate the strains of Severe Acute Respiratory Infection Coronavirus 2 (SARS-Cov-2) circulating in a healthy population. Materials and methods: This study was conducted by taking nasopharyngeal samples from randomly selected volunteers. Antigen detection was performed systematically, and RT-PCR was done on the positive samples. Results and discussion: We collected 2,554 samples. Thirty were found RT-PCR positive (1.2%) and sent for viral genome sequencing. Twenty-eight SARS-Cov-2 strains belonged to the Omicron type, and only 2 to the Delta type. Conclusion: Thus, infections were uncommon in the tested population, but the presence of Omicron and Delta types raises concerns that vaccination may not be effective in fighting the virus, and newly designed vaccines should be implemented to better protect the population at risk of infection and reinfection by these variants.
文摘Introduction: In many societies, sexuality is still a taboo subject. In the Central African Republic, this topic is rarely discussed outside the context of gynecological consultations and infertility, whereas the sexual life of couples is often disrupted by the arrival of a child, particularly by the ordeal of childbirth. The aim of the study is to analyze the sexual experience of Central African women after childbirth in order to contribute to improving the health of the population, in particular that of mother and child, and to facilitate harmony within the couple. Methodology: Descriptive and analytical cross-sectional study covering the period from July 1 to August 30, 2023, at the maternity ward of the Center University Hospitalier Communautaire. The study concerned only women who had given birth between the second week and the sixth month postpartum. The sampling was exhaustive. Results: A total of 303 women agreed to take part in our study, aged between 15 and 44, more than half of whom had completed secondary school. The eagerness of the women to take part in the study shows that they are ready to express themselves about their sexuality despite certain biases linked to the method of patient selection. Resumption of sexual relations was initiated by the partners within six weeks in the vast majority of cases. Conclusion: Resumption of sexual intercourse was delayed, often at the partner’s initiative. Further studies are needed to understand the cultural, religious and psychological dimensions of postpartum sexuality in the Central African context.
文摘Introduction: Fetal macrosomia is a birth weight greater than or equal to 4000 grams. The aim of this study is to determine the frequency of macrosomia, to identify the risk factors, and to evaluate the maternal and perinatal prognosis in the obstetrics and gynaecology department of the Community University Hospital Centre (CHUC). Methodology: This was a retrospective case-control study over a period of 24 months in the maternity ward of the CHUC. Results: The frequency of delivery of macrosomic fetuses was 4.1%, and the average age of women with large fetuses was 29.5 years. In 65.7% of cases, they were not engaged in any income-generating activity. Most of them had at least secondary education (65.7%) and were mainly multiparous (78.8%). The risk factors found were maternal age greater than or equal to 35 years, multiparity, previous large fœtus, gestational diabetes, obesity and male sex. Maternal complications were dominated by uterine atony (52.2%), perineal tear (31.9%), and cervical tear (15.9%). In our series, macrosomic newborns were three times more likely to present with a neonatal complication than normal-weight newborns. Neonatal mortality was 2.1%. Conclusion: Reducing macrosomia requires a better understanding of the risk factors, early detection, correct management during vaginal delivery and close monitoring of labour with good control of obstetric manoeuvres.
文摘Twins are one of the congenital anomalies described as phenomenal or mysterious. It is a rare and specific complication of monochorionic monoamniotic pregnancies resulting either from the late and incomplete splitting of one embryo into two distinct twins, or from the early secondary fusion of two initially separate embryos. These anomalies are often amenable to early diagnosis by ultrasound in the first trimester, which is still lacking in our community due to the uneven resources available. The aim of our clinical case study was to remind obstetric clinicians and the medical imaging sector that this very rare disease exists, hence the importance of obstetric ultrasound in the first trimester as an essential diagnostic tool to enable a management strategy to be put in place to avoid any surprises that could jeopardise the vital prognosis of the pregnant woman, particularly during parturition.
文摘Context and objective: The COVID-19 pandemic has become a major public health problem and has mobilized many innovative means of diagnosis. The Central African Republic is not spared. The emergence of variants and their impact require health monitoring despite the obligation of vaccination. The purpose of this campaign was to determine the circulation of pending second-wave variants. Patients and Methods: A second mass screening campaign took place from 02 to 22 July 2021 in the main land and river entry points of Bangui (Exit North-PK12, Exit South-PK9, Port Beach) and at the LNBCSP. Antigenic and RT-PCR tests carried out on nasopharyngeal samples made it possible to select strains which were finally sequenced. Results: Of 2687 participants included in the study, 53 (1.97%) were positive for SARS-CoV-2. Thirteen (1.53%) were male and 40 (2.18%) female. The analyses carried out on the LumiraDx analyzer were positive for 109 samples against 53 on the RT-PCR. The prevalence was higher in the most tested age groups (30 to 50 years) with two clusters identified. B.1.617.2 (Delta) variants were predominant (57%). Conclusion: SARS-CoV-2 continues to circulate. The acquisition of automated antigenic tests (LumiraDx®) with sensitivity and specificity close to those of the reference test (RT-PCR) will allow better mass diagnosis for an optimization of the surveillance of COVID-19 in our countries with limited resources. The predominance of the B.1.617.2 (Delta) variant would suggest a third wave in the Central African Republic.
文摘Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing countries. Objective: To identify the determinants that contribute to maternal morbidity and mortality in the Gynaecology and Obstetrics Department of the University Community Hospital. Methodology: We conducted a retrospective study from 1 January 2015 to 31 December 2019 (5 years) in the obstetrics and gynaecology department of the Centre Hospitalier Universitaire Communautaire (CHUC). It focused on the determinants of maternal mortality. Our study population consisted of all women who died during the period and met the World Health Organization (WHO) definition of maternal mortality (MOMA). We used non-probability sampling with the exhaustive choice technique. Results: The study revealed that the number of deaths recorded was 98, while 17,172 live births were registered during the same period. The maternal mortality ratio was 570 per 100,000 live births. The most common age group was 20 to 24, with an average age of 26. The frequency of death among primiparous women was 37.74%, pauciparous women 28.30% and multiparous women 26.42%. Direct causes were dominated by abortion complications (22.41%), followed by infections (9.30%) and haemorrhage (8.19%). Indirect causes were dominated by anaemia with a proportion of 45.16%. The majority of maternal deaths occurred in the post-partum period (34.71%). Most maternal deaths occurred after vaginal delivery, 19 cases (63.33%), while 11 deaths (36.66%) occurred after caesarean section. The occurrence of direct causes was associated with age less than or equal to 25 years, abortion complications and primiparity, with a statistically significant difference. Conclusion: At the end of this study, complications of unsafe abortion and poverty are all factors contributing to the rise in the maternal mortality rate. Emphasis should be placed on promoting family planning, as this would make a major contribution to reducing maternal mortality.
