Severe malaria during pregnancy at the maternity ward of the municipal medical center of Ratoma, Guinea-Conakry.

2021 ◽  
Author(s):  
MH Diallo ◽  
IS Baldé ◽  
N Keita
Author(s):  
Mamadou H. Diallo ◽  
Ibrahima S. Baldé ◽  
Alpha B. Barry ◽  
Ibrahima Sylla ◽  
Fatoumata B. Diallo ◽  
...  

Background: Gestational malaria remains a major public health problem in malarious areas. The objectives of this work were to describe the socio-demographic, clinical, paraclinical, therapeutic and prognostic characteristics of patients who developed severe malaria during pregnancy.Methods: It was a descriptive prospective study carried out in the maternity ward of Ratoma municipal medical center, which was carried out over a period of 6 months from 01 October 2018 to 31 March 2019. This study involved all pregnant women who had presented severe malaria according to WHO criteria.Results: The incidence of severe malaria during pregnancy was 7%. The average age of our patients was 22.4 years with extremes of 15 and 47 years. The symptomatology that motivated the consultation was variable, the most frequent signs were: hyperthermia (100%), headache (79%), vomiting (99%). The general examination at admission objectified a fever with an average temperature of 39°C with extremes of 38-40.4°C. All patients had a positive rapid diagnostic test (RDT) as well as their thicker drop. The hemogram revealed the existence of a more or less severe anemia in 89.9% of cases. All patients were treated with parenteral quinine (100%). Maternal lethality was 1.8%. After severe malaria, 70 patients (62.5%) carried their pregnancy to term and 40 delivered an eutrophic child (35.71%), 30 (26.78%) delivered a hypotrophic child, 20 (17.85%) had a spontaneous abortion, premature delivery was observed in 10 patients (8.9%), and fetal death in utero was observed in 12 patients (10.71%).Conclusions: All patients had received parenteral quinine curative therapy. Maternal and perinatal complications were common. To improve this prognosis, intermittent preventive treatment and the use of insecticide-treated nets, which are the most effective prevention method at this time, must be further promoted in anticipation of the much hoped-for vaccine.


Author(s):  
Daniel W. A. Leno ◽  
Mamoudou E. Bah ◽  
Jerry C. Moumbagna ◽  
Tamba M. Millimouno ◽  
David Lamah ◽  
...  

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.


2019 ◽  
Vol 6 ◽  
pp. 2333794X1988481
Author(s):  
Benetta Collins-Andrews ◽  
Patricia McQuilkin ◽  
Kanagasabai Udhayashankar ◽  
Eric Adu ◽  
Ann Moormann

Malaria is endemic in Liberia with a prevalence rate of up to 60% in some regions, and it has been a major cause of death in children under 5 years of age. Prior to the recent Ebola epidemic, we undertook a prospective, hospital-based pilot study at the National Referral Hospital in Monrovia, to characterize the presentation, accuracy of diagnosis, and treatment outcomes of children presenting for treatment of malaria. From June 2013 to May 2014, we recruited children 5 years and under who presented to the JFK Medical Center with suspected malaria. We collected both clinical and laboratory data on admission and on discharge. We enrolled 477 patients with an average age of 1.6 years. Demographic factors associated with testing negative for malaria included regular bed net use and prior treatment for malaria. The most common presenting symptoms of severe malaria in this population were headache and seizures. Of 246 patients admitted and treated for severe malaria, 33% tested negative by rapid diagnostic test and blood smear for malaria. The case fatality rate was higher for the patients who tested negative for malaria (4.9%) versus those who tested positive (0.6%). Three children who tested negative for malaria showed evidence of undiagnosed Salmonella typhi infection. These results suggest that malaria may be overdiagnosed and that the diagnoses of other infectious diseases, which present in a similar fashion, may be neglected. These findings underscore the need to develop rapid diagnostic tests to screen for alternative causes of febrile illness.


2018 ◽  
Vol 18 (4) ◽  
pp. e133-e146 ◽  
Author(s):  
Umberto D'Alessandro ◽  
Jenny Hill ◽  
Joel Tarning ◽  
Christopher Pell ◽  
Jayne Webster ◽  
...  

1999 ◽  
Vol 27 (2) ◽  
pp. 205-205
Author(s):  
choeffel Amy

The U.S. Court of Appeals for the District of Columbia upheld, in Presbyterian Medical Center of the University of Pennsylvania Health System v. Shalala, 170 F.3d 1146 (D.C. Cir. 1999), a federal district court ruling granting summary judgment to the Department of Health and Human Services (DHHS) in a case in which Presbyterian Medical Center (PMC) challenged Medicare's requirement of contemporaneous documentation of $828,000 in graduate medical education (GME) expenses prior to increasing reimbursement amounts. DHHS Secretary Donna Shalala denied PMC's request for reimbursement for increased GME costs. The appellants then brought suit in federal court challenging the legality of an interpretative rule that requires requested increases in reimbursement to be supported by contemporaneous documentation. PMC also alleged that an error was made in the administrative proceedings to prejudice its claims because Aetna, the hospital's fiscal intermediary, failed to provide the hospital with a written report explaining why it was denied the GME reimbursement.


Crisis ◽  
2016 ◽  
Vol 37 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Nicole J. Peak ◽  
James C. Overholser ◽  
Josephine Ridley ◽  
Abby Braden ◽  
Lauren Fisher ◽  
...  

Abstract. Background: People who feel they have become a burden on others may become susceptible to suicidal ideation. When people no longer feel capable or productive, they may assume that friends and family members would be better off without them. Aim: The present study was designed to assess preliminary psychometric properties of a new measure, the Perceived Burdensomeness (PBS) Scale. Method: Depressed psychiatric patients (N = 173) were recruited from a veterans affairs medical center. Patients were assessed with a structured diagnostic interview and self-report measures assessing perceived burdensomeness, depression severity, hopelessness, and suicidal ideation. Results: The present study supported preliminary evidence of reliability and concurrent validity of the PBS. Additionally, perceived burdensomeness was significantly associated with higher levels of hopelessness and suicidal ideation. Conclusion: It is hoped that with the aid of the PBS clinicians may be able to intervene more specifically in the treatment of suicidality.


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