Les taux d’incidence et de mortalité par cancers ne cessent d’augmenter en Afrique de l’Ouest. La cancérologie est une discipline récente au Mali et les moyens disponibles pour traiter les malades sont insuffisants. Le Mali compte un unique appareil de radiothérapie pour le pays et ses dysfonctionnements sont régulièrement relayés par les médias. Afin de comprendre les insatisfactions récurrentes liées à l’accès à la radiothérapie au Mali, nous avons retracé l’historique de cet appareil et en avons décrit le fonctionnement. À partir d’entretiens semi-directifs menés avec des associations de patientes et des professionnels de santé impliqués en cancérologie à Bamako, nous décrivons la façon dont l’appareil de radiothérapie du Mali révèle des enjeux de santé mondiale à travers l’intervention de nombreuses coopérations internationales. De façon complémentaire, et à partir d’une collecte de données sur registres médicaux et de rapports institutionnels, nous signalons que la durée moyenne pour obtenir un rendez-vous en radiothérapie est de trois à six mois au Mali, mais aussi que l’appareil de radiothérapie a fait face à 198 pannes entre le 3 avril 2014 et le 24 septembre 2021, ce qui représente plus de 54 semaines d’arrêts cumulés. La radiothérapie est un élément crucial de la prise en charge des cancers, et le manque d’accès à ce traitement aggrave le pronostic vital des malades. Alors que le gouvernement malien s’est engagé dans des réformes de couverture santé universelle, le renforcement des infrastructures de traitement des cancers doit également être considéré comme une priorité de santé publique pour le Mali.
In this paper, we investigate a mathematical model of malaria transmission dynamics with maturation delay of a vector population in a periodic environment. The incidence rate between vector and human hosts is modeled by a general nonlinear incidence function which satisfies a set of conditions. Thus, the model is formulated as a system of retarded functional differential equations. Furthermore, through dynamical systems theory, we rigorously analyze the global behavior of the model. Therefore, we prove that the basic reproduction number of the model denoted by 0 is the threshold between the uniform persistence and the extinction of malaria virus transmission. More precisely, we show that if 0 is less than unity, then the disease-free periodic solution is globally asymptotically stable. Otherwise, the system exhibits at least one positive periodic solution if 0 is greater than unity. Finally, we perform some numerical simulations to illustrate our mathematical results and to analyze the impact of the delay on the disease transmission.
Background: In Mali, contraceptive prevalence is low, while the unmet need for family planning is very high. Postpartum contraception can help to significantly reduce these unsatisfied needs. The introduction of the intrauterine device (IUD) in the postpartum quickly encountered problems with the type of forceps used to make the insertions (Kelly or Heart forceps), and also their availability at the various health centers. Thus, in 2016, the Population Services International Mali (PSI-Mali) introduced the insertion of the IUD in the postpartum with the new inserter in order to counter this forceps problem and to contribute to guaranteeing the quality of postpartum IUD insertions. Objectives: They were to determine the frequency, the socio-demographic and clinical characteristics and to report the side effects and the complications. Methods: This was a descriptive and analytical cross-sectional study from September 1 st 2016 to August 31 st , 2018. All deliveries that met the eligibility criteria, having chosen and benefited the postpartum intra-uterine device with the new inserter were included. Results: During the 2 years, we recorded 73 cases of insertion of the postpartum intra-uterine device with the new inserter over 7797 clients meeting of the world health organization's criteria of medical admissibility for the use of an intra-uterine device with a frequency of 0.93%. They were married in 97% of cases, large multiparous in 48% of cases, aged between 30 and 39 years in 62% of cases. We didn't notice any complications in 96% of cases. Expulsion with 4% was the only complication. The clients didn't have any side effects in 98% of cases. Conclusion: The
The uterus bicorne is a uterine malformation whose pathophysiology is known but the etiology remains obscure. Few studies have been interested in this subject. This is the clinical observation of Mrs. X 26-year-old housewife nulliparous who consulted for repeated late spontaneous abortions. The clinical examination was normal. The ultrasound revealed a double uterine cavity in Y, in favor of a unicervical bicorne uterus. At hysterosalpingography, the tubes were permeable and the uterus doubled with a single cervix. The treatment consisted of a uterine plasty. The postoperative course was simple. The patient gave birth to a newborn male 20 months after surgery.
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