Introduction:Ovarian tumors are classified into 4 main groups: epithelial tumors, germ cell tumors (GCT), sex cord-stromal tumors (SCST) and metastatic tumors. Their clinicopathological features and biological behavior vary largely across age groups and World regions. Methods:We retrospectively collected 358 cases of ovarian tumors diagnosed at our Pathology service in a tertiary care hospital (February 2020 - March 2024). We performed statistical comparison between clinical and histopathological groups (Student's t-test, Fisher exact and chi-square tests). We also performed logistic regression analysis to identify clinicopathological factors associated with malignancy in ovarian tumors (using odds ratio (OR) and 95% confidence interval (CI)). Results:The mean age was 37.1 years ± 15.9 (range of 4-81 years), with 38 cases (10.7%) from pediatric patients. Epithelial tumors and GCT were the most frequent tumors representing 52% and 34.6%, respectively. The majority of ovarian tumors were benign (283 cases, 79.1%) with 72 ovarian cancers (20.1%), representing 41.1% of all gynecological tract malignancies diagnosed at our department. Patients with adnexal torsions were younger than those without torsion and had larger cystic, left-sided tumors (p<0.05), irrespective of biological behavior (p˃0.05). Ovarian cancer was often found in older and post-menopausal women (mean ages of 48.35±16.56 years versus 34.2±14.40 years; 58.8% versus 15.7%; p<0.001). Ovarian malignant tumors were more often larger and heterogenous with mixed macroscopic aspect (mean size of 17.73±11.46 versus 13.40±8.71 cm; p=0.006; 56.9% versus 9.9%; p<0.001). The epithelial histological differentiation (OR = 5.08, 95% CI = 2.12-12.17, p<0.001) and the solid/mixed gross feature (OR = 36.93, 95% CI =14.91-91.47, p<0.001) were significantly associated with tumor malignancy. Conclusion:We found that the clinicopathological features of ovarian tumors vary widely according to age groups, macroscopic aspects and histological differentiation. Ovarian cancer is often found in post-menopausal women with larger and heterogenous tumors compared to patients with benign tumors.
Despite the proven efficacy multidrug therapy (MDT), drug resistance continues to be reported globally. In Niger, the historical period of long-term dapsone monotherapy may explain the emergence and persistence of these resistant strains, challenging the success of leprosy control programs. To address this challenge, this study focuses a long-term bacteriological monitoring. Specially, we report a case of a primary molecular dapsone-resistant strain identified at the Centre National Dermato-Lèpre (CNDL) in Niamey, the national center for leprosy. A two-year surveillance study screened 24 patients with multibacillary (MB) leprosy presenting a bacteriological index (BI) ≥ 2+. Genetic resistance mutations in rpoB , folP1 , and gyrA genes (conferring resistance to rifampicin, dapsone, and fluoroquinolones, respectively) were investigated using multiplex PCR followed by the GenoType LepraeDR test. One patient with primary molecular resistance to dapsone representing a prevalence of 4.16% within the cohort was identified and monitored during a 12-month MDT regimen. Bacteriological follow-up evaluated both the BI and the morphological index (MI) at baseline and at the end of treatment. Following 12 months of MDT, the patient showed a decrease of 1.33 points in the BI. The MI dropped drastically from 69% to 1%, indicating near-complete clearing of viable bacilli. These results confirm the therapeutic efficacy of standard MDT against dapsone-resistance Mycobacterium leprae strains. However, the residual 1% MI suggests the persistence of viable mutated bacilli. Strict, long-term monitoring of this patient remains crucial to prevent clinical relapse and contain the transmission of drug-resistant leprosy in Niger.
Typhoid fever remains a major public health challenge in low-income countries, where surgical complications particularly ileal perforation account for the greatest share of associated mortality. In Niger, restricted access to bacteriological investigations leads to substantial under recognition of the true disease burden. To describe the epidemiological, clinical, therapeutic, and outcome characteristics of presumed typhoid ileal perforations managed surgically in two referral hospitals in Niger, and to identify factors independently associated with in-hospital mortality. A multicentre retrospective descriptive study was conducted at the Zinder National Hospital (ZNH) and the Maradi Regional Hospital Centre (RHC/M) between January 2014 and December 2019. All patients who underwent surgery for acute peritonitis secondary to presumed typhoid ileal perforation, defined on the basis of epidemiological, clinical, and intraoperative criteria, were included. Factors associated with in-hospital mortality were identified by multivariate logistic regression. A total of 2,931 cases of presumed typhoid ileal perforation were recorded among 4,271 operated acute peritonitis cases (68.6
Background Ballistic cranial trauma in Niger occurs within a care pathway disrupted by terrorism-related insecurity, delayed evacuation, limited imaging, restricted blood product availability, and constrained postoperative monitoring. Objective To synthesize Niger-specific evidence with current guidance on penetrating traumatic brain injury and to propose a practical neurosurgical pathway for austere, violence-affected settings. Methods PubMed/MEDLINE and Google Scholar were searched in March 2026 and updated on 23 July 2026 for English- or French-language sources published from January 2019 through July 2026. Targeted guideline and humanitarian-source searches and reference-list screening were also performed. Sources were selected using predefined clinical and health-system relevance criteria. Results Thirteen sources published from 2020 to 2026 were retained: 10 peer-reviewed studies, two guidance documents, and one humanitarian report. Nigerien evidence indicates prolonged delays to computed tomography and surgery, a substantial operative burden at the national referral center, and local experience with penetrating injuries. Regional evidence and current guidance support early stabilization, prompt imaging, risk-based vascular assessment, timely surgery in salvageable patients, competency-based task sharing, and structured postoperative surveillance. Conclusion The central challenge is the mismatch between a time-critical lesion and a fragile continuum of rescue, transfer, imaging, surgery, and postoperative care. A context-adapted national pathway based on protected referral, early stabilization, damage-control neurosurgery, minimum neurocritical care, supervised task sharing, and prospective audit may reduce preventable mortality.
We report a rare cause of gastrointestinal bleeding in two infants under 6 months of age, both presenting with hematemesis and melena without other apparent skin lesions. Endoscopic examinations revealed flat, diffuse, active mucosal bleeding due to petechial lesions of the fundus in one infant and of the antrum in the other, suggestive of congenital gastric angiomatosis. The first patient received systemic hemostatic therapy and gastric protection with good clinical outcome. The second patient, who had a more persistent bleeding syndrome, was treated with hemostatic therapy, gastric protection, a proton pump inhibitor, and a beta-blocker, with good clinical resolution of symptoms.
