BACKGROUND:Azithromycin mass drug administration (MDA) to ages 1-59 months can reduce childhood mortality; however, more evidence is needed to support targeting a narrower age range of 1-11 months. This trial assesses the efficacy of azithromycin MDA to 1-11-month-old children in reducing mortality in a real-world setting with integration of vitamin A delivery within the established Child Health Days platform in Burkina Faso. METHODS:Mortalite Infantile Reduite par l'Administration de Masse de l'Azithromycine is a double-masked, cluster-randomised, placebo-controlled trial in Child Health Days communities in Burkina Faso. Primary healthcare centre catchment areas (Centres de Santé et de Promotion Sociale (CSPS)) were randomised 2:1 to deliver biannual azithromycin or placebo for 1-11-month-old children. Birth history data at the study endpoint were used to calculate mortality rates and compare between groups. FINDINGS:From September 2021 to January 2024, 201 709 children in 303 CSPS received azithromycin and 100 959 children in 158 CSPS received placebo, with an overall treatment coverage of 85%. Mortality rates were 2.6 (95% CI 2.1 to 3.1) deaths per 1000 person-years in the azithromycin arm and 2.5 (95% CI 1.8 to 3.2) per 1000 person-years in the placebo arm. There was no significant difference in the mortality rates by arm (incidence rate ratio: 1.04; 95% CI 0.75 to 1.46; p value 0.80). There were 16 non-serious adverse events and no serious adverse events recorded during the trial. INTERPRETATION:This trial demonstrates that azithromycin MDA for child survival can be scaled up and integrated into existing child health programmes but was unable to demonstrate an effect of azithromycin distribution on infant mortality. These findings indicate future policy decisions should consider treatment delivery to the larger age group of children up to 5 years old. FUNDING:The trial was funded by the Bill and Melinda Gates Foundation (INV-005395). TRIAL REGISTRATION NUMBER:NCT04716712.

This study assessed the floristic diversity and carbon storage capacity of four major urban green spaces in Yamoussoukro using 26 plots of 400 m² and allometric equations for biomass estimation. A total of 24 woody species belonging to 22 genera and 13 families were recorded, with introduced species representing 77% of individuals. Carbon stocks ranged from 35.1 to 130 t/ha, with the highest values associated with sites containing larger basal areas and mature trees. The findings demonstrate that vegetation structure and species composition-rather than green-space size-are the primary determinants of carbon sequestration in the city. These results underscore the importance of informed species selection and structural management to optimize the climate-regulating functions of urban green spaces.

Objective: To determine the prevalence of patients with ultrasound signs of a full stomach during surgery at the Sominé Dolo Hospital in Mopti. Methodology: Observational study investigated prospective, single-center over a period of one month include patients in surgery program aged 18 to 85 years. Our data was collected on individual survey sheets and analysed with the Epi info7 software. Result: Out of a total of 140 patients, 41 patients were included in our study, i.e. a frequency of 29.28%. The mean age of patients was 38 years +/-17. The average body mass index was 23+/- 4.65. Females predominated: 60.98% (n=25) compared to 39.02% (n=16) for males, with a sex ratio of 0.6/1. The ASA classification was rated at II in 51.22% of patients (n=21). The gastric antrum was visualized in 40 patients, i.e. an ultrasound sensitivity of 97.56%, of which seven (07) were difficult to see and not visualized in one patient. We found a relationship between high BMI and difficulty in visualizing gastric contents (P-value = 0.00001), but no relationship was found between BMI and Perlas score (P-Value = 0.75411). The Perlas score was rated at 0 in 85% (n=34), fluid content was found in 12.5% (n=5) of patients while one patient had solid content. Patients observed an estimated preoperative fasting duration of an average of 11 hours +/- 2.86. Conclusion: Despite the implementation of a preoperative fasting protocol, cases of full stomachs are still to be feared and the ultrasound at the bedside of patients is a simple, quick examination to best adjust the anesthesia protocol. Keywords: full stomach, gastric antrum, ultrasound, Perlas score, Mopti.

Schistosomiasis is a parasitic disease of human origin caused by flatworms. This condition affects millions of people in developing countries where it is endemic. In 2017, the WHO classified schistosomiasis as a neglected tropical disease (NTD), deserving particular attention due to its potential complications, including infertility. Several initiatives have been undertaken to eradicate this condition, among which regular administration of praziquantel (PZQ), an anthelminthic medication, to school-age children (and other high-risk groups) is the cornerstone of schistosomiasis control. Although the efficacy of PZQ against infections of a single schistosome species is well known, its efficacy against mixed-species infections is less understood, as are the reinfection patterns after treatment. We report a case in a child in Bamako. Patient was a 9-year-old student who presented with pruritic solid lesions on the abdomen that had been continuously evolving, gradually increasing in number and size. The child used water from the marigot for group amusements. Since schistosomes can survive for decades in the host’s bloodstream, they are clearly capable of evading host immune responses, and their ability depends on the properties of the tegument surface. This hypothesis is plausible in our child due to his previous baths in the marigot. This highlights the need for proper management of stagnant water in endemic countries. This observation serves as a warning to clinicians that any hematuria warrants a systematic dermatological examination to search for skin lesions.

Summary: The pilar cyst or trichilemmal is a benign tumour of the skin appendages. This tumour develops on the isthmic part of the pilar follicle and is characterised histologically by trichilemmal keratinisation. We report a case of bilateral giant temporal trichilemmal cysts with a giant occipital lipoma. Observation: This is a 53-year-old patient who presented with multiple scalp lesions that had been present for three years. On clinical examination, there were two bilateral symmetrical temporal tumours with an occipital mass. Histology revealed a trichellemmal cyst for the temporal and a lipoma for the occipital.

Introduction: According to the WHO, osteoarthritis is the result of mechanical and biological phenomena that destabilise the balance between the synthesis and degradation of cartilage and subchondral bone. Gonarthrosis is a genuine public health problem in developed countries due to its high frequency, the functional impotence it causes and its socio-economic impact [2, 3]. Its prevalence is estimated at between 7% and 17% in people aged over 45 [4]. This incidence has continued to increase over the last few decades due to the industrialisation of the world and the sedentary lifestyle of human beings. In the absence of any study on the role of physiotherapy in the management of gonarthrosis in Mali. We deemed it necessary to undertake a study whose aim was to evaluate the impact of physiotherapy in the management of non-operated gonarthrosis in the physiotherapy department of the Centre National d'Appareillage Orthopédique du Mali (C.N.A.O.M). Methods and Patients: This was a descriptive cross-sectional study over a period of one month. All patients seen in consultation with gonarthrosis and consenting were included. Results: In total, out of 561 patients seen in consultation at the C.N.A.O.M, we included 10 patients, i.e. 1.78%. Females accounted for 86%, with an average age of 55 years. Gonarthrosis was unilateral in 28.6% and bilateral in 71.4%. With the exception of one patient, all the other patients were overweight or obese. Apart from one patient, physiotherapy improved the symptoms in all our patients. Conclusion: Gonarthrosis is a very disabling condition. Our results are similar to those in the literature, i.e. it mainly affects obese adult women. Management is multidisciplinary. Physiotherapy plays a key role in the management of gonarthrosis. It significantly improves the clinical signs and quality of life of patients. A multicentre case-control study would be useful to assess the efficacy of physiotherapy alone in the management of gonarthrosis.

The alopecic aseptic nodule of the scalp (NAAS) is a recently described entity known as a "pseudocyst of the scalp". It can be confused with dissecting folliculitis of the scalp (Hoffmann's disease) by certain clinical signs. We report three cases of NAAS mimicking MH with favourable evolution under doxycycline associated with intra-lesional corticotherapy. Case 1: A 36-year-old man presented with painful nodules of the scalp. Examination revealed two fluctuating subcutaneous nodules measuring 4 and 5 cm, both painful. The skin opposite the nodules was alopecic and not scarred. Case 2: A 28-year-old man presented with a scalp nodule that had been present for 3 months. Clinical examination revealed a fluctuating, painful subcutaneous nodule measuring 7cm, alopecic and non-scarring, with surrounding small patches of alopecia. In addition, inflammatory acne lesions were noted on the face. Case 3: A 33-year-old obese male smoker presented with a scalp nodule. Examination revealed a painful subcutaneous nodule measuring 3 cm, with smooth alopecic skin. Discussion: The pathophysiology of NAAS remains poorly understood, and a link with the spectrum of follicular occlusion pathologies has been suggested. Inflammatory acne was observed in two of our patients. The biopsy was non-specific; the pus came back sterile in all cases; after aspiration, the patients benefited from intra-lesional corticosteroid therapy associated with doxycycline 100mg/dr with a good evolution. Conclusion: Aseptic alopecic nodules of the scalp are clinically similar to folliculitis dissecans of the scalp. Certain clinical signs can help the practitioner to make the correct diagnosis in order to avoid aggressive treatment.

Anesthesia for emergency caesarean section constitutes a real challenge for the anesthetist-resuscitator not only because of the complexity linked to the physiology of the pregnant woman but also because of the delay in fetal extraction, especially since the patient would be in a unstable haemodynamic status (HDM).In our case, it is a 26-year-old patient, housewife, married, with no known medical-surgical history (G3, P2) with two living children (V2), having carried out no prenatal consultation, a Glasgow at 14 /15 on admission associated with an unstable haemodynamic state.She was operated by Caesarean section for hemorrhage in the third trimester of pregnancy lasting more than 24 hours in a pregnancy estimated at term.We performed bilateral ultrasoundguided TAP BLOCK with 0.8 ml/ KgP of 0.25% Levo-Bupivacaine plus local infiltration of the incision site with 10 ml of XYLOCAINE 20 mg/ml ADRENALINE 0.005 mg/ml.Verbal contact was maintained with the patient throughout the surgery and she kept a stable HDM state intraoperatively with a mean arterial pressure (MAP) of 70 mmHg at the end of the procedure.Wall BLOCK techniques are feasible, reliable and beneficial on fragile sites where general anesthesia and neuro-axial methods (epidural or intrathecal) are contraindicated or even dangerous.

Ivorian classified forests have been highly anthropized by cocoa farming. In an attempt to provide guidance to the government on approaches to the restoration of the forest while respecting the aspirations of local populations, permanent plots were set up in the classified forest of Haut-Sassandra, and were monitored and measured for 3 years. This study was intended to analyze the evolution of the vegetation of permanent plots in the classified forest of Haut-Sassandra from 2018 to 2021. The results show that the vegetation evolves with the cessation of some agricultural activities. These plantations are colonized by pioneer species during the first three years of the abandonment of agricultural activities. Mortality rates increased by 477.59% and recruitment rates were reduced by 61.87% in regularly maintained plantations compared to their condition three years ago. However, the plantations with no agricultural activities and those which were not maintained but harvested had the highest recruitment rates of pioneer and heliophilous individuals. In sum, tree species could recolonize the classified forest of Haut-Sassandra if clearing is prohibited in cocoa farms. However, the populations could continue to harvest the pods from the cocoa trees which are already established in the classified forest of Haut-Sassandra.

Background To facilitate mass distribution of azithromycin, trachoma control programmes use height instead of weight to determine dose for children 6 months to 15 years old. WHO has recommended azithromycin distribution to children 1–11 months old to reduce mortality in high mortality settings under carefully monitored conditions. Weight was used to determine dose in children 1–5 months old in studies of azithromycin distribution for child survival, but a simplified approach using age or height for all aged 1–11 months old could increase programme efficiency in real-world settings.Methods This secondary analysis used data from two cluster randomised trials of azithromycin distribution for child mortality in Niger and Burkina Faso. An exhaustive search algorithm was developed to determine the optimal dose for different age groups, using tolerance limits of 10–20 mg/kg for children 1–2 months old and 15–30 mg/kg for children 3–11 months old. Height-based dosing was evaluated against the existing trachoma dosing pole and with a similar exhaustive search.Results The optimal two-tiered age-based approach suggested a dose of 80 mg (2 mL) for children 1–2 months old and 160 mg (4 mL) for children 3–11 months old. Under this schedule, 89%–93% of children would have received doses within tolerance limits in both study populations. Accuracy was 93%–94% with a three-tiered approach, which resulted in doses of 80 mg (2 mL), 120 mg (3 mL) and 160 mg (4 mL) for children 1–2, 3–4 and 5–11 months old, respectively. For children 1–5 months old, the existing height pole would result in 70% of doses within tolerance limits. The optimisation identified height-based dosing options with 95% accuracy, although this would require changes to the existing dosing pole as well as additional training to measure infants lying flat.Conclusions Overall, an age-based approach with two age tiers resulted in high accuracy while considering both concerns about overdosing in this young population and simplicity of field operations.

Located in the extreme north of Côte d’Ivoire, the Sudanian zone is an area where 95% of the population depends on agricultural activities, particularly rain-fed agriculture. Given the serious threats that climate variability poses to food security and household incomes, it is important to understand the evolution of climate variables and their impacts on crops, perceptions, and adaptation measures taken by farmers. To do this, various statistical analyses were conducted using rainfall and temperature data from 1987 to 2018. These analyses were coupled with a survey of 287 farmers. The results showed a strong variability of precipitation marked by the succession of deficit and surplus periods with a return to wetter conditions since 2008. At the same time, an increase in temperature was observed. These phenomena have been perceived by farmers. Thus, to cope with the adverse effects of climate variability, farmers have developed numerous adaptation strategies that include the use of organic manure, agroforestry, changing planting dates, and introducing new crops, notably cashews.

In Côte d'Ivoire, cassava is widely grown all over the country, and a large variety of varieties is encountered. This diversity is due, on the one hand, to the fact that genotypes respond differently to various soil, climate and biotic factors and, on the other hand, to the continuous exchange of seeds among producers. The objective of this study was to find a limited number of reliable and stable morphological criteria that would allow clones to be identified throughout the cassava chain. The study first consisted of a visit in the experimental station with the aim of identifying all the clones found on the different plots. Twenty clones were randomly selected. Then, cassava descriptors developed by the International Institute of Tropical Agriculture (IITA) were used to identify differences between these clones. The PCA analysis method highlighted seven main criteria: "color of the last branch", "color of the leaf", "color of the petiole", "color of the rib", "number of branches", "profile of the petioles" and " shape of the branches". These criteria made it possible to differentiate eleven clones.Keywords: cassava, clone, criterion, morphology, Côte d’Ivoire

The ageing of cocoa orchards in south-western Cote d'Ivoire in the early 2000s resulted in the relocation of the pioneer front to the forested west. This influx of population would have modified the landscape structure or the composition of land use classes in the areas where the people settled. The purpose of this study is to assess the impact of cocoa production on the dynamics of rural and protected areas in the Biankouma department in western Cote d'Ivoire. To achieve this, four satellite images dating from 2002, 2006, 2013, and 2018 from Landsat sensors were processed. The results showed that over the period 2002 to 2018, the number of cocoa farms installed in the protected area was twice as high as in the rural area. In fact, during this period, the surface of cocoa farms increased by 1232.5% in the protected area compared to 567.9% in the rural area. The increase in cocoa cultivation was entirely to the detriment of natural vegetation (-34.7%) in the rural area, whereas it was detrimental to all the classes (-56.8%) in the protected area. The land-use change map indicates that the conversion of natural vegetation to cocoa is mostly concentrated in the protected areas. Thus, cocoa cultivation has had a greater negative effect on the landscape in the protected area compared to the rural area in the west of Cote d'Ivoire.

The classified forest of Haut-Sassandra (CFHS) located in the Center-West of Côte d'Ivoire was infiltrated by the population for agriculture in the 2000s. This forest, initially devoted to timber production before its degradation, is today a vast cocoa-growing area associated with food crops, mainly plantains. The objective of the present study is to assess the overall production of wood, cocoa, and plantain in this state-owned area before (2000) and after its degradation (2019). Processed satellite images covering the CFHS showed an increase in anthropogenic vegetation classes and a decrease in the forest cover class from 2000 to 2019. These transformations resulted in an expansion of cocoa (from 146 t to 18,384 t) and plantain production (from 3,087 t to 187,061 t) at the expense of logging in the CFHS, 16,388 and 3,844 m3 respectively in 2000 and 2019. In addition, there was a loss of about 57% of the expected income from the sale of timber and a 15,912% increase in profits from the sale of agricultural products in 2019 compared to 2000. In such circumstances, it is recommended to implement a sustainable cropping system that will integrate timber production and agricultural production within the same area. Key words: Ecosystem service, timber, cocoa production, plantain, anthropogenic pressure, Côte-d’Ivoire, West Africa.

In Cote d'Ivoire, the political-military crisis from 2002 to 2011 caused an intensification of human pressure on certain protected areas. This increased pressure has led to significant deforestation in the Mont Peko national Park. However, the impact of disturbances on the forest cover structure of this park is little known. The purpose of this study was to document the impact of the crisis on the fragmentation of the forest cover of Mont Peko national Park in order to contribute to its rehabilitation. Thus, the structural dynamics of the landscape were analyzed using metrics of landscape ecology derived from four thematic digital maps from Landsat satellite imagery, throughout the periods before, during and after the crisis. Analysis of landscape spatial transformation processes between 1988 and 2016 showed a growing trend in forest cover fragmentation. Statistics on selected landscape metrics were produced to quantify the structural changes resulting from this fragmentation. Analysis of landscape metrics showed a significant increase in the level of fragmentation of forest cover during and after the period of crisis. The overall structural dynamics of the landscape of the Mont Peko national Park during the periods studied reveals a fragmentation of the forest at the expense of the creation of cocoa plantations. There is therefore an urgent need to strengthen the supervisory capacity of managers in order to eradicate the scourge of cocoa cultivation in the Mont Peko national Park.

In Côte d'Ivoire, the political-military crisis from 2002 to 2011 caused an intensification of human pressure on certain protected areas. This increased pressure has led to significant deforestation in the Mont Péko national Park. However, the impact of disturbances on the forest cover structure of this park is little known. The purpose of this study was to document the impact of the crisis on the fragmentation of the forest cover of Mont Péko national Park in order to contribute to its rehabilitation. Thus, the structural dynamics of the landscape were analyzed using metrics of landscape ecology derived from four thematic digital maps from Landsat satellite imagery, throughout the periods before, during and after the crisis. Analysis of landscape spatial transformation processes between 1988 and 2016 showed a growing trend in forest cover fragmentation. Statistics on selected landscape metrics were produced to quantify the structural changes resulting from this fragmentation. Analysis of landscape metrics showed a significant increase in the level of fragmentation of forest cover during and after the period of crisis. The overall structural dynamics of the landscape of the Mont Péko national Park during the periods studied reveals a fragmentation of the forest at the expense of the creation of cocoa plantations. There is therefore an urgent need to strengthen the supervisory capacity of managers in order to eradicate the scourge of cocoa cultivation in the Mont Péko national Park.

Over the last decade, cashew tree cultivation has grown significantly in the sub-prefecture of Séguéla (northwestern Côte d'Ivoire) to the point where it has become the main cash crop. The objective of this study is to analyze the spatio-temporal dynamics of the landscape of this region under the impetus of the expansion of cashew cultivation. To achieve this goal, land use maps were generated from the digital processing of four Landsat satellite images (2001, 2006, 2013 and 2018). Subsequently, the evolution rates and spatial structure indices of the plantation were then used to analyze its spatial dynamics in the district's landscape. The study shows that between 2001 and 2018, the composition and structure of the landscape of the Séguéla sub-prefecture experienced significant changes with regard to cashew nut cultivation. At the spatial level, the creation process for new, larger plantations has been identified. In fact, a very limited number of cashew orchards in 2001 with only 83 plantations increased to 1290 in 2018. The total area of cashew tree plantations has also increased by more than 7000% to 4,678.5 ha in 2018. Such gain in the cashew nut sector is at the expense of food crops, raising concerns about food insecurity and land conflicts in this rural area in the long term.

A la faveur de la culture de l’anacarde, savanes et forêts des zones Nord de la Côte d’Ivoire sont transformées en de vastes vergers d’anacardiers. Ces travaux visent à analyser les modifications du paysage dans les espaces ruraux au Sud-Ouest du Parc National de Comoé (PNC), patrimoine mondial de l’Unesco. De façon spécifique, il s’est agi de : (i) cartographier à partir de trois images satellitaires Landsat acquises respectivement les 29/01/2002, 02/12/2006 et 23/02/2014, l’occupation du sol des espaces ruraux au Sud-Ouest du parc national de Comoé et de (ii) suivre la dynamique des différents types d’occupation du sol de 2002 à 2014. Les résultats ont révélé que les surfaces occupées par la culture de l’anacarde dans la zone couverte par cette étude sont passées de 11 743 hectares en 2002 à 29 872 hectares en 2014 (soit plus de 160%), tandis que les surfaces des forêts (galeries forestières et forêts denses sèches) ont fortement régressé et sont passées de 26 242 hectares en 2002 à 6 133 hectares en 2014 (soit -76%). Si la dynamique actuelle du paysage se poursuit, le PNC risque à moyen terme d’être objet de convoitise par les populations rurales, ce qui fragiliserait sa préservation et sa conservation.© 2019 International Formulae Group. All rights reservedMots clés: Végétation, Culture de l’anacarde, Télédétection, Cartographie, Dynamique du paysage, Côte d’IvoireEnglish Title: Reach of cashew fields on forests and savannas in a rural environment around the National Park of ComoéEnglish AbstractOwing to the cultivation of cashew nuts, savannas and forests in the northern parts of Côte d'Ivoire are transformed into vast orchards of cashew trees. This work aims to analyze landscape changes in the rural areas in the South-West of the Comoé National Park (CNP) which is known as Unesco World Heritage. Specifically, it consisted of: (i) mapping from three Landsat satellite images acquired respectively on 2002/01/29, 2006/12/02 and 2014/02/23, the land use of the South-West of Comoé National Park, and (ii) monitor the dynamics of different types of land use from 2002 to 2014. The results revealed that the areas covered by the cashew crop in the study zone increased from 11,743 hectares in 2002 to 29,872 hectares in 2014 (ie more than 160%), while forest areas (galleries forest and dry dense forests) declined sharply from 26,242 hectares in 2002 to 6,133 hectares in 2014 (ie -76%). If the current dynamics of the landscape continues, the CNP could be coveted by the rural populations, in the medium term, so that would weaken its preservation and conservation.© 2019 International Formulae Group. All rights reservedKeywords: Vegetation, Cashew crop, Remote sensing, Cartography, Landscape Dynamics, Côte d’Ivoire