Suchergebnisse

Maternal and fetal complications represent a public health problem. The aim of this study is to identify the effects of prenatal consultation (PNC) in pregnant women to the maternal and fetal complications of deliveries in Military hospital of Soavinandriana (CENHOSOA). This is an analytical study using "Historical Cohort" comparing two groups of population, one group have done PNC or "PNC+" and the other group without PNC or "PNC-".The study was conducted in the CENHOSOA over a period of 13 months from 01 May 2012 to May 31, 2013. During the study period, we have include 296 (23.2%) belonged to the group of PNC- and 982 (76.8%) to the PNC+. The proportion of term birth is lower in PNC- than PNC+ (80.4% versus 93.3%, p<10-6). The cesarean section was high in the PNC- group in comparison with the "PNC+" (32.1% versus 24.1% p<10-2). Group of PNC- have a relative risk RR = 6.64, 95% CI [1.22 – 36.05] of dyspnea. Infections and phlebitis are non significant in the two groups. Concerning fetal complication, PNC- group had RR=1.99, 95% CI [1.13 – 3.52] to have APGAR score<7 and RR=2.65, 95% CI [1.58 – 4.47] of weight <2,000mg. Concerning complications conducting in deaths, mother with PNC- had RR=3.32, 95% CI [0.21 – 52.88] of maternal death and newborns had RR=2.65, 95% CI [0.72 – 9.82] to intrauterine fetal death. In brief, maternal and fetal complications have been more frequent among women who have not had PNC. The state should promote the practice of adequate and well-conducted PNC for the good of the mother and the baby.

BACKGROUND: In 1988, the World Health Assembly launched the Global Polio Eradication Initiative. WHO AFRO is close to achieve this goal with the last wild poliovirus detected in 2014 in Borno States in Nigeria. The certification of the WHO African Region requires that all the 47 member states meet the critical indicators for a polio free status. Madagascar started implementing polio eradication activities in 1996 and was declared polio free in June 2018 in Abuja. This study describes the progress achieved towards polio eradication activities in Madagascar from 1977-2017 and highlights the remaining challenges to be addressed. METHODS: Data were collected from the national routine immunization services, Country Acute Flaccid surveillance databases and national reports of SIAS and Mop Up campaign. Country complete polio and immunization related documentation provided detailed historical information's. RESULTS: From 1997 to 2017, Madagascar reported one wild poliovirus (WPV) outbreak and four circulating Vaccine Derived Polio Virus (cVDPV) oubreaks with a total of 21 polioviruses (1 WPV and 21 cVDPV). The last WPV and cVDPV were notified in 1997 in Antananarivo and 2015 in Sakaraha health districts respectively. Madagascar met the main polio surveillance indicators over the last ten years and made significant progress following the last cVDPV2 outbreak in 2014 -2015. In addition, the country successfully implemented the switch from trivalent Oral Polio Vaccine (tOPV) to bivalent Oral Polio vaccine (bOPV) and containment activities. Environmental Surveillance established since 2015 did not reveal any poliovirus. The administrative coverage of the 3rd dose of oral polio vaccine (OPV3) varied across the years from 55% in 1991 to a maximum of 95% in 2007 before a progressive decrease to 86% in 2017. The percentage of AFP cases with more than 3 doses of oral polio vaccines increased from 56% in 2014 to 88% in 2017. A total of 19 supplementary immunization activities (SIA) were conducted in Madagascar from 1997 to 2017, ...