Objectives: To assess vitamin A supplementation (VAS) coverage of children aged 6 -59 months and the factors that favour or limit this coverage during the National Nutrition Weeks in Mali. Design: Cross-sectional study. Interviews about demographic factors and children's adherence to the vitamin A capsule distribution programme were conducted. Professionals' knowledge of vitamin A and various aspects related to the supplementation strategy were assessed. Setting: Five regions out of the eight regions in the country, in addition to Bamako District. Three rural communes were selected in three regions to represent rural areas. Subjects: Parents or caregivers of children under 5 years of age, health agents who participated in the weeks, and community and administrative leaders. Results: At least 80% of the children received the supplement. More 'traditional' communication channels (town criers, friends and family members) appeared to be more effective in reaching the target groups than modern methods, i.e. radio and television. Mothers' possession of a radio (Pearson x 2 ¼ 5.03; P ¼ 0.025) and fathers' education (Pearson x 2 ¼ 19.02; P , 0.001), possession of a radio (Pearson x 2 ¼ 8.93; P ¼ 0.003) and listening to it (Pearson x 2 ¼ 7.62; P ¼ 0.006) all appeared to be statistically and significantly associated with children's coverage. In multivariate logistic regression analysis, only the study site (urban/rural) (P ¼ 0.004), 'traditional channels' (P ¼ 0.02) and fathers' education (P ¼ 0.04) were significantly associated with children's coverage. Knowledge about VAS was high among community and administrative leaders, and health professionals. The planning and implementation of activities at the district level were found to be good in general. Conclusion: National Nutrition Weeks provide a successful example of a periodic VAS strategy with high coverage among children aged 6-59 months in Mali. Campaigns aimed at informing and sensitising populations during the Nutrition Weeks should also target children's fathers. Keywords Vitamin A supplementationChild survival National Nutrition Weeks MaliVitamin A repletion was shown to reduce the mortality of children aged 6-59 months by 23-34% in areas where vitamin A deficiency (VAD) is prevalent 1 -4 . In sub-Saharan Africa, it is estimated that 42% of children under 5 years of age are at risk of VAD and that adequately controlling this deficiency can avert over 645 000 child deaths per year in the region . This prevalence is higher than the cut-off point of 5%, indicating that VAD is a public health problem in a population 7 . In order to tackle this situation, Mali developed and applied strategies q The Authors 2007

Résumé -Introduction : Les manifestations buccales de l'infection à VIH sont fréquentes et variées. Elles constituent souvent les premières manifestations cliniques de l'infection à VIH. Objectifs : Les objectifs étaient de déterminer la prévalence des affections buccales, les habitudes d'hygiène bucco-dentaires et de dégager les caractéristiques épidémiocliniques de ces affections chez les PVVIH. Méthodologie : Il s'agissait d'une étude prospective, transversale et descriptive basée sur l'observation des lésions bucco-dentaires chez les PVVIH/sida. Résultats : Sur un total de 72 patients, le sexe féminin était majoritaire (66,7 %) et l'âge moyen était de 40 ans. Le type 1 du VIH a été le plus représenté (97,2 %). L'indice de plaque moyen était compris entre 0,1-0,9 (68,1 %), égale à 0 (22,2 %). Près de 80 % des patients avaient un taux de CD4 en dessous de 500 cellules/mm 3 et 86 % des patients étaient sous antirétroviraux. L'indice CAO/D était de 10,17. La fréquence des affections bucco-dentaires était de 87,5 %. Les lésions de la muqueuse buccale étaient majoritaires (71 %), et dominées par les candidoses (52,8 %). Conclusion : Les affections bucco-dentaires sont fréquentes chez les PVVIH/SIDA. La prise en charge médicale des PVVIH/SIDA doit intégrer l'examen systématique de la cavité buccale. Abstract -Oral manifestations associated with HIV infection in the Infectious

Open tibiofibular fractures resulting from domestic animal bites are exceptional. We report two such cases, in patients of 11 and 13 years of age, and discuss the etiological, pathogenic, anatomic, and clinical aspects of these injuries. These were type III fractures according to the Cauchoix and Duparc classification. The fractures were treated with emergency wound care, wound dressing, and conservative orthopaedic treatment using a long leg cast for immobilization. Preventive parenteral antibiotics were also given. Evolution was favorable in both cases and the patients returned to their normal activities with no substantial disability.

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Noma or cancrum oris is a multi-bacterial and opportunistic infection that destroys soft tissue, as well as muscle and bone, and can be fatal. We present a rare case of Noma in a 32-year-old Malian woman, from whom we isolated an Escherichia coli extended-spectrum beta-lactamase.