Le but de cette étude est de connaître les mécanismes géochimiques qui gouvernent la migration verticale des métaux lourds et évaluer le risque de contamination de la nappe du Continental Terminal par ces métaux issus de la décharge d'Akouédo. Les analyses chimiques de 56 échantillons de sol ont montré que le sol de la décharge d'Akouédo est riche en Cu (20-369,7 ppm), Fe (850-12500 ppm), Zn (18,6-1163,7 ppm), Pb (10,3-1450 ppm), Cd (1-11,5 ppm) et Cr (27,7-125 ppm). L'adsorption, principal mécanisme géochimique dans le sol, permet la rétention de la plupart des métaux (Cu, Fe, Zn, Pb, Cd) sur la matière organique (NTK et Corg) abondante dans les couches superficielles et sur les couches argileuses. Le chrome est peu adsorbé et migre de ce fait plus facilement vers les couches profondes. Le chrome est donc capable d'atteindre facilement la nappe et provoquer une contamination de celle-ci.

Background Data in the literature on acute coronary syndrome in sub‐Saharan Africa are scarce. Methods and Results We conducted a systematic review of the MEDLINE (PubMed) database of observational studies of acute coronary syndrome in sub‐Saharan Africa from January 1, 2010 to June 30, 2020. Acute coronary syndrome was defined according to current definitions. Abstracts and then the full texts of the selected articles were independently screened by 2 blinded investigators. This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses standards. We identified 784 articles with our research strategy, and 27 were taken into account for the final analysis. Ten studies report a prevalence of acute coronary syndrome among patients admitted for cardiovascular disease ranging from 0.21% to 22.3%. Patients were younger, with a minimum age of 52 years in South Africa and Djibouti. There was a significant male predominance. Hypertension was the main risk factor (50%–55% of cases). Time to admission tended to be long, with the longest times in Tanzania (6.6 days) and Burkina Faso (4.3 days). Very few patients were admitted by medicalized transport, particularly in Côte d'Ivoire (only 34% including 8% by emergency medical service). The clinical presentation is dominated by ST–elevation sudden cardiac arrest. Percutaneous coronary intervention is not widely available but was performed in South Africa, Kenya, Côte d'Ivoire, Sudan, and Mauritania. Fibrinolysis was the most accessible means of revascularization, with streptokinase as the molecule of choice. Hospital mortality was highly variable between 1.2% and 24.5% depending on the study populations and the revascularization procedures performed. Mortality at follow‐up varied from 7.8% to 43.3%. Some studies identified factors predictive of mortality. Conclusions The significant disparities in our results underscore the need for a multicenter registry for acute coronary syndrome in sub‐Saharan Africa in order to develop consensus‐based strategies, propose and evaluate tailored interventions, and identify prognostic factors.

BackgroundMajor in-hospital mortality rate in patients with ST-segment Elevation Myocardial Infarction (STEMI) in Sub-Saharan Africa has been reported. Data on follow-up in these patients with STEMI are scarce. We aimed to assess medium and long-term prognosis in patients with STEMI admitted to Abidjan Heart Institute.MethodsProspective cohort study including 260 patients admitted for STEMI to Abidjan Heart Institute, from January 1, 2012 to December 31, 2015. We compared mortality and nonfatal cardiovascular complications in revascularized and non-revascularized groups. Survival curve was generated with the Kaplan-Meier method. Predictors of mortality after STEMI were determined by multivariable Cox regression.ResultsOf the 260 patients followed up on a median period of 39 months [28–68 months], 94 patients (36.1%) were revascularized and 166 (63.8%) were non-revascularized. Crude all-cause mortality was 10.4%. It was significantly higher in non-revascularized patients (p = 0.04). There was no difference in the occurrence of nonfatal cardiovascular complications in the 2 groups. In multivariable Cox regression, age ≥ 70 years, female gender and heart failure were the predictive factors for death after adjustment.ConclusionsSTEMI remains an important cause of mortality in our practice. Healthcare policies should be developed to improve patient care and long-term outcomes.

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