Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention.

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BackgroundDigital health interventions (DHIs) have increased exponentially all over the world. Furthermore, the interest in the sustainability of digital health interventions is growing significantly. However, a systematic synthesis of digital health intervention sustainability challenges is lacking. This systematic review aimed to identify the barriers and facilitators for the sustainability of digital health intervention in low and middle-income countries.MethodsThree electronic databases (PubMed, Embase and Web of Science) were searched. Two independent reviewers selected eligible publications based on inclusion and exclusion criteria. Data were extracted and quality assessed by four team members. Qualitative, quantitative or mixed studies conducted in low and middle-income countries and published from January 2000 to May 2022 were included.ResultsThe sustainability of digital health interventions is very complex and multidimensional. Successful sustainability of digital health interventions depends on interdependent complex factors that influence the implementation and scale-up level in the short, middle and long term. Barriers identified among others are associated with infrastructure, equipment, internet, electricity and the DHIs. As for the facilitators, they are more focused on the strong commitment and involvement of relevant stakeholders: Government, institutional, sectoral, stakeholders' support, collaborative networks with implementing partners, improved satisfaction, convenience, privacy, confidentiality and trust in clients, experience and confidence in using the system, motivation and competence of staff. All stakeholders play an essential role in the process of sustainability. Digital technology can have long term impacts on health workers, patients, and the health system, by improving data management for decision-making, the standard of healthcare service delivery and boosting attendance at health facilities and using services. Therefore, management changes with effective monitoring and evaluation before, during, and after DHIs are essential.ConclusionThe sustainability of digital health interventions is crucial to maintain good quality healthcare, especially in low and middle-income countries. Considering potential barriers and facilitators for the sustainability of digital health interventions should inform all stakeholders, from their planning until their scaling up. Besides, it would be appropriate at the health facilities level to consolidate facilitators and efficiently manage barriers with the participation of all stakeholders.

Dans la vallée du Sourou, des enquêtes parasitologiques portant sur la prévalence des parasitoses intestinales ont été menées entre 2000 et 2002 dans les villages traditionnels de Wèrè, Toma-île, Yayo, Touroukoro, Di, Oué et Sono situés respectivement sur le cours d’eau et au bord du lac pour les cinq premiers, et à une dixaine de kilomètres pour les deux derniers. Les enquêtes ont également concerné les sites aménagés de Débé, Guiédougou et Niassan. Afin de déterminer la prévalence et l’intensité des parasitoses intestinales dans les villages concernés, les selles de 1142 enfants âgés de 0 à 16 ans ont été examinées.Les résultats ont globalement mis en évidence une prévalence générale des parasitoses intestinales de 46,5% dans la zone d’étude et des prévalences de 20,9% pour Schistosoma mansoni, 10,6% pour Entamoeba hystolytica (kystes d’amibes), 10,2% pour Hymenolepis nana (ténia), 1,65% pour Necator americanus (ankylostomes), 1,1% pour Giardia intestinalis (kystes) et Strongyloïdes stercolaris (anguilules). D’autres parasites intestinaux (Ascaris lumbricoïdes, , Trichuris trichiura) sont également présents mais à des taux de prévalence faibles. Les résultats ont surtout mis en évidence une grande disparité des prévalences en fonction du site. Les villages situés dans les zones inondables ou en bordure et plus spécifiquement ceux situés sur le cours d’eau présentent les plus fortes prévalences (77,1%, 60,2%, 50%, 48,4%, et 45,7%) et pour Schistosoma mansoni (53,7%, 54,1%, 43,3%, 22,1%, et 22,5%) respectivement à Toma-île, Wèrè, Touroukoro,  Yayo et Di) comparativement à ceux situés à une dixaine de kilomètres du lac (0% à Oué et Sono pour Schistosoma mansoni). Les données observées incitent à mettre en œuvre un programme d’éradication et de contrôle des parasitoses intestinales dans la zone du complexe hydroagricole du Sourou.

In low income countries, severe acute malnutrition remains a major problem for HIV-infected children and an important risk factor for mortality. This study aims to analyze HIV impact on mortality rate and nutritional recovery among severely malnourished HIV/AIDS uninfected and infected children. This was a retrospective cohort study conducted from data of 521 hospitalized severely malnourished children. We used Pearson's Chi square test to compare proportions; and Student's independent t-test to compare means; general linear model to analyze repeated measurements. We used mortality relative risk with confidence interval (CI 95%), Kaplan-Meir survival curves and Cox proportional hazard models to analyze the HIV impact on mortality rate. Case fatality rate differed significantly from SAM HIV uninfected (10.7%) and HIV infected children (39.7%), p < 0.001. Mortality relative risk was 3.71, 95% IC [2.51-5.47] for HIV infected children. Kaplan-Meir survival curves differed significantly between the two groups, (p Log Rank < 0.001). Cox regression adjusted mortality relative risk of HIV infected children was 4.27, CI: 2.55-7.15, p < 0.001. Mean weight gain differed significantly among infected children, p < 0.001. Anthropometric Z-scores means evolution differed significantly between HIV infected and uninfected children and within each group's subjects for WHZ (p < 0.001) and WAZ (p < 0.001). Mortality relative risk was 3.71 times higher for HIV infected children. Multiples infections and metabolic complications have synergism on death occurrence in sever acute malnutrition; when associated to HIV infection, case fatality rate increases many times. Weight gain and anthropometrics index evolution were very slow for SAM HIV infected children, and specific diet may be needed for more nutritional recovery. Effective interventions, updated and adapting to local country context, to improve survival of severely malnourished HIV/AIDS infected children in HIV and SAM prevalent settings are urgently needed in the area of SAM's community-based treatment approach.