Digestive Surgical Emergencies at Analankininina Toamasina Madagascar University Hospital during the Covid-19 Pandemic

During the period of total containment during the Covid-19 pandemic; our department became the sole treatment center for all surgical emergencies. The influx of many patients made the task very difficult for the surgeon. This is a 3-month descriptive prospective study in the visceral surgery department at the Analankininina Toamasina University Hospital Center. Of the 81 patients hospitalized during the study, 32 patients were admitted for digestive surgery emergency, i.e. 39.50%. The mean age was 34.87 years with a sex ratio of 1.66, predominantly male. Abdominal pain occupied 43.75% of the reason for consultation, the most frequent pathologies were acute intestinal obstruction (18.75%) and acute appendicitis (18.75%). An exploratory laparotomy is performed on 40.62% of patients. Many patients were operated on for proctologic emergency (18.75%). The average length of hospitalization is 4.18 days. The visceral emergencies are present despite the presence of the Covid-19 pandemic and the activities of the health personnel are uninterrupted.

The Prevalence of Malaria and Assessment of the Uptake of Malaria Prevention Measures in Blood Donors in Two Regional Blood Transfusion Centres in Kenya

Transfusion transmitted malaria is one of the most common transfusion transmissible infections and is a threat to blood safety and malaria control in Sub-Saharan African countries where malaria is endemic. The majority of healthy adults living in malaria endemic areas have some degree of immunity to the disease and an asymptomatic low-level parasitaemia is known to exist in a subset of this population. Blood donors recruited from the population are screened using a donor-selection criteria that includes age, weight, self-declared well-being and measurement of vital signs but not history of recent malaria infection or treatment. The Kenya National Blood Transfusion Services does not currently screen donated blood for malaria, opting instead for prophylactic anti-malarial use. This policy is inconsistent with the current WHO guidelines for the prevention of transfusion transmitted malaria, and the national policy guiding malaria treatment which states that antimalarial use is reserved for laboratory confirmed cases. A cross-sectional survey was conducted at two regional blood transfusion centres of differential malarial endemicity to determine the prevalence of malaria in blood donors. Of the 1,100 donors who participated in this study, five donors tested positive for malaria antigen, 3 from the Mombasa RBTC and 2 from the Nairobi RBTC giving an overall prevalence of 0.5% malaria antigen positivity. Only one peripheral blood film examined was positive for malaria yielding a total prevalence of 0.1% slide positivity. The prevalence of malaria in blood donors does not justify the routine use of prophylactic anti-malarias with each transfusion and a blood donor malaria screening algorithm as an alternative to malaria prophylaxis in the prevention of transfusion transmitted malaria should be developed and implemented.