clove and Hemorrhage

Topics: Adolescent; Adult; Domestic Violence; Female; Hematoma; Hemorrhage; Humans; Madagascar; Male; Middle Aged; Prevalence; Public Health; Risk Factors; Socioeconomic Factors; Spouse Abuse; Young Adult

Prehospital care in developing countries is severely lacking. Few countries can afford the relatively expensive formalised Western model of a prehospital emergency medical system. The WHO has highlighted the development of layperson first responder programmes as the most basic step in the development of a functioning prehospital system.. To describe the first training programme of its kind, run in Mahajanga, Madagascar. The faculty was invited by Mahajanga Medical School.. Local input was taken into account in developing the curriculum. 26 taxi drivers were invited to attend in cooperation with the local municipality. The faculty consisted of five instructors from the Division of Emergency Medicine and EMSSA, plus local doctors from University Hospital Mahajanga. The 1-day course included workshops on prehospital scene management, bleeding and broken bones, immobilisation and patient movement, and labour and delivery. The workshops made use of commonly available items only including packets, string and towels; French and Malagasy translators were available throughout.. Both faculty and candidates deemed the course a success and plans for formal evaluation of knowledge and skill retention are underway. Future plans are to continue the training using local instructors and in rural districts.

Topics: Automobile Driving; Delivery, Obstetric; Emergency Medical Services; Emergency Treatment; First Aid; Health Education; Hemorrhage; Humans; Immobilization; Madagascar; Moving and Lifting Patients; Wounds and Injuries

The authors describe clinical and epidemiologic characteristics of severe presentations of Rift valley fever (RVF) during the 2008 epidemic in Madagascar.. The diagnosis was confirmed by RVF virus polymerase chain reaction (PCR), or detection of specifics antibodies by Elisa.. Sixteen cases of severe RVF were recorded. The sex-ratio was 7/1 and median age was 32 years (20/59 years). The risk factors of infection were: contact with infected animals or their meat (n=8), and travelling to a risk area (n=2). Hemorrhagic, neurological, and ocular manifestations were observed respectively in 87.5%, 43.8% and 6.3% of cases. All patients who died (n=4) presented with a hemorrhagic form of the disease.. The hemorrhagic form was the most frequent presentation of RVF and was responsible for a high level of mortality. Epidemiologic surveillance must be implemented.

Topics: Adult; Animal Husbandry; Animals; Antibodies, Viral; Cattle; Cattle Diseases; Disease Outbreaks; Female; Food Contamination; Hemorrhage; Humans; Insect Vectors; Madagascar; Male; Meat; Meningoencephalitis; Middle Aged; Occupational Diseases; Population Surveillance; Retinitis; Rift Valley Fever; Rift Valley fever virus; Risk Factors; RNA, Viral; Travel; Young Adult; Zoonoses

Topics: Acute Disease; Adolescent; Adult; Aged; Child; Child, Preschool; Conjunctivitis; Disease Outbreaks; Female; Hemorrhage; Humans; Madagascar; Male; Middle Aged