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The authors examined mortality during road traffic accidents (RTAs) to propose solutions for their prevention. This descriptive prospective study took place over a 12-month period (June 1, 2011, to May 30, 2012) and included all fatalities from RTAs brought to selected hospitals. These RTA fatalities were studied in the morgues and selected sites. An autopsy was conducted for each victim to clarify the cause of death. An injury severity score (ISS) was also calculated for each victim. The data were analyzed with Epi-Info 2008. The study included 1283 victims of RTAs, 217 of whom died, for a lethality rate of 16.9%. Among the deceased, 116 died before reaching the hospital, for a prehospital lethality rate of 53.5%. The 101 remaining victims died in hospital, 68 of them in the emergency department before admission. Head trauma accounted for the largest proportion of deaths (57.6%), followed by the polytrauma (25.7%). Passengers in cargo trucks (39.3%) and motorcyclists (13.9%) were the most exposed to fatal accidents. For an ISS > 25, the mortality rate was 41.7%, and for an ISS > 40, 100%. Based on the ISS, most of these deaths could have been avoided. The urgent establishment of a public transportation system, improvement of transportation of RTA victims to hospitals, and an effective healthcare system could reduce this high mortality rate.

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Encouraging responsible sexual behavior has become an important issue in recent years mainly due to the worldwide human immunodeficiency virus (HIV) epidemic and to the high number of unwanted pregnancies that often end in high-risk abortions. Young people and in particular students in higher education are high-risk groups for both unwanted pregnancy and HIV. The purpose of this report is to describe the findings of a month-long survey conducted among students at the University of Bangui (UB) in 1998-1999. Individual students were asked to give immediate responses to semi-open questions. The Chi test was used to assess correlation between a number of variables. A total of 422 UB students including 218 males (51.7%) and 204 females (483%) were included in the survey. Mean age was 24.9 years for females and 26.1 years for males. Over half of the students of both sexes reported having their first sexual relation between the ages of 15 and 19 years. Males were more satisfied by their first experience than females. The percent of married students (male or female) was 5.9%. Most students (62.1%) had at least 2 sex partners and 58.3% had at least one child. The preferred contraceptive method was condom use for males and the Ogino technique for females. The percent of female students expressing fear of HIV infection was 27.4%. The results of this study show that information and education campaigns are needed to encourage UB students to practice sexual behavior to avoid both unwanted pregnancies and sexually transmitted diseases such as HIV infection.

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Encouraging re s p o n s i ble sexual behavior has become an important issue in recent ye a rs mainly due to the world-wide human immu n o d e fi c i e n cy virus (HIV) epidemic and to the high number of unwanted pregnancies that often end in highrisk abortions. Young people and in particular students in higher education are high-risk groups for both unwanted preg nancyand HIV. The purpose of this report is to describe the findings of a month-long survey conducted among students at the University of Bangui (UB) in 1998-1999. Individual students we re asked to give immediate responses to semi-open questions. The Chitest was used to assess corre l ation between a number of vari ables. A total of 422 UB students including 218 males (51.7) and 204females (48.3) were included in the survey. Mean age was 24.9 years for females and 26.1 years for males. Over half of the students of both sexes reported having their first sexual relation between the ages of 15 and 19 years. Males were more satisfied by their fi rst ex p e rience than females. The percent of married students (male or female) was 5.9. Most students (62.1) had at least 2 sex partners and 58.3had at least one child. The preferred contraceptive method was condom use for males and the Ogino technique for females. The percent of female students expressing fear of HIV infection was 27.4. The results of this study show that information and education campaigns are needed to encourage UB students to practice sexual behavior to avoid both unwanted pregnancies and sexually transmitted diseases such as HIV infection

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Although now uncommon in developed countries, uterine rupture is among the major obstetrical emergencies dealt on a daily bases in the maternity ward of the Bangui Community Hospital in Central African Republic, which is the national reference facility. Uterine rupture is life-threatening for both the fetus and mother. In view of the relatively high rate of rupture observed in our department in previous years, this cross-sectional study was undertaken in order to determine incidence, identify predisposing factors, evaluate prognosis for the mother and newborn, and propose solutions. From January 1997 to December 1997, all deliveries by the vaginal route or cesarean section including cases involving uterine rupture were recorded. The length of time elapsed between the decision to perform cesarean section and actual performance of the procedure was determined. Risk factors associated with uterine rupture in our department were noted. The outcome of uterine rupture was evaluated in both the mother and fetus. Of a total of 5763 deliveries during the study period, 299 required cesarean section (5.9%). Uterine rupture occurred in 35 cases of the 299 women (11.7%). In 10 cases of uterine rupture, the time lapse for performance of cesarean section was at least 2 hours. The main cause of delay was the lack of funding for cesarean section. Six women died due to irreversible shock (0.1% of deliveries, 2% of cesarean sections and 17.1% of uterine ruptures). The perinatal mortality rate was 80%. In our department, uterine rupture is a common emergency causing high mortality in mothers and newborns. Most of these patients could have been saved.

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This 9-month longitudinal study was carried out in a cohort of 287 women hospitalized for various obstetrical reasons in Bouar, the third largest city in Central Africa. A total of 225 of these women gave birth to 229 children. The purpose of study was to evaluate attendance at prenatal examinations, risk factors for obstetrical morbidity, and maternal and neonatal prognosis. Results showed an overall absence rate at scheduled examinations of 38 p. 100. Only 8.4 p. 100 of women enrolled for prenatal care complied fully with the examination schedule. The factors associated poor attendance were age older than 19 years, distance greater than 5 kilometers between the woman's home and care facility, and illiteracy. The incidence of complicated pregnancy was significantly higher in refractory women. Reported complications included eclampsia, extrauterine pregnancy, and death of the mother. A total of 43.5 p. 100 of home deliveries involved women that did not attend prenatal care clinics. A total of 23.1 p. 100 of newborns without prenatal care presented complications requiring intensive neonatal care with an Apgar score below 7. Overall the perinatal death rate was 12.7 p. 100 (n = 29). The stillbirth rate was 10.1 p. 100 (n = 16). The findings of this study demonstrate the favorable impact of prenatal care on pregnancy outcome for both mother and child. Prenatal care should be made available to all pregnant women.

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During a study carried out over twelve months in the National Reference Center for Gynecology and Obstetrics at Bangui Hospital, we recorded 1,369 cases of evacuation in a total 5,020 admissions to the department. This corresponds to a frequency of 27.3%. In 73.8% of cases, this intervention was performed for obstetric reasons. It was justified in 73.1% of cases, and 96.5% of the justified interventions were for obstetric reasons. The unjustified interventions led to a normal delivery in 97% of cases. Errors in diagnosis were detected in 16.5% of the cases. In terms of prognosis, we recorded 91 deaths in the perinatal period (96 per thousand live births) and 37 maternal deaths (of the 39 recorded in the department), accounting for 94.9% of all maternal deaths, with a mortality rate of 2.7% for women undergoing uterine evacuation. Infant mortality was higher in cases of late intervention. The most frequent causes of death of the mothers were hemorrhagia on delivery, severe infection, rupture of the uterus and the tearing of soft tissues.

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We report the first observation of subcutaneous phycomycosis with isolation of the strain in Central African Republic and the efficiency of fluconazole therapy.

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