Mali - Mysterious disease claims lives in Mondoro, Mopti Region - hypothesis of malnutrition in the community

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https://en.wikipedia.org/wiki/Mopti_Region

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The magazine of August 04, 2018: Mopti, an unknown disease makes 40 dead in Mondoro

Saturday August 4th 2018 15:00

A mysterious disease whose causes remain to be determined is causing casualties in the circle of Douentza, Mopti region. According to local officials, this pathology has already killed more than 40 people in the last three months and many people would be infected. According to them, the disease is manifested by the appearance of pimples on the feet that spread gradually over the rest of the body.
...

https://www.studiotamani.org/index.php/magazines/16546-le-magazine-du-04-aout-2018-region-de-mopti-une-maladie-inconnue-fait-40-morts-a-mondoro

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Mondoro (Mopti): The appearance of a mysterious disease makes about ten victims

Posted on Sunday August 5th, 2018 | Kibaru

For some time now, a mysterious illness has claimed victims in the locality of Mondoro, administratively under the jurisdiction of the Mopti region. For the moment, the causes of this disease, which remains very contagious, remain to be determined.

Already, there are between 10 to 15 deaths from this disease and a dozen other people would suffer. All that is known is that the symptoms of this disease are, among others, heat in the lower limbs, followed by evolutionary oedema from the bottom up. Most often, these symptoms are accompanied by blackening of the skin.

For now, only the NGO M?decins Sans Fronti?res is working to take care of patients. At least three villages in Mondoro commune have seen the onset of this disease. Due to insecurity, the situation of other localities remains unknown. So, at this stage, it's hard to talk about an epidemic. The elected municipal officials hope a visit of a medical mission of the state to determine the real situation.

Recall that edema is the swelling of an organ or tissue due to an accumulation or intratissue excess of liquids in the interstitial medium. Edema may be due to many primitive causes.

http://news.abamako.com/h/194273.html

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Echoes of the North: In Mondoro, an unknown disease causes more than 20 deaths

Editorial staff
Published 5 hours ago Health

For the last few days, in the Mopti Region, Douentza Circle, more precisely in the Rural Municipality of Mondoro, there have been reports of an unknown disease circulating that has already claimed several lives.

According to the NGO Doctors Without Borders, which operates in the area, it is an unusual pathology manifested by a heat in the lower limbs (legs and thighs) followed by swelling with accumulation of fluid and often accompanied by blackening of the skin affected parties. For the moment, the origin of the disease is not known; but, the Ministry of Health and Public Hygiene dispatched a team to the field and analyzes are being conducted to find the cause.

In a press release from the NGO M?decins Sans Fronti?res, it appears that this new pathology appeared in the Rural Municipality of Mondoro, Circle of Douentza, Region of Mopti, reached 204 people including 161 in Douna and 43 in Tiguila with 29 deaths of which 20 in Douna and 9 in Tiguila.

After being informed, M?decins Sans Fronti?res went to the scene on 3 August. According to their Leaders, the team dispatched to the mission was able to provide care to 56 patients who had the symptoms. Among the patients consulted, there are all the sexes and age groups, namely men, women, old people and children.

The mission also announces that two days later, a joint team of the Ministry of Health arrived on the scene by helicopter, to take samples.

As for the agents of M?decins Sans Fronti?res, in their communiqu?, they stress that they will remain on site to continue to treat patients, pending the results of the laboratory tests.

This situation comes at a time when insecurity is raging in the same Region of Mopti where it is prevented health professionals from exercising to respond to the suffering of local populations. According to MSF, due to the phenomenon of insecurity, there are no more medical staff in the Mondoro CSCOM and the supply of drugs is no longer well insured to cope with this disease. Thus, in the interest of all of the Douentza area, they urge the authorities to take steps to give free passage to health personnel and humanitarian vehicles.

Adama A. Haidara: THE COMBAT

http://lecombat.fr/echos-du-nord-a-mondoro-une-maladie-inconnue-fait-plus-de-20-morts/

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Translation Google

Region of Mopti Republic of Mali
Regional Direction A People- A Goal- A Faith
From the health of Mopti

REPORT OF THE CASE INVESTIGATION MISSION
UNUSUAL DISEASE IN HEALTH AREAS OF
DOUNA, NIAGASSADIOU AND TIGUILA
COMMON OF MONDORO, CIRCLE OF DOUENTZA

INTRODUCTION

The Chief Medical Officer of the Douentza Health District addressed the Regional Director
of health a narrative report highlighting cases of unusual diseases
since 15 March 2018 in the health areas of Douna, Niagassadiou and
Tiguila. This disease is manifested by the following signs:
lower limbs, myalgia, functional impotence, dyspnea sometimes followed by
death. This report lists 224 cases of illness, including 161 cases in Douna, 20 to
Niagassadiou and 43 cases in Tiguila with 35 deaths (20 in Douna, 6 in Niagassadiou and
9 at Tiguila). Following this situation, the Regional Directorate of Health dispatched
an investigation mission on August 05, 2018 in the village of Mondoro chef
place of the municipality where some patients could be moved to the center
village because the security situation did not allow the
mission to reach the villages directly concerned. The mission was
organized with the technical support of partners: WHO, UNICEF, OCHA and
logistical and security assistance from MINUSMA and FAMA on site.

This investigation was carried out by a multidisciplinary team composed of:
- the regional health department of Mopti,
- the regional management of social development and solidarity economy of Mopti,
- the Somin? DOLO Hospital in Mopti,
- the reference health center of Douentza,
- WHO.

The team was accompanied by the second deputy mayor of the municipality of
Mondoro. (See the nominative list attached)

I. SITUATIONAL ANALYSIS
- Analysis of the security context:
Since 2012, after the outbreak of armed rebellion in northern Mali; the
security has never been fully found in the town of Mondoro. The
mayor of that commune was assassinated in front of his home in Douentza on 28
January 2017. Since that date, no authority can visit this
common and all technical service agents have fallen back into the city
Douentza because of growing insecurity.

The intercommunal conflict between Dogons and Fulani has contributed to aggravate
this already existing situation in the municipality having seriously affected all
sectors of socio-economic life.
- Analysis of the socio-economic context:
? In the field of agriculture: Agricultural productions are
usually insufficient and do not cover the nutritional needs of the
populations. This situation is exacerbated by insecurity which
populations to access their fields to cultivate. Cereal stocks are
exhausted and people do not have the opportunity to stock up on food
food.
? In the field of animal husbandry: pastoralists have left the municipality because of
removal of animals and inaccessibility to grazing areas because of
insecurity. This led to a lack of livestock products (milk,
meat), which are the main sources of protein for the populations.
? Commercial activity: is also affected by the worsening of
insecurity situation. Weekly fairs are no longer frequented
especially by the populations coming from the villages of Douna, Niagassadiou
and Tiguila. The barter system which consists in exchanging the products of
agriculture against those of livestock no longer works.

The lack of road infrastructure connecting the villages of the commune between
they, the existence of improvised explosive devices and robberies of any kind
make any movement in the area by road dangerous.
In this context, any initiative to assist the population is almost
impossible by the road.

? In the field of health: the municipality has 4 health centers
community in the villages of Mondoro, Niagassadiou, Douna and Tiguila.
Due to the insecurity, the qualified personnel of the CSCom Niagassadiou,
Douna and Tiguila left their posts to withdraw to Douentza and the centers are
held by caregivers.

No health activities can be properly carried out in this commune
because of the insecurity aggravated by the inter-communal conflict.
Humanitarian actors have difficulties in assisting these populations by
the risk of exposure to improvised explosive devices.
So people in the villages of Douna, Niagassadiou and Tiguila
mostly Dogons are cut off from the rest of the world since about Six (6)
month. According to the local authorities (mayors and notables) no movement is
possible outside the villages of these areas because of the presence of
improvised explosives and armed men who are ready to shoot any
someone who is intercepted outside the villages. In a word a blockade was imposed
to these areas by armed men.
...
Arrival on the field the investigation team found on the spot 53 patients coming
villages of Douna and Niagassadiou.

The methodology adopted was to select 10 patients whose condition was judged
serious (3 men, 4 children and 3 women).

Overall, the reasons for consultation were similar for all
sick, namely the swelling of the lower limbs, painful with
lameness.

History of the disease: the onset of the disease would be around 3 to 4 months
towards the beginning of the month of Lent marked by the gradual
alteration of the general condition, swelling of the lower extremities followed
arthralgia and functional impotence without fever.

On-site investigations revealed patients with a condition
altered general condition (anorexia, asthenia, weight loss), with edema
painful lower limbs guarding the scoop, functional impotence,
stomatitis-gingivitis and with conjunctival paleness, signs of
malnutrition ranging from Kwashiorkor to marasmus in children (hair
fine, relaxed, brittle, discolored, sometimes blond). Two children had Tests
Rapid Diagnosis of Malaria positive. Faced with these symptoms,
patients have benefited from symptomatic and specific treatments. Table
was marked in children with sadness, apathy and nervousness.

In the social antecedents, there are difficulties to live
because of insecurity, food shortage in these areas. No notion of
Infectious syndrome has been reported. Episodes of diarrhea have been reported
at some patients.
Some pictures

Reported deaths had similar tables to those described above. At this
224 cases were reported by the community including 35 deaths.

In summary :

Clinical investigations have revealed an edematous syndrome
painful, clinical signs of malnutrition, oral signs of gingivostomatitis,
cutaneous syndrome of malnutrition and signs of irritation in
children without any infectious syndrome.
Actions undertaken on site:
- case management;
- Blood sampling for biological examinations (NFS, VS, protidemia,
complete ionogram, biochemistry etc.);
- Advice provided to the populations (take care of the sick, respect the
individual and collective hygiene measures, nutritional advice)
- Endowment of the Mondoro CSCom in drugs and consumables.

CONCLUSION:

August 05, 2018, following information on the occurrence of an illness
unusual affecting women and children in the villages of Douna,
Niagassadiou and Tiguila, Mondoro Commune, Douentza Health District,
an investigative team was deployed in the field.

The findings observed during this investigation led to
the hypothesis of malnutrition in the community following a shortage
related to the intercommunal conflict in Mondoro commune.
In the face of insufficient supply of living due to insecurity, all
populations in Mondoro commune are at risk of
severe acute malnutrition and its complications due to vitamin B1 deficiency
and live C.
...

https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/assessments/rapport_dinvestigation_mondoro-fv_07-08-2018.pdf

https://www.humanitarianresponse.info/ru/operations/mali/assessment/rapport-de-la-mission-d%E2%80%99investigation-des-cas-de-maladie-inhabituelle

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Sanitary emergency in the rural district of MONDORO, CERCLE de DOUENTZA, MOPTI REGION

BY MALIACTU ? 21/07/2019

From March 15, 2018 to today, residents of the rural town of Mondoro are facing serious health crises that continue to kill children, women, youth and old people.

This disease is manifested by swelling of the upper and lower limbs, reducing the victims to painful paralysis. Also burning wounds appear in the mouth of the victims, while preventing them from drinking or eating.

From March 2018 to December 2018 this disease caused the death of a hundred (100) people in the villages of Douna, Niangassadiou and Tiguila.

The intervention of the members of the doctor without border on 05 August 2018 had found a lull against this mysterious disease.

But in recent times, despite the noble efforts of M?decin Sans Fronti?re, this mysterious disease has resumed more and continues to make victims.

On July 11, 2019, 74 patients reported as emergency cases from the villages of Douna and Niangassadiou were evacuated to the Mondoro CSCOM. Regarding the case of the village of Tiguila, 86 emergency cases were reported, but they did not have access to the Mondoro CSCOM, because the village has been under the control of armed bandits since January 2018.

This morning, July 21, 2019, the local authorities reported to us the death of two people who were under treatment in Mondoro; three days rather two other people who were on treatment lost their lives.

However the disease is proposed in new villages such as Boulkessi, Toikana, Banai, Djoulouna and Mondoro city, chief town of commune. In a word, the whole population of Mondoro commune is in danger of being ravaged if serious precautions are taken.

In conclusion, in order to find a solution to this epidemic, the Executive Board of the Mondoro Development Association has sent a four-fold request for a hearing to the Prime Minister and the Minister of Health and Public Hygiene. which remained without result. The last request for a hearing addressed to the Ministry of Health dates from June 12, 2019.

Diaka Sanogo

(Information provided by Oumar Ongo?ba, Segal of the Mondoro Youth Development Association (AJDM)

http://maliactu.info/societe/urgence-sanitaire-dans-la-commune-rurale-de-mondoro-cercle-de-douentza-region-de-mopti