Guirou N, Thera JP, Abba KY
… +4 more, Dougnon A, Traoré L, Bamani S, Traoré J
Med Sante Trop
· 2018 Nov · PMID 30499448
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INTRODUCTION: Among the 1.4 million blind children in the world, 300,000 live in Africa. The causes of blindness vary from one country to another. The purpose of our study was to report the causes of childhood blindness...INTRODUCTION: Among the 1.4 million blind children in the world, 300,000 live in Africa. The causes of blindness vary from one country to another. The purpose of our study was to report the causes of childhood blindness and visual impairment in children attending the only school for the blind in Mali (National Institute for the Blind in Mali, INAM). MATERIALS AND METHODS: All children attending the INAM were examined. Blindness was defined as visual acuity less than 3/60 (20/400 or 0.05). Visual impairment was moderate when the visual acuity was less than 6/18 (20/70 or 0.30), but greater than or equal to 6/60 (20/200 or 0.1), and severe when visual acuity was less than 6/60 (20/200 or 0.1), but greater than or equal to 3/60 (20/400 or 0.05). RESULTS: The study included a total of 104 children. The average age of our patients was 12 years with a M/F sex-ratio of 1.12. In all, 85.6 % of the children were blind and 14.4 % visually impaired. The main causes of blindness were corneal opacities (26 %), and whole globe lesions and conditions (19.2 %). Ametropia accounted for 60 % of visual impairment. DISCUSSION: According to WHO, corneal and retinal damage are the leading cause of blindness (50.6 %) in children. In our series, corneal diseases were the leading cause, following by damage to the whole globe. CONCLUSION: The results of our study indicate that avoidable and treatable causes of childhood blindness are the leading causes of blindness of children at INAM.
Kabamba Ngombe L, Nlandu Ngatu R, Nyembo Mukena C
… +5 more, Kabyla Ilunga B, Wembonyama Okitotsho S, Kakoma Sakatolo JB, Luboya Numbi O, Danuser B
Med Sante Trop
· 2018 Nov · PMID 30499446
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Silicosis is one of the most prevalent occupational lung diseases and a public health problem throughout the world. Underground miners of copper and cobalt are exposed to the dust of these minerals and thus to the risk o...Silicosis is one of the most prevalent occupational lung diseases and a public health problem throughout the world. Underground miners of copper and cobalt are exposed to the dust of these minerals and thus to the risk of developing silicosis. The objective of this report was to describe a series of silicosis cases in miners exposed to mineral dusts at a mining company operating since the colonial era in Lubumbashi, Katanga province, in the Democratic Republic of the Congo (DRC). This descriptive retrospective study reviewed records at the occupational safety and health department of the mining company mentioned above and included 2500 underground miners who worked there between 1970 and 1995; it collected and analyzed their medical records. Chest radiographs of silicosis patients were classified according to the ILO International Classification of Radiographs of Pneumoconiosis. All miners were males (mean age: 48.5 ±12.5), had low literacy levels, and used no protective device (i.e., mask) against dust. Their mean number of working years in the underground mines was 25.07±7.39 years. Of the 2500 miners, 1.08 % (27/2,500) had developed silicosis. The most common clinical manifestations were dyspnea and cough, and the most prevalent radiologic features large opacities (92.59 %), small opacities (96.27 %), and pleural thickening (25.92 %). The fatality rate was 100 %. This study revealed the absence of safety measures among Congolese underground miners from Lubumbashi, which might have contributed to the development of silicosis in some of them. It is thus necessary to implement occupational safety measures to reduce their risk of silicosis.
Med Sante Trop
· 2018 Nov · PMID 30442632
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Furuncular myiasis is a cutaneous parasitosis that occurs in tropical regions. It is manifested by lesions with the appearance of pustules, because of the presence of the fly larva in the skin. This misleading appearance...Furuncular myiasis is a cutaneous parasitosis that occurs in tropical regions. It is manifested by lesions with the appearance of pustules, because of the presence of the fly larva in the skin. This misleading appearance can delay diagnosis. The extraction of these Cayor worms can be facilitated by the use of a comedo-extractor.
Conan PL, Flateau C, Delattre C
… +4 more, Cremades A, Andriamanantena D, Rapp C, Ficko C
Med Sante Trop
· 2018 Aug · PMID 30270843
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Causes of hypereosinophilia among travelers returning from North Africa are dominated by helminth infections, especially when associated with gastrointestinal signs. Non-infectious causes must nonetheless be investigated...Causes of hypereosinophilia among travelers returning from North Africa are dominated by helminth infections, especially when associated with gastrointestinal signs. Non-infectious causes must nonetheless be investigated after negative microbiological assessment and failure of a broad empiric antiparasite treatment. We report the case of a young man with epigastralgia and major weight loss since a stay in Tunisia. Empiric treatment with albendazole was not successful. Eosinophilic gastroenteritis was diagnosed and resolved under corticosteroid treatment.
Adam S, Sama DH, Mouzou T
… +3 more, Akakpovi A, Tomta K, Bellier M
Med Sante Trop
· 2018 Aug · PMID 30270842
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The management of patients in emergency departments is an important indicator of the quality of a healthcare system. In sub-Saharan Africa, emergency care is characterized by human and material difficulties. The purpose...The management of patients in emergency departments is an important indicator of the quality of a healthcare system. In sub-Saharan Africa, emergency care is characterized by human and material difficulties. The purpose of this work was to assess the difficulties in managing emergencies at the surgical emergency admissions unit of Sylvanus Olympio teaching hospital of Lomé. This descriptive prospective study took place during the last 6 months of 2013. Epidemiological, clinical, and therapeutic data were collected. All admissions for acute conditions requiring urgent care were included. The study excluded patients who died at admission and patients receiving care in the medical emergency department. The study included 2880 patients, 60.3% men; the mean age was 46 years (range: 4 days to 92 years). Traffic accidents accounted for 519 cases (18%). Among patients with trauma, 23.7% had limb injuries and 17.2% head injury. Appendicitis accounted for 32.9% of the non-trauma emergencies, followed by peritonitis (27.3%), burns represented 1%. Laboratory tests were performed for 49.4% of patients, ultrasound for 14.2%, and computed tomography scans for 0.8%. Overall, 44.1% received venous catheterization, 40% volume replacement, 20% oxygen therapy, 16% blood products, 2% pressor amines, and 0.1% intubation. Analgesia was administered to 82%, antibiotic treatment (37%), and sedation to 1%. In all, 34.8% of patients underwent laparotomy, 26.6% trimming with sutures, 21.4% dressing of wounds, and 14.5% immobilization. Time to discharge was less than 24 hours for 82%, and 6.2% were transferred to intensive care. Eighteen patients died (0.6%). Management of surgical emergencies remains a major health problem in developing countries. Prevention measures and accessibility of the population to emergency care will reduce morbidity and mortality for these conditions.
Gnazegbo A, Akani AF, Karidioula HA
… +5 more, Kouamé-Assouan AE, Bony KE, Sylla A, Koffi AT, Traoré A
Med Sante Trop
· 2018 Aug · PMID 30270841
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INTRODUCTION: The incidence of stroke is rising in developing countries. In Côte d'Ivoire, it accounts for nearly 45 % of admissions to the neurology departments in Abidjan. In Bouaké, no study has dealt with this subjec...INTRODUCTION: The incidence of stroke is rising in developing countries. In Côte d'Ivoire, it accounts for nearly 45 % of admissions to the neurology departments in Abidjan. In Bouaké, no study has dealt with this subject since peace returned. Our aim was to assess the epidemiological characteristics of stroke patients at Bouaké University Hospital. METHODOLOGY: This cross-sectional study took place from September 2013 to December 2015 and included all patients hospitalized for a stroke confirmed by brain imaging. RESULTS: The study included 164 cases: 60% ischemic strokes, and 40 % hemorrhagic. Patients' mean age was 62 years with a sex ratio of 0.66. Patients not in the labor force accounted for the largest portion (61.6 %). The interval between the stroke and admission to the neurology department ranged between 24 and 72 hours for 61 % of the patients. The main risk factor was hypertension (62.8 %). The average length of hospitalization was 8.44 days. Hospital mortality was 18.3 %. CONCLUSION: Stroke is responsible for high morbidity and mortality in the neurology department of Bouaké University Hospital.
Houzou P, Fianyo E, Kakpovi K
… +4 more, Koffi-Tessio VS, Tagbor KC, Oniankitan O, Mijiyawa M
Med Sante Trop
· 2018 Aug · PMID 30270840
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To determine the frequency and epidemiological profile of inflammatory arthropathies seen during rheumatologic consultations in Togo. This retrospective study examined the records of patients with inflammatory arthropath...To determine the frequency and epidemiological profile of inflammatory arthropathies seen during rheumatologic consultations in Togo. This retrospective study examined the records of patients with inflammatory arthropathy seen at a rheumatologic consultation at Kara Teaching Hospital (Northern Togo) over a four-year period. Among the 2361 patients with rheumatic disorders, 152 (6.43%) had an inflammatory arthropathy: 57.24% were men and 42.76% women. The main causes observed were: chronic inflammatory rheumatism (CIR) and connective tissue disease (49.34%), infectious arthritis (26.32%), and gout (24.34%). The mean age of the 75 patients with CIR at the onset of the disease was 40 years and the average duration of evolution was 3.11 years. The main clinical forms of CIR were rheumatoid arthritis (11 cases), spondylarthropathies (20 cases within 11 cases of reactive arthritis), connective tissue diseases (4 cases), and unclassified CIR (31 cases). Nine patients with reactive arthritis were HIV positive. The infectious arthritis was caused by a banal germ in 31 cases and by Koch bacillus in nine other cases. Gout patients (35 men and 2 women) had a mean age of 43 years at the onset of the disease, and the mean duration of the disease was 4.1 years. Gout was monoarticular in 8 cases, oligoarticular in 19 cases and polyarticular in the other 10 cases. This study demonstrates the high incidence of chronic inflammatory rheumatism in Northern Togo.
Mulongo Mbarambara P, Bangwa Bulase A, Muhumu Mututa P
… +1 more, Kyambikwa Bisangamo C
Med Sante Trop
· 2018 Aug · PMID 30270839
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Malaria during pregnancy is a major cause of morbidity and mortality among women and their children. However, its clinical diagnosis still presents problems. The aim of this study was to study the accuracy of the rapid d...Malaria during pregnancy is a major cause of morbidity and mortality among women and their children. However, its clinical diagnosis still presents problems. The aim of this study was to study the accuracy of the rapid diagnostic test (RDT) for malaria during pregnancy, compared with thick blood smears. 349 pregnant women seeking prenatal care in the Kitutu Health Zone were examined by the RDT and by microscopy in May and June 2015, with microscopy the reference test. Its sensitivity, specificity, positive and negative predictive values, accuracy, and Youden J statistic were calculated. The prevalence of malaria among pregnant women was 33.5 % by the thick smear and 35.0 % by the RDT. The performance of the RDT for the diagnosis of malaria was excellent, with a sensitivity of 97.4 %, specificity of 96.5 %, and a Youden J statistic of 0.94). The RDT is invaluable in the early diagnosis of malaria during quality prenatal care to combat malaria effectively in pregnant women in a rural setting.
Mbame JP, Bonoy L, Djofang H
… +2 more, Chako K, Mayoughouo Mouliom A
Med Sante Trop
· 2018 Aug · PMID 30270838
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Establishing a program to raise awareness and fight against STI/AIDS and unwanted pregnancies in schools requires knowledge of factors significantly associated with the behavior to be promoted. The objective of this stud...Establishing a program to raise awareness and fight against STI/AIDS and unwanted pregnancies in schools requires knowledge of factors significantly associated with the behavior to be promoted. The objective of this study is to identify the determinants of the intention to use condom among students at Mimboman High School in Cameroon. A descriptive association study was conducted among 134 students, aged 13-23 years. Using a pretested questionnaire, we collected data about this intention, related attitudes and social norms, and the perception of behavioral control. We used SPSS version 20 software to analyze the data. The study included 134 students, with a mean age of 16 years. The results indicate a very significant correlation between intention to use a condom and attitudes (r = 0.36; P < 0.01), between this intention and social norms (r = 0.32; P < 0.01), and between this intenstion and the perception of behavioral control (r = 0.22; P < 0.01). Any effort to increase Mimboman students' intentions to use condoms should target their attitudes, social norms, and perception of behavioral control.
Servais S, Desclaux A, Berthé A
… +2 more, Bila B, Msellati P
Med Sante Trop
· 2018 Aug · PMID 30270837
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To meet the objective of ending the AIDS pandemic in 2030, screening and access to antiretroviral treatments (ARV) must be extended in Africa. This in turns requires that people agree to be screened and treated. Since th...To meet the objective of ending the AIDS pandemic in 2030, screening and access to antiretroviral treatments (ARV) must be extended in Africa. This in turns requires that people agree to be screened and treated. Since the beginning of the epidemic, however, the stigmatization of people persons living with HIV (PlHIV) has been a major obstacle in the battle against HIV/AIDS. Despite a substantial reduction in its prevalence over the past 20 years in Burkina Faso, its stigma remains high. The objective of this study is to characterize the local expression of stigmatization in this country towards these women to help to combat it. The method used a long-term ethnographic survey that combined observations of the setting and qualitative interviews of 40 women - both seronegative and seropositive. The results show the appearance of a sort of normalization of HIV/AIDS because the bioclinical effects of the infection are less serious and less visible than they were before ARV. The social effects of the disease nonetheless continue to constitute a threat, or at least they are so perceived by both seropositive and seronegative women. Although less visible, stigmatization persists and constrains seropositive women to use strategies to withdraw from some social spaces to protect themselves. PlHIV active in community associations play an essential role in this setting. They help women to keep their stigmata "under control" and play a role in its normalization by helping to moderate representations of HIV/AIDS and the people who have it.
Lawson-Ananissoh LM, Bouglouga O, Bagny A
… +4 more, El-Hadji Yakoubou R, Sewu KE, Kaaga L, Redah D
Med Sante Trop
· 2018 Aug · PMID 30270836
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AIM: To determine the factors associated with the death of patients infected with human immunodeficiency virus (HIV) while hospitalized in the hepato-gastroenterology department of the Lomé University Hospital, Togo. PAT...AIM: To determine the factors associated with the death of patients infected with human immunodeficiency virus (HIV) while hospitalized in the hepato-gastroenterology department of the Lomé University Hospital, Togo. PATIENTS AND METHOD: A retrospective cross-sectional study reviewed records covering a 10-year period from this department. It included all patients aged 15 years and older who were positive for HIV infection. RESULTS: The study included 432 HIV patients, including 201 men and 231 women (sex ratio: 0.87). Their median age was 41 years (interquartile range: 35 to 48.2 years). The death rate was 15.3 %, and differed significantly between men (19.4%) and women (11.7%) (P = 0.0262). The probability of death increased significantly with age assessed in quartiles (P = 0.0472). Impaired general status, jaundice, and abdominal distension were associated with a high risk of death (P = 0.0017). Conditions unrelated to HIV that were associated with a high risk of death were hepatocellular carcinoma, cirrhosis, and toxic hepatitis (P < 0.0001). Anemia and CD4 count were not associated with death. CONCLUSION: Death was associated with social and demographic (male sex and age) and clinical (altered general status, jaundice, cirrhosis, hepatocellular carcinoma and toxic hepatitis) factors.
Razafimanjato NNM, Ralaizafindraibe TH, Ramarolahy AR
… +2 more, Rajaonera TA, Rakotovao HJL
Med Sante Trop
· 2018 Aug · PMID 30270835
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Acute mediastinitis, also called descending necrotizing mediastinitis and cervicomediastinal necrotizing fasciitis, is a disease due to the spread of severe cervical or oropharyngeal infection. Our retrospective study ex...Acute mediastinitis, also called descending necrotizing mediastinitis and cervicomediastinal necrotizing fasciitis, is a disease due to the spread of severe cervical or oropharyngeal infection. Our retrospective study examined clinical records of patients admitted to the surgical intensive care unit for the management of acute mediastinitis during the four-year period 2009-2012. The records showed 14 cases admitted during these four years. The patients' mean age was 30 years and 8 months, and the M/F sex-ratio was 1.33. The main predisposing factors found were the presence of a severe cervical infection, such as fasciitis, of odontogenic origin or the administration of anti-inflammatory drugs. The diagnosis is based on clinical data findings of thoracic pain with dyspnea or orthopnea, fever, or even septic shock and is confirmed by radiologic findings. The patient's multidisciplinary management combines medical management (supportive medical care in an intensive care unit and broad-spectrum antibiotic therapy) and surgical treatment by bilateral cervicotomy with mediastinal drainage. The mortality rate was high at 71.42%. In Madagascar, neglect of dental health can cause odontogenic fasciitis, which plays an important role in descending mediastinitis, a disease that still has a catastrophic prognosis today.
Issoufou I, Harmouch H, Belliraj L
… +8 more, Ammor F, Rabiou S, Younssa H, James DL, Lakranbi M, Sani R, Ouadnouni Y, Smahi M
Med Sante Trop
· 2018 Aug · PMID 30270834
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INTRODUCTION: Our purpose is to report our experience in the management of pulmonary hydatid cysts ruptured in the pleura. Materiel and methods: We collected all records of patients with a ruptured hydatid cyst of the lu...INTRODUCTION: Our purpose is to report our experience in the management of pulmonary hydatid cysts ruptured in the pleura. Materiel and methods: We collected all records of patients with a ruptured hydatid cyst of the lung in the pleura who underwent surgery for this in the department of thoracic surgery of the CHU Hassan II of Fes during the 6-year period that started in 2010. RESULTS: The study included 20 men and 14 women with an average age of 30.44 ± 18.4 years. Radiological findings showed a hydropneumothorax in 21 cases, hydrothorax in 10, pachypleuritis in 29, and a floating membrane in 13 cases. In all cases, pleuropulmonary decortication was associated with pericystectomy in 20 cases and parenchymal resection in 3 cases. A hydatid membrane bathing in the pleural cavity was found in 32 cases. The postoperative course was uneventful in 28 cases. CONCLUSION: Long-term follow-up should be established to detect possible recurrences or pleural dissemination, which appear to be prevented by long-term use of anthelmintic agents.
Okemba Okombi FH, Bemba E, Bopaka RG
… +2 more, Oosale Abacka KB, Kaswa M
Med Sante Trop
· 2018 Aug · PMID 30270833
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Extensively drug-resistant (XDR) tuberculosis is currently a major public health problem in most developing countries, including the Republic of Congo, where antituberculosis agents are repeatedly unavailable. We report...Extensively drug-resistant (XDR) tuberculosis is currently a major public health problem in most developing countries, including the Republic of Congo, where antituberculosis agents are repeatedly unavailable. We report four cases from by the National Program for Tuberculosis Control in collaboration with its National Reference Laboratory (NRL) of the Republic of Congo. The presence of these highly resistant strains causes therapeutic problems (treatment depends on the profile of individual mutations and the unavailability of new drugs) and public health (major risk of spread of the disease in the community).
Pessinaba S, Atti YDM, Yayehd K
… +8 more, Simwétaré MBF, Kaziga W, Afassinou YM, Atta B, Pio M, Kpélafia M, Baragou S, Damorou F
Med Sante Trop
· 2018 Aug · PMID 30270832
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Publisher ↗
INTRODUCTION: The aim of this work was to describe the epidemiological, clinical, and therapeutic characteristics of acute coronary syndromes (ACS) in the cardiology department of Lome Campus University Hospital in Togo....INTRODUCTION: The aim of this work was to describe the epidemiological, clinical, and therapeutic characteristics of acute coronary syndromes (ACS) in the cardiology department of Lome Campus University Hospital in Togo. METHODOLOGY: We conducted a prospective study that consistently included patients hospitalized from 2014 to 2017 for ACS, based on clinical, electrocardiographic, and laboratory findings. RESULTS: Of 1914 patients admitted to the department during the study period, 67 were admitted for ACS, for a 3.5% prevalence. The (M/F) sex ratio was 1.91. Patients' mean age was 60 ± 12 years. The clinical presentation was an ST elevation myocardial infarction (STEMI) in 71.6% of cases, and non-STEMI in 28.4% of cases, including 18.1% non-Q-wave infarction and 10.3% unstable angina. The mean time to admission after the onset of symptoms was 81.9 ± 124.6 hours. Patients were transported to the hospital by a private vehicle in 82.1% of cases. Thrombolysis was performed for 14.6% of patients (7/48 patients with ACS STEMI), with a success rate of 85.7% (n=6). In-hospital mortality was 10.5% (7/67). This mortality was significantly associated with the interval from onset of symptoms to admission and with the Killip stage. CONCLUSION: Acute coronary syndromes are increasingly common in Togo. They are characterized by a relatively young age and a long delay until admission. Improving the management of these conditions in our countries requires effective primary prevention.
Egbohou P, Sama HD, Mouzou T
… +4 more, Assenouwe S, Akala-Yoba G, Tchetike F, Tomta K
Med Sante Trop
· 2018 Aug · PMID 30270831
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To analyze the causes of deaths in the intensive care unit (ICU) at the CHU Sylvanus Olympio (CHU SO) teaching hospital of Lomé. This retrospective study examined the files of patients who died in the ICU of CHU SO, duri...To analyze the causes of deaths in the intensive care unit (ICU) at the CHU Sylvanus Olympio (CHU SO) teaching hospital of Lomé. This retrospective study examined the files of patients who died in the ICU of CHU SO, during the 12-month period from November 2012 to October 2013. Of 732 patients admitted to the ICU, 237 died, for a mortality rate of 32.38%. Men accounted for 163 (68.8%) of the deaths, and women 74 (31.2%), for a M/F ratio of 2.2. The average age of patients who died was 41.7 years; the age group 21-30 years comprised 16% of the deaths, that 31-40 years 19.8%, and 41-50 years 17.7%. Trauma (50.64%) dominated the causes of death, including especially severe traumatic brain injury (34.18%), followed by postoperative intensive care (25.32%), including peritonitis (8%). Medical diseases accounted for 18.14% of ICU admissions. More than half the deaths (55.7%) took place in the 72 hours after ICU entry. Mortality in the ICU at CHU SO of Lomé remains very high. It affects young patients, mainly with traumatic and surgery-related pathologies.
Akakpo AS, Teclessou JN, Saka B
… +4 more, Mouhari-Toure A, Monsila G, Kombate K, Pitche P
Med Sante Trop
· 2018 Aug · PMID 30270830
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The aim of this study was to describe the epidemiological, clinical, and therapeutic profile as well as the outcomes of children with erythroderma (also known as exfoliative dermatitis) in hospital dermatology department...The aim of this study was to describe the epidemiological, clinical, and therapeutic profile as well as the outcomes of children with erythroderma (also known as exfoliative dermatitis) in hospital dermatology departments in Lomé, Togo. This retrospective descriptive study examined the records of patients aged 0 to 15 years who were treated for erythroderma in dermatology departments in Lomé from January 1997 to December 2016. The study included 28 patients, with a mean age of 6.3 ± 5 years. The mean duration of progression of erythroderma before the consultation was 39.2 days. Pruritus was present in 60 % of the children, fever in 13.3 %, and impairment of general status in 3.3 %. Among the children aged 3 months and older, 84.2 % had dry squamous erythrodermic dermatosis, and among those younger than 3 months, 15.8 %. Among those with erythrodermic dermatosis, atopic dermatitis (70.6 %) was the most frequent dermatosis. No cause was found in 32.1 % cases. Course and outcome were favorable in 53.3 % of cases; one child died, and the rate of loss to follow-up was 43.3 %. Erythroderma is a rare disease in children in hospital dermatology departments in Lomé. Erythrodermic dermatosis, particularly atopic eczema, remains the most frequent cause.
Sondo KA, Diendéré EA, Ouédraogo MS
… +10 more, Ouédraogo GA, Diallo I, Zoungrana J, Poda A, Bognounou R, Da L, Savadogo M, Ouédraogo SM, Niamba P, Sangaré L
Med Sante Trop
· 2018 Aug · PMID 30270829
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The necrotizing and not necrotizing acute bacterial dermohypodermitis (DHD) are acute bacterial infections of tissues situated between the skin and the muscles. The localizations of the face are infrequent, and sometimes...The necrotizing and not necrotizing acute bacterial dermohypodermitis (DHD) are acute bacterial infections of tissues situated between the skin and the muscles. The localizations of the face are infrequent, and sometimes put diagnostic difficulties with other current facial dermatosis. We report in this article 4 cases of DHD of the face with skin source, hospitalized in the service of the Infectious and Tropical Diseases of the Teaching Hospital Yalgado Ouédraogo of Ouagadougou (Burkina Faso). The objective is to make a current situation of their etiologies and complications, and to look for the difficulties to take care of them in a country with limited resources. The patient's care journey for this disease is long while it constitutes a medical or medical-surgical emergency. Imaging, which is essential for the diagnosis of heart valve disease and the daunting complications of necrotizing fasciitis and mediastinitis, is generally available only in tertiary hospitals. Antibiotic therapy is most often inadequate or insufficient. Anti-inflammatories, widely used, according to several authors contribute to serious forms and excess mortality. Health workers in resource-limited settings need to be better educated and guidelines issued to recognize the signs of this condition in order to enable early referral of patients in specialized settings. In addition, education of the population and hygiene awareness of skin lesions should be a priority to reduce complications.
Saka B, Gnassingbe W, Akakpo S
… +6 more, Mahamadou G, Teclessou J, Mouhari-Toure A, Kombaté K, Tchangaï-Walla K, Pitché P
Med Sante Trop
· 2018 Aug · PMID 30270828
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The aim of this study was to report the frequency of and reasons for dermatology admissions in Lomé (Togo) between 2005 and 2016. This retrospective study examined records from August 2005 to December 2016 from the derma...The aim of this study was to report the frequency of and reasons for dermatology admissions in Lomé (Togo) between 2005 and 2016. This retrospective study examined records from August 2005 to December 2016 from the dermatology departments of the two teaching hospitals in Lomé, Togo. During the study period, 454 (1.1%) of the 40,231 new patients who consulted in dermatology were hospitalized, with a total of 460 separate admissions (mean dermatology hospitalizations per year: 42). Patients' mean age was 43±17.6 years and the sex ratios (M/F) was 0.6. The main reasons for hospitalization were Stevens-Johnson syndrome (SJS), also known as erythema multiforme majus, and toxic epidermal necrolysis (TEN) (28.9%), followed by bullous erysipelas (21.4%), connective tissue disease (10.3%), and Kaposi sarcoma-associated herpes virus (9%). The average length of stay in hospital was 15±13.7 days. The diagnosis that accounted for the longest mean length of stay was deep fungal infections (63.5 days) (P<0.0001). We recorded 39 deaths, for a death rate of 8.6%. Death rates were highest for deep fungal infections (37.5%) and SJS/TEN (12.2%). Our study confirmed the low rate of inpatient admissions in dermatology and revealed a change in the reasons for hospitalization and a decrease in mortality in dermatology in Lomé, compared with the previous 13 years. This decrease in mortality may be attributed to the improvement of hospital care provided to patients but also by the generalization of antiretroviral treatment in Togo that began more than 10 years ago.
Diadie S, Ndiaye M, Diatta BA
… +6 more, Diallo M, Diop K, Deh A, Dieng MT, Kane A, Niang SO
Med Sante Trop
· 2018 Aug · PMID 30270827
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The authors report the case of a 22-year-old man referred seven months after the onset of papulo-nodular skin lesions, lymphadenopathy, splenomegaly and hepatomegaly. Mycologic and histologic examination of skin lesions...The authors report the case of a 22-year-old man referred seven months after the onset of papulo-nodular skin lesions, lymphadenopathy, splenomegaly and hepatomegaly. Mycologic and histologic examination of skin lesions enabled the diagnosis of African histoplasmosis, by Histoplasma capsulatum var duboisii. The lymph nodes were caseous. The culture in Lowenstein-Jensen medium was negative.