Iba Ba J, Andjuma Mindze PL, Nseng Nseng I
… +2 more, Nzenze JR, Boguikouma JB
Med Sante Trop
· 2018 May · PMID 29997074
·
Publisher ↗
Lupus is an autoimmune disease of the connective tissue that occurs predominantly in women and blacks and whose expression is influenced by environmental factors, especially ultraviolet rays. The rising temperature in Ga...Lupus is an autoimmune disease of the connective tissue that occurs predominantly in women and blacks and whose expression is influenced by environmental factors, especially ultraviolet rays. The rising temperature in Gabon for nearly two decades led us to look for correlations between the onset of lupus, the patients' regions of origin, and environmental temperatures before and at diagnosis. retrospective, descriptive, and analytic study conducted in the Department of Internal Medicine of the CHU of Libreville (Gabon), from 01/01/2016 to 31/05/2016, based on the files of patients with diagnosed lupus receiving care in the department since 01/2002. Data collection forms listed for each patients age, sex, occupation, date and season of diagnosis, and place of residence (during childhood, adolescence, and adulthood). We looked for correlations between these data and temperatures, based on meteorological data from the country's seven main weather stations over a period from 1996 to 2015. The study included 53 women and 7 men (sex ratio 0.13), with a mean age of 32.7 +/- 8.9 years. The population included students (n = 25), civil servants (n = 15), the unemployed (n = 8), private-sector employees (n = 6), and shopkeepers (n=6). Diagnoses varied according to season, with 56.6% of the cases in the dry season and 43.4% in the rainy season. From 1 to 4 cases of lupus were diagnosed annually before 2011, 7 each year from 2011 to 2014, and at least 14 per year since 2015. Most patients (62.5%) had spent their childhood, adolescence, and adulthood in the country's capital (industrial zone par excellence), 17.8% in mining regions, and 12.5% in oil-drilling areas. The increase in the number of cases of lupus appears to be correlated with their greater prevalence in regions with higher temperature exposures, that is, in industrial, mining and petroleum regions, which are the regions of greatest exposure among our lupus patients.
Ndione RA, Diop D, Riveau G
… +2 more, Ba CT, Jouanard N
Med Sante Trop
· 2018 May · PMID 29997073
·
Publisher ↗
The implementation and expansion of development projects (dams and irrigation schemes) in the Senegal River valley have led to a significant proliferation of snails. We conducted a one-year (2014) study project, monitori...The implementation and expansion of development projects (dams and irrigation schemes) in the Senegal River valley have led to a significant proliferation of snails. We conducted a one-year (2014) study project, monitoring their density in the commune of Richard Toll, to assess the role of environmental parameters on mollusc population dynamics. Four species involved in the transmission of human schistosomiasis were found: Bulinus globosus, B. truncatus, B. senegalensis, and Biomphalaria pfeifferi. Among the intermediate hosts, B. truncatus is the most abundant species, followed by B. globosus. Snail density depends on the nature of the water point but also on environmental parameters such as vegetation. This study showed that vegetation, water level (flood), and flow velocity influence the dynamics of the snail populations that are intermediate hosts of human schistosomes.
Demba Kodindo K, Kana-Mbang A, Moundai T
… +5 more, Nakebang Fadel A, Yangalbé-Kalnoné E, Mahamat Oumar A, Mallaye P, Kerah-Hinzoumbé C
Med Sante Trop
· 2018 May · PMID 29997072
·
Publisher ↗
Mosquito resistance to insecticides remains a major concern for vector control programs based on chemical methods. Hence, a thorough knowledge of vector susceptibility to products recommended for public health is require...Mosquito resistance to insecticides remains a major concern for vector control programs based on chemical methods. Hence, a thorough knowledge of vector susceptibility to products recommended for public health is required for effective vector control programs. In this study, we assessed the susceptibility of wild Anopheles gambiae sl and Culex quinquefasciatus populations from N'Djamena (Chad) to four insecticide classes recommended for public health. The study took place from July to October 2014. Following WHO guidelines, bioassays were performed on two- to four-day-old, non-engorged female mosquitoes of both species, collected in the field. The insecticides used were deltamethrin (0.05%), permethrin (1%), DDT (4%), bendiocarb (0.01%), and malathion (5%). Anopheles gambiae sl showed full susceptibility to bendiocarb and malathion but was resistant to pyrethroids; mortality rates were 2% for deltamethrin, 2% for permethrin, and 0% for DDT. Culex quinquefasciatus was susceptible to malathion but resistant to the other insecticides, with a mortality rate of 22% for deltamethrin, 29% for permethrin, 23% for DDT, and 45% bendiocarb. The resistance of Anopheles gambiae sl and of Culex quinquefasciatus may affect the population's adherence to the use of insecticide-treated mosquito nets. Malaria control programs are advised to extend insecticide resistance monitoring to the main culicide species that bite human populations.
Tonen-Wolyec S, Filali M, Mboup S
… +1 more, Bélec L
Med Sante Trop
· 2018 May · PMID 29997071
·
Publisher ↗
HIV self-testing constitutes a new complementary strategy for HIV testing for general populations as well as "key" populations such as sex workers and their clients, men who have sex with men, and young people; it may he...HIV self-testing constitutes a new complementary strategy for HIV testing for general populations as well as "key" populations such as sex workers and their clients, men who have sex with men, and young people; it may help to reach the UNAIDS 90-90-90 objectives by 2020. In Africa, many pilot studies have been conducted, mainly in English-speaking countries, and they have demonstrated the high acceptability, practicability and clinical performance of HIV self-testing. Innovative strategies, including the translation of HIV self-test instructions for use into vernacular languages in association with educational pictograms, should be developed and evaluated in sub-Saharan Africa to implement HIV self-testing.
Kahouli S, Naoui H, Uwingabiye J
… +4 more, Reggad A, Ennibi K, Bouchrik M, Lmimouni BE
Med Sante Trop
· 2018 May · PMID 29997070
·
Publisher ↗
Tick-borne relapsing fever is a zoonosis caused by spirochetes of the genus Borrelia, transmitted by hematophagous ticks. This life-threatening condition is still misdiagnosed. We report a case of tick-borne relapsing fe...Tick-borne relapsing fever is a zoonosis caused by spirochetes of the genus Borrelia, transmitted by hematophagous ticks. This life-threatening condition is still misdiagnosed. We report a case of tick-borne relapsing fever in a 54 year-old man in Morocco with a history of hiking, who was hospitalized for an isolated fever. On admission, the clinical examination showed no specific signs. The laboratory assessment showed inflammatory syndrome with disturbance of the liver function. The blood culture was sterile. Serology was negative for HIV and Lyme disease, as were all the rest of the paraclinical tests. The patient's course was marked by spontaneous resolution of the fever and then, seven days later, the onset of a new episode of fever. Malaria was suspected and a blood sample was sent to the parasitology department. The thick smear and blood smear stained with May-Grünwald Giemsa showed the presence of spirochetes. Tick-borne relapsing fever was diagnosed and the patient responded favorably to treatment by cycline drugs. This disease is poorly known and should be considered in cases of presence of intermittent fever without a specific clinical-laboratory picture, according to epidemiological context. The diagnosis is confirmed by the presence of spirochetes on thick smear and blood or cerebrospinal fluid smear stained with MGG.
Mathieu L, Grosset A, Bertani A
… +4 more, Potier L, Murison JC, Niang CD, Rigal S
Med Sante Trop
· 2018 May · PMID 29997068
·
Publisher ↗
In developing countries, road traffic accidents result in many cases of open trauma, especially fractures, with the tibia area at particular risk in motorcycle crashes. Despite a high prevalence of severe leg trauma with...In developing countries, road traffic accidents result in many cases of open trauma, especially fractures, with the tibia area at particular risk in motorcycle crashes. Despite a high prevalence of severe leg trauma with multi-tissue injuries, few studies have focused on the challenge of their reconstruction in these limited-resource settings. The first part of this review presents the surgical strategy. Limitations and principles of initial limb salvage are detailed. Orthopedic procedures for early damage control, based on debridement and temporary bone stabilization, are often required. The priority is to shorten the time to initial surgical management to avoid infection, which jeopardizes reconstruction.
Degui H, de la Volpilière A, Duteil Q
… +1 more, Gentilini M
Med Sante Trop
· 2018 May · PMID 29997066
·
Publisher ↗
A Day of Action against counterfeit medications was organized in Brazzaville on March 22, 2018, by the French Embassy, the French Institute of the Congo (IFC), and the Ministry of Health and the Population, with the part...A Day of Action against counterfeit medications was organized in Brazzaville on March 22, 2018, by the French Embassy, the French Institute of the Congo (IFC), and the Ministry of Health and the Population, with the participation of the Chirac Foundation. The success of this day, during which more than 1500 people came to the IFC, may be an original idea for mobilizing civil society on health subjects that directly affect the behavior of young people.
Med Sante Trop
· 2018 May · PMID 29997064
·
Publisher ↗
Blood transfusion in Mali is constantly confronted with the problem of the availability of blood products, even in life-threatening emergencies. Although the number of donations increases each year, so does the need for...Blood transfusion in Mali is constantly confronted with the problem of the availability of blood products, even in life-threatening emergencies. Although the number of donations increases each year, so does the need for blood products; donations do not appear to meet demand. With an infrastructure that does not meet standards for security, confidentiality, or quality, the Mali national blood transfusion center has nonetheless seen an increase in donations - from 30,000 annually in 2007-2010 to about 50,000 donations in 2015. Immunohematological analyses for donors and patients are limited to ABOD antigens. In 2015, the prevalence of markers for HIV was 3%, for HBV 15.5 %, for HCV 1.7%, and for syphilis 0.1 %. This situation has been the subject of an analysis of the needed improvements and prospects for them at all stages of the transfusion chain.
Akakpo AB, Saka B, Abilogoun-Chokki AE
… +6 more, Teclessou JN, Mahamadou G, Gnassingbe W, Mouhari-Toure A, Kombate K, Pitche P
Med Sante Trop
· 2018 May · PMID 29976535
·
Publisher ↗
OBJECTIVE: The aim of this study was to document the profile of children with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN, also called Lyell syndrome) in hospital settings in Lomé, Togo. METHOD: Th...OBJECTIVE: The aim of this study was to document the profile of children with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN, also called Lyell syndrome) in hospital settings in Lomé, Togo. METHOD: This descriptive retrospective study examined the records of children aged 0 to 15, seen and/or hospitalized in the dermatology department of CHU-SO Lomé and diagnosed with SJS/TEN between 2000 and 2015. RESULTS: Records were identified for 14 children with these diagnoses during the study period. Their average age was 10.9 ± 3.9 years. The average time between taking the apparently causal medication and the onset of symptoms was 10.5 days (range: 4 to 21 days). SJS accounted for 64.3% of the cases. Six children with SJS and one with TEN had ocular involvement. Antibacterial sulfonamides were the main drug involved for 43% of children, followed by anticonvulsants for 14/3%. CONCLUSION: Our results show that SJS/TEN is rare but serious in children. The antibacterial sulfonamides used for the treatment of malaria and anticonvulsants are their most frequent cause.
Med Sante Trop
· 2018 May · PMID 29799424
·
Publisher ↗
Scorpion envenomation is common in northern Chad and associated with a high lethality rate. We report the management of 16 cases of scorpion envenomation in 2014 at our Faya-Largeau medical post. Our clinical experience...Scorpion envenomation is common in northern Chad and associated with a high lethality rate. We report the management of 16 cases of scorpion envenomation in 2014 at our Faya-Largeau medical post. Our clinical experience revealed dissociated muscarinic symptoms in patients treated early in contrast to those treated later, who presented cardiogenic shock. In the absence of antivenom, patients with an isolated muscarinic syndrome received small doses of atropine, and their signs and symptoms improved afterwards. Although the use of atropine is controversial, the question here is about using it to treat muscarinic symptoms of scorpion envenomation in the absence of severe hypertension and with no signs of heart failure.
Teclessou JN, Kombaté K, Akakpo AS
… +4 more, Neh CP, Saka B, Mouhari-Toure A, Pitché P
Med Sante Trop
· 2018 May · PMID 29799423
·
Publisher ↗
The aim of this study was to determine the epidemiological and clinical profile of cutaneous parasitosis in Lomé, Togo. Of the 71422 patients seen in 3 dermatology departments during the study period, 1217 (1.7%) had cut...The aim of this study was to determine the epidemiological and clinical profile of cutaneous parasitosis in Lomé, Togo. Of the 71422 patients seen in 3 dermatology departments during the study period, 1217 (1.7%) had cutaneous parasitosis, 98% of them ectoparasitosis.
Apetse K, Assogba K, Diatewa JE
… +5 more, Dongmo Tajeuna JJ, Maneh N, Tassa Kayem FM, Kombate D, Balogou KA
Med Sante Trop
· 2018 May · PMID 29798830
·
Publisher ↗
Neuromyelitis optica (NMO) appears to affect blacks disproportionately in mixed populations. We report the first case of documented NMO in Togo (West Africa). A 26-year-old Togolese woman was admitted for progressive tet...Neuromyelitis optica (NMO) appears to affect blacks disproportionately in mixed populations. We report the first case of documented NMO in Togo (West Africa). A 26-year-old Togolese woman was admitted for progressive tetraplegia, acute urine retention, and dyspnea. Magnetic resonance imaging of the cervical spinal cord demonstrated an extensive longitudinal lesion, and an ophthalmologic examination found bilateral optic neuritis. Antibody testing for AQP4-IgG was positive. The patient died of severe respiratory distress despite high doses of intravenous corticosteroids. Epidemiological data about NMO in sub-Saharan Africa would improve our understanding of the role of genetic and environmental risk factors in this disease.
Wade KA, Ndong SI, Kounta MB
… +5 more, Ngom DT, OuldEthmane S, Gassama A, Bah FY, Diatta B
Med Sante Trop
· 2018 Feb · PMID 29616654
·
Publisher ↗
Overloaded emergency departments are common around the world. This prospective, descriptive, and analytical study evaluates the reasons for emergency room use and describes the severity of the patients' conditions and ho...Overloaded emergency departments are common around the world. This prospective, descriptive, and analytical study evaluates the reasons for emergency room use and describes the severity of the patients' conditions and how they reach the emergency department. It took place at the emergency department of the principal hospital of Dakar (the Armed Forces Teaching Hospital) over a one-week period (from August 23 to August 30, 2016) and included a sample of 219 patients of both sexes aged 15 years and older. Data were collected about social and demographic characteristics, reasons for choosing the emergency department rather than other care, time of day, day of the week, accessibility, means of transport, diagnosis, and severity. More than half of patients (55 %) were men, with a mean age of 42 +/- 18. Only 10 % of patients lived within 5 km of the hospital. Most (84.5 %) came from the Dakar region and lived between 5 and 35 km from the hospital. Most patients reached the hospital by their own means (83 %). Only 2 % were transported by the public emergency ambulance service. The reasons for choosing the emergency unit were the opportunity for additional tests in 41.1 % of cases ; the desire to be hospitalized in 26.9 % ; fear of death in 26.5 %, no waiting list in 14.2 %, and lack of money in 11 % of cases. Patients in truly serious condition accounted for only 5 % of cases. Most (88 %) returned home after stabilization, 12 % were hospitalized, and 0.5 % died. Good practices, good organization, and improved complementarity between public, private, and emergency services are needed to reduce the use of the latter.
Mongbo V, Saïzonou J, Sopoh G
… +3 more, Sossa-Jérôme C, Ouendo EM, Godin I
Med Sante Trop
· 2018 Feb · PMID 29616653
·
Publisher ↗
To be used effectively, emergency obstetric and neonatal care must be available and accessible. This study sought to measure the accessibility of cesarean deliveries in Benin. Cross-sectional study of randomly selected w...To be used effectively, emergency obstetric and neonatal care must be available and accessible. This study sought to measure the accessibility of cesarean deliveries in Benin. Cross-sectional study of randomly selected women in each of the 12 obstetrics departments in Benin. Geographical accessibility was measured by estimating the distance between the parturientes residence and the hospital. Financial accessibility was the average direct cost of the cesarean delivery -the sum of medical and non-medical costs. The functionality of the referral system was assessed according to the conditions of referral of women referred for cesareans. The mean distance between women's homes and the hospital was 20.2 ± 22.3 kilometers. Of the 579 women, 63.0 % were referred from a peripheral health center to a hospital; the referral conditions were completed in the obstetric record for only half of them. The data sheet for the referral was completed for only 34.4 %; venous access had been placed in 28.5 %, and the patient was accompanied by medical personnel in only 1.7% of cases. The average direct cost of the cesarean to families was 36,782 ± 30,859 FCFA. Cesarean deliveries are now more accessible financially due to the policy of free access, but they remains geographically inaccessible, because of the long distances to be covered and the poor organization of referrals to ensure continuity of care.
Agbo S, Bemanana HS, Aziagbenyo KM
… +1 more, Lahaye FM
Med Sante Trop
· 2018 Feb · PMID 29616651
·
Publisher ↗
OBJECTIVE: To identify the determinants of the knowledge and practice of Togolese women concerning cervical cancer. METHODS: This cross-sectional study with a descriptive and analytical focus took place in Togo during th...OBJECTIVE: To identify the determinants of the knowledge and practice of Togolese women concerning cervical cancer. METHODS: This cross-sectional study with a descriptive and analytical focus took place in Togo during the four-month period from May to August 2016 and surveyed women aged 18 to 60 living in the Lomé municipal area for at least 12 months. Sampling of the intervention zones was based on reasoned choice depending on the availability of health structures in the area. Once in the field, the health centers were taken as landmarks, and the individual living closest to the center was the first to be surveyed. The snowball technique was adopted. All data were entered and analyzed by Epi Info version 7.2 and Excel 2016. Bivariate (chi-2) and multivariate (logistic regression) analyses were performed to study potential associations between different variables. RESULTS: We interviewed 207 women, whose mean age was 31.7 years (±10.7). Of the 65.5 % (95 % CI = 58.6-72.0) of respondents who had heard of cervical cancer, 2.9 % (95 % CI = 0.6-5.2) knew HPV infection is a risk factor. Of the 70 women seeing a gynecologist-obstetrician, only 23.2 % (95 % CI = 13.0-34.9) had been screened for cervical cancer. More than half of our respondents had a history (96.1 %) of voluntary interruption of pregnancy, or miscarriage, infection and gynecological and obstetric surgery. The proportion of women with both an obstetric history and screening was 9.7 % (95 % CI = 6.0-14.5). The leading reason for not being screened among our respondents was a fear of pelvic examination (frequency: 11.9%, 95% CI = 7.2-16.5). CONCLUSION: Women seeing a gynecologist and/or with a high educational level are more likely to be informed about cervical cancer and have a greater likelihood of screening.