Deh A, Diatta BA, Diadie S
… +5 more, Gaye AM, Diop K, Ndiaye M, Diallo M, Niang OS
Med Sante Trop
· 2020 Feb · PMID 32043467
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Tuberculosis is an endemic disease in Senegal. Cutaneous forms are rare and are characterized by their clinical polymorphism. They account for 2% of the extrapulmonary locations of tuberculosis [1, 2]. We report an obser...Tuberculosis is an endemic disease in Senegal. Cutaneous forms are rare and are characterized by their clinical polymorphism. They account for 2% of the extrapulmonary locations of tuberculosis [1, 2]. We report an observation of a tuberculous gumma of the buttock that led to the discovery of an active pulmonary localization in an immunocompetent adult. A 47-year-old man was admitted for a painful swelling of the right buttock that had been developing for four years. The physical examination noted an indurated, multinodular, and polyfistulized plaque, with confluent yellowish pus emission, on the inferomedial face of the right buttock, associated with bilateral inguinal lymphadenopathy. Cutaneous tuberculosis was found in the histology, which showed TB granuloma, and the gastric tube fluid was positive for acid-fast bacilli. Thoracoabdominopelvic CT showed multiple basal acinar micronodules in both lungs. Serology was negative for both HIV and HBV. All signs of tuberculosis disappeared after six months of treatment. In endemic zones, cutaneous tuberculosis is characterized by its clinical polymorphism. It must also be looked for in any perineal abscess. Early management greatly improves the prognosis.
Alaoui H, Qamouss Y, Seddiki R
… +1 more, Boughalem M
Med Sante Trop
· 2019 Nov · PMID 31885003
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Scorpion envenomation is a public health problem in several countries in the tropics and subtropics, with high mortality in the severe forms involving multiple organ failure. The correlation between young age and clinica...Scorpion envenomation is a public health problem in several countries in the tropics and subtropics, with high mortality in the severe forms involving multiple organ failure. The correlation between young age and clinical manifestations of severe scorpion envenomation is well established. We report the case of a 3-month-old infant admitted for severe scorpion envenomation who rapidly developed fatal multiple organ failure, and we discuss the different physiopathological aspects of severe scorpion envenomation.
Fafa Cisse M, Dia Kane Y, Abessolo Amougou IN
… +3 more, Mbaye FB, Thiam K, Touré NO
Med Sante Trop
· 2019 Nov · PMID 31885002
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For many patients, a history of tuberculosis is synonymous with disabling sequelae, impaired quality of life, and high morbidity and mortality. This retrospective study reviewed the files of patients hospitalized for seq...For many patients, a history of tuberculosis is synonymous with disabling sequelae, impaired quality of life, and high morbidity and mortality. This retrospective study reviewed the files of patients hospitalized for sequelae of thoracic tuberculosis during 2017, to assess its various manifestations and their impact on quality of life. Of the 176 patients included, 75 % were aged from 35 to 65 years. They were predominantly male, with a sex ratio of 3.76. The socioeconomic level was mostly low (70 %). Only one episode of tuberculosis sufficed to cause sequelae in 89.8 % of cases. Smoking was often noted (52.3 %). Functional signs were dominated by coughs (90.3 %) and dyspnea (72.7 %). Pulmonary sequelae with fibrous scarring were observed in 52.2 % of the patients. Bacterial and/or viral superinfection was the leading cause of hospitalization (50 %). The death rate during hospitalization was 19 %. An improvement followed by discharge was observed for 81 %, 14.2 % of them with chronic respiratory insufficiency. In all, 13.28 % of the discharged patients died within the 6 months that followed. The sequelae of thoracic tuberculosis should be considered as long-term chronic conditions and deserve the same treatment.
Djibo I, Yanogo PK, Kaboré J
… +4 more, Sawadogo B, Alkassoum I, Antara S, Meda N
Med Sante Trop
· 2019 Nov · PMID 31885001
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INTRODUCTION: Niger, located in the meningitis belt, faces recurrent epidemics of magnitudes that vary with the year. The objective of this study was to describe the trends in meningitis and identify the profile of the m...INTRODUCTION: Niger, located in the meningitis belt, faces recurrent epidemics of magnitudes that vary with the year. The objective of this study was to describe the trends in meningitis and identify the profile of the microbes implicated in meningitis epidemics in Niger. METHODS: We conducted a descriptive study (a secondary analysis) of meningitis data from 2008 through 2015. The study population comprised patients with suspected and confirmed meningitis. We conducted an exhaustive sampling of all suspected and confirmed meningitis cases reported in Niger from 2008 to 2015. RESULTS: A total of 6167 (40.6 %) confirmed cases of meningitis were identified. Among them, 5,507 (89.3 %) were attributable to Neisseria meningitidis, 593 (9.6 %) to Streptococcus pneumoniae, and 66 (1.1 %) to Haemophilus influenzae respectively. Among the Neisseria meningitidis cases, 2,984 (54.2 %) were caused by serogroup A, 1,333 (24.2 %) by serogroup W, 1,165 (21.1 %) by serogroup C, 23 (0.4 %) by serogroup X, and 2 (0.03 %) by the serogroup B. CONCLUSION: This study enabled us to describe meningitis trends and identify the profile of the bacteria implicated in its epidemics in Niger. We observed the emergence of Neisseria meningitidis C and recommend vaccination against this serogroup.
Rakotozafiarison AN, Rakotomalala HN, Nivo Andriamampianina S
… +1 more, Ralandison S
Med Sante Trop
· 2019 Nov · PMID 31885000
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Septic arthritis is a serious disease and its treatment remains a major challenge. Demonstration of the microorganism is the key to diagnosis according to all international guidelines. In developing countries such as Mad...Septic arthritis is a serious disease and its treatment remains a major challenge. Demonstration of the microorganism is the key to diagnosis according to all international guidelines. In developing countries such as Madagascar, where access to basic health services is still difficult, bacteriological analysis of the joint fluid is not yet available in most healthcare facilities. We propose effective solutions that are scientifically valid, adapted to the country's socioeconomic conditions and current health situation, while taking international recommendations into consideration. We propose that the few university hospitals with rheumatology departments and good reference laboratories should be supported to participate in a pilot program to compile data to establish the clinical and bacteriological profiles of septic arthritis here. In lower level health centers where bacteriological examinations of the joint fluid and other complementary tests are more or less impossible, a diagnosis of septic arthritis is mainly based on clinical findings. Accordingly, all diagnosis and management should be centralized in these reference centers, which will allow the adaptation and progressive update of guidelines for the management of septic arthritis.
Méda ZC, Thiombiano STA, Hien H
… +8 more, Hien L, Traoré I, Ilboudo B, Couibaly L, Kpoda H, Sakana L, Savadogo GBL, Sombié I
Med Sante Trop
· 2019 Nov · PMID 31884999
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Patients must receive high-quality and safe health care. Peripheral venous catheterization (PVC) exposes patients to complications, mostly phlebitis. This study investigated the incidence of phlebitis and its PVC-related...Patients must receive high-quality and safe health care. Peripheral venous catheterization (PVC) exposes patients to complications, mostly phlebitis. This study investigated the incidence of phlebitis and its PVC-related risk factors among patients in the medical and surgical emergency departments of the Souro Sanou University Hospital Center (CHUSS) in Bobo Dioulasso, Burkina Faso. This prospective cross-sectional study took place from July 4 to August 3, 2018. The incidence of PVC-related phlebitis was calculated and its risk factors were identified by logistic regression, with SPSS software version 20 (entry option), with significance set at 5%. The 511 patients included in the study had a mean age of 44.7 (95% CI 43.1-46.3) years. The mean duration of PVC was 3.1 days. Of these patients, 149 developed phlebitis, for an incidence of 29.2% (95% CI 25.0%-33.0%). There was no statistically significant difference between the two emergency (medical and surgical) departments. Second-degree phlebitis accounted for slightly more than half the cases (53%). Risk factors associated with the occurrence of PVC-related phlebitis were female gender, catheterization duration more than 3 days, small size of the catheter, and the healthcare worker's failure to use friction in washing with a hydroalcoholic hand solution. Preventive measures are essential.
Ouedraogo MS, Korsaga/Some N, Ouedraogo NA
… +6 more, Tapsoba GP, Traoré F, Konkissere GO, Barro/Traoré F, Niamba P, Traoré A
Med Sante Trop
· 2019 Nov · PMID 31884998
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Angiomas are vascular abnormalities that affect less than 1% of the world's population. Data on these disorders in Africa are limited. The purpose of our work was to study the epidemiological and clinical aspects of angi...Angiomas are vascular abnormalities that affect less than 1% of the world's population. Data on these disorders in Africa are limited. The purpose of our work was to study the epidemiological and clinical aspects of angiomas in the Dermatology-Venerology Department of the University Hospital of Yalgado Ouedraogo in Ouagadougou (Burkina Faso) to contribute to improving knowledge of this group of pathologies in our region. This cross-sectional descriptive, retrospective, and prospective study covers cases from 1998 through 2014. We identified 61 patients with angioma, 67.2% of them younger than 30 months. The sex ratio was 0.56. Vascular tumors (hemangiomas) accounted for 43 cases (70.5%) and vascular malformations 18 (29.5%). Lesions appeared between 0 and 15 days of life in 57.4% of cases. Their size ranged from 1 to 3 cm in 49.2% of cases. They were most frequently located on the head (49.2%). The most frequent clinical forms were cutaneous hemangiomas (tuberous) (36 cases), followed by the nevus flammeus (8 cases), and mixed hemangiomas (7 cases). Only one complex forms was observed: one case of Klippel-Trenaunay syndrome. Superficial vascular abnormalities are rare in our dark skin type context including infantile hemangiomas. The clinical peculiarities of the angiomas observed in this African series in Ouagadougou seem quite similar to the characteristics described in European and American series.
Med Sante Trop
· 2019 Nov · PMID 31884997
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To study the prevalence and distribution of dermatosis in hospitals and identify factors related to mortality and morbidity due to dermatosis Descriptive and analytical study conducted from 4 years of records of patients...To study the prevalence and distribution of dermatosis in hospitals and identify factors related to mortality and morbidity due to dermatosis Descriptive and analytical study conducted from 4 years of records of patients hospitalized in the department of dermatology of the University Hospital Center of Brazzaville. We identified 296 files of patients with dermatosis. The M/F ratio was 1.2. Erysipelas and cutaneous drug reactions accounted for 61.1% of the causes. Patients' mean age was 44.3 years. Comorbidity was found in 58.3% of cases. Cardiovascular disease and HIV infection were the most common conditions. The mortality rate was 6.9%. Erysipelas and cutaneous drug reactions are the most frequent dermatoses treated at the University Hospital Center of Brazzaville. Comorbidity exists in more than half the cases. Mortality is high.
Med Sante Trop
· 2019 Nov · PMID 31884996
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Publisher ↗
Children in developing tropical countries are frequently undernourished. In rural areas, they are also often affected by Buruli ulcers. The treatment of this mutilating disease is sometime long and difficult for malnouri...Children in developing tropical countries are frequently undernourished. In rural areas, they are also often affected by Buruli ulcers. The treatment of this mutilating disease is sometime long and difficult for malnourished patients. Moreover, the eating behavior of patients with Buruli ulcers does not promote its quick healing, with numerous foods prohibited. They eat fewer fruits and legumes, which are rich in vitamins and minerals. Our survey in two health centers showed that only 8% ate fruits and legumes, and 29% leafy greens. This food deprivation increases their nutritional deficiencies. We conducted a nutritional intervention among Buruli ulcer patients (30 patients) in one center, and compared their healing with that of Buruli patients without nutritional care (n = 21). Those patients who received the intervention spent less time at the hospital (less than six months). Our study shows the association between the healing of Buruli ulcers in Côte d'Ivoire and good nutritional status: those with the intervention healed faster and presented fewer disabilities than the control patients.
Degboe B, Sopoh GE, Alimi M
… +6 more, Koudoukpo C, Akpadjan F, Agbéssi N, Johnson RC, Adégbidi H, Atadokpèdé F
Med Sante Trop
· 2019 Nov · PMID 31884995
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The objective of our study was to evaluate the medico-surgical management of Buruli ulcer (BU) in the BU Screening and Treatment Center (CDTUB) of Allada in Benin. This retrospective and descriptive study retrospectively...The objective of our study was to evaluate the medico-surgical management of Buruli ulcer (BU) in the BU Screening and Treatment Center (CDTUB) of Allada in Benin. This retrospective and descriptive study retrospectively reviewed records of patients seen from 2010 to 2014 at the CDTUB of Allada. It included patients diagnosed with BU according to WHO epidemiological and clinical criteria as well as laboratory results and who were treated according to WHO medical and surgical recommendations. In all, 274 patients were diagnosed and treated, 57.7% of them children younger than 15 years. Ulcerative lesions (189, 69%) and WHO category II lesions (144, 52.5%) predominated. All patients received dual antibiotic therapy and 43.4% (119) underwent surgery as well. Category III lesions and multifocal lesions required more surgery, whereas most category I lesions healed under medical treatment. The overall rate of healing was 92%: 53.3% for patients who received only antibiotic therapy and 38.7% for those who also had surgery. The median healing time was 13 weeks and ranged from 4 to 56 weeks. In the CDTUB of Allada, between 2010 and 2014, most patients were treated with antibiotic therapy alone, but a significant number still received surgery.
Igala M, Ledaga Lentombo LE, Kouégnigan Rerambiah L
… +3 more, Ntsame Ngoua S, Bouyou Akotet M, Boguikouma JB
Med Sante Trop
· 2019 Nov · PMID 31884994
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The treatment of cancer, whether a solid tumor or a malignant hemopathy, is accompanied by bouts of infection, the severity and prognosis of which are often correlated to the patient's immune status. In Gabon, where the...The treatment of cancer, whether a solid tumor or a malignant hemopathy, is accompanied by bouts of infection, the severity and prognosis of which are often correlated to the patient's immune status. In Gabon, where the transmission of Plasmodium falciparum malaria is perennial, the prevalence - around 36% in Libreville - increases in older children and adults. Few authors have described the involvement of this parasite during fever after chemotherapy for hematological malignancies. This work reports three cases of malaria including two severe and one with neutropenia occurring in patients treated for hematological neoplasms.
Mandoko PN, Mbongi DM, Mumba DN
… +5 more, Bi Shamamba SK, Tshilolo LM, Muyembe JJ, Parzy D, Sinou V
Med Sante Trop
· 2019 Nov · PMID 31884993
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In the Democratic Republic of the Congo, the first recourse in case of suspected malaria in the health system is the private pharmacy sector. This study was therefore designed to assess private provider adherence to nati...In the Democratic Republic of the Congo, the first recourse in case of suspected malaria in the health system is the private pharmacy sector. This study was therefore designed to assess private provider adherence to national case management guidelines in Kimpese, a rural area of Central Kongo province. A descriptive cross-sectional survey of 103 pharmacies took place in March 2016. The study included 97 pharmacies. The artemether-lumefantrine combination recommended as the first-line treatment for uncomplicated P. falciparum malaria was available in 100% of pharmacies but only 3% stocked quality-assured medicines. The sulfadoxine-pyrimethamine recommended for intermittent preventive treatment of malaria in pregnant women and quinine, which is no longer part of national policy, were widely available (>97.0% of pharmacies). Among providers, fewer than 20% were aware of the national malaria treatment guidelines. The main reasons for non-adherence to national guidelines among private dispensers was the high cost (up to 10 times more expensive than sulfadoxine-pyrimethamine treatment) and adverse effects of artemisinin-based combination therapies. Governmental interventions to improve private sector engagement in implementation of the national guidelines and to prevent the spread of ineffective and non-quality assured antimalarial medicines must be intensified.
Koffi FK, Monin AJ, N'Cho CM
… +4 more, N'Cho JA, Djetouan KJ, Kouakou ND, Amoikon KE
Med Sante Trop
· 2019 Nov · PMID 31884992
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The study aims to establish the sociodemographic profile of consumers of garba (a street food sold in Côte d'Ivoire), understand its frequency of consumption, and develop a typology of its consumers. We interviewed 547 c...The study aims to establish the sociodemographic profile of consumers of garba (a street food sold in Côte d'Ivoire), understand its frequency of consumption, and develop a typology of its consumers. We interviewed 547 consumers at 10 points of sale. A factorial analysis of the data collected was performed and a decision tree produced for the social and demographic variables, followed by a multiple correspondence analysis (MCA) and then a hierarchical ascending clustering (HAC). Garba is consumed more by men (70.6%), students (42%), and single people (68.2%). The consumers are mainly Christian (51.7%) or Muslims (35.8%). The principal deciding factors explaining the frequency of individual consumption are age, occupation, and marital status. Four classes of consumers are defined according to the socioprofessional category of the individuals. Garba is highly consumed in 47% of cases, moderately consumed in 35.1% of cases and poorly consumed in 17.9%. Garba is frequently consumed by all sociodemographic levels. Its consumers can be divided into four classes. In view of its high frequency of consumption, a study of its nutritional quality is necessary to ensure guarantee consumer health.
Garcia M, Chanlin R, Blanchet D
… +3 more, Demar M, Couppie P, Blaizot R
Med Sante Trop
· 2019 Nov · PMID 31884985
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Case report from French Guiana of an atypical keloid in a Brazilian man: Lobomycosis. Lobomycosis is a rare fungal skin infection, endemic to the Amazon basin. Its clinical manifestations are slow-growing keloid-like nod...Case report from French Guiana of an atypical keloid in a Brazilian man: Lobomycosis. Lobomycosis is a rare fungal skin infection, endemic to the Amazon basin. Its clinical manifestations are slow-growing keloid-like nodules, with a granulomatous reaction on histopathology. The etiological agent, Lacazia loboi, has never been isolated in the environment or cultured in a laboratory. Diagnosis is based on the typical appearance on microscopy. Treatment is disappointing, with a high recurrence rate. We report a new case in French Guiana and review the literature. Only 10 cases have been reported outside of the endemic area, 2 involving no travel; the mean time to diagnosis was 21 years. Phylogenetic analysis has recently proved that lobomycosis in dolphins is caused by a fungus more closely related to Paracoccidioides brasiliensis than to L. loboi (two very closely related species). Molecular diagnosis is possible in a few centers. Climate change may result in spreading lobomycosis to currently disease-free areas of the world.