Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to descr...Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to describe the impact of COVID-19 vaccination on the prognosis of hospitalized patients. Methods: This was a retrospective cohort study of patients admitted to the Centre Hospitalier Régional Lomé Commune (Togo) between June 1, 2021 and May 31, 2022. Primary outcomes (admission to the intensive care unit and death) were presented with frequency and proportion. Mortality rates were presented by sociodemographic and clinical characteristics and compared by appropriate statistical tests. Factors associated with inpatient death were described by performing a Cox proportional hazard regression. Results: A total of 604 patients were hospitalized (50.0% women). The mean age was 54.03 ±17.1 years. Only 55 patients were fully vaccinated (9.1%). ICU admission was significantly more frequent in unvaccinated patients than in vaccinated ones (63.0% vs. 38.2%;p Conclusion: COVID-19 vaccination had a significant benefit for patients with COVID-19 infection in terms of reducing the risk of death. Based on real-world data from sub-Saharan Africa, this information can help optimize the benefit of COVID-19 vaccination by raising community awareness and increasing vaccine coverage while reducing hesitancy.展开更多
<strong>Background:</strong> Dengue is under-reported in the indicators and directories of health statistics in Togo and the diagnostic hypothesis of dengue during medical consultations is often not mentio...<strong>Background:</strong> Dengue is under-reported in the indicators and directories of health statistics in Togo and the diagnostic hypothesis of dengue during medical consultations is often not mentioned. <strong>Objective:</strong> The objective is to assess healthcare workers’ knowledge of dengue and its management in public health centers in the health district of Lomé Commune. <strong>Materials and Methods: </strong>This is a cross-sectional and descriptive study that took place from November 1, 2019 to February 29, 2020 in the health district of Lomé Commune. <strong>Results: </strong>This study involved 280 healthcare workers out of 310 concerned, <em>i.e.</em>, a participation rate of 90.32%, distributed over the 22 public health centers of the health district of Lomé Commune. The age of the healthcare workers ranged from 18 to 58 years with an average age of 33 years (±8.14). The age group [25 - 35 years] was more represented with 53.20%. Physicians were more represented with 46.07%. The majority of healthcare professionals were aware of the existence of dengue (90.36%). The essential clinical signs were more or less known, especially by the physicians. Dengue hemorrhagic fever was the most known clinical form and represented 70%. Treatment was symptomatic according to the majority (63.21%) and was based on analgesics (71.43%) and antipyretics (65%). The existence of a vaccine is not well known and represented 16.79%;the use of impregnated mosquito net is more cited as a secondary means of prevention, 77.86%. <strong>Conclusion: </strong>Dengue is not well known by the health professionals involved in the survey. Nevertheless, physicians have a more or less good knowledge compared to paramedics. In practice, the diagnosis of dengue is often not mentioned.展开更多
Background: Ophidian envenomation is common in Sub-Saharan Africa, and its management is hampered by the lack of access to healthcare services in rural areas, in particular the availability and appropriate use of anti...Background: Ophidian envenomation is common in Sub-Saharan Africa, and its management is hampered by the lack of access to healthcare services in rural areas, in particular the availability and appropriate use of antivenom. Rare cases of serious side effects following the administration of antivenom have been reported. This is the case for a young farmer from the central region of Togo, who experienced a second snake bite within four years, and in whom antivenom serotherapy led to severe allergic manifestations. Case presentation: This 24-year-old patient, with a history of antivenom and tetanus serotherapy, was admitted to the Centre Hospitalier Régional (CHR) of Sokodé for a snakebite that occurred 45 minutes earlier while working in the field. Clinical assessment on admission revealed grade 1 envenomation, characterized by local pain in the right upper limb, with no sign of complication. He received an intravenous infusion of antivenom serotherapy, which rapidly relieved the pain, allowing him to be discharged after 24 hours of hospital monitoring. However, he was readmitted five days later for a skin rash associated with generalized pruritus and edema of the face and the neck, which prompted his evacuation to the Sylvanus Olympio University Hospital. He was diagnosed with a hypersensitivity-type allergic reaction to antivenom serum. Symptomatic treatment with antihistamines resulted in a favourable outcome after five days in the hospital. Conclusion: This young farmer developed a severe allergic reaction following a second course of antivenom serotherapy for low-grade ophidian envenomation. Although the efficacy of antivenom serum is undeniable in the management of snakebites, its use should be guided by a sound clinical assessment and framed by rigorous monitoring, especially in people sensitized to antivenom or antitoxin serotherapy. This highlights the importance of training healthcare staff alongside the availability of anti-venomous sera at peripheral healthcare centres.展开更多
Objective: To evaluate the virological status of ineligible HIV patients for anti-retroviral therapy based on the criterion of CD4+ T lymphocytes rate over than 350/μl of blood. Method: This is a prospective study wh...Objective: To evaluate the virological status of ineligible HIV patients for anti-retroviral therapy based on the criterion of CD4+ T lymphocytes rate over than 350/μl of blood. Method: This is a prospective study which was conducted from November 2011 to July 2012 in the tropical and infectious disease department of CHU Sylvanus Olympio of Lomé. All HIV-1 infected patients whose CD4+ T lymphocytes rate was ≥350/μl of blood were retained. The count of CD4+ T lymphocytes was made by cytometer FACSCalibur? flow of BD biosciences and the determination of viral load was achieved by NASBA laboratory method of Biomérieux. Results: We have recruited 102 PLWHA aged between 19 and 58 years with a median of 35 years. Biologically, 102 patients had a T-CD4 rate between 355 and 432/μl of blood. The determination of viral load showed a very high viral replication more than 10,000 copies/ml among all patients and 28 (27.5%) patients had a viral load > 100,000 copies/ml of blood. Conclusion: Our results argue for a reconsideration of the criteria for starting antiretroviral therapy in Togo by including virological data if necessary in patients with T-CD4 rate below 500/μl of blood.展开更多
Avascular osteonecrosis of the femoral head is increasingly affecting HIV-infected patients. Several factors may contribute to its occurrence, including antiretroviral therapy and its complications. We report a case o...Avascular osteonecrosis of the femoral head is increasingly affecting HIV-infected patients. Several factors may contribute to its occurrence, including antiretroviral therapy and its complications. We report a case of avascular necrosis of the femoral head in a black woman infected with HIV and treated with antiretroviral drugs in Lomé, Togo, for about 13 years at the time of consultation and with therapeutic success. The antiretroviral treatment included a protease inhibitor initiated 3 years before the onset of the symptomatology which was marked by bilateral hip pain. Biochemical tests showed hypercholesterolemia (total and LDL-cholesterol) and a slight increase in triglycerides. Antiretroviral treatment with a protease inhibitor was changed to an integrase inhibitor. The surgical treatment that was indicated could not be performed because of the patient’s lack of financial means.展开更多
文摘Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to describe the impact of COVID-19 vaccination on the prognosis of hospitalized patients. Methods: This was a retrospective cohort study of patients admitted to the Centre Hospitalier Régional Lomé Commune (Togo) between June 1, 2021 and May 31, 2022. Primary outcomes (admission to the intensive care unit and death) were presented with frequency and proportion. Mortality rates were presented by sociodemographic and clinical characteristics and compared by appropriate statistical tests. Factors associated with inpatient death were described by performing a Cox proportional hazard regression. Results: A total of 604 patients were hospitalized (50.0% women). The mean age was 54.03 ±17.1 years. Only 55 patients were fully vaccinated (9.1%). ICU admission was significantly more frequent in unvaccinated patients than in vaccinated ones (63.0% vs. 38.2%;p Conclusion: COVID-19 vaccination had a significant benefit for patients with COVID-19 infection in terms of reducing the risk of death. Based on real-world data from sub-Saharan Africa, this information can help optimize the benefit of COVID-19 vaccination by raising community awareness and increasing vaccine coverage while reducing hesitancy.
文摘<strong>Background:</strong> Dengue is under-reported in the indicators and directories of health statistics in Togo and the diagnostic hypothesis of dengue during medical consultations is often not mentioned. <strong>Objective:</strong> The objective is to assess healthcare workers’ knowledge of dengue and its management in public health centers in the health district of Lomé Commune. <strong>Materials and Methods: </strong>This is a cross-sectional and descriptive study that took place from November 1, 2019 to February 29, 2020 in the health district of Lomé Commune. <strong>Results: </strong>This study involved 280 healthcare workers out of 310 concerned, <em>i.e.</em>, a participation rate of 90.32%, distributed over the 22 public health centers of the health district of Lomé Commune. The age of the healthcare workers ranged from 18 to 58 years with an average age of 33 years (±8.14). The age group [25 - 35 years] was more represented with 53.20%. Physicians were more represented with 46.07%. The majority of healthcare professionals were aware of the existence of dengue (90.36%). The essential clinical signs were more or less known, especially by the physicians. Dengue hemorrhagic fever was the most known clinical form and represented 70%. Treatment was symptomatic according to the majority (63.21%) and was based on analgesics (71.43%) and antipyretics (65%). The existence of a vaccine is not well known and represented 16.79%;the use of impregnated mosquito net is more cited as a secondary means of prevention, 77.86%. <strong>Conclusion: </strong>Dengue is not well known by the health professionals involved in the survey. Nevertheless, physicians have a more or less good knowledge compared to paramedics. In practice, the diagnosis of dengue is often not mentioned.
文摘Background: Ophidian envenomation is common in Sub-Saharan Africa, and its management is hampered by the lack of access to healthcare services in rural areas, in particular the availability and appropriate use of antivenom. Rare cases of serious side effects following the administration of antivenom have been reported. This is the case for a young farmer from the central region of Togo, who experienced a second snake bite within four years, and in whom antivenom serotherapy led to severe allergic manifestations. Case presentation: This 24-year-old patient, with a history of antivenom and tetanus serotherapy, was admitted to the Centre Hospitalier Régional (CHR) of Sokodé for a snakebite that occurred 45 minutes earlier while working in the field. Clinical assessment on admission revealed grade 1 envenomation, characterized by local pain in the right upper limb, with no sign of complication. He received an intravenous infusion of antivenom serotherapy, which rapidly relieved the pain, allowing him to be discharged after 24 hours of hospital monitoring. However, he was readmitted five days later for a skin rash associated with generalized pruritus and edema of the face and the neck, which prompted his evacuation to the Sylvanus Olympio University Hospital. He was diagnosed with a hypersensitivity-type allergic reaction to antivenom serum. Symptomatic treatment with antihistamines resulted in a favourable outcome after five days in the hospital. Conclusion: This young farmer developed a severe allergic reaction following a second course of antivenom serotherapy for low-grade ophidian envenomation. Although the efficacy of antivenom serum is undeniable in the management of snakebites, its use should be guided by a sound clinical assessment and framed by rigorous monitoring, especially in people sensitized to antivenom or antitoxin serotherapy. This highlights the importance of training healthcare staff alongside the availability of anti-venomous sera at peripheral healthcare centres.
文摘Objective: To evaluate the virological status of ineligible HIV patients for anti-retroviral therapy based on the criterion of CD4+ T lymphocytes rate over than 350/μl of blood. Method: This is a prospective study which was conducted from November 2011 to July 2012 in the tropical and infectious disease department of CHU Sylvanus Olympio of Lomé. All HIV-1 infected patients whose CD4+ T lymphocytes rate was ≥350/μl of blood were retained. The count of CD4+ T lymphocytes was made by cytometer FACSCalibur? flow of BD biosciences and the determination of viral load was achieved by NASBA laboratory method of Biomérieux. Results: We have recruited 102 PLWHA aged between 19 and 58 years with a median of 35 years. Biologically, 102 patients had a T-CD4 rate between 355 and 432/μl of blood. The determination of viral load showed a very high viral replication more than 10,000 copies/ml among all patients and 28 (27.5%) patients had a viral load > 100,000 copies/ml of blood. Conclusion: Our results argue for a reconsideration of the criteria for starting antiretroviral therapy in Togo by including virological data if necessary in patients with T-CD4 rate below 500/μl of blood.
文摘Avascular osteonecrosis of the femoral head is increasingly affecting HIV-infected patients. Several factors may contribute to its occurrence, including antiretroviral therapy and its complications. We report a case of avascular necrosis of the femoral head in a black woman infected with HIV and treated with antiretroviral drugs in Lomé, Togo, for about 13 years at the time of consultation and with therapeutic success. The antiretroviral treatment included a protease inhibitor initiated 3 years before the onset of the symptomatology which was marked by bilateral hip pain. Biochemical tests showed hypercholesterolemia (total and LDL-cholesterol) and a slight increase in triglycerides. Antiretroviral treatment with a protease inhibitor was changed to an integrase inhibitor. The surgical treatment that was indicated could not be performed because of the patient’s lack of financial means.
