Introduction: Coagulase-negative staphylococci (CoNS) are currently recognized as genuine pathogens. However, little is known about the resistance and virulence genes that explain their pathogenicity in hospitals in C...Introduction: Coagulase-negative staphylococci (CoNS) are currently recognized as genuine pathogens. However, little is known about the resistance and virulence genes that explain their pathogenicity in hospitals in Cte d'Ivoire. The aim of this study was to contribute to the genotypic identification of resistance and virulence genes in CoNS isolated from blood cultures at the University Teaching Hospital (CHU) of Bouak, in order to improve patient management. Material and Methods: This was a descriptive study conducted from September to December 2023. The CoNS isolates studied came from the collection of strains isolated from blood cultures of febrile patients hospitalized or attending consultations at the CHU of Bouak. The strains were analyzed using conventional simplex PCR. Results: Of the 45 isolates analyzed, 46.7% carried both the aacA-aphD and tetK genes and 40% carried the mecA gene. With regard to virulence genes, only the LukS-PV gene was observed in S. epidermidis and S. haemolyticus isolates. Conclusion: The high prevalence of CoNS isolates carrying the mecA gene and the presence of virulence genes observed in this study give cause for concern in hospitals. It is important to develop comprehensive surveillance strategies against nosocomial and multi-resistant infections at the CHU of Bouak.展开更多
Introduction: Retroplacental haematoma (RPH) is a very serious complication of pregnancy, with life-threatening consequences for both the mother and foetus. The aim of this study is to determine the incidence and epid...Introduction: Retroplacental haematoma (RPH) is a very serious complication of pregnancy, with life-threatening consequences for both the mother and foetus. The aim of this study is to determine the incidence and epidemiological characteristics of patients with retroplacental haematoma (RPH) and describe the maternal-foetal complications at Bouaké University Hospital. Methods: This was a cross-sectional prospective, descriptive and analytical study carried out at Bouaké University Hospital over a period of 3 years, from January 1, 2019 to December 31, 2021. All parturients with RPH whose delivery took place at the hospital were included in the study. Data were entered and analysed using EPI INFO software version 7.2.2.6. Results: We recorded 2,0959 deliveries, including 202 cases of RPH, representing an incidence of 0.96%. The 21 to 35 age group accounted for 64.4%, multigestas and large multigestas accounted for 58.5% and multiparas accounted for 41.6%. The main signs on clinical examination were metrorrhagia (100%), arterial hypertension (84.6%) and cervical cerclage (79.7%). Preeclampsia accounted for 50% of per-gestational pathologies. Maternal mortality was 12.9%. Morbidity was dominated by anaemia in 64.1%, followed by disseminated intravascular coagulation (DIC) in 21.8%, and the factors associated with this maternal prognosis were multiple gestations, multiparity, Sher grade IIIb and the occurrence of complications such as DIC, shock, renal complications and HELLP syndrome. Neonatal mortality was 79.2%, and the factors associated with these fetal prognoses were cup size ≥ 5 cm and hematoma weight ≥ 500 g. Conclusion: Better screening of at-risk populations, early diagnosis and treatment in an organised and equipped medical and surgical facility would improve prognosis.展开更多
Background: Non traumatic gonalgia is the second most common reason for rheumatology consultations and accounted for 15.6% of rheumatological disorders in Abidjan. Objective: The aim of this work was to study the epid...Background: Non traumatic gonalgia is the second most common reason for rheumatology consultations and accounted for 15.6% of rheumatological disorders in Abidjan. Objective: The aim of this work was to study the epidemiological and diagnostic features of non-traumatic gonalgia (NTG) in a black adult population from sub-Saharan Africa. Patients and Methods: This was a five-year retrospective descriptive study (January 2014 to December 2018) of black sub-Saharan African adult patients with non traumatic gonalgia seen in the rheumatology department of the Bouake University Hospital in Côte d’Ivoire. Results: Of 2198 patients seen for rheumatological conditions, 140 had non traumatic gonalgia (6.4%). The mean age of patients was 56.13 ± 13.3 years (extremes 20 and 87 years), and the sex ratio was 0.43 (42 men and 98 women). Gonalgia without swelling was observed in 33.6% of cases. Symptoms were predominantly progressive (97.1%), chronic (82.1%) and bilateral (50%). The causes of TNM were gonarthrosis (85%), septic arthritis (7.1%), reactive arthritis (2.9%), gout (2.9%), rheumatoid arthritis (1.4%) and chondrocalcinosis (0.7%). Gonarthrosis (119/140) was bilateral in 65 patients, bi- or tri-compartmental in 83, radiographic stage (Kellgren and Lawrence) III in 80 and IV in 15. A germ was isolated in two cases of septic arthritis (methicillin-sensitive Staphylococcus aureus and Streptococcus pneumoniae). Conclusion: GNT is common in rheumatology practice in Bouake, and mainly affects women in their fifties. It is most often a chronic bilateral gonalgia, with gonarthrosis as the main etiology.展开更多
Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hy...Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.展开更多
Introduction: The clinical manifestations of many diseases vary with age, and older people often do not show typical symptoms of the disease. The present study aims to compare the epidemiological, clinical, therapeuti...Introduction: The clinical manifestations of many diseases vary with age, and older people often do not show typical symptoms of the disease. The present study aims to compare the epidemiological, clinical, therapeutic and evolutionary aspects of elderly patients with COVID-19 compared to young adult patients and to identify risk factors for mortality. Patients and Methods: This was a retrospective single-center analytical study conducted from January 27, 2021 to January 27, 2022 at the COVID-19 Care Center of the Infectious and Tropical Diseases Department of the Bouaké University Teaching Hospital. The study population consisted of all patients aged at least 18 years seen in consultation and/or hospitalized with a positive COVID-19 RT-PCR. The patients were divided into two groups: younger patients (Results: Of a total of 779 patients, 644 (82.7%) were young. The median age of all patients was 41 years (IQR 32 - 54, extreme 18 and 96). Of all the patients 38.5% had a comorbidity. Compared to younger patients, chronic heart disease (61.7% vs 21.5%;p Conclusion: Elderly people with COVID-19 have a different clinical presentation from younger, characterized by more atypical symptoms. Mortality risk factors are age, dyspnoea, impaired consciousness and fever. It is therefore necessary to act on its various factors to improve the prognosis of COVID-19 in this age group.展开更多
Context: COVID-19 is a global public health problem and diabetes mellitus is a poor prognostic factor for the disease. The aim of this study was to investigate the epidemiological, clinical and evolutionary characteri...Context: COVID-19 is a global public health problem and diabetes mellitus is a poor prognostic factor for the disease. The aim of this study was to investigate the epidemiological, clinical and evolutionary characteristics of COVID-19 in diabetic patients in Bouaké. Patients and Methods: This was a retrospective study carried out from January 2021 to December 2022. We included patients with diabetes known before COVID-19 infection and having a positive COVID-19 RT-PCR. Data were analyzed with Epi info7 software. Results: Among 1122 infected patients, 71 patients (6.3%) were diabetic, the sex ratio was 1.3 and the mean age was 58.7 years. Type 2 diabetes (97.2%) was predominant and the average seniority was 3.1 years. Arterial hypertension (46.5%) was the main comorbidity. The main clinical signs were cough (69%), dyspnea (43.7%) and fever (23.9%). Oxygen saturation was Conclusion: Diabetes mellitus remains one of the most important comorbidities of severe Covid-19. The death rate of diabetics was high. Hence the need to vaccinate people living with diabetes.展开更多
Objective: To determine the epidemiology and maternal-fetal prognosis of eclampsia at Bouaké University Teaching Hospital. Material and Methods: This was a prospective study with descriptive and analytical aims o...Objective: To determine the epidemiology and maternal-fetal prognosis of eclampsia at Bouaké University Teaching Hospital. Material and Methods: This was a prospective study with descriptive and analytical aims over a period from 01 January 2019 to 31 December 2021. It took place in the obstetrics and gynaecology department of the Bouaké University Teaching Hospital. The inclusion criterion was any seizure in the gravid-puerperal period in the context of preeclampsia. Data were entered and analysed using EPI INFO software version 7.2.2.6. Results: We performed 20,958 deliveries and recorded 241 cases of eclampsia, representing a prevalence of 1.14%. The ages of the participants ranged from 13 to 47 years with a mean age ± SD of 22 ± 7 years. The age group ≤ 19 years represented 45.64% of participants. Housewives accounted for 46.47%, and single women accounted for 54.77% of participants. The average parity ± SD was 1 ± 1.6 with range of 0 to 10, and nulliparous women accounted for 49.8% of participants. Patients who were evacuated accounted for 74.27% of our study population. The majority of eclampsia attacks occurred in the antepartum period (56.84%). The mean gestational age ± SD was 36 ± 3.6 weeks with a range of 24 to 42 weeks. The mode of delivery was caesarean section in 64.7% of cases. Maternal lethality was 7.88%. The factors associated with maternal mortality due to eclampsia were evacuation and parity of less than 3. Maternal morbidity was 16.6%. Neonatal lethality was 18.95%. The factor associated with neonatal death in eclampsia was prematurity. Conclusion: We need to detect and manage preeclampsia early and effectively to reduce the frequency of eclampsia and improve its maternal-foetal prognosis in our context.展开更多
Introduction: With the eradication of smallpox in 1980, vaccination against smallpox ceased and there was an upsurge in cases of monkeypox. The objective of this observation is to describe the characteristics of monke...Introduction: With the eradication of smallpox in 1980, vaccination against smallpox ceased and there was an upsurge in cases of monkeypox. The objective of this observation is to describe the characteristics of monkeypox in the vaccinated subject. Case Report: A 45-year-old, heterosexual, rural resident was referred for a rash. The history of the disease revealed signs of acute course marked by headache, asthenia, diffuse myalgia, chest pain, fever and pruritic rash. His background is marked by vaccination against smallpox in 1977, cohabitation with game hunters and domestic animals as well as a notion of contact with a person who presented similar but more generalized signs. The physical examination revealed a conscious patient with good general state, feverish, tachycardic, eupneic presenting skin lesions in the type of striated vesicles more or less umbilical, on the scalp, face, neck, trunk and the upper limbs associated with cervical lymphadenopathy. RT-PCR was performed on a dry swab by rubbing several vesicles and a throat swab proved positive for Monkeypox Virus (MPXV). Management consisted of isolation and symptomatic treatment. The evolution has been favorable. Conclusion: The symptomatology of monkeypox is similar to that of smallpox. Without widely available treatment or prophylaxis, rapid identification of cases is essential. Vaccination of people at risk is an alternative to curb the epidemic. However, the main prevention strategy is to raise awareness of the risk factors.展开更多
Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of no...Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.展开更多
Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis e...Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. Our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (Results: Our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan<sup>®</sup> value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal ALT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).展开更多
<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Cirrhosis, an ineluctable development of chronic liver disease, still h...<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Cirrhosis, an ineluctable development of chronic liver disease, still has high mortality throughout the world despite many advances in physiopathology and therapy. This high mortality is closely </span><span style="font-family:Verdana;">related</span><span style="font-family:Verdana;"> to the unpredictable course of cirrhosis with numerous complications.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:""><span style="font-family:Verdana;"> To evaluate the predictive factors of death during cirrhosis. </span><b><span style="font-family:Verdana;">Materials and methods:</span></b><span style="font-family:Verdana;"> This is an observational, descriptive study on cirrhotic patients hospitalized in the hepatology unit of the Center Hospitalier Universitaire in Bouake (Ivory Coast) during the period from January 01, 2018 to December 31, 2019. The study focused on the data collected in the medical files (paper format) of hospitalized cirrhotics and the death register of the service.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">The diagnosis of cirrhosis and the death of the cirrhotic were the main criteria for judgment. The secondary criteria defined were: history of cirrhosis, reasons for consultation, clinical signs, biological signs, complications of cirrhosis</span><span style="font-family:Verdana;"> and</span><span style="font-family:Verdana;"> the treatment received. The relationship between the parameters was expressed as an odds ratio (OR) with a 95% confidence interval (CI) and the significance threshold fixed at p <</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.05. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The study retained 206 files of cirrhotics including 146 men and 60 women.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">The hospital prevalence of cirrhosis was 44.17% and the mortality rate was 42.23%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The deceased patients were mainly men with an average age of 49 years.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The etiologies of cirrhosis were dominated by viral hepatitis B, chronic alcohol poisoning and viral hepatitis C, respectively 46.95%, 37.35% and 10.84%. The predictors of death were: the presence of icterus (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 1.89, 95%CI [1.08</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">3.30], p = 0.036), hepatic encephalopathy (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 8.75,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [4.51</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">16.94], p < 0.001) and hepatocellular carcinoma (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.23,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.25</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">3.98], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.010);the presence in the biology of hepatic cytolysis (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.57, 95%CI [1.35</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">4.89], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.006), severe hepatocellular insufficiency (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.57,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.38</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">4.77], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.004), severe renal insufficiency</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.41,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.09</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">5.32], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.044)</span><span style="font-family:""> </span><span style="font-family:Verdana;">and hyperleukocytosis (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.28,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.29</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">4.04], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.007);Child-Pugh stage C (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 19.64,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [9.02</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">42.74], p</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001);the presence on ultrasound of large liver</span><span style="font-family:""> </span><span style="font-family:Verdana;">and variable nodules (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 4.16, 95%CI [2.02</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">8.58], p < 0.001). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cirrhosis is a public health problem at the Bouake university hospiler center. Decompensated and complicated old cirrhosis, hepatic cytolysis, severe hepatocellular insufficiency, severe renal insufficiency and hyperleukocytosis, heterogeneous nodular large liver are the detrimental factors.展开更多
Introduction: Children are likely to present with atypical and non-specific clinical manifestations of COVID-19, unlike adults. The aim of this observation is to identify the difficulties related to the diagnosis and ...Introduction: Children are likely to present with atypical and non-specific clinical manifestations of COVID-19, unlike adults. The aim of this observation is to identify the difficulties related to the diagnosis and the curative and preventive management of SARS-CoV-2 infection in children. Observation: This is a 15-month-old infant admitted for febrile seizures. The interrogation revealed signs evolving 48 hours before his admission marked by post-prandial vomiting, wet cough, hypotonia, food refusal, incessant crying, fever, and seizures. His antecedents can be summed up as an uneventful pre- and per-natal period, good eating habits, good psychomotor and staturo-ponderal development, and outdated vaccination. The physical and paraclinical examination made it possible to retain the diagnosis of severe pneumonia. The initial management consisted of oxygenation, hydroelectrolyte intake, antibiotic therapy, and neurosedation. The evolution 3 days later was marked by a worsening of the clinical features, and the hypothesis of infection with SARS-CoV-2 was raised. The nasopharyngeal swab for COVID-19 RT-PCR performed was positive. The infant was isolated in the intensive care unit, where he received oxygen therapy with a mask, enteral nutrition, antibiotic therapy, corticosteroid therapy, and adequate nursing. The evolution was favorable 48 hours later. In addition, his asymptomatic mother and 14-year-old brother were placed in isolation after a positive RT-PCR COVID-19 test. Her father who was very often away from home for professional reasons was negative for COVID-19 RT-PCR. They all four live in the same 3-room house. Conclusion: Childhood COVID-19 has many facets. Clinicians should think about it in the face of any infectious manifestation, in order to avoid delays in treatment and improve the prognosis.展开更多
Context: Compared to adults, there are relatively few studies on pediatric COVID-19 due to the high rate of asymptomatic or paucisymptomatic forms. The aim of this study is to determine the epidemiological, clinical, ...Context: Compared to adults, there are relatively few studies on pediatric COVID-19 due to the high rate of asymptomatic or paucisymptomatic forms. The aim of this study is to determine the epidemiological, clinical, therapeutic, evolutionary and prognostic aspects of COVID-19 infection in children. Patients and Methods: This was a prospective analytical study carried out from February 27, 2021 to January 27, 2022 at the COVID-19 Care Center of the Infectious and Tropical Diseases Department of the Bouaké University Teaching Hospital. The study population consisted of all children under the age of 16, seen in consultation and/or hospitalized with a positive COVID-19 RT-PCR. Data analysis was performed with Epi Info 7 software. The statistical tests used were the chi-square test and Fisher’s exact test depending on the conditions of validity with a significance threshold of p Results: Out of 955 patients received at the COVID-19 Care Center in Bouaké, there were 56 children (26 boys/30 girls), or, a prevalence of 5.86%. The mean age was 9.18 years ± 4.48 [extremes 3 months and 15 years]. Children over the age of 11 accounted for 48.21% of cases. They were contact cases in 35.71% and the contact person was the mother in 75% of cases. The main reasons for screening were cough (67.86%), fever (25%) and sneezing (21.43%). The pathological histories were asthma (83.33%), heart disease (33.33%) and sickle cell disease (16.67%). The medical examination revealed 6 cases of children in vital distress. The care consisted of home confinement for simple cases (89.29%) and hospitalization for cases presenting with vital distress (10.71%). The duration of confinement or hospitalization was between 10 and 15 days in 83.93% of cases. No cases of death were noted. The factors associated with the occurrence of symptomatic forms were age (p = 0.028), pathological history (p Conclusion: The proportion of pediatric cases of COVID-19 is low with a predominance during the season of harmattan. Pediatric infection with COVID-19 is benign and has a favorable evolution, with an almost intra-family transmission wich symptomatology is different from that of adults. Age and pathological history were the factors associated with the occurrence of symptomatic forms.展开更多
文摘Introduction: Coagulase-negative staphylococci (CoNS) are currently recognized as genuine pathogens. However, little is known about the resistance and virulence genes that explain their pathogenicity in hospitals in Cte d'Ivoire. The aim of this study was to contribute to the genotypic identification of resistance and virulence genes in CoNS isolated from blood cultures at the University Teaching Hospital (CHU) of Bouak, in order to improve patient management. Material and Methods: This was a descriptive study conducted from September to December 2023. The CoNS isolates studied came from the collection of strains isolated from blood cultures of febrile patients hospitalized or attending consultations at the CHU of Bouak. The strains were analyzed using conventional simplex PCR. Results: Of the 45 isolates analyzed, 46.7% carried both the aacA-aphD and tetK genes and 40% carried the mecA gene. With regard to virulence genes, only the LukS-PV gene was observed in S. epidermidis and S. haemolyticus isolates. Conclusion: The high prevalence of CoNS isolates carrying the mecA gene and the presence of virulence genes observed in this study give cause for concern in hospitals. It is important to develop comprehensive surveillance strategies against nosocomial and multi-resistant infections at the CHU of Bouak.
文摘Introduction: Retroplacental haematoma (RPH) is a very serious complication of pregnancy, with life-threatening consequences for both the mother and foetus. The aim of this study is to determine the incidence and epidemiological characteristics of patients with retroplacental haematoma (RPH) and describe the maternal-foetal complications at Bouaké University Hospital. Methods: This was a cross-sectional prospective, descriptive and analytical study carried out at Bouaké University Hospital over a period of 3 years, from January 1, 2019 to December 31, 2021. All parturients with RPH whose delivery took place at the hospital were included in the study. Data were entered and analysed using EPI INFO software version 7.2.2.6. Results: We recorded 2,0959 deliveries, including 202 cases of RPH, representing an incidence of 0.96%. The 21 to 35 age group accounted for 64.4%, multigestas and large multigestas accounted for 58.5% and multiparas accounted for 41.6%. The main signs on clinical examination were metrorrhagia (100%), arterial hypertension (84.6%) and cervical cerclage (79.7%). Preeclampsia accounted for 50% of per-gestational pathologies. Maternal mortality was 12.9%. Morbidity was dominated by anaemia in 64.1%, followed by disseminated intravascular coagulation (DIC) in 21.8%, and the factors associated with this maternal prognosis were multiple gestations, multiparity, Sher grade IIIb and the occurrence of complications such as DIC, shock, renal complications and HELLP syndrome. Neonatal mortality was 79.2%, and the factors associated with these fetal prognoses were cup size ≥ 5 cm and hematoma weight ≥ 500 g. Conclusion: Better screening of at-risk populations, early diagnosis and treatment in an organised and equipped medical and surgical facility would improve prognosis.
文摘Background: Non traumatic gonalgia is the second most common reason for rheumatology consultations and accounted for 15.6% of rheumatological disorders in Abidjan. Objective: The aim of this work was to study the epidemiological and diagnostic features of non-traumatic gonalgia (NTG) in a black adult population from sub-Saharan Africa. Patients and Methods: This was a five-year retrospective descriptive study (January 2014 to December 2018) of black sub-Saharan African adult patients with non traumatic gonalgia seen in the rheumatology department of the Bouake University Hospital in Côte d’Ivoire. Results: Of 2198 patients seen for rheumatological conditions, 140 had non traumatic gonalgia (6.4%). The mean age of patients was 56.13 ± 13.3 years (extremes 20 and 87 years), and the sex ratio was 0.43 (42 men and 98 women). Gonalgia without swelling was observed in 33.6% of cases. Symptoms were predominantly progressive (97.1%), chronic (82.1%) and bilateral (50%). The causes of TNM were gonarthrosis (85%), septic arthritis (7.1%), reactive arthritis (2.9%), gout (2.9%), rheumatoid arthritis (1.4%) and chondrocalcinosis (0.7%). Gonarthrosis (119/140) was bilateral in 65 patients, bi- or tri-compartmental in 83, radiographic stage (Kellgren and Lawrence) III in 80 and IV in 15. A germ was isolated in two cases of septic arthritis (methicillin-sensitive Staphylococcus aureus and Streptococcus pneumoniae). Conclusion: GNT is common in rheumatology practice in Bouake, and mainly affects women in their fifties. It is most often a chronic bilateral gonalgia, with gonarthrosis as the main etiology.
文摘Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.
文摘Introduction: The clinical manifestations of many diseases vary with age, and older people often do not show typical symptoms of the disease. The present study aims to compare the epidemiological, clinical, therapeutic and evolutionary aspects of elderly patients with COVID-19 compared to young adult patients and to identify risk factors for mortality. Patients and Methods: This was a retrospective single-center analytical study conducted from January 27, 2021 to January 27, 2022 at the COVID-19 Care Center of the Infectious and Tropical Diseases Department of the Bouaké University Teaching Hospital. The study population consisted of all patients aged at least 18 years seen in consultation and/or hospitalized with a positive COVID-19 RT-PCR. The patients were divided into two groups: younger patients (Results: Of a total of 779 patients, 644 (82.7%) were young. The median age of all patients was 41 years (IQR 32 - 54, extreme 18 and 96). Of all the patients 38.5% had a comorbidity. Compared to younger patients, chronic heart disease (61.7% vs 21.5%;p Conclusion: Elderly people with COVID-19 have a different clinical presentation from younger, characterized by more atypical symptoms. Mortality risk factors are age, dyspnoea, impaired consciousness and fever. It is therefore necessary to act on its various factors to improve the prognosis of COVID-19 in this age group.
文摘Context: COVID-19 is a global public health problem and diabetes mellitus is a poor prognostic factor for the disease. The aim of this study was to investigate the epidemiological, clinical and evolutionary characteristics of COVID-19 in diabetic patients in Bouaké. Patients and Methods: This was a retrospective study carried out from January 2021 to December 2022. We included patients with diabetes known before COVID-19 infection and having a positive COVID-19 RT-PCR. Data were analyzed with Epi info7 software. Results: Among 1122 infected patients, 71 patients (6.3%) were diabetic, the sex ratio was 1.3 and the mean age was 58.7 years. Type 2 diabetes (97.2%) was predominant and the average seniority was 3.1 years. Arterial hypertension (46.5%) was the main comorbidity. The main clinical signs were cough (69%), dyspnea (43.7%) and fever (23.9%). Oxygen saturation was Conclusion: Diabetes mellitus remains one of the most important comorbidities of severe Covid-19. The death rate of diabetics was high. Hence the need to vaccinate people living with diabetes.
文摘Objective: To determine the epidemiology and maternal-fetal prognosis of eclampsia at Bouaké University Teaching Hospital. Material and Methods: This was a prospective study with descriptive and analytical aims over a period from 01 January 2019 to 31 December 2021. It took place in the obstetrics and gynaecology department of the Bouaké University Teaching Hospital. The inclusion criterion was any seizure in the gravid-puerperal period in the context of preeclampsia. Data were entered and analysed using EPI INFO software version 7.2.2.6. Results: We performed 20,958 deliveries and recorded 241 cases of eclampsia, representing a prevalence of 1.14%. The ages of the participants ranged from 13 to 47 years with a mean age ± SD of 22 ± 7 years. The age group ≤ 19 years represented 45.64% of participants. Housewives accounted for 46.47%, and single women accounted for 54.77% of participants. The average parity ± SD was 1 ± 1.6 with range of 0 to 10, and nulliparous women accounted for 49.8% of participants. Patients who were evacuated accounted for 74.27% of our study population. The majority of eclampsia attacks occurred in the antepartum period (56.84%). The mean gestational age ± SD was 36 ± 3.6 weeks with a range of 24 to 42 weeks. The mode of delivery was caesarean section in 64.7% of cases. Maternal lethality was 7.88%. The factors associated with maternal mortality due to eclampsia were evacuation and parity of less than 3. Maternal morbidity was 16.6%. Neonatal lethality was 18.95%. The factor associated with neonatal death in eclampsia was prematurity. Conclusion: We need to detect and manage preeclampsia early and effectively to reduce the frequency of eclampsia and improve its maternal-foetal prognosis in our context.
文摘Introduction: With the eradication of smallpox in 1980, vaccination against smallpox ceased and there was an upsurge in cases of monkeypox. The objective of this observation is to describe the characteristics of monkeypox in the vaccinated subject. Case Report: A 45-year-old, heterosexual, rural resident was referred for a rash. The history of the disease revealed signs of acute course marked by headache, asthenia, diffuse myalgia, chest pain, fever and pruritic rash. His background is marked by vaccination against smallpox in 1977, cohabitation with game hunters and domestic animals as well as a notion of contact with a person who presented similar but more generalized signs. The physical examination revealed a conscious patient with good general state, feverish, tachycardic, eupneic presenting skin lesions in the type of striated vesicles more or less umbilical, on the scalp, face, neck, trunk and the upper limbs associated with cervical lymphadenopathy. RT-PCR was performed on a dry swab by rubbing several vesicles and a throat swab proved positive for Monkeypox Virus (MPXV). Management consisted of isolation and symptomatic treatment. The evolution has been favorable. Conclusion: The symptomatology of monkeypox is similar to that of smallpox. Without widely available treatment or prophylaxis, rapid identification of cases is essential. Vaccination of people at risk is an alternative to curb the epidemic. However, the main prevention strategy is to raise awareness of the risk factors.
文摘Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.
文摘Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. Our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (Results: Our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan<sup>®</sup> value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal ALT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).
文摘<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Cirrhosis, an ineluctable development of chronic liver disease, still has high mortality throughout the world despite many advances in physiopathology and therapy. This high mortality is closely </span><span style="font-family:Verdana;">related</span><span style="font-family:Verdana;"> to the unpredictable course of cirrhosis with numerous complications.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:""><span style="font-family:Verdana;"> To evaluate the predictive factors of death during cirrhosis. </span><b><span style="font-family:Verdana;">Materials and methods:</span></b><span style="font-family:Verdana;"> This is an observational, descriptive study on cirrhotic patients hospitalized in the hepatology unit of the Center Hospitalier Universitaire in Bouake (Ivory Coast) during the period from January 01, 2018 to December 31, 2019. The study focused on the data collected in the medical files (paper format) of hospitalized cirrhotics and the death register of the service.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">The diagnosis of cirrhosis and the death of the cirrhotic were the main criteria for judgment. The secondary criteria defined were: history of cirrhosis, reasons for consultation, clinical signs, biological signs, complications of cirrhosis</span><span style="font-family:Verdana;"> and</span><span style="font-family:Verdana;"> the treatment received. The relationship between the parameters was expressed as an odds ratio (OR) with a 95% confidence interval (CI) and the significance threshold fixed at p <</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.05. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The study retained 206 files of cirrhotics including 146 men and 60 women.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">The hospital prevalence of cirrhosis was 44.17% and the mortality rate was 42.23%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The deceased patients were mainly men with an average age of 49 years.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The etiologies of cirrhosis were dominated by viral hepatitis B, chronic alcohol poisoning and viral hepatitis C, respectively 46.95%, 37.35% and 10.84%. The predictors of death were: the presence of icterus (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 1.89, 95%CI [1.08</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">3.30], p = 0.036), hepatic encephalopathy (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 8.75,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [4.51</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">16.94], p < 0.001) and hepatocellular carcinoma (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.23,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.25</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">3.98], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.010);the presence in the biology of hepatic cytolysis (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.57, 95%CI [1.35</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">4.89], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.006), severe hepatocellular insufficiency (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.57,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.38</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">4.77], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.004), severe renal insufficiency</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.41,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.09</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">5.32], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.044)</span><span style="font-family:""> </span><span style="font-family:Verdana;">and hyperleukocytosis (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 2.28,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [1.29</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">4.04], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.007);Child-Pugh stage C (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 19.64,</span><span style="font-family:""> </span><span style="font-family:Verdana;">95%CI [9.02</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">42.74], p</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001);the presence on ultrasound of large liver</span><span style="font-family:""> </span><span style="font-family:Verdana;">and variable nodules (OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 4.16, 95%CI [2.02</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">8.58], p < 0.001). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cirrhosis is a public health problem at the Bouake university hospiler center. Decompensated and complicated old cirrhosis, hepatic cytolysis, severe hepatocellular insufficiency, severe renal insufficiency and hyperleukocytosis, heterogeneous nodular large liver are the detrimental factors.
文摘Introduction: Children are likely to present with atypical and non-specific clinical manifestations of COVID-19, unlike adults. The aim of this observation is to identify the difficulties related to the diagnosis and the curative and preventive management of SARS-CoV-2 infection in children. Observation: This is a 15-month-old infant admitted for febrile seizures. The interrogation revealed signs evolving 48 hours before his admission marked by post-prandial vomiting, wet cough, hypotonia, food refusal, incessant crying, fever, and seizures. His antecedents can be summed up as an uneventful pre- and per-natal period, good eating habits, good psychomotor and staturo-ponderal development, and outdated vaccination. The physical and paraclinical examination made it possible to retain the diagnosis of severe pneumonia. The initial management consisted of oxygenation, hydroelectrolyte intake, antibiotic therapy, and neurosedation. The evolution 3 days later was marked by a worsening of the clinical features, and the hypothesis of infection with SARS-CoV-2 was raised. The nasopharyngeal swab for COVID-19 RT-PCR performed was positive. The infant was isolated in the intensive care unit, where he received oxygen therapy with a mask, enteral nutrition, antibiotic therapy, corticosteroid therapy, and adequate nursing. The evolution was favorable 48 hours later. In addition, his asymptomatic mother and 14-year-old brother were placed in isolation after a positive RT-PCR COVID-19 test. Her father who was very often away from home for professional reasons was negative for COVID-19 RT-PCR. They all four live in the same 3-room house. Conclusion: Childhood COVID-19 has many facets. Clinicians should think about it in the face of any infectious manifestation, in order to avoid delays in treatment and improve the prognosis.
文摘Context: Compared to adults, there are relatively few studies on pediatric COVID-19 due to the high rate of asymptomatic or paucisymptomatic forms. The aim of this study is to determine the epidemiological, clinical, therapeutic, evolutionary and prognostic aspects of COVID-19 infection in children. Patients and Methods: This was a prospective analytical study carried out from February 27, 2021 to January 27, 2022 at the COVID-19 Care Center of the Infectious and Tropical Diseases Department of the Bouaké University Teaching Hospital. The study population consisted of all children under the age of 16, seen in consultation and/or hospitalized with a positive COVID-19 RT-PCR. Data analysis was performed with Epi Info 7 software. The statistical tests used were the chi-square test and Fisher’s exact test depending on the conditions of validity with a significance threshold of p Results: Out of 955 patients received at the COVID-19 Care Center in Bouaké, there were 56 children (26 boys/30 girls), or, a prevalence of 5.86%. The mean age was 9.18 years ± 4.48 [extremes 3 months and 15 years]. Children over the age of 11 accounted for 48.21% of cases. They were contact cases in 35.71% and the contact person was the mother in 75% of cases. The main reasons for screening were cough (67.86%), fever (25%) and sneezing (21.43%). The pathological histories were asthma (83.33%), heart disease (33.33%) and sickle cell disease (16.67%). The medical examination revealed 6 cases of children in vital distress. The care consisted of home confinement for simple cases (89.29%) and hospitalization for cases presenting with vital distress (10.71%). The duration of confinement or hospitalization was between 10 and 15 days in 83.93% of cases. No cases of death were noted. The factors associated with the occurrence of symptomatic forms were age (p = 0.028), pathological history (p Conclusion: The proportion of pediatric cases of COVID-19 is low with a predominance during the season of harmattan. Pediatric infection with COVID-19 is benign and has a favorable evolution, with an almost intra-family transmission wich symptomatology is different from that of adults. Age and pathological history were the factors associated with the occurrence of symptomatic forms.
