BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for...BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.展开更多
Introduction: Invasive cancers of the vulva are uncommon;it is a pathology of the elderly. More and more young women are concerned. Objectives: To study and analyze vulvar cancer in our context. Patients and Method: R...Introduction: Invasive cancers of the vulva are uncommon;it is a pathology of the elderly. More and more young women are concerned. Objectives: To study and analyze vulvar cancer in our context. Patients and Method: Retrospective, descriptive and analytical study carried out in the Gynecology Department of the Owendo University Hospital over a period of 5 years from 2020 to 2024. All cancer cases of the period were concerned and we included vulvar cancers. We studied the epidemiological, clinical and therapeutic aspects. Results: We collected 5 files, the median age was 41.8 years [30 - 57 years], the average consultation time was 18 months [12 - 36 months]. Ulcerated, budding, and itchy lesions were present in 80% of cases. Invasive squamous cell carcinoma was the histological type present in all patients. Surgery was performed in 40% of cases. Concomitant radiochemotherapy (CRC) was offered in all patients. HIV was the comorbidity found in 100% of cases. Conclusion: Vulvar cancers are rare. They are often seen at advanced stages because of their location, the taboo nature they represent on the one hand and underdiagnosis on the other.展开更多
Gabon,located on the west coast of Central Africa,is one of the most forested countries.This small but richly biodiverse country is covered by rainforests,which make up approximately 85%of its land area.These forests ...Gabon,located on the west coast of Central Africa,is one of the most forested countries.This small but richly biodiverse country is covered by rainforests,which make up approximately 85%of its land area.These forests are home to a wide variety of wildlife,including elephants and numerous bird species,making Gabon a crucial area for conservation efforts.展开更多
Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and ...Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and perinatal prognosis. Patients and Method: Preliminary longitudinal and analytical survey at the Owendo University Hospital (OHU) over 6 months. It focused on prenatal surveillance. The study population consisted of parturients who gave birth within 24 hours and we studied sociodemographic characteristics, variables related to antenatal contact, those of delivery as well as maternal and newborn outcomes. Results: 2485 deliveries were recorded and 1300 patients were retained according to the inclusion criteria. No prenatal contact (ANC0) was performed in 93 (7.15%), insufficient (ANCI) in 943 patients (72.5%), and sufficient (ANCS) in 264 patients (20.30%). Patients with low school level were significantly found when the NPC was not performed or insufficient and the same was true for the group of patients who were not employed and those who were single (p < 0.005). The caesarean section rate and perinatal mortality are high in this case. Conclusion: The quality of prenatal contact is insufficient in our context. The absence or inadequacy of the latter has a strong negative impact on maternal and perinatal morbidity and mortality.展开更多
Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. ...Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.展开更多
Introduction: Ambulatory surgery requires effective analgesia with few side effects to allow a return home on the day of surgery. The aim of the study was to compare the efficacy of intrathecal morphine (Ram) and erec...Introduction: Ambulatory surgery requires effective analgesia with few side effects to allow a return home on the day of surgery. The aim of the study was to compare the efficacy of intrathecal morphine (Ram) and erector spinae plane block (ESP) in outpatient abdominal wall surgery. Methodology: Thirty-six patients were randomized into two groups. The ESP group (n = 23) benefited from the ESP block with bupivacaine 5% (20 ml) followed by spinal anesthesia with bupivacaine (7.5 mg) and sufenta (2.5 µg). The Ram group (n = 13) benefited from spinal anesthesia with bupivacaine (7.5 mg), sufenta (2.5 µg) and morphine (100 µg). The primary endpoint was whether or not to return home on the day of surgery. The secondary endpoint was the pain score by the visual analog scale (VAS) in the post-intervention monitoring room (SSPI). After 2 hours (H2) and one day (D1) after surgery, the morphine consumption in the immediate postoperative period (mg) and the undesirable effects. Results: Inguinal hernia surgery predominated (n = 30). No difference in age (45.05 vs 50.7;p = 0.4), ASA score (1.43 vs 1.53;p = 0.57). All patients (n = 36) returned home on the day of surgery. No difference in postoperative pain in SSPI (p = 0.6), 2 hours after surgery (p = 0.40) and the day after surgery (p = 0.6). Postoperative morphine consumption was identical (0.9 mg vs 0.2 mg, p = 0.2). There were 2 urinary retentions in the Ram group. Conclusion: The erector spinae plane block and intrathecal morphine are well tolerated and perfectly compatible with the requirements of outpatient abdominal wall surgery.展开更多
Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivaria...Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivariate soil quality indice (SQI) models, such as additive quality index (AQI), weighted quality indexes (WQI<sub>add</sub> and WQI<sub>com</sub>) and Nemoro quality index (NQI), applied to two approaches of indicator selection: total data set (TDS) and minimum data set (MDS). Physical and chemical soil indicators were extracted from the ORSTOM’s reports resulting from a sampling campaign in different provinces of Gabon. The TDS approach shows soil quality status according to eleven soil indicators extracted from the analysis of 1,059 samples from arable soil layer (0 - 30 cm depth). The results indicated that 87% of all provinces presented a very low soil quality (Q5) whatever the model. Among soil indicators, exchangeable K<sup>+</sup> and Mg<sup>2+</sup>, bulk density and C/N ratio were retained in MDS, using principal component analysis (PCA). In the MDS approach, 50 to 63% of provinces had low soil quality grades with AQI, WQI<sub>add</sub> and NQI, whereas the total was observed with WQI<sub>com</sub>. Only 25% of provinces had medium soil quality grades with AQI and NQI models, while 12.5% (NQI) and 25% (AQI) presented high quality grades. Robust statistical analyses confirmed the accuracy and validation (0.80 r P ≤ 0.016) of AQI, WQI<sub>add</sub> and NQI into the TDS and MDS approaches. The same sensitivity index value (1.53) was obtained with AQI and WQI<sub>add</sub>. However, WQI<sub>add</sub> was chosen as the best SQI model, according to its high linear regression value (R<sup>2</sup> = 0.82) between TDS and MDS. This study has important implications in decision-making on monitoring, evaluation and sustainable management of Gabonese soils in a pedoclimatic context unfavorable to plant growth.展开更多
Honey harvesting throughout beekeeping is a technology recently introduced in Gabon comparing to the other African countries well known in international honey trade. The purpose of this study is to contribute to the k...Honey harvesting throughout beekeeping is a technology recently introduced in Gabon comparing to the other African countries well known in international honey trade. The purpose of this study is to contribute to the knowledge of the quality of multi-flower honeys from the savannah-gallery forest complex and primary forest not well documented in Gabon. Physical and chemical parameters of different honeys were analyzed using the official methods of analysis of the Association of Official Analytical Chemists. The results of physico-chemical analysis show variations in pH (3.4 to 3.9), free acidity (37.12 to 76.65 meq∙kg−1), water content (17.49% to 21.21%), electrical conductivity (0.64 to 1.24 mS∙cm−1), density (1.02 to 1.03) and total sugar content (77% to 82%). These variations were significantly different (p < 0.05) between certain honeys, but independent of the type of ecosystem considered. The pH values confirmed the botanical origin of the five honeys. The physico-chemical parameters of the honeys show significant correlations (p < 0.05). Moisture content is negatively correlated with conductivity (r = −0.628), pH (r = −0.631), density (r = −0.552) and total sugar content (r = −0.890). Conductivity is positively correlated with free acidity (r = 0.688) and total sugar content (r = 0.776), and negatively correlated with water content (r = −0.628). All honeys were in line with Codex Alimentarius standards, except for 3 types of honey (M1, M2 and M4) for free acidity and electrical conductivity, showing possible fermentation of these honeys.展开更多
Gabonese’s estuary is an important coastal mangrove setting and soil plays a key role in mangrove carbon storage in mangrove forests. However, the spatial variation in soil organic carbon (SOC) storage remain unclear...Gabonese’s estuary is an important coastal mangrove setting and soil plays a key role in mangrove carbon storage in mangrove forests. However, the spatial variation in soil organic carbon (SOC) storage remain unclear. To address this gap, determining the SOC spatial variation in Gabonese’s estuarine is essential for better understanding the global carbon cycle. The present study compared soil organic carbon between northern and southern sites in different mangrove forest, Rhizophora racemosa and Avicennia germinans. The results showed that the mean SOC stocks at 1 m depth were 256.28 ± 127.29 MgC ha<sup>−</sup><sup>1</sup>. Among the different regions, SOC in northern zone was significantly (p p < 0.001). The deeper layers contained higher SOC stocks (254.62 ± 128.09 MgC ha<sup>−</sup><sup>1</sup>) than upper layers (55.42 ± 25.37 MgC ha<sup>−</sup><sup>1</sup>). The study highlights that low deforestation rate have led to less CO<sub>2</sub> (705.3 Mg CO<sub>2</sub>e ha<sup>−</sup><sup>1</sup> - 922.62 Mg CO<sub>2</sub>e ha<sup>−</sup><sup>1</sup>) emissions than most sediment carbon-rich mangroves in the world. These results highlight the influence of soil texture and mangrove forest types on the mangrove SOC stocks. The first national comparison of soil organic carbon stocks between mangroves and upland tropical forests indicated SOC stocks were two times more in mangroves soils (51.21 ± 45.00 MgC ha<sup>−</sup><sup>1</sup>) than primary (20.33 ± 12.7 MgC ha<sup>−</sup><sup>1</sup>), savanna and cropland (21.71 ± 15.10 MgC ha<sup>−</sup><sup>1</sup>). We find that mangroves in this study emit lower dioxide-carbon equivalent emissions. This study highlights the importance of national inventories of soil organic carbon and can be used as a baseline on the role of mangroves in carbon sequestration and climate change mitigation but the variation in SOC stocks indicates the need for further national data.展开更多
Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique th...Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO<sub>2</sub>/FiO<sub>2</sub> ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanical ventilation is a risk factor for death.展开更多
The Gabon Coastal Basin is a typical saliferous basin located in the middle portion of the West African passive continental margin. Complex salt tectonics make sedimentary sequences and structural frameworks difficult...The Gabon Coastal Basin is a typical saliferous basin located in the middle portion of the West African passive continental margin. Complex salt tectonics make sedimentary sequences and structural frameworks difficult to interpret and can lead to difficulties in construction of balanced cross-sections and reconstruction of basin evolutionary processes. Sedimentary facies and salt structur- al patterns displaying zonation are based on seismic reflection profiles and drilling data. Two near-vertical fault systems, NW-SE and NE-SW, caused basin to be subdivided E-W zoning and N-S partitioning. Scarp slopes and extension faults formed in the Hinge belt III zone where salt diapir piercement occurred and numbers of salt pillars, salt stocks and salt rollers developed under transten- sion of coupled near-orthogonal fault systems. The zone east of Hinge belt III is characterized by small-scale salt domes and salt pillows. To the west are large-scale salt walls and salt bulge anticlines caused by diapirism promoted by tension and torsion that also resulted in formation of numerous salt pillars, salt stocks and salt rollers. Our modeling of salt tectonic structures indicates that they were produced by plastic rheological deformation of salt under regional stress fields that varied during three distinct phases of extension, compression and re-activation. Hinge belt III was active from Coniacian to Early Eocene, which was a critical period of formation of salt structures when many extension-related salt structures formed and salt diapirism controlled the distribution of turbidite fans. Rootless extrusion-related salt stocks developed throughout the Late Eocene to Early Oligocene as a result of lo- cal ephemeral low-intensity tectonic inversion. Post Oligocene salt diapirism was weak and salt tecton- ics had a weak influence on sedimentation. Balanced cross-sections of two saliferous horizons crossing different tectonic units from east to west reveal that the basin tectonic evolution and sediment filling processes can be divided into three stages containing seven episodes of rifting, transition and drifting.展开更多
Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis an...Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis and associated factors among patients at the Amissa Bongo Regional Hospital in Franceville, Gabon. Patients and Methods: This prospective, cross-sectional study was conducted in the biomedical analysis laboratory of the Amissa Bongo Regional University Hospital in Franceville from 19 June 2021 to 22 January 2022. After agreeing to take part in the study, participants were asked to fill in a questionnaire to collect their socio-demographic data and habits. Clinical signs were also observed. Sputum and gastric fluid samples were collected and examined using the Xpert MTB/RIF test and BAAR smear microscopy. Data were analysed using R software version 3.6.1. The results of the univariate and multivariate analyses were considered significant for p ≤ 0.05. Results: A total of 309 patients were included in this study, 50.81% (n = 157) men and 49.19% (n = 152) women. Of these, 98 had a positive diagnosis of pulmonary tuberculosis, giving an overall prevalence rate of 31.72%. There were 40 women or 40.82% (95% CI: [0.30 - 0.51]) and 58 men or 59.18% (95% CI: [0.48 - 0.69]). A univariate analysis of the prevalence of tuberculosis according to risk factors and clinical signs indicated a certain association between certain variables. However, an in-depth multivariate logistic regression analysis of this prevalence, according to the risk factors and clinical signs observed in the patients in the study, indicated that the age group 15 and 49 years (Adjusted OR = 47.77;95% CI: [4.4;519.7] p = 0.001*), fever (Adjusted OR = 4.83;95% CI: [1.16, 20.12] p = 0.031*), alcohol consumption (Adjusted OR = 12.2;95% CI: 12.2 [2.5;5.9] p = 0. 002*), smoking (Adjusted OR = 9.83;95% CI: [1.78;54.24] p = 0.037), HIV infection (Adjusted OR = 4.63;95% CI: [1.25;17.1] p = 0.022), cough (Adjusted OR = 4.31;95% CI: [1.21, 15.4] p = 0. 025*), chest pain (Adjusted OR = 103.6;95% CI: [19.4;55.2] p = 0.000), night sweating cough (Adjusted OR = 10.84;95% CI: [3.18;36.98] p = 0.000*) were significant risk factors for pulmonary tuberculosis. Conclusion: The results of the present study showed that the prevalence of pulmonary tuberculosis was greatest among males in Franceville and the surrounding area. The 15 - 49 age group, fever, alcohol consumption, smoking, HIV infection, chest pain, night sweats and cough were significant risk factors for pulmonary tuberculosis. Consequently, screening for tuberculosis in HIV-positive patients, public awareness and community mobilisation should be encouraged.展开更多
The Francevillian Group in Gabonese Republic was recently established as a typical sedimentary sequence for the Paleoproterozoic.However,its age is rather poorly constrained,mainly based on Rb-Sr and Nd-Sm datings.Thi...The Francevillian Group in Gabonese Republic was recently established as a typical sedimentary sequence for the Paleoproterozoic.However,its age is rather poorly constrained,mainly based on Rb-Sr and Nd-Sm datings.This study reports new zircon data obtained from Chaillu massif and N＇goutou complex,which constrain the protolith age of the basement orthogneisses and the igneous age of an intrusive granite,respectively.Most zircons from the orthogneisses are blue and exhibit oscillatory zoning in cathode-luminescence images.Zircons with lower common lead abundances tend to be distributed close to the concordia curve.Two age clusters around 2860 Ma and 2910 Ma are found in zircons plotted on the concordia curve.Based on the Th/U ratios of zircons,these ages correspond to the protolith ages of the orthogneisses,and the zircons are not metamorphic in origin.Syenites and granites were collected from the N＇goutou complex that intrudes into the FA and FB units of the Francevillian Group.The granitoids exhibit chemical composition of A-type granite affinity.Half of zircons separated from the granite are non-luminous,and the remaining half exhibit obscure internal textures under cathode-luminescence observation.All zircon grains contain significant amounts of common lead;the lead isotopic variability is probably attributed to the mixing of two components in the zircons.The zircon radiogenic ^（207）Pb/^（206）Pb ratio is 0.13707 ± 0.0010.corresponding to a ^（207）Pb/^（206）Pb age of 2191 ± 13 Ma.This constrains the minimum depositional age of the FA and FB units.Furthermore,the FB unit consists of manganese-rich carbonate rocks and organic carbon-rich black shales with macroscopic fossils.Based on our age constraints,these organisms appeared in the study area just after the last Paleoproterozoic Snowball Earth event,in concert with global scale oxidation event encompassing the Snowball Earth.展开更多
Neurocysticercosis(NCC) is recognized as a cause of neurologic disease worldwide.We reported two cases(one co-infected with the HIV) of NCC.Medical treatment led to recovery.NCC should be considered in tropical countr...Neurocysticercosis(NCC) is recognized as a cause of neurologic disease worldwide.We reported two cases(one co-infected with the HIV) of NCC.Medical treatment led to recovery.NCC should be considered in tropical countries as a cause of epilepsy and included in the diagnosis of neurologic infections in HIV patients.展开更多
Objective:To explore the possible association between polymorphisms in CD1 genes and both asymptomatic and mild Plasmodium falciparum infection.Methods:Two clusters of 85 school children,from the village of Dienga(Gab...Objective:To explore the possible association between polymorphisms in CD1 genes and both asymptomatic and mild Plasmodium falciparum infection.Methods:Two clusters of 85 school children,from the village of Dienga(Gabon)were investigated.The first group was analysed for the prevalence and the multiplicity of asymptomatic Plasmodium falciparum infection,whereas the second group was screened for the frequency of malarial attacks.Results:Our findings showed that homozygosity for the CD1E★02 allele was associated with a low frequency of malarial attacks.Furthermore,a strong association between CD1E★02 homozygotes and the resistance to multiple malarial attacks was identified.The CD1A★01 allele showed a weak association with a small number of malarial attacks.Conclusion:Our results suggest a possible role of CD1E polymorphisms in malaria protection among school children and that CD1e molecules are involved in anti-malarial immunity.展开更多
Background: Tungiasis is a skin infestation caused by the female sand flea called Tunga penetrans. Associated with a significant morbidity, this ectoparasite is present in all tropical regions, such as Gabon. Unfortun...Background: Tungiasis is a skin infestation caused by the female sand flea called Tunga penetrans. Associated with a significant morbidity, this ectoparasite is present in all tropical regions, such as Gabon. Unfortunately, in this country, no study has ever been undertaken on this disease. However, in both urban and rural areas of this country, it causes disfigurement and mutilation of the feet or hands in infested persons, and is sometimes responsible for the school dropout of many children. It is in this context that this timely and relevant research was conducted to assess the prevalence and risk factors associated with Tungiasis in school-aged children in the city of Port Gentil, Ogooué-Maritime province, Gabon in Central Africa. Materials and Methods: This prospective and cross-sectional study took place from May 22 to August 18, 2022, in two popular and underprivileged neighborhoods of the city of Port Gentil. It consisted of a physical diagnosis of the participants, and with the help of a questionnaire submitted to their parents/guardians, numerous data were collected. Entered into an Excel 2016 spreadsheet, the data were exported to the R software in its R Commander interface, for two types of analyses. A univariate and a multivariate analysis, using logistic regression, first on socio-demographic characteristics and then on habitual and environmental behavioral characteristics, was performed and the variables in this analysis reported odds ratios and their 95% confidence intervals. The results were statistically significant at p Results: A total of 637 school-aged children with a mean age of 12.73 years and a standard deviation of 5.44, were registered and examined for this study. Among them, Tunga penetrans infestation was found in 242 children, indicating an overall prevalence of 37.99% (95% CI [0.34 - 0.41]). Univariate and multivariate analyses, using logistic regression, first according to socio-demographic characteristics and then according to risk factors indicated that, the age groups of 5 to 9 years (Adjusted Odds Ratio = 9.27;95% CI: [6.66 - 12. 91]) and 10 - 14 years (Adjusted Odds Ratio = 0.16;95% CI: [0.10 - 0.25]), Eshira ethnicity (Adjusted Odds Ratio = 7.46;95% CI: [2.97 - 18.76]), child’s primary education level (Adjusted Odds Ratio = 0.008;95% CI: [0.006 - 0.011]), Father’s/Guardian’s education level (Adjusted Odds Ratio = 0.22;95% CI: [0.13 - 0.35]), homemaker status (Adjusted Odds Ratio = 4.89;95% CI: [3.51 - 6. 79]) and risk factors such as: promiscuity with dogs, cats or other animals around the house (Adjusted Odds Ratio = 38.30;95% CI: [22.13 - 66.26]), wearing shoes a few times (Adjusted Odds Ratio = 0.02;95% CI [0.01 - 0.03]), walking sometimes barefoot, on land or sand (Adjusted Odds Ratio = 0.28;95% CI: [0.18 - 0.42]), having other sources of water consumed than the tap (Adjusted Odds Ratio = 0.25;95% CI: [0.16 - 037]), living in a dwelling with soil or sand (Adjusted Odds Ratio = 6.8;95% CI: [4.58 - 10.09]), having average housing conditions (Adjusted Odds Ratio = 46.8;95% CI [24.29 - 90.16]), and the number of people living in the family that was greater than or equal to 6 (Adjusted Odds Ratio = 0.1;95% CI [0.07 - 0.13]), were significantly associated with the prevalence of Tungiasis. Conclusion: The results of this study will inform control programs and water and sanitation interventions for the Tunga penetrans epidemic in Port Gentil, Gabon.展开更多
Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptiv...Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.展开更多
Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a c...Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episodes, the underlying cause could not be determined. Nonetheless, malaria was identified as one of the principal identifiable causes of fever among children with SDC in Libreville. Treatment for malaria upon admission, and the promotion of preventative measures, therefore seems to be appropriate for our clinical setting. In light of the large number of unresolved cases, systematic prescription of broad-spectrum antibiotics may also be called for.展开更多
Context: Diabetes mellitus is experiencing an alarming progression throughout the world, but more and more drugs are available with the use not always adapted. The aim of this work is to analyze the anti-diabetic pres...Context: Diabetes mellitus is experiencing an alarming progression throughout the world, but more and more drugs are available with the use not always adapted. The aim of this work is to analyze the anti-diabetic prescriptions at the university hospital center of Libreville (Gabon) and confront them with the concept of therapeutic inertia. Patients and Methods: In diabetics coming for their periodic control, we transcripted for 2 months, beyond their characteristics, their glycated hemoglobin rate and the treatment followed. Results: 200 patients have consulted and among them, 160 (80%) had done their A1c analysis. 46% had an A1c ≤ 7% and 54% above with sometimes an unsuitable treatment evoking therapeutic inertia, the factors of which we discuss. Conclusion: Therapeutic inertia is a multifactorial problem, one of the components of which may be the resistance to change of the adult learners who are the practitioners.展开更多
Pregnancy and systemic lupus erythematosus in black African women: about 10 cases in Libreville (Gabon). Objectives: Through a study in a population of systemic lupus erythematosus (SLE) pregnant black Gabonese women,...Pregnancy and systemic lupus erythematosus in black African women: about 10 cases in Libreville (Gabon). Objectives: Through a study in a population of systemic lupus erythematosus (SLE) pregnant black Gabonese women, we describe the characteristics of these pregnancies to clarify their main complications and to make recommendations to their follow-up in low resource countries. Patients and Methods: This is a longitudinal descriptive study conducted over a period of six years, from 1 January 2008 to October 31, 2013, in Libreville (Gabon). We’ve included, systemic lupus erythematosus women carrying a pregnancy during the period of the study. Results: Seventy-two SLE women were followed and were eligible. Only 8 patients (11%) were pregnant during the follow up period. These 8 SLE patients allowed us to monitor 10 pregnancies. The average parity was 0.88. Eight pregnancies in ten (80%) had complications and most frequent was preeclampsia. Nine pregnancies (90%) resulted in the birth of viable children of which 4 (44.4%) were born by caesarean section and the 5 others (55.6%) were born by natural route. Conclusion: We recommend a monthly prenatal care for these high-risk pregnancies and early detection of preeclampsia.展开更多
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.
文摘Introduction: Invasive cancers of the vulva are uncommon;it is a pathology of the elderly. More and more young women are concerned. Objectives: To study and analyze vulvar cancer in our context. Patients and Method: Retrospective, descriptive and analytical study carried out in the Gynecology Department of the Owendo University Hospital over a period of 5 years from 2020 to 2024. All cancer cases of the period were concerned and we included vulvar cancers. We studied the epidemiological, clinical and therapeutic aspects. Results: We collected 5 files, the median age was 41.8 years [30 - 57 years], the average consultation time was 18 months [12 - 36 months]. Ulcerated, budding, and itchy lesions were present in 80% of cases. Invasive squamous cell carcinoma was the histological type present in all patients. Surgery was performed in 40% of cases. Concomitant radiochemotherapy (CRC) was offered in all patients. HIV was the comorbidity found in 100% of cases. Conclusion: Vulvar cancers are rare. They are often seen at advanced stages because of their location, the taboo nature they represent on the one hand and underdiagnosis on the other.
文摘Gabon,located on the west coast of Central Africa,is one of the most forested countries.This small but richly biodiverse country is covered by rainforests,which make up approximately 85%of its land area.These forests are home to a wide variety of wildlife,including elephants and numerous bird species,making Gabon a crucial area for conservation efforts.
文摘Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and perinatal prognosis. Patients and Method: Preliminary longitudinal and analytical survey at the Owendo University Hospital (OHU) over 6 months. It focused on prenatal surveillance. The study population consisted of parturients who gave birth within 24 hours and we studied sociodemographic characteristics, variables related to antenatal contact, those of delivery as well as maternal and newborn outcomes. Results: 2485 deliveries were recorded and 1300 patients were retained according to the inclusion criteria. No prenatal contact (ANC0) was performed in 93 (7.15%), insufficient (ANCI) in 943 patients (72.5%), and sufficient (ANCS) in 264 patients (20.30%). Patients with low school level were significantly found when the NPC was not performed or insufficient and the same was true for the group of patients who were not employed and those who were single (p < 0.005). The caesarean section rate and perinatal mortality are high in this case. Conclusion: The quality of prenatal contact is insufficient in our context. The absence or inadequacy of the latter has a strong negative impact on maternal and perinatal morbidity and mortality.
文摘Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.
文摘Introduction: Ambulatory surgery requires effective analgesia with few side effects to allow a return home on the day of surgery. The aim of the study was to compare the efficacy of intrathecal morphine (Ram) and erector spinae plane block (ESP) in outpatient abdominal wall surgery. Methodology: Thirty-six patients were randomized into two groups. The ESP group (n = 23) benefited from the ESP block with bupivacaine 5% (20 ml) followed by spinal anesthesia with bupivacaine (7.5 mg) and sufenta (2.5 µg). The Ram group (n = 13) benefited from spinal anesthesia with bupivacaine (7.5 mg), sufenta (2.5 µg) and morphine (100 µg). The primary endpoint was whether or not to return home on the day of surgery. The secondary endpoint was the pain score by the visual analog scale (VAS) in the post-intervention monitoring room (SSPI). After 2 hours (H2) and one day (D1) after surgery, the morphine consumption in the immediate postoperative period (mg) and the undesirable effects. Results: Inguinal hernia surgery predominated (n = 30). No difference in age (45.05 vs 50.7;p = 0.4), ASA score (1.43 vs 1.53;p = 0.57). All patients (n = 36) returned home on the day of surgery. No difference in postoperative pain in SSPI (p = 0.6), 2 hours after surgery (p = 0.40) and the day after surgery (p = 0.6). Postoperative morphine consumption was identical (0.9 mg vs 0.2 mg, p = 0.2). There were 2 urinary retentions in the Ram group. Conclusion: The erector spinae plane block and intrathecal morphine are well tolerated and perfectly compatible with the requirements of outpatient abdominal wall surgery.
文摘Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivariate soil quality indice (SQI) models, such as additive quality index (AQI), weighted quality indexes (WQI<sub>add</sub> and WQI<sub>com</sub>) and Nemoro quality index (NQI), applied to two approaches of indicator selection: total data set (TDS) and minimum data set (MDS). Physical and chemical soil indicators were extracted from the ORSTOM’s reports resulting from a sampling campaign in different provinces of Gabon. The TDS approach shows soil quality status according to eleven soil indicators extracted from the analysis of 1,059 samples from arable soil layer (0 - 30 cm depth). The results indicated that 87% of all provinces presented a very low soil quality (Q5) whatever the model. Among soil indicators, exchangeable K<sup>+</sup> and Mg<sup>2+</sup>, bulk density and C/N ratio were retained in MDS, using principal component analysis (PCA). In the MDS approach, 50 to 63% of provinces had low soil quality grades with AQI, WQI<sub>add</sub> and NQI, whereas the total was observed with WQI<sub>com</sub>. Only 25% of provinces had medium soil quality grades with AQI and NQI models, while 12.5% (NQI) and 25% (AQI) presented high quality grades. Robust statistical analyses confirmed the accuracy and validation (0.80 r P ≤ 0.016) of AQI, WQI<sub>add</sub> and NQI into the TDS and MDS approaches. The same sensitivity index value (1.53) was obtained with AQI and WQI<sub>add</sub>. However, WQI<sub>add</sub> was chosen as the best SQI model, according to its high linear regression value (R<sup>2</sup> = 0.82) between TDS and MDS. This study has important implications in decision-making on monitoring, evaluation and sustainable management of Gabonese soils in a pedoclimatic context unfavorable to plant growth.
文摘Honey harvesting throughout beekeeping is a technology recently introduced in Gabon comparing to the other African countries well known in international honey trade. The purpose of this study is to contribute to the knowledge of the quality of multi-flower honeys from the savannah-gallery forest complex and primary forest not well documented in Gabon. Physical and chemical parameters of different honeys were analyzed using the official methods of analysis of the Association of Official Analytical Chemists. The results of physico-chemical analysis show variations in pH (3.4 to 3.9), free acidity (37.12 to 76.65 meq∙kg−1), water content (17.49% to 21.21%), electrical conductivity (0.64 to 1.24 mS∙cm−1), density (1.02 to 1.03) and total sugar content (77% to 82%). These variations were significantly different (p < 0.05) between certain honeys, but independent of the type of ecosystem considered. The pH values confirmed the botanical origin of the five honeys. The physico-chemical parameters of the honeys show significant correlations (p < 0.05). Moisture content is negatively correlated with conductivity (r = −0.628), pH (r = −0.631), density (r = −0.552) and total sugar content (r = −0.890). Conductivity is positively correlated with free acidity (r = 0.688) and total sugar content (r = 0.776), and negatively correlated with water content (r = −0.628). All honeys were in line with Codex Alimentarius standards, except for 3 types of honey (M1, M2 and M4) for free acidity and electrical conductivity, showing possible fermentation of these honeys.
文摘Gabonese’s estuary is an important coastal mangrove setting and soil plays a key role in mangrove carbon storage in mangrove forests. However, the spatial variation in soil organic carbon (SOC) storage remain unclear. To address this gap, determining the SOC spatial variation in Gabonese’s estuarine is essential for better understanding the global carbon cycle. The present study compared soil organic carbon between northern and southern sites in different mangrove forest, Rhizophora racemosa and Avicennia germinans. The results showed that the mean SOC stocks at 1 m depth were 256.28 ± 127.29 MgC ha<sup>−</sup><sup>1</sup>. Among the different regions, SOC in northern zone was significantly (p p < 0.001). The deeper layers contained higher SOC stocks (254.62 ± 128.09 MgC ha<sup>−</sup><sup>1</sup>) than upper layers (55.42 ± 25.37 MgC ha<sup>−</sup><sup>1</sup>). The study highlights that low deforestation rate have led to less CO<sub>2</sub> (705.3 Mg CO<sub>2</sub>e ha<sup>−</sup><sup>1</sup> - 922.62 Mg CO<sub>2</sub>e ha<sup>−</sup><sup>1</sup>) emissions than most sediment carbon-rich mangroves in the world. These results highlight the influence of soil texture and mangrove forest types on the mangrove SOC stocks. The first national comparison of soil organic carbon stocks between mangroves and upland tropical forests indicated SOC stocks were two times more in mangroves soils (51.21 ± 45.00 MgC ha<sup>−</sup><sup>1</sup>) than primary (20.33 ± 12.7 MgC ha<sup>−</sup><sup>1</sup>), savanna and cropland (21.71 ± 15.10 MgC ha<sup>−</sup><sup>1</sup>). We find that mangroves in this study emit lower dioxide-carbon equivalent emissions. This study highlights the importance of national inventories of soil organic carbon and can be used as a baseline on the role of mangroves in carbon sequestration and climate change mitigation but the variation in SOC stocks indicates the need for further national data.
文摘Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO<sub>2</sub>/FiO<sub>2</sub> ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanical ventilation is a risk factor for death.
基金supported by the National Natural Science Fundation of China(Nos.40839902 and 40739901)
文摘The Gabon Coastal Basin is a typical saliferous basin located in the middle portion of the West African passive continental margin. Complex salt tectonics make sedimentary sequences and structural frameworks difficult to interpret and can lead to difficulties in construction of balanced cross-sections and reconstruction of basin evolutionary processes. Sedimentary facies and salt structur- al patterns displaying zonation are based on seismic reflection profiles and drilling data. Two near-vertical fault systems, NW-SE and NE-SW, caused basin to be subdivided E-W zoning and N-S partitioning. Scarp slopes and extension faults formed in the Hinge belt III zone where salt diapir piercement occurred and numbers of salt pillars, salt stocks and salt rollers developed under transten- sion of coupled near-orthogonal fault systems. The zone east of Hinge belt III is characterized by small-scale salt domes and salt pillows. To the west are large-scale salt walls and salt bulge anticlines caused by diapirism promoted by tension and torsion that also resulted in formation of numerous salt pillars, salt stocks and salt rollers. Our modeling of salt tectonic structures indicates that they were produced by plastic rheological deformation of salt under regional stress fields that varied during three distinct phases of extension, compression and re-activation. Hinge belt III was active from Coniacian to Early Eocene, which was a critical period of formation of salt structures when many extension-related salt structures formed and salt diapirism controlled the distribution of turbidite fans. Rootless extrusion-related salt stocks developed throughout the Late Eocene to Early Oligocene as a result of lo- cal ephemeral low-intensity tectonic inversion. Post Oligocene salt diapirism was weak and salt tecton- ics had a weak influence on sedimentation. Balanced cross-sections of two saliferous horizons crossing different tectonic units from east to west reveal that the basin tectonic evolution and sediment filling processes can be divided into three stages containing seven episodes of rifting, transition and drifting.
文摘Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis and associated factors among patients at the Amissa Bongo Regional Hospital in Franceville, Gabon. Patients and Methods: This prospective, cross-sectional study was conducted in the biomedical analysis laboratory of the Amissa Bongo Regional University Hospital in Franceville from 19 June 2021 to 22 January 2022. After agreeing to take part in the study, participants were asked to fill in a questionnaire to collect their socio-demographic data and habits. Clinical signs were also observed. Sputum and gastric fluid samples were collected and examined using the Xpert MTB/RIF test and BAAR smear microscopy. Data were analysed using R software version 3.6.1. The results of the univariate and multivariate analyses were considered significant for p ≤ 0.05. Results: A total of 309 patients were included in this study, 50.81% (n = 157) men and 49.19% (n = 152) women. Of these, 98 had a positive diagnosis of pulmonary tuberculosis, giving an overall prevalence rate of 31.72%. There were 40 women or 40.82% (95% CI: [0.30 - 0.51]) and 58 men or 59.18% (95% CI: [0.48 - 0.69]). A univariate analysis of the prevalence of tuberculosis according to risk factors and clinical signs indicated a certain association between certain variables. However, an in-depth multivariate logistic regression analysis of this prevalence, according to the risk factors and clinical signs observed in the patients in the study, indicated that the age group 15 and 49 years (Adjusted OR = 47.77;95% CI: [4.4;519.7] p = 0.001*), fever (Adjusted OR = 4.83;95% CI: [1.16, 20.12] p = 0.031*), alcohol consumption (Adjusted OR = 12.2;95% CI: 12.2 [2.5;5.9] p = 0. 002*), smoking (Adjusted OR = 9.83;95% CI: [1.78;54.24] p = 0.037), HIV infection (Adjusted OR = 4.63;95% CI: [1.25;17.1] p = 0.022), cough (Adjusted OR = 4.31;95% CI: [1.21, 15.4] p = 0. 025*), chest pain (Adjusted OR = 103.6;95% CI: [19.4;55.2] p = 0.000), night sweating cough (Adjusted OR = 10.84;95% CI: [3.18;36.98] p = 0.000*) were significant risk factors for pulmonary tuberculosis. Conclusion: The results of the present study showed that the prevalence of pulmonary tuberculosis was greatest among males in Franceville and the surrounding area. The 15 - 49 age group, fever, alcohol consumption, smoking, HIV infection, chest pain, night sweats and cough were significant risk factors for pulmonary tuberculosis. Consequently, screening for tuberculosis in HIV-positive patients, public awareness and community mobilisation should be encouraged.
基金supported by a grant for"Chronostratigraphy for the Mesoproterozoic strata in Jixian,North China(No.26800259)"and"Hadean BioScience(No.26106002)"from the Ministry of Education,Culture,Sports,Science,and Technology,Japan
文摘The Francevillian Group in Gabonese Republic was recently established as a typical sedimentary sequence for the Paleoproterozoic.However,its age is rather poorly constrained,mainly based on Rb-Sr and Nd-Sm datings.This study reports new zircon data obtained from Chaillu massif and N＇goutou complex,which constrain the protolith age of the basement orthogneisses and the igneous age of an intrusive granite,respectively.Most zircons from the orthogneisses are blue and exhibit oscillatory zoning in cathode-luminescence images.Zircons with lower common lead abundances tend to be distributed close to the concordia curve.Two age clusters around 2860 Ma and 2910 Ma are found in zircons plotted on the concordia curve.Based on the Th/U ratios of zircons,these ages correspond to the protolith ages of the orthogneisses,and the zircons are not metamorphic in origin.Syenites and granites were collected from the N＇goutou complex that intrudes into the FA and FB units of the Francevillian Group.The granitoids exhibit chemical composition of A-type granite affinity.Half of zircons separated from the granite are non-luminous,and the remaining half exhibit obscure internal textures under cathode-luminescence observation.All zircon grains contain significant amounts of common lead;the lead isotopic variability is probably attributed to the mixing of two components in the zircons.The zircon radiogenic ^（207）Pb/^（206）Pb ratio is 0.13707 ± 0.0010.corresponding to a ^（207）Pb/^（206）Pb age of 2191 ± 13 Ma.This constrains the minimum depositional age of the FA and FB units.Furthermore,the FB unit consists of manganese-rich carbonate rocks and organic carbon-rich black shales with macroscopic fossils.Based on our age constraints,these organisms appeared in the study area just after the last Paleoproterozoic Snowball Earth event,in concert with global scale oxidation event encompassing the Snowball Earth.
文摘Neurocysticercosis(NCC) is recognized as a cause of neurologic disease worldwide.We reported two cases(one co-infected with the HIV) of NCC.Medical treatment led to recovery.NCC should be considered in tropical countries as a cause of epilepsy and included in the diagnosis of neurologic infections in HIV patients.
基金International Centre of Medical Research(Franceville,Gabon)that is supported by the government of Gabon,Total-Gabonthe French Ministry of Foreign Affairs,Histocompatibility and Immunology Laboratory AP-HP,IUH and INSERM U662,Saint-Louis hospital(Paris,France)
文摘Objective:To explore the possible association between polymorphisms in CD1 genes and both asymptomatic and mild Plasmodium falciparum infection.Methods:Two clusters of 85 school children,from the village of Dienga(Gabon)were investigated.The first group was analysed for the prevalence and the multiplicity of asymptomatic Plasmodium falciparum infection,whereas the second group was screened for the frequency of malarial attacks.Results:Our findings showed that homozygosity for the CD1E★02 allele was associated with a low frequency of malarial attacks.Furthermore,a strong association between CD1E★02 homozygotes and the resistance to multiple malarial attacks was identified.The CD1A★01 allele showed a weak association with a small number of malarial attacks.Conclusion:Our results suggest a possible role of CD1E polymorphisms in malaria protection among school children and that CD1e molecules are involved in anti-malarial immunity.
文摘Background: Tungiasis is a skin infestation caused by the female sand flea called Tunga penetrans. Associated with a significant morbidity, this ectoparasite is present in all tropical regions, such as Gabon. Unfortunately, in this country, no study has ever been undertaken on this disease. However, in both urban and rural areas of this country, it causes disfigurement and mutilation of the feet or hands in infested persons, and is sometimes responsible for the school dropout of many children. It is in this context that this timely and relevant research was conducted to assess the prevalence and risk factors associated with Tungiasis in school-aged children in the city of Port Gentil, Ogooué-Maritime province, Gabon in Central Africa. Materials and Methods: This prospective and cross-sectional study took place from May 22 to August 18, 2022, in two popular and underprivileged neighborhoods of the city of Port Gentil. It consisted of a physical diagnosis of the participants, and with the help of a questionnaire submitted to their parents/guardians, numerous data were collected. Entered into an Excel 2016 spreadsheet, the data were exported to the R software in its R Commander interface, for two types of analyses. A univariate and a multivariate analysis, using logistic regression, first on socio-demographic characteristics and then on habitual and environmental behavioral characteristics, was performed and the variables in this analysis reported odds ratios and their 95% confidence intervals. The results were statistically significant at p Results: A total of 637 school-aged children with a mean age of 12.73 years and a standard deviation of 5.44, were registered and examined for this study. Among them, Tunga penetrans infestation was found in 242 children, indicating an overall prevalence of 37.99% (95% CI [0.34 - 0.41]). Univariate and multivariate analyses, using logistic regression, first according to socio-demographic characteristics and then according to risk factors indicated that, the age groups of 5 to 9 years (Adjusted Odds Ratio = 9.27;95% CI: [6.66 - 12. 91]) and 10 - 14 years (Adjusted Odds Ratio = 0.16;95% CI: [0.10 - 0.25]), Eshira ethnicity (Adjusted Odds Ratio = 7.46;95% CI: [2.97 - 18.76]), child’s primary education level (Adjusted Odds Ratio = 0.008;95% CI: [0.006 - 0.011]), Father’s/Guardian’s education level (Adjusted Odds Ratio = 0.22;95% CI: [0.13 - 0.35]), homemaker status (Adjusted Odds Ratio = 4.89;95% CI: [3.51 - 6. 79]) and risk factors such as: promiscuity with dogs, cats or other animals around the house (Adjusted Odds Ratio = 38.30;95% CI: [22.13 - 66.26]), wearing shoes a few times (Adjusted Odds Ratio = 0.02;95% CI [0.01 - 0.03]), walking sometimes barefoot, on land or sand (Adjusted Odds Ratio = 0.28;95% CI: [0.18 - 0.42]), having other sources of water consumed than the tap (Adjusted Odds Ratio = 0.25;95% CI: [0.16 - 037]), living in a dwelling with soil or sand (Adjusted Odds Ratio = 6.8;95% CI: [4.58 - 10.09]), having average housing conditions (Adjusted Odds Ratio = 46.8;95% CI [24.29 - 90.16]), and the number of people living in the family that was greater than or equal to 6 (Adjusted Odds Ratio = 0.1;95% CI [0.07 - 0.13]), were significantly associated with the prevalence of Tungiasis. Conclusion: The results of this study will inform control programs and water and sanitation interventions for the Tunga penetrans epidemic in Port Gentil, Gabon.
文摘Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.
文摘Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episodes, the underlying cause could not be determined. Nonetheless, malaria was identified as one of the principal identifiable causes of fever among children with SDC in Libreville. Treatment for malaria upon admission, and the promotion of preventative measures, therefore seems to be appropriate for our clinical setting. In light of the large number of unresolved cases, systematic prescription of broad-spectrum antibiotics may also be called for.
文摘Context: Diabetes mellitus is experiencing an alarming progression throughout the world, but more and more drugs are available with the use not always adapted. The aim of this work is to analyze the anti-diabetic prescriptions at the university hospital center of Libreville (Gabon) and confront them with the concept of therapeutic inertia. Patients and Methods: In diabetics coming for their periodic control, we transcripted for 2 months, beyond their characteristics, their glycated hemoglobin rate and the treatment followed. Results: 200 patients have consulted and among them, 160 (80%) had done their A1c analysis. 46% had an A1c ≤ 7% and 54% above with sometimes an unsuitable treatment evoking therapeutic inertia, the factors of which we discuss. Conclusion: Therapeutic inertia is a multifactorial problem, one of the components of which may be the resistance to change of the adult learners who are the practitioners.
文摘Pregnancy and systemic lupus erythematosus in black African women: about 10 cases in Libreville (Gabon). Objectives: Through a study in a population of systemic lupus erythematosus (SLE) pregnant black Gabonese women, we describe the characteristics of these pregnancies to clarify their main complications and to make recommendations to their follow-up in low resource countries. Patients and Methods: This is a longitudinal descriptive study conducted over a period of six years, from 1 January 2008 to October 31, 2013, in Libreville (Gabon). We’ve included, systemic lupus erythematosus women carrying a pregnancy during the period of the study. Results: Seventy-two SLE women were followed and were eligible. Only 8 patients (11%) were pregnant during the follow up period. These 8 SLE patients allowed us to monitor 10 pregnancies. The average parity was 0.88. Eight pregnancies in ten (80%) had complications and most frequent was preeclampsia. Nine pregnancies (90%) resulted in the birth of viable children of which 4 (44.4%) were born by caesarean section and the 5 others (55.6%) were born by natural route. Conclusion: We recommend a monthly prenatal care for these high-risk pregnancies and early detection of preeclampsia.
