Elbow dislocations are rare injuries in children due to the resistance of the capsuloligamentous structures. Anterior dislocation is very rare and its combination with an olecranon fracture is unusual. The authors rep...Elbow dislocations are rare injuries in children due to the resistance of the capsuloligamentous structures. Anterior dislocation is very rare and its combination with an olecranon fracture is unusual. The authors report a case of this lesion in a 7-year-old child managed nonoperatively.展开更多
Water contamination by chemical pollutants is increasingly associated with waterborne diseases worldwide. The objective of this study is to assess the chemical health risk associated with drinking water consumption in...Water contamination by chemical pollutants is increasingly associated with waterborne diseases worldwide. The objective of this study is to assess the chemical health risk associated with drinking water consumption in Dakar, Senegal. The methodology adopted in this study is based on the determination of trace metals (Cd, Pb, Fe, Cu and Mn) in human drinking water by flame atomic absorption spectrometry, the estimation of the exposure of populations of the study area on the basis of the quantity of water consumed daily and the determination of the hazard quotient which allows estimating the health risk. The results indicate unacceptable levels of Pb and Cd in the water according to World Health Organization (WHO) guidelines, while the concentrations of Fe, Cu and Mn are below the regulatory values. The hazard quotient (HQ) is in the majority of samples higher than 1 in children and infants for scenario 1 (based on WHO data), reflecting a high risk for this target. In scenario 2 based on consumption data from the populations studied, the HQ is greater than 1 only in heavy consumers. The drinking water consumed by Dakar population presents health risks related to Pb and Cd, particularly for infants, children and heavy consumers, hence the need to strengthen the water treatment system before home consumption.展开更多
Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried ...Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried out. Its objective was to evaluate the effects of physical rehabilitation on cardiac function. Methods: Patients were evaluated at the beginning and at the end of cardiovascular rehabilitation by cardiovascular, biological, and echocardiographic parameters including the size of the heart chambers, the kinetics of the walls, and the systolic function of the ventricles. Results: The study involved 12 patients, 67% of whom were men. After cardiac rehabilitation, the mean hemodynamic constants had not been significantly modified. However, a significant decrease in Total-Cholesterol, LDL-Cholesterol and triglyceride levels was noted. Mean fasting blood sugar decreased from 1.25 ± 0.48 g/L to 0.92 ± 0.18 g/L and glycated hemoglobin from 7.72% ± 0.01% to 6.45% ± 0.008%. The echocardiographic parameters studied showed an improvement in the dilation of the heart chambers in 8.33% of the patients, the normalization of the ejection fraction of the left ventricle in 16% patients, the improvement of the kinetic disorders in 16% of patients and recovery of right ventricular systolic function in all patients. Conclusion: Cardiac rehabilitation as a secondary preventive measure for cardiovascular disease has contributed significantly to improving the clinico-biological parameters of the disease.展开更多
Background: COVID-19 has shown the vulnerability of our healthcare staff in terms of exposure. Staff contamination is a reality to be explored and prevented. Objective: It was to describe the epidemiological, clinical...Background: COVID-19 has shown the vulnerability of our healthcare staff in terms of exposure. Staff contamination is a reality to be explored and prevented. Objective: It was to describe the epidemiological, clinical, therapeutic and evolutionary profiles of health staff infected with COVID-19 in the Health District of Sangalkam (Senegal). Materials and Methodologies: This was a retrospective study from April 1, 2020 to April 20, 2021. District health staff tested positive of Sars-CoV-2 were included. Results: Sixty-six professionals were sampled, of whom seventeen were positive (25.8%). The medical history found was diabetes type 2 (n = 1) and hypertension/obesity (n = 1). Only one victim had previously received an incomplete vaccination. The average age of the infected personnel was 38.4 years. Victims with an identified epidemiological link were more numerous (64.7%). Respiratory signs (cough, rhinorrhea) and fever predominated. Caregivers accounted for 76% of the victims, compared with 26% of the administrative staff. Most patients were followed at home (76.4%). One severe case was admitted to the intensive care unit. The recovery rate was 100%. The average length of absence was 13 days. Conclusion: Infection of the staff is of great concern. Regular and decontamination and systematic cleaning of consultation offices and hospital wards are necessary. In addition, vaccination, screening, strict compliance with barrier measures (wearing masks, hand washing, physical distancing).展开更多
Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle ...Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle to reducing maternal and infant mortality. To support the Ministry of Health and Social Action in the implementation of its Strategic Plan for Reproductive Health (2012-2015), the NGO Micronutriment Initiative has developed a project based on community-based maternal and neonatal health services (CBMNHS) in the Kolda region. The general objective of this study is to collect the perceptions of the actors on the Community-Based Maternal and Neonatal Health Services project in the Kolda and Sedhiou regions. Method: This was a qualitative study consisting of an evaluation of the activities carried out within the framework of the CBMNHS project at the level of the intervention zone. The study focused on support groups, community actors, post nurses and implementers of the intervention. Sampling was comprehensive for community actors and nurse heads. Focus groups and in-depth individual interviews were used to assess the perceptions of women and support groups, as well as to better understand the dynamics of the intervention. The content analysis was performed to exploit the qualitative data. Results: All local and national health authorities interviewed are unanimous about the relevance of the project. The project’s strategies are essentially community-oriented. Thus, a large number of committees have been set up. A total of 1258 support groups were set up during the project, distributed as follows: 260 grandmother groups (Grandmothers Strategy);266 groups of pregnant women (Pregnant Women’s Solidarity Circles);248 Care Group;468 community watch and alert circles and 16 Future Fathers’ Groups (Future Fathers’ Solidarity Circles). These committees aimed to involve women of reproductive age, mothers, mothers-in-law and fathers. More than 70% of women surveyed agree that support groups have improved their knowledge of maternal health, nutrition, and children’s health. Groups also improved their attendance at health facilities, which is a major asset of the project. Conclusion: The analysis of the perception of the different actors of the CBMNHS project shows that the project is well conducted in the area of intervention that is the region of Kolda. However, the central question of the success of sustainability is the existence of a withdrawal plan. Indeed, this plan must be studied from the very beginning and must be adapted to the local context. As a result, support groups are urged to become more involved in reproductive health activities, especially those related to the exclusive breastfeeding, and to continue to provide all forms of support (financial and moral) to women of reproductive age for reproductive health carrying out reproductive health activities for better access to services.展开更多
Cervical cancer is the leading cause of cancer deaths of women in developing world. Several studies demonstrated evidences of inflammatory cytokines implication in cancer progression including in initiation, promotion...Cervical cancer is the leading cause of cancer deaths of women in developing world. Several studies demonstrated evidences of inflammatory cytokines implication in cancer progression including in initiation, promotion and invasion by affecting the immune surveillance. Our aim was to measure blood circulating pro- and anti-inflammatory cytokines levels, their profiles according to treatment issue and relation with prognostic factors in cervical cancer during chemotherapy. Blood samples were collected from a cohort of 35 cervical cancer women and 42 women healthy controls (HC) with no history of malignancy. For each CP, three samples were taken at three-week intervals. The first one (S1) was taken before initiation of the chemotherapy protocol. S2 and S3 were samples collected respectively at day 21 and day 42. Cytokines levels were evaluated by ELISA. Mean age of patients was 54.1 year (35 - 77 yo). In groups, no relation was observed between age and cytokines levels. Before chemotherapy, high levels of IL-6, IL-4 and IFN-γ were observed in CP compared to HC (p 0.001) and at the same period, IL-10 and TNF-α levels were significantly low in CP (p 0.05) and negatively correlated (r = —0.79;p = 0.017). In this CP group, IL-4 levels were positively correlated between S1 and S2 (r = 0.72;p = 0.002) and between S1 and S3 (r = 0.74;p = 0.019). Similar correlations were observed for TNF-α levels: S1/S2 (r = 0.54;p = 0.027), S2/S3 (r = 0.82;p = 0.009) and S1/S3 (r = 0.66;p = 0.036) with a significant increase of TNF-α in blood during treatment. Depending on chemotherapy’s efficacy, CP patients were separated into 1) non responders (NR), 2) partial responders (PR) and 3) good responders (GR). Compared to PR and GR groups, NR patients showed: a) higher serum levels of IL-6, IL-10 and IFN-γ during the follow-up and b) lower serum levels of IL-4 and TNF-α. In addition, serum levels of IL-4 were significantly higher in GR patients however TNF-α was the predominant cytokines in PR group. Our results highlight the variation of circulating cytokines such as IL-6, IL-10 and IFN-γ during cervical cancer chemotherapy. In addition, this study suggested that IL-4 and TNF-α might represent potential biomarkers candidate in cervical cancer. Applications in cancer management need further investigations particularly about the relevant prognostic indicator following chemotherapy and validation studies must provide more assurance for translation into clinical practice.展开更多
Background: In Africa, malaria-endemic regions have not been spared from COVID-19 outbreak which emerged in the first quarter of 2020. This pandemic has shown clinical and therapeutic similarities with malaria. This f...Background: In Africa, malaria-endemic regions have not been spared from COVID-19 outbreak which emerged in the first quarter of 2020. This pandemic has shown clinical and therapeutic similarities with malaria. This following study sought to determine the impact of COVID-19 on the malaria diagnosis. Method: A review of laboratory registers and an exploitation of the District Health Information Software 2 (DHIS2) to collect information on the diagnosis of malaria by microscopy and by rapid diagnostic test (RDT), but also that of COVID-19 was done from 2017 to 2021 at the Thierno Mouhamadoul Mansour Hospital in Mbour, Senegal. Results: In 2017, 199 Thick drops (TDs) and 1852 RDTs were performed for malaria diagnosis. In 2018, it was 2352 malaria tests with 2138 RDTs and 214 TDs, before reaching a peak of 3943 tests in 2019 including 3742 RDTs and 201 TDs. By 2020, 2263 tests were performed with 2097 malaria RDTs, 158 TDs and 8 COVID RDTs. The latter increased significantly in 2021, reaching 444 COVID RDTs, while TDs and malaria RDT kept decreasing to 147 and 1036 respectively. Positive TDs were higher in 2020 (11.4%) compared to 2017 (3.5%), 2018 (1.4%), 2019 (6.5%) and 2021 (6.8%). For malaria RDTs, a decrease in the number of positive tests was noted between 2017 (4.5%) and 2021 (1.3%). The COVID RDTs were all negative in 2020, 29.5% were positive and 4.1% were undetermined in 2021. Conclusion: COVID-19 has led to changes in efforts to diagnose malaria as well as an increase in malaria prevalence directed towards children under 5 years of age.展开更多
Background: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia. The latter plays an essential role in inflammation by stimulating the production of pro-inflammatory cytokines or by increasin...Background: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia. The latter plays an essential role in inflammation by stimulating the production of pro-inflammatory cytokines or by increasing their secretion by an oxidative mechanism. These cytokines control the hepatic synthesis of an inflammatory protein called C-Reactive Protein (CRP). High or average values of CRP would have a predictive value of cardiovascular diseases and type 2 diabetes. The relationship between low CRP values and the risk of developing type 2 diabetes and its cardiovascular complications is not sufficiently studied. The hsCRP could serve as a predictive biomarker of risk of onset, follow-up and prognosis for type 2 diabetes and its cardiovascular complications. To answer this problem, we conducted this study, the aim of which was to study the predictive role of hsCRP in the risk of occurrence of type 2 diabetes and its cardiovascular complications. Materials and Methods: This is a prospective and cross-sectional case-control study involving 200 participants including 100 control women and 100 women with type 2 diabetes (mean age was respectively 49.89 years ± 8.26 & 51.92 years ± 7.18;p = 0.066). The interviews were conducted on the basis of a questionnaire. Physical examination collected biometric data and cardiovascular constants. The biochemical parameters such as hsCRP were analyzed by an automated Abbott device. Results: We noted that hsCRP was significantly higher in type 2 diabetic subjects compared to control subjects (p (rho = 0.40, p systolic blood pressure (rho = 0.30, p = 0.003), diastolic blood pressure (rho = 0.28, p = 0.006), total body fat (rho = 0.48, p Conclusion: hsCRP has a prognostic value in the evaluation of cardiovascular risk. It seems to play an important role in the pathogenesis of type 2 diabetes mellitus and its cardiovascular complications. It could thus be considered as a biomarker for the screening, monitoring and prognosis of type 2 diabetes mellitus.展开更多
Background/Objective: Very intense and repeated exercise, particularly when performed over many years, could cause respiratory health problems. The combination of a sustained high ventilation and provocative training ...Background/Objective: Very intense and repeated exercise, particularly when performed over many years, could cause respiratory health problems. The combination of a sustained high ventilation and provocative training environments may impact the susceptibility of athletes to ventilatory disorders. Previous studies suggest that impaired ventilatory function in elite athletes can be detected in the absence of respiratory symptoms even after cessation of sports activity. The purpose of this study was to evaluate the ventilatory function of elite athletes compared to sedentary subjects. Material and Methods: This study included sedentary subjects and elite athletes, all male, aged 16 to 23 years. The athletes played regularly in the Senegalese league 1 championships (football and basketball) for at least two seasons with more than 10 hours of training per week during two years. For all participants, an interrogation was submitted and we conducted a clinic examination was performed following by a basic and post-bronchodilator spirometry. Results: The mean age of athletes (n = 66) and sedentary subjects (n = 61) was respectively 19.16 ± 2 years and 19.54 ± 2.12 years. The elite athletes presented significantly higher spirometry values (p Conclusion: This study found a high prevalence (72.73%) of ventilatory disorders (VD) in Senegalese elite athletes. Many previously undiagnosed elite athletes had significant ventilatory problems. To prevent the respiratory risk, athletes should be encouraged to avoid certain environmental factors and to adapt the period of their training.展开更多
Objective: Evaluate the immunological status to hepatitis B virus of Senegalese pregnant women by screening HBs antigen. Material and methods: The selection criteria of women were presence at the laboratory for biolog...Objective: Evaluate the immunological status to hepatitis B virus of Senegalese pregnant women by screening HBs antigen. Material and methods: The selection criteria of women were presence at the laboratory for biological exams of pregnancy follow-up. All volunteers for the study were screened for HBs antigen (HBs Ag). Investigation of chronic hepatitis B markers (HBe Ag, anti-HBe, viral quantification) was performed in HBs Ag positive participants. The concentration of anti-HBs antibodies was assessed in HBs Ag negative women. Results: One hundred and fifteen (115) pregnant women were included in the study from July to October 2014. The mean age was 29 ± 6 years, ranging from 16 to 47. The seroprevalence of HBs Ag was 12% and the majority of women (90%) were not vaccinated. Any of the 14 HBs Ag-positive subjects did not express serum HBe Ag, (marker of active viral replication) and all were positive for anti-HBe antibodies. Their viral load (HBV DNA) was undetectable and serum transaminases were normal. The anti-HBs antibodies titrated in HBs-Ag negative women serum revealed that only 46 had protective levels against HBV whilst 55 of them were unprotected.展开更多
Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-...Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-sectional, descriptive, and analytical study of physicians in permanent contact with patients at the Fann and Aristide Le Dantec teaching hospitals in Dakar, Senegal. Results: A total of 159 doctors were included in the study, with a sex ratio (M/F) of 1.3 in favor of men. The prevalence of burnout was 91.8%. Burnout was significantly associated (p Conclusion: Burnout is a threat to doctors at university hospitals in Senegal. It has several determinants linked above all to work organization. It is essential to set up psychological support units in hospitals and integrate occupational medicine into various organizational processes.展开更多
We investigated relationship between galectin-3 (Gal-3) levels and T lymphocytes apoptosis and the activation rates in breast cancer during chemotherapy. We used plasma samples from 112 women classified into two group...We investigated relationship between galectin-3 (Gal-3) levels and T lymphocytes apoptosis and the activation rates in breast cancer during chemotherapy. We used plasma samples from 112 women classified into two groups: 70 women with breast cancer (BC) and submitted to neoadjuvant chemotherapy (3 cycles) and 42 healthy women used as controls. In the group of BC, blood samples were taken before each cycle of chemotherapy and Gal-3 levels was evaluated by ELISA sandwich. Flow cytometry was used to study T cells apoptosis and activation. Before treatment, median value of Gal-3 was 6.31 ng/ml (range 1.07 - 50.74) in BC and 0.84 ng/ml (range 0.00 - 4.82) in HC. Gal-3 levels were highest in plasmas from BC (p p p = 0.010). In addition, we found a dynamic relationship between gal-3 levels, tumor size and T lymphocytes apoptosis rates during treatment depending to the cure efficiency. We suggest gal-3 plasma concentrations could be used as predictive biomarker for chemotherapy efficiency in breast cancer patients.展开更多
Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA...Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA) assay, digital rectal examination (DRE) and prostate biopsy, its incidence has increased significantly. The aim of our study was to analyse aspects of bone scintigraphy (BS) as part of the metastatic extension assessment of prostate cancer in Senegal. Patients and Methods: This was a retrospective descriptive and analytical study, running from January 1<sup>er</sup> 2022 to August 31 2023. Patients with histologically confirmed prostate cancer were included. Whole-body scans (WBS) were performed using a dual-head SPECT gamma camera (Mediso Nucline TM Spirit DH-V type), 3 hours after intravenous injection of 8 MBq/kg (555 to 740 MBq) of <sup>99m</sup>Tc-HMDP. Results: A total of 288 patients with a mean age of 68.37 ± 7.79 years were included. The median total PSA level was 97.6 ng/ml, with 144 patients having a level greater than or equal to 20 ng/ml. All patients had adenocarcinoma, and the Gleason score was available in 202 (70.13%) patients, 75.75% of whom had a score greater than or equal to 7. BS was contributory in 70.48% of cases, with 30.90% positive and 39.58% negative. The result was inconclusive in 85 patients (29.51%). The mean PSA for patients with a positive scan was 190.2 ng/ml and 40.6 ng/ml for those with a negative scan. Multiple metastatic lesions predominated (87.35% of cases). Metastatic lesions occurred preferentially in the axial skeleton, with a proportion of 68% versus 32% in the appendicular skeleton. Classification of bone metastases according to the SOLOWAY score revealed grade I (62.07%), grade II (35.63%) and grade IV (2.30%). Conclusion: In Senegal, prostate cancer is generally diagnosed in men of advanced age. The presence of bone metastases is frequent in its evolution, transforming a curable localized disease into a generalized disease with a compromised prognosis. Bone scintigraphy remains an essential part of the initial work-up and evaluation of response to treatment.展开更多
The aim of this study was to evaluate the dose delivered to patients during scannographic examinations at the Kaolack Regional Hospital (one of the 14 regions of Senegal located in the center-west of the country, 192 ...The aim of this study was to evaluate the dose delivered to patients during scannographic examinations at the Kaolack Regional Hospital (one of the 14 regions of Senegal located in the center-west of the country, 192 km from Dakar) and to compare these irradiation doses at diagnostic reference levels found in the literature in order to optimize our scanning protocols. To achieve this goal, we carried out a prospective study involving 218 CT scans. These examinations focused on cerebral, thoracic, abdominopelvic and lumbar spine acquisitions made in adults and cerebral only in children. We compared the median values of dosimetric indicators (CTDIvol and DLP) per acquisition with NRDs in the literature. During the course of this study, we found a dosimetric ratio lower than that of the NRDs for thoracic, abdomino-pelvic and lumbar spine CT scans in adults and a significant dosimetric exceedance for brain scans in adults and in children. These results encourage us to extend these dosimetric evaluations to other hospital structures in order to establish rigorous monitoring of dosimetric indicators and to respect the principles of radiation protection and good practice.展开更多
Lipid metabolism disorders would be among the components responsible for the risk of the onset of T2DM and its vascular complications. Apolipoprotein E plays an important role in lipid metabolism. We studied the invol...Lipid metabolism disorders would be among the components responsible for the risk of the onset of T2DM and its vascular complications. Apolipoprotein E plays an important role in lipid metabolism. We studied the involvement of the APOE gene in the onset of T2DM and its vascular complications. Clinical and biochemical parameters were assessed in each participant. APOE genotypes were identified by PCR-RFLP. Arterial stiffness was studied using a pOpmetre<sup>®</sup> which evaluates the pulse wave velocity (ft-PWV). Endothelial dysfunction was studied using an EndoPAT2000<sup>®</sup> which measures endothelium-dependent vasodilation (RHI). In control subjects, the ε3 allele was associated with an increase in fasting blood glucose (r = 2.36, p = 0.018), and a decrease in LDL cholesterol levels (r = −2.17, p = 0.03), and ε4 was associated with an increase in total cholesterol (r = 2.59, p = 0.01), LDL cholesterol (r = 2.84, p = 0.004), and No-HDL cholesterol (r = 2.74, p = 0.006). In type 2 diabetes subjects, the ε2 was associated with a decrease in diastolic blood pressure (r = −2.25, p = 0.02). The ε3 was associated with a decrease in ft-PWV (r = −2.26, p = 0.024) while the ε4 was associated with an increase in ft-PWV (r = 2.52, p = 0.012). Carrying the ε2ε3 genotype would have in 99% a limited risk of developing T2DM, and in event of T2DM, only 1 to 2% would have a significant risk of developing atherosclerosis, which would be severe in 17%. Of the ε2ε4 genotype, 93% had a limited or even possible risk of developing T2DM, the remaining 7% had a very high risk of developing T2DM. Diabetics carrying ε2ε4 had in 7% very high risk of developing atherosclerosis. The latter had a 20% very high risk of being very severe. Subjects carrying the ε3ε4 genotype had a 67% possible or even probable risk of developing T2DM and in the event of diabetes, there was in 34% very high risk of developing atherosclerosis which will not have even the time to evolve towards severity. For subjects carrying the ε3ε3, the risk of developing T2DM and athérosclerosis was higher than that of the ε2ε3, and ε2ε4 genotypes but lower than that ε3ε4 genotype. The physio-pathological role of the APOE gene and the impacts of its polymorphisms are important in the onset and progression of type 2 diabetes mellitus.展开更多
Neonatal thrombocytopenia accounts for 20% of neonates hospitalized in the neonatal intensive care unit (NICU) at DPH. The etiologies are multiple, but bacterial infection is the third leading cause of neonatal mortal...Neonatal thrombocytopenia accounts for 20% of neonates hospitalized in the neonatal intensive care unit (NICU) at DPH. The etiologies are multiple, but bacterial infection is the third leading cause of neonatal mortality worldwide. We therefore set out to assess the frequency of neonatal thrombocytopenia associated or not with bacterial infection in the NICU. We conducted a retrospective and prospective study with the DPH NICU, over 10 months (August 2018 and April 2019). Thrombocytopenia encountered in the NICUs, were the subject of research into bacteriological, inflammatory, and epidemiological parameters using Inlog laboratory data processing software. During this period, 1280 babies were hospitalized, 94 of whom underwent thrombocytopenia, corresponding to 7.34%, with a sex ratio of 0.92. The number of babies presenting with thrombocytopenia during the first week of hospitalization was 72, accounting for 76.6%. The clinical context was usually low birth weight in 30.8% of cases and perinatal asphyxia (25%). Thrombocytopenia ranged from 2000 to 137,000 with an average of 69,520/mm3. Among these thrombocytopenias, 64 cases (68%) were below 100,000 mm3 and 44 cases had a CRP >5 mg/l. A total of 30 bacteria were isolated, including 23 Enterobacteria, 2 Streptococci, and 1 Acinetobacter. Among these enterobacteria, 14 were multidrug-resistant (MDR). Thrombocytopenia associated with a multidrug-resistant bacterial infection is a real challenging management.展开更多
Introduction: Previous studies in sickle cell disease (SCD) patients have demonstrated low muscle mass (MM) and high fat mass (FM) percentages compared to individuals with normal hemoglobin. The relationship between t...Introduction: Previous studies in sickle cell disease (SCD) patients have demonstrated low muscle mass (MM) and high fat mass (FM) percentages compared to individuals with normal hemoglobin. The relationship between the evolutions of body composition (BC) parameters in the active SCD population is not well elucidated. The aim of the present study was to assess the body composition in active adult SCD patients in sub-Saharan Africa during the inter-critical period. Methodology: We conducted a descriptive and analytical cross-sectional study over an 8-month period. Eighteen SCD patients (sex ratio = 1) reported regular physical activity (RPA) corresponding to level 3 (RPA of moderate intensity) of the 4-level Saltin-Grimby physical activity scale were recruited. Anthropometric and BC parameters such as BMI, percentage FM and percentage MM were evaluated using an impedance meter. Results: The study population had a mean age of 26 ± 7 years and a mean BMI of 20.5 ± 1.9 kg/m2. We found a significantly higher percentage of FM in women compared to the men (25.6% ± 10.2% vs 11.1% ± 2.1%;p = 0.001). For the proportion of MM, all the women had a normal percentage. The men mostly had high levels of MM compared with reference norms. Men had significantly greater MM percentages than women (45.4% ± 1.8% vs. 26.5% ± 1.4%;p Conclusion: RPA appears to have positive effects on BC in active population with SCD, and a greater-than-expected effect was observed on MM in male patients. Promoting regular, adapted physical activity would be a promising way of improving BC parameters and quality of life in the SCD population. Further studies with larger cohorts will be needed to better substantiate these results.展开更多
Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functio...Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functional asplenia (associated with repeated thrombosis of splenic vessels), resulting in increased susceptibility to infection. However, several studies have reported differences in the spectrum of bacterial infections in malaria-endemic areas. Therefore, we proposed to conduct a study to determine the rate of positive blood cultures and the bacteriological spectrum in sickle cell patients. Materials and Method: This is a descriptive cross-sectional study of blood culture samples from patients who received a request for hemoglobin electrophoresis as part of their treatment at the Principal’s hospital in Dakar. The study took place from January 2008 to December 2021. For each patient, we collect demographic information, including age, gender, and the service from which the analysis request originated. Data were collected in the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: Our study included 1419 patients. The most common types of hemoglobin profiles were: normal profile (n = 1025), AS profile (n = 283), SS profile (n = 104), SC profile (n = 7). This corresponds to the proportions of 72%, 20%, 0.5% and 7.5% for the profiles Normal, AS, SC and SS. The male proportion was 61.1%, 61.5%, 57.1, respectively %, 55.8% for Normal, SA, SC, and SS profiles. A total of 19,090 individual blood culture bottles were collected from 1419 impatient patients as follows: Normal profile (n = 18,042 bottles), AS profile (n = 677 culture bottles), SS profile (n = 362 bottles). The majority of blood culture orders come from pediatric services, accounting for 70% of the total number of orders. Of 19,090 vials examined in this current study, 19.6% developed a positive blood culture. Overall, the most commonly isolated bacteria were Staphylococci (41.1%), Enterobacteriaceae (36.7%), Bacillaceae (10.2%), unfermented (6.30%), Streptococci (5.01%), and a small proportion of yeast (0.75%). There is no significant difference in bacterial spectrum between the SS profile and the normal profile of individuals (p = 0.104). Coagulase-negative staphylococci accounted for 32%, 24%, and 40% of the species isolated in the normal AS and SS profiles. respectively. Coagulase-negative staphylococci were the most commonly isolated organisms in SS. Group E and sptagged streptococci each account for less than 2% of the organisms isolated in SS. Pneumococci were not found. Bacillus accounts for 25% of isolates in SS subjects compared to 9% in normal and AS subjects, respectively. Pseudomonas aeruginosa and Burkholderia cepacia then make up 10% of the isolates in the subjects of the SS profile as non-fermenters. Conclusion: Our study shows that enterobacteria and staph are prevalent in people with sickle cell disease. There is no significant difference in bacterial spectrum between SS subjects compared to subjects with a normal profile. The rarity of Streptococcus pneumoniae in bacteremia isolates underlines the need for further studies with larger patient numbers to better understand the spectrum of bacterial infections in patients with sickle cell disease in West Africa.展开更多
Background: Chronic hepatitis B virus (HBV) infection is one of the largest public health problems with nearly 350 million chronic carriers and 500,000 deaths each year. These deaths are most often associated with dis...Background: Chronic hepatitis B virus (HBV) infection is one of the largest public health problems with nearly 350 million chronic carriers and 500,000 deaths each year. These deaths are most often associated with disease progression to cirrhosis or hepatocellular carcinoma, which some studies have shown is associated with long-term viral replication in chronic carriers. Viral load quantification, a key element of disease management, is expensive and difficult to access. Viral load plays a crucial role in patient classification and treatment initiation. Four years after the implementation of viral load platform, the objective of this study was to assess viral load profile in HBs chronic carriers in a sub-Saharan Hospital and to determine the potential impact of this distribution on preventive and therapeutic strategies against hepatitis B infection. Materials and Method: The study was carried out between April 2016 and October 2020 in the laboratory of the PRINCIPAL Hospital in Dakar. All patients referred for HBV DNA viral load testing following a positive AgHBs test were included. Incomplete medical records were excluded from the study. Only the first quantification test performed on each patient is recorded. DNA extraction was performed with COBAS AmpliPrep (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Amplification was performed using COBAS TaqMan48 (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Data were collected from the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: A total of 3002 patients, 76.1% (2285/3002) men and 33.9% (717/3002) women, were included in the study. Young adults were most represented among the subjects (23.2%) and (20.1%) in the age groups 25 - 30 and 30 - 35. The majority (52.7%) of patients had viral loads between 20 and 2000 IU. Patients with undetectable viral loads and patients with viral loads below 20 IU comprised 14.6% and 7.53% of the study population, respectively. Patients with viral loads between 2000 and 20,000 IU/ml and those with viral loads greater than 20,000 IU/ml represented 16.3% and 8.89% of the study population, respectively. Viral load was higher in males than females, with corresponding median and interquartile ranges of 2.7 log IU (2.2, 2.75) and 2.23 log IU (2.1, 2.4) (p Conclusion: This study shows a successful implementation of virus quantification in the context of resource-constrained countries. The second finding of this study is the high prevalence of adolescents with high plasma viral loads, indicating the need for additional investigations to initiate therapy. The large population with a low HBV replication rate points to the problem of financing follow-up care for chronically infected people. Studying this population in the context of an unknown genomic profile indicates the need to deepen virological laboratory testing through a sequencing platform. Finally, regular viral load reporting in major hospital cities could be a powerful and accessible management tool for hepatitis B programs in resource-constrained countries.展开更多
Background: Over the past two decades, blood transfusion safety has made significant advances in the fight against infectious diseases. However, hepatitis B is still a problem in blood banks due to its high endemicity...Background: Over the past two decades, blood transfusion safety has made significant advances in the fight against infectious diseases. However, hepatitis B is still a problem in blood banks due to its high endemicity in Senegal. In this context, we proposed to first determine the prevalence of HBs antigen (HBsAg) in regular and new blood donors. Second, to determine the influence of the number of blood donations on the prevalence of hepatitis B. Materials and Method: We conducted a retrospective transversal study using data from all blood donations received at the Principal Hospital of Dakar Blood bank from July 2007 to December 31, 2021. Hepatitis B testing was carried out with Automaton E411 (Roche Diagnostics). For all donors, information on age, sex, hepatitis B serology, and the number of donations was collected through the lab’s computer system. Data entry and statistical analysis were performed with Epi-info version 7. Results: HBsAg carriers were identified in 4311 primary donors, corresponding to a prevalence of 12.39% (IC 95% = 12.04 - 12.74). The prevalence of the HBsAg antigen was higher in men (12.9%) than in women (6.85%). Men are twice as likely to be infected with HBV as women (OR = 2.00 (IC 95% = 1.85 - 2.17)). The highest prevalence (12.4%) was found in young adults (23 - 29) years old. After 10 donations, the prevalence of the HBs antigen was stable at around 1%. Individuals with a single blood donation and individuals with 2 to 5 blood donations are 9 and 7 times more likely to carry the HBs antigen than regular donors (more than 10 blood donations), respectively. Conclusion: Our results demonstrate the endemic nature of hepatitis B in Senegal. On the other hand, the non-negligible prevalence of the virus in first-time donors reminds us of the need for continuous improvement in donor selection. These first-time donors, particularly young adults, are important indicators of transmission of the virus to the general population. This study also demonstrates the need to develop strategies to maintain the pool of regular donors, which represent significant barriers to the spread of hepatitis B.展开更多
文摘Elbow dislocations are rare injuries in children due to the resistance of the capsuloligamentous structures. Anterior dislocation is very rare and its combination with an olecranon fracture is unusual. The authors report a case of this lesion in a 7-year-old child managed nonoperatively.
文摘Water contamination by chemical pollutants is increasingly associated with waterborne diseases worldwide. The objective of this study is to assess the chemical health risk associated with drinking water consumption in Dakar, Senegal. The methodology adopted in this study is based on the determination of trace metals (Cd, Pb, Fe, Cu and Mn) in human drinking water by flame atomic absorption spectrometry, the estimation of the exposure of populations of the study area on the basis of the quantity of water consumed daily and the determination of the hazard quotient which allows estimating the health risk. The results indicate unacceptable levels of Pb and Cd in the water according to World Health Organization (WHO) guidelines, while the concentrations of Fe, Cu and Mn are below the regulatory values. The hazard quotient (HQ) is in the majority of samples higher than 1 in children and infants for scenario 1 (based on WHO data), reflecting a high risk for this target. In scenario 2 based on consumption data from the populations studied, the HQ is greater than 1 only in heavy consumers. The drinking water consumed by Dakar population presents health risks related to Pb and Cd, particularly for infants, children and heavy consumers, hence the need to strengthen the water treatment system before home consumption.
文摘Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried out. Its objective was to evaluate the effects of physical rehabilitation on cardiac function. Methods: Patients were evaluated at the beginning and at the end of cardiovascular rehabilitation by cardiovascular, biological, and echocardiographic parameters including the size of the heart chambers, the kinetics of the walls, and the systolic function of the ventricles. Results: The study involved 12 patients, 67% of whom were men. After cardiac rehabilitation, the mean hemodynamic constants had not been significantly modified. However, a significant decrease in Total-Cholesterol, LDL-Cholesterol and triglyceride levels was noted. Mean fasting blood sugar decreased from 1.25 ± 0.48 g/L to 0.92 ± 0.18 g/L and glycated hemoglobin from 7.72% ± 0.01% to 6.45% ± 0.008%. The echocardiographic parameters studied showed an improvement in the dilation of the heart chambers in 8.33% of the patients, the normalization of the ejection fraction of the left ventricle in 16% patients, the improvement of the kinetic disorders in 16% of patients and recovery of right ventricular systolic function in all patients. Conclusion: Cardiac rehabilitation as a secondary preventive measure for cardiovascular disease has contributed significantly to improving the clinico-biological parameters of the disease.
文摘Background: COVID-19 has shown the vulnerability of our healthcare staff in terms of exposure. Staff contamination is a reality to be explored and prevented. Objective: It was to describe the epidemiological, clinical, therapeutic and evolutionary profiles of health staff infected with COVID-19 in the Health District of Sangalkam (Senegal). Materials and Methodologies: This was a retrospective study from April 1, 2020 to April 20, 2021. District health staff tested positive of Sars-CoV-2 were included. Results: Sixty-six professionals were sampled, of whom seventeen were positive (25.8%). The medical history found was diabetes type 2 (n = 1) and hypertension/obesity (n = 1). Only one victim had previously received an incomplete vaccination. The average age of the infected personnel was 38.4 years. Victims with an identified epidemiological link were more numerous (64.7%). Respiratory signs (cough, rhinorrhea) and fever predominated. Caregivers accounted for 76% of the victims, compared with 26% of the administrative staff. Most patients were followed at home (76.4%). One severe case was admitted to the intensive care unit. The recovery rate was 100%. The average length of absence was 13 days. Conclusion: Infection of the staff is of great concern. Regular and decontamination and systematic cleaning of consultation offices and hospital wards are necessary. In addition, vaccination, screening, strict compliance with barrier measures (wearing masks, hand washing, physical distancing).
文摘Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle to reducing maternal and infant mortality. To support the Ministry of Health and Social Action in the implementation of its Strategic Plan for Reproductive Health (2012-2015), the NGO Micronutriment Initiative has developed a project based on community-based maternal and neonatal health services (CBMNHS) in the Kolda region. The general objective of this study is to collect the perceptions of the actors on the Community-Based Maternal and Neonatal Health Services project in the Kolda and Sedhiou regions. Method: This was a qualitative study consisting of an evaluation of the activities carried out within the framework of the CBMNHS project at the level of the intervention zone. The study focused on support groups, community actors, post nurses and implementers of the intervention. Sampling was comprehensive for community actors and nurse heads. Focus groups and in-depth individual interviews were used to assess the perceptions of women and support groups, as well as to better understand the dynamics of the intervention. The content analysis was performed to exploit the qualitative data. Results: All local and national health authorities interviewed are unanimous about the relevance of the project. The project’s strategies are essentially community-oriented. Thus, a large number of committees have been set up. A total of 1258 support groups were set up during the project, distributed as follows: 260 grandmother groups (Grandmothers Strategy);266 groups of pregnant women (Pregnant Women’s Solidarity Circles);248 Care Group;468 community watch and alert circles and 16 Future Fathers’ Groups (Future Fathers’ Solidarity Circles). These committees aimed to involve women of reproductive age, mothers, mothers-in-law and fathers. More than 70% of women surveyed agree that support groups have improved their knowledge of maternal health, nutrition, and children’s health. Groups also improved their attendance at health facilities, which is a major asset of the project. Conclusion: The analysis of the perception of the different actors of the CBMNHS project shows that the project is well conducted in the area of intervention that is the region of Kolda. However, the central question of the success of sustainability is the existence of a withdrawal plan. Indeed, this plan must be studied from the very beginning and must be adapted to the local context. As a result, support groups are urged to become more involved in reproductive health activities, especially those related to the exclusive breastfeeding, and to continue to provide all forms of support (financial and moral) to women of reproductive age for reproductive health carrying out reproductive health activities for better access to services.
文摘Cervical cancer is the leading cause of cancer deaths of women in developing world. Several studies demonstrated evidences of inflammatory cytokines implication in cancer progression including in initiation, promotion and invasion by affecting the immune surveillance. Our aim was to measure blood circulating pro- and anti-inflammatory cytokines levels, their profiles according to treatment issue and relation with prognostic factors in cervical cancer during chemotherapy. Blood samples were collected from a cohort of 35 cervical cancer women and 42 women healthy controls (HC) with no history of malignancy. For each CP, three samples were taken at three-week intervals. The first one (S1) was taken before initiation of the chemotherapy protocol. S2 and S3 were samples collected respectively at day 21 and day 42. Cytokines levels were evaluated by ELISA. Mean age of patients was 54.1 year (35 - 77 yo). In groups, no relation was observed between age and cytokines levels. Before chemotherapy, high levels of IL-6, IL-4 and IFN-γ were observed in CP compared to HC (p 0.001) and at the same period, IL-10 and TNF-α levels were significantly low in CP (p 0.05) and negatively correlated (r = —0.79;p = 0.017). In this CP group, IL-4 levels were positively correlated between S1 and S2 (r = 0.72;p = 0.002) and between S1 and S3 (r = 0.74;p = 0.019). Similar correlations were observed for TNF-α levels: S1/S2 (r = 0.54;p = 0.027), S2/S3 (r = 0.82;p = 0.009) and S1/S3 (r = 0.66;p = 0.036) with a significant increase of TNF-α in blood during treatment. Depending on chemotherapy’s efficacy, CP patients were separated into 1) non responders (NR), 2) partial responders (PR) and 3) good responders (GR). Compared to PR and GR groups, NR patients showed: a) higher serum levels of IL-6, IL-10 and IFN-γ during the follow-up and b) lower serum levels of IL-4 and TNF-α. In addition, serum levels of IL-4 were significantly higher in GR patients however TNF-α was the predominant cytokines in PR group. Our results highlight the variation of circulating cytokines such as IL-6, IL-10 and IFN-γ during cervical cancer chemotherapy. In addition, this study suggested that IL-4 and TNF-α might represent potential biomarkers candidate in cervical cancer. Applications in cancer management need further investigations particularly about the relevant prognostic indicator following chemotherapy and validation studies must provide more assurance for translation into clinical practice.
文摘Background: In Africa, malaria-endemic regions have not been spared from COVID-19 outbreak which emerged in the first quarter of 2020. This pandemic has shown clinical and therapeutic similarities with malaria. This following study sought to determine the impact of COVID-19 on the malaria diagnosis. Method: A review of laboratory registers and an exploitation of the District Health Information Software 2 (DHIS2) to collect information on the diagnosis of malaria by microscopy and by rapid diagnostic test (RDT), but also that of COVID-19 was done from 2017 to 2021 at the Thierno Mouhamadoul Mansour Hospital in Mbour, Senegal. Results: In 2017, 199 Thick drops (TDs) and 1852 RDTs were performed for malaria diagnosis. In 2018, it was 2352 malaria tests with 2138 RDTs and 214 TDs, before reaching a peak of 3943 tests in 2019 including 3742 RDTs and 201 TDs. By 2020, 2263 tests were performed with 2097 malaria RDTs, 158 TDs and 8 COVID RDTs. The latter increased significantly in 2021, reaching 444 COVID RDTs, while TDs and malaria RDT kept decreasing to 147 and 1036 respectively. Positive TDs were higher in 2020 (11.4%) compared to 2017 (3.5%), 2018 (1.4%), 2019 (6.5%) and 2021 (6.8%). For malaria RDTs, a decrease in the number of positive tests was noted between 2017 (4.5%) and 2021 (1.3%). The COVID RDTs were all negative in 2020, 29.5% were positive and 4.1% were undetermined in 2021. Conclusion: COVID-19 has led to changes in efforts to diagnose malaria as well as an increase in malaria prevalence directed towards children under 5 years of age.
文摘Background: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia. The latter plays an essential role in inflammation by stimulating the production of pro-inflammatory cytokines or by increasing their secretion by an oxidative mechanism. These cytokines control the hepatic synthesis of an inflammatory protein called C-Reactive Protein (CRP). High or average values of CRP would have a predictive value of cardiovascular diseases and type 2 diabetes. The relationship between low CRP values and the risk of developing type 2 diabetes and its cardiovascular complications is not sufficiently studied. The hsCRP could serve as a predictive biomarker of risk of onset, follow-up and prognosis for type 2 diabetes and its cardiovascular complications. To answer this problem, we conducted this study, the aim of which was to study the predictive role of hsCRP in the risk of occurrence of type 2 diabetes and its cardiovascular complications. Materials and Methods: This is a prospective and cross-sectional case-control study involving 200 participants including 100 control women and 100 women with type 2 diabetes (mean age was respectively 49.89 years ± 8.26 & 51.92 years ± 7.18;p = 0.066). The interviews were conducted on the basis of a questionnaire. Physical examination collected biometric data and cardiovascular constants. The biochemical parameters such as hsCRP were analyzed by an automated Abbott device. Results: We noted that hsCRP was significantly higher in type 2 diabetic subjects compared to control subjects (p (rho = 0.40, p systolic blood pressure (rho = 0.30, p = 0.003), diastolic blood pressure (rho = 0.28, p = 0.006), total body fat (rho = 0.48, p Conclusion: hsCRP has a prognostic value in the evaluation of cardiovascular risk. It seems to play an important role in the pathogenesis of type 2 diabetes mellitus and its cardiovascular complications. It could thus be considered as a biomarker for the screening, monitoring and prognosis of type 2 diabetes mellitus.
文摘Background/Objective: Very intense and repeated exercise, particularly when performed over many years, could cause respiratory health problems. The combination of a sustained high ventilation and provocative training environments may impact the susceptibility of athletes to ventilatory disorders. Previous studies suggest that impaired ventilatory function in elite athletes can be detected in the absence of respiratory symptoms even after cessation of sports activity. The purpose of this study was to evaluate the ventilatory function of elite athletes compared to sedentary subjects. Material and Methods: This study included sedentary subjects and elite athletes, all male, aged 16 to 23 years. The athletes played regularly in the Senegalese league 1 championships (football and basketball) for at least two seasons with more than 10 hours of training per week during two years. For all participants, an interrogation was submitted and we conducted a clinic examination was performed following by a basic and post-bronchodilator spirometry. Results: The mean age of athletes (n = 66) and sedentary subjects (n = 61) was respectively 19.16 ± 2 years and 19.54 ± 2.12 years. The elite athletes presented significantly higher spirometry values (p Conclusion: This study found a high prevalence (72.73%) of ventilatory disorders (VD) in Senegalese elite athletes. Many previously undiagnosed elite athletes had significant ventilatory problems. To prevent the respiratory risk, athletes should be encouraged to avoid certain environmental factors and to adapt the period of their training.
文摘Objective: Evaluate the immunological status to hepatitis B virus of Senegalese pregnant women by screening HBs antigen. Material and methods: The selection criteria of women were presence at the laboratory for biological exams of pregnancy follow-up. All volunteers for the study were screened for HBs antigen (HBs Ag). Investigation of chronic hepatitis B markers (HBe Ag, anti-HBe, viral quantification) was performed in HBs Ag positive participants. The concentration of anti-HBs antibodies was assessed in HBs Ag negative women. Results: One hundred and fifteen (115) pregnant women were included in the study from July to October 2014. The mean age was 29 ± 6 years, ranging from 16 to 47. The seroprevalence of HBs Ag was 12% and the majority of women (90%) were not vaccinated. Any of the 14 HBs Ag-positive subjects did not express serum HBe Ag, (marker of active viral replication) and all were positive for anti-HBe antibodies. Their viral load (HBV DNA) was undetectable and serum transaminases were normal. The anti-HBs antibodies titrated in HBs-Ag negative women serum revealed that only 46 had protective levels against HBV whilst 55 of them were unprotected.
文摘Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-sectional, descriptive, and analytical study of physicians in permanent contact with patients at the Fann and Aristide Le Dantec teaching hospitals in Dakar, Senegal. Results: A total of 159 doctors were included in the study, with a sex ratio (M/F) of 1.3 in favor of men. The prevalence of burnout was 91.8%. Burnout was significantly associated (p Conclusion: Burnout is a threat to doctors at university hospitals in Senegal. It has several determinants linked above all to work organization. It is essential to set up psychological support units in hospitals and integrate occupational medicine into various organizational processes.
文摘We investigated relationship between galectin-3 (Gal-3) levels and T lymphocytes apoptosis and the activation rates in breast cancer during chemotherapy. We used plasma samples from 112 women classified into two groups: 70 women with breast cancer (BC) and submitted to neoadjuvant chemotherapy (3 cycles) and 42 healthy women used as controls. In the group of BC, blood samples were taken before each cycle of chemotherapy and Gal-3 levels was evaluated by ELISA sandwich. Flow cytometry was used to study T cells apoptosis and activation. Before treatment, median value of Gal-3 was 6.31 ng/ml (range 1.07 - 50.74) in BC and 0.84 ng/ml (range 0.00 - 4.82) in HC. Gal-3 levels were highest in plasmas from BC (p p p = 0.010). In addition, we found a dynamic relationship between gal-3 levels, tumor size and T lymphocytes apoptosis rates during treatment depending to the cure efficiency. We suggest gal-3 plasma concentrations could be used as predictive biomarker for chemotherapy efficiency in breast cancer patients.
文摘Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA) assay, digital rectal examination (DRE) and prostate biopsy, its incidence has increased significantly. The aim of our study was to analyse aspects of bone scintigraphy (BS) as part of the metastatic extension assessment of prostate cancer in Senegal. Patients and Methods: This was a retrospective descriptive and analytical study, running from January 1<sup>er</sup> 2022 to August 31 2023. Patients with histologically confirmed prostate cancer were included. Whole-body scans (WBS) were performed using a dual-head SPECT gamma camera (Mediso Nucline TM Spirit DH-V type), 3 hours after intravenous injection of 8 MBq/kg (555 to 740 MBq) of <sup>99m</sup>Tc-HMDP. Results: A total of 288 patients with a mean age of 68.37 ± 7.79 years were included. The median total PSA level was 97.6 ng/ml, with 144 patients having a level greater than or equal to 20 ng/ml. All patients had adenocarcinoma, and the Gleason score was available in 202 (70.13%) patients, 75.75% of whom had a score greater than or equal to 7. BS was contributory in 70.48% of cases, with 30.90% positive and 39.58% negative. The result was inconclusive in 85 patients (29.51%). The mean PSA for patients with a positive scan was 190.2 ng/ml and 40.6 ng/ml for those with a negative scan. Multiple metastatic lesions predominated (87.35% of cases). Metastatic lesions occurred preferentially in the axial skeleton, with a proportion of 68% versus 32% in the appendicular skeleton. Classification of bone metastases according to the SOLOWAY score revealed grade I (62.07%), grade II (35.63%) and grade IV (2.30%). Conclusion: In Senegal, prostate cancer is generally diagnosed in men of advanced age. The presence of bone metastases is frequent in its evolution, transforming a curable localized disease into a generalized disease with a compromised prognosis. Bone scintigraphy remains an essential part of the initial work-up and evaluation of response to treatment.
文摘The aim of this study was to evaluate the dose delivered to patients during scannographic examinations at the Kaolack Regional Hospital (one of the 14 regions of Senegal located in the center-west of the country, 192 km from Dakar) and to compare these irradiation doses at diagnostic reference levels found in the literature in order to optimize our scanning protocols. To achieve this goal, we carried out a prospective study involving 218 CT scans. These examinations focused on cerebral, thoracic, abdominopelvic and lumbar spine acquisitions made in adults and cerebral only in children. We compared the median values of dosimetric indicators (CTDIvol and DLP) per acquisition with NRDs in the literature. During the course of this study, we found a dosimetric ratio lower than that of the NRDs for thoracic, abdomino-pelvic and lumbar spine CT scans in adults and a significant dosimetric exceedance for brain scans in adults and in children. These results encourage us to extend these dosimetric evaluations to other hospital structures in order to establish rigorous monitoring of dosimetric indicators and to respect the principles of radiation protection and good practice.
文摘Lipid metabolism disorders would be among the components responsible for the risk of the onset of T2DM and its vascular complications. Apolipoprotein E plays an important role in lipid metabolism. We studied the involvement of the APOE gene in the onset of T2DM and its vascular complications. Clinical and biochemical parameters were assessed in each participant. APOE genotypes were identified by PCR-RFLP. Arterial stiffness was studied using a pOpmetre<sup>®</sup> which evaluates the pulse wave velocity (ft-PWV). Endothelial dysfunction was studied using an EndoPAT2000<sup>®</sup> which measures endothelium-dependent vasodilation (RHI). In control subjects, the ε3 allele was associated with an increase in fasting blood glucose (r = 2.36, p = 0.018), and a decrease in LDL cholesterol levels (r = −2.17, p = 0.03), and ε4 was associated with an increase in total cholesterol (r = 2.59, p = 0.01), LDL cholesterol (r = 2.84, p = 0.004), and No-HDL cholesterol (r = 2.74, p = 0.006). In type 2 diabetes subjects, the ε2 was associated with a decrease in diastolic blood pressure (r = −2.25, p = 0.02). The ε3 was associated with a decrease in ft-PWV (r = −2.26, p = 0.024) while the ε4 was associated with an increase in ft-PWV (r = 2.52, p = 0.012). Carrying the ε2ε3 genotype would have in 99% a limited risk of developing T2DM, and in event of T2DM, only 1 to 2% would have a significant risk of developing atherosclerosis, which would be severe in 17%. Of the ε2ε4 genotype, 93% had a limited or even possible risk of developing T2DM, the remaining 7% had a very high risk of developing T2DM. Diabetics carrying ε2ε4 had in 7% very high risk of developing atherosclerosis. The latter had a 20% very high risk of being very severe. Subjects carrying the ε3ε4 genotype had a 67% possible or even probable risk of developing T2DM and in the event of diabetes, there was in 34% very high risk of developing atherosclerosis which will not have even the time to evolve towards severity. For subjects carrying the ε3ε3, the risk of developing T2DM and athérosclerosis was higher than that of the ε2ε3, and ε2ε4 genotypes but lower than that ε3ε4 genotype. The physio-pathological role of the APOE gene and the impacts of its polymorphisms are important in the onset and progression of type 2 diabetes mellitus.
文摘Neonatal thrombocytopenia accounts for 20% of neonates hospitalized in the neonatal intensive care unit (NICU) at DPH. The etiologies are multiple, but bacterial infection is the third leading cause of neonatal mortality worldwide. We therefore set out to assess the frequency of neonatal thrombocytopenia associated or not with bacterial infection in the NICU. We conducted a retrospective and prospective study with the DPH NICU, over 10 months (August 2018 and April 2019). Thrombocytopenia encountered in the NICUs, were the subject of research into bacteriological, inflammatory, and epidemiological parameters using Inlog laboratory data processing software. During this period, 1280 babies were hospitalized, 94 of whom underwent thrombocytopenia, corresponding to 7.34%, with a sex ratio of 0.92. The number of babies presenting with thrombocytopenia during the first week of hospitalization was 72, accounting for 76.6%. The clinical context was usually low birth weight in 30.8% of cases and perinatal asphyxia (25%). Thrombocytopenia ranged from 2000 to 137,000 with an average of 69,520/mm3. Among these thrombocytopenias, 64 cases (68%) were below 100,000 mm3 and 44 cases had a CRP >5 mg/l. A total of 30 bacteria were isolated, including 23 Enterobacteria, 2 Streptococci, and 1 Acinetobacter. Among these enterobacteria, 14 were multidrug-resistant (MDR). Thrombocytopenia associated with a multidrug-resistant bacterial infection is a real challenging management.
文摘Introduction: Previous studies in sickle cell disease (SCD) patients have demonstrated low muscle mass (MM) and high fat mass (FM) percentages compared to individuals with normal hemoglobin. The relationship between the evolutions of body composition (BC) parameters in the active SCD population is not well elucidated. The aim of the present study was to assess the body composition in active adult SCD patients in sub-Saharan Africa during the inter-critical period. Methodology: We conducted a descriptive and analytical cross-sectional study over an 8-month period. Eighteen SCD patients (sex ratio = 1) reported regular physical activity (RPA) corresponding to level 3 (RPA of moderate intensity) of the 4-level Saltin-Grimby physical activity scale were recruited. Anthropometric and BC parameters such as BMI, percentage FM and percentage MM were evaluated using an impedance meter. Results: The study population had a mean age of 26 ± 7 years and a mean BMI of 20.5 ± 1.9 kg/m2. We found a significantly higher percentage of FM in women compared to the men (25.6% ± 10.2% vs 11.1% ± 2.1%;p = 0.001). For the proportion of MM, all the women had a normal percentage. The men mostly had high levels of MM compared with reference norms. Men had significantly greater MM percentages than women (45.4% ± 1.8% vs. 26.5% ± 1.4%;p Conclusion: RPA appears to have positive effects on BC in active population with SCD, and a greater-than-expected effect was observed on MM in male patients. Promoting regular, adapted physical activity would be a promising way of improving BC parameters and quality of life in the SCD population. Further studies with larger cohorts will be needed to better substantiate these results.
文摘Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functional asplenia (associated with repeated thrombosis of splenic vessels), resulting in increased susceptibility to infection. However, several studies have reported differences in the spectrum of bacterial infections in malaria-endemic areas. Therefore, we proposed to conduct a study to determine the rate of positive blood cultures and the bacteriological spectrum in sickle cell patients. Materials and Method: This is a descriptive cross-sectional study of blood culture samples from patients who received a request for hemoglobin electrophoresis as part of their treatment at the Principal’s hospital in Dakar. The study took place from January 2008 to December 2021. For each patient, we collect demographic information, including age, gender, and the service from which the analysis request originated. Data were collected in the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: Our study included 1419 patients. The most common types of hemoglobin profiles were: normal profile (n = 1025), AS profile (n = 283), SS profile (n = 104), SC profile (n = 7). This corresponds to the proportions of 72%, 20%, 0.5% and 7.5% for the profiles Normal, AS, SC and SS. The male proportion was 61.1%, 61.5%, 57.1, respectively %, 55.8% for Normal, SA, SC, and SS profiles. A total of 19,090 individual blood culture bottles were collected from 1419 impatient patients as follows: Normal profile (n = 18,042 bottles), AS profile (n = 677 culture bottles), SS profile (n = 362 bottles). The majority of blood culture orders come from pediatric services, accounting for 70% of the total number of orders. Of 19,090 vials examined in this current study, 19.6% developed a positive blood culture. Overall, the most commonly isolated bacteria were Staphylococci (41.1%), Enterobacteriaceae (36.7%), Bacillaceae (10.2%), unfermented (6.30%), Streptococci (5.01%), and a small proportion of yeast (0.75%). There is no significant difference in bacterial spectrum between the SS profile and the normal profile of individuals (p = 0.104). Coagulase-negative staphylococci accounted for 32%, 24%, and 40% of the species isolated in the normal AS and SS profiles. respectively. Coagulase-negative staphylococci were the most commonly isolated organisms in SS. Group E and sptagged streptococci each account for less than 2% of the organisms isolated in SS. Pneumococci were not found. Bacillus accounts for 25% of isolates in SS subjects compared to 9% in normal and AS subjects, respectively. Pseudomonas aeruginosa and Burkholderia cepacia then make up 10% of the isolates in the subjects of the SS profile as non-fermenters. Conclusion: Our study shows that enterobacteria and staph are prevalent in people with sickle cell disease. There is no significant difference in bacterial spectrum between SS subjects compared to subjects with a normal profile. The rarity of Streptococcus pneumoniae in bacteremia isolates underlines the need for further studies with larger patient numbers to better understand the spectrum of bacterial infections in patients with sickle cell disease in West Africa.
文摘Background: Chronic hepatitis B virus (HBV) infection is one of the largest public health problems with nearly 350 million chronic carriers and 500,000 deaths each year. These deaths are most often associated with disease progression to cirrhosis or hepatocellular carcinoma, which some studies have shown is associated with long-term viral replication in chronic carriers. Viral load quantification, a key element of disease management, is expensive and difficult to access. Viral load plays a crucial role in patient classification and treatment initiation. Four years after the implementation of viral load platform, the objective of this study was to assess viral load profile in HBs chronic carriers in a sub-Saharan Hospital and to determine the potential impact of this distribution on preventive and therapeutic strategies against hepatitis B infection. Materials and Method: The study was carried out between April 2016 and October 2020 in the laboratory of the PRINCIPAL Hospital in Dakar. All patients referred for HBV DNA viral load testing following a positive AgHBs test were included. Incomplete medical records were excluded from the study. Only the first quantification test performed on each patient is recorded. DNA extraction was performed with COBAS AmpliPrep (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Amplification was performed using COBAS TaqMan48 (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Data were collected from the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: A total of 3002 patients, 76.1% (2285/3002) men and 33.9% (717/3002) women, were included in the study. Young adults were most represented among the subjects (23.2%) and (20.1%) in the age groups 25 - 30 and 30 - 35. The majority (52.7%) of patients had viral loads between 20 and 2000 IU. Patients with undetectable viral loads and patients with viral loads below 20 IU comprised 14.6% and 7.53% of the study population, respectively. Patients with viral loads between 2000 and 20,000 IU/ml and those with viral loads greater than 20,000 IU/ml represented 16.3% and 8.89% of the study population, respectively. Viral load was higher in males than females, with corresponding median and interquartile ranges of 2.7 log IU (2.2, 2.75) and 2.23 log IU (2.1, 2.4) (p Conclusion: This study shows a successful implementation of virus quantification in the context of resource-constrained countries. The second finding of this study is the high prevalence of adolescents with high plasma viral loads, indicating the need for additional investigations to initiate therapy. The large population with a low HBV replication rate points to the problem of financing follow-up care for chronically infected people. Studying this population in the context of an unknown genomic profile indicates the need to deepen virological laboratory testing through a sequencing platform. Finally, regular viral load reporting in major hospital cities could be a powerful and accessible management tool for hepatitis B programs in resource-constrained countries.
文摘Background: Over the past two decades, blood transfusion safety has made significant advances in the fight against infectious diseases. However, hepatitis B is still a problem in blood banks due to its high endemicity in Senegal. In this context, we proposed to first determine the prevalence of HBs antigen (HBsAg) in regular and new blood donors. Second, to determine the influence of the number of blood donations on the prevalence of hepatitis B. Materials and Method: We conducted a retrospective transversal study using data from all blood donations received at the Principal Hospital of Dakar Blood bank from July 2007 to December 31, 2021. Hepatitis B testing was carried out with Automaton E411 (Roche Diagnostics). For all donors, information on age, sex, hepatitis B serology, and the number of donations was collected through the lab’s computer system. Data entry and statistical analysis were performed with Epi-info version 7. Results: HBsAg carriers were identified in 4311 primary donors, corresponding to a prevalence of 12.39% (IC 95% = 12.04 - 12.74). The prevalence of the HBsAg antigen was higher in men (12.9%) than in women (6.85%). Men are twice as likely to be infected with HBV as women (OR = 2.00 (IC 95% = 1.85 - 2.17)). The highest prevalence (12.4%) was found in young adults (23 - 29) years old. After 10 donations, the prevalence of the HBs antigen was stable at around 1%. Individuals with a single blood donation and individuals with 2 to 5 blood donations are 9 and 7 times more likely to carry the HBs antigen than regular donors (more than 10 blood donations), respectively. Conclusion: Our results demonstrate the endemic nature of hepatitis B in Senegal. On the other hand, the non-negligible prevalence of the virus in first-time donors reminds us of the need for continuous improvement in donor selection. These first-time donors, particularly young adults, are important indicators of transmission of the virus to the general population. This study also demonstrates the need to develop strategies to maintain the pool of regular donors, which represent significant barriers to the spread of hepatitis B.
