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The Management of Lumbosciatic Disc Related Disease at Renaissance University Teaching Hospital of N’Djamena-Chad: About 156 Cases

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Open Journal of Modern Neurosurgery 2023年第1期13卷 25-32页

作者： Goumantar Felicien Toudjingar Yannick Canton Kessely Ngaoussandjim Ndom-Assal Olivier Ouambi Donald Djasde Mahouli Fata Vounki alio hamit mahamat Momar Code Ba Department of Neurosurgery La Renaissance University Hospital N’Djamena Chad Department of Neurosurgery Reference Nationale University Hospital Center N’Djamena Chad Department of Neurosurgery Fann University Hospital Center Dakar Senegal

Introduction: Low back disc disease (LSD) is a neurosurgical condition with significant socioeconomic repercussions. The objective of this study was to determine the frequency and report the modalities of management. Methodology: This study on lumbosciatic disc disease was carried out in the neurosurgery department of the University Hospital Center (CHU), la Renaissance in N’Djamena. It covered a period of 12 months (from September 2019 to August 2020). A descriptive and an analytical approach were used. The variables studied were epidemiology, clinic, radiology and therapy. Results: the results showed that LSD represented 14.7% of the reasons for consultation in neurosurgery. The average age was 45.8, and to some extent, it ranges between 18 and 76. Lifting was the main reason behind lumbosciatic disc disease with 35.9% of cases, followed by a sedentary life style which represents 30.8%. Lumbosciatica L5 was noted in 49.4%. Obesity and overweight were significant risk factors (P = 0.02) reported in 59% of cases. Motor and sensory deficits were observed in 14.8% and 17.3% of cases, respectively. CT of the lumbar spine was performed in 91% and MRI in 28.9%. The L4-L5 disc herniation represented 74.3% of cases, with a lateral location in 44.2% and L5 radicular impingement in 30.8%. Conservative treatment was instituted in 87.2% and surgical treatment in 12.8% of cases. Conclusion: LSD is caused by a sedentary lifestyle, physical work and overweight. Surgery deals with complicated cases and cases not responding to conservative treatment.

关键词： Lumbosciatica Herniated Disc Surgical Treatment Conservative Treatment Chad

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Sydenham’s Chorea: Apropos of Three Observed Cases at the N’Djamena Mother and Child University Teaching Hospital (CHU-ME)-Chad

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Open Journal of Pediatrics 2023年第4期13卷 507-514页

作者： Hassan Adam Annour mahamat Ali Bolti Ildjima Ousmane Kadallah hamit mahamat alio Teaching Hospital Renaissance University Hospital N’Djamena Chad Department of Pediatrie Faculty of Human Health Sciences of the University of N’Djamena N’Djamena Chad Internal Medicine Department Faculty of Human Health Sciences of the University of N’Djamena N’Djamena Chad Teaching Hospital Mother and Child University N’Djamena Chad Laboratory Department Faculty of Human Health Sciences of the University of N’Djamena N’Djamena Chad

Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.

关键词： Sydenham Chorea AAR Streptococcus CHU-ME Chad

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Clinical Efficacy of Artemether-Lumefantrine Artesunate-Amodiaquine of Children from Three Chadian Provinces with Acute of Uncomplicated Falciparum malariae from 6 Months to 5 Years

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Advances in Infectious Diseases 2022年第4期12卷 788-798页

作者： Issa Ramat Adam Nack Jacques hamit mahamat alio Akono Ntonga Patrick Abakar Idriss Lawane mahamat Ali Bolti Laboratory of Medical Parasitology and Mycology Faculty of Health and Human Sciences University of N’Djamena N’Djamena Chad Laboratory of Animal Biology University of Douala Douala Cameroon Renaissance University Teaching Hospital N’Djamena Chad

Introduction: Artemisinin-based combination therapies are the first-line antimalarial drugs used to treat uncomplicated Plasmodium falciparum malaria in many endemic countries worldwide. In Chad, since the adoption of artemisinin-based combination therapy (ACTs) in its first-line treatment policy for uncomplicated malaria in 2005, Artemether-Lumefantrine and Artesunate-Amodiaquine have been used in many hospitals and health centers. The main objective of this study was to provide the baseline data of Artemether-Lumefantrine and Artesunate-Amodiaquine efficacy in three regions where many people suffered from malaria disease. Material and Methods: The baseline efficacy of two combination therapies was evaluated between January and April 2020 in Mosoro, Mondou and Dourbali Provinces in Chad. A two-arm single cohort study was conducted to assess the clinical efficacy of artesunate-amodiaquine and artemether-lumefantrine for the treatment of 1113 children aged from 6 to 59 months with uncomplicated Falciparum malariae diagnosed by thick blood smear examination, using the World Health Organization validated protocol. Results: On day 3, all patients in both groups had cleared parasitemia, after treatment, the patients presented a higher hemoglobin level in both groups artemether-lumefantrine (10.97 ± 1.39) and artesunate-amodiaquine (11.87 ± 1.81), respectively. On day 28, all patients had adequate clinical and parasitological responses with 99.82% of artesunate-amodiaquine and 99.10% of artemether-lumefantrine. Overall, both drugs were well tolerated at the clinical and biological level, no late parasitological failures have been recorded in artemether-lumefantrine and artesunate-amodiaquine groups, also both forms of Artemisinin-based combination therapy were still effective and safe in the treatment of uncomplicated P. falciparum malaria in Chad.

关键词： Plasmodium falciparum Artemeter-Lumefantrine Artesunate-Amodiaquine Efficacy Parasitological Density Hemoglobin Levels

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Antimicrobial Resistance of Pseudomonas aeruginosa Isolated from Human Infections in N’Djamena, Chad

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Open Journal of Medical Microbiology 2023年第1期13卷 17-30页

作者： Ahmat mahamat Ahmat mahamat Ali Bolti Fissou Henry Yandai hamit mahamat alio Martin-Paul Baane Mayoré Atéba Djibrine Evariste Bako Nicolas Barro Choua Ouchemi Ecole Doctorale Sciences Techniques et Environnement Université de N’Djamena N’Djamena Tchad Centre Hospitalier Universitaire la Renaissance (CHU-R) N’Djamena Tchad Faculté des Sciences de la Santé Humaine Université de N’Djamena N’Djamena Tchad Institut de Recherche en Elevage pour le Développement (IRED) N’Djamena Tchad Laboratoire de Biologie Moléculaire d’Epidémiologie et de Surveillance des Bactéries et Virus Transmissibles par les Aliments (LaBESTA) Université Joseph KI-ZERBO Ouagadougou Burkina Faso Hôpital de la Caisse Nationale de Prévoyance Sociale Maroua Cameroun Institut National Supérieur du Sahara Iriba Tchad

Background: Urinary Tract infections and pus are major public health problems. The evolution of bacterial resistance to antibiotics makes the treatment of these infections problematic. This is why this study is undertaken to identify and evaluate the resistance of Pseudomonas aeruginosa to antibiotics. Methods: This is a prospective study carried out from December 2020 to November 2021. The germs were isolated on the agar supplemented with cetrimide and identified by the API 20 NE gallery method according to the manufacturer’s protocol. The strains’ resistance profiles were determined by the diffusion method on Mueller-Hinton according to the criteria EUCAST- 2021. Results: A total of 46/1467 (3.13%) Pseudomonas aeruginosa were identified, of which 29/1008 (2.87%) were urinary tract infections and 17/459 (3.70%) were pus. The high resistances were: 97.8% to ceftazidim, 91.3% to aztreonam, 93.5% to cefepim, 82.6% to piperacillin, 58.7% to levofloxacin, 52.2% to amikacin, 47.8% to tazobactam-piperacillin, 47.8% to tobramycin and 43.5% to ciprofloxacin. Low resistance was only 2.2% to fosfomycin, 2.2% to colistin and 15.2% to imipenem. Conclusion: This study reveals the considerable resistance of Pseudomonas aeruginosa to commonly used antibiotics, and thus compromises the empirical treatment practiced in hospitals. This result motivates the need to carry out susceptibility testing of isolates before any prescription of antimicrobials.

关键词： Pseudomonas aeruginosa Resistance to Antibiotics Urine Pus N’Djamena

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HIV and Seroconversion among Pregnant Women at the University Hospital of Mother and Child in Chad

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Journal of Biosciences and Medicines 2023年第1期11卷 106-115页

作者： Fissou Henry Yandai Ali mahamat Moussa mahamat Ali Bolti Djidda Abakar Oumar Hissene Adanaou Khadidja Attimer hamit mahamat alio Kuan Abdoulaye Traore Nicolas Barro Institut de Recherche en Elevage pour le Développement (IRED) N’Djamena Tchad Centre Hospitalier Universitaire la Renaissance (CHU-R) N’Djamena Tchad Laboratoire de Biologie Moléculaire d’Epidémiologie et de Surveillance des Bactéries et Virus Transmissibles par les Aliments (LaBESTA) Université Joseph KI-ZERBO Ouagadougou Burkina Faso Faculté des Sciences de la Santé Humaine (FSSH) N’Djamena Tchad Laboratoire de Sciences de la Vie et de la Terre (LaSVT) Université Norbert ZONGO Koudougou Burkina Faso

Background: HIV in pregnant women presented a risk of transmission to newborns. This study was to determine HIV prevalence among pregnant women in the birthing rooms and give antiretrovirals to women infected and their newborns. Methods: A preliminary study was conducted from 2013 to 2015 at the Mother and Child Hospital. Pregnant women were counseled and tested for HIV-antibody according to the national algorithm using Determine HIV 1 & 2 and Immunocomb II Bispot HIV1 & 2. The women screened HIV-negative during the prenatal consultation and who accepted a second test were screened in the birth room. The data collected were processed using the Access Microsoft office 16 and SPSS software version 18. Results: A total of 6080 pregnant women were tested before and in the birth room. Of these, 5943 (97.4%) were detected as HIV-negative and 159 (2.6%) were HIV-positive. Of the 5943 with HIV-negative status, 1333 accepted the second test in the birth room, 10 of which have become HIV-positive. The rate of seroconversions was 0.75%. Conclusion: This study determined the prevalence of HIV in pregnant women. The result reveals the importance and necessity of repeating the screening test in the birth room because of the possibility of seroconversion or new infection during pregnancy.

关键词： HIV Prevalence Seroconversion Pregnancy Chad

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The Management Problem of Miliary Tuberculosis in the Service of Pneumo-Phtisiology at the National References University Teaching Hospital of N’Djamena (Chad): About 103 Cases

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Journal of Tuberculosis Research 2022年第3期10卷 160-169页

作者： mahamat Ali Bolti Rangar Ngakoutou Abdoulaye Ahmet Mad-Toingue Joseph Dluida Dieudonné Lodoum Mbainadji Josephine Toralta Meurde Nemian Lucien Allawaye Koboye Bonté Adjougoulta Yusra Aboulbachar hamit mahamat alio Faculty of Human and Health Sciences and The Renaissance University Teaching Hospital of N’Djamena N’Djamena Chad Faculty of Human and Health Sciences and The National Reference University Teaching Hospital of N’Djamena N’Djamena Chad

Introduction: Miliary tuberculosis (MT) is a rare form of tuberculosis (TB) and it is a major public health problem in our countries with limited resources. Materials and Methods: It is a retrospective and descriptive study that started from 1st January 2018 to 31 December 2020 at the pneumo-phtisiology service of the CHU-RN of N’Djamena., All records of patients aged at least 15 years treated for miliary tuberculosis confirmed by X-ray chest were included in our study. Results: The prevalence of TD was 1.5% (n = 103) of all TB diagnosed in the service. The sex ratio was 1.34. The average age was 37.7 years with extremes ranging from 19 to 80 years. A low social economic level was found in 75.7%. The principal comorbidity found in this study was HIV with the prevalence of (22.3%). The general signs were dominated by deterioration of general condition (96.1%) and fever (91.3%). The main symptoms were cough (85.4%) and dyspnea (52.4%). The radiology of chest found a homogeneous dissemination and symmetrical in both lung fields in 100% of cases. Our study reported that 14 (13.6%) of death cases were found among patients. Conclusion: TM is a severe form of TB;it affects a young population in our context. Mortality remains high with prevalence of 13.6% of cases. Early management would improve the prognosis.

关键词： Miliary Tuberculosis CHU-RN N’Djamena (Chad)

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Management of Secondary Leyll Syndrome Due to Anti-Covid Vaccine in a Case, at the Renaissance University Teaching Hospital, Ndjamena (CHAD)

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Journal of Biosciences and Medicines 2022年第10期10卷 47-54页

作者： Traoré Sory Adamou Abassi Mana Abdelsalam Hissein Hassan Kader Ndjaye Nouradine Abakar Abdesalam Mahamt Bahar mahamat Ali Bolti Ngamai Kotyadé Mwabanyol Loobe Regis Michel Slama hamit mahamat alio Anesthesia-Resuscitation Department of the Renaissance University Teaching Hospital N’Djamena Chad Emergency Department of the N’Djamena Renaissance University Teaching Hospital N’Djamena Chad Internal Medicine Department N’Djamena Renaissance University Teaching Hospital N’Djamena Chad Surgery Department of N’Djamena Renaissance University Teaching Hospital N’Djamena Chad Ophthalmology Department of the N’Djamena Renaissance University Teaching Hospital N’Djamena Chad Head of Resuscitation Department CHU Amiens-Picardie Amiens France Laboratory Department of the Renaissance University Teaching Hospital of N’Djamena N’Djamena Chad Faculty of Human Health Sciences of the University of N’Djamena N’Djamena Chad

Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one million inhabitants per year and its evolution can be fatal. Materials and Methods: We report the observation of a 60-year-old patient, with no significant pathological history, admitted to our intensive care unit at the Renaissance University Teaching Hospital in N’Djamena for the treatment of Toxic Epidermal Necrolysis. In whom the onset of symptoms dates back to few hours after vaccination against COVID-19 with Ag Johnson and Johnson. Results: An ophthalmology opinion was requested and the patient was put on Fucithalmic. In our case, in addition to the advanced age of the patient (60 years old), her SCORTEN was ≥5. Conclusion: The late management as well as the absence of a specific department for severe burns, which condition the presence of a technical plate was fatal to her despite multidisciplinary care: Resuscitators, Traumato-Orthopedist and ophthalmologist.

关键词： Lyell Syndrome Renaissance University Teaching Hospital N’Djamena Symptomatology Vaccination Covid-19 SCORTEN

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Ethnobotanical Study of Medicinal Plants Used for Treating Urinary Tract Infections in N’Djamena (Chad)

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American Journal of Plant Sciences 2024年第1期15卷 46-55页

作者： Alhadj Djidda mahamat Soudy Imar Djibrine hamit Mht alio Abakar Tadjadine Emmanuel Issa Issa Ramat Adam Abdel-Aziz Arada Baroua Abouna Elisabeth Ngo Bum Laboratory of the Faculty of Human Health Sciences of the University of N’Djamena N’Djamena Chad Faculty of Sciences of the University of Maroua Maroua Cameroun Food Quality Control Centre (CECOQDA) N’Djamena Chad National Reference University Hospital of N’Djamena N’Djamena Chad Lute Sectorial Programme against AIDS and Hepatitis (PSLS) N’Djamena Chad Research and Livestock Institute for Development (IRED) N’Djamena Chad

Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants w

关键词： Urinary Infections Medicinal Plant and Traditherapists

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Social Services for Mobile Pastoralists： Cross-sector Strategy Based on ＂One Health＂

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Sociology Study 2012年第9期2卷 705-714页

作者： mahamat Bechir Zinsstag Jakob mahamat Abdoulaye Schelling Esther Kessely hamit Fokou Gilbert Moto Daugla Bonfoh Bassirou Tanner Marcel University of N'Djamena Chad Centre de Support en Sante lnternationale Chad Swiss Tropical and Public Health Institute/University ofBasel Swiss Centre Suisse de Recherche Scientifique Cite d'Ivoire

Mobile pastoralist communities in Sahel countries have serious problems of access to social services. Classic strategies for social services were always based on a single sector, focused on settled populations, and hardly reached mobile communities. This paper aims to show a cross-sector approach as a part of solutions to provide social services for mobile pastoralist communities and describes the ongoing scaling-up process. The method used is based on a transdisciplinary approach which involves target communities and authorities in all processes through workshops and site visits. Interventions adopted the concept of ＂one health＂ benefiting of an added value of closer cooperation between human and animal health. This approach was tested with joint interventions between human and animal health, which provided access to health services for unreached communities and saved resource when compared with single sector intervention. Such approaches could be extended to other social services within cross-sector interventions such as the delivery of basic education in nomadic areas. Such a strategy was validated by the communities and authorities and was further transformed into a national programme after a series of six national stakeholders＇ seminars. The cross-sector intervention will provide a minimum package of services （MPS） without compromising the structural services.

关键词： Mobile pastoralists integrated cross-sector approach transdisciplinary one health Chad

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Hydrochemical and Isotopic Characteristics of the Basement Aquifer in the Wadi Fira Area, Eastern Chad

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Journal of Water Resource and Protection 2017年第13期9卷 1688-1708页

作者： Hamza B. mahamat Mathieu Le Coz hamit Abderamane Paul Sardini Moumtaz Razack University of Poitiers Poitiers France Departement of Geology Polytechnic Institute of Mongo N’Djamena Chad Departement of Geology Faculty of Exact and Applied Sciences University of N’Djamena N’Djamena Chad

The Wadi-Fira region in eastern Chad is facing dramatic water supply problems, related to the climatic semi-arid context and the reception of refugees from the Darfour, which has increased the local population by 22% these last years. Expansion of agglomerations (temporary new towns), development of agricultural and pastoral practices together with the augmentation of the population have led to dramatic water needs. The basement aquifer of Wadi-Fira constitutes the main source of water supply. However, little is known about this system. Within this context, this work aims at better understanding and identifying hydrogeochemical processes and their relations to groundwater quality within this complex environment, and groundwater recharge mechanisms. 31 groundwater samples were collected at two sites, Am Zoer and Guereda-Iriba, from hand dug wells and deep wells. Major chemical elements were analyzed on all samples and stables isotopes (oxygen-18 and deuterium) on 17 samples. Various methods were used to interpret the hydrochemical data (descriptive and multivariate statistics, Piper and Schoeller diagrams, scatter plots, minerals saturation indices). The stable isotopes were interpreted using conventional IAEA methods. The results permitted to differentiate the laterite reservoir from the deep fractured reservoir. The main process controlling groundwater mineralization is water-rocks interaction and natural minerals dissolution. Ion exchanges, evaporation and anthropogenic activities have also a moderate impact on groundwater quality. Based on isotopes data, it is concluded that groundwater in the basement aquifer is related with modern rainfall. These results provide further insights into this basement aquifer, which is a vital resource for the region of Wadi-Fira.

关键词： Wadi-Fira Chad Basement Aquifer Hydrochemistry Stable Isotopes

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