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Epidemiology and antibiotic resistance of bacterial meningitis in Dapaong,northern Togo

Asian Pacific Journal of Tropical Medicine 2012年第11期5卷 848-852页

作者： Simplice D Karou abago balaka Mitiname Bamok Damhan Tchelougou Malki Assih Kokou Anani Kodjo Agbonoko Jacques Simpore Comlan de Souza Ecole Superieure des Techniques Biologiques et Alimentaires(ESTBA-UL) Universit de LomTogo Centre de Recherche Biomoleculaire Pietro Annigoni(CERBA/LABIOGENE) OuagadougouBurkina Faso Faculte Mixte de Medecine et de Pharmacie(FMMP-UL) Universit de LomTogo Centre Hospitalier Regional(CHR)de Dapaong Togo

Objective:To assess the seasonality of the bacterial meningitis and the antibiotic resistance of incriminated bacteria over the last three years in the northern ***:From January 2007 to January 2010,533 cerebrospinal fluids(CSF) samples were collected from patients suspected of meningitis in the Regional Hospital of Dapaong(northern Togo).After microscopic examination,samples were cultured for bacterial identification and antibiotic susceptibility. Results:The study included 533 patients(306 male and 227 female) aged from 1 day to 55 years [average age(13.00±2.07) years].Bacterial isolation and identification were attempted for 254/533 (47.65%) *** bacteria]species identified were:Neisseria meningitidis A(*** A)(58.27%),Neisseria meningitidis W135(N,meningitidis W135)(7.09%),Streptococcus pneumoniae(***)(26.77%),Haemophilus influenza B(*** B)(6.30%) and Enterobacteriaceae(1.57%).The results indicated that bacterial meningitis occur from November to May with a peak in February for *** and *** and March for Neisseriaceae. The distribution of positive CSF with regards to the age showed that subjects between 6 and 12 years followed by subjects of 0 to 5 years were most affected with respective frequencies of 67.82%and 56.52%(P20%for both bacterial strains),macrolides(resistance rate>30%for ***) quinolones(resistance rate>15% for *** and *** W135).Over three years,the prevalence of *** significantly increased from 8.48%to 73.33%(P<0.001),while the changes in the prevalence of *** B were not statistically significant:4.24%,vs.8.89%,(P= 0.233).Conclusions: Our results indicate that data in African countries differ depending on geographical location in relation to the African meningitis *** underlines the impo

关键词： Meningitis Bacteria Antibiotics Cerebrospinal fluid Togo

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Cryptococcal Meningitis of the HIV-Infected Person in Lomé: About 102 Cases over 10 Years

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World Journal of AIDS 2017年第3期7卷 217-222页

作者： Ihou Majesté Wateba abago balaka Alain Lidaw Bawe Awereou Kotosso Tropical and Infectious Diseases Service of CHU SO Lome Togo Internal Medicine Service of CHU SO Lome Togo

Objective: To describe the clinical, epidemiological and evolutionary aspects of cryptococcal meningitis. Methods: This was a retrospective descriptive study on all HIV-infected patients who had been hospitalized for cryptococcal meningitis between 2006 and 2016 in the principal structures for the care of HIV infected person in Lomé. The diagnosis of meningitis was clinical and confirmed by the presence of cryptococci on Chinese ink or the detection of CSFsoluble antigens. All patients have made the CD4 rate assay and received an antifungal treatment based on fluconazole or Amphotericin B, followed later by antiretroviral triple therapy. Results: A total of 102 patients infected with cryptococcal meningitis (62 men for 40 women) were found. The sex ratio was 1.55. The median age was 34 years with extremes of 15 to 49 years. Clinically, headache was the symptomatic symptom in 100% of cases, prone to long runs and weight loss respectively in the proportions of 45% and 65%. The mean CD4 cell count was 65 ± 22 cells per mm3. The duration of hospital stay was short (less than 7 days) for the deceased. A total of 62 patients were able to receive treatment, 40 of them with fluconazole and 22 with Amphotericin B. The mortality was very high (65%), 25% were lost to follow-up, and 9.5% still in live 3 months after admission to the hospital. Conclusion: Cryptococcal meningitis has a very reserved prognosis. It is to be feared in cases of severe immunosuppression, hence the early detection of HIV for optimal management is important.

关键词： Cryptococcal Meningitis HIV Lomé

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The Lassa Virus Epidemic in Mango, Togo: Therapeutic Route of the First 4 Cases

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Advances in Infectious Diseases 2017年第4期7卷 135-142页

作者： Majesté Ihou Wateba Aimé Dakévi Lidawu Bawé abago balaka Awereou Kotosso Tropical and Infectious Diseases Service of CHU SO Lomé Togo Internal Medicine Service CHU of SO Lomé Togo

Introduction: Lassa viral hemorrhagic fever is caused by the Lassa virus. The aim of our study is to describe the therapeutic itinerary of the 4 cases of Lassa virus hemorrhagic of February-March 2017 epidemic that occurred in Mango. Methodology: Our study is a transverse retro-prospective and descriptive study from February, 1st to March, 31st 2017 that dealt with 4 confirmed Lassa fever cases declared positive on the PCR basis;hospitalized or deceased at the hospital “Esperance” of Mango;support center of Lassa viral hemorrhagic fever. Results: we reported 4 clinical observations of Lassa viral hemorrhagic fever diagnosed on the PCR basis during the Lassa fever epidemic. Patients came from Benin (2 cases) or from Burkina-Faso (1 case) and were 25, 60, 52 years old and a premature baby of 13 days. The reasons for admission were external hemorrhage, a pultated tonsillitis and abdominal pains. Fever was observed for all the cases. Complications were marked by hemorrhages and shocks. Only two patients benefitted from Antiviral therapy with Ribavirin and were declared healed. The other two patients did not benefit from the treatment due to diagnostic and therapeutic delays. Lethality was 75% (3 cases) with a highly secured burial. Effective management of contacts was established. Conclusion: Diagnostic and therapeutic delays of patients are responsible of the Dark Prognosis of Lassa fever during the epidemic.

关键词： Fever Hemorrhage Lassa Virus Mango (Togo)

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Self-Care Capacities of Diabetic Patients Monitored in the Internal Medicine Unit at the Kara Teaching Hospital (CHU Kara)

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Open Journal of Internal Medicine 2020年第2期10卷 103-111页

作者： Toyi Tchamdja abago balaka Kodjo Agbéko Djagadou Djalogue Lihanimpo Mohaman Awalou Djibril Service de Médecine Interne Kara Lomé Togo Faculté des Sciences de Santé Université de Kara Kara Lomé Togo Faculté des Sciences de Santé Université de Lomé Kara Lomé Togo

Objectives: To evaluate the practice of self-care in diabetic patients monitored at the Kara Teaching Hospital, known as CHU Kara. Method: We conducted a quantitative, descriptive and cross-sectional study of 40 diabetic patients monitored at the Kara CHU. The data collection took place from February 20 to May 28, 2018 and the data was collected anonymously. Results: Out of the forty (40) respondents, 60% were male with a sex ratio of 1.5 and an average age of 56.15 years. Two-thirds (2/3) of the patients did not have the blood glucose meter. More than half (52%) did not know the normal blood glucose value and 82.5% were on a low carbohydrate diet. Eighty-two point fifty percent (82.50%) were under Oral antidiabetic (ADO). Forty percent (40%) of patients often forgot their medication. Forty-seven point-fifty percent reported frequent episodes of hypoglycaemia with dizziness (58%), tremors (53%), hunger (53%), sweat (37%), tingling (26%) and the most common gestures were: sugar ingestion (53%) and glycemic control (26%). Eighty-five (85%) said they used to feel hyperglycemia with fatigue (76%), polyuria (65%), polydipsia (44%) the most common precursors and the most frequent interventions were taking hypoglycemic drugs (74%) and controlling blood glucose (24%). Conclusion: The practice of self-care remains risky for diabetic patients. Hence the need for the establishment of adequate therapeutic education programs.

关键词： Self-Care Diabetic Patient The Kara CHU

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Resistance to Beta Lactam Antibiotics of <i>Pseudomonas aeruginosa</i>Isolated in Community Infections within HIV Infected Persons in Lomé-Togo

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World Journal of AIDS 2014年第1期4卷 81-84页

作者： Majesté Ihou Wateba Kanyni Ekoue-Kouvahey abago balaka Komivi Tsatsu Ousseni Tidjani Department of Infectious Diseases and Pneumology CHU Sylvanus Olympio Lomé Togo Department of Internal Medicine CHU Sylvanus Olympio Lomé Togo Medical Center of NGO VISA Lomé Togo

Objective: Describe resistance to beta lactam antibiotics of Pseudomonas aeruginosa in community infection within HIV-1 infected persons. Methods: We have studied prospectively from June 15th to December 31st 2013 inthe Clinic Hotel-Dieu and NGO VISA of Lomé, adult HIV-1 infected patients under anti retroviral therapy combining tenofovir, lamivudine and efavirenz for at least one year. The technique of agar diffusion susceptibility using discs of Ticarcillin + clavulanic acid is used to study the β-lactamase production. The diagnosis of species was performed by the chloroform test and the test for sensitivity to kanamycin and colistin. Results: Thirty five strains of Pseudomonas aeruginosa were obtained. The T-lymphocytes CD4 mediane was 575 cells/mm3 of blood. Urine represented 15 cases, skin abscesses 11 cases, externa suppurate otitis 7 cases and vaginal swab for 2 cases. The phenotypes were: wild phenotypes 23 cases (65.7%), resistant phenotypes 12 cases. Among resistant phenotypes, 4 were complex phenotype;5 were ESBL phenotypes;2 were hyper productive cephalosporinases phenotypes and 1 was a specific phenotype with impermeability to imipenem. Conclusion: The acquisition of resistance of Pseudomonas aeruginosa to beta lactam antibiotics in community infections among HIV-1 infected person incentives controls and promotes the rational use of antibiotics.

关键词： HIV-1 Pseudomonas aeruginosa Resistance Phenotypes Beta Lactam Antibiotic

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Complicated High Blood Pressure in Hospital Area in Lomé

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Open Journal of Internal Medicine 2019年第2期9卷 5-11页

作者： abago balaka Kodjo Agbé ko Djagadou Toyi Tchamdja Mohaman Awalou Djibril Findibe Damorou Internal Medecine Unit Lom&#233 & Kara Togo Health Science Faculty Universit&#233 de Lomé Lom&#233 Togo Health Science Faculty Universit&#233 de Kara Kara Togo

The target of the study was to identify patients living with Compound high blood pressure and describe the epidemiological, treatment and progressive aspects. We had realized retrospective and descriptive study completed throughout twelve months from 1st January to December 31, 2011. The study took into account 250 hypertensives known or not admitted in the cardiology and medical intensive care units at the Sylvanus Olympio Teaching Hospital in Lomé. In total, the frequency of complications of the High Blood Pressure was 33.3% with a male predominance. Patients’ average age was 52.4 years. The most frequent reasons of admission were coma (32%) and hypertensive eruption (28%). The excessive consumption of salt and alcohol were other dominant modifiable risks factors with respectively 36.8% and 22.8%. Neurologic complications were the most frequent of cerebrovascular accidents (CVA) (66%) among which strokes represented 69.7%. Cardiac complications came in second position (31.2%). Double treatment was optional in 62.2% cases with IEC+ Ica++ associated. In 56.6% cases patients with renal disease in terminal stage had been dialysed. The level of total lethality was 34%. The main cause of death was CVA (cerebrovascular accidents) (85.9%). High Blood Pressure is then a very plague with regard to its complications. Its effective caretaking is nothing but through primary prevention based on sensitization, education of the entire grass-roots and it requires the mobilization of all social components.

关键词： High Blood Pressure Target Organs Complications Young Patient

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Incidence of Tuberculosis in Latent TB Infected (LTBI) Patients Living with HIV under Antiretroviral Therapy in the LoméInfectious Disease Department

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World Journal of AIDS 2017年第3期7卷 223-229页

作者： Majesté Ihou Wateba Komi Adjoh Lidawou Bawe Awerewou Kotosso A. Patassi abago balaka Infectious and Tropical Diseases Service of CHU SO Lomé Togo Respirory and Lung Diseases Service of CHU SO Lomé Togo Internal Medicine Service of CHU SO Lomé Togo

Objective: To determine the incidence of tuberculosis in person living with HIV infected by latent TB and under antiretroviral (ARV) therapy. Method: We studied prospectively for 36 months the occurrence of bacilliform pulmonary tuberculosis in patients infected with HIV, naive of BCG and receiving antiretroviral treatment. Each patient had an intradermal reaction (IDR) of 10 IU tuberculin Mérieux. The measurement of the nodule is made 72 hours later. During follow-up, patients were reviewed every six months for active tuberculosis. Results: A total of 212 out of 257 patients had an IDR greater than 5 mm, an ITL prevalence of 86.33%. Three patients were lost to follow-up during the study. The predominant female sex is 69.81%. The mean age was 42.8 ± 10.02 years. A previous history of tuberculosis was found in 14.15% of patients and 208 patients (98.11%) had HIV1. In 39.15% of patients, patients had a CD4 count lower than 350 cells/mm3 at baseline in the study. At the end of the three-year follow-up, among the 14 patients, 11 had failed ARV therapy and had developed TB, with an incidence of 2.20 cases per 100 patients. Conclusion: The incidence of active tuberculosis in LTBI was very high in HIV-positive patients with low CD4 count, hence the importance of reliable LTBI screening such as gamma interferon is better than patient follow-up.

关键词： LTBI Incidence Tuberculosis HIV

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Viral Characteristic of HIV Infected Patients Naïf of Anti-Retroviral Therapy with CD4+ T Lymphocytes Rate Greater than 350 per Microliter of Blood in LoméTogo

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World Journal of AIDS 2013年第4期3卷 364-366页

作者： Ihou Nazoba Majesté Wateba Akouda Akessiwe Patassi abago balaka Ousséni Tidjani Service de Maladies Infectieuses et de Pneumologie CHU Sylvanus Olympio Lomé Togo

Objective: To evaluate the virological status of ineligible HIV patients for anti-retroviral therapy based on the criterion of CD4+ T lymphocytes rate over than 350/μl of blood. Method: This is a prospective study which was conducted from November 2011 to July 2012 in the tropical and infectious disease department of CHU Sylvanus Olympio of Lomé. All HIV-1 infected patients whose CD4+ T lymphocytes rate was ≥350/μl of blood were retained. The count of CD4+ T lymphocytes was made by cytometer FACSCalibur? flow of BD biosciences and the determination of viral load was achieved by NASBA laboratory method of Biomérieux. Results: We have recruited 102 PLWHA aged between 19 and 58 years with a median of 35 years. Biologically, 102 patients had a T-CD4 rate between 355 and 432/μl of blood. The determination of viral load showed a very high viral replication more than 10,000 copies/ml among all patients and 28 (27.5%) patients had a viral load > 100,000 copies/ml of blood. Conclusion: Our results argue for a reconsideration of the criteria for starting antiretroviral therapy in Togo by including virological data if necessary in patients with T-CD4 rate below 500/μl of blood.

关键词： Viral Load CD4+ T Lymphocytes Naive Anti-Retroviral Therapy Patients

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Chronic Nephropathies in the Internal Medicine Department of the Sylvanus Olympio University Hospital

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Open Journal of Internal Medicine 2021年第3期11卷 140-150页

作者： Agbeko Kodjo Djagadou Toyi Tchamdja Abdou-Bakari Tchala Yawovi Mawufemo Tsevi abago balaka Awalou Mohaman Djibril Department of Internal Medicine Sylvanus Olympio University Hospital University of Lomé Lomé Togo Department of Internal Medicine Kara University Hospital University of Kara Kara Togo Department of Nephrology and Hemodialysis Sylvanus Olympio University Hospital University of Lomé Lomé Togo

Introduction: The chronic nephropathies constitute a real global public health concern due to the constant increase in the prevalence estimated between 10% and 15%. In Sub-Saharan Africa, this prevalence has been estimated at 13.9%. This study will allow knowing the epidemiological, clinical, paraclinical and etiological aspects of chronic kidney disease in the internal medicine department of CHU-SO Lomé. Method: This was a cross-sectional, retrospective and descriptive study. It concerned all the patients suffering from a chronic kidney disease, hospitalized between the 1st of January 2014 and the 31st of December 2018, for a duration of 5 years. Results: During our study, 330 cases of chronic nephropathy were identified. The prevalence of chronic kidney disease was 8.3% of admissions. The mean age of the patients was 46.3 years with extremes of 19 and 86 years and a sex ratio of 1.32. A low socio-economic level of patients was observed in 63.9% with an urban origin in 69.7%. The main risk factors for renal impairment were hypertension (55.2%), diabetes mellitus (29.1%), obesity (20.6%), use of nephrotoxic products (19.4%), HIV infection (17%) and smoking (16.1%). The causes were dominated by nephroangiosclerosis (33.3%), followed by diabetic nephropathy (25.5%) and HIV-associated nephropathy (17%). Chronic renal failure was present in 95.8% of cases and was end stage in 69.7% of cases. Anemia was the main complication during the evolution of chronic kidney disease (98.2%). Mortality was 57.3% during hospitalization. Conclusion: Chronic kidney disease is a fairly common reason for hospitalization in the internal medicine department. Emphasis should therefore be placed on preventive measures for hypertension, diabetes and HIV.

关键词： Chronic Kidney Disease Profile CHU Lomé (Togo)

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Management of Obstructive Renal Failure in Adults at the Sylvanus Olympio University Hospital

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Open Journal of Nephrology 2021年第3期11卷 348-357页

作者： Yawovi Mawufemo Tsevi Edoé Viyomé Sewa abago balaka Ablavi Adani-Ifè Eyram Yoan Amekoudi Komi Daniel Dokouvi Department of Nephrology and Hemodialysis Sylvanus Olympio Hospital Lomé Togo Department of Urology Sylvanus Olympio Hospital Lomé Togo Department of Internal Medicine Sylvanus Olympio Hospital Lomé Togo

Background: Obstructive nephropathies are a topical issue in urology and nephrology consultations, but no study has yet been conducted on the subject in our country. Objective: Describe the epidemiological, clinical, therapeutic and evolutionary profile of obstructive nephropathies at the Sylvanus Olympio University hospital of Togo. Method: It was a descriptive and cross-sectional study with a collection of retrospective data over a period of 08 years (2012-2019) which focused on obstructive nephropathies in the Urology-Andrology, Nephrology and Internal Medicine departments at the medical clinic of CHU SO. The diagnosis of obstructive nephropathy is retained on the basis of radiological and medical imaging results. Results: The study population included 131 patients. The annual hospital frequency was 2.84 cases for 100 admissions. The mean age was 56.72 ± 17.76 years. These patients were mostly male (72.52%). The most frequent age group was 60 - 80 years. Common symptoms at presentation were loin pain (45.75%) and dysuria (25.95%). The average length of probable course of the disease before hospitalization was 636.94 ± 258.88 days (21 months). The etiologies of obstructive nephropathy were largely dominated by prostatic tumors in half of the cases (45.80%). Among these patients, 121 have presented renal failure (92.36%). The average serum creatinine at admission was 59.01 ± 21.56 mg/l. Of the 121 patients with obstructive nephropathy presenting renal failure, 54 (44.63%) had decreased their serum creatinine at the output of more than 25%. The open surgery (54.20%) was the main treatment. There was an improvement in kidney function in patients who had a shorter duration of disease progression and who did not have a history of loin pain, oliguria and that the etiologies of the disease were not tumors. Tumoral etiologies, the presence of a history of high blood pressure, oedema of the lower members,

关键词： Obstructive Nephropathy Renal Failure Etiologies Lomé (Togo)

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