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Prevalence and Factors Associated with Virologic Failure among People Living with HIV (PLHIV) Monitored in a Decentralized Health Care Facility

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Advances in Infectious Diseases 2019年第3期9卷 226-237页

作者： Selly ba Ndeye dia.a ba Lamanatou Sembene Habibatou dia.Mohamed Coulibaly Jean Louis Ndia.e Ndeye Méry dia.Cheikh Tidia.e Ndour Doctoral School of Thies University Thies Senegal Intrahealth International Dakar Senegal Roi baudouin Hospital Dakar Senegal AIDS Monitoring Unit/Ministry of Health Dakar Senegal Department of Health Gaston Berger University Saint Louis Senegal

Introduction: In Senegal, the decentralization of Health Care Centers has contributed significantly to the intensification of antiretroviral treatment. However, Care providers are still facing the treatment optimizing challenge. Objectives: To determine the prevalence of virologic failures of PLHIV monitored in a decentralized Health care center and to determine associated factors. Patients and Methods: This is a cross-sectional descriptive and analytical study of PLHIV, aged 18 years and over, on first-line treatment, monitored onsite from February 1st to December 31st, 2018. A data collection form was completed from medical records (clinical, immuno-virologic and evolutionary). Any VL > 1000 cp/ml after 6 months of antiretroviral therapy (ART) was considered as virologic failure. Data were captured and analysed using the EPI INFO 2002software. Chi-square test and the Fisher test were used to compare the proportions;a value of p ≤ 0.05 was considered significant. Results: 331 patients were treated with HIV-1 profile in 89% of cases. A proportion of 55% was married and 97% came from rural areas. 80% were either not or poorly educated. The media. of age was 44 ± 11 years with a F/M ratio of 3.4. At baseline, 56% were symptomatic at stage 3 or 4 of WHO. They had severe immunosuppression with a media. CD4 count of 217 ± 187 cells/mm3, the viral load was detectable in half of the patients with a media. VL of 97,000 cp/ml ± 70,569. The antiretroviral regimen combined 2 NRTIs with 1 NNRTI in 88% of cases. The media. of follow-up was estimated at 60 ± 43 months. The prevalence of virologic failure was 19%. This prevalence was associated with age less than 25 years (p = 0.04), late dia.nosis (CD4 at baseline less than 200 cel/mm3 (p = 0.002), stage 3 or 4 WHO (p = 0.04) High viral load greater than 10,000 (p = 0.04) at baseline. Conclusion: These results suggest making the new therapeutic classes accessible for first-line treatment.

关键词： ART Virologic Failure Associated Factors

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Factors Associated with Adverse Therapeutic Outcomes in People Living with HIV (PLHIV) Monitored in Roi baudouin Health Care Center, Dakar, Senegal

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World Journal of AIDS 2020年第1期10卷 23-35页

作者： Selly ba Ndeye dia.a ba Lamanatou Sembene Thierno Souleymane baal Anne Habibatou dia.Jean Louis Ndia.e Ndeye Mery dia.ba.0}e Cheikh Tidia.e Ndour Doctoral School of Thies University Thies Senegal Intrahealth International Dakar Senegal Roi baudouin Hospital Dakar Senegal Department of Health Gaston Berger University Saint Louis Senegal AIDS Department/Ministry of Health Dakar Senegal

background: Optimizing antiretroviral therapy is an essential step to reach the 90 - 90 - 90 targets. Despite tremendous progress made for antiretroviral treatment (ART) to be accessible in countries with limited resources, health care providers continue to face challenges due to the under-optimization of ART due to therapeutic failures and poor retention. Objectives: To determine the prevalence of adverse therapeutic outcomes in a decentralized health care center and to determine associated factors. Patients and Methods: This is a cross-sectional descriptive and analytical study targeting PLHIV, aged 18 years and over, on first line antiretroviral treatment (ART), monitored onsite from February 1st to December 31st, 2018. A data collection form was completed from medical records (clinical, immuno-virological, therapeutic and evolutionary). Data were also collected from interviews with patients for additional socio-demographic information including the level of HIV knowledge. Data were captured and analyzed using EPI 2002 and R software. Proportions were compared using the chi -square and Fisher tests and logistic regression. A value of p dia. of age was 44 ± 11 years with a F/M ratio of 3.5. 30% that had not shared their HIV status, and more than half had a low knowledge of HIV transmission. At baseline, 56% were symptomatic at WHO stage 3 or 4. They had severe immunosuppression with a media. CD4 count of 217 ± 187 cells/mm3;the viral load was detectable in half of the patients with a media. viral load (VL) of 97,000 ± 70,569 cp/ml. The antiretroviral regimens combined 2 nucleoside reverse transcriptase inhibitor (NRTI) with 1 no nucleoside reverse transcriptase inhibitor (NNRTI) in 88% of the cases. The media. duration of follow-up was estimated

关键词： Antiretroviral Treatment Adverse Therapeutic Outcomes Associated Factors

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Coronary Angioplasty in a Low Income Sub-Saharan Country: Situational Analysis

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World Journal of Cardiovascular Diseases 2018年第12期8卷 539-544页

作者： Mouhamed Cherif Mboup Djibril Marie ba Modou Jobe Massamba Thiam Khadidia.ou dia.Pape dia.ie Fall Hopital Principal de Dakar Dakar Senegal Military Hospital of Ouakam Dakar Senegal Clinique Du Golf Dakar Senegal

Introduction: Coronary angioplasty is not widely conducted in sub-Saharan Africa in general and Senegal in particular. The objective of this work was to describe the indications, techniques, results and difficulties of coronary angioplasty in Senegal. Patients and Methods: We prospectively included all patients who underwent coronary angioplasty between July 2012 and November 2014. We evaluated the clinical characteristics, techniques used, and the peri-procedural complications. Results: 110 coronary angioplasties were performed at the cardia. catheterisation unit of the Clinique du Golf in Dakar. The average age of patients was 60.41 ± 10.93 years. A male predominance was noted with a sex ratio of 6.3. Hypertension was found in 57% of patients. The principal indications for coronary angioplasty were for the management of acute coronary syndromes with or without ST elevation, in 29 and 39 patients respectively. The femoral artery was the puncture site in 104 patients. The lesions treated were type A/B1 or B2/C in 53 and 57 cases respectively. The success rates of coronary angioplasties and 30-day mortality were 91% and 0.9% respectively. Conclusion: In sub-Saharan Africa, Senegal in particular, the practice of coronary angioplasty is low. Indeed, many factors linked to socioeconomic status limit the development of coronary angioplasty in Senegal.

关键词： Coronary Angioplasty Acute Coronary Syndrome Interventional Cardiology

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Double Compression of Left Atrium and Pulmonary Artery by a Huge Descending Aortic Aneurysm with Intramural Hematoma Mimicking Pulmonary Embolism: A Case Report

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World Journal of Cardiovascular Diseases 2019年第6期9卷 419-424页

作者： Djibril Marie ba Aminata dia.k Alain Affangla Khadidia.ou dia.Mouhamed Cherif Mboup Mouhamed Leye Abdoul Kane Unit of Training and Research in Medical Sciences University of Thies Thies Senegal Department of Radiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Cheikh Anta Diop University Dakar Senegal

Hemodynamic instability secondary to left atrial (LA) compression by an aortic aneurysm is a rare entity. We report?the case of a 43-year old woman with no previous dia.nosis of congestive heart failure who was admitted for an initial dia.nosis of pulmonary embolism (PE) based on shortness of breath, hypotension and D-Dimers?elevation. The electrocardiogram and blood counts were within normal limits. The chest X-ray revealed widening of the media.tinum. Transthoracic echocardiography demonstrated LA compression by a large descending thoracic aortic aneurysm. Left and right ventricle systolic functions were preserved. Chest angiography showed LA and left pulmonary artery (LPA) compression by a descending aortic aneurysm and an intramural hematoma with no evidence of PE evidence. Emergency surgery could not be done because of her financial status. She was treated medically and was discharged 1?week later with significant improvement. However she remained hypotensive.

关键词： Aortic Aneurysm Left Atrium Compression Pulmonary Artery Compression Intramural Hematoma Echocardiography

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Family Planning Knowledge and Practices among Reproductive Age Women in Widou Thiengoly, Louga Region, Senegal

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Advances in Reproductive Sciences 2018年第1期6卷 1-11页

作者： Abdoul Aziz Ndia.e Niang Aminata Tall Alioune badara Diop-ba Awa Ngom-Gueye Ndeye Fatou dia.Mountaga Bop Martial Coly Gaye Awa Gueye Lamine Tal-dia.Anta Department of Community Health University of Bambey Bambey Senegal Department Public Health University Cheikh Anta Diop Dakar Senegal

Family planning is an effective intervention to improve the health of the mother, newborn and child. It was introduced in Senegal in the 1960s. Significant disparities were noted between urban and rural areas. This research aimed at measuring family planning methods knowledge and practices among reproductive age women (RAW) in the village of Widou Thiengoly, Louga region, Senegal. A descriptive and analytical cross-sectional study was carried out from 12 to 20 August 2016 and involved 150 RAW with an average age of 29.34 years. They were mostly married (98%), with a fertility rate of 3.22 children/woman. 67.3% of RAW knew at least one FP method and the contraceptive prevalence was 40.7%. Birth spacing is the main reason or utilization for more than half of users, while for non-users, more than half were ignorant of FP. Knowledge and practices of contraception were not related to the age of WCA, or the number of children. Fears or experiences of side effects were barriers to initiation and continuous use of FP methods, hence the importance of focusing awareness campaigns on alleviating fears about side effects.

关键词： Knowledge Practices Family Planning Widou Thiengoly-Senegal

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Availability,Management and Use of Priority Life-Saving Medicines for Under-Five Children in Two Health Districts in Senegal:A Cross-Sectional Study

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Health 2020年第2期12卷 204-218页

作者： Oumar bassoum Abou ba Alioune badara Tall Oumou Khairy Kane Adama Faye Ibrahima Seck Anta Tal-dia Department of Preventive Medicine and Public Health Faculty of MedicinePharmacy and OdontologyCheikh Anta Diop UniversityDakarSenegal Institute of Health and Development Cheikh Anta Diop UniversityDakarSenegal University Service of Pedia.rics Faculty of MedicinePharmacy and OdontologyCheikh Anta Diop UniversityDakarSenegal National Hospital Center Dalal Jam DakarSenegal Department of Community Health Alioune Diop UniversityBambeySenegal Faculty of Medicine Pharmacy and OdontologyCheikh Anta Diop UniversityDakarSenegal

Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the availability, management and use of these drugs in two health districts in Senegal. A descriptive cross-sectional study was conducted in the health districts of Guedia.aye and Pete from 01 November 2018 to 31 January 2019. The health district of Guedia.aye is in the region hosting the Senegalese capital while that of Pete is located in the region of Saint Louis, northern Senegal. Nine drugs that can prevent and treat malaria, dia.rhea, pneumonia and malnutrition were selected. An inventory form and a self-administered questionnaire were used to collect data that was analyzed with SPSS and expressed as a percentage and average. Drug availability was 50.4% and 54.3% in Guedia.aye and in Pete, respectively. Average stock-out duration in the past three months was estimated at 22.6 and 26 days, respectively. The drug management was marked, on the one hand, by a good availability of stock cards in the two districts with proportions equal to 100% and 94.1%, respectively, and on the other hand, by the presence of expired stocks in Pete (12.2%). About 79% and 88% of prescribers reported prescribing the basket drug, respectively. These results show that access to priority life-saving medicines for children remains a challenge. Measures to be taken should include improving the distribution channels and training of health professionals. Further studies should be conducted in other health districts to better understand the barriers to access to child health services.

关键词： Priority Life-Saving Medicines Access Under-Five Children Senegal

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Outcome of Unclassified Inflammatory Rheumatism: Observation of 7 Cases in Dakar

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Open Journal of Internal Medicine 2022年第1期12卷 22-28页

作者： Awa Cheikh Ndao Faye Atoumane dia.ne Nafissatou Fall Biram Codou dia.dia.ou Gueye dia.Amadou Diop Diop Mohamed Sow Maïmouna Kane baïdy Sy Boundia.Djiba Pouye Abdoulaye Cheikh Anta Diop University Dakar Senegal Gaston Berger Saint-Louis University Dakar Senegal Department of Internal Medicine in Aristide Le Dantec Hospital Dakar Senegal

Introduction: Unclassified inflammatory rheumatism is persistent inflammatory arthralgias with or without synovitis without sufficient classification criteria for an inflammatory rheumatism or a well-defined connective disease. Their outcome is variable and has been little studied in Africa. We report the epidemiological, paraclinical and evolutionary characteristics of seven cases of indeterminate polyarthritis. Material and Method: From January 2012 to May 2021, we selected all the files of patients followed up for unclassified inflammatory rheumatism and in whom a precise dia.nosis was retained during the course of the disease. The dia.nosis of unclassified inflammatory rheumatism was retained after biological, immunological and radiological explorations without specificities. Our study took place in the Internal Medicine Department of Aristide Le Dantec Hospital (HALD). Results: Seven cases out of 274 consulted were collected. They consisted of seven women with an average age of 39 years at the time of the first consultation (extremes: 19 and 67 years). All seven patients presented with inflammatory polyarthralgia or non-deforming, non-erosive peripheral polyarthritis, without extra-articular manifestations. A biological inflammatory syndrome was present in all seven patients. Autoantibodies (rheumatoid factor, ANA, anti-ENA and ACPA) were negative in all patients. The first-line treatments in all seven cases were hydroxychloroquine (200 - 400 mg/day) and prednisone (5 - 10 mg/day). Methotrexate was added in 3 cases. During follow-up, 2 cases progressed to Polyarthritis Rheumatoid (PR) after 3 and 4 years. Two cases progressed to Sjögren’s syndrome after 4 and 5 years. Two patients progressed to systemic scleroderma after 5 and 8 years. One patient progressed to lupus after 5 years. Conclusion: Regular follow-up is essential in IAN. It allows the early dia.nosis of IJR or a well-differentiated connective tissue disease and ensures adequate management, especially

关键词： Rheumatic Unclassified Rheumatoid Arthritis Connective Tissue Disease

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Conservative Approach Might Be the Strategy by Default in Stable Angina Patients: A Case Report

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World Journal of Cardiovascular Diseases 2020年第11期10卷 769-774页

作者： Serigne Cheikh Tidia.e Ndao Mame Madjiguene Ka Djibril Marie ba Khadidia.ou dia.Mouhamed Chérif Mboup Pape dia.ie Fall Department of Cardiology Hospital Principal Dakar Dakar Senegal

Management of stable angina is still a matter of debate. Whether a conservative or invasive approach is better remains unclear. Even though recent large-scale randomized trials depict the conservative strategy as safe and efficient. In this report, we present a case of a 53-year-old male patient with cardiovascular risk factors of hypertension and hypercholesterolemia. He complained about typical chest pain at exertion. The coronary angiogram (CA) revealed severe stenosis of the proximal left anterior descending artery (LAD) ostium. After heart team discussion, coronary artery bypass graft (CABG) was advocated. However, due to a lack of means, the CABG was postponed. Meanwhile, he was managed with guideline-based medical therapy. In addition, he exercised regularly and adopted a healthy diet. Evolution was favorable with excellent symptoms control. A regular follow-up was organized with his cardiologist. A new CA before an eventual CABG six years later showed a significant plaque volume regression of the proximal LAD. We decided to continue conservative management. The stress echocardiogram to assess symptoms and exercise tolerance was normal. Our patient was sent to surgery on top of optimal medical therapy even though angioplasty was a good indication and was feasible. However, while he was struggling to afford the CABG procedure, he adopted a very healthy lifestyle along with medical therapy. Six years later, the result of that approach was without appeal, suggesting and reinforcing the conservative management

关键词： Stable Angina Chronic Coronary Syndrome Conservative Treatment Case Report

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Late dia.nosis of Takayasu Disease in a 50-Year-Old African Black Woman with Repeated Episodes of Heart Failure: Seeing the Forest through the Trees—A Case Report

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World Journal of Cardiovascular Diseases 2020年第10期10卷 683-697页

作者： Djibril Marie ba Aminata dia.k Alain Affangla Serigne Cheikh Tidia.e Ndao Madjiguene KA Khadidia.ou dia.Mouhamed Cherif Mboup Mouhamed Leye Unit of Research and Training in Medical Sciences University of Thies Thies Senegal Department of Radiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Principal Hospital of Dakar Dakar Senegal

background: First described in 1908, TAK has now been recognized as a non-specific inflammatory disease of unknown etiology, predominantly affecting young females. Sometimes, it progresses into relatively rare and potentially fatal scenarios such heart failure. Case Presentation: Here, we present the case of a 50-year sub-saharan female suffering from acute heart failure related to TAK. Despite constitutional symptoms (fever, malaise, weight loss) and more characteristic features such claudication of lower extremities, carotydinia, and pulseless syndrome, diagnosis of TAK was delayed since main presentation was heart failure. Immunosuppressive and anticoagulant therapies have induced improvement in cardiac manifestations. Conclusion: Early diagnosis and proper treatment can protect the patient from dangerous complications such heart failure.

关键词： Takayasu Heart Failure Corticotherapy Pulseless Syndrome Sub-Saharan Black Female Case Report

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Model Associated with the Study of the Degradation based on the Accelerated Test: A Literature Review

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Open Journal of Applied Sciences 2016年第1期6卷 49-63页

作者： Fatou dia.Nacire Mbengue Omar Ngalla Sarr Moulaye dia.ne Omar A. Niasse Awa Dieye Mor Niang bassirou ba Cheikh Sene Laboratory of Semiconductor and Solar Energy Department of Physics Faculty of Science and Techniques University Cheikh Anta Diop Dakar Senegal

Most manufacturers of solar modules guarantee the minimum performance of their modules for 20 to 25 years, and 30-year warranties have been introduced. The warranty typically guarantees that the modules will perform to at least 90% capacity in the first 10 years and to at least 80% in the following 10 - 15 years. Early degradation resulting from design flaws, materials or processing issues is often apparent from startup to the first few years in service. Importantly, many module failures and performance losses are the result of gradual accumulated damage resulting from long-term outdoor exposure in harsh environments, referred. Many of these processes occur on relatively long time scales and the various degradation processes may be chemical, electrical, thermal or mechanical in nature. These are either initiated or accelerated by the combined stresses of the service environment, in particular solar radia.ion, temperature and moisture, and other stresses such as salt air, wind and snow. Accelerated Life Testing (ALT) test methodology is normally predicated on first being able to reproduce a specific degradation or failure mode without altering it (correlation);and, second, to produce that result in less than real-time acceleration. Degradation and failure may result when an applied stress exceeds material or product strength. This may be a one-time catastrophic event, the result of cyclic fatigue, or a gradual decline in requisite properties due to ageing mechanisms. Engineers in the manufacturing industries have used accelerated test (AT) experiments for many decades. The purpose of AT experiments is to acquire reliability information quickly. Test units of a material, component, subsystem or entire systems are subjected to higher-than-usual levels of one or more accelerating variables such as temperature or stress. Then the AT results are used to predict life of the units at use conditions. The extrapolation is typically justified (correctly or incorrectly) on the

关键词： Degradation Acceleration Factor Arrhenius Relationship Eyring Relationship Inverse Power Relationship Voltage-Stress Photodegradation

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