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Profile of SARS-CoV-2 Infected Patients Hospitalized at the Epidemic Treatment Center (ETC) in Saint-Louis, Senegal during the First Two Waves

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Advances in Infectious Diseases 2024年第2期14卷 322-337页

作者： Alassane Dièye Papa Latyr Junior Diouf Bourama Diémé Moustapha Diedhiou diatou dia-gueye Amadou Diop dia Samba Niang Ibrahima Louis Martin Dieng Ameth Dieng Seynabou Lô Ndéye Méry dia-Badiane Health Sciences Training and Research Unit Gaston Berger University Saint-Louis Senegal Emergency Department of Regional Hospital Center Saint-Louis Senegal Department of Infectious and Tropical Diseases of Fann Dakar Senegal

Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.0

关键词： SARS-CoV-2 Saint-Louis Senegal

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COVID-19/Tuberculosis Co-Infection at the Epidemic Treatment Center (ETC) of Saint-Louis (Senegal): About 9 Cases

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Advances in Infectious Diseases 2024年第1期14卷 56-66页

作者： Alassane Dièye Moustapha Diedhiou Papa Latyr Junior Diouf Mba Bambo diakhaby Demba Makalou Samba Niang diatou dia-gueye Amadou Diop dia Ibrahima Louis Martin Dieng Seynabou Lô Ndéye Méry dia-Badiane Health Sciences Training and Research Unit Gaston Berger University Saint-Louis Senegal Department of Medicine Saint-Louis Regional Hospital Saint-Louis Senegal Infectious and Tropical Diseases Clinic of Fann Dakar Senegal

Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert? MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.

关键词： COVID-19 Tuberculosis Saint-Louis Senegal

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Connective Tissue Diseases on the Elderly Population in Dakar Hospital Setting

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Open Journal of Internal Medicine 2022年第2期12卷 103-111页

作者： Ndao Awa Cheikh Atoumane Faye Amadou Diop dia Nafissatou diagne diatou gueye dia Birame Codou Fall Michel Assane Ndour Mouhamed Dieng Maïmouna Sow Abdoulaye Pouye Department of Internal Medicine Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Regional Hospital of Saint-Louis Gaston Berger University Saint-Louis Senegal Department of Internal Medicine DalalJamm Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Abass Ndao Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Aristide Le Dantec Hospital Dakar Senegal

Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age. This study aims to determine the clinical and paraclinical characteristics of connective tissue diseases in the elderly population. Materials and Methods: We conducted a retrospective and descriptive study, from March 2010 to March 2021, in the Internal Medicine Department of Aristide Le Dantec Hospital, including all the medical records of patients followed up for connective tissue disease and whose symptomatology began at an age greater than or equal to 65 years. Epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from a pre-established survey form and then processed using SPSS software. Results: Overall, 22 cases were collected out of 275 seen on consultation. They involved 16 women and 6 men, aged between 65 and 85 years with a median of 70 years. The mean duration of the clinical picture was 15.7 months with extremes of 1 and 96 months. The clinical symptoms were joint pain in 21 patients associated with dry eye and mouth syndrome in seven cases and one patient underwent isolated dry eye and mouth syndrome. Joint involvement was deforming in 13 patients. Poor general condition was noted in 20 patients. Biology showed anemia in 14 patients, hyperleukocytosis (2 patients) and thrombocytosis (5 patients). The sedimentation rate (SR) was accelerated in 9 patients and the C-reactive protein (CRP) was positive in 12 patients. Immunology showed a positive Latex test (3 patients/6), Waaler-Rose reaction (8 patients/13), anti-cyclic citrullinated peptides (anti-CCP) antibodies (11 patients/11), anti-nuclear antibodies (2 patients/4). Anti-extractable nuclear antigens (anti-ENA) antibody testing in 4 patients showed positive anti-U1RNP (1 case), anti-SSA and anti-SSB (1 case). Plain X-Rays of the hands, wrists and feet

关键词： Connective Tissue Disease Elderly Rheumatoïd Polyarthritis Sjögren’s Syndrome Dakar

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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 diagne Nafissatou Fall Biram Codou dia diatou 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 diagnosis was retained during the course of the disease. The diagnosis 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 diagnosis 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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Prevalence and Association of Criteria of Metabolic Syndrome in a Cohort of diabetes Type 2 in Saint-Louis

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Open Journal of Internal Medicine 2019年第3期9卷 45-51页

作者： dia diatou gueye dia Amadou Diop diagne Nafissatou M. Ngouamba Blaise Ndao Awa Cheikh Pouye Abdoulaye UFR of Health Sciences Gaston Berger University Saint Louis USA Regional Hospital Center of Saint-Louis Saint Louis USA Cheikh Anta Diop University Dakar Senegal

Introduction: The metabolic syndrome is characterized by an aggregate of metabolic disorders whose coexistence in the same individual can correspond on the one hand to a common pathophysiological mechanism and on the other hand to expose the subject to an increased risk of cardiovascular diseases. The prevalence of the metabolic syndrome is increasing rapidly in both developed and developing countries, but has been poorly described in sub-Saharan Africa. Most of them reported the components of the metabolic syndrome only in isolation. Methods: This cross-sectional study carried out on a cohort of 76 patients followed at the Sait-louis regional hospital used the definition criteria of the International diabetes Federation. Results: The average age of our patients is 56.92 with extremes ranging from 32 to 80 years old. The sex ratio is 0.49. The average duration of diabetes progression is 68 months. The prevalence of the metabolic syndrome in this population is 67.1%. Abdominal obesity and high blood pressure are the most commonly found criteria. Abdominal obesity was the most associated component of MS in both sexes followed by high blood pressure. We found relatively weak data for dyslipidemia, especially hypertriglyceridemia. HypoHD is dyslipidemia more found in our cohort: in 45% of women and 21% of men. Conclusion: The management of the metabolic syndrome therefore requires fighting against all the factors that compose it, the first of which is the accumulation of visceral fat. Lifestyle modification is the first priority for these patients facing a society where the reduction of physical activity and the enrichment of the fat diet are becoming more and more important.

关键词： diabetes Dyslipidemia Abdominal Obesity Saint-Louis (Senegal)

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Epidemiology of Sleep Disorders among Chronic Hemodialysis Patients in Senegal: A Multicentric Study

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Health 2016年第1期8卷 42-48页

作者： Zeinabou Maiga Moussa Tondi Sidy Mohamed Seck Elhadj Fary Ka Mouhamadou Moustapha Cisse Amadou Diop dia diatou gueye dia Boucar Diouf Lamine gueye Nephrology Department Faculty of Health Sciences University Abdou Moumouni Niamey Niger Faculty of Health Sciences University Gaston Berger Saint-Louis Senegal UMI 3189 “Environnement Santé Société UCAD” Dakar Senegal Nephrology Department University Hospital HALD Dakar Senegal

Introduction: Sleep disorders (SD) are common dialysis patients and can impact their quality of life. In previous studies, black ethnicity was associated with higher incidence of SD but a few data are available in African patients. This study aimed to describe prevalence and risk factors of SD among Senegalese dialysis patients. Methods: We performed a cross-sectional study between February 15th and April 30th 2012 including 127 patients (75 males and 52 females) aged 46.8 ± 16.9 (16 - 85 years) and dialysed since >6 months in three dialysis centres. For each patient, we assessed insomnia according to international definition, obstructive sleep apnea syndrome (OSAS) with the Berlin questionnaire, restless leg syndrome (RLS) using abridged version of Cambridge-Hopkins RLS questionnaire, and excessive daytime sleepiness (EDS) with Epworth sleepiness scale. Logistic multivariate regression was used to identify factors associated with different SD. Results: Overall prevalence of SD was 88% comprising: insomnia (64.3%), OSAS (49.1%), RLS (24.1%) and EDS (20.5%). Forty-two patients presented at least two disorders. No difference was noticed in prevalence of SD between genders (p = 0.14). Level of blood pressure were not different across patients with and without SD. Insomnia correlated with anemia, inflammation and EDS. OSAS was associated with age ≥50 years, EDS and neck circumference ≥25 cm. RLS correlated with anemia and EDS. Other parameters such as gender, dialysis vintage, KT/V, obesity, diabetes status and hypoalbuminemia were not associated with the different SD. The majority of patients had not been diagnosed before the survey and none of them was under treatment. Conclusions: Our findings are compatible with high prevalence of sleep disorders reported in other populations. Insomnia and OSAS are the most frequent SD but some patients combined many disorders. Nephrologists should be more aware of these SD in order to detect them early and provide efficient treatme

关键词： Sleep Disorders Hemodialysis Epidemiology Senegal

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Indications and Results of Thyroidectomies in Northern Senegal

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Open Journal of Internal Medicine 2018年第1期8卷 18-23页

作者： diatou gueye dia Hady Tall Jacques Noel Tendeng Amadou Diop dia Ibrahima Louis Martin Dieng Ibrahima Konaté Faculty of Health Sciences Université Gaston Berger Saint-Louis Senegal Régional Hospital of Saint-Louis Saint-Louis Senegal

Goiters account for a very high prevalence disease. In Senegal, surgery is a very important part of the management. Our aim is to determine indications and results of thyroidectomies at the regional hospital of St. Louis. Patient and Method: We conducted a descriptive retrospective study over a period of 6 years on 81 records. All patients who underwent thyroidectomy during the study period were included. Computer software EPI INFO and Excel were used for collection and processing of data. Results: The average age of our patients was 40 years with a sex ratio at 0.05. The determination of TSH found 88.9% in euthyroid, 1.2% in hypothyroidism and 9.9% in hyperthyroidism. Thyroid ultrasound was performed in 97.5% of patients. Surgically, gestures performed were divided between the lobo-isthmectomies (43.1%), subtotal thyroidectomy (9.8%), total thyroidectomy (46.91%). The postoperative course was uneventful in all patients. The histology was benign in 88.9% of surgical specimens and found adenocarcinoma in 11.1%. Conclusion: Our study confirms the predominance of female thyroid pathology. The thyroidectomy which is getting better codified occupies an important place in the management. It offers the advantage around the problem of therapeutic non-compliance and also stockouts in our region.

关键词： Thyroid Disease Thyroidectomy Saint Louis Senegal

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Evaluation of Access to Care for Patients with Chronic Kidney Disease Not on dialysis in Saint-Louis Region (SENEGAL)

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Open Journal of Nephrology 2020年第1期10卷 1-10页

作者： Seck Sidy Mohamed Doupa Dominique Ndongo Modou Ahoui Seraphin Diop-dia Amadou dia diatou gueye Ngouampa Blaise Magloire Enguerran Macia Internal Medicine and Nephrology Department University Gaston Berger Saint-Louis Senegal UMI 3189 Environnement santé sociétés (CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST Burkina-Faso) Faculté de Médecine de Pharmacie et d’Odontostomatologie Dakar Senegal Biochemistry Department University Gaston Berger Saint-Louis Senegal Nephrology Department Borgou Regional Teaching Hospital Parakou Benin

Introduction: Patients with chronic diseases, especially kidney diseases, frequently use the health care system and free dialysis policies are being implemented in many countries in Africa. This study aimed to evaluate access to care for patients with chronic kidney disease (CKD) in northern region of Saint-Louis. Methodology: In a cross-sectional survey, we included non-dialyzed CKD patients aged ≥20 years who attended outpatient nephrology clinic at University Hospital of Saint-Louis between January 1st and January 31st 2018. Access to care was measured using a questionnaire that integrated dimensions such as availability, geographic and financial accessibility, convenience, acceptability, effectiveness of care and quality of information. Socio-demographic and clinical data were also collected and analyzed with Epi Info 7. Results: Among 97 surveyed patients, 90 were included (response rate of 92.8%). Patients’ mean age was 35.2 years (20 - 89 years) and 55% were male. Only 30% of patients had health coverage either by the government, or private insurance or community health insurance. Access to care was rated as globally low by 73% of participants. However, we noticed some variations according to dimensions of access. Geographical accessibility and convenience of delivered care were good for the majority of patients, while financial access and acceptability of care were considered as very limited. Bivariate analysis showed that acceptability and effectiveness of care were linked to CKD stage while the quality of patients’ information was correlated with their educational level. Furthermore, health coverage was also associated with financial accessibility of care but not with its availability. Conclusion: This study showed that access to care is poor for majority of patients with CKD in Saint-Louis. Identification of the main barriers will help define appropriate strategies to achieve universal access to quality renal care.

关键词： Access to Care Chronic Kidney Disease Saint-Louis

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Secondary Hypertension in Sub-Saharan African Populations: A Retrospective Study between 2011 and 2016 at Regional Hospital of Saint-Louis, Senegal

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Open Journal of Nephrology 2016年第3期6卷 93-97页

作者： Yaya Kane Joel Simon Manga diatou gueye dia Maiga Moussa Zeinabou Tondi Ahmed Tall Lemrabott Maria Faye Sidy Mouhamed Seck Mouhamadou Moustapha Cisse Alex Ismael Keita Kalilou diallo El Hadj Fary Ka Abdou Niang Boucar Diouf Nephrology-Cardiology and Internal Medicine Department Assane Seck University Ziguinchor Sénégal Nephrology and Internal Medicine Department Gaston Berger University Saint-Louis Sénégal Nephrology Department Abdou Moumouni University Niamey Niger Nephrology Department Teaching Hospital Aristide Le Dantec Dakar Senegal

Introduction: High blood pressure (HBP) is a worldwide health issue responsible of high cardiovascular morbidity and mortality. Even though essential HBP is far the most frequently reported in patients, secondary causes must be known because of their severity and the possibility of aetiological treatment. No recent epidemiological data are available about secondary causes of HBP in black African populations. The aim of this study was to describe aetiological patterns of secondary HBP in patients followed at Saint-Louis Hospital. Patients and Method: We conducted a retrospective and descriptive study in regional hospital of Saint-Louis. All patients aged ≥15 years old admitted from January 1st 2011 to January 31st 2015 in internal medicine, nephrology, emergency and cardiology departments were included. Clinical, paraclinical data and patients outcomes were collected from medical records. Hypertension was defined according to JNC8 criteria. Secondary HBP was considered if explorations identified a clear aetiology to hypertension. Statistical analysis was done with Excel 2010 and STATA 12.0. Results: We included 9253 patients with mean age of 35 ± 12 years (15 - 83 years) and sex-ratio of 1.6. Overall 67.5% of patients had hypertension and secondary causes were found in 10.5% of them. The majority of patients presented clinical symptoms suggesting a secondary cause of HBP and first-line laboratory explorations were normal in half of cases. Renal diseases were responsible for 79.1% of secondary HBP cases mainly dominated by glomerulonephritis (22.6%), vascular nephropathies (18.7%) and autosomal dominant polycystic kidney disease (5.8%). They were followed by preeclampsia (13.6%) and endocrinal aetiologies such as hyperthyroidism (5.8%), hypercorticism (0.5%), pheochromcytoma (0.5%), primary hyperparathyroidism (0.4%) and Conn’s adenoma (0.1%). Combination of ≥3 antihypertensive drugs was necessary in 71.5% of cases and surgical treatment was performed in three patient

关键词： Secondary High Blood Pressure Internal Medicine Black Africans

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