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Assessing Biomedical Solid and Liquid Waste Management in University Hospital Centers (CHU) in Togo, 2021

Open Journal of Epidemiology 2022年第4期12卷 401-420页

作者： Takpaya Gnaro Awedeou Ali Atèhèzi Adom Etsri Sename Abiassi Cyriaque Degbey Yenduban Douti Dédé Koeviakoe Messan Ghislain Emmanuel Sopoh didier koumavi ekouevi Training and Research Center in Public Health University of Lomé Lomé Togo Head Office of Hygiene and Basic Sanitation of Togo Lomé Togo Regional Institute of Public Health Comlan Alfred Quenum (IRSP-CAQ) University of Abomey-Calavi Ouidah Benin Faculty of Health Sciences (FSS) University of Lomé Lomé Togo

Introduction. Biomedical waste represents an environmental concern and a risk to healthcare workers, users of healthcare services, and the surrounding population. This study aimed to assess the management of solid and liquid biomedical waste in University Hospitals Centers (UHC) in Togo in 2021. Methods. This is a cross-sectional, evaluative and analytical study undertaken in 2021. It involved 3 UHCs, 25 departments, 340 care providers and departments randomly selected, 72 directors or deputies, supervisors and heads of departments, 27 collection and incineration agents selected by a reasoned choice technique, and 44 patients and attendants selected by an accidental choice technique. Data analysis was done using Pearson’s Chi2 statistical test for comparing proportions and logistic regression. Results. Solid and liquid waste management was “poor” due to non-use of waste management guidelines (ORa = 3.50;p = 0.0000), insufficient training of healthcare providers and collection agents (ORa = 6.55;p = 0.0000 and ORa = 6.08;p = 0.0000 respectively), insufficient user awareness sessions (ORa = 4.04;p = 0.0001), insufficient coordination of activities (ORa = 5.07;p = 0.0002), insufficient supervision of service providers and collection agents (ORa = 2.34;p = 0.0000), insufficient monitoring and follow-up of activities (ORa = 20.40;p = 0.0000). The sorting was not systematic (74.1%), and the Biochemical Oxygen Demand (BOD) and Chemical Oxygen Demand (COD) of the effluents were relatively high. Conclusion. Managing solid and liquid biomedical waste is insufficient in Togo’s university hospitals and represents a potential risk to human health and the environment.

关键词： Management Biomedical Waste Healthcare Providers and Services University Hospitals Togo

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Biochemical Profile of Patients Hospitalized for COVID-19 at the Infectious Disease Management Centre in Lomé in 2020

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Open Journal of Internal Medicine 2023年第4期13卷 271-294页

作者： Lochina Feteke Wemboo Afiwa Halatoko Mamadou Alpha Prateaux Aweréou Kotosso Fagdéba David Bara Komi Séraphin Adjoh Mounerou Salou koumavi didier ekouevi Mohaman Djibril Centre National de Transfusion Sanguine Lomé Togo Département de Biochimie Médicale Université de Lomé Lomé Togo Institut National D’Hygiène Lomé Togo Centre Médico-Chirurgical Interarmé Conakry Guinée Département de Pneumologie Centre Hospitalier Universitaire Sylvanus Olympio Lomé Lomé Togo Unité de Recherche en Immunologie et Immunomodulation (UR2IM) Laboratoire de Microbiologie et de Contr&ocircle de Qualité des Denrées Alimentaires (LAMICODA) Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA) Université de Lomé Lomé Togo Services de Laboratoire Centre Hospitalier Universitaire Campus Lomé Togo Département de Santé Publique Université de Lomé Lomé Togo

Background: COVID-19, an infectious viral disease, has caused a global health crisis. Most cases remain asymptomatic. The majority of patients have mild symptoms while about 15% develop a severe form. The clinical spectrum of SARS-CoV-2 infection appears broad, encompassing asymptomatic infection, upper respiratory tract symptoms, and severe viral pneumonia with respiratory failure that can lead to death. Laboratory tests play an important role in the management of COVID-19 patients. In addition to being essential for the diagnosis, several biological analyses make it possible to identify the inflammatory processes and the potential complications of this disease. This study attempted to identify biochemical assays that could help in the prognosis of the disease to ensure early management. Methods: This was a descriptive study. It focused on patients hospitalized for COVID-19 from March 19, 2020, to January 26, 2021, at the Infectious Disease Management Centre in Lomé (Togo). Medians were compared using the (Mann-Whitney and Wilcoxon) test and frequencies were compared using the Chi-square test or Fisher’s exact test. Results: We included 782 patients. The median age was 41 years IQR from 32 to 55. We observed several biochemical abnormalities in varying proportions for all biochemical parameters studied. Compared to non-serious patients, critically ill patients at admission had more frequently elevated urea, creatinine, transaminases, TG, GGT, CRP and blood glucose. Also, they had more frequent decreases in total cholesterol, HDL-c, blood chloride, and blood calcium. As for patients who died during hospitalization, compared with healed patients, they had more frequent elevations of urea, creatinine, AST, ALT, GGT. CRP and blood glucose. They also had a more frequent decrease in total cholesterol, HDL-c, blood chloride, blood calcium, and blood glucose (p = 0.025). Conclusion: This study shows that COVID-19 is a multi-organ systemic inflammatory viral disease that sh

关键词： COVID-19 Biochemical Anomalies Togo 2022

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Hospital Stakeholders’ Perception on Environmental Effects Related to Biomedical Waste in Togo’s University Hospitals (UHC) in 2021

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Open Journal of Preventive Medicine 2023年第2期13卷 57-72页

作者： Takpaya Gnaro Awedeou Ali Kokou Ayamekpe Cyriaque Degbey Farouk Salami-Odjo Abdoul-Rahim Ouro-Koura Panaveyi Malou Adom Ghislain Emmanuel Sopoh didier koumavi ekouevi Public Health Training and Research Center University of Lomé Lomé Togo Basic Sanitation and Hygiene Office of Togo Lomé Togo Regional Public Health Institute Comlan Alfred Quenum (IRSP-CAQ) University of Abomey-Calavi Ouidah Benin Faculty of Health Sciences (FSS) University of Lomé Lomé Togo

Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health care stakeholders on the environmental effects related to biomedical waste produced in Teaching Hospitals (CHU) in Togo in 2021. Methods: This was a cross-sectional study held from June 24 to August 28, 2021. It targeted three university hospitals, 340 health care providers and services selected by a probabilistic method with a simple random technique in 25 services, 72 directors, deputy directors, supervisors and heads of services, 27 collection and incineration agents selected by a non-probabilistic method with a reasoned choice technique, 44 patients and attendants and 36 householders of neighboring residents selected by a non-probabilistic method with an accidental choice technique. Variables such as the spreading of disease vectors, soil, air and water contamination, the presence of unpleasant odors and unsightly living conditions were assessed. Results: According to the respondents, biomedical waste causes the proliferation of vectors (55.3%), an unsightly environment inside the hospital (47.1%), and unpleasant odors (61.2%). Incineration operations disturb hospital residents (52.8%), according to the householders of the residents. During observation, we note deposits of waste that have not been destroyed and wastewater flowing in some places. Conclusion: Biomedical waste in Togo’s university hospitals generates environmental effects and therefore potentially high risks for human health. Improving their management should be a concern for all hospital actors.

关键词： Environmental Effects Biomedical Waste Teaching Hospitals Environment Togo

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Screening for Precancerous Cervical Lesions in Women of Reproductive Age in the Kara Region of Togo in 2022

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Open Journal of Epidemiology 2023年第4期13卷 293-305页

作者： Gatibe Yendu-Suglpak Gnatou Zézé Onivogui Latame Komla Adoli Fifonsi Adjidossi Gbeasor-Komlanvi Arnold Junior Sadio Yao Rodion Konu Martin Kouame Tchankoni Wendpouiré Ida Carine Zida-Compaore Amegnona Agbonon didier koumavi ekouevi Department of Public Health University of Lomé Faculty of Health Sciences Lomé Togo African Centre for Research in Epidemiology and Public Health (CARESP) Lomé Togo Institute of Public Health and Development University of Bordeaux Bordeaux France French School of Public Health (EHESP) University of Rennes Rennes France Laboratory of Pharmacology and Physiology University of Lomé Lomé Togo Center for Training and Research in Public Health University of Lomé Lomé Togo

Introduction: Worldwide, cervical cancer is the 4th most common cancer in women and is a public health problem. The objective of this study was to estimate the prevalence of precancerous cervical lesions and to describe its associated factors among women of reproductive age in the Kara region of Togo. Methods: A cross-sectional study was conducted from March 6 to 14, 2022 in 11 health centers in Kara. Data were collected using a standardized questionnaire and screening for precancerous cervical lesions was performed by visual inspection of the cervix, after application of 5% acetic acid and Lugol’s. Logistic regression analysis was performed to describe factors associated with precancerous lesions. Results: A total of 728 women with a median age of 36, interquartile range [31 - 41] were enrolled. The prevalence of precancerous cervical lesions was 3.9%, 95% confidence interval (95% CI: [2.6 - 5.4]. Factors associated with the presence of precancerous lesions were age at first sexual intercourse ≥ 18 years (adjusted odds ratio (aOR = 3.67;95% CI [1.17 - 18.4]) and being a sex worker (aOR = 8.14;95% CI [1.96 - 27.1]). HIV infection was not associated with the presence of precancerous lesions. Conclusion: The results of this study underscore the importance of intensifying cervical cancer screening efforts in resource-limited countries for better management. These efforts should prioritize vulnerable populations such as female sex workers.

关键词： Precancerous Lesions Cervix Visual Inspection Togo

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Prevalence of Viral Hepatitis B among Women of Childbearing Age in the Kara Region of Togo in 2022

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Open Journal of Preventive Medicine 2023年第12期13卷 319-328页

作者： Gatibe Yendu-Suglpak Gnatou Fatoumata Binta Tidiane Diallo Fifonsi Adjidossi Gbeasor-Komlanvi Sibabe Agoro Arnold Junior Sadio Latame Komla Adoli Wendpouire Ida Carine Zida-Compaore Yao Rodion Konu Martin Kouame Tchankoni Amegnona Agbonon didier koumavi ekouevi Department of Public Health Faculty of Health Sciences University of Lomé Lomé Togo African Centre for Research in Epidemiology and Public Health (CARESP) Lomé Togo Togo Office World Health Organization (WHO) Lomé Togo Center for Training and Research in Public Health University of Lomé Lomé Togo Ministry of Health Public Hygiene and Universal Access to Health Care Lomé Togo Laboratory of Pharmacology and Physiology University of Lomé Lomé Togo Institute of Public Health and Development University of Bordeaux Bordeaux France

Introduction: The hepatitis B virus (HBV) is one of the major causes of morbidity and mortality in the world. Few up-to-date data on this disease are available in developing countries, including Togo. The aim of this study was to estimate the prevalence of hepatitis B among women of childbearing age in the Kara region of Togo. Methods: A cross-sectional study was carried out from 23 to 25 September 2022 during a fairground campaign. Data were collected using a standardised questionnaire. HBV screening was performed using “SD-BIOLINE HBsAg WB” rapid immunochromatographic tests. HBV prevalence was reported with its 95% confidence interval (CI). Regression analyses were performed to identify factors associated with HBV infection. Results: A total of 327 women were enrolled, with a median age of 34 years and an interquartile range of [25 - 43]. Nearly half (49.5%) of the women had had their first sexual intercourse before the age of 18 and 2.1% had at least 2 sexual partners at the time of the survey. The majority (91.7%) had not used a condom the last time they had sex. The prevalence of hepatitis B was 10.4% (95% CI: 7.5 - 14.2]). In multivariable analysis, having had sexual intercourse for the first time after the age of 18 (ORa = 0.17;95% CI [0.06 - 0.43];p Conclusion: The results of this study underline the importance of monitoring the prevalence of hepatitis B in women of childbearing age, and of implementing targeted prevention and screening measures to eliminate mother-to-child transmission of HBV.

关键词： Hepatitis B Virus Women of Childbearing Age Togo

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World Journal of Gastroenterology 2008年第40期14卷 6115-6121页

作者： didier Merlin Department of Medicine Division of Digestive DiseasesEmory University School of Medicine

Recently, inflammatory bowel disease （IBD） has been the subject of considerable research, with increasing attention being paid to the loss of intestinal epithelial cell barrier function as a mechanism of pathogenesis. Ste20-related proline/alanine-rich kinase （SPAK） is involved in regulating barrier function. SPAK is known to interact with inflammation-related kinases （such as p38, JNK, NKCC1, PKCS, WNK and MLCK）, and with transcription factor AP-1, resulting in diverse biological phenomena, including cell differentiation, cell transformation and proliferation, cytoskeleton rearrangement, and regulation of chloride transport. This review examines the involvement of Ste20-1ike kinases and downstream mitogen-activated protein kinases （MAPKs） pathways in the pathogenesis and control of intestinal inflammation. The primary focus will be on the molecular features of intestinal inflammation, with an emphasis on the interaction between SPAK and other molecules, and the effect of these interactions on homeostatic maintenance, cell volume regulation and increased cell permeability in intestinal inflammation.

关键词： Inflammatory bowel diseases WNK NKCCl Barrier function Ste20-related proline/alanine-rich kinase

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Preliminary study of mollusk fossils in the Qinan Miocene loess-soil sequence in western Chinese Loess Plateau

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Science China Earth Sciences 2006年第7期49卷 724-730页

作者： Denis-didier Rousseau Université Montpellier II Institut des Sciences de l’Evolution (UMR CNRS 5554) Case 61 Place E. Bataillon 34095 Mont-pellier Cedex 05 France Lamont-Doherty Earth Observatory of Columbia University Palisades New York 10964 USA

The first near continuous mollusk fossil record from the Qinan Miocene loess-soil se-quence is presented. Results show that mollusk species are abundant in the QA-I section between 22 and 6.2 Ma, and both loess layers and soil layers yield mollusk fossil individuals. All mollusk species are terrestrial and well preserved in the section. Most species are identical to those identified in the Quaternary loess-soil sequence of the Loess Plateau. The thermo-humidiphilous group generally is distributed in soil layers, whereas cold-aridiphilous group can be observed in loess layers. From the Miocene to Quaternary, the occurrence and divergence of new species of Metodontia and Cathaica correspond to the crucial periods of regional and global environmental changes, indicating that mol-lusk species are sensitive to environmental variations. Preliminary study on the QA-I mollusk record indicates that the Qinan Miocene loess-soil sequence may have a similar sedimentary environment to the Quaternary loess-soil sequence of the Loess Plateau.

关键词： mollusk fossils, Miocene loess, Loess Plateau, mollusk evolution, sedimentary environment.

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Electron spectroscopies and their use for materials characterization

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Nuclear Science and Techniques 2003年第1期14卷 28-48页

作者： didier SBILLEAU Bat.11C France Laboratoire PALMS UMR CNRS-Universite 6627 Universite de Rennes-1 35042 Rennes-Cedex

We present here a general overview of electron spectroscopies from a practical point of view. The most frequently used ones are described and the type of structural information they can provide on materials is explained in relation to the physical processes on which they are based. Furthermore, we explore critically and in detail various tools that have been developed to allow a systematic solving of structures by these spectroscopies.

关键词： Electron spectroscopy Materials characterization Surface analysis

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On the Motion Law of Fronts for Scalar Reaction-Diffusion Equations with Equal Depth Multiple-Well Potentials

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Chinese Annals of Mathematics,Series B 2017年第1期38卷 83-148页

作者： Fabrice BETHUEL didier SMETS UPMC-Paris6 UMR 7598 LJLLParisF-75005France

Slow motion for scalar Allen-Cahn type equation is a well-known phenomenon,precise motion law for the dynamics of fronts having been established first using the socalled geometric approach inspired from central manifold theory(see the results of Carr and Pego in 1989). In this paper, the authors present an alternate approach to recover the motion law, and extend it to the case of multiple wells. This method is based on the localized energy identity, and is therefore, at least conceptually, simpler to implement. It also allows to handle collisions and rough initial data.

关键词： Reaction-diffusion systems Parabolic equations Singular limits

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Capabilities and limitations of 3D printed microserpentines and integrated 3D electrodes for stretchable and conformable biosensor applications

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Microsystems & Nanoengineering 2020年第1期6卷 1078-1092页

作者： Charles didier Avra Kundu Swaminathan Rajaraman Nanoscience Technology Center(NSTC) University of Central FloridaOrlandoFL 32826USA Burnett School of Biomedical Sciences University of Central FloridaOrlandoFL 32827USA Department of Materials Science&Engineering University of Central FloridaOrlandoFL 32816USA Department of Electrical&Computer Engineering University of Central FloridaOrlandoFL 32816USA

We explore the capabilities and limitations of 3D printed microserpentines(µserpentines)and utilize these structures to develop dynamic 3D microelectrodes for potential applications in in vitro,wearable,and implantable microelectrode arrays(MEAs).The device incorporates optimized 3D printedµserpentine designs with out-of-plane microelectrode structures,integrated on to a flexible Kapton®package with micromolded PDMS *** flexibility of the optimized,printedµserpentine design was calculated through effective stiffness and effective strain equations,so as to allow for analysis of various designs for enhanced *** optimized,down selectedµserpentine design was further sputter coated with 7–70 nm-thick gold and the performance of these coatings was studied for maintenance of conductivity during uniaxial strain ***/conforming analysis of the final devices(3D MEAs with a Kapton®package and PDMS insulation)were performed to qualitatively assess the robustness of the finished device toward dynamic MEA applications.3D microelectrode impedance measurements varied from 4.2 to 5.2 kΩduring the bending process demonstrating a small change and an example application with artificial agarose skin composite model to assess feasibility for basic transdermal electrical recording was further demonstrated.

关键词： microelectrode insulation utilize

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