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Hand Hygiene by Ward Staff at Dapaong Regional Hospital in Togo

Open Journal of Nursing 2023年第2期13卷 95-112页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe eyram Yoan Makafui amekoudi Tchaa Hodabalo Towoezim Tchetike Pikabalo School of Health Sciences University of Kara Kara Togo Anesthesia and Intensive Care Service University Hospital of Kara Kara Togo Medical Intensive Care Service University Hospital of Kara Kara Togo Traumatology and orthopedic Service University Hospital of Kara Kara Togo Anesthesia and Intensive Care Service Sylvanus Olympio University Hospital of Lomé Lomé Togo

Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at Dapaong regional hospital (DRH). Methodology: This was a prospective, descriptive cross-sectional study conducted from March to June 2022 in the DRH wards. Data were collected using a questionnaire and observation grid. Results: 90 care providers were surveyed. Males and non-physician personnel predominated with 57.8%, and 94.4% respectively. The survey on staff’s knowledge reported: 31.1% of practitioners did not wash their hands on arrival and departure in services. 24% did not know the difference between simple hand washing (SHW) and hygienic hand washing (HHW). 23.3% did not know the type of soap to use for HHW. The caregivers did not know the type of hand washing (HW) required after a septic and non-septic procedure in respectively 41.6%, and 37.8%. They did not know that there are two types of hand antiseptics (45.4%), nor the amount of antiseptic for HW (78.9%). The survey on staff’s attitude regarding HW found that: 70% did not remove all jewels prior HW, and 51.1% did not know that wearing gloves cannot replace the HW. For HW Staff Practice: 62.2% did not wash their hands before treatment. 91.1% did not spread the soap on their hands and forearms after wetting them. 65.55% did not rinse hands from nails to elbows. Conclusion: The HH was poorly known, the attitude of the staff was dangerous in relation to the HH and the practice of HH was very inadequate at the RHC-Dapaong. As a result, there is a need to retrain staff to increase their capacity to prevent care-related infections and enhance patient safety in the hospital.

关键词： Hand Hygiene Care Providers Hand Washing Antiseptics Dapaong Regional Hospital

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Early Postoperative Deaths in the Surgical Intensive Care Unit of CHU-Kara

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Open Journal of Internal Medicine 2023年第1期13卷 32-50页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe Pikabalo Tchetike eyram Yoan Makafui amekoudi Tchaa Hodabalo Towoezim Department of Anesthesia and Intensive Care at CHU-Kara Kara Togo Anesthesia Resuscitation Service at CHU-Sylvanus Olympio in Lomé Lomé Togo Medical Resuscitation and Nephrology Department of CHU-Kara Kara Togo Trauma Service CHU-Kara Kara Togo

Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. Anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.

关键词： Mortality Early Postoperative Surgical Resuscitation CHU-Kara Togo

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Practice of Pediatric Spinal Anesthesia in a Country with Limited Means: Example of Togo

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Open Journal of Anesthesiology 2023年第2期13卷 32-45页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe Pikabalo Tchetike eyram Yoan Makafui amekoudi Tchaa Hodabalo Towoezim Resuscitation Anesthesia Department at the Kara-CHU Kara Togo CHU-Sylvanus Olympio Anesthesia Resuscitation Department in Lome Lome Togo Medical Resuscitation and Nephrology Service of the CHU-Kara Kara Togo CHU-Kara Traumatology Department Kara Togo

Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in pediatric surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in pediatric surgery at CHU SO de Lomé, in the operating room and hospital ward of CHU Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.

关键词： Pediatric Surgery Spinal Anesthesia 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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Emphysematous Pyelonephritis in a Black African Woman Managed with Antibiotics Alone

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Open Journal of Nephrology 2016年第4期6卷 151-156页

作者： Kossi Akomola Sabi Béfa Noto Kadou Kaza eyram Yoan amekoudi Jacques Vigan Vicko Manou Dazé Apollinaire Gnionsahe Department of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo

Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the EPN is currently limited to case series reported. No cases have been described in black Africa. Aims: Related a first case of EPN diagnosed and treated in the University Hospital Center Sylvanus Olympio of Lomé in Togo. Observation: A 40 years old woman, with antecedent of diabetes presented pyelonephritis emphysematous class 2. She was treated successfully with antibiotic alone without using percutaneous drainage or nephrectomy. Conclusion: As reported in every case series, it was a young diabetic patient with a clinical features of acute pyelonephritis which CT scan had helped lay the EPN class 2 diagnosed. The germ was Klebsiella pneumoniae. She was treated with adapted antibiotic alone.

关键词： Emphysematous Pyelonephritis Africa Togo

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Predictors of Mortality in Chronic Kidney Disease Patients with Covid-19 in Togo

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Advances in Infectious Diseases 2022年第4期12卷 838-846页

作者： Yawovi Mawufemo Tsevi Lidaw Déassoua Bawe Badomta Dolaama eyram Yoan Makafui amekoudi Komlan Georges Tona Awalou Mohaman Djibril Lomé-Commune Regional Hospital National Center for the Care of Covid-19 in Togo Sylvanus Olympio University Hospital of Lomé Lomé Togo University Hospital of Kara Kara Togo

Background: Coronavirus disease mortality is high in people with chronic kidney disease. Method: we present the characteristics and factors associated with mortality of patients hospitalized for Covid-19 and with chronic kidney disease in a descriptive and analytical cross-sectional study of CKD patients admitted to the Lomé Commune Regional Hospital Center (CHR-LC) from March 2020 to August 2021. Results: A total of 127 patients met our inclusion criteria. We found a mortality rate of 48.8% in Lomé (Togo). Factors associated with this mortality in our study were severity of Covid-19 (p Conclusion: Mortality is very high in CKD patients with Covid-19.

关键词： Mortality Covid-19 CKD Togo

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Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at LoméUniversity Hospital

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Open Journal of Nephrology 2019年第3期9卷 55-64页

作者： eyram Yoan Makafui amekoudi Kossi Akomola Sabi Badomta Dolaama Komlan Georges Tona Bé fa Noto-Kadou-Kaza Epiphane Kola Bayaki Saka Department of Nephrology and Hemodialysis CHU Sylvanus Olympio Lome Togo Department of Dermatology and Venerology CHU Sylvanus Olympio Lome Togo

HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at Sylvanus Olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m2: 2.9% had an eGFR 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/μL [IQR = 72 - 274/μL];the median hemoglobin level was 10.4 g/dL [IQR = 8.8 - 11.9 g/dL];all patients had thrombocytopenia less than 100.000/mm3;8.5% had leukocytosis greater than 10.000/mm3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.

关键词： HIV Chronic Kidney Disease Epidemiology Togo

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COVID-19 Infection and Acute Kidney Injury: About 43 Cases Report Collected at the Nephrology Department of the Farah Polyclinic in Abidjan

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Open Journal of Nephrology 2022年第4期12卷 410-425页

作者： Badomta Dolaama Serge Didier Konan Sery Patrick Diopoh Mohamed Alex Moudachirou Komlan Georges Tona eyram Yoan Makafui amekoudi Mawufemo Claude Tsevi Kouamé Hubert Yao Farah Polyclinic Abidjan Cote d’Ivoire Nephrology and Hemodialysis Department Teaching Hospital of Sylvanus Olympio Lome Togo Nephrology Department Teaching Hospital of Treichville Treichville Cote d’Ivoire Nephrology Department Teaching Hospital of Kara Lome Togo

Background: Acute kidney injury (AKI) is one of the increasingly described complications of coronavirus infection. Objectives: To identify factors associated with death in patients with acute kidney injury (AKI) during Coronavirus disease (COVID-19) in Abidjan, C?te d’Ivoire. Material and Method: This was a monocentric retrospective analytical study of all patients over 18 years of age with AKI during COVID-19 at the Farah Polyclinic in Abidjan, C?te d’Ivoire. AKI was defined and ranked according to Kidney Disease Improving Global Outcomes (KDIGO) 2012. The data were collected from the medical record and processed using RStudio. Results: Forty-three cases were collected. The average age was 58.5 12 years. The sex ratio (M/F) was 4.4. The main comorbidities were high blood pressure (60.4%) and diabetes (37.2%). AKI was at KDIGO stage 3 in 58%, KDIGO 2 in 21% and KDIGO 1 in 21%. The diagnosis of acute tubular necrosis was retained in 44.2% of patients followed by acute functional kidney injury in 32.6%. Hemodialysis was initiated in 48.8% of cases. The main indication of dialysis was anuria (46.6%). In total, 55.8% of patients died. Factors associated with death were KDIGO stage (p = 0.049), and invasive ventilation (p Conclusion: Mortality is high in patients with AKI during COVID-19 infection.

关键词： Coronavirus Acute Kidney Injury Abidjan 2020

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Erectile Dysfunction in Hemodialysis in Togo

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Open Journal of Nephrology 2016年第4期6卷 145-150页

作者： Kossi Akomola Sabi Béfa Noto Kadou Kaza eyram Yoan amekoudi Jacques Vigan Souleymane Pessinaba Kafui Avouwadan Kodjo Tengue Tchilabalo Matchona Kpatcha Dazé Apollinaire Gnionsahe Departement of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Cotonou Cotonou Benin Departement of Cardiology Campus University Teaching Hospital of Lomé Lomé Togo Departement of Urology and Andrology Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Yopougon Abidjan Ivoiry Coast

Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.

关键词： Erectile Dysfunction Hemodialysis Togo

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Acute Kidney Injury during Malaria in Togolese Children

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Open Journal of Nephrology 2018年第4期8卷 85-93页

作者： Kossi Akomola Sabi Befa Noto Kadou Kaza eyram Yoan Makafui amekoudi Weu Melanie Tia Jacques Vigan Hamat Ibrahim Guillaume Abderhamman Mahamat Sandra Amouzou-Glikpa Edem Djadou Service de néphrologie et hémodialyse CHU SylvanusOlympio Lomé Togo Service de néphrologie et d’hémodialyse CHU de YOPOUGON Abidjan République de C&ocirc te d’Ivoire Clinique de néphrologie CNHU Cotonou. Bénin Service de néphrologie et d’hémodialyse h&ocirc pital universitaire de N’djaména Tchad Service de pédiatrie CHU SylvanusOlympio Lomé Togo

Objective: To describe clinical, biological and evolutionary profile of Acute Kidney Injury (AKI) due to Severe Malaria in the pediatric department. Methodology: This was a retrospective descriptive study that took place from January to December 2012. It has been included children aged 0 - 15 years admitted for severe malaria with positive thick drop. AKI was defined by using the modified RIFLE (Risk Injury Failure Loss End stage) classification for Pediatrics. Results: 338 children admitted for severe malaria were included. AKI was diagnosed in 24 children, a prevalence of 7.1% according to pRIFLE classification: RISK in 10 (3%), INJURY in 9 (2.6%) and FAILURE in 5 (1.5%). The average age was 8.16 ± 4.2 years. Clinical features were dominated by hemoglobinuria in 87.5%, oliguria, vomiting and fever in 75%. The biological features were dominated by severe anemia (Hb 5.5 mmol/l) was found in 2 cases. The mean parasitic density was 22,120 trophozoites. Malaria was treated primarily with artemether in 83.3% of the cases. Dialysis was indicated in 2 cases for menacing hyperkalaemia, but was not done because of lack of financial means. In one case, hyperkalaemia was successfully treated with symptomatic measures, but in the second case, these measures were not allowed to normalize kalaemia, and death occurred. Conclusion: Acute post-malarial renal failure secondary to tubular necrosis may be the dominant clinical features of severe malaria. Death may occur. Preventing malaria would be the best way to avoid it.

关键词： AKI Severe Malaria Haemoglobinuria Togo

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