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

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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

Natural Regeneration of Marker Species of the Tropical Dense Humid Ecosystems in the Loukaya Peri-Urban Forest, Brazzaville-Congo

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Open Journal of Ecology 2020年第10期10卷 664-687页

作者： Victor Kimpouni Jean de Dieu Nzila Oracle Clément Tondo Bafouiri Ntsoni ghislain Bileri-Bakala Josérald Chaîph Mamboueni Charmes Maïdet Massamba-Makanda école Normale Supérieure Université Marien Ngouabi Brazzaville Congo Institut National de Recherche Forestière (IRF) Brazzaville Congo

The study aimed at evaluating the natural regeneration of some characteristic species in the Loukaya peri-urban forest was carried out in Brazzaville, over three surveys of one hectare each. The botanical inventory of the 23 species monitored covers the subjects of 2 ≤ d0.20 1.30 ≥ 10 cm. The study shows 1255 individuals of which 68.27% are 2 ≤ d0.20 < 10 cm. While being tropophilic and mesophilic, this ecosystem is pauciflorous and paucispecific. The phytoecological data show that this formation, which is a link in the African dense humid forest, presents values far below those known elsewhere;while being faithful to the forests of the Cataractes Plateau. As for the rate of natural regeneration, this index is greater than or equal to 100 for 69.56% of the taxa. Sarcochores and heliophytes are the taxa that best support this natural regeneration. This high rate of regeneration would be correlated with the high level of anthropization, whose large canopy gaps are accompanied by a flow of light conducive to the installation of seedlings.

关键词： Congo Biodiversity Index Peri-Urban Forest Phytoecology Natural Regeneration

Investigating Non-Compliance with COVID-19 Vaccination through Hesitancy, Refusal, and Access Limitation: A Community-Based Survey from the Democratic Republic of the Congo

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Journal of Biosciences and Medicines 2024年第9期12卷 280-306页

作者： Nestor Kalala-Tshituka Alain Cimuanga-Mukanya Alain Yamba Mukendi Faustin Ndjibu Mpoji ghislain Disashi-Tumba Joris Losimba Likwela Nadine Kayiba Kalenda Evariste Tshibangu-Kabamba Department of Public Health Faculty of Medicine Pharmacy and Public Health University of Mbujimayi Mbuji-Mayi Democratic Republic of the Congo Department of Public Health Faculty of Medicine and Pharmacy University of Kisangani Kisangani Democratic Republic of the Congo Department of Internal Medicine Faculty of Medicine Pharmacy and Public Health University of Mbujimayi Mbuji-Mayi Democratic Republic of the Congo Department of Environmental and Preventive Medicine Faculty of Medicine Oita University Oita Japan Research Institute of Health and Society Catholic University of Louvain Brussels Belgium

Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.

关键词： COVID-19 Vaccination Non-Observance Community Democratic Republic of the Congo

Role of CD4+ and CD8+ T Lymphocyte in the Onset of Stroke in People Living with HIV in Pointe-Noire

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World Journal of Neuroscience 2022年第1期12卷 1-7页

作者： Prince Eliot Galieni Sounga Bandzouzi ghislain Armel Mpandzou Josué Euberma Diatewa Dina Happia Motoula-Latou Charles Godefroy Koubemba Paul Macaire Ossou-Nguiet Donatien Moukassa Faculty of Health Sciences Marien N’Gouabi University Brazzaville Republic of Congo Department of Neurology Loandjili General Hospital Pointe-Noire Republic of the Congo Department of Neurology University Hospital Center of Brazzaville Brazzaville Republic of Congo

Objective: To determine the role of CD4+ and CD8+ T lymphocytes in the onset of stroke in people living with HIV. Methodology: This was a descriptive, cross-sectional study from January to July 2019, in the neurology department of loandjili general hospital, including any patient hospitalized for a first episode of stroke confirmed by brain scan. The study variables were: age, sex, CRP value, serum T cell CD4+, CD8+. The statistical analysis was carried out using the EPI info 7 software. Results: Twenty stroke patients were included. The relative frequency of HIV was 20%. The risk factors were potentiated by immunosuppression of CD4+ T cells. Sixty percent (60%) of the patients had a CD4+ count 3 and the mean CD4+ count was ±191/mm3. Stroke was the predominant mechanism of injury with a frequency of 70%, the only injury mechanism of stroke in patients with CD8+ T cell count > 800/mm3 (p = 0.04). Conclusion: Risk factors are potentiated by TCD4+ lymphocyte immunosupression, also CD8+ lymphocytes of immune system activation marker are a cardiovascular risk factor for living people with HIV.

关键词： CD4+ CD8+ T Lymphocytes HIV Stroke Pointe-Noire

Screening for Hepatitis B and C in Occupational Settings: Cross-Sectional Study about 4268 Corporates Agents in Cote d’Ivoire

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Open Journal of Gastroenterology 2017年第3期7卷 89-95页

作者： Constant Assi Amadou Ouattara Siaka Kone Dramane Soro Emile Allah-Kouadio Claude ghislain Kouakou Nigué Luc Benoit-Mathieu Camara Marie-Jeanne Lohoues-Kouacou Teaching Hospital Center of Cocody Abidjan Cote d’Ivoire

Aim: To screen hepatitis B and C in occupational setting. Methods: Cross-sectional study multicenter in 16 enterprises (one occupational exposure;5602 agents). Screening was preceded by information, sensibilisation and informed consenting physician labor, labor union and agents. Hepatitis B surface antigen (HBsAg) and antibodies anti-hepatitis C (Elisa, third generation) were tested in all. For those with HBsAg positive, this test was completed by IgM and IgG, anti HBc, HBeAg, antibodies anti HBe, transaminases and HBB DNA;for those with positive anti-VHC antibodies, test was completed by transaminases and VHC’s RNA. Results: Rate of participation was 76.2% (4268/5602 labors). HBsAg or hepatitis C antibodies were positives in 425 (9.9%) of cases (HBsAg positive: 8.48%;Hepatitis C Antibodies positives: 1.50%;both: 0.05%). In HBsAg positive, viral replication and cytolysis were seen respectively in 2.5 % and 18.2%. According with transaminases, serologic markers and viral load, immunotolerance, inactive and immuno active phase were suspected in 0.56%, 80.9% and 1.6% of cases. In hepatitis C antibodies positives persons, any had viral replication but cytolysis was observed in 33.3% (n = 21). HBsAg was significantively (p < 0.00001) higher in exposed occupational enterprise versus non-occupational setting (14.4% vs 7.8%). They were no differences (p = 0.71) about hepatitis C antibodies in the two setting (1.8% vs 1.7%). Conclusion: Prevalence of HBsAg and hepatitis C antibodies was high in occupational setting in hepatitis endemic country. It’s important to screen all of person in these setting with no consideration with blood exposed or not exposed enterprise.

关键词： Hepatitis B and C Screening Occupational Setting Blood Exposed Enterprise

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

Psychological Experience of Children and Adolescents with Homozygous Sickle Cell Disease in Brazzaville

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Open Journal of Pediatrics 2021年第1期11卷 35-49页

作者： Engoba Moyen ghislain Armel Mpandzou Matimé Julianna Déborah Boukoulou Josué Euberma Diatewa Armel Landry Batchi-Bouyou Paul Macaire Ossou-Nguiét Georges Moyen Université Marien Ngouabi Brazzaville Congo Service de Soins Intensifs Pédiatriques CHU de Brazzaville Brazzaville Congo Service de Neurologie CHU de Brazzaville Brazzaville Congo

Introduction: Sickle cell disease, the most frequent hemoglobinopathy, is one of many causes of psychological repercussions. Objectives: To determine the prevalence of psychological disorders in children/adolescents living with sickle cell disease and to identify the associated factors. Patients and Method: An analytical cross-sectional study was conducted from June to September 2019 at the national sickle cell center and at the mother-child consultation of the University Hospital of Brazzaville. Children/adolescents aged six to 19 years old followed for sickle cell disease were included. Psychological disorders were assessed using the Diagnostic and Statistical Manual of Mental Disorders “DSM-5” which assesses depression and anxiety disorders, the Rosenberg Self-Esteem Scale, and the Brief Illness Perception Questionnaire which assesses representations of chronic diseases. SPSS 20.0 software was used for statistical analysis.

Frequency of Transfusions and Risk Factor for Bleeding Risk to Guide a Blood-Sparing Program during Hip Arthroplasty in Gabon

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Open Journal of Anesthesiology 2023年第3期13卷 47-57页

作者： ghislain Edjo Nkilly Raphael Okoue Ondo Arthur Matsanga Pascal Christian Nze Obiang Stéphane Oliveira Léandre Nguiabanda Jean-Marcel Mandji-Lawson Romain Tchoua Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic surgery service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip arthroplasty in order to guide a blood-saving program. Method: Retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion data, anesthetic and intraoperative data. The primary outcome was intraoperative or postoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 276 patients included, 179 benefited from Total Hip Prosthesis (THP) and 97 from Intermediate Hip Prosthesis (IHP). Spinal anesthesia was performed in 67.4% of patients. The ASA 2 score predominated (65.9%). The transfusion incidence was 56.9% (157/276). Tranexamic acid was used in 16.3% (45/276) of patients. The average bleeding was 528 ± 405 ml. Preoperative anemia (OR = 0.78, 95% CI [0.66 - 0.91]) and total hip prosthesis (OR = 2.02 95% CI [1.11 - 3.67]) were predictors of bleeding and transfusion to be significant. The average serum hemoglobin predictive of a transfusion was 11.6 ± 1.8. ASA score and operative time were not found as risk factors for bleeding and transfusion. Conclusion: The incidence of transfusion is high. Preoperative anemia remains a major but modifiable risk factor unlike the choice of implant. The implementation of a patient blood management protocol could reduce this transfusion incidence.

关键词： Arthroplasty Hip Gabon Transfusion

Cost of Stroke Care at Public Hospitals in Brazzaville and Implication of Third Parties in Stroke Care Expenditure

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World Journal of Neuroscience 2022年第2期12卷 82-92页

作者： Josué Euberma Diatewa ghislain Armel Mpandzou Patrice Bruno Mokoko Dinah Happhia Boubayi Motoula-Latou Eliot Prince Galiéni Sounga-Banzouzi Paul Macaire Ossou-Nguiet Neurology Department University Hospital of Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Neurology Department Loandjili General Hospital Pointe Noire Congo

Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a health insurance system. Objectives: To evaluate the in-hospital costs of stroke care in Brazzaville;to determine the factors influencing the total mean in-hospital cost of stroke care;to identify third parties contributing to stroke care expenditure. Methods: This was a cross-sectional prospective and analytical study. It was carried out at 4 public hospitals in Brazzaville (University Hospital Center, Chinese and Congolese Friendship Hospital, Talangaï Hospital and Makélékélé Hospital), from May to August 2019 (4 months). It focused on patients who had a first episode of stroke confirmed by brain imaging and were at least 18 years old. The bottom-up approach was used to determine the in-hospital costs of stroke care. Results: This study included 109 patients who fulfilled inclusion criteria. Their mean age was 59.2 ± 13.7 years old, with limits of 35 and 90 years old. The total direct in-hospital cost of stroke care was 47,308,330 francs CFA (72,122 euro). The total mean in-hospital cost of stroke care was 1,389,590 francs CFA (2118 euro). The mean cost of intracerebral hemorrhage care was 510,988 francs CFA (779 euro) versus 373,457 francs CFA (569 euro) for cerebral arterial infarction care. The following factors affected the total mean cost of stroke care: type of hospital (p < 0.0001), length of hospital stay (p = 0.001), type of stroke (p = 0.01), stroke severity (p = 0.001) and complications (p = 0.001). The level of contribution to stroke care expenditure covered by third parties was: 78% for patient families;2.8% for community self-help associations. Conclusion: In Congo, the mean in-hospital cost of stroke care is elevated considering the guaranteed minimum wage of 70,000 francs CFA (107 euro). Five factors affect the total mean cost of

关键词： Stroke Hospital Cost Associated Factors Brazzaville