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World Journal of AIDS 2013年第4期3卷 364-366页

作者： ihou nazoba majesté wateba Akouda Akessiwe Patassi Abago Balaka Ousséni Tidjani Service de Maladies Infectieuses et de Pneumologie CHU Sylvanus Olympio Lomé Togo

Objective: To evaluate the virological status of ineligible HIV patients for anti-retroviral therapy based on the criterion of CD4+ T lymphocytes rate over than 350/μl of blood. Method: This is a prospective study which was conducted from November 2011 to July 2012 in the tropical and infectious disease department of CHU Sylvanus Olympio of Lomé. All HIV-1 infected patients whose CD4+ T lymphocytes rate was ≥350/μl of blood were retained. The count of CD4+ T lymphocytes was made by cytometer FACSCalibur? flow of BD biosciences and the determination of viral load was achieved by NASBA laboratory method of Biomérieux. Results: We have recruited 102 PLWHA aged between 19 and 58 years with a median of 35 years. Biologically, 102 patients had a T-CD4 rate between 355 and 432/μl of blood. The determination of viral load showed a very high viral replication more than 10,000 copies/ml among all patients and 28 (27.5%) patients had a viral load > 100,000 copies/ml of blood. Conclusion: Our results argue for a reconsideration of the criteria for starting antiretroviral therapy in Togo by including virological data if necessary in patients with T-CD4 rate below 500/μl of blood.

关键词： Viral Load CD4+ T Lymphocytes Naive Anti-Retroviral Therapy Patients

Prognosis and Evolution of Lassa Virus Infected Persons during the 2017 Epidemic in Togo

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Advances in Infectious Diseases 2018年第4期8卷 262-267页

作者： majesté ihou wateba Lidawou Bawé Sika Dossim Tropical and Infectious Diseases Service of CHU SO Lomé Togo Microbiology Laboratory of CHU SO Lomé Togo

Introduction: Lassa viral hemorrhagic fever is common in West Africa. Almost 300,000 persons are affected each year with 5000 deaths. The mice of the genus mastomys is the wild tank. Objective: The aim of our study is to describe clinic, therapeutic and evolution of the affected patients during February-March 2017 epidemic that occurred in the north of Togo. Methodology: Our study is a record review study from patients’ record, who were hospitalized from February, 1st to March, 31st 2017 at Mango hospital. Lassa diagnosis was performed by PCR. They patients have received Ribavirin and blood transfusion when necessary. Results: We have reported 5 clinical observations of Lassa viral hemorrhagic fever. Patients came from Benin (03 cases), from Burkina-Faso (1 case), from Togo (1 case) and were 25, 34, 60, 52 years old and a premature baby of 13 days. External hemorrhage and abdominal pains were the main symptoms. Fever was observed for all the cases. Complications were marked by hemorrhages and shocks. Only 3 patients had benefitted of Antiviral therapy with Ribavirin. The other 2 patients did not benefit from the treatment because the diagnosis of Lassa fever was done the day they dead before the treatment started. Lethality was 80% (4 cases) with a highly secured burial. Effective management of contacts was done. Conclusion: Diagnostic and therapeutic delays of patients are responsible of the bad prognosis of the disease.

关键词： Fever Hemorrhage Lassa Virus Mango (Togo)

Cryptococcal Meningitis of the HIV-Infected Person in Lomé: About 102 Cases over 10 Years

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World Journal of AIDS 2017年第3期7卷 217-222页

作者： ihou majesté wateba Abago Balaka Alain Lidaw Bawe Awereou Kotosso Tropical and Infectious Diseases Service of CHU SO Lome Togo Internal Medicine Service of CHU SO Lome Togo

Objective: To describe the clinical, epidemiological and evolutionary aspects of cryptococcal meningitis. Methods: This was a retrospective descriptive study on all HIV-infected patients who had been hospitalized for cryptococcal meningitis between 2006 and 2016 in the principal structures for the care of HIV infected person in Lomé. The diagnosis of meningitis was clinical and confirmed by the presence of cryptococci on Chinese ink or the detection of CSFsoluble antigens. All patients have made the CD4 rate assay and received an antifungal treatment based on fluconazole or Amphotericin B, followed later by antiretroviral triple therapy. Results: A total of 102 patients infected with cryptococcal meningitis (62 men for 40 women) were found. The sex ratio was 1.55. The median age was 34 years with extremes of 15 to 49 years. Clinically, headache was the symptomatic symptom in 100% of cases, prone to long runs and weight loss respectively in the proportions of 45% and 65%. The mean CD4 cell count was 65 ± 22 cells per mm3. The duration of hospital stay was short (less than 7 days) for the deceased. A total of 62 patients were able to receive treatment, 40 of them with fluconazole and 22 with Amphotericin B. The mortality was very high (65%), 25% were lost to follow-up, and 9.5% still in live 3 months after admission to the hospital. Conclusion: Cryptococcal meningitis has a very reserved prognosis. It is to be feared in cases of severe immunosuppression, hence the early detection of HIV for optimal management is important.

关键词： Cryptococcal Meningitis HIV Lomé

The Lassa Virus Epidemic in Mango, Togo: Therapeutic Route of the First 4 Cases

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Advances in Infectious Diseases 2017年第4期7卷 135-142页

作者： majesté ihou wateba Aimé Dakévi Lidawu Bawé Abago Balaka Awereou Kotosso Tropical and Infectious Diseases Service of CHU SO Lomé Togo Internal Medicine Service CHU of SO Lomé Togo

Introduction: Lassa viral hemorrhagic fever is caused by the Lassa virus. The aim of our study is to describe the therapeutic itinerary of the 4 cases of Lassa virus hemorrhagic of February-March 2017 epidemic that occurred in Mango. Methodology: Our study is a transverse retro-prospective and descriptive study from February, 1st to March, 31st 2017 that dealt with 4 confirmed Lassa fever cases declared positive on the PCR basis;hospitalized or deceased at the hospital “Esperance” of Mango;support center of Lassa viral hemorrhagic fever. Results: we reported 4 clinical observations of Lassa viral hemorrhagic fever diagnosed on the PCR basis during the Lassa fever epidemic. Patients came from Benin (2 cases) or from Burkina-Faso (1 case) and were 25, 60, 52 years old and a premature baby of 13 days. The reasons for admission were external hemorrhage, a pultated tonsillitis and abdominal pains. Fever was observed for all the cases. Complications were marked by hemorrhages and shocks. Only two patients benefitted from Antiviral therapy with Ribavirin and were declared healed. The other two patients did not benefit from the treatment due to diagnostic and therapeutic delays. Lethality was 75% (3 cases) with a highly secured burial. Effective management of contacts was established. Conclusion: Diagnostic and therapeutic delays of patients are responsible of the Dark Prognosis of Lassa fever during the epidemic.

关键词： Fever Hemorrhage Lassa Virus Mango (Togo)

Incidence of Tuberculosis in Latent TB Infected (LTBI) Patients Living with HIV under Antiretroviral Therapy in the LoméInfectious Disease Department

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World Journal of AIDS 2017年第3期7卷 223-229页

作者： majesté ihou wateba Komi Adjoh Lidawou Bawe Awerewou Kotosso A. Patassi Abago Balaka Infectious and Tropical Diseases Service of CHU SO Lomé Togo Respirory and Lung Diseases Service of CHU SO Lomé Togo Internal Medicine Service of CHU SO Lomé Togo

Objective: To determine the incidence of tuberculosis in person living with HIV infected by latent TB and under antiretroviral (ARV) therapy. Method: We studied prospectively for 36 months the occurrence of bacilliform pulmonary tuberculosis in patients infected with HIV, naive of BCG and receiving antiretroviral treatment. Each patient had an intradermal reaction (IDR) of 10 IU tuberculin Mérieux. The measurement of the nodule is made 72 hours later. During follow-up, patients were reviewed every six months for active tuberculosis. Results: A total of 212 out of 257 patients had an IDR greater than 5 mm, an ITL prevalence of 86.33%. Three patients were lost to follow-up during the study. The predominant female sex is 69.81%. The mean age was 42.8 ± 10.02 years. A previous history of tuberculosis was found in 14.15% of patients and 208 patients (98.11%) had HIV1. In 39.15% of patients, patients had a CD4 count lower than 350 cells/mm3 at baseline in the study. At the end of the three-year follow-up, among the 14 patients, 11 had failed ARV therapy and had developed TB, with an incidence of 2.20 cases per 100 patients. Conclusion: The incidence of active tuberculosis in LTBI was very high in HIV-positive patients with low CD4 count, hence the importance of reliable LTBI screening such as gamma interferon is better than patient follow-up.

关键词： LTBI Incidence Tuberculosis HIV

Resistance to Beta Lactam Antibiotics of <i>Pseudomonas aeruginosa</i>Isolated in Community Infections within HIV Infected Persons in Lomé-Togo

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World Journal of AIDS 2014年第1期4卷 81-84页

作者： majesté ihou wateba Kanyni Ekoue-Kouvahey Abago Balaka Komivi Tsatsu Ousseni Tidjani Department of Infectious Diseases and Pneumology CHU Sylvanus Olympio Lomé Togo Department of Internal Medicine CHU Sylvanus Olympio Lomé Togo Medical Center of NGO VISA Lomé Togo

Objective: Describe resistance to beta lactam antibiotics of Pseudomonas aeruginosa in community infection within HIV-1 infected persons. Methods: We have studied prospectively from June 15th to December 31st 2013 inthe Clinic Hotel-Dieu and NGO VISA of Lomé, adult HIV-1 infected patients under anti retroviral therapy combining tenofovir, lamivudine and efavirenz for at least one year. The technique of agar diffusion susceptibility using discs of Ticarcillin + clavulanic acid is used to study the β-lactamase production. The diagnosis of species was performed by the chloroform test and the test for sensitivity to kanamycin and colistin. Results: Thirty five strains of Pseudomonas aeruginosa were obtained. The T-lymphocytes CD4 mediane was 575 cells/mm3 of blood. Urine represented 15 cases, skin abscesses 11 cases, externa suppurate otitis 7 cases and vaginal swab for 2 cases. The phenotypes were: wild phenotypes 23 cases (65.7%), resistant phenotypes 12 cases. Among resistant phenotypes, 4 were complex phenotype;5 were ESBL phenotypes;2 were hyper productive cephalosporinases phenotypes and 1 was a specific phenotype with impermeability to imipenem. Conclusion: The acquisition of resistance of Pseudomonas aeruginosa to beta lactam antibiotics in community infections among HIV-1 infected person incentives controls and promotes the rational use of antibiotics.

关键词： HIV-1 Pseudomonas aeruginosa Resistance Phenotypes Beta Lactam Antibiotic

Acute Renal Failure in Hospitals in Togo: Comparative Analysis of HIV Positive Patients and HIV Negative Patients

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Open Journal of Nephrology 2019年第3期9卷 77-86页

作者： Yawovi Mawufemo Tsevi Lidaw Deassoua Bawe Komi Dzidzonu Nemi Akouda Patassi ihou majesté wateba Department of Nephrology and Hemodialysis University Hospital Sylvanus Olympio of Lom&eacute University of Lome Lome Togo Departement of Infectious and Tropical Diseases University Hospital Sylvanus Olympio of Lom&eacute University of Lome Lome Togo Department of Internal Medicine University Hospital Sylvanus Olympio Lom&eacute University of Lome Lome Togo

Introduction: Human Immunodeficiency (HIV) is a risk factor often associated with the occurrence of Acute Renal Failure (ARF). Objectives: To describe the profile of Acute Renal Failure (ARF) in HIV-infected patients and compare them to non-infected patients. Patients and Methods: It was a prospective study from January 2018 to February 2019 that took place in the nephrology, infectious diseases and internal medicine departments of the Sylvanus Olympio University Hospital Center in Lomé (Togo). Results: The prevalence of ARF in HIV-infected patients was 48.07%. HIV-infected patients had an average age of 46.9 ± 11.6 years (p = 0.36) compared to 44.0 ± 20.4 years for non-HIV infected patients. Female sex was predominant in the HIV-infected population with a sex ratio H/F of 0.6 (p 3) in 50% of cases. HIV infected patients had more anemia (52.0% versus 22.2%) with p = 0.002. Conclusion: No deaths were recorded in the HIV-infected group.

关键词： ARF HIV Togo

Antiretroviral Therapeutic Profile in Patients Living with HIV with Chronic Kidney Disease

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Advances in Infectious Diseases 2019年第3期9卷 252-262页

作者： Yawovi Mawufemo Tsevi Lidaw Déassoua Bawe Komi Dzidzonu Nemi Abdou Razak Moukaila Akessiwe Akouda Patassi majesté ihou majesté ihou Department of Nephrology and Hemodialysis University Hospital Sylvanus Olympio of Lomé University of Lome-Togo Departement of Infectious and Tropical Diseases University Hospital Sylvanus Olympio of Lomé University of Lome-Togo Department of Internal Medicine University Hospital Sylvanus Olympio Lomé University of Lome-Togo

Chronic Kidney disease (CKD) is one of the important complications during HIV infection. The advent of Highly Active Antiretroviral Therapy (HAART) has significantly improved the prognosis of these patients. This was a descriptive and analytical cross-sectional study of people living with HIV received at the Ambulatory Treatment Center (ATC) of the Department of Infectious Diseases of Sylvanus Olympio University Hospital (CHU-SO). The study period was 6 months from January 1, 2018 to June 30, 2018. A total of 234 patients were enrolled during the study period. The mean age of patients at initiation of treatment was 42.07 ± 9.49 years with an average duration of follow-up under antiretroviral treatment of 5.61 ± 3.22 years. The female sex was predominant (70.09%) and a sex ratio (M/F) of 0.43. Most people living with HIV were mostly classified at clinical stage 2 (30.77) and 3 (31.62%) of WHO at initiation of HAART. The mean CD4 rate was 223.30 ± 143.764 at initiation of HAART and 462.58 ± 202.723 at the time of study. The frequency of CKD was 11.11%. The majority of patients were placed in a fixed combination of Tenofovir/Lamivudine/Efavirenz in a proportion of 81.20% of cases. In univariate analysis shows that age greater than 45 years (p = 0.017). Pathological proteinuria (p = 0.021) were associated with CKD. In multivariate analysis, only age (p = 0.045) and pathological proteinuria (p = 0.035) were significantly associated with CKD.

关键词： Therapeutic Profile CKD HIV HAART Togo

Severe Allergic Reaction Following Administration of Antivenom Serum for Snakebite: A Case Report from Togo

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Case Reports in Clinical Medicine 2024年第8期13卷 297-303页

作者： Awèréou Kotosso Lidaw Deassoua Bawe Akouda Akessiwe Patassi Lampouguini Nebona Cici Amouzou Esso-Essinam Félix Pissang Bawoubadi Abaltou Gnimdou Tchamdja Magnoudewa Poko Hassimou Bramah majesté ihou wateba Facult des Sciences de la Sant Universit de Lom Lom Togo Department of Infectious Diseases Centre Hospitalier Rgional Lom-Commune Lom Togo Department of Infectious Diseases and Tropical Medicine Centre Hospitalier Universitaire Sylvanus Olympio Lom Togo Department of General Medicine Centre Mdical des Armes de Sokod Lom Togo

Background: Ophidian envenomation is common in Sub-Saharan Africa, and its management is hampered by the lack of access to healthcare services in rural areas, in particular the availability and appropriate use of antivenom. Rare cases of serious side effects following the administration of antivenom have been reported. This is the case for a young farmer from the central region of Togo, who experienced a second snake bite within four years, and in whom antivenom serotherapy led to severe allergic manifestations. Case presentation: This 24-year-old patient, with a history of antivenom and tetanus serotherapy, was admitted to the Centre Hospitalier Régional (CHR) of Sokodé for a snakebite that occurred 45 minutes earlier while working in the field. Clinical assessment on admission revealed grade 1 envenomation, characterized by local pain in the right upper limb, with no sign of complication. He received an intravenous infusion of antivenom serotherapy, which rapidly relieved the pain, allowing him to be discharged after 24 hours of hospital monitoring. However, he was readmitted five days later for a skin rash associated with generalized pruritus and edema of the face and the neck, which prompted his evacuation to the Sylvanus Olympio University Hospital. He was diagnosed with a hypersensitivity-type allergic reaction to antivenom serum. Symptomatic treatment with antihistamines resulted in a favourable outcome after five days in the hospital. Conclusion: This young farmer developed a severe allergic reaction following a second course of antivenom serotherapy for low-grade ophidian envenomation. Although the efficacy of antivenom serum is undeniable in the management of snakebites, its use should be guided by a sound clinical assessment and framed by rigorous monitoring, especially in people sensitized to antivenom or antitoxin serotherapy. This highlights the importance of training healthcare staff alongside the availability of anti-venomous sera at peripheral healt

关键词： Snakebite Antivenom Allergic Reaction Sub-Saharan Africa Togo

Metabolic Syndrome in People Living with HIV in Lome (Togo): Epidemiological Aspects and Associated Factors

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Open Journal of Endocrine and Metabolic Diseases 2020年第4期10卷 59-75页

作者： Abdou Razak Moukaila Edem Komi Mossi Mouhaman-Inouwa Kpelafia Komi Dzidzonu Nemi Kossi Kodjo Agbeko Kodjo Djagadou Lidaw Déassoua Bawe Akessiwe Akouda Patassi Yawovi Mawufemo Tsevi ihou majesté wateba Awalou Mohaman Djibril Department of Internal Medecine Sylvanus Olympio University Hospital University of Lome Lome Togo Diabetes Academic Afrique Lome Togo Department of Infectious and Tropical Diseases Sylvanus Olympio University Hospital University of Lome Lome Togo Department of Cardiology Campus University Hospital University of Lome Lome Togo Department of Nephrology and Hemodialysis Sylvanus Olympio University Hospital University of Lome Lome Togo

Introduction: People living with HIV (PLWHIV) are exposed to Metabolic Syndrome (MS), which increases their risk of having cardiovascular events and type 2 diabetes. No data on this subject is available in Togo. Objective: The objective of our study was to make an inventory of the metabolic syndrome among PLWHIV in Togo. Method: This was a prospective cross-sectional descriptive and analytical study on PLWHIV received at the day hospital of the Infectious Diseases Department of the Sylvanus Olympio University Hospital for a period of six months. Results: A total of 279 PLWHIV patients were enrolled, of which 237 (84.9%) were on Highly Active Antiretroviral Treatment (HAART) and 42 (15.1%) were naive. Metabolic syndrome has been demonstrated in 28.7% of the study population. Abdominal obesity was the most represented component of MS with a proportion of 57.7%. Risk factors associated with MS were female sex (OR = 3.01;CI: 1.52 - 5.93;p 2 (OR = 3.29;CI: 1.92 - 5.64;p 3 (OR = 1.85;CI: 1.06 - 3.20;p Conclusion: There is a need to screen MS for PLWHIV so that risk factors associated with it can be addressed early.

关键词： HIV HAART Metabolic Syndrome Dyslipidemia Hypertension Hyperglycemia Togo