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Assessing the Impact of Health Insurance on Household Financial Protection in Togo

Health 2023年第6期15卷 507-516页

作者： Aboubakar Issa Yaovi Tossou kodjo evlo Département d’Politique et Système de Santé Institut Régional de Santé Publique Ouidah Bénin Programme Couverture Sanitaire Universelle Ministère de la Santé de l’Hygiène Publique et de l’Accès Universel Aux Soins Lomé Togo Direction des études de la Planification et de la Programmation Ministère de la Santé de l’Hygiène Publique et de l’Accès Universel Aux Soins Lomé Togo Département d’Economie Faculté des Sciences économiques et de Gestion Université de Lomé Lomé Togo

Context: To facilitate financial access to care for the population, health insurance mechanisms have been established, in particular the National Health Insurance Institute, which covers civil servants and their dependents. In addition, other voluntary and community mechanisms have been developed. After several years of implementation, the level of catastrophic health expenditures among insured individuals shows that there is still a considerable level of financial risk associated with health care. This study aims to assess the impact of health insurance in Togo on insured populations. Methodology: The data used in this study come from the harmonized survey on household living conditions carried out in 2018 by the National Institute of Statistics, Economic and Demographic Studies. The propensity score matching method was used according to the following steps: estimation of propensity scores, verification of the conditional independence hypothesis (balancing property) and estimation of the average treatment effect on treated. Stata V14.2 software was used. Findings: The average effect of health insurance on household financial protection is −0.012 for the nearest neighbor method, −0.013 for the matching radius method, −0.015 for the Kernel and −0.016 for the stratification method. Results showed that health insurance contributes to reducing catastrophic health expenditures, but their effect remains very limited. This could be explained by the level of care package covered and the cost covered. Conclusion: Health insurance contributes to the reduction of catastrophic health expenses for households. However, it is important to widen the range of care covered and the cost covered. In addition, measures to extend this coverage to a larger proportion of the population will make it possible to have a greater impact.

关键词： Impact Health Insurance Catastrophic Expenditure

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Shear Resistance of Siltous Sands Improved with Bridelia Tannins

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Geomaterials 2024年第1期14卷 1-11页

作者： Sinko Banakinao Soviwadan Drovou Komlan Lolo kodjo Attipou Department of Civil Engineering Polytechnic School of Lomé University of Lomé Lomé Togo Laboratory of Structure and Mechanic of Materials (LaS2M) University of Lomé Lomé Togo

The ruin of several civil engineering works occurs due to shear rupture of the ground. When the stress is greater than the shear resistance, the internal friction angle and the cohesion of the soil loosen and rupture occurs. Cement and lime are often used to stabilize soils and improve soil strength. The costs and environmental problems of these technologies raise concerns and challenge researchers to innovate with clean, inexpensive materials, accessible to the most disadvantaged social classes. The question that this study seeks to answer is whether the binders derived from plant tannins, which also stabilize soils, improve the shear resistance of these soils. To do this, we determined for silty sand the shear parameters, notably the cohesion and the angle of internal friction in the non-stabilized state and when they are stabilized with the powder of the bark of the Bridelia under different water states. The results show that the addition of Bridelia powder to silty sand increases the cohesion of the soil by nearly 70.71% and the friction angle by 4.31%. But in unfavourable water conditions, the cohesion and internal friction angle of the silty sand material improved with Bridelia bark powder drops drastically by nearly 81.56%. but does not dissolve completely as for the same material. When it is not stabilized. This information is an invaluable contribution in the search for solutions to increase the durability of earthen constructions by improving the water-repellent properties of soils.

关键词： Silty Sand Bridelia Tannins Shear Resistance Cohesion Angle of Friction

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New Fusion Approach of Spatial and Channel Attention for Semantic Segmentation of Very High Spatial Resolution Remote Sensing Images

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Open Journal of Applied Sciences 2024年第2期14卷 288-319页

作者： Armand kodjo Atiampo Gokou Hervé Fabrice Diédié Unité de Recherche et d’Expertise du Numerique (UREN) Université Virtuelle de Céte d’Ivoire Abidjan Ivory Coast Laboratoire de Mathématiques et Informatique Université Peleforo Gon Coulibaly Korhogo Ivory Coast

The semantic segmentation of very high spatial resolution remote sensing images is difficult due to the complexity of interpreting the interactions between the objects in the scene. Indeed, effective segmentation requires considering spatial local context and long-term dependencies. To address this problem, the proposed approach is inspired by the MAC-UNet network which is an extension of U-Net, densely connected combined with channel attention. The advantages of this solution are as follows: 4) The new model introduces a new attention called propagate attention to build an attention-based encoder. 2) The fusion of multi-scale information is achieved by a weighted linear combination of the attentions whose coefficients are learned during the training phase. 3) Introducing in the decoder, the Spatial-Channel-Global-Local block which is an attention layer that uniquely combines channel attention and spatial attention locally and globally. The performances of the model are evaluated on 2 datasets WHDLD and DLRSD and show results of mean intersection over union (mIoU) index in progress between 1.54% and 10.47% for DLRSD and between 1.04% and 4.37% for WHDLD compared with the most efficient algorithms with attention mechanisms like MAU-Net and transformers like TMNet.

关键词： Spatial-Channel Attention Super-Token Segmentation Self-Attention Vision Transformer

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Hyperprolactinemia in Hospitals in Lomé: Diagnostic and Therapeutic Aspects

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Open Journal of Internal Medicine 2024年第1期14卷 43-52页

作者： Tchamdja Toyi Djalogue Lihanimpo kodjo Kossi Ganu Koudjo Kaaga Laconi Yéba Mossi Komi Edem M’bortché B. kodjo Djibril Mohaman Awalou Balaka Abago Internal Medicine Departement University de Kara Kara Togo Internal Medicine Departement Université of Lomé Lomé Togo

Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.

关键词： Hyperprolactinemia Hospital Environment CHU SO Togo

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Micropenis Associated or Not with Cryptorchidism in the Endocrinology Department of Yopougon University Hospital in Ivory Coast: Epidemiological, Clinical, Paraclinical and Therapeutic Aspects

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Open Journal of Endocrine and Metabolic Diseases 2024年第3期14卷 75-85页

作者： Adélaïde Hue Kossi kodjo Michèle Fotso Jacko Abodo Department of Endocrinology Diabetology at Yopougon University Hospital Abidjan Ivory Coast Internal Medicine and Endocrinology Department of Sylvanus Olympio University Hospital Lomé Togo

Background: Congenital malformations such as micropenis and cryptorchidism do not have immediate dramatic consequences. However, the diagnosis is often unknown at birth, and therefore late. In Ivory Coast, there are few studies on cryptorchidism and micropenis. We conducted this study to identify the epidemiological, clinical, etiological and therapeutic characteristics of the micropenis associated or not with cryptorchidism at Yopougon University Hospital. Methods: We conducted a retrospective descriptive study in the Department of Endocrinology-Diabetology of the Yopougon University Hospital carried out over 13 years from January 2005 to December 2018. All patients were included regardless of the presence of a micropenis associated or not with cryptorchidism in the clinical or paraclinical examination. Results: A total of 14 micropenis were reported associated in 6 cases with cryptorchidism. It was unilateral cryptorchidism in 4 patients or 66.66% of cases. The average age of affected patients was 21.32 years with extremes ranging from 10 months to 48 years. The reason for consultation was micropenis in 12 out of 14 cases or 85.75%. The associated signs apart from cryptorchidism were obesity in 42.86% of cases, gynecomastia in 35.71% of cases. The aetiology was dominated by idiopathic causes. Treatment with testosterone enanthate was more effective in pre-pubertal children than in adults. Conclusion: The diagnosis of micropenis associated or not with cryptorchidism is late because of the frustrations, taboos and psycho-social states that it causes. However, drug treatment is effective when treatment is started early.

关键词： Micropenis Cryptorchidism Hospital Environment Ivory Coast

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Compliance with Oral Anti-Diabetic Treatment in Lome

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Open Journal of Internal Medicine 2024年第1期14卷 53-63页

作者： Tchamdja Toyi Djalogue Lihanimpo kodjo Kossi Kaaga Laconi Yéba Mossi Komi Edem M’bortché B. kodjo Ehon Ata Edem Djibril Mohaman Awalou Balaka Abago Internal Medicine Departement Université de Kara Kara Togo Internal Medicine Departement Université de Lomé Lomé Togo

Objective: The objective of this study was to assess adherence to antidiabetic therapy in type II diabetic patients and factors associated with Lomé. Method: This was a descriptive observational study conducted among diabetics in diabetes care centers from May 1, 2020 to October 1, 2020, for a period of 6 months. Results: A total of 300 patients were questioned. The mean age was 56.61 years (standard deviation = 11.7). The sex ratio was 0.6. All the patients were on drug treatment, 83.4% of whom were on metformin and 37.5% on Glibenclamide. In 58.3% of the cases, the patients were on dual therapy and 96.2% had an abovenormal glycated hemoglobin value. There was a medication adherence problem with poor adherence in 30.7%. Being aged 50 and over (ORC = 1.78, p = 0.048), playing sports (ORR = 1.87, p = 0.046), have reaching a higher level of education (ORR = 5.78, p = 0.005) significantly increased the chances of patients having a good/minimal problem of adherence. Conclusion: Diabetes affects in Togo, more women than men with a predominance of those aged 50 and over. Adherence to therapy remains a challenge.

关键词： Type II Diabetes Metformin Compliance Associated Factors

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Validation of the TOPAS Monte-Carlo Code of the Off-Field Dose of a 6 MV Synergy Linac

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Journal of Biosciences and Medicines 2024年第7期12卷 38-54页

作者： kodjo Joel Fabrice N’Guessan Ibrahima Sakho Bogbé D. L. H. Gogon Department of Physics and Chemistry Faculty of Sciences and Technology Iba Der Thiam University of This This Senegal International Cancer Center of Dakar Dakar Senegal Department of Physics Faculty of Sciences and Technology Flix Houphouet Boigny University of Abidjan Abidjan Cte dIvoire

The risk of radiation-induced second cancer and the late tissue loss due to Off-field doses in radiotherapy remain a serious concern. Monte Carlo (MC) simulation is currently one of the most accurate methods for calculating these doses. MC simulation model based on the Particle Simulation Tool (TOPAS) has been developed to simulate the off-field dose of an Elekta Synergy linear accelerator (Linac) emitting 6 MV photons. Measurements were taken in a water phantom using an ionization chamber to validate this model. The Percentage Depth Dose (PDD) at the depth of 0.0, 5.0, 10.0 and 15.0 cm from the beam axis for a 10 × 10 cm2 field size was measured and simulated. Off-field dose profiles at the depth of 1.5 (dmax), 5.0 and 10.0 cm for field sizes of 5 × 5, 10 × 10, 15 × 15, and 20 × 20 cm2 respectively were measured and simulated. Comparison of measured and simulated off-field dose values showed a good agreement. The average gamma passing rate of the PDDs and profiles curves for off-field doses were 87.5% and 98.11% respectively. The local dose difference based on the PDD curve between the measured and simulated was less than 6.0 % for all locations. For all field size considered in this study, the average difference between profile curves for off-field dose measured and simulated was 9.1%. PDDs and Profiles curves for off-field dose simulation uncertainties were less than 2.0% and 1.0% respectively. TOPAS-MC simulation model developed is a good representation of our 6 MV Linac Elekta Synergy for assessing off-field dose, which would be the primary cause of some secondary cancers.

关键词： Radiotherapy Off-Field Dose Secondary Cancer TOPAS-MC Simulation Dosimetry

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Viral Hepatitis B and C: Epidemiological, Clinical and Paraclinical Aspects in the Internal Medicine Department of KARA University Hospital in Togo

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Open Journal of Internal Medicine 2024年第1期14卷 131-139页

作者： Lihanimpo Djalogue Mossi Komi Edem El Hadj Yacoubou Tchamdja Toyi Djagadou kodjo Agbeko Balaka Abago Djibril Mohaman Awalou Internal Medicine Department University of Kara Kara Togo Internal Medicine Department University of Lome Lome Togo Hepato-Gastroenterology Department University of Kara Lomé Togo

Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases;those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.

关键词： Hepatitis B Hepatitis C Internal Medicine Kara University Hospital

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East African Cassava Mosaic Virus and East African Cassava Mosaic Cameroon Virus: Two Species Emerging in Togo

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Agricultural Sciences 2024年第8期15卷 864-876页

作者： Senya Sakina Allado Kossikouma Djodji Adjata Justin Simon Pita kodjovi Atassé Dansou-kodjo Assion Sétu Mivedor Koffi Tozo Laboratoire de Virologie et de Biotechnologies Vgtales Ecole Suprieure dAgronomie (ESA) Universit de Lom Lom Togo Laboratory of Plant Virology Universit Flix Houphout-Boigny Ple Scientifique et dInnovation Bingerville Cte dIvoire Laboratoire de Physiologie et Biotechnologies Vgtales Facult des Sciences Universit de Lom Lom Togo

Cassava mosaic disease (CMD) caused by the whitefly-transmitted Begomoviruses (family Geminiviridae) is a major threat to production of cassava (Manihot esculenta Crantz) in Togo. Survey was conducted in 2020 in the 5 agroecological zones of Togo to assess the status of East African cassava mosaic virus (EACMV), East African cassava mosaic Cameroon virus (EACMCMV) and its distribution. Polymerase chain reaction (PCR) and Sanger sequencing were used for the detection of cassava mosaic Begomoviruses (CMBs) in the sampled leaves. The incidence of EACMV was 47.93% (278/580) and varied between 41.30% (Zone V) and 62.29% (Zone IV) across the agroecological zone but no significant difference was observed. The EACMCMV incidence was 13.67% (38/278) and varied significantly (p ≤ 0.001) through the agroecological zone. Phylogenetic analysis of the viral isolates showed that they are closely related to those from Nigeria, Ghana, and Ivory coast. Nucleotide sequence analysis of CP revealed an overall genetic diversity (π) of around 3.4%. These results showed that EACMV was the predominant virus and that EACMCMV incidence could be more widespread in Togo.

关键词： Begomovirus PCR EACMV EACMCMV Togo Genetic Diversity

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Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology Department of KARA Teaching Hospital (Togo)

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Open Journal of Urology 2024年第1期14卷 20-26页

作者： Musapudi Éric Mbuya Komi Hola Sikpa Edoe Viyome Sewa Messan Semefa Agbedey Gnimdou Botcho kodjo Tengue Tchilabalo Matchonna Kpatcha Urology and Andrology Department Kara Teaching Hospital Kara Togo Urology and Andrology Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Surgery Department University Clinics of Lubumbashi Lubumbashi DRC Aneho Prefectural Hospital Center Aneho Togo Urology and Andrology Department Kpalime Prefectural Hospital Center Kpalime Togo Urology and Andrology Department Sokodé Regional Hospital Center Sokodé Togo Urology and Andrology Department Sylvanus Olympio Teaching Hospital Lomé Togo

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

关键词： Internal Urethrotomy Urethral Stenosis Kara Togo

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