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Medical Ultrasound Practice in Developing Countries: Example of Togo

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Open Journal of Radiology 2018年第4期8卷 217-222页

作者： Pihou Gbande Kokou Adambounou Lantam Sonhaye Lama Kegdigoma Agoda-Koussema komlavi adjenou Radiology Department Campus Teaching Hospital Lomé Togo Radiology Department Sylvanus Olympio Teaching Hospital Lomé Togo

Background: Ultrasound has become the most widely practiced medical imaging examination even in developing countries because of its non-irradiating, non-invasive nature and its relatively affordable cost. Objective: The objective of this study was to review the practice of medical ultrasound in Lomé city. We carried out a descriptive cross-sectional study using the pre-established fact sheets. It took place from 16 August to 30 November 2013 in the healthcare facilities of the city of Lomé. Results: A total of 47 centers were surveyed, including 14 public centers and 33 private centers. The ultrasound scanners were mostly acquired in the new state (59.6%) with only 34.1% of these ultrasound scanners equipped with the Doppler mode. There were 3 ultrasound scanners (6.4%) that had a 3D probe. Radiologists were the ones who carried out most of the ultrasound examinations in public centers, while in private they accounted for half of the performers (45.5%). Physicians enrolled in a specialty in radiology played a significant role in these private structures, accounting for 24.2% of performers. Cardiac ultrasound was performed only in 2 centers (4.2%). The ultrasound report was available in all public centers using the pre-established and standardized forms. The qualification of sonographers and the status of ultrasound scanners are relatively acceptable. Conclusion: Ultrasound scanners were mostly acquired in new condition. Radiologists remained the ones who carried out the largest number of ultrasound examination in Lomé.

关键词： Ultrasound Practice Sonographer Radiologist Togo

Biometrics of the Cervical Spinal Canal and Cord by Computer Tomography in Togo

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Open Journal of Radiology 2017年第1期7卷 45-53页

作者： Abdoulatif Amadou Lantam Sonhaye Kossivi Apetse Komlan Amoussou Mazamaesso Tchaou Bidamin N’timon Kahabilou Atsa Agbangba Gani Watara komlavi adjenou Department of Radiology Campus University Teaching Hospital of Lomé Lomé Togo Department of Neurology Campus University Teaching Hospital of Lomé Lomé Togo Department of Radiology Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of Radiology University Teaching Hospital of Kara Kara Togo

Studies on the canal dimensions of the cervical spinal are rare in Africa. The aim of this study is to provide normal values of the cervical spinal canal and spinal cord dimensions of adult people in Togo. It was about a twelve-year prospective study conducted in the main Hospitals of Campus Teaching Hospital. This study involved people of more than 18 years who neither presented any clinical sign nor rachis defect. The distances measured were antero-posterior 1 (APD1) and inter-pedicular (IPD) of the cervical spinal canal, the antero-posterior 2 (APD2) and the transverse (TD) diameters of the cervical spinal cord, followed with APD2/APD1 (R1) and TD/IPD (R2) research reports. The mean age was 38 +/- 9.34 years old. The average of APD1 of the cervical spinal canal stood at 15.41 ± 0.55 mm, with a minimum of 10.48 ± 0.57 mm and a maximum of 25.00 ± 2.60 mm. The IPD average stood at 23.27 ± 1.67 mm with a minimal average of 13.68 ± 1.46 mm and a maximal average of 33.68 ± 1.46 mm. The average of DAP2 was 11.66 ± 0.66 mm, with a minimum of 10.7 ± 0.66 mm and a maximum of 12.77 ± 0.66 mm. The DT average stood at 15.55 ± 1.54 mm, with a minimal average of 14.03 ± 2.43 mm and a maximal average of 17.63 ± 1.82 mm. The ratio R1 (APD2/APD1) average was 0.80 ± 0.04, with a minimum of 0.76 ± 0.06 and a maximum of 0.85 ± 0.07. The ratio R2 (TD/IPD) average stood at 0.69 ± 0.14, with a minimum of 0.5 ± 0.12 and a maximum of 0.84 ± 0.08. The cervical spinal canal and the cervical spinal cord diameters in Togo are not significantly different from those described above.

关键词： Cervical Spinal Canal Cervical Spinal Cord Biometrics CT Scan-Togo

Mechanical Confining of Sinonasal Anatomic Variants by Computer Tomography in Togo

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Open Journal of Radiology 2017年第2期7卷 85-94页

作者： Abdoulatif Amadou Mawuena Yao Dansou Lantam Sonhaye Komlan Amoussou Mazamaesso Tchaou Bidamin N’timon Kahabilou Atsa Agbangba Gani Watara komlavi adjenou Department of Radiology Campus University Hospital of Lomé Lomé Togo Department of Radiology Sylvanus Olympio University Hospital of Lomé Lomé Togo Department of Radiology University Hospital of Kara Kara Togo

Objective: Determine the frequency of the sinonasal mechanical anatomic variants by CT Scan. Patients and method: Six-month retrospective study concerning sinus CT scans in the registers of Teaching Hospitals’ Imaging Services of Lomé and Kara (TOGO). It involves patients without distinction of sex, of over 15 years without anomaly that can lead to a modification of the normal anatomical configuration of the paranasal sinuses’ cavities. The analysis has been made by only one radiologist. Results: The frequency of mechanical sinonasal anatomic variants stood at 91.87%. The narrowing of the middle nasal turbinate was the variant mostly observed (55.03%), dominated by the deviation of the nasal septum whose frequency was 25.48%. The narrowing of the infundibulum represented 10.80% of population. They were more represented by the Haller cell which displayed a frequency of 3.60%. The variants venturing to narrow the upper nasal turbinate, represented only by extra turbinates, involved 1.02% of the population. The other variants of mechanical sinonasal anatomic variants represented 25.02%. They were dominated by the maxillary sinus septa (11.2%). Our study showed a feminine predominance which is statistically important for Haller cells (p = 0.037) and the ethmoidbulla hypertrophy (p = 0.0036). Conclusion: The anatomic variants of mechanical sinonasal are very frequent in Togo.

关键词： CT Scan Anatomic Variants Mechanical Confining Paranasal Sinuses

Doppler Ultrasound of Hepatic Vessels in the Diagnosis of Cirrhosis of the Liver in Togo

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Open Journal of Radiology 2018年第1期8卷 53-63页

作者： Lantam Sonhaye Abarchi Habibou Boube Abdoulatif Amadou Bérésa Kolou Mohaman Djibril Bidamin Ntimon Mazamaesso Tchaou Nouhou Mamoudou Garba Lama Kègdigoma Agoda-Koussema komlavi adjenou Department of Radiology University Teaching Hospital of Lomé Lomé Togo Department of Internal Medicine University Teaching Hospital of Lomé Lomé Togo Department of Radiology University Teaching Hospital of Kara Kara Togo

The aim of this work is to evaluate the role of Ultrasound-Doppler in the hemodynamic study of hepatic vessels during the liver cirrhosis in Togo. Method: This was an analytic cross-sectional study that measured the velocimetric parameters of hepatic vessels in cirrhotic patients and in non-cirrhotic patients. Results: The velocimetric parameters of the hepatic artery, the portal vein, and the hepatic veins were measured in 50 cirrhotic patients and 50 non-cirrhotic The caliber of the portal vein was significantly increased in cirrhotic patients compared to non-cirrhotic patients with 13.11 ± 2.16 mm versus 11.45 ± 1.02 (p Conclusion: The hemodynamic study of the hepatic vessels can and must rightly be a diagnostic argument for liver cirrhosis.

关键词： Doppler Hepatic Vessels Diagnosis Cirrhosis Togo

Echo-Mammographic and Anatomo-Pathological Aspects of Male Breast Cancer in Togo

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Open Journal of Radiology 2017年第4期7卷 250-258页

作者： Bidamin N’timon Tchin Darré Massaga Dagbé Pihou Gbandé Abdoulatif Amadou Mazamaesso Tchaou Lantam Sonhaye Samadou Aboubakari Kodzo Selom Edi Lama Kègdigoma Agoda-Koussema komlavi adjenou Department of Radiology University Teaching Hospital of Kara Kara Togo Department of Pathology Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of Radiology Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of Radiology Campus University Teaching Hospital of Lomé Lomé Togo Department of Obstetrics and Gynecology University Teaching Hospital of Kara Kara Togo

Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lomé. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.

关键词： Male Breast Cancer Mammography-Ultrasound Pathology Togo

Economic and Psychosocial Impacts of Health Evacuations Abroad for Coronary Angioplasty in Togolese Patients

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World Journal of Cardiovascular Diseases 2021年第12期11卷 583-592页

作者： Mouhaman-Inouwa Kpelafia Soulemane Pessinaba Abdou Razak Moukaila Marodégueba Barma Nkenon Watani N’Da Yawo Dodzi Molba Atti Ekpé Togbossi komlavi Yayehd Findibe Damorou Department of Cardiology CHU Campus University of Lomé Lomé Togo Department of Internal Medicine University of Lomé Lomé Togo

Introduction: Coronary artery disease is the leading cause of premature death worldwide. The management of its severe form requires angioplasty, not yet available a year ago in Togo, which motivated the evacuation of Togolese patients with this disease. Objectives: To evaluate the cost of angioplasty and the economic and psychosocial impacts in evacuated Togolese patients. Methodology: This was a three-year descriptive and prospective study (January 2015 to December 2018) that included all Togolese patients evacuated for coronary angiography from 4 health facilities in the city of Lomé. Results: The mean age was 56.8 ± 11 years. There was a male predominance with a sex ratio of 2.63. The main countries of evacuation were France (50%), Tunisia (25%) and Ivory Coast (20%). The main indications of coronary angiography were myocardial infarction in 47.5%, NSTEMI (22.5%) and ischemic heart disease (15%). Fifty-five percent of the patients had monotroncular involvement. Angioplasty was performed in 16 patients, 3 patients had bypass surgery and only one patient had medical treatment. Sixty percent of patients received an active stent and 20% a bare stent. The total cost of the 40 evacuations was four hundred and fifty one thousand four hundred and nineteen US dollars (US$451,419). The average cost per evacuation was eleven thousand two hundred and eighty-six US dollars (US$11,286), or 182 times the Togolese minimum wage. At the announcement of the disease and evacuation, 40% had been afraid and 35% had accepted their illness. Fifty-five percent perceived evacuation as a healthy outcome. In 25% of cases the coronary angiography was simple and 20% found it painful. After the coronary angiography 40% had regained hope of recovery, 37.5% had accepted their result and 37.5

关键词： Evacuation Cost Angioplasty Economic Impact ACS

Assessment of Oral Anticoagulation with Vitamin K Antagonists in Patients Living in a Low-Income Country of West Africa

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World Journal of Cardiovascular Diseases 2024年第1期14卷 27-42页

作者： komlavi Yayehd Tchaa Tcherou Hervé Libérus A. Edorh Agossou Defodji Mohamed Kpelafia Ekpé Togbossi Ablawa Adzodo Soulemane Pessinaba Machihude Pio Soodogoua Baragou Findibe Damorou Department of Cardiology Faculty of Health Sciences University of Lomé Lomé Togo Department of Cardiology Faculty of Health Sciences University of Kara Kara Togo

Introduction: Despite the rise of direct oral anticoagulants (DOACs), vitamin K antagonists (VKA) remain the most widely used oral anticoagulants in developing countries. The aim of this study was to estimate the prevalence of good anticoagulation in patients treated with VKA in Lomé and describe associated factors. Methods: This was a cross-sectional study conducted from November 2019 to October 2020 in the cardiology departments of two University teaching hospitals in Lomé (CHU Sylvanus Olympio and CHU Campus), involving patients on VKA for ≥3 months, with a target international normalized ratio (INR) of 2.5 and a therapeutic margin between 2 and 3. The quality of anticoagulation was assessed by the time in therapeutic range (TTR) which was assessed by the Rosendaal method. Good anticoagulation was defined by a TTR > 70%. Results: A total of 344 patients were included (mean age = 58 ± 13.8 years, women = 56.1%). Indications for VKA treatment were represented by venous thromboembolic disease (43.3%), supraventricular arrhythmia (28.2%), severe left ventricular systolic dysfunction (19.8%) and pulmonary hypertension (8.7%). The average TTR was 47.6 ± 20.8%. The rate of good anticoagulation was 17.7%. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol (OR = 11.17;95% CI: 3.2 - 39.6;p = 0.0002), concomitant low-dose aspirin (OR 4.44;95% CI: 1.4 - 13.9;p = 0.01) and INR monitoring exclusively by the patient himself (OR = 4.92;95% CI: 1.5 - 16.3;p = 0.008). The rate of thromboembolic and hemorrhagic complications was each 2.6% and was not correlated with the quality of anticoagulation. Quality of anticoagulation by VKAs was poor in our practice. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol, concomitant low-dose aspirin and monitoring of INR exclusively by the patient himself. Conclusion: The quality of oral anticoagulation by VKAs could be improved in our practice by the creation of antico

关键词： Vitamin K Antagonists Time in Therapeutic Range Lomé Togo

Ventricular Non-Compaction: About the First Cases Reported in Lomé(Togo)

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World Journal of Cardiovascular Diseases 2020年第12期10卷 775-783页

作者： Soodougoua Baragou Soulemane Pessinaba Tchalla Abéna Ekpé Togbossi Wiyaou Kaziga komlavi Yayehd Mohamed Kpélafia Nkenon Watani N’Da El Nassirine Oloudé Machihude Pio Findibe Damorou Cardiology Department Sylvanus Olympio Teaching Hospital Lomé Togo Cardiology Department Campus Teaching Hospital Lomé Togo Cardiology Department Tomde Hospital Kara Togo Cardiology Department Kara Teaching Hospital Kara Togo

Introduction: Ventricular non-compaction, a cardiomyopathy recently described as likely to be rare, belongs to the group of unclassified cardiomyopathy according to European Society of Cardiology. Few studies have been published on the ventricular non-compaction in sub-Saharan Africa. We aim to find out the various aspects, being diagnosis, therapeutic, in Togolese patients carrying the ventricular non-compaction. Methodology: This is a three-year prospective and descriptive study conducted from January 2017 to December 2019 in the two University Hospital of Lomé. Patients having echocardiographic criteria of ventricular non-compaction were included in our study. Results: 10 patients (6 men and 4 women) were diagnosed for ventricular non-compaction during the study period. The mean age of patients was 32.3 years. The most frequent clinical manifestation was heart failure (7 patients). The main electrocardiogram anomaly was left ventricle hypertrophy (9 patients). The preferential segments were: apical (9 cases), apicolateral (8 cases), and septoapical (7 cases). The average ratio of non-compaction/compaction was 3.31. The main complication was thromboembolic event (4 patients). Angiotensin converting enzyme inhibitors and beta-blockers were essentially the medicines used. After a three (3) year follow-up, two (2) of the patients died. Conclusion: Tough ventricular non-compaction has been recently described. It is present in Togo. It displays many clinical manifestations and the prognosis is often guarded.

关键词： Ventricular Non-Compaction Hypertrophy Sub-Saharan Africa Heart Failure Togo

Associated Factors to Poor Blood Pressure Control in Hypertensives Followed Up at the Campus University Hospital of Lome (Togo)

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World Journal of Cardiovascular Diseases 2024年第6期14卷 374-380页

作者： Soulemane Pessinaba Yaovi Mignazonzon Afassinou Wiyao Dieudonné Kaziga komlavi Yayehd Kolani Lamboni Sélim Bolarinwa Mohamed Kpélafia Ekpe Togbossi Akpe Adzodo Machihude Pio Soodougoua Baragou Findibé Damorou Cardiology Department University Hospital of Campus Lome Togo Cardiology Department Sylvanus Olympio University Hospital Lome Togo Cardiology Department Kara University Hospital Kara Togo

Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.

关键词： Hypertension Poor Control Associated factors Togo