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Chronic Kidney Disease (CKD) in Patients Living with HIV under Antiretroviral Treatment: Prevalence and Risk Factors

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Open Journal of Nephrology 2019年第4期9卷 87-96页

作者： Yawovi Mawufemo Tsevi Abdou Razak Moukaila lidaw Déassoua bawe Hubert Yao Nephrology and Hemodialysis department Sylvanus Olympio Hospital of Lomé University of Lome-Togo Lomé Togo Internal Medicine department Sylvanus Olympio Hospital of Lome University of Lome-Togo Lome Togo Infectious and Tropical Diseases department Sylvanus Olympio Hospital of Lome University of Lome-Togo Lome Togo Internal Medicine department Treichville University Hospital Université of Cocody (Ivory Coast) Abidjan Ivory Coast

CKD is one of the major complications when infected by HIV. The surveillance of CKD indicators and control of its determinants in the HIV-infected population in our African communities is essential. This was a descriptive and analytical cross-sectional study of people living with HIV received at the Ambulatory Treatment Center (ATC) at Infectious Diseases department of Sylvanus Olympio University Hospital (CHU-SO). The study period was 6 months—from January 1, 2018 to June 30, 2018—CKD was defined by a clearance below 60 ml/min/1.73 m2 for at least 3 months. A total of 117 patients were enrolled during the study period. The average age of patients for trial treatment was between 9.49 and 42.0 7 years. The duration of follow-up for antiretroviral treatment was ±3.22 to ±5.64 years. The female gender was predominant (70.09%) with a sex ratio (M/F) of 0.43. Most of people living with HIV were mostly classified at clinical stage 2 (31.03%) and 3 (31.90%) of WHO at initiation of HAART. The main CD4 rate was 223.30 ± 143.764 at initiation of HAART and 462.58 ± 202.723 at the time of the study. The majority of patients were placed in a fixed combination of Tenofovir/Lamivudine/Efavirenz in a proportion of 81.20% cases. CKD was found in 13 patients—that is 11.11% of patients. Univariate analysis shows that age greater than 45 years plus (p = 0.017) and pathological proteinuria (p = 0.021) were associated with CKD. In multivariate analysis, only ages (p = 0.045) and pathological proteinuria (p = 0.035) were significantly associated with CKD. The prevalence of CKD in HIV-infected patients is significant in Togo. The occurrence of proteinuria is linked to the delay in taking antiretroviral therapy.

关键词： CKD HIV HAART Togo

Acute Kidney Injury during Coronavirus Disease in Togo

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Open Journal of Internal Medicine 2023年第1期13卷 8-15页

作者： Yawovi Mawufemo Tsevi lidaw Déassoua bawe Kofi Atsu Aziagbe Badomta Dolaama Edem Cruz Affanou Kodjo Agbeko Djagadou 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

Background: Acute kidney injury (AKI) is frequently reported in the context of coronavirus infection. The incidence of AKI, particularly in patients hospitalized in intensive care units, is high. The aim was to study the associated factors to mortality in acute kidney injury (AKI) during COVID-19 in Togo. Method: This was a cross-sectional analytical study with retrospective data collection. It involved all patients hospitalized at CHR-LC from March 2020 to August 2021 suffering from COVID-19 who presented an AKI. Results: We identified 113 cases of acute kidney injury according to the predefined criteria. The prevalence of AKI during COVID-19 was 3.90%. Subjects over 65 years of age were the most represented. The age extremes were 17 and 85 years. The sex ratio (M/F) was 2.89. The main factors significantly associated with the severity of acute kidney injury were diabetes, asthma, HIV infection, and stroke. There was a correlation between the degree of acute kidney failure and severity on admission. Patients with AKI severity 2 and 3 were on hemodialysis. There was a statistically significant correlation between intra-hospital mortality and the severity of acute kidney injury (p = 0.04). The intra-hospital mortality rate was 23%. Conclusion: Acute kidney injury (AKI) during COVID-19 is a real concern for clinicians. Its medical care involves a multidisciplinary team. Particular emphasis should therefore be placed on the management of comorbidities and preventive nephroprotection measures.

关键词： Acute Kidney Injury COVID-19 Lomé (Togo)

The COVID-19 Vaccine Acceptance in Hemodialysis Patients in Togo

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Open Journal of Nephrology 2022年第1期12卷 162-168页

作者： Yawovi Mawufemo Tsevi Agbeko Kodjo Djagadou Awèréou Kotosso lidaw Déassoua bawe Abdou-Razak Moukaïla Awalou Mohaman Djibril Nephrology and Hemodialysis department Sylvanus Olympio University Hospital Lomé Togo Infectious and Tropical Diseases department Sylvanus Olympio University Hospital Lomé Togo Internal Medicine department Sylvanus Olympio University Hospital Lomé Togo

Introduction: Wide adoption of vaccination is the key to successfully control the spread of coronavirus 2019 (COVID-19). Objective: To evaluate the acceptability of COVID-19 vaccines and associated factors in hemodialysis patients in Lomé. Patients and Method: Cross-sectional study was conducted from August 1 to 31, 2021 in hemodialysis patients at the Sylvanus Olympio University Hospital to obtain their opinion on the anti-COVID-19 vaccination. Results: One hundred and twenty-three patients on regular hemodialysis were interviewed;their mean age was 45 years [37 - 55.5 years]. The average number of years patients were on dialysis was 3 years [2 - 5 years]. The general opinion on vaccination was mostly unfavorable (59.3%). Reasons given included: doubts about the quality of the vaccine (49.6%), fear of side effects (51.2%), alarming messages on social networks (36.5%) and doubts about the efficacy of the vaccines (33.3%). Only half of the patients in favor of vaccination were already vaccinated at the time of the survey. The main motivations for getting vaccinated were dominated by: fear of developing a severe form of COVID-19 if infected (32.5%), frailty due to age (19.5%) and medical history (15.4%). Social networks (72.3%), television (60.1%), family and friends (55.2%) were the main sources of information for patients about COVID-19 vaccination. Conclusion: Hemodialysis patients are mostly septic to anti-COVID-19 vaccination.

关键词： Acceptance Vaccination Covid-19 Hemodialysis 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

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

Mechanical ventilation and outcomes in COVID-19 patients admitted to intensive care unit in a low-resources setting: A retrospective study

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Journal of Acute Disease 2023年第5期12卷 186-191页

作者： Sarakawabalo Assenouwe Tabana Essohanam Mouzou Ernest Ahounou lidaw Déassoua bawe Awèréou Kotosso Koffi Atsu Aziagbe Eyram Makafui Yoan Amekoudi Mamoudou Omourou Chimene Etonga Anoudem Komi Séraphin Adjoh National COVID-19 Referral Hospital Regional Hospital of LoméCommuneLoméTogo Faculty of Health Sciences University of KaraKaraTogo Faculty of Health Sciences University of Abomey-CalaviCotonouBénin Faculty of Medicine University of OttawaOttawaCanada

Objective:To describe the strategies and outcomes of mechanical ventilation in a poorly equipped ***:This retrospective descriptive study included patients with COVID-19 who were admitted to the intensive care unit(ICU)and mechanically ventilated between September 1,2020,and May 31,*** were collected from medical records and ***:54 Patients aged(62.9±13.3)years were *** these cases,79.6%had at least one *** admission,all patients had *** median peripheral oxygen saturation in room air was 76%(61%,83%).Non-invasive ventilation(NIV)was performed in 75.9%of the patients,and invasive mechanical ventilation(IMV)in 68.5%.IMV was performed on patients due to severe coma(8.1%),failure of standard oxygen therapy(27.0%),and failure of NIV(64.9%).An arterial blood gas test was performed in 14.8%of the *** failed in 90.2%of cases and succeeded in 9.8%.IMV was successful in 5.4%of cases,vs.94.6%of *** overall mortality rate of patients on ventilation in the ICU was 88.9%.The causes of death included severe respiratory distress syndrome(85.2%),multiple organ failure(14.8%),and pulmonary embolism(13.0%).Conclusions:The ventilation management of COVID-19 patients in the ICU with NIV and IMV in a scarce resource setting is associated with a high mortality *** are identified in ventilation strategies,protocols,and *** improvements were also proposed.

关键词： Coronavirus disease 2019 Intensive care unit Hy-poxia Invasive ventilation Non-invasive ventilation Arterial blood gas

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

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

COVID-19 Vaccination Status and Severe Outcomes among Patients Hospitalized for COVID-19 in West Africa, Togo, 2021

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Advances in Infectious Diseases 2024年第1期14卷 87-104页

作者： Awèréou Kotosso Yao Rodion Konu lidaw Déassoua bawe Sarakawabalo Assenouwe Yawovi Mawufemo Tsevi Koffi Atsu Aziagbe Akouda Akessiwe Patassi Bawoubadi Abaltou Gnimdou Tchamdja Lampouguini Nebona Komi Séraphin Adjoh Didier Ekouevi Majesté Ihou Wateba Faculté des Sciences de la Santé Université de Lomé Lomé Togo Centre Hospitalier Régional Lomé Commune Lomé Togo Service des Maladies Infectieuses Centre Hospitalier Universitaire Sylvanus-Olympio Lomé Togo Unité de Recherche Mixte 1219 Bordeaux Population Health Centre University of Bordeaux National Institute for Health and Medical Research (INSERM) Research Institute for Sustainable Development (IRD) Bordeaux France Département de Santé Publique Université de Lomé Lomé Togo Faculté des Sciences de la Santé Université de Kara Kara Togo Service d’Anesthésie et Réanimation Centre Hospitalier Universitaire Kara Kara Togo Service de Néphrologie et d’Hémodialyse Centre Hospitalier Universitaire Sylvanus-Olympio Lomé Togo Service de Pneumo-Phtisiologie Centre Hospitalier Universitaire Sylvanus-Olympio Lomé Togo

Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to describe the impact of COVID-19 vaccination on the prognosis of hospitalized patients. Methods: This was a retrospective cohort study of patients admitted to the Centre Hospitalier Régional Lomé Commune (Togo) between June 1, 2021 and May 31, 2022. Primary outcomes (admission to the intensive care unit and death) were presented with frequency and proportion. Mortality rates were presented by sociodemographic and clinical characteristics and compared by appropriate statistical tests. Factors associated with inpatient death were described by performing a Cox proportional hazard regression. Results: A total of 604 patients were hospitalized (50.0% women). The mean age was 54.03 ±17.1 years. Only 55 patients were fully vaccinated (9.1%). ICU admission was significantly more frequent in unvaccinated patients than in vaccinated ones (63.0% vs. 38.2%;p Conclusion: COVID-19 vaccination had a significant benefit for patients with COVID-19 infection in terms of reducing the risk of death. Based on real-world data from sub-Saharan Africa, this information can help optimize the benefit of COVID-19 vaccination by raising community awareness and increasing vaccine coverage while reducing hesitancy.

关键词： COVID-19 Vaccination Prognosis Mortality Sub-Saharan Africa