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Macrophage Activation Syndrome in a Context of Pre-B Type Lymphoblastic Acute Leucemia: A Case Report

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Open Journal of Blood Diseases 2023年第4期13卷 141-147页

作者： Mamadou Wagué Gueye Sokhna Moumi Mbacké Daffé Mor Ngom maguette ndoye Papa Silman Diawara Nata Dieng Demba Makalou Macoura Gadji Macoura Gadji Awa Oumar Touré/Fall Bécaye Fall Laboratory Federation H&#244pital Principal de Dakar (HPD) Dakar Senegal Onco-Hematology H&#244pital Principal de Dakar (HPD) Dakar Senegal Laboratory CHR Saint-Louis Saint Louis Senegal Biological Hematology and Oncological Hematology Department (BOHD) Centre National de Transfusion Sanguine (CNTS)/FMPOS-UCAD Dakar Senegal Biology H&#244pital Aristide Le Dantec (HALD) Dakar Senegal

Macrophage activation syndrome (MAS) is linked to inappropriate stimulation of macrophage cells in the bone marrow and lymphoid system, resulting in abnormal phagocytosis of figurative blood elements and the release of pro-inflammatory cytokines. It is a rare and serious hyper-inflammatory condition of diagnostic and therapeutic emergency. MAS is characterized by non-specific clinical and laboratory signs associated with images of hemophagocytosis. MAS is either “primary” (familial or pediatric forms), or “secondary/reactive” to infection, neoplasia, or autoimmune disease. Hemopathies dominate MAS secondary to neoplasia. B-type acute lymphoblastic leukemia (ALL) is a hematological malignancy characterized by the proliferation and accumulation of B lymphoid progenitors, blocked at an early stage of differentiation, leading to suppression of polyclonal hematopoiesis and subsequent development of signs associated with bone marrow failure. In this context, we report the observation of a macrophage activation syndrome (MAS) associated with ALL, diagnosed at Hôpital Principal de Dakar/Senegal, in a 69-year-old patient with a well-controlled type 2 diabetes under oral antidiabetic therapy (OAD) and good general condition.

关键词： Macrophage Activation Syndrome Acute Lymphoblastic Leukemia Adult

Hepatitis B in Senegalese Blood Donors: Low Prevalence after Five Blood Donations?

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Advances in Infectious Diseases 2022年第3期12卷 422-432页

作者： Papa Silman Diawara Mamadou Wague Gueye Sokhna M. Daffe Mor Ngom maguette ndoye Nata Dieng Ibrahima Diallo Bécaye Fall Macoura Gadji Moustapha Diop Pape Samba Ba Yankhoba Diop Federation of Laboratories Principal Hospital of Dakar Dakar Senegal Hematology Department Dakar Principal Hospital Dakar Senegal Hepato-Gastro-Enterology Department Dakar Principal Hospital Dakar Senegal Department of Biological Hematology & Oncology—Hematology (HBOH) National Blood Transfusion Center (CNTS)/FMPOS-UCAD Dakar Senegal Infectious Diseases Department Dakar Principal Hospital Dakar Senegal

Background: Over the past two decades, blood transfusion safety has made significant advances in the fight against infectious diseases. However, hepatitis B is still a problem in blood banks due to its high endemicity in Senegal. In this context, we proposed to first determine the prevalence of HBs antigen (HBsAg) in regular and new blood donors. Second, to determine the influence of the number of blood donations on the prevalence of hepatitis B. Materials and Method: We conducted a retrospective transversal study using data from all blood donations received at the Principal Hospital of Dakar Blood bank from July 2007 to December 31, 2021. Hepatitis B testing was carried out with Automaton E411 (Roche Diagnostics). For all donors, information on age, sex, hepatitis B serology, and the number of donations was collected through the lab’s computer system. Data entry and statistical analysis were performed with Epi-info version 7. Results: HBsAg carriers were identified in 4311 primary donors, corresponding to a prevalence of 12.39% (IC 95% = 12.04 - 12.74). The prevalence of the HBsAg antigen was higher in men (12.9%) than in women (6.85%). Men are twice as likely to be infected with HBV as women (OR = 2.00 (IC 95% = 1.85 - 2.17)). The highest prevalence (12.4%) was found in young adults (23 - 29) years old. After 10 donations, the prevalence of the HBs antigen was stable at around 1%. Individuals with a single blood donation and individuals with 2 to 5 blood donations are 9 and 7 times more likely to carry the HBs antigen than regular donors (more than 10 blood donations), respectively. Conclusion: Our results demonstrate the endemic nature of hepatitis B in Senegal. On the other hand, the non-negligible prevalence of the virus in first-time donors reminds us of the need for continuous improvement in donor selection. These first-time donors, particularly young adults, are important indicators of transmission of the virus to the general population. This study also demo

关键词： First-Time Donor Regular Donor Hepatitis B Prevalence

Neonatal Thrombocytopenia at Dakar Principal Hospital

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Advances in Infectious Diseases 2023年第4期13卷 586-595页

作者： Guèye Mamadou Wagué Fall Khadija Gadji Macoura Diawara Papa Silman ndoye maguette Nakoulima Aminata Diop Daffé Sokhna Moumi Mbacké Ngom Mor Fall Mbène Niang Tagouthie Seye Meissa Ndew Fall Bécaye Laboratory Federation Dakar Principal Hospital (DPH) Dakar Senegal Pediatrics Department Dakar Principal Hospital Dakar Senegal Biological Hematology and Oncological Hematology Department (BHOH) National Blood Transfusion Centre (CNTS)/FMPOS Cheikh Anta Diop University Dakar Senegal

Neonatal thrombocytopenia accounts for 20% of neonates hospitalized in the neonatal intensive care unit (NICU) at DPH. The etiologies are multiple, but bacterial infection is the third leading cause of neonatal mortality worldwide. We therefore set out to assess the frequency of neonatal thrombocytopenia associated or not with bacterial infection in the NICU. We conducted a retrospective and prospective study with the DPH NICU, over 10 months (August 2018 and April 2019). Thrombocytopenia encountered in the NICUs, were the subject of research into bacteriological, inflammatory, and epidemiological parameters using Inlog laboratory data processing software. During this period, 1280 babies were hospitalized, 94 of whom underwent thrombocytopenia, corresponding to 7.34%, with a sex ratio of 0.92. The number of babies presenting with thrombocytopenia during the first week of hospitalization was 72, accounting for 76.6%. The clinical context was usually low birth weight in 30.8% of cases and perinatal asphyxia (25%). Thrombocytopenia ranged from 2000 to 137,000 with an average of 69,520/mm3. Among these thrombocytopenias, 64 cases (68%) were below 100,000 mm3 and 44 cases had a CRP >5 mg/l. A total of 30 bacteria were isolated, including 23 Enterobacteria, 2 Streptococci, and 1 Acinetobacter. Among these enterobacteria, 14 were multidrug-resistant (MDR). Thrombocytopenia associated with a multidrug-resistant bacterial infection is a real challenging management.

关键词： Neonatal Thrombocytopenia Bacterial Infection Enterobacteria Newborns

Profiling Hepatitis B Viral Load: Treatment and Epidemiological Implications in a West African Hospital

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Advances in Infectious Diseases 2022年第4期12卷 703-714页

作者： Papa Silman Diawara Mor Ngom maguette ndoye Mamadou Wague Gueye Sokhna M. Daffe Nata Dieng Ibrahima Diallo Bécaye Fall Macoura Gadji Moustapha Diop Pape Samba Ba Yankhoba Diop Federation of Laboratories Principal Hospital of Dakar Dakar Senegal Hematology Department Dakar Principal Hospital Dakar Senegal Hepato-Gastro-Enterology Department Dakar Principal Hospital Dakar Senegal Department of Biological Hematology & Oncology-Hematology (HBOH) National Blood Transfusion Center (CNTS)/FMPOS-UCAD Dakar Senegal Infectious Diseases Department Dakar Principal Hospital Dakar Senegal

Background: Chronic hepatitis B virus (HBV) infection is one of the largest public health problems with nearly 350 million chronic carriers and 500,000 deaths each year. These deaths are most often associated with disease progression to cirrhosis or hepatocellular carcinoma, which some studies have shown is associated with long-term viral replication in chronic carriers. Viral load quantification, a key element of disease management, is expensive and difficult to access. Viral load plays a crucial role in patient classification and treatment initiation. Four years after the implementation of viral load platform, the objective of this study was to assess viral load profile in HBs chronic carriers in a sub-Saharan Hospital and to determine the potential impact of this distribution on preventive and therapeutic strategies against hepatitis B infection. Materials and Method: The study was carried out between April 2016 and October 2020 in the laboratory of the PRINCIPAL Hospital in Dakar. All patients referred for HBV DNA viral load testing following a positive AgHBs test were included. Incomplete medical records were excluded from the study. Only the first quantification test performed on each patient is recorded. DNA extraction was performed with COBAS AmpliPrep (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Amplification was performed using COBAS TaqMan48 (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Data were collected from the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: A total of 3002 patients, 76.1% (2285/3002) men and 33.9% (717/3002) women, were included in the study. Young adults were most represented among the subjects (23.2%) and (20.1%) in the age groups 25 - 30 and 30 - 35. The majority (52.7%) of patients had viral loads between 20 and 2000 IU. Patients with undetectable viral loads and patients with viral loads below 20 IU comprised 14.6% and

关键词： Hepatitis B Viral Load Senegal Treatment

Bacteremia in Subjects with Sickle Cell Disease: High Rate of Gram-Negative Isolates in the West African Context!

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Journal of Biosciences and Medicines 2023年第2期11卷 15-29页

作者： Papa Silman Diawara Sokhna Moumy Daffe Mamadou Wague Gueye Khadija Fall Moustapha Diop Aminata Diop Nakoulima Tagoutie Niang Mbene Fall Alice Ingabire Mor Ngom maguette ndoye Nata Dieng Bécaye Fall Macoura Gadji Meissa Ndew Seye Pape Samba Ba Yankhoba Diop Federation of Laboratories Dakar Principal Hospital Dakar Senegal Pediatrics Department Dakar Principal Hospital Dakar Senegal Infectious Diseases Department Dakar Principal Hospital Dakar Senegal Hematology Department Dakar Principal Hospital Dakar Senegal Department of Biological Hematology & Oncology-Hematology (HBOH) National Blood Transfusion Center (CNTS)/FMPOS-UCAD Dakar Senegal

Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functional asplenia (associated with repeated thrombosis of splenic vessels), resulting in increased susceptibility to infection. However, several studies have reported differences in the spectrum of bacterial infections in malaria-endemic areas. Therefore, we proposed to conduct a study to determine the rate of positive blood cultures and the bacteriological spectrum in sickle cell patients. Materials and Method: This is a descriptive cross-sectional study of blood culture samples from patients who received a request for hemoglobin electrophoresis as part of their treatment at the Principal’s hospital in Dakar. The study took place from January 2008 to December 2021. For each patient, we collect demographic information, including age, gender, and the service from which the analysis request originated. Data were collected in the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: Our study included 1419 patients. The most common types of hemoglobin profiles were: normal profile (n = 1025), AS profile (n = 283), SS profile (n = 104), SC profile (n = 7). This corresponds to the proportions of 72%, 20%, 0.5% and 7.5% for the profiles Normal, AS, SC and SS. The male proportion was 61.1%, 61.5%, 57.1, respectively %, 55.8% for Normal, SA, SC, and SS profiles. A total of 19,090 individual blood culture bottles were collected from 1419 impatient patients as follows: Normal profile (n = 18,042 bottles), AS profile (n = 677 culture bottles), SS profile (n = 362 bottles). The majority of blood culture orders come from pediatric services, accounting for 70% of the total number of orders. Of 19,090 vials examined in this current study, 19.6% developed a positive blood culture. Overal

关键词： Sickle Cell Disease Senegal Bacteremia Blood Culture Infection

The Outcome of Endoscopic Third Ventriculostomy in a Mixed Population of Adult and Pediatric Patients

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Open Journal of Modern Neurosurgery 2020年第3期10卷 325-333页

作者： maguette Mbaye Lebrun Gahito Alioune Badara Thiam Mbaye Thioub Elcheikh Ndiaye Sy Mohameth Faye Sagar Diop Moustapha Ndongo Ndaraw ndoye Momar Code Ba Seydou Boubakar Badiane Neurosurgical Department of Fann Teaching Hospital Cheikh Anta Diop University Dakar Senegal

Background: Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has been a safe alternative to ventriculoperitoneal shunt (VP shunt), which has a high complication rate with significant socio-economic consequences. The authors report the results of ETV performed in the neurosurgical department of FANN teaching hospital in Dakar. Methods: This retrospective study presents the results of ETV performed in 513 patients with hydrocephalus of various etiologies, ranging from February 2010 to February 2018. We have included in our series from 2010 to 2016, all patients with clinically revealed non-communicating hydrocephalus followed by a brain computed tomography (CT) scan or brain magnetic resonance imaging (MRI) and who have benefited from an ETV, in which the ETV Success Score was evaluated. Results: The mean age of our patients was 14.10 years, with 298 (58%) males. The clinical symptomatology varied in both children and adults and manifested in children as macrocrania in 67.8% of the patients, while in adults, it manifested as raised intracranial pressure (ICP) in 87.5% of patients. A brain CT scan was performed in 461 (89.86%) of patients. The causes of hydrocephalus were dominated in 49% of patients by malformative pathologies, followed by tumors in 41% of patients, infections in 2.33% of patients, and normal-pressure hydrocephalus in 3.8% of patients. During the postoperative period, we found 21.41% of various complications. Conclusions: The findings in our series were compared to those in the literature and were satisfactory, thus proving the effectiveness and safety of ventriculocisternostomy in our department. In resource-limited countries, ETV can be performed with good results and less mortality and morbidity.

关键词： Endoscopic Third Ventriculostomy Hydrocephalus Minimally Invasive Neurosurgery

Inventory of Radiation Protection in Hospitals of Level III in Senegal

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Open Journal of Biophysics 2021年第4期11卷 397-406页

作者： Boucar Ndong Sidi Ahmed Dia Mamadou Salif Djigo Herbert Fachinan El Hadji Lamine Bathily Ousseynou Diop Kanta Ka Gérard Léra Kelvin Akpo El Hadji Fallou Diouf Louis Auguinstin Diaga Diouf Pape Mady Sy Alphonse Djiboune Gora Mbaye maguette Diagne Omar ndoye Mamadou Mbodji Laboratoire de Biophysique Médecine Nucléaire Universite Cheikh Anta Diop Dakar Senegal Service de Médecine du Travail Universite Cheikh Anta Diop Dakar Senegal Faculté de Médecine Université de Parakou Parakou Benin Service de Radiothérapie de Dalal Jamm Dakar Senegal Service de Radiologie de l’Hô pital Aristide Le Dantec Dakar Senegal Laboratoire de Physique Pharmaceutique Universite Cheikh Anta Diop Dakar Senegal Service de Radiothérapie de l’Hô pital Aristide Le Dantec Dakar Senegal

The aim of this study was to evaluate the level of protection of employees who are exposed to radiation in a level III hospital establishment. It was a descriptive cross-sectional survey of six months’ duration, involving eight level III Hospitals (Aristide Le Dantec, Fann, Hoggy, Hear, Abass Ndao, Pikine, Touba, and Thiès) in Senegal. Sixty-one of the one hundred questionnaires were recovered (overall response rate of 61%). The population of the study was mainly female (54.1%). The average age was 38.57 with extremes ranging from 23 to 65 years old. In the places where ionizing radiation sources are handled, only at the Aristide Le Dantec Hospital did we find a “competent person in radiation protection”. This explained the lack of a classification of employees and work areas. Forty out of sixty-one (73.77%) had no knowledge of the basic principles of radiation protection (justification, optimisation, dose limitation) and had not ever taken radiation holidays. For radiovigilance, exposure time limits to ionizing radiation concerned only 29/61 or 47.54% of the study population. The inverse square law of distance was known by only 40 workers, of whom 15 had no compliance. We found the presence of dosifilms in only 7/61 or 11.47% of the workers. On the other hand, the use of lead aprons was well established and concerned 57/61 workers, i.e., 93.44%. In sum, ionizing radiation causes adverse health effects. The absence of a good radiation protection culture in Senegal requires the presence of at least 4 to 5 competent persons in radiation protection for quality training of workers in radiobiology, radiopathology and radiation protection.

关键词： Ionizing Radiation Radiation Protection Workers Senegal