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Prevalence and Factors Associated with Virologic Failure among People Living with HIV (PLHIV) Monitored in a Decentralized Health Care Facility

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Advances in Infectious Diseases 2019年第3期9卷 226-237页

作者： Selly ba ndeye diama ba Lamanatou Sembene Habibatou Dia Mohamed Coulibaly Jean Louis Ndiaye ndeye Méry Dia Cheikh Tidiane Ndour Doctoral School of Thies University Thies Senegal Intrahealth International Dakar Senegal Roi baudouin Hospital Dakar Senegal AIDS Monitoring Unit/Ministry of Health Dakar Senegal Department of Health Gaston Berger University Saint Louis Senegal

Introduction: In Senegal, the decentralization of Health Care Centers has contributed significantly to the intensification of antiretroviral treatment. However, Care providers are still facing the treatment optimizing challenge. Objectives: To determine the prevalence of virologic failures of PLHIV monitored in a decentralized Health care center and to determine associated factors. Patients and Methods: This is a cross-sectional descriptive and analytical study of PLHIV, aged 18 years and over, on first-line treatment, monitored onsite from February 1st to December 31st, 2018. A data collection form was completed from medical records (clinical, immuno-virologic and evolutionary). Any VL > 1000 cp/ml after 6 months of antiretroviral therapy (ART) was considered as virologic failure. Data were captured and analysed using the EPI INFO 2002software. Chi-square test and the Fisher test were used to compare the proportions;a value of p ≤ 0.05 was considered significant. Results: 331 patients were treated with HIV-1 profile in 89% of cases. A proportion of 55% was married and 97% came from rural areas. 80% were either not or poorly educated. The median of age was 44 ± 11 years with a F/M ratio of 3.4. At baseline, 56% were symptomatic at stage 3 or 4 of WHO. They had severe immunosuppression with a median CD4 count of 217 ± 187 cells/mm3, the viral load was detectable in half of the patients with a median VL of 97,000 cp/ml ± 70,569. The antiretroviral regimen combined 2 NRTIs with 1 NNRTI in 88% of cases. The median of follow-up was estimated at 60 ± 43 months. The prevalence of virologic failure was 19%. This prevalence was associated with age less than 25 years (p = 0.04), late diagnosis (CD4 at baseline less than 200 cel/mm3 (p = 0.002), stage 3 or 4 WHO (p = 0.04) High viral load greater than 10,000 (p = 0.04) at baseline. Conclusion: These results suggest making the new therapeutic classes accessible for first-line treatment.

关键词： ART Virologic Failure Associated Factors

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Factors Associated with Adverse Therapeutic Outcomes in People Living with HIV (PLHIV) Monitored in Roi baudouin Health Care Center, Dakar, Senegal

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World Journal of AIDS 2020年第1期10卷 23-35页

作者： Selly ba ndeye diama ba Lamanatou Sembene Thierno Souleymane baal Anne Habibatou Dia Jean Louis Ndiaye ndeye Mery Dia badiane Cheikh Tidiane Ndour Doctoral School of Thies University Thies Senegal Intrahealth International Dakar Senegal Roi baudouin Hospital Dakar Senegal Department of Health Gaston Berger University Saint Louis Senegal AIDS Department/Ministry of Health Dakar Senegal

background: Optimizing antiretroviral therapy is an essential step to reach the 90 - 90 - 90 targets. Despite tremendous progress made for antiretroviral treatment (ART) to be accessible in countries with limited resources, health care providers continue to face challenges due to the under-optimization of ART due to therapeutic failures and poor retention. Objectives: To determine the prevalence of adverse therapeutic outcomes in a decentralized health care center and to determine associated factors. Patients and Methods: This is a cross-sectional descriptive and analytical study targeting PLHIV, aged 18 years and over, on first line antiretroviral treatment (ART), monitored onsite from February 1st to December 31st, 2018. A data collection form was completed from medical records (clinical, immuno-virological, therapeutic and evolutionary). Data were also collected from interviews with patients for additional socio-demographic information including the level of HIV knowledge. Data were captured and analyzed using EPI 2002 and R software. Proportions were compared using the chi -square and Fisher tests and logistic regression. A value of p baseline, 56% were symptomatic at WHO stage 3 or 4. They had severe immunosuppression with a median CD4 count of 217 ± 187 cells/mm3;the viral load was detectable in half of the patients with a median viral load (VL) of 97,000 ± 70,569 cp/ml. The antiretroviral regimens combined 2 nucleoside reverse transcriptase inhibitor (NRTI) with 1 no nucleoside reverse transcriptase inhibitor (NNRTI) in 88% of the cases. The median duration of follow-up was estimated

关键词： Antiretroviral Treatment Adverse Therapeutic Outcomes Associated Factors

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Ecthyma Gangrenosum about a Case at the Centre Hospitalier Roi baudoin de Guédiawaye in Senegal

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Open Journal of Pediatrics 2022年第4期12卷 652-656页

作者： Jean baptiste Niokhor Diouf Hadja Mariama barry Louis Philippe Sarr Ndèye diama ba Pediatric Department Centre Hospitalier Roi Baudouin de Guédiawaye Guédiawaye Senegal Saint Christopher Iba Mar Diop School of Medicine-Pharmacy-Dental Dakar Senegal

background and Aim: Ecthyma gangrenosum (EG) is a rare necrotic skin infection caused by Pseudomonas aeruginosa occurring on healthy skin mainly, but not exclusively, in immunocompromised patients. We report the case of EG of unusual presentation in a 12-month-old infant. Case Presentation: This was a 12-month-old male infant who was referred from a peripheral structure for the treatment of facial swelling associated with fever. In his antenatal and intra nasal history, there was a notion of hospitalization for 15 days for early neonatal infection and a delay in psychomotor development. The admission examination showed the fair general condition, hyperthermia at 39°C, tachycardia at 136 beats/minute, and polypnea at 48 cycles/minute. The weight-for-height index with a z-score of 3DS was also found. The dermatological examination at the entrance found an extensive brownish inflammatory tense infiltrated plaque taking the mandibular, submental, retro-auricular occipital regions rapidly evolving towards necrosis, a significant swelling predominant on the upper right eyelid preventing the opening of the associated eyes to mouth ulceration. Biological abnormalities were predominantly neutrophilic leukocytosis, elevated CRP, and elevated muscle enzymes. Microbiological examination of skin samples had isolated Pseudomonas aeruginosa. He had received antibiotic therapy, and a necrosectomy under general anesthesia. The evolution was favorable and he was discharged from the hospital on D26 of hospitalization. Conclusion: This observation is rare due to its location, its early onset, and non-neutropenic background.

关键词： Ecthyma Gangrenosum Pseudomonas aeruginosa Infant

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Ecthyma Gangrenosum about a Case at the Centre Hospitalier Roi baudoin de Guédiawaye in Senegal

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Open Journal of Pediatrics（儿科学期刊） 2022年第4期

作者： jean baptiste niokhor diouf hadja mariama barry louis philippe sarr ndèye diama ba

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