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Characteristics, Management, and Outcomes of Tetanus Cases in a Referral Center in Senegal, between 2010 and 2017

Advances in Infectious Diseases 2023年第3期13卷 375-388页

作者： Daouda Thioub ndeye Aissatou Lakhe Khardiata Diallo Mbaye Papa Latyr Junior Diouf Catherine Sarr ndeye Amy Sarr Aboubakar Sidikh Badiane Mamadou Seck ndeye maguette fall Viviane Marie Pierre Cisse-Diallo Daye Ka Moussa Seydi Louise Fortes Department of Infectious and Tropical Diseases Fann National University Hospital Dakar Senegal Department of Infectious and Tropical Diseases Dalal Jamm National Hospital Guediawaye Senegal

Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiology and treatment, tetanus remains a real public health problem, particularly in developing countries. Tetanus in children and adults is still a frequent cause of hospitalization in the Infectious and Tropical Diseases Department (SMIT) of the Fann National University Hospital (CHNU). We conducted this study with the main objective of carrying out a situational analysis of tetanus at SMIT from 2010 to 2017. We recorded 706 cases of tetanus in a total of 8123 hospitalized patients. The median age of the patients was 23 years [1 - 90 years]. The sex ratio (M/F) was 4/1. More than half (58.78%) came from suburban areas. The population was most frequently made up of students (24%) or manual workers (22.1%). At least one comorbidity was present in 107 patients (15.15%). The absence of a vaccination record was found in 99.56%. The main portal of entry was integumentary (83.3%), post-circumcision (5.7%) and otogenous (4%). Tetanus was generalized in 93.9% of cases. The main signs of tetanus found were trismus and dysphagia. Patients were most frequently classified as stage II (78.7%). Antibiotic therapy was based on metronidazole (51.41%). Anti-tetanus serotherapy was carried out by sub-occipital administration in 97.6%. Tracheostomy was performed in 48 patients. Complications occurred in 226 patients (32.01%). The main complications were respiratory (53.98%), infectious (45.13%) and cardiovascular (41.59%). The average delay in hospitalization was 3.6 ± 3.4 days. The mean length of hospital stay was 11.9 ± 8.2 days. The hospital case-lethality rate was 18.98%. Despite the decline in cases over the years in our country, tetanus remains a public health problem because of its prevalence, severity, and lethality.

关键词： Tetanus Management Outcomes Senegal

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Neuro-meningeal Tuberculosis in Adult Senegalese Patients: Profile and Outcome of Cases Diagnosed at a Referral Service, from 2015 to 2020

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Case Reports in Clinical Medicine 2023年第8期12卷 270-278页

作者： Daouda Thioub Viviane Marie Pierre Cisse-Diallo Papa Latyr Junior Diouf ndeye Aissatou Lakhe Agbogbenkou TeviDéla-dem Lawson Aboubakar Sidikh Badiane ndeye maguette fall Khardiata Diallo-Mbaye Daye Ka Sylvie Audrey Diop Moussa Seydi Infectious and Tropical Diseases Department of Fann National University Hospital Dakar Senegal Health Sciences Training and Research Unit Iba Der Thiam University Thiès Senegal

Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16 - 77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%). Meningeal signs were present in 94.55% of patients, and consciousness disorders and intracranial hypertension were present in 63.64% and 56.36% respectively. Nerve palsy was found in 38.18%. CSF was clear in 81.64%. GeneXpert MTB/RIF in CSF was performed in 33 patients and was positive in 4 patients. Brain CT was abnormal in 72.09% of cases. Tuberculoma, hydrocephalus and meningeal contrast enhancement were the main lesions. The neuro-meningeal localization was associated with a pulmonary form i

关键词： Neuro-meningeal Outcome Profile Senegal Tuberculosis

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Groundwater Geochemistry and Saltwater Intrusion in the Dakar Coastal Area, Senegal

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Journal of Geoscience and Environment Protection 2022年第12期10卷 45-64页

作者： Ousmane Coly Diouf Lutz Weihermüller Mathias Diedhiou Edgar Y. Terence Benam Beltoungou ndeye maguette Dieng Seynabou Cissé Faye Harry Vereecken Serigne Faye Geology Department Faculty of Sciences and Techniques Cheikh Anta Diop University of Dakar Dakar Senegal Forschungszentrum Jülich GmbH Agrosphere Institute IBG-3 Jülich Germany

Groundwater levels and water samples were collected from 20 drinking water pumping and piezometer wells in the urban area of Dakar coastal region in the year 2019. The pH-value, electrical conductivity, as well as calcium, magnesium, sodium, potassium, chloride, sulfate, bicarbonate, and nitrate concentrations were measured to assess the hydrochemical quality of the infrabasaltic aquifer in the area. The present work carried out a hydrochemical analysis to interpret the groundwater chemistry of the aquifer. The results of this chemical analysis indicate that Na+ > Mg2+ > Ca2+ > K+ was the most dominant cation sequence in the groundwater, while Cl- > HCO3- > SO42- > NO3- was the most dominant one for anions. The chemical analysis of our samples showed, that the Cl-Ca-Mg facies was dominant in the aquifer, while Cl-Na-K and HCO3-Na-K facies represent 20% and 10% of the groundwater sampled, respectively. A comparison of the measured groundwater quality in relation to WHO drinking water quality standards revealed that 80% of the water samples are suitable for drinking purposes. Ca enrichment, Simpson ratio, ratio of sodium chloride, and calculating Base Exchange (BEX) indices for the samples revealed that the groundwater is mainly affected by three factors: seawater intrusion due to aquifer overexploitation on one hand, and freshening processes and nitrate pollution, on the other, mainly caused by the groundwater flow from the unconfined aquifer.

关键词： Coastal Groundwater Major Ions Hydrochemical Facies Anthropogenic Activities Nitrate Pollution

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