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Factors Associated with Death among Tuberculosis Patients in Dakar

Advances in Infectious Diseases 2021年第2期11卷 122-139页

作者： Moustapha Diop papa Samba Ba Jean Augustin Diegane Tine Ndèye Maguette Fall Tracie Youbong Mouhamadou Ndiaye Ndèye Mouminatou Mbaye Mouhamed Bouye Nestor Diatta Alassane Sarr Sokhna Walo Ndiaye Ibrahima Cisse Louise Fortes Degenonvo Abdourahmane Niang Adama faye Moussa Seydi Department of Infectious and Tropical Diseases Dakar Principal Hospital Dakar Senegal Health and Development Institute Cheikh Anta Diop University of Dakar Dakar Senegal Department of Infectious and Tropical Diseases FANN Teaching Hospital Dakar Senegal Department of Pulmonology Dakar Principal Hospital Dakar Senegal Faculty of Medicine and Odontology Cheikh Anta Diop University of Dakar Dakar Senegal Private Institute for Training and Research in Medicine Dakar Senegal

Introduction-Objective: Tuberculosis (TB) is the leading cause of death from a single infectious agent worldwide. The predictors of mortality due to TB are rarely evaluated in Senegal. The aim of our study was to identify factors associated with related TB death in two treatment centers in Dakar, Senegal. Method: We conducted a prospective descriptive-analytical study dealing with TB patients followed in the Department of Infectious and Tropical Diseases at FANN Teaching Hospital and Dakar Principal Hospital and in the Department of Pulmonology at Dakar Principal Hospital from March 1st, 2019 to February 29th, 2020. Univariate and multivariate logistic regressions were performed to identify the associated factors of death. Results: Two hundred eighty-two patients in the Department of Infectious and Tropical Diseases at FANN teaching hospital (57%), in the Department of Infectious and Tropical Diseases at Dakar Principal Hospital (31%), and in the Department of Pulmonology at Dakar Principal Hospital (12%) were included in the study. The mean age was 39 ± 16 years and the male to female ratio was 2.2. Isolated pulmonary TB, isolated extrapulmonary TB, and both pulmonary and extrapulmonary TB were present in 33.3%, 30.5% and 36.2% of cases, respectively. Twenty-two patients died, corresponding to a mortality rate of 7.8%. Factors independently associated with death were age ≥ 60 years (26.2 [3.6 - 191.2]) compared to 16 - 40 years’ age group, HIV infection (7.2 [1.4 - 36.9]), neurological localization of TB (13.19 [3.2 - 54.3]), and hemoglobin level Conclusion: Tuberculosis remains a fatal disease despite therapeutic advances. Better knowledge of associated factors of death from TB may help to reduce its mortality.

关键词： Tuberculosis Death Associated Factors Dakar

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Descriptive and Analytical Study of Factors Associated with Mortality in Severe Malaria among Children in Dakar Emergency Departments from July to December 2022

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Open Journal of Pediatrics 2023年第6期13卷 866-878页

作者： Aliou Thiongane Abou Ba Fatou Ly Aliou A. Ndongo Djibril Boiro Younoussa Kéita Idrissa Basse Babacar Niang Indou Dême Ly Yaye Joor Dieng Djenaba Fafa Cissé Ndiogou Seck Lamine Thiam papa Moctar faye Amadou Lamine Fall Assane Sylla Ousmane Ndiaye Centre Hospitalier National d’Enfants Albert Royer Dakar Sénégal Service de pédiatrie Hô pital Dalal Jamm Dakar Sénégal Service de pédiatrie Hô pital Pikine Dakar Sénégal Service de pédiatrie Hô pital Abass Ndao Dakar Sénégal Centre Hospitalier National d’Enfants de Diamniadio Dakar Sénégal Service de pédiatrie Hô pital régional Saint Louis Sénégal Service de pédiatrie Hô pital de la paix de Ziguinchor Ziguinchor Sénégal

Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and analytical study of the factors associated with mortality during severe malaria in children attending emergency departments in Dakar, Senegal. Methods: This is a prospective, observational and analytical study conducted over a 6-month period (July 1 to December 31, 2022), focusing on children hospitalized for severe malaria according to WHO severity criteria. Results: A total of 403 patients were hospitalized, including 78 cases of severe malaria (19.35%). Males predominated (60.26%) (sex ratio 1.51). The average age was 6.56 years [8 months - 14 years], with the [5 - 10 years] age group the most represented (40.26%). The average consultation time was 5.33 days (1 - 19 days). The main reasons for consultation were fever (70.51%), vomiting (24.35%) and convulsions (14.10%). Biological signs of severity were severe anemia (17.95%), renal failure (6.4%) and hypoglycemia (3.85%). Thrombocytopenia was noted in 52.56% of patients, including 32.05% of severe cases (sis in 61.41% of cases. Hyponatremia was noted in 39.74% of cases and hyperkalemia in 2 patients. Artesunate was the main drug used (93.59% of cases). Mortality was estimated at 1.5%. Factors leading to death were coma (P < 0.01), respiratory distress (P Conclusion: Malaria is still a public health problem, with a high mortality rate in emergency departments. Reducing this mortality rate requires effective management of the factors associated with death.

关键词： Children Malaria Death Factors

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Evolutionary Profile of Graves’ Disease in Children at Albert Royer National Children Hospital in Dakar

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Open Journal of Pediatrics 2019年第2期9卷 119-125页

作者： Babacar Niang Lamine Thiam Fatou Ly Indou Dème Ly Djibril Boiro Amadou Sow Aliou Thiongane Aliou Abdoulaye Ndongo Aminata Mbaye Younoussa Keita Abou Ba Idrissa Demba Ba Yaay Joor Dieng Dienaba Fafa Cissé papa Matar faye Amadou Lamine Fall Ousmane Ndiaye Albert Royer National Children Hospital Center Dakar Senegal La Paix Hospital Ziguinchor Senegal Pediatric Ward University Hospital Center of Pikine Dakar Senegal Pediatric Ward University Hospital Center of Abass Ndao Dakar Senegal Pediatric Ward University Hospital Center of Aristide Le Dantec Dakar Senegal

Graves’ disease is the most common cause of hyperthyroidism. Adequate management is an area of controversy, especially when it comes to children. The objective of our study was to assess the outcome of Graves’ disease treatment in Albert Royer Children Hospital of Dakar. This was a retrospective study conducted from 2001 to 2015, and which involved all children between 0 to 15 years of age who were being monitored in the Albert Royer National Children Hospital. The evolutionary modalities were: stability, remission, failure, relapse, lost to follow-up and death. The data were analyzed with SPSS software version 20.0. For the comparisons, the KHI 2 or Fisher test was used with a significance threshold (p < 0.05). During the study period, 88 children were enrolled. The average age was 8.6 years [ranging from 8 months to 15 years]. The consultation delay was 11.36 months. In our study, 61.4% of the patients were regular in the follow-up, the observance was good in 40.9% of the cases and 19 patients (21.6%) were lost to follow-up. Clinical courses of 69 children after treatment with Carbimazole for 37 months were promising in 21 cases (30.43%), with 17 cases of remission (24.63%) and 4 cases of stability (5.8%). Age older than 10, the initial ATD dose greater than 1 mg/kg/day and the initial free T4 lower than 50 pmol/l were significantly associated with remission with a p value of 0.01;0.024 and 0.004.

关键词： Graves’ Disease Child Antithyroid Drug Remission Senegal

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A Severe COVID-19 Infection in Neonates: A Case Report

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Journal of Biosciences and Medicines 2021年第12期9卷 118-123页

作者： Idrissa Demba Ba Mohameth Mbodj Fatim Tall Serigne T. Ndiaye Safietou Dieye Mouhamed Fattah Amadou Sow Ndeye F. Sow Awa Kane Aita Seck Aminata Mbaye Alioune M. Coundoul Khadim Bop Pape S. Sow Amadou L. Fall papa M. faye Ousmane Ndiaye Albert Royer National Children Hospital Dakar Senegal Cheikh Anta DIOP University Dakar Senegal Abass Ndao Hospital Center Dakar Senegal

Coronavirus disease (COVID-19) is a highly contagious infectious disease. First case was reported at the end of 2019 in China. Children and neonate population appears to be relatively free of the virus. We reported a severe and fatal neonate case of COVID-19 in a 22 days old neonate female due to the delta variant strain during the third wave outbreak. She presented with fever, cough, grunting and diarrhea started 5 days before admission. Physical exam’s revealed severe respiratory distress, hypoxia and bilateral pulmonary condensation. PCR test for COVID-19 was positive. Chest X-ray found bilateral infiltrates. Chest CT showed diffuse ground glass images with 75% of lung parenchymal involvement. She was treated with antibiotics, corticostoid, respiratory support (CPAP and oxygen). Death occurred after 15 days of hospitalization in the context of multiple organ failure and pulmonary hypertension.

关键词： COVID-19 Hypoxia Newborn Variant Delta Senegal

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Primary Immune Deficiencies (PID): Diagnosis Challenges

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Open Journal of Pediatrics 2021年第3期11卷 388-392页

作者： Indou Deme/ly Awa Kane Mame Sokhna Gueye Ibrahima Diop Mame Tene Ndiaye Abou Ba Idrissa Demba Ba Babacar Niang Aliou Thiongane Yaay Joor Dieng Yaye Fatou Mbodj/Diop Ouafae Achnin papa Moctar faye Amadou Lamine Fall Ibrahima Diagne Tandakha Ndiaye Dièye Ousmane Ndiaye Albert Royer National Children’s Hospital Center Université Cheikh Anta Diop Dakar Senegal National Blood Transfusion Center Dakar Senegal Health Science Unit Gaston Berger University Saint -Louis Senegal

Background: Primary Immune Deficiencies (PID) are rare, under-determined diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. Aim: Our aim was to share the challenge of diagnosis and treatment in PID. Case Presentation: It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decreased level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants requires a substitution for life of immunoglobulin which is unavailable in our countries. Conclusion: PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.

关键词： Primary Immune Deficiencies Hypo-Gammaglobulinemia Infants

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Risk Factors for COVID-19 Related Death during the First Three Waves of the Pandemic in an Epidemic Treatment Center at Dakar, Senegal

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Advances in Infectious Diseases 2023年第2期13卷 117-131页

作者： Moustapha Diop papa Samba Ba Viviane Marie Pierre Cisse Ndèye Aissatou Lakhe Betty Fall Moustapha Lo Ndong Essomba Bruce Wembulua Fatimata Wone Becaye Fall Khardiata Diallo-Mbaye Daye Ka Louise Fortes Ousmane faye Ndongo Dia Khalifa Ababacar Wade Abdou Rajack Ndiaye Amadou Alpha Sall Moussa Seydi Mame Thierno Dieng Epidemic Treatment Center Dakar Principal Hospital Dakar Senegal Infectious and Tropical Diseases Department FANN Teaching Hospital Dakar Senegal Psychiatry Department Dakar Principal Hospital Dakar Senegal Internal Medicine Department Deido District Hospital Douala Cameroon Dalal Jamm Hospital Dakar Senegal Federation of Laboratories Dakar Principal Hospital Dakar Senegal Pasteur Institute of Dakar Dakar Senegal Anesthesia-Resuscitation Department Dakar Principal Hospital Dakar Senegal Dakar Principal Hospital Dakar Senegal

Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of Dakar Principal Hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: Our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.

关键词： COVID-19 Waves Death Risk Factors Dakar

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