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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

Hand Hygiene by Ward Staff at Dapaong Regional Hospital in Togo

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Open Journal of Nursing 2023年第2期13卷 95-112页

作者： Essohanam Tabana Mouzou sarakawabalo assenouwe Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim Tchetike Pikabalo School of Health Sciences University of Kara Kara Togo Anesthesia and Intensive Care Service University Hospital of Kara Kara Togo Medical Intensive Care Service University Hospital of Kara Kara Togo Traumatology and orthopedic Service University Hospital of Kara Kara Togo Anesthesia and Intensive Care Service Sylvanus Olympio University Hospital of Lomé Lomé Togo

Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at Dapaong regional hospital (DRH). Methodology: This was a prospective, descriptive cross-sectional study conducted from March to June 2022 in the DRH wards. Data were collected using a questionnaire and observation grid. Results: 90 care providers were surveyed. Males and non-physician personnel predominated with 57.8%, and 94.4% respectively. The survey on staff’s knowledge reported: 31.1% of practitioners did not wash their hands on arrival and departure in services. 24% did not know the difference between simple hand washing (SHW) and hygienic hand washing (HHW). 23.3% did not know the type of soap to use for HHW. The caregivers did not know the type of hand washing (HW) required after a septic and non-septic procedure in respectively 41.6%, and 37.8%. They did not know that there are two types of hand antiseptics (45.4%), nor the amount of antiseptic for HW (78.9%). The survey on staff’s attitude regarding HW found that: 70% did not remove all jewels prior HW, and 51.1% did not know that wearing gloves cannot replace the HW. For HW Staff Practice: 62.2% did not wash their hands before treatment. 91.1% did not spread the soap on their hands and forearms after wetting them. 65.55% did not rinse hands from nails to elbows. Conclusion: The HH was poorly known, the attitude of the staff was dangerous in relation to the HH and the practice of HH was very inadequate at the RHC-Dapaong. As a result, there is a need to retrain staff to increase their capacity to prevent care-related infections and enhance patient safety in the hospital.

关键词： Hand Hygiene Care Providers Hand Washing Antiseptics Dapaong Regional Hospital

Early Postoperative Deaths in the Surgical Intensive Care Unit of CHU-Kara

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Open Journal of Internal Medicine 2023年第1期13卷 32-50页

作者： Essohanam Tabana Mouzou sarakawabalo assenouwe Pikabalo Tchetike Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim Department of Anesthesia and Intensive Care at CHU-Kara Kara Togo Anesthesia Resuscitation Service at CHU-Sylvanus Olympio in Lomé Lomé Togo Medical Resuscitation and Nephrology Department of CHU-Kara Kara Togo Trauma Service CHU-Kara Kara Togo

Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. Anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.

关键词： Mortality Early Postoperative Surgical Resuscitation CHU-Kara Togo

Practice of Pediatric Spinal Anesthesia in a Country with Limited Means: Example of Togo

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Open Journal of Anesthesiology 2023年第2期13卷 32-45页

作者： Essohanam Tabana Mouzou sarakawabalo assenouwe Pikabalo Tchetike Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim Resuscitation Anesthesia Department at the Kara-CHU Kara Togo CHU-Sylvanus Olympio Anesthesia Resuscitation Department in Lome Lome Togo Medical Resuscitation and Nephrology Service of the CHU-Kara Kara Togo CHU-Kara Traumatology Department Kara Togo

Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in pediatric surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in pediatric surgery at CHU SO de Lomé, in the operating room and hospital ward of CHU Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.

关键词： Pediatric Surgery Spinal Anesthesia Togo

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 facility.Methods: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 31,2021.Data were collected from medical records and databases.Results:54 Patients aged(62.9±13.3)years were included.Among these cases,79.6%had at least one comorbidity.On admission,all patients had hypoxia.The 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 patients.NIV failed in 90.2%of cases and succeeded in 9.8%.IMV was successful in 5.4%of cases,vs.94.6%of mortality.The 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 rate.Shortcomings are identified in ventilation strategies,protocols,and monitoring.Required improvements were also proposed.

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