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COVID-19 Vaccination Status and Severe Outcomes among Patients Hospitalized for COVID-19 in West Africa, Togo, 2021

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

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Acute Kidney Injury during Coronavirus Disease in Togo

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Open Journal of Internal Medicine 2023年第1期13卷 8-15页

作者： yawovi mawufemo tsevi Lidaw Déassoua Bawe Kofi Atsu Aziagbe Badomta Dolaama Edem Cruz Affanou Kodjo Agbeko Djagadou Awalou Mohaman Djibril Lomé-Commune Regional Hospital National Center for the Care of COVID-19 in Togo Sylvanus Olympio University Hospital of Lomé Lomé Togo

Background: Acute kidney injury (AKI) is frequently reported in the context of coronavirus infection. The incidence of AKI, particularly in patients hospitalized in intensive care units, is high. The aim was to study the associated factors to mortality in acute kidney injury (AKI) during COVID-19 in Togo. Method: This was a cross-sectional analytical study with retrospective data collection. It involved all patients hospitalized at CHR-LC from March 2020 to August 2021 suffering from COVID-19 who presented an AKI. Results: We identified 113 cases of acute kidney injury according to the predefined criteria. The prevalence of AKI during COVID-19 was 3.90%. Subjects over 65 years of age were the most represented. The age extremes were 17 and 85 years. The sex ratio (M/F) was 2.89. The main factors significantly associated with the severity of acute kidney injury were diabetes, asthma, HIV infection, and stroke. There was a correlation between the degree of acute kidney failure and severity on admission. Patients with AKI severity 2 and 3 were on hemodialysis. There was a statistically significant correlation between intra-hospital mortality and the severity of acute kidney injury (p = 0.04). The intra-hospital mortality rate was 23%. Conclusion: Acute kidney injury (AKI) during COVID-19 is a real concern for clinicians. Its medical care involves a multidisciplinary team. Particular emphasis should therefore be placed on the management of comorbidities and preventive nephroprotection measures.

关键词： Acute Kidney Injury COVID-19 Lomé (Togo)

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Predictors of Mortality in Chronic Kidney Disease Patients with Covid-19 in Togo

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Advances in Infectious Diseases 2022年第4期12卷 838-846页

作者： yawovi mawufemo tsevi Lidaw Déassoua Bawe Badomta Dolaama Eyram Yoan Makafui Amekoudi Komlan Georges Tona Awalou Mohaman Djibril Lomé-Commune Regional Hospital National Center for the Care of Covid-19 in Togo Sylvanus Olympio University Hospital of Lomé Lomé Togo University Hospital of Kara Kara Togo

Background: Coronavirus disease mortality is high in people with chronic kidney disease. Method: we present the characteristics and factors associated with mortality of patients hospitalized for Covid-19 and with chronic kidney disease in a descriptive and analytical cross-sectional study of CKD patients admitted to the Lomé Commune Regional Hospital Center (CHR-LC) from March 2020 to August 2021. Results: A total of 127 patients met our inclusion criteria. We found a mortality rate of 48.8% in Lomé (Togo). Factors associated with this mortality in our study were severity of Covid-19 (p Conclusion: Mortality is very high in CKD patients with Covid-19.

关键词： Mortality Covid-19 CKD Togo

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The COVID-19 Vaccine Acceptance in Hemodialysis Patients in Togo

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Open Journal of Nephrology 2022年第1期12卷 162-168页

作者： yawovi mawufemo tsevi Agbeko Kodjo Djagadou Awèréou Kotosso Lidaw Déassoua Bawe Abdou-Razak Moukaïla Awalou Mohaman Djibril Nephrology and Hemodialysis Department Sylvanus Olympio University Hospital Lomé Togo Infectious and Tropical Diseases Department Sylvanus Olympio University Hospital Lomé Togo Internal Medicine Department Sylvanus Olympio University Hospital Lomé Togo

Introduction: Wide adoption of vaccination is the key to successfully control the spread of coronavirus 2019 (COVID-19). Objective: To evaluate the acceptability of COVID-19 vaccines and associated factors in hemodialysis patients in Lomé. Patients and Method: Cross-sectional study was conducted from August 1 to 31, 2021 in hemodialysis patients at the Sylvanus Olympio University Hospital to obtain their opinion on the anti-COVID-19 vaccination. Results: One hundred and twenty-three patients on regular hemodialysis were interviewed;their mean age was 45 years [37 - 55.5 years]. The average number of years patients were on dialysis was 3 years [2 - 5 years]. The general opinion on vaccination was mostly unfavorable (59.3%). Reasons given included: doubts about the quality of the vaccine (49.6%), fear of side effects (51.2%), alarming messages on social networks (36.5%) and doubts about the efficacy of the vaccines (33.3%). Only half of the patients in favor of vaccination were already vaccinated at the time of the survey. The main motivations for getting vaccinated were dominated by: fear of developing a severe form of COVID-19 if infected (32.5%), frailty due to age (19.5%) and medical history (15.4%). Social networks (72.3%), television (60.1%), family and friends (55.2%) were the main sources of information for patients about COVID-19 vaccination. Conclusion: Hemodialysis patients are mostly septic to anti-COVID-19 vaccination.

关键词： Acceptance Vaccination Covid-19 Hemodialysis Togo

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Chronic Kidney Disease (CKD) in Patients Living with HIV under Antiretroviral Treatment: Prevalence and Risk Factors

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Open Journal of Nephrology 2019年第4期9卷 87-96页

作者： yawovi mawufemo tsevi Abdou Razak Moukaila Lidaw Déassoua Bawe Hubert Yao Nephrology and Hemodialysis Department Sylvanus Olympio Hospital of Lomé University of Lome-Togo Lomé Togo Internal Medicine Department Sylvanus Olympio Hospital of Lome University of Lome-Togo Lome Togo Infectious and Tropical Diseases Department Sylvanus Olympio Hospital of Lome University of Lome-Togo Lome Togo Internal Medicine Department Treichville University Hospital Université of Cocody (Ivory Coast) Abidjan Ivory Coast

CKD is one of the major complications when infected by HIV. The surveillance of CKD indicators and control of its determinants in the HIV-infected population in our African communities is essential. This was a descriptive and analytical cross-sectional study of people living with HIV received at the Ambulatory Treatment Center (ATC) at Infectious Diseases department of Sylvanus Olympio University Hospital (CHU-SO). The study period was 6 months—from January 1, 2018 to June 30, 2018—CKD was defined by a clearance below 60 ml/min/1.73 m2 for at least 3 months. A total of 117 patients were enrolled during the study period. The average age of patients for trial treatment was between 9.49 and 42.0 7 years. The duration of follow-up for antiretroviral treatment was ±3.22 to ±5.64 years. The female gender was predominant (70.09%) with a sex ratio (M/F) of 0.43. Most of people living with HIV were mostly classified at clinical stage 2 (31.03%) and 3 (31.90%) of WHO at initiation of HAART. The main CD4 rate was 223.30 ± 143.764 at initiation of HAART and 462.58 ± 202.723 at the time of the study. The majority of patients were placed in a fixed combination of Tenofovir/Lamivudine/Efavirenz in a proportion of 81.20% cases. CKD was found in 13 patients—that is 11.11% of patients. Univariate analysis shows that age greater than 45 years plus (p = 0.017) and pathological proteinuria (p = 0.021) were associated with CKD. In multivariate analysis, only ages (p = 0.045) and pathological proteinuria (p = 0.035) were significantly associated with CKD. The prevalence of CKD in HIV-infected patients is significant in Togo. The occurrence of proteinuria is linked to the delay in taking antiretroviral therapy.

关键词： CKD HIV HAART Togo

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Acute Renal Failure in Hospitals in Togo: Comparative Analysis of HIV Positive Patients and HIV Negative Patients

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Open Journal of Nephrology 2019年第3期9卷 77-86页

作者： yawovi mawufemo tsevi Lidaw Deassoua Bawe Komi Dzidzonu Nemi Akouda Patassi Ihou Majesté Wateba Department of Nephrology and Hemodialysis University Hospital Sylvanus Olympio of Lom&eacute University of Lome Lome Togo Departement of Infectious and Tropical Diseases University Hospital Sylvanus Olympio of Lom&eacute University of Lome Lome Togo Department of Internal Medicine University Hospital Sylvanus Olympio Lom&eacute University of Lome Lome Togo

Introduction: Human Immunodeficiency (HIV) is a risk factor often associated with the occurrence of Acute Renal Failure (ARF). Objectives: To describe the profile of Acute Renal Failure (ARF) in HIV-infected patients and compare them to non-infected patients. Patients and Methods: It was a prospective study from January 2018 to February 2019 that took place in the nephrology, infectious diseases and internal medicine departments of the Sylvanus Olympio University Hospital Center in Lomé (Togo). Results: The prevalence of ARF in HIV-infected patients was 48.07%. HIV-infected patients had an average age of 46.9 ± 11.6 years (p = 0.36) compared to 44.0 ± 20.4 years for non-HIV infected patients. Female sex was predominant in the HIV-infected population with a sex ratio H/F of 0.6 (p 3) in 50% of cases. HIV infected patients had more anemia (52.0% versus 22.2%) with p = 0.002. Conclusion: No deaths were recorded in the HIV-infected group.

关键词： ARF HIV Togo

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Management of Obstructive Renal Failure in Adults at the Sylvanus Olympio University Hospital

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Open Journal of Nephrology 2021年第3期11卷 348-357页

作者： yawovi mawufemo tsevi Edoé Viyomé Sewa Abago Balaka Ablavi Adani-Ifè Eyram Yoan Amekoudi Komi Daniel Dokouvi Department of Nephrology and Hemodialysis Sylvanus Olympio Hospital Lomé Togo Department of Urology Sylvanus Olympio Hospital Lomé Togo Department of Internal Medicine Sylvanus Olympio Hospital Lomé Togo

Background: Obstructive nephropathies are a topical issue in urology and nephrology consultations, but no study has yet been conducted on the subject in our country. Objective: Describe the epidemiological, clinical, therapeutic and evolutionary profile of obstructive nephropathies at the Sylvanus Olympio University hospital of Togo. Method: It was a descriptive and cross-sectional study with a collection of retrospective data over a period of 08 years (2012-2019) which focused on obstructive nephropathies in the Urology-Andrology, Nephrology and Internal Medicine departments at the medical clinic of CHU SO. The diagnosis of obstructive nephropathy is retained on the basis of radiological and medical imaging results. Results: The study population included 131 patients. The annual hospital frequency was 2.84 cases for 100 admissions. The mean age was 56.72 ± 17.76 years. These patients were mostly male (72.52%). The most frequent age group was 60 - 80 years. Common symptoms at presentation were loin pain (45.75%) and dysuria (25.95%). The average length of probable course of the disease before hospitalization was 636.94 ± 258.88 days (21 months). The etiologies of obstructive nephropathy were largely dominated by prostatic tumors in half of the cases (45.80%). Among these patients, 121 have presented renal failure (92.36%). The average serum creatinine at admission was 59.01 ± 21.56 mg/l. Of the 121 patients with obstructive nephropathy presenting renal failure, 54 (44.63%) had decreased their serum creatinine at the output of more than 25%. The open surgery (54.20%) was the main treatment. There was an improvement in kidney function in patients who had a shorter duration of disease progression and who did not have a history of loin pain, oliguria and that the etiologies of the disease were not tumors. Tumoral etiologies, the presence of a history of high blood pressure, oedema of the lower members,

关键词： Obstructive Nephropathy Renal Failure Etiologies Lomé (Togo)

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Chronic Nephropathies in the Internal Medicine Department of the Sylvanus Olympio University Hospital

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Open Journal of Internal Medicine 2021年第3期11卷 140-150页

作者： Agbeko Kodjo Djagadou Toyi Tchamdja Abdou-Bakari Tchala yawovi mawufemo tsevi Abago Balaka Awalou Mohaman Djibril Department of Internal Medicine Sylvanus Olympio University Hospital University of Lomé Lomé Togo Department of Internal Medicine Kara University Hospital University of Kara Kara Togo Department of Nephrology and Hemodialysis Sylvanus Olympio University Hospital University of Lomé Lomé Togo

Introduction: The chronic nephropathies constitute a real global public health concern due to the constant increase in the prevalence estimated between 10% and 15%. In Sub-Saharan Africa, this prevalence has been estimated at 13.9%. This study will allow knowing the epidemiological, clinical, paraclinical and etiological aspects of chronic kidney disease in the internal medicine department of CHU-SO Lomé. Method: This was a cross-sectional, retrospective and descriptive study. It concerned all the patients suffering from a chronic kidney disease, hospitalized between the 1st of January 2014 and the 31st of December 2018, for a duration of 5 years. Results: During our study, 330 cases of chronic nephropathy were identified. The prevalence of chronic kidney disease was 8.3% of admissions. The mean age of the patients was 46.3 years with extremes of 19 and 86 years and a sex ratio of 1.32. A low socio-economic level of patients was observed in 63.9% with an urban origin in 69.7%. The main risk factors for renal impairment were hypertension (55.2%), diabetes mellitus (29.1%), obesity (20.6%), use of nephrotoxic products (19.4%), HIV infection (17%) and smoking (16.1%). The causes were dominated by nephroangiosclerosis (33.3%), followed by diabetic nephropathy (25.5%) and HIV-associated nephropathy (17%). Chronic renal failure was present in 95.8% of cases and was end stage in 69.7% of cases. Anemia was the main complication during the evolution of chronic kidney disease (98.2%). Mortality was 57.3% during hospitalization. Conclusion: Chronic kidney disease is a fairly common reason for hospitalization in the internal medicine department. Emphasis should therefore be placed on preventive measures for hypertension, diabetes and HIV.

关键词： Chronic Kidney Disease Profile CHU Lomé (Togo)

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Antiretroviral Therapeutic Profile in Patients Living with HIV with Chronic Kidney Disease

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Advances in Infectious Diseases 2019年第3期9卷 252-262页

作者： yawovi mawufemo tsevi Lidaw Déassoua Bawe Komi Dzidzonu Nemi Abdou Razak Moukaila Akessiwe Akouda Patassi Majesté Ihou Majesté Ihou Department of Nephrology and Hemodialysis University Hospital Sylvanus Olympio of Lomé University of Lome-Togo Departement of Infectious and Tropical Diseases University Hospital Sylvanus Olympio of Lomé University of Lome-Togo Department of Internal Medicine University Hospital Sylvanus Olympio Lomé University of Lome-Togo

Chronic Kidney disease (CKD) is one of the important complications during HIV infection. The advent of Highly Active Antiretroviral Therapy (HAART) has significantly improved the prognosis of these patients. This was a descriptive and analytical cross-sectional study of people living with HIV received at the Ambulatory Treatment Center (ATC) of the Department of Infectious Diseases of Sylvanus Olympio University Hospital (CHU-SO). The study period was 6 months from January 1, 2018 to June 30, 2018. A total of 234 patients were enrolled during the study period. The mean age of patients at initiation of treatment was 42.07 ± 9.49 years with an average duration of follow-up under antiretroviral treatment of 5.61 ± 3.22 years. The female sex was predominant (70.09%) and a sex ratio (M/F) of 0.43. Most people living with HIV were mostly classified at clinical stage 2 (30.77) and 3 (31.62%) of WHO at initiation of HAART. The mean CD4 rate was 223.30 ± 143.764 at initiation of HAART and 462.58 ± 202.723 at the time of study. The frequency of CKD was 11.11%. The majority of patients were placed in a fixed combination of Tenofovir/Lamivudine/Efavirenz in a proportion of 81.20% of cases. In univariate analysis shows that age greater than 45 years (p = 0.017). Pathological proteinuria (p = 0.021) were associated with CKD. In multivariate analysis, only age (p = 0.045) and pathological proteinuria (p = 0.035) were significantly associated with CKD.

关键词： Therapeutic Profile CKD HIV HAART Togo

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Metabolic Syndrome in People Living with HIV in Lome (Togo): Epidemiological Aspects and Associated Factors

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Open Journal of Endocrine and Metabolic Diseases 2020年第4期10卷 59-75页

作者： Abdou Razak Moukaila Edem Komi Mossi Mouhaman-Inouwa Kpelafia Komi Dzidzonu Nemi Kossi Kodjo Agbeko Kodjo Djagadou Lidaw Déassoua Bawe Akessiwe Akouda Patassi yawovi mawufemo tsevi Ihou Majesté Wateba Awalou Mohaman Djibril Department of Internal Medecine Sylvanus Olympio University Hospital University of Lome Lome Togo Diabetes Academic Afrique Lome Togo Department of Infectious and Tropical Diseases Sylvanus Olympio University Hospital University of Lome Lome Togo Department of Cardiology Campus University Hospital University of Lome Lome Togo Department of Nephrology and Hemodialysis Sylvanus Olympio University Hospital University of Lome Lome Togo

Introduction: People living with HIV (PLWHIV) are exposed to Metabolic Syndrome (MS), which increases their risk of having cardiovascular events and type 2 diabetes. No data on this subject is available in Togo. Objective: The objective of our study was to make an inventory of the metabolic syndrome among PLWHIV in Togo. Method: This was a prospective cross-sectional descriptive and analytical study on PLWHIV received at the day hospital of the Infectious Diseases Department of the Sylvanus Olympio University Hospital for a period of six months. Results: A total of 279 PLWHIV patients were enrolled, of which 237 (84.9%) were on Highly Active Antiretroviral Treatment (HAART) and 42 (15.1%) were naive. Metabolic syndrome has been demonstrated in 28.7% of the study population. Abdominal obesity was the most represented component of MS with a proportion of 57.7%. Risk factors associated with MS were female sex (OR = 3.01;CI: 1.52 - 5.93;p 2 (OR = 3.29;CI: 1.92 - 5.64;p 3 (OR = 1.85;CI: 1.06 - 3.20;p Conclusion: There is a need to screen MS for PLWHIV so that risk factors associated with it can be addressed early.

关键词： HIV HAART Metabolic Syndrome Dyslipidemia Hypertension Hyperglycemia Togo

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