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Technique of Granulation Tissue Genesis from Diploe

Modern Plastic Surgery 2018年第2期8卷 9-14页

作者： Essossinam Kpelao Moumouni Abd El Kader Beketi Kadanga Anthony Amouzou Alain doleagbenou agbeko Ahanogbe Hobli Egu Komi Bakonde Essolim Abalo Anani Department of Neurosurgery Sylvanus Olympio University Hospital Lomé Togo Department of Plastic and Reconstructive Surgery Sylvanus Olympio University Hospital Lomé Togo Department of Traumatology and Orthopedics Sylvanus Olympio University Hospital Lomé Togo

Introduction: Many techniques are used in surgery for importing scalp losses. Microsurgery reinsertion dominates these techniques. When reinsertion is not possible, other alternatives are available. Among these is the production of the granulation tissue by diploic perforation. Many authors have reported this technic without explaining the physiological mechanisms that contribute to the genesis of this granulation tissue from the diploe. We intend to recall them. Patients and Methods: This was a series of 3 cases supported for significant loss of the scalp. The technic consisted in making trepan drill holes and carrying the outer table to the diploe by using a Doyen drill. Then fat dressings were applied every other day until the formation of granulation tissue over the entire loss of tissue surface. Observations: Three patients benefited from this technique, 2 traumatic and the other one iatrogenic after a scalp tumor excision. The missing area of traumatic wounds was estimated at 18 and 25 cm2 respectively. The third patient had a loss of scalp after surgical removal of an ulcerous-budding tumor of the scalp without any impacting the skull. Granulation tissue was obtained in all cases after an average of 30 days. There was no infection. Two patients were grafted with favorable progress and one patient went under indirect wound healing. Conclusion: The ability of the diploe to generate granulation tissue is due to its intrinsic anatomical and functional potentialities. This is a technic of last resort when conventional reconstructive surgery is contraindicated for several reasons.

关键词： Granulation Tissue Diploe

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Pre-Hospital Management of Craniocerebral Trauma in South Saharan Africa: Cotonou Experience

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Open Journal of Modern Neurosurgery 2019年第3期9卷 221-226页

作者： Abd El Kader Moumouni Essossinam Kpelao Holden Olatoundji Fadigba agbeko Achille doleagbenou Ibrahima Berete Dabou Abiba Tamou Tabe Emile Mensah Martin Chobli CHU KARA Kara Togo SAMU Benin Cotonou Benin CHU Sylvanus Olympio Lomé Togo University of Parakou Borgou Benin Universite Gamal de Conakry Conakry Guinee HIA Parakou Parakou Benin SAMU Benin of Parakou Borgou Benin

The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.

关键词： Emergency Craniocerebral Africa South-Sahara Pre Hospital Management

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Primitive Bilateral Ocular Melanoma in a Black Patient

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Open Journal of Ophthalmology 2017年第4期7卷 256-261页

作者： Essossinam Kpelao Nidain Maneh Harrefegena Bissa Koffi Amegbor Kadanga Anthony Beketi Abdel Kader Moumouni agbeko doleagbenou Thierry Alihounou Julienne Noudé Teclessou Komi Patrice Balo Department of Neurosurgery University of Lome Lome Togo Department of Ophthalmology University of Lome Lome Togo Department of Maxillofacial Surgery and Stomatology University of Lome Lome Togo Department of Pathology University of Lome Lome Togo Department of Surgery Oueme and Plateau Teaching Hospital Porto-Novo Benin Department of Dermatology University of Lome Lome Togo

Introduction: Ocular melanoma develops at the expense of eyes’ melanocytes which give to the eyes their color. It is the first primitive intraocular tumor in the White race. It is rare, as that of the skin in black people. The bilateral cases are exceptional even in the white race, estimated at 0.2%. We present the case of bilateral ocular melanoma with bad prognosis in a black patient. Patient and observation: A 56-year-old black male patient, who had benefited 4 years earlier from an enucleation of the right eye for ocular melanoma, and admitted for bilateral exophthalmos which evolved for three months in a context of bilateral blindness. The cerebral Scanning had allowed to objectify a bilateral lateral-conical mass which evoked an inflammatory pseudo tumor. The failure of the medical treatment led to the exeresis of a conical, juxta-orbital and mid-muscular blackish mass, to the later apex respecting the surrounding structures. The histological examination ends again in a melanoma. No additional therapy was undertaken. The evolution 2 years later was marked by a local recurrence, multiple hepatic metastases and patient death. Conclusion: Bilateral ocular melanoma is exceptional in Black people. The etiologic factors as well as bilateralism mechanisms are still hypothetic. Its most effective treatment is local and the prognosis, bad in case of metastases due to the absence of an effective chemotherapy.

关键词： Bilateral Ocular Melanoma Black Patient

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Hospital Information Systems Shortage in Sub-Saharan African Hospitals: Opportunities and Challenges

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E-Health Telecommunication Systems and Networks 2022年第1期11卷 1-13页

作者： Abd El Kader Moumouni Dede Regina Ajavon Komlan agbeko doleagbenou Dabou Abiba Tamou Tabe Kodjo Mensah Hobli Ahanogbe Massaga Dagbe Akoete Simon Gbessena Komi Amagnga Desama-Esso Banawe Tchilabalo Bamazi Amona Department of Surgery CHU Kara Kara Togo Department of Gynaecology and Obstetrics CHR Tomde Kara Togo Department of Surgery CHU Sylnanus Olympio Lomé Togo Radilogy Department CHR Tomde Kara Togo Radilogy Department CHU Kara Kara Togo Department of Network and Computer Maintenance CHU Kara Kara Togo

The HIS is recognised as an essential tool for optimising the management of a health establishment in particular and the health system in general. But it is still very little implemented in hospitals in the South. Open source HIS software, available on the Internet, can be a solution for starting a (HIS) project in these hospitals. A search on the Internet for open source HIS software allowed us to choose MedBoard, the second most popular open source software out of 381, to start an HIS project called PERFORMANCE at the Kara University Hospital in northern Togo. A questionnaire allowed us to assess the level of knowledge of health actors on hospital information systems. The results of this evaluation allowed us to strengthen our proposal. The analysis of the current computer park of the CHU Kara does not allow whatever the functionalities of MedBoard to implement PERFORMANCE at the CHU Kara. Logistics are needed to make PERFORMANCE work. The real difficulty to start and perpetuate HIS project is linked to the human factor.

关键词： Free Software Hospital Information System Performance Chu Kara

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Viral Hepatitis B and C: Epidemiological, Clinical and Paraclinical Aspects in the Internal Medicine Department of KARA University Hospital in Togo

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Open Journal of Internal Medicine 2024年第1期14卷 131-139页

作者： Lihanimpo Djalogue Mossi Komi Edem El Hadj Yacoubou Tchamdja Toyi Djagadou Kodjo agbeko Balaka Abago Djibril Mohaman Awalou Internal Medicine Department University of Kara Kara Togo Internal Medicine Department University of Lome Lome Togo Hepato-Gastroenterology Department University of Kara Lomé Togo

Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases;those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.

关键词： Hepatitis B Hepatitis C Internal Medicine Kara University Hospital

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尼罗罗非鱼肠道芽孢杆菌的分离、鉴定及益生性评价

尼罗罗非鱼肠道芽孢杆菌的分离、鉴定及益生性评价

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作者： Felix Kofi agbeko Kuebutornye 广东海洋大学

学位级别：硕士

罗非鱼是全球养殖总量仅低于鲤鱼的水产养殖品种之一。它是许多发达国家和发展中国家人民的重要蛋白质来源。为了满足对鱼类的高需求,罗非鱼通常养殖密度较高,导致养殖罗非鱼疾病时常发生,对水产养殖业造成了重大打击。在水产养殖中,益... 详细信息

罗非鱼是全球养殖总量仅低于鲤鱼的水产养殖品种之一。它是许多发达国家和发展中国家人民的重要蛋白质来源。为了满足对鱼类的高需求,罗非鱼通常养殖密度较高,导致养殖罗非鱼疾病时常发生,对水产养殖业造成了重大打击。在水产养殖中,益生菌在抗病、提高免疫力、改善水质等方面的应用得到了很好的阐明。然而,在水产养殖中使用的益生菌很多并非来源于鱼体,因此,它们在水产动物上应用的效果相对较差。宿主相关的益生菌,即“最初从养殖水体或宿主的消化道中分离出来,以改善宿主的生长和健康的细菌”,被认为是水产养殖业的未来。在许多候选微生物中,益生芽孢杆菌由于具有孢子形成能力,使它们在恶劣环境条件下（耐热和更长的寿命）存活,此外,多数芽孢杆菌对鱼类没有致病性且无毒,并能产生广泛的抗菌物质,因此比其他益生菌更适合作为候选益生菌。因此,本论文从罗非鱼消化道中分离和鉴定芽孢杆菌,通过体外实验对其形态、生化和抑菌活性等进行研究,通过养殖实验,对其体内益生菌潜力进行了评估,研究了不同菌株对尼罗罗非鱼生长、消化酶和抗氧化酶能力、血清和粘液免疫、基因表达的影响及其对尼罗罗非鱼菌群和肠道形态的影响。同时,通过人工感染实验,对分离的芽孢杆菌抵御无乳链球菌和嗜水气单胞菌感染的能力进行了评价。结果显示,我们从尼罗罗非鱼的肠道成功分离到3株芽孢杆菌,分别为贝莱斯芽孢杆菌TPS3N（MK130897）、枯草芽孢杆菌TPS4（MK130899）和淀粉酶样芽孢杆菌TPS17（MK130898）。贝莱斯芽孢杆菌TPS3N和淀粉酶样芽孢杆菌TPS17表现为α-溶血,而枯草芽孢杆菌TPS4表现为γ-溶血。体外研究表明,三种芽孢杆菌在高温（80℃、90℃和100℃）下均具有较高的生存能力,对低p H值（1）和低胆盐浓度（0.5%）具有耐受性,同时具有较高的细胞表面疏水性和自凝集性,说明易于肠道定植。这三种芽孢杆菌可相互兼容,因此可以联合使用。这些菌株对庆大霉素、头孢氨苄、氨苄青霉素、头孢曲松钠、、卡那霉素、阿米卡星、盘尼西林、头孢哌酮钠、氯霉素、红霉素、四环素、强力霉素、环丙沙星、克林霉素（除枯草芽孢杆菌TPS4）和呋喃唑酮（除淀粉酶样芽孢杆菌TPS17）是敏感的。抗菌鉴定结果表明,在3株分离菌中,TPS3N、TPS17对3种鱼类致病菌（无乳链球菌、嗜水气单胞菌、哈氏弧菌）均有较好的抗菌活性,而枯草杆菌TPS4仅对无乳链球菌有效。为了评估尼罗罗非鱼体内三种宿主相关芽孢杆菌的益生菌潜力,进行了为期四周的饲养试验。试验鱼被分为5个处理组,包括不含细菌的对照组CT组、含有贝莱斯芽孢杆菌TPS3N的V组,含有枯草芽孢杆菌TPS4的S组,含有淀粉酶样芽孢杆菌TPS17的为A组以及三株芽孢杆菌按照1:1:1混合投喂的CB组。试验结束时,芽孢杆菌处理组在终重（FW）、增重（WG）、比较生长率（SGR）、饲料转化率（FCR）等方面均有提高,其中CB组表现最佳。处理组与对照组比较,免疫球蛋白M（Ig M）、溶菌酶（LZM）、酸性磷酸酶（ACP）、碱性磷酸酶（AKP）、抗氧化酶(超氧化物歧化酶（SOD）、过氧化氢酶（CAT）、消化酶（脂肪酶、胰蛋白酶）等指标均有提高。与对照组相比,V、S、A、CB组的GOT和MDA活性明显降低。生长相关基因GHR-1和IGF-1在投喂了芽孢杆菌的鱼的肝脏和头肾（HK）中均显著上调。同样,CB组诱导显著提高TNF-α,TLR-2,Ig M（除了在肝脏）和C-LYZ在所有组织的表达。随后用无乳链球菌进行的攻毒试验,CT、V、S、A和CB处理组的累积死亡率分别为60.0%、33.33%、26.67%、20.0%和13.33%。进一步研究了三种宿主相关芽孢杆菌对尼罗罗非鱼黏膜免疫、肠道形态、肠道消化酶活性、肠道菌群和抵御嗜水气单胞菌感染能力的影响。试验鱼被分为5个处理组,包括不含细菌的对照组CT组、含有贝莱斯芽孢杆菌TPS3N的V组,含有枯草芽孢杆菌TPS4的S组,含有淀粉酶样芽孢杆菌TPS17的为A组,三株芽孢杆菌1:1:1混合投喂表示CB组。饲养试验结束时,实验组的皮肤黏液和肠道免疫滴定度记录的一氧化氮（NO）（除了V组和S组的粘膜）,免疫球蛋白M（Ig M）（除了V组肠）,溶菌酶（LZM）和碱性磷酸酶（AKP）均显著高于对照组。肠道抗氧化酶（过氧化氢酶（CAT）（S组除外）和超氧化物歧化酶（SOD））活性在实验组较高。此外,补充芽孢杆菌的实验组肠道脂肪酶活性升高,与对照组相比,补充芽孢杆菌组肠道形态学参数(绒毛高度、绒毛宽度、杯状细胞计数（S组和A组除外）、肠道肌肉厚度均明显增强。肠道菌群研究表明,补充益生菌还会影响尼罗罗非鱼的肠道菌群组成。一般,在本研究中,变形杆菌门的丰度最高,其次是厚壁菌门、梭杆菌门和拟杆菌门。在属水平上,与对照组相比,补充芽孢杆菌组的致病菌葡萄球菌和气单胞菌的丰度

关键词：尼罗罗非鱼益生菌芽孢杆菌免疫微生物群

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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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Pituitary Adenoma Complicated by Acute Bacterial Meningitis in a Patient in Kara (Togo)

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Open Journal of Internal Medicine 2023年第4期13卷 364-370页

作者： Lihanimpo Djalogue Leleng Agba Komi Edem Mossi Toyi Tchamdja Kodjo agbeko Djagadou Abago Balaka Mohaman Awalou Djibril Internal Medicine Department of Kara University Hospital University of Kara Kara Togo Neurology Department of Kara University Hospital University of Kara Kara Togo Internal Medicine Department of Sylvanus Olympio University Hospital University of Lomé Lomé Togo Internal Medicine Department of Campus University Hospital University of Lomé Lomé Togo

Introduction: In the context of pituitary adenoma, bacterial meningitis is a possible complication of surgical or medical treatment. The occurrence of meningitis before any treatment is exceptional, explained by the existence of an osteomeningeal breach caused by the adenoma whose main symptom is rhinorrhea. Case Report: We report a case of bacterial meningitis complicating a prolactin pituitary macroadenoma. The patient had been referred for jet vomiting in a febrile context preceded by headaches and visual blurring. There was no rhinorrhea. The examination revealed a meningeal syndrome and the diagnosis of acute bacterial meningitis was made. The isolated germ was the pneumococcus. Faced with headaches and visual blurring, a cerebral scan revealed a pituitary macroadenoma and pituitary hormone dosage had shown hyperprolactinemia. The meningitis was sterilized and the prolactinoma was treated with dopaminergic agonists. This allowed the normalization of prolactinemia and the disappearance of symptoms. Conclusion: The pituitary adenoma was complicated by bacterial meningitis without treatment and the presence of a meningeal breach. Hormonal and bacterial treatments have been successful.

关键词： Pituitary Adenoma Prolactin Meningitis

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西非经济货币联盟（WAEMU）小额信贷机构分析与效率评价

西非经济货币联盟（WAEMU）小额信贷机构分析与效率评价

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作者：高德文（KOUDALO Y M agbeko）内蒙古大学

学位级别：硕士

在西非经济货币联盟(WAEMU)中,小额信贷在90年代初显露了并成为了中小企业(SMEs)和农业领域的另一种融资体系。由于这些小额信贷机构(MFI)在一个非正式的环境操作,西非中央银行(BCEAO)决定通过建立一个监管框架为了促进小额信贷发展。... 详细信息

在西非经济货币联盟(WAEMU)中,小额信贷在90年代初显露了并成为了中小企业(SMEs)和农业领域的另一种融资体系。由于这些小额信贷机构(MFI)在一个非正式的环境操作,西非中央银行(BCEAO)决定通过建立一个监管框架为了促进小额信贷发展。这导致了PARMEC(支持和监管储蓄和信贷的项目)及其它项目和的出现,目的是保护储蓄者,SFD的财政自主权和非正式金融的法律框架的整合,总体来说提高小额信贷机构的效率。我们的研究首先通过WAEMU的小额信贷行业的分析使了解该行业整体的发展和不同国家的表现。事实上,按总体实力排名,前12位的机构(即非政府组织和合作社)单独占联盟总储蓄的88%和贷款总额的82%。关于不同国家MFI的发展,科特迪瓦(尽管投资组合的高降解率)和塞内加尔都在顶部。总体来看,这两个国家占西非经货联盟市场份额的40%：客户的41%,占贷款总额的39%,总存款的46%。对应于经济发展水平,小额信贷行业在几内亚比绍和尼日尔欠发达。研究后来通过使用DEA(数据包络分析)的方法衡量西非经济货币联盟中小额信贷机构(MFI)的效率。这是考虑到在该区域这些机构的中介作用和支农功能的首批研究之一。我们发现非常低的平均效率,50%在规模报酬不变(CRS),63%在可变规模报酬(VRS)。在过去的十年(2004-2014年),整个地区的效率降低是由于小额信贷部门所面临的困难(这导致了一些机构的倒闭)以及支农指标的恶化,这种情况特别出现在科特迪瓦、塞内加尔和贝宁。我将效率得分与一系列影响小额信贷机构效率的因素进行了回归,得出结论如下：财务和投资组合的健全管理以及赠款对效率产生了积极影响,而小额信贷机构的大小和培训则对效率产生了负面影响。鉴于这些研究结果,小额信贷行业的挑战仍然很多。从小额信贷机构的本身到它们的监督机构,这个行业必须进行一些调整来使它更盈利和有效,从而减少贫困,因为这是联盟每个国家发展政策的主要领域之一。

关键词：效率小额信贷机构西非经货联盟数据包络分析

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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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