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Assessment of Oral Anticoagulation with Vitamin K Antagonists in Patients Living in a Low-Income Country of West Africa

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World Journal of Cardiovascular Diseases 2024年第1期14卷 27-42页

作者： Komlavi Yayehd Tchaa Tcherou Hervé Libérus A. Edorh agossou Defodji Mohamed Kpelafia Ekpé Togbossi Ablawa Adzodo Soulemane Pessinaba Machihude Pio Soodogoua Baragou Findibe Damorou Department of Cardiology Faculty of Health Sciences University of Lomé Lomé Togo Department of Cardiology Faculty of Health Sciences University of Kara Kara Togo

Introduction: Despite the rise of direct oral anticoagulants (DOACs), vitamin K antagonists (VKA) remain the most widely used oral anticoagulants in developing countries. The aim of this study was to estimate the prevalence of good anticoagulation in patients treated with VKA in Lomé and describe associated factors. Methods: This was a cross-sectional study conducted from November 2019 to October 2020 in the cardiology departments of two University teaching hospitals in Lomé (CHU Sylvanus Olympio and CHU Campus), involving patients on VKA for ≥3 months, with a target international normalized ratio (INR) of 2.5 and a therapeutic margin between 2 and 3. The quality of anticoagulation was assessed by the time in therapeutic range (TTR) which was assessed by the Rosendaal method. Good anticoagulation was defined by a TTR > 70%. Results: A total of 344 patients were included (mean age = 58 ± 13.8 years, women = 56.1%). Indications for VKA treatment were represented by venous thromboembolic disease (43.3%), supraventricular arrhythmia (28.2%), severe left ventricular systolic dysfunction (19.8%) and pulmonary hypertension (8.7%). The average TTR was 47.6 ± 20.8%. The rate of good anticoagulation was 17.7%. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol (OR = 11.17;95% CI: 3.2 - 39.6;p = 0.0002), concomitant low-dose aspirin (OR 4.44;95% CI: 1.4 - 13.9;p = 0.01) and INR monitoring exclusively by the patient himself (OR = 4.92;95% CI: 1.5 - 16.3;p = 0.008). The rate of thromboembolic and hemorrhagic complications was each 2.6% and was not correlated with the quality of anticoagulation. Quality of anticoagulation by VKAs was poor in our practice. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol, concomitant low-dose aspirin and monitoring of INR exclusively by the patient himself. Conclusion: The quality of oral anticoagulation by VKAs could be improved in our practice by the creation of antico

关键词： Vitamin K Antagonists Time in Therapeutic Range Lomé Togo

Audits of Death in HIV-Infected Children and Adolescents Followed up in the Pediatric Department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

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Open Journal of Pediatrics 2024年第2期14卷 285-296页

作者： Alphonse Noudamadjo Mohamed Falilatou Agbeille Dénagan Kévin Amoussou Médétinmè Gérard Kpanidja Lahanatou Séidou Chantal Chabi Réckya Kilaya Julien Didier Adédémy agossou Joseph Mother and Child Department Faculty of Medicine University of Parakou Parakou Benin Pediatric Department Regional Teaching Hospital of Borgou/Alibori Parakou Benin

Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.

关键词： HIV Death Children Adolescents Dysfunctions Benin

Children with Sickle Cell Disease in Northern Benin: Follow up of a Cohort at the Borgou/Alibori Branch of Integrated Medical Healthcare Center for Infants and Pregnant Women with Sickle Cell Disease from 2017 to 2022

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Open Journal of Pediatrics 2024年第3期14卷 445-458页

作者： Falilatou Agbeille Mohamed Alphonse Noudamadjo Médétinmè Gérard Kpanidja Yémalin Zinsou François Anikè Akinola Kpedio Clarisse Marie Chantal Bossa Julien Didier Adédémy Joseph agossou Teaching and Research Unit Department of Mother and Child Faculty of Medicine University of Parakou Parakou Benin Integrated Healthcare Center for Infants and Pregnant Women with Sickle Cell Disease (CPMI-NFED) Branch of Borgou/Alibori Parakou Benin

Introduction: Sickle cell disease is a public health problem in sub-Saharan Africa. A national referral center for the management of infants and pregnant women with sickle cell disease (CPMI-NFED) was created three decades ago in Cotonou, in the south of Benin with two regional branches including that of Parakou in the North for better access of patients to specialized care. This work is a review of five years of activities in order to describe the epidemiological, clinical, hematological and evolutionary profiles of the children followed up in the said branch. Method: This was a descriptive and retrospective cross-sectional study on the medical records of children with sickle cell disease, followed up at the regional branch of CPMI-NFED in Borgou/Alibori from June 1, 2017 to May 31, 2022. The variables studied were epidemiological, clinical, biological and evolutionary. Results: A total of 101 children with sickle cell disease were included in the study, including 78 homozygous SS (77.2%) and 23 heterozygous SC (22.8%). Their mean age at inclusion was 51.2 ± 37.6 months [6 - 204]. The sex ratio was 1.4. Vaso-occlusive crises were the main diagnostic circumstances in 42.3% of homozygotes. More than half of the children (51.5%) had a regular follow-up. The average baseline level of hemoglobin (Hb) in homozygous children was 8.8 ± 1.4 g/dl [5.8 - 11.5];and the rate of Hb S varied between 61.9 and 94.7%. In heterozygous SC children, the mean baseline level of Hb was 10.7 ± 0.6 g/dl [9.7 - 11.5]. Acute complications observed during follow-up were dominated by pneumonia and vaso-occlusive crises in both phenotypes. The overall mortality was 3% and only affected homozygous patients. Conclusion: On average, three out of four children were homozygous in our cohort. The main acute complications were infectious and vaso-occlusive. The mortality only affected homozygous carriers. Specialized follow-up has contributed to improving the quality of life of children with sickle cel

关键词： Sickle Cell Disease Children CPMI-NFED Parakou Benin

Climate-influenced vector-borne diseases in Africa: a call to empower the next generation of African researchers for sustainable solutions

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贫困所致传染病(英文) 2024年第2期13卷 83-92页

作者： Obame-Nkoghe Judica?l agossou Adjoavi Esse Mboowa Gerald Kamgang Basile Caminade Cyril Duke Dawn C. Githeko Andrew Karanja Ogega Obed M. Elloué Nestor Engone Sarr Fatou Bintou Nkoghe Dieudonné Kengne Pierre Ndam Nicaise T. Paupy Christophe Bockarie Moses Otomo Patricks Voua Molecular and Cellular Biology Laboratory (LabMC) Biology Department University of Science and Technology of Masuku BP Franceville Gabon Ecology and Health Research Unit Interdisciplinary Center for Medical Research of Franceville BP Franceville Gabon Department of Zoology and Entomology Faculty of Natural and Agricultural Sciences University of the Free State Private Bag x13 Phuthaditjhaba Republic of South Africa Laboratory of Pharmacology and Improved Traditional Medicines Department of Animal Physiology Faculty of Science and Technology University of Abomey-Calavi BP Cotonou Benin The African Center of Excellence in Bioinformatics and Data-Intensive Sciences Infectious Diseases Institute College of Health Sciences Makerere University P. O Box Kampala Uganda Africa Centers for Disease Control and Prevention African Union Commission Roosevelt Street P.O. Box WKAddis Ababa Ethiopia Centre for Research in Infectious Diseases P.O. Box Yaoundé Cameroon Earth System Physics Department The Abdus Salam International Centre for Theoretical Physics Trieste Italy Africa Research Excellence Fund Charterhouse Street London EC1MHR UK Community Health Support Program P.O. Box Kisumu Kenya The African Academy of Sciences Nairobi Kenya Center for Phylosophical Studies and Research (CERP) Omar Bongo University (UOB) BP Libreville Gabon UMRED Health Training and Research Unit University of Iba Der Thiam of Thiès BP Thiès Senegal National Parasitic Diseases Control Program Ministry of Health Libreville Gabon MIVEGEC Univ. Montpellier CNRS IRD Montpellier France MERIT IRD Paris Cité University Paris France Department of Parasitology Noguchi Memorial Institute for Medical Research University of Ghana LG Accra Ghana School of Community Health Sciences Njala University Bo Sierra Leone

We look at the link between climate change and vector-borne diseases in low- and middle-income countries in Africa. The large endemicity and escalating threat of diseases such as malaria and arboviral diseases, intensified by climate change, disproportionately affects vulnerable communities globally. We highlight the urgency of prioritizing research and development, advocating for robust scientific inquiry to promote adaptation strategies, and the vital role that the next generation of African research leaders will play in addressing these challenges. Despite significant challenges such as funding shortages within countries, various pan-African-oriented funding bodies such as the African Academy of Sciences, the Africa Research Excellence Fund, the Wellcome Trust, the U.S. National Institutes of Health, and the Bill and Melinda Gates Foundation as well as initiatives such as the African Research Initiative for Scientific Excellence and the Pan-African Mosquito Control Association, have empowered (or are empowering) these researchers by supporting capacity building activities, including continental and global networking, skill development, mentoring, and African-led research. This article underscores the urgency of increased national investment in research, proposing the establishment of research government agencies to drive evidence-based interventions. Collaboration between governments and scientific communities, sustained by pan-African funding bodies, is crucial. Through these efforts, African nations are likely to enhance the resilience and adaptive capacity of their systems and communities by navigating these challenges effectively, fostering scientific excellence and implementing transformative solutions against climate-sensitive vector-borne diseases.

关键词： Climate change Vector-borne diseases Africa Environmental justice Research and development Pan-African funding initiatives

Understanding Farmers’ Perceptions of and Adaptations to Climate Change and Variability: The Case of the Maritime, Plateau and Savannah Regions of Togo

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Agricultural Sciences 2015年第12期6卷 1441-1454页

作者： agossou Gadédjisso-Tossou West African Science Service Center on Climate Change and Adapted Land Use (WASCAL) Université de Lomé Lomé Togo

Togolese agriculture is predominantly rain-fed and hence fundamentally dependent on the vagaries of weather. Thus, it is negatively affected by climate change. The present study assesses farmers’ perceptions and adaptation to climate change to enhance policy towards tackling the challenges climate change poses to the farmers in the study area. Descriptive statistics and multinomial logit (MNL) were used to analyze data obtained from a cross-sectional survey executed during the 2013/2014 agricultural production year in the maritime, plateau and savannah regions of Togo. The analysis of farmers’ perception to climate change reveals high increase in temperature and decrease in rainfall. These results are in line with the trend analysis of climate data that records from 1961 to 2013 about the study area especially on the temperature. Furthermore, the results show that crop diversification, change in crops, find off-farm jobs, change of the amount of land, change of the planting date and plant short season variety are the adaptation methods employed by the farmers. Moreover, with respect to the multinomial logit analysis, the results highlight that education level, farming experience, access extension services, access to credit and access to climate information are the factors that enhance farmers’ adaptive capacity to climate change and variability. Thus, there is room for better adaptation if government intensifies activities of extension workers and ensures that farmers have access to affordable credit schemes to increase their ability and flexibility to adopt adaptation measures. There is also a need to include climate change communication to facilitate exchange of climatic information that could enable smallholder farmers to adapt to changing planting dates. Finally, investment in education systems and creation of off-farm job opportunities in the rural areas can be underlined as a good policy option.

关键词： Climate Change Agriculture Perception Adaptation Multinomial Logit

Assessment of Oral Anticoagulation with Vitamin K Antagonists in Patients Living in a Low-Income Country of West Africa

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World Journal of Cardiovascular Diseases（心血管病） 2024年第1期

作者： Komlavi Yayehd Tchaa Tcherou Hervé Libérus A.Edorh agossou Defodji Mohamed Kpelafia Ekpé Togbossi Ablawa Adzodo Soulemane Pessinaba Machihude Pio Soodogoua Baragou Findibe Damorou

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Audits of Death in HIV-Infected Children and Adolescents Followed up in the Pediatric Department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

Open Journal of Pediatrics（儿科学期刊） 2024年第3期 445页

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Physical Characterization of Laterite for the Formulation of Structural Concrete

Open Journal of Pediatrics（儿科学期刊） 2024年第2期 285页

作者： Alphonse Noudamadjo Mohamed Falilatou Agbeille Dénagan Kévin Amoussou MédétinmèGérardKpanidja Lahanatou Séidou Chantal Chabi Réckya Kilaya Julien Didier Adédémy agossou Joseph

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Open Journal of Civil Engineering 2023年第3期13卷 411-426页

作者： Dekandji Thomas Ekpo Yemalin Daniel agossou Judicial Agbelele Edmond C. Adjovi INSTI Lokossa National University of Sciences Technologies Engineering and Mathematics Abomey Benin L2EGC/ENSTP Materials and Structure Team National University of Sciences Technologies Engineering and Mathematics Abomey Benin

This study presents another approach to the use of laterite as a common construction material for the development of a new type of concrete. Laterites are found all over the world and are used in various ways in road construction as sub-base, base course or wear courses. Being a material consisting in the raw state of sand and gravel, the study addresses its use for the formulation of structural concrete. The physical characterization made it possible to identify three granular classes distributed as follows: 28.26% passing at 80 μm, 32.12% sand (0.08/4 mm) and 39.62% nodule (4/25) mm. The absolute density of the aggregates varies from 2.73 and 2.82 from the sand to the nodules. The absorption rate varies from 3.01% and 5.71% respectively for sand and nodules. The granular compactness of the different granular classes studied varies from 0.580 to 0.630. The formulation of the concrete was made by the method of absolute volumes by varying the W/C ratio from 0.4 to 0.7, N/S from 2.2 to 2.8 and that of the cement dosage from 350 to 450 kg/m3. The results obtained show that the density of the concrete formulated based on these aggregates of lateritic origin have a density which varies between 2000 and 2300 kg/m3. With a cement content of 400 kg/m3, a W/C ratio of 0.4 and N/S of 2.8, concrete based on lateritic aggregates offers better mechanical performance in compression of approximately 21.23 ± 1.24 MPa at 28 days. This strength class obtained allows laterite concrete to be used as structural concrete in the structure of civil engineering works.

关键词： Laterite Concrete Granular Compactness Mechanical Strength