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HIV Genetic Diversity, Virological Failure, and Drug Resistance in Libreville, Capital of Gabon, before a Total Dolutegravir-Based Regimen Transition

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World Journal of AIDS 2022年第3期12卷 156-168页

作者： Berthold Bivigou-Mboumba berthe amélie iroungou Pamela Moussavou-Boundzanga Laurette Guignali Mangouka Falone Larissa Akombi Aurore Bouassa-Bouassa Sandrine Francois-Souquière Jean Raymond Nzenze Research Mixed Unit between the International Center for Medical Research of Franceville and the Military Health Service (UMR CIRMF-SSM) Libreville Gabon Department of Internal Medicine Omar Bongo Ondimba Army Training Hospital (HIA-OBO) Libreville Gabon Department of Hepato Gastroenterology Centre Hospitalier Universitaire de Limoges Libreville Gabon

Context: The Human Immunodeficiency Virus (HIV) continues to be the main public health challenge in Gabon. The latest studies highlight a high rate of virological failure and HIV drug resistance in semi-rural Gabon. In Libreville, virological failure data is sparse, data on HIV drug resistance for the former first line and new first-line regimen is lacking. Methods: Between January 28th, 2019, and January 31st, 2020, we received patient living with HIV (PLWHA) for CD4 counts, HIV-1 viral load, and/or genotyping of HIV-1 mutation drug resistance. We used the BD FACSPresto for CD4 count, the Biocentric Generic HIV viral load test for HIV-1 quantification, and the HIV-1 drug resistance mutation genotyping (ARNS protocol). Results: A total of 1129 HIV-1 patients have been enrolled for this study. The median age was 46 years old and the median of CD4 was 386 cells per cubic millimeter. The virological suppression success was observed at 62.7% of patients on the former first line regimen and 70.6% of the patient on DBR. We successfully amplified and analyzed 76 sequences and noticed the presence of the nineteen different subtypes with the predominance of the subtypes CRF02-AG (37.95%), followed by subtype A (22.3%). For HIV drug resistance analyses, 108 (65.1%) had resistance mutation to nucleoside reverse transcriptase inhibitors (NRTIs);of these, 91 (84%) present M184V/I. When looking for NNRTI mutations, 119 (71.7%) sequences had at least one mutation. Of these, 82 had K103N (68.9%), representing the main NNRTI mutations. The pattern showing the high level of resistance (HLR) in all molecules of NRTIs and NNRTIs, except for the TDF (intermediate resistance) was M41L-E44DL74I-M184-L210W-T215Y-K101P-K103N-V106I. Conclusion: This report paints a picture of a relatively female-dominated HIV-infected Gabonese population with a low level of immunity. The level of drug resistance with the former first-line regimen suggests the need to monitor the drug Do

关键词： HIV Infection HIV Drug Resistance HIV Genetic Diversity Dolutegravir Gabon

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Phenotipic Prevalence of Antibiotic Resistance in Gabon

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Open Journal of Medical Microbiology 2021年第2期11卷 100-118页

作者： Annicet-Clotaire Dikoumba Richard Onanga Pierre Philippe Mbehang Nguema Laurette G. Mangouka berthe amélie iroungou Fabrice Kassa Kassa Berthold Bivigou Mboumba Elvire Mbongo Kama Jean-Fabrice Yala Edgard-Brice Ngoungou Sylvain Godreuil Hô pital d’Instruction des Armées Omar Bongo Ondimba Département de biologie médicale Libreville Gabon Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF) Laboratoire de Bactériologie de Recherche Unité de recherche et d’Analyses Médicales (URAM) Franceville Gabon Centre Hospitalier Universitaire de Montpellier Laboratoire de Bactériologie France Institut de Recherche en Ecologie Tropicale (IRET/CENAREST) Département Ecologie animale Libreville Gabon Hô pital d’Instruction des Armées Omar Bongo Ondimba Département de Médecine Libreville Gabon Unité mixte de Recherche Santé Militaire/CIRMF Libreville Gabon Université des sciences et techniques de Masuku (USTM) Laboratoire de Biologie Moléculaire et Cellulaire équipe de Microbiologie et Immunologie Franceville Gabon Université des Sciences de la Santé Faculté de Médecine Département d’Epidémiologie Biostatistiques et Informatique Médicale (DEBIM)/Unité de Recherche en Epidémiologie des Maladies Chroniques et Santé Environnement (UREMCSE) Libreville Gabon MIVEGEC IRD CNRS Université de Montpellier Montpellier France

Background: The increasing phenomenon of bacterial resistance to antibiotics is a real public health problem. The main causes are poor management of hygiene and water quality, but also the use of antibiotics without precaution. The objective of this study was to isolate and determine the antibiotic resistance profile of the different bacteria found in the main hospitals and bacteriology laboratories in Gabon. Methods: 6034 samples were taken from hospitals in seven main cities of Gabon, and analyzed according to the usual techniques. The pathogenic strains were identified by Matrix-Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry. Antimicrobial susceptibility testing was performed by the agar disc diffusion method, according to the Antibiogram Committee of the French Society for Microbiology guidelines. Results: 974 pathogenic bacterial strains were found, including 890/974 (91.4%) Gram-negative bacilli. The systematic antimicrobial susceptibility testings identified 160/974 (16.4%) multi-resistant strains. Escherichia coli was the most represented species. 12.5% - 25% of Escherichia coli, Klebsiel

关键词： Gabon Antibiotic Resistance Profiles Methicillin-Resistant S. aureus (MRSA) Extended Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL-PE) Carbapenems

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Dosage Formula in Anesthesia for Manual Intrauterine Aspiration Post-Abortion in Resource-Limited Settings

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Pharmacology & Pharmacy 2024年第4期15卷 71-80页

作者： Serge Ibula Rivain Iteke berthe Barhayiga Doddie Tsansya Roger Cishugi Jean Jacques Kalongo Sandra Sagboze Jean Paul Cikwanine Dieudonné Sengeyi ISTM/Bukavu Anesthesia-Resuscitation Section CIMAC Hospital Center in Goma Goma The Democratic Republic of the Congo Department of Anesthesia-Resuscitation University of Lubumbashi Lubumbashi The Democratic Republic of the Congo Department of Anesthesia-Resuscitation University of Kinshasa Kinshasa The Democratic Republic of the Congo Department of Gyneco-Obstetrics University of Kinshasa Kinshasa The Democratic Republic of the Congo Anesthesia-Resuscitation Department Panzi Hospital Bukavu The Democratic Republic of the Congo

Setting: Provincial General Reference Hospital of Bukavu, General Reference Hospital of Panzi, General Reference Hospital of Ciriri, General Reference Hospital of Nyatende and Biopharm Hospital Center. Objective: Contribute to the improvement of the anesthetic ECP of patients benefiting from MVA for incomplete abortion, Describe the methodology used for adoption of the dosage formula in Anesthesia for MVA, present the mathematical demonstration leading to the dosage formula in anesthesia for MVA. Materials and Methods: Our study was descriptive by mathematical demonstration of obtaining the equilibrium constant of the dosage formula of bipuvacaine 0.1% and Fentanyl 50 µg% adapted to the weight and specific size of patients treated anesthetically in MVA cases for incomplete abortion. We also carried out an operational research by first determining the interval where our equilibrium constant is included and secondly by means of the ends of the intervals found correlated to the ends of intervals of possible weights and sizes in the being normal human female of childbearing age to arrive at the real numerical value of the equilibrium constant of the BUKAVU Dosage Formula in the case of anesthesia for MVA during the management of incomplete abortions. Results: TWO-STAGE OPERATIONAL RESEARCH: • Determination of the interval where the equilibrium constant x = −0.95 x x by crossing the means between the extremes of volumes of anesthetic drugs giving a satisfactory sensory block without hemodynamic disturbance and the extremes of normal weight and height for women of childbearing age. We ended up with X = 0.37. Conclusion: At the end of our study which had the general objectives of contributing to the improvement of the anesthetic PEC of patients receiving MVA for incomplete abortion and specific objectives of describing the methodology used for adoption of the dosage formula in Anesthesia for MVA and present the mathematical demonstration which resulted in the dosage formul

关键词： Dosage Anesthesia Intrauterine Aspiration DR Congo

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Nephroblastoma in Adults about a Clinical Case

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Surgical Science 2024年第2期15卷 81-88页

作者： Tounkara Cheickna Coulibaly amara Malle Oumar amadou Bréhima Bolo Coulibaly Bagoyoko Kaloga Daye Samake Hamidou berthe Honoré Jean-Baptiste Gabriel Diakite Mamadou Lamine Department of General Surgery Hospital Center “Mother Child” Luxembourg Bamako Mali Directorate of Army Health Services Kati Mali Department of Urology and Andrology Point G University Hospital Bamako Mali

Nephroblastoma is the most common malignant renal tumor in children and is related to an abnormal proliferation of cells resembling those of the embryonic kidney (metanephroma), hence the terminology;embryonal tumor. These are tumors that remain and remain unstudied in Mali because they are common in adults in our context. Its annual incidence is estimated at approximately 1/10,000 births. Nephroblastoma is a rare or even exceptional tumor in adults. The clinical manifestation was a large swelling of the right hypochondrium;abdominal pain for a year;unquantified fever, hypertension, initial hematuria associated with burning during urination and anemia. The main clinical manifestation remained fever and abdominal pain. This renal tumor posed a diagnostic problem which was previously labeled as a mesenteric tumor in our general surgery department. The diagnosis was made by imaging: CT and magnetic resonance imaging. The treatment is multidisciplinary and combines chemotherapy, surgery with or without radiotherapy. The prognosis is poor due to late diagnosis and less effectiveness of chemotherapy compared to the child. Survival did not exceed a year and a half because the renal tumor in our patient was surgically overcome. We report a case of nephroblastoma in an 86-year-old patient with unfavorable histology (hematogenous metastases), operated on in the general surgery department and whose postoperative course was simple and who was referred to oncology for treatment.

关键词： Nephroblastoma Malignant Kidney Tumor Treatment Adult Mali

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Morbidity and Mortality of Acute Renal Failure in COVID-19 Patients in Intensive Care According to Waves/Variant: Case of the Grand Hôpital de l’Est Francilien Site de Meaux

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Open Journal of Internal Medicine 2024年第1期14卷 16-29页

作者： Khazy Anga Ariel Makembi Éric amisi Éric Delpierre Vivien Hong Tuan Ha Wilfrid Mbombo Jean Claude Mubenga Dan Kankonde Chris Nsituavibidila Lionel Diyamona Noelly Mukuna Gracia Likinda Tharcisse Mabiala Martin Mukenga Médard Bula-Bula berthe Barhayiga Département d’Anesthésie Réanimation Université de Kinshasa Kinshasa République démocratique du Congo Service de Réanimation Grand H&ocircpital de l’Est Francilien Meaux France Département de Médecine Interne Université de Kinshasa Kinshasa République démocratique du Congo Service d’Anesthésie Réanimation Centre Hospitalier Monkole Kinshasa République démocratique du Congo Department of Anaesthesia and Intensive Care H&ocircpital Général de Référence de Kinshasa Kinshasa République démocratique du Congo Department of Anaesthesia and Intensive Care Université Protestante du Congo Kinshasa République démocratique du Congo

Introduction: The incidence of acute renal failure (ARF) varies between 20% and 40% of cases for COVID-19 patients admitted to the intensive care unit, with very high mortality, but heterogeneous according to the different epidemic waves, probably due to the genetic variant phenomenon of the virus. The aim of this study is to determine the morbidity and mortality of COVID-19 patients admitted with ARF to the intensive care unit of the Grand H?pital Est Francilien (GHEF) according to the waves and variants. Methods: Cross-sectional observational study of COVID-19 patients with ARF admitted to the intensive care unit of the GHEF site in Meaux covering the period from March 1st 2020 to December, 31st 2021. Per-hospitalisation and outcome data were collected and analysed with SPSS version 25.0 software using the Chi-square or Fischer’s exact test or Student’s t-test and logistic regression for p Results: A total of 86 patients were included. The mean age was higher (70 ± 8.5) in patients in the fourth wave than in the other waves (p = 0.015), with male predominance in all waves without significant difference. Co-morbidities: hypertension, diabetes, heart disease, dyslipidaemia and arrhythmia complete with fibrillation were present in all waves. The majority of patients were classified as KDIGO 1 for the different waves (1st: 61.9%, 2nd: 86.5%, 3rd: 80%, and 4th: 75%), with the same trend according to variant (alpha: 80%, beta: 75%, delta: 81.3%, omicron: 75%). Mortality by the wave was: 1st: 28.5%, 2nd: 37.5%, 3rd: 23% and 4th: 11%) and by variant: alpha: 24.2%, beta: 44.8%, delta: 20.7%, omicron: 10.3%). Overall mortality was 33.7%. Case fatality was higher in the fourth wave. Hypertension, shock, failure to recover renal function, acute lung oedema, ventilator-associated lung disease and hyperkalaemia were factors associated with mortality (p Conclusion: Acute renal failure is common in COVID-19 patients admitted to the intensive care unit, and m

关键词： Mortality COVID-19 Morbidity Renal Failure Intensive Care Unit

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Morbidity and Mortality during Anaesthesia in Patients with versus without Diabetes: Single-Centre Cohort Study

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Open Journal of Anesthesiology 2024年第3期14卷 93-107页

作者： Noelly Mukuna Wilfrid Mbombo Joseph Nsiala Aliocha Nkodila Alphonse Mosolo Freddy Mbuyi Jonathan Kukila Paul Kambala Rémy Kashala Chris Nsitwavibidila Patrick Kobo Dan Kankonde Gracias Likinda Jean Claude Mubenga Khazi Anga Lionel Diyamona berthe Barhayiga Department of Anaesthesia and Intensive Care Kinshasa University Clinics University of Kinshasa Kinshasa DRC Department of Anaesthesia and Intensive Care Monkole Hospital Kinshasa DRC Protestant University of Congo Kinshasa DRC Laboratory Department Monkole Hospital Kinshasa DRC Department of Clinical Biology Kinshasa University Clinics University of Kinshasa Kinshasa DRC Surgical Department Monkole Hospital Kinshasa DRC Department of Internal Medicine Monkole Hospital Kinshasa DRC

Background and objective: Classically, diabetic subjects are at high risk of anaesthesia compared with general population. However, some recent publications have shown contrasting and sometimes contrary results. The aim of our study was to evaluate morbidity and mortality during and after anaesthesia in patients with versus without diabetes operated on at Monkole Hospital over the last ten years. Methods: Retrospective cohort study including all patients who underwent all-comers surgery excluding cardiac surgery between 2011 and 2021. Each diabetic patient was matched to 2 non-diabetic controls on age and sex. The evaluation criterion was the frequency of occurrence of at least one perioperative complication and/or death up to day 30. A multivariate analysis using a Cox model was used to determine the factors associated with the occurrence of this morbidity and mortality. The model was adjusted for comorbidities, preoperative hyperglycaemia, ASA score, type of anaesthesia and severity of surgery. Results: A total of 351 diabetic patients (mean age 53.3 ± 14.18 years) and 701 non-diabetic patients (mean age 53.52 ± 14.7 years) were included and analysed. Preoperatively, hyperglycaemia (blood glucose > 180 mg/dl) was observed in 24.3% of diabetic patients compared with 1.6% of non-diabetic patients. The incidence of overall perioperative complications was 25.6% in diabetic patients compared with 28.6% in non-diabetic patients (p = 0.27). The risk factors associated with this morbidity were general anaesthesia with oro-tracheal intubation vs loco-regional anaesthesia (OR = 3.06 [95%CI: 1.91 - 4.94];p Conclusion: This study shows that there is not significant increase in perioperative morbidity and mortality in diabetic patients compared with non-diabetic ones of similar severity. These results suggest that diabetes itself (excluding associated comorbidities) has only a minor impact on perioperative morbidity and mortality.

关键词： Anaesthesia Diabetes Morbidity Mortality Perioperative

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Fractal image encoding based on adaptive search

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Journal of University of Science and Technology Beijing 2003年第6期10卷 67-71页

作者： Kya berthe Information Engineering School University of Science and Technology BeijingBeijing 100083China

Finding the optimal algorithm between an efficient encoding process and therate distortion is the main research in fractal image compression theory. A new method has beenproposed based on the optimization of the Least-Square Error and the orthogonal projection. A largenumber of domain blocks can be eliminated in order to speed-up fractal image compression. Moreover,since the rate-distortion performance of most fractal image coders is not satisfactory, an efficientbit allocation algorithm to improve the rate distortion is also proposed. The implementation andcomparison have been done with the feature extraction method to prove the efficiency of the proposedmethod.

关键词： fractal optimization bit allocation adaptive search image compression

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Optimization of Fractal Iterated Function System(IFS) with Probability and Fractal Image Generation

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Journal of University of Science and Technology Beijing 2001年第2期8卷 152-156页

作者： berthe Kya, Yang Yang (Information Engineering School, University of Science and Technology Beijing, Beijing 100083, China) Information Engineering School University of Science and Technology Beijing 100083 China

There are several methods for rendering fractal images based on IFS (Iterated Function System) in computer graphic; but one concern of the computer graphic community has been the efficiency rendering algorithms. The invariant measures arising from IFSP (Iterate Function System with Probability) using the probabilistic algorithm are also known as chaos games. The role of these probabilities to generate the image of the attractor has been investigated using a multi-fractal analysis. The conventional choice of probability associated with each set /S/ to generate the attractor in least time possible is introduced, then a new method based on the self similarity and multi-fractal analysis is presented. The efficiency of the new method has been proved over the conventional method.

关键词： optimization of fractal IFS compression IFSP multi-fractal analysis

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Epidemiological and Clinical Aspects of Bladder Tumours at the Nianankoro Fomba Hospital in Segou in the Urology Department

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Open Journal of Urology 2022年第5期12卷 294-303页

作者： Sory Ibrahim Kone Honoré Jean Gabriel berthe Aly Douro Tembely Zanafon Ouattara Mamadou Lamine Diakite Urology Department Nianankoro Fomba Hospital Ségou Mali Department of Urology CHU Point G Bamako Mali Department of Urology CHU Gabriel TOURE Bamako Mali Department of Urology CHU Gabriel TOURE Bamako Mali

Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.

关键词： Bladder Tumour Bladder Cancer Epidemiological and Clinical Aspects

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Fractal image compression based on fuzzy theory

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Journal of University of Science and Technology Beijing 2002年第3期9卷 228-232页

作者： berthe Kya and Yang YangInformation Engineering School, University of Science and Technology Beijing, Beijing 100083, China (Received 2001-11-13) Info. Eng. Sch. Univ. of Sci. and Technol. Beijing Beijing 100083 China

Though progress has been made in fractal compression techniques, the longencoding times still remain the main drawback of this technique, which results from the need ofperforming a large number of range-domain matches. The total encoding time is the sum of the timerequired to perform each match. In order to make this method more efficient in practical use, thefuzzy theory based on feature extraction of the projection and normalized codebook method has beenprovided to optimize the encoding time, based on the c-means clustering approach. The results of theimplementation of Rate Mean Square (RMS), Peak signal noise ratio (PSNR) and the encoding time ofthis proposed method have been compared to other methods like the Feature Extraction andSelf-orgarnization methods to show its efficiency.

关键词： fractal compression fractal optimization fuzzy logic c-mean clusteringalgorithm hybrid fractal-fuzzy compression

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