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Short, Medium, and Long-Term Stroke Mortality in Libreville and Associated Factors

Neuroscience & Medicine 2024年第1期15卷 39-50页

作者： Grass Aurelle Mambila Matsalou Jennifer Nyangui Mapaga Pupchen M. Gnigone Minka’a Pagbe Michael Chermine Mboumba Mboumba Christian Allognon Mahutondji Aissata Ibrahima Camara Annick A. Nsounda Nelly Diouf Mbourou Michel-Arnaud Saphou-Damon elsa ayo bivigou Philomene Kouna Ndouongo Neurology Department University Hospital of Libreville Libreville Gabon Cardiology Department University Hospitalof Libreville Libreville Gabon

Strokes are common around the world and especially in sub-Saharan Africa. They are responsible for severe sequelae and the majority of deaths. In Gabon, no study on stroke mortality has been conducted. Objective: To determine short, medium, long-term mortality and factors associated with long-term stroke mortality. Method: Our study took place in the Neurology Department of the University Hospital Center of Libreville (UHCL). It was a historical cohort study with descriptive and analytical purposes covering the period from June 1 to August 31, 2018 and taking into account hospitalized patients from January 1, 2013 to December 31, 2017. We conducted a comprehensive systematic recruitment of patients with stroke, 18 years old and more, and had been agreed to give information. We included all patients meeting the inclusion criteria. The data was gathered using Epi-Info 7 software. The CHI-2 test was used for the comparison of frequencies and the Student’s test, for comparison of means. Multivariate analysis with logistic regression allowed us to look for factors associated with long-term mortality. A result was statistically significant for a p 0.05 value. Results: At 3 months, 28 patients (18.1%) died, at 6 months thirty-one patients or 20.1% died. At 5 years old, fifty-three patients or 34.4% had died. The factors associated with long-term mortality, if the lost of sight were all alive were tobacco (p = 0.01) and stroke (p = 0.008). If all those who were lost to sight had died, no factor was associated with 5-year mortality. Conclusion: Stroke mortality must not be taken for granted, it can be underestimated because of the large number of lost sight. Measures must be put in place to strengthen post-stroke monitoring. .

关键词： Stroke Mortality Associated Factors Libreville

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Lower Extremity Arterial Disease in Patients with Type 2 Diabetes: Prevalence and Associated Factors at the Libreville University Hospital Center

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World Journal of Cardiovascular Diseases 2024年第5期14卷 295-308页

作者： Allognon Mahutondji Christian ayo bivigou elsa Ntoutoume Mvé Dylan Anthony N’nang Jean-Fidel Kinga Armel Mpori Jamila Myrtille Akagah Kondé Christelle Ndoume Obiang Francis Yékini Carole Fadylath Ndjibah Alakoua Cajole Ludvine Babongui Boussougou Latifah Mipinda Jean-Bruno Moubamba Franck Ecke Nzengue Jean-Emmanuel Houenassi Dèdonougbo Martin Boguikouma Jean-Bruno Department of Medicine and Medical Specialties Health Sciences University (USS) Libreville Gabon Cardiology Service Libreville University Hospital Center (CHUL) Libreville Gabon Department of Physiology Health Sciences University Libreville Gabon Amissa Bongo Regional Hospital Franceville Gabon Mother-Child Hospital Center Jeanne Ebori Foundation Libreville Gabon Medicine Service Owendo University Hospital Center Owendo Gabon

Introduction: Lower extremity arterial disease in diabetic patients has distinct characteristics. Objectives: To study the hospital frequency of lower extremity arterial disease and identify associated factors in diabetic patients at the Libreville University Hospital Center (CHUL). Materials and Methods: This was a cross-sectional study conducted from July 1, 2023, to January 31, 2024, in the endocrinology department of the CHUL. All patients with type 2 diabetes over the age of 18 admitted to this department, regardless of the reason for hospitalization, who provided informed consent, were included. Socio-demographic data and cardiovascular risk factors were recorded. Personal and family cardiovascular history and functional symptoms were investigated. The physical examination included measuring blood pressure, heart rate, and the ankle-brachial index in all patients. Results: A total of 219 patients were included, of whom 75 had lower extremity arterial disease, representing a prevalence of 34.24%. It was compensated in 28 cases (37.33%) and decompensated in 39 patients (52%). In eight cases (10.67%), there was critical chronic ischemia. Cardiovascular risk factors associated with diabetes were physical inactivity (89.5%), hypertension (55.25%), overweight (49.77%), obesity (22.84%), and smoking (10.04%). In multivariate analysis, only hypertension (OR = 2.09;95% CI: 1.05 - 4.17;p = 0.035) and LDL cholesterol (OR = 2.75;95% CI: 1.10 - 6.85;p = 0.03) were significantly associated with lower extremity arterial disease in diabetics at the University Hospital of Libreville. Conclusion: Lower extremity arterial disease is common in diabetic patients at the University Hospital of Libreville. It is often asymptomatic, thus requiring systematic screening.[-rId11-]

关键词： Lower Extremity Arterial Disease Diabetes Hypertension Ankle-Brachial Index Gabon

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Heart Failure in Children in a Context of Sars-Cov 2 Infection: About Two Cases at the University Hospital Center of Libreville, Gabon

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Open Journal of Pediatrics 2022年第1期12卷 274-282页

作者： ayo bivigou elsa Mpori Jamila Mba Aki Tatiana Ondo Mba Léo Békalé Joachim Kouna Philomene Cardiology Department University Hospital of Libreville Libreville Gabon Department of Internal Medicine and Medical Specialties Medical School University of Health Sciences Libreville Gabon Cardiology Unit Jeanne Ebori Mother and Child Foundation University Hospital Center Libreville Gabon Department of Ophthalmology University Hospital of Owendo Libreville Gabon Intensive Care Unit Jeanne Ebori Mother and Child Foundation University Hospital Center Libreville Gabon

This study reports two observations of heart failure diagnosed in the context of SARS-CoV 2 infection in children at the University Hospital Center of Libreville, Gabon. Long considered exempted from serious forms of Covid-19 infection, the fatal evolution of one of the two cases proves that there is an interest for a more rigorous approach in their management in a pandemic context. The multisystem inflammatory syndrome associated with this virus in children can be responsible for cardiac manifestations that can be life-threatening. Early diagnosis and treatment are necessary to reduce mortality. However, this approach is made difficult in our regions by the limited biomedical equipment and the absence of essential therapies as noted in these two observations.

关键词： Heart Failure Children Sars-Cov 2 Infection

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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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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

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

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