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Open Journal of Nephrology 2019年第3期9卷 55-64页

作者： Eyram Yoan Makafui Amekoudi kossi Akomola Sabi Badomta Dolaama Komlan Georges Tona Bé fa Noto-Kadou-Kaza Epiphane Kola Bayaki Saka Department of Nephrology and Hemodialysis CHU Sylvanus Olympio Lome Togo Department of Dermatology and Venerology CHU Sylvanus Olympio Lome Togo

HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at Sylvanus Olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m2: 2.9% had an eGFR 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/μL [IQR = 72 - 274/μL];the median hemoglobin level was 10.4 g/dL [IQR = 8.8 - 11.9 g/dL];all patients had thrombocytopenia less than 100.000/mm3;8.5% had leukocytosis greater than 10.000/mm3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.

关键词： HIV Chronic Kidney Disease Epidemiology Togo

Delivery Outcome in Women with Major Sickle Cell Syndrome: A Comparative Study of the Homozygous Forms “SS” versus the Heterozygous “SC”

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Open Journal of Obstetrics and Gynecology 2015年第12期5卷 713-722页

作者： Amah Biova Adama-Hondégla Abdoul-Samadou Aboubakari kossi Edem Logbo-Akey Kodjo Fiagnon Akila Bassowa Koffi Akpadza Department of Gynecology and Obstetrics of the Sylvanus Olympio University Hospital of Lomé Lomé Togo Department of Gynecology and Obstetrics of the University Hospital of Kara Kara Togo

Objectives: To determine the prevalence of women who delivered in the two major sickle cell syndromes, “SS” and “SC”, and to identify maternal and early neonatal prognosis inherent to each form. Material and Methods: This is a comparative, descriptive and retrospective cross-sectional study of 226 files of women carrying major sickle cell syndrome (66 cases of “SS” form versus 160 cases of “SC” form), collected from May 2008 to May 2013 at the Gynecology and Obstetrics Clinic of the Sylvanus Olympio’s University Hospital of Lomé. Data were processed by Epi Info 6 software. For comparison of variables, the Chi-2 test of Fisher with significance as p < 0.05 has been used, so is the calculation of Odds Ratio with its confidence interval at 95%. Results: Carriers of the two major sickle cell syndromes represent 0.8% of all the deliveries during the study period. Caesarean section, especially prophylactic one, was the dominant mode of delivery. The SS forms have been exposed to have more vaso-occlusive crises (22.7% vs. 13.1%;p = 0.04, OR = 0.31), more blood transfusion (57.6% vs. 29.4%;p = 7 × 10-5, OR = 3.2) and more puerperal infections (p < 0.05). Acute chest syndrome was not related to any of the two forms of sickle cell disease (13.6% vs. 8.1%;p = 0.15). The maternal mortality rate and the perinatal mortality among SS form against SC form were not significant (respectively 15.1% vs. 8.7%;20.9% vs. 17.1%). Conclusion: Maternal and fetal complications were present in both forms of major sickle cell syndrome but the "SS" form gave exposure to greater maternal morbidity. Resuscitative measures in adults and newborns should be reinforced at the delivery time of these “at-risk-pregnancies”.

关键词： Sickle Cell Disease Childbirth Prognosis Homozygous SS Heterozygous SC Togo Africa

Outcome of Pregnancies under Cupper Intrauterine Device: Experience of 10 Cases Collected at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

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Open Journal of Obstetrics and Gynecology 2022年第7期12卷 616-623页

作者： Bingo Kignomon M’bortche kossi Edem Logbo-Akey Tina Ayoko Ketevi Baguilane Douaguibe Francis Baramna-Bagou Abdoul-Samadou Aboubakari Koffi Akpadza Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) Lomé Togo Department of Gynaecology-Obstetrics The University Hospital Kara Kara Togo Department of Gynaecology-Obstetrics The University Hospital Sylvanus Olympio Lomé Togo

Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with special reference to etiologies and pregnancy outcomes. Methodology: We analyzed all women who got pregnant under Cu-IUD at ATBEF Main Clinic from July 1, 2015 to June 30, 2020. Results: We retrieved 10 patients. The durations of Cu-IUD use were 3 months to 6 years. The etiologies were poor insertion;migration and spontaneous expulsion. The occurrence of pregnancy was poorly accepted by the women: 20% of women considered it was due to the providers’ incompetence. Of the 10 pregnancies, 5 women had given vaginal birth spontaneously;2 induced abortions, 2 spontaneous abortions and 1 ectopic pregnancy. The contraceptive method adopted after pregnancy was jadelle implants in 8 cases and spousal vasectomy in 2 cases. Conclusion: The prevention of IUD pregnancies may require adequate insertion time, insertion technique and follow-up.

关键词： Contraception Pregnancy Etiologies Outcome Lomé

Renal Risk among Diabetic Patients in Togo

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Open Journal of Nephrology 2022年第3期12卷 249-261页

作者： Kodjo kossi Tsevi Yawovi Mawufemo Dolaama Badomta Tona Komlan Georges Balaka Abago Yao K. Hubert Gnionsahe Daze Apollinaire Centre Hospitalier Universitaire Sylvanus Olympio Lome Togo Centre Hospitalier Universitaire de Treichville Abidjan Cote d’Ivoire Centre Nationale de Prévention et de Traitement de l’Insuffisance Renal Abidjan Cote d’Ivoire

Background: Diabetic patients have risk of kidney disease. The aim of this study was to assess the level of renal risk in our study population and to identify the associated predictive factors. Methods: It was a descriptive and analytical cross-sectional study carried out over 5 years (January 1, 2016 to December 31, 2020). All patients were included regardless of the duration of diabetes and having achieved at least one serum creatinine and at least two (2) proteinuria in the 24 hours over a period of at least three months. The level of renal risk was assessed using the KDIGO 2012 classification. Results: A total of 320 patient medical files were retained. The sex ratio M/F was 1.2. The average age was 57.2 ± 11.8 years. Hypertension was the most common comorbidity (84.4%). Diabetic nephropathy was found in 177 patients, a frequency of 42.8%. The very significant renal risk was found in 174 patients (54.4%). In multivariate logistic regression, the risk factors significantly associated with renal risk were: Male sex (OR = 2.50;95% CI = 1.29 - 4.84, p-value = 0.006);microangiopathy (OR = 5.54;95% CI = 1.82 - 16.85 p = 0.002) and beta-blockers (OR = 5.64;95% CI = 1.04 - 30.53 p = 0.004). The Oral Antidiabetes (OR = 0.23;95% CI = 0.10 - 0.55, p = 0.001), the blockers of Renin-Angiotensin system (OR = 0.58;95% CI = 0.41 - 0.90, p = 0.040) and the average socioeconomic level (OR = 0.50;95% CI = 0.25 - 0.98, p = 0.044) were rather the protective factors.

关键词： Diabetic Kidney Disease Kidney Risk Togo

Dermoid Cysts of the Conus Medullaris Associated with Sacral Meningocele. A Case Report

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Open Journal of Modern Neurosurgery 2022年第3期12卷 153-159页

作者： Mustapha Hemama Dimbi Makoso José Dognon kossi François de Paul Adjiou Moune Yolande Nizare El Fatemi Moulay Rachid El Maaqili Department of Neurosurgery Ibn Sina University Hospital Rabat Morocco Faculty of Medicine and Pharmacy University of Mohammed V Rabat Morocco

Spinal dermoid cysts are gradually progressive benign tumors that may be congenital or acquired. They account for 0.8% to 1.1% of all primary spinal tumors. MRI is the gold standard for the radiological assessment. Management is difficult for tumors involving highly eloquent areas such as the conus medullaris. In this report, we present a rare case of an adult woman with dermoid cysts in the conus medullaris associated with a sacral meningocele which was treated with a midline myelotomy that drained yellowish keratinous fluid and decompressed the cyst. No aggressive attempt at complete resection of the cyst wall was undertaken. The patient fully recovered, and her condition considerably improved after surgery and remains good at a 6-month follow-up.

关键词： Dermoid Cysts Intramedullary Meningocele

Prevalence and Factors Associated with Hepatitis B Virus Surface Antigen and Human Immunodeficiency Virus Antibodies in Chronic Hemodialysis Patients Followed-Up in Lomé, Togo

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Open Journal of Medical Microbiology 2019年第1期9卷 16-27页

作者： Mounerou Salou kossi Akomola Sabi Amen Tevi Koumavi Ekouevi Sika Dossim Fiali Lack Maléwé Kolou Yaotsè Anoumou Dagnra National Reference Centre for HIV STIs and Viral Hepatitis of Togo Lomé Togo Pharmaceutical Department Health Sciences Faculty of University of Lomé Lomé Togo Nephrology Ward University Teaching Hospital Sylvanus Olympio Lomé Togo Public Health Department Health Sciences Faculty of University of Lomé Lomé Togo Basic Medical Sciences Department Health Sciences Faculty of University of Lomé Lomé Togo

Introduction: In haemodialysis patients, the risk of acquiring blood-borne viral infections is an important cause of the dialysis’s process. Indeed, viral infections are quite common in chronic haemodialysis patients including those due to viral hepatitis B and HIV. Objective: Determine the prevalence of HIV infection and hepatitis B infection among chronic hemodialysis patients of Togo. Methods: A cross-sectional study was conducted in chronic hemodialysis patients of Togo from January 1st to December 31st, 2016. Sociodemographic and clinical data were collected. Antigen HBs was screened by a rapid immunochromatographic test (SD BIOLINE? HBsAg), and HIV antibodies were detected using a combination of 2 rapid diagnostic test, SD BIOLINE? HIV-1/2 (first step) and TRIDOT test (second step). Results: During the study period, 95 subjects were included. Patient’s age was ranking from 13 to 80 years with a mean of 46.6 years. The sex-ratio (M/F) was 1.8 and a duration average of dialysis was 51.7 months. The aetiologies of the chronic endstage kidney failure were related respectively to a vascular renal disease for 42.1% of the patients, glomerular nephropaty for 34.74%, interstitial nephropaty for 9.47% and hereditary for 3.16%. For 10.53% of the patients, the initial renal disease remained indefinite. Prevalence of antigen HBs and HIV antibodies were respectively 10.5% and 7.4%. The frequency of co-infection HBV and HIV was 1.1%. Conclusion: The rates of HBV infection and HIV infection remain high in chronic hemodialysis in Togo, somewhat which is linked to an endemic aspect of these two viruses in the country. The type of initial renal disease (glomerular) and the vascular way (the central catheters) established the risk factors for the HIV infection while for the infection of HVB no factor was incriminated.

关键词： HIV HBV Prevalence Hemodialysis Chronic Renal Insufficiency

Neurological Disorders among the Outpatients Living with Human Immuno Deficiency Virus (HIV) Following at the Parakou Hospital in 2014

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Neuroscience & Medicine 2019年第3期10卷 199-206页

作者： Adoukonou Thierry Agbétou Mendinatou Dassi Gbénou Jolianelle Ahanhanzo Rhonel Kpangon Arsene kossi Oyéné Agballa Gottfried Dovonou Albert Houinato Dismand Department of Neurology Faculty of Medicine University of Parakou Parakou Benin Department of Neurology University Departmental Hospital of Parakou Parakou Benin Department of Neurology Faculty of Health Sciences Universitéy of Abomey-Calavi Abomey-Calavi Benin

Objective: To study the frequency of neurological disorders associated to HIV infection. Methods: This cross-sectional study was carried out from 16th June to 16th September 2014 and included all 289 HIV-outpatients admitted to the Parakou University hospital. All data were recorded, physical examination was performed and the medical sheet of each patient was assessed. The diagnosis of neurological disorder (central and peripheral) was based on clinical features, past medical history, biological test and CT-scan data after multidisciplinary staff. Epi-data and Epi-Info 6.04C were used to perform analysis. Results: They were 73 (25.3%) male with a mean age of 38.0 years +/−?10.1 years. The mean duration of disease was 48.5 months +/−37.1 months. 150 (51.9%) of them were at Stage 3 of the disease. All patients (99.7%) were infected by HIV1, 188 (76.1%) had CD4 cells at the onset of the follow-up less than 350 cells/mm3 and 260 (90.0%) were on ART. Among the 289 patients, 110 had at least one neurological disorder, the frequency of neurological disorders was 38.1%. The main neurological disorders were peripheral neuropathy (34.3%), isolated headache (5.2%), stroke (0.7%), cerebral toxoplasmosis (0.7%) and one case of dementia (0.7%). The main associated factors were the age of patient and exposure on neurotoxic drug, especially ART. Conclusion: The neurological disorders were more frequent among HIV patients with a high frequency of peripheral neuropathy probably due to ART.

关键词： Neurological Disorders HIV AIDS Peripheral Neuropathy Epidemiology

Cystic Degeneration of Uterine Leiomyoma Misdiagnosed as Ovarian Malignancy: A Case Report

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 745-751页

作者： kossi Edem Logbo-Akey Kignomon Bingo M’bortche Pierre Yendoubé Kambote Kibandou Noe Patidi Dédé Régine Diane Ajavon Abdoul-Samadou Aboubakari 1Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Togolese Association for Family Welfare (ATBEF) Clinic University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the University Hospital Sylvanus Olympio University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the Regional Hospital Center of Tomdé University of Kara Kara Togo

Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5th post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.

关键词： Leiomyoma Cystic Degeneration Ovarian Tumor

Erectile Dysfunction in Hemodialysis in Togo

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Open Journal of Nephrology 2016年第4期6卷 145-150页

作者： kossi Akomola Sabi Béfa Noto Kadou Kaza Eyram Yoan Amekoudi Jacques Vigan Souleymane Pessinaba Kafui Avouwadan Kodjo Tengue Tchilabalo Matchona Kpatcha Dazé Apollinaire Gnionsahe Departement of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Cotonou Cotonou Benin Departement of Cardiology Campus University Teaching Hospital of Lomé Lomé Togo Departement of Urology and Andrology Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Yopougon Abidjan Ivoiry Coast

Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.

关键词： Erectile Dysfunction Hemodialysis Togo

Methotrexate Treatment of Ectopic Pregnancy: Prognosis at Senlis Hospital

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1086-1091页

作者： kossi Edem Logbo-Akey Kignomon Bingo M’bortche Pierre Yendoubé Kambote Dédé Régine Diane Ajavon Kibandou Noe Patidi Koko Gueze Abdoul-Samadou Aboubakari Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Togolese Association for Family Welfare (ATBEF) Clinic University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the Regional Hospital Center of Tomdé University of Kara Kara Togo Department of Gynecology and Obstetrics of the University Hospital Sylvanus Olympio University of Lome Lome Togo

Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient if it is ignored. Diagnosed early, it offers the possibility of medical treatment with methotrexate. Objective: To describe the prognosis of ectopic pregnancies treated methotrexate. Patients and Methods: Retrospective study of the management of ectopic pregnancy by Methotrexate at Senlis hospital from June 2020 to May 2021 were included in the study, patients with a Fernandez score of less than 13, and having received Methotrexate as first-line treatment. Data were collected using gynecological emergency admission registers, and telephone interviews. Results: 35 cases were identified. The average age of the patients was 32 years old. Forty-nine percent were smokers. The mean gestational age was 5 weeks + 2 days. The diagnosis was made in all of our patients with the combination of the kinetics of ß-hcg and vaginal ultrasound. The size of adnexal mass was less than 4 cm with an average size of 20 mm. The average value of ß-hcg was 1405 IU/L. All patients had received a single dose of methotrexate 1 mg/kg intramuscularly. A second dose was administered to 17.1% of patients for stagnation or re-ascension of the ß-hcg level. The success rate was 91.4%. Thirty percent were obtained spontaneous intra uterine pregnancy, the first year following methotrexate treatment. Conclusion: The success rate of medical treatment for ectopic pregnancy is high in terms of meeting the eligibility criteria for treatment. The subsequent prognosis of fertility is generally preserved.

关键词： Ectopic Pregnancy Methotrexate Prognosis