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Knowledge, Attitudes and Practices of Diabetic Patients on Ocular Complications of Diabetes in Lomé(Togo)

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Open Journal of Endocrine and Metabolic Diseases 2022年第9期12卷 197-210页

作者： Kokou Vonor kossi Kodjo Kwam Dodji Godwin Yaovi Tété Koffi Didier Ayéna Méba Banla Komi Patrice Balo Department of Ophthalmology Regional Hospital of Kara Kara Togo Departement of Ophthalmology Faculty of Health Sciences University of Lomé Togo Department of Internal Medicine and Endocrinology Sylvanus Olympio University Hospital of Lomé Lomé Togo

Introduction: The frequency and severity of eye complications from diabetes make patient education essential, which is the basis for adequate management. What is the level of education of diabetic patients in Lomé? The aim of this study was to assess the knowledge, attitudes and practices of diabetic patients on the ocular complications of diabetes in Lomé. Methods: We conducted a cross-sectional study by surveys on diabetic patients from April 1 to June 31, 2020, in 6 diabetes management centers in Lomé. The correct response rate was established for each component. Knowledge: poor (≤ 50%), low (50% - 65%), medium (65% - 85%) and good (≥ 85%). Attitudes: harmful (≤ 50%), erroneous (50% - 65%), approximate (65% - 85%) and fair (≥ 85%). Practice: harmful (≤ 50%), inadequate (50% - 65%) and adequate (>65%). Results: Over the study period, 150 patients were enrolled. The mean age was 56.98 ± 13.37 years with a sex ratio of 1.1 (79 men/71 women). The overall level of knowledge was insufficient (50.6%) with 65.5% for general knowledge about diabetes and 35.8% for ocular complications of diabetes. Attitudes were approximate (68.7%). In the case of hyperglycemia, 31.3% of patients would confide in a diabetologist and 22.0% in a general practitioner. If decrease in vision, 84.3% of patients would contact the ophthalmologist. The level of practice was harmful (20.4%). For diabetic follow-up, 36.7% of patients have already seen an ophthalmologist, 41.3% have performed a fundus examination, 17.3% retinal angiography, 4% laser retinal photocoagulation and 2.7% intravitreal injection (IVT). An awareness session on the ocular complications of diabetes was followed by 52.7% of patients and 50.7% of patients followed a therapeutic education session. Conclusion: This study has shown that the level of knowledge was poor, attitudes approximate and practices harmful. It is therefore important to raise awareness about diabetes and its ocular complications with the aim to change behavior.

关键词： Knowledge Attitudes Practices Eye Complications Diabetes Lomé

Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at LoméUniversity Hospital

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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

Does Eye Camp Contribute to the Fight against Blindness? Experience of the Central Region in Togo

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Open Journal of Ophthalmology 2017年第3期7卷 196-203页

作者： Kassoula Batomaguela Nonon Saa Nidain Maneh Messan Kokou Amedome Kokou Vonor kossi Dzidzinyo Koffi Didier Ayena Komi Patrice Balo Eye Department of Sokode Faculty of Health Sciences University of Lome Lome Togo Eye Department of Lome Faculty of Health Sciences University of Lome Lome Togo Eye Department of Kara Faculty of Health Sciences University of Lome Lome Togo

Aim: To evaluate results of cataract surgery in Eye Camp in rural areas. Patients and Method: This study set about the retrospective analysis of cases and operating reports of patients over the age of 10, operated for cataract in Eye Camp and fixed strategy from January, 2010 to December, 2012. Postoperative data were specified and compared. Results: Out of a total of 1145 patients operated, 577 (50.40%) were men compared with 568 (49.60%) women. The general mean age was 62 years, similar in Eye Camp and in fixed strategy. Sixty percent of patients were operated in Eye Camp. After 4 weeks of follow-up, 77% of patients were met again, and 83% among them showed good results (corrected visual acuity = 3/10). This rate of good results was 80.43% in Eye Camp against 87.7% in fixed strategy. We noted 18.25% of complications among which 11.25% were in Eye Camp. The functional outcomes of both strategies get closer to WHO standards. Conclusion: Eye Camp in the Central Region of Togo is an interesting alternative that contributes to the fight against blindness, even if postoperative follow-up is still to be improved.

关键词： Cataract Surgery Eye Camp Functional Outcomes

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

Place of Ocular Ultrasound in the Diagnosis of Optic Disc Druses in Developing Countries: About a Case and Review of the Literature

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Open Journal of Ophthalmology 2021年第4期11卷 325-331页

作者： Kokou Messan Amedome Kokou Vonor Codjo Rodrigue Abel Assavédo Nidain Maneh Massaga Dagbe kossi Dzidzinyo Koffi Didier Ayéna Komi Balo Centre Hospitalier Universitaire de Kara Kara Togo Centre Hospitalier Régional de Kara Tomdè Kara Togo Centre Hospitalier Départemental Borgou-Alibori Parakou Benin Centre Hospitalier Universitaire Campus de Lomé Lomé Togo Centre Hospitalier Universitaire Sylvanus Olympio de Lomé Lomé Togo Hô pital Secondaire de Bè Lomé Togo

Background: Druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. Aim: The aim of this study is to show the utility of ocular ultrasound in ophthalmology in underdeveloped countries for the characterization of optic disc druse. Case Presentation: Our study relates to a clinical observation of buried papillary druses diagnosed by ocular ultrasound. The ophthalmologic examination revealed an aspect of false papillary edema in the fundus. The ocular ultrasound revealed hyperechogenic deposits buried in the papillary margins, which suggests the deep papillary druses. Conclusion: Ocular ultrasound still has a prominent place in the diagnosis of certain eye conditions despite the new sophisticated means available to ophthalmology to date.

关键词： Ultrasound Druses Hyperechoic Globe