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Humoral Response and Tolerance of Vaccination against SARS-CoV-2 in Adults Senegalese Patients Undergoing Hemodialysis: A Multicenter Prospective Study

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Open Journal of Nephrology 2024年第1期14卷 70-80页

作者： Lot Nehemie Motoula Latou Moustapha Mbow modou ndongo Gnagna Faye Gora Lo Sidy Mohamed Seck Department of Nephrology and Dialysis Military Hospital of Ouakam Dakar Senegal Immunology Laboratory Military Hospital of Ouakam Dakar Senegal Department of Nephrology and Dialysis Regional Hospital of Kedougou Kedougou Senegal Department of Nephrology Idrissa Pouye General Hospital Dakar Senegal Bacterioloy and Virology Laboratory CMIA Dakar Senegal IRL-3189 ESS/UGB/CNRS/UCAD/CNRST/USTB Faculty of Health Sciences University Gaston Berger Saint-Louis Senegal

Introduction: Following the COVID-19 pandemic, vaccination has been proposed in several countries as the main preventive measure despite very limited data, particularly in dialysis patients. We conducted this study to assess the immunological response to vaccination in Senegalese hemodialysis patients. Patients and Methods: We conducted a prospective study, in two dialysis centers in Dakar from March 30th to August 30th, 2021 including patients on hemodialysis for >6 months, vaccinated against SARS-CoV-2 according to the vaccination schedule recommended by WHO. A vaccine response was considered positive when seroconversion was observed after one dose of vaccine. The clinical efficacy of immunization was defined as the absence of new COVID-19 infection in patients who received a complete vaccination. Results: Among the 81 patients included in the study, 7.4% had anti-Spike IgM antibodies before their first vaccination. Seroprevalence of IgM antibodies was 38.3% one month after the first vaccine dose (at M1) and 8.6% one month after the second dose (at M4). Anti-Spike IgG antibodies were present in 40.3% of patients before vaccination, in 90.1% at M1, and in 59.7% at M4. Among patients previously infected with SARS-CoV-2, 10.2% had IgM antibodies at M0, 31.6% at M1, and 10.5% at M4 post-vaccination. Similarly, seroprevalences of IgG antibodies in this subgroup were 31.5%, 61.3%, and 50.0% respectively at M0, M1, and M4 post-vaccination. A comparison of seroconversion rates between M0 and M4 showed significant differences only for IgG in COVID-19 naive patients. Mean duration in dialysis and the existence of previous COVID-19 infection were associated with patients’ vaccinal response after the two doses. Age, gender and the use of immunosuppressive treatment did not influence post-vaccinal antibody production. Conclusion: Vaccination against COVID-19 in Senegalese hemodialysis patients induced a low seroconversion rate but it was well tolerated. M

关键词： SARS-Cov2 Vaccination Humoral Response Tolerance Hemodialysis Senegal

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Prevalence and outcomes of polycystic kidney disease in African populations:A systematic review

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World Journal of Nephrology 2024年第1期13卷 33-40页

作者： modou ndongo Lot Motoula Nehemie Baratou Coundoul Abou Abdallah Malick Diouara Sidy Mohamed Seck Department of Nephrology and Dialysis Regional Hospital of KedougouKedougou 26005Senegal Department of Nephrology and Dialysis Military Hospital of OuakamDakar 28216Senegal Department of Chemical Engineering and Applied Biology Polytechnic high School of Cheikh Anta Diop UniversityDakar 5085Senegal Department of Nephrology Faculty of Health SciencesUniversity Gaston BergerSaint-Louis 234Senegal

BACKGROUND Polycystic kidney disease(PKD)is the most common genetic cause of kidney *** is a progressive and irreversible condition that can lead to end-stage renal disease and many other visceral *** comprehensive data on PKD patterns in Africa is *** To describe the prevalence and outcomes of PKD in the African *** A literature search of PubMed,African journal online,and Google Scholar databases between 2000 and 2023 was *** Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed to design the *** presentations and outcomes of patients were extracted from the included *** Out of 106 articles,we included 13 studies from 7 African *** of them were retrospective descriptive studies concerning 943 PKD patients with a mean age of 47.9 *** accurate prevalence and incidence of PKD were not known but it represented the third causal nephropathy among dialysis *** majority of patients,the diagnosis of the disease was often *** function impairment,abdominal mass,and hypertension were the leading symptoms at presentation with a pooled prevalence of 72.1%(69.1-75.1),65.8%(62.2-69.4),and 57.4%(54.2-60.6)*** and infections were the most frequent *** was performed in few studies that revealed a high proportion of new mutations mainly in the PKD1 *** The prevalence of PKD in African populations is not clearly *** symptoms were almost present with most patients who had kidney function impairment and abdominal mass at the *** studies including genetic testing are needed to determine the burden of PKD in African populations.

关键词： Polycystic kidney disease Africa Genetic disorder Systematic review

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Cardiac Decompensation after Dilatation of an Arteriovenous Fistula Stenosis: A Case Report

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Open Journal of Nephrology 2022年第4期12卷 369-374页

作者： modou ndongo Sid Ali Toufik Benyaghla Fabrice Tiako Mamadou Mouctar Diallo Misylias Bouaoud Houyem Attia Fatiha Lahouel Djillali Ziane Berroudja Nestor Nankeu Tayeb Bensalem Catherine Albert Department of Nephrology Dialysis and Kidney Transplantation of Aristide Le Dantec hospital Dakar Senegal Department of Nephrology Dialysis of Louis Pasteur Hospital Chartres France

The arteriovenous fistula (AVF) has been considered for several decades as the preferred approach for hemodialysis because of its longevity and its lower morbidity and mortality rate. However, it can be the cause of several infectious and especially cardiovascular complications. Stenosis is the most common complication of AVF. It is favored by several hemodynamic, cellular and mechanical factors. Reduced dialysis performance and thrombosis are the main risks associated with stenosis. Intervention for dilation is indicated in the presence of any pre-thrombotic stenosis or stenosis that alters the quality of dialysis. However, in patients with heart disease, an assessment of the risk of decompensation is mandatory before considering any gesture of dilation of a fistula. We report a case of acute cardiac decompensation in an 85-year-old patient with severe but stable dilated cardiomyopathy after dilatation of an AVF stenosis. This observation shows that particular attention should be given to elderly subjects with AVF stenosis, especially in the presence of underlying heart disease where closure of the AVF with placement of a tunneled catheter is an alternative that should always be discussed.

关键词： Arteriovenous Fistula Stenosis Hyperflow Hemodialysis Cardiotoxic

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Intra-Dialytique Hypotension: Prevalence and Associated Factors in 2 Haemodialysis Centres in Senegal

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Open Journal of Nephrology 2022年第4期12卷 361-368页

作者： Ba A. Mamadou Yaya Kane Moustapha Faye Ameth Dieng Ba Bacary Niakhalen Keita Babacar Ndiaye modou ndongo Sy Abou Maria Faye Ahmed Tall Lemrabott Ka E. Fary Department of Nephrology Internal Medicine Faculty of Health Sciences Assane Seck University Ziguinchor Senegal Department of Nephrology ALDH Cheikh Anta Diop University Dakar Senegal

Introduction: This study aimed to assess the prevalence of Intra-dialytic hypotension (IDH) according to the European Best Practice Guidelines (EBPG) definition in relation to the number of haemodialysis sessions and the number of chronic haemodialysis patients and to identify its associated factors. Patients and Methods: We conducted an observational, multicentre and looking-forward study of descriptive and analytical purposes over a 4-week period. The study included all patients with regular chronic haemodialysis with at least two sessions per week and a duration of 180 minutes, who consented to participate in the study and were over 15 years of age. Data collection was done with pre-established forms. The following data were collected: blood pressure before each session, at 30, 60, 120, 180 and 240 minutes of each session;socio-demographic data;dialysis data;clinical, paraclinical, therapeutic data and nursing interventions. Results: The mean age of the patients was 43.84 ± 12.10 years. Among 568 haemodialysis sessions recorded in 50 patients, IDH was noted in 12 haemodialysis sessions, representing a prevalence of 2.11%. Fatigue was found in 5 sessions with IDH episodes (41.66%) followed by yawning (25%), nausea ± vomiting (16.66%) and cramps (16.66%). As nursing interventions, Trendelenburg position and normal saline administration were performed in all IDH episodes. High blood pressure, inter-dialytic weight gain greater than 3 kg, Uf/H > 10 ml/kg/H, anaemia and hypoalbuminaemia were associated with the occurrence of IDH. Conclusion: The prevalence of IDH according to the EBPG definition is low. However, it is an important cause of morbidity and mortality, especially cardiovascular involvement, and the factors associated with its presence have been clearly identified.

关键词： Intra-Dialytic Hypotension Chronic Hemodialysis Patients Dakar Ziguinchor

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Evaluation of the Therapeutic Management of Hypercalcemia in Myeloma at the Nephrology Department of Louis Pasteur Hospital of Chartres: About 8 Cases

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Open Journal of Nephrology 2022年第4期12卷 403-409页

作者： modou ndongo Babacar Ndiaye Nestor Nankeu Abou Sy Houyem Attia Fatiha Lahouel Djillali Ziane Berroudja Tayeb Bensalem Sid Ali Toufik Benyaghla Catherine Albert Sidy Mohamed Seck El Hadji Fary Ka Department of Nephrology Dialysis and Kidney Transplantation of Aristide Le Dantec Hospital Dakar Senegal Department of Nephrology Dialysis of Louis Pasteur Hospital Chartres France Department of Nephrology Dialysis of Ouakam Military Hospital Dakar Senegal

Introduction: Hypercalcemia is the most common metabolic complication in myeloma. The aim of this study was to evaluate the management strategy of hypercalcemia in myeloma at the nephrology department of Louis Pasteur hospital of Chartres. Patients and Methods: We carried a retrospective study of patients treated for myeloma-related hypercalcemia between January 1, 2019 to December 31, 2021. The clinical, paraclinical, therapeutic and evolutive characteristics were studied. Results: Eight patients were included in this study with a median age of 67 years [41 - 85] and a sex ratio (M/F) of 1. A quarter of patients were known with chronic kidney disease. Four patients (50%) had symptoms of hypercalcemia. Biologically, the mean hemoglobin was 9.8 ± 2.7 g/dl, all patients had an acute kidney injury with a mean creatinine level of 364.1 ± 173.3 mmol/l, a mean serum calcium of 3.42 ± 0.59 mmol/l and three quarter of patients had bone lesions. Five patients (62.5%) were rehydrated with a mean volume of saline of 2700 ± 836.7 ml/24h. Seven patients (87.5%) received biphosphonates and none received diuretics. The mean normalization time of the serum calcium was 5 days. Conclusion: Hypercalcemia is frequent in malignancy and represents a poor prognosis factor of the disease. A well-conducted therapeutic strategy allows rapid normalization.

关键词： Hypercalcemia Myeloma Treatment Malignancy Neoplasia

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Calcific Uremic Arteriolopathy or Calciphylaxis in a Hemodialysis Patient: Case Study and Review of the Literature

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Open Journal of Nephrology 2022年第3期12卷 303-310页

作者： modou ndongo Nestor Nankeu Josephine Nkok Helene Messet Fabrice Tiako Mamadou Mouctar Diallo Misylias Bouaoud Attia Houyem Fatiha Lahouel Djillali Ziane Berroudja Tayeb Bensalem Sid Ali Toufik Benyaghla Catherine Albert Sidy Mohamed Seck El Hadji Fary Ka Department of Nephrology Dialysis and Kidney Transplantation of Aristide Le Dantec Hospital Dakar Senegal Department of Nephrology Dialysis of Louis Pasteur Hospital Chartres France Department of Nephrology Dialysis of Ouakam Military Hospital Dakar Senegal

Calcific uremic arteriolopathy (CUA) is a rare pathology affecting 5% of dialysis patients but with a poor prognosis. It is characterized by calcification and thrombotic lesions of the microcirculation leading to hyperalgesic ischemic skin lesions. Several risk factors have been identified, mainly warfarin treatment, mineral and bone disorders (MBD), inflammation and malnutrition. In the evocative forms, the diagnosis is made based upon the physical examination finding of classic painful ulcerated lesions that are covered by a black eschar. Skin biopsy, due to the risk of aggravation and delayed healing, is only performed in case of doubt diagnosis. The therapeutic attitude due to the lack of solid randomized studies is based on expert consensus and requires a multidisciplinary approach. We report here the case of a patient with CUA revealed in the form of multiple ulcerative-necrotic skin lesions associated with pressure sores and arterial wounds.

关键词： Calcific Uremic Arteriolopathy Calciphylaxis Hemodialysis

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Evaluation of Access to Care for Patients with Chronic Kidney Disease Not on Dialysis in Saint-Louis Region (SENEGAL)

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Open Journal of Nephrology 2020年第1期10卷 1-10页

作者： Seck Sidy Mohamed Doupa Dominique ndongo modou Ahoui Seraphin Diop-Dia Amadou Dia Diatou Gueye Ngouampa Blaise Magloire Enguerran Macia Internal Medicine and Nephrology Department University Gaston Berger Saint-Louis Senegal UMI 3189 Environnement santé sociétés (CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST Burkina-Faso) Faculté de Médecine de Pharmacie et d’Odontostomatologie Dakar Senegal Biochemistry Department University Gaston Berger Saint-Louis Senegal Nephrology Department Borgou Regional Teaching Hospital Parakou Benin

Introduction: Patients with chronic diseases, especially kidney diseases, frequently use the health care system and free dialysis policies are being implemented in many countries in Africa. This study aimed to evaluate access to care for patients with chronic kidney disease (CKD) in northern region of Saint-Louis. Methodology: In a cross-sectional survey, we included non-dialyzed CKD patients aged ≥20 years who attended outpatient nephrology clinic at University Hospital of Saint-Louis between January 1st and January 31st 2018. Access to care was measured using a questionnaire that integrated dimensions such as availability, geographic and financial accessibility, convenience, acceptability, effectiveness of care and quality of information. Socio-demographic and clinical data were also collected and analyzed with Epi Info 7. Results: Among 97 surveyed patients, 90 were included (response rate of 92.8%). Patients’ mean age was 35.2 years (20 - 89 years) and 55% were male. Only 30% of patients had health coverage either by the government, or private insurance or community health insurance. Access to care was rated as globally low by 73% of participants. However, we noticed some variations according to dimensions of access. Geographical accessibility and convenience of delivered care were good for the majority of patients, while financial access and acceptability of care were considered as very limited. Bivariate analysis showed that acceptability and effectiveness of care were linked to CKD stage while the quality of patients’ information was correlated with their educational level. Furthermore, health coverage was also associated with financial accessibility of care but not with its availability. Conclusion: This study showed that access to care is poor for majority of patients with CKD in Saint-Louis. Identification of the main barriers will help define appropriate strategies to achieve universal access to quality renal care.

关键词： Access to Care Chronic Kidney Disease Saint-Louis

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Congenital Heart Disease in Rural Senegal: A Retrospective Study of 79 Patients

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Open Journal of Pediatrics 2023年第1期13卷 43-49页

作者： Babacar Niang Aminata Mbaye Djibril Boiro Aliou Abdoulaye ndongo Mame Diarra Thiam Aliou Thiongane modou Guéye Amadou Lamine Fall Ousmane Ndiaye Albert Royer Children’s Hospital Dakar Sénégal Abass Ndao Hospital Dakar Sénégal

Introduction: Congenital heart disease (CHD) is a malformation of the heart present at birth and resulting from a developmental defect during embryonic life. The aim was to assess CHD in rural areas. Methodology: This is a retrospective study conducted over a period of 2 years in rural Senegal. Results: During the study period, we collected 79 patients with CHD, representing a hospital prevalence of 2.6%. The mean age at diagnosis was 17.05 months and the sex ratio was 1.19. The mean birth weight was 2826 g. The main comorbidities were anaemia (54.43%) and respiratory infections 38 cases (48.10%). Respiratory distress was the most common sign with 98.73%. Radiological cardiomegaly was noted in 86.7%. The most frequent CHD were interventricular septal defect (IVD) 21.51% and atrial septal defect (ASD) 8.86%. No patient was able to receive surgical treatment. Seven children died (8.86%) and 21 children were lost to follow-up (26.58%). On Doppler echocardiography, 16.45% of the patients had pulmonary arterial hypertension (PAH). Conclusion: In light of this work, emphasis should be placed on the quality of antenatal consultations, the quality of management and the regular availability of echocardiography and a cardio-paediatrician in order to reduce morbidity and mortality.

关键词： Heart Disease Congenital Children Senegal

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Assessment of Insulin Therapy in 281 Children and Adolescents with Type 1 Diabetes in Senegal

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Open Journal of Pediatrics 2022年第1期12卷 283-292页

作者： Djibril Boiro Amadou Sow Aliou Abdoulaye ndongo Idrissa Basse Lamine Thiam Ndiogou Seck Cheha Fatoumia Babacar Niang modou Guéye Maïmouna Ndour Mbaye Ousmane Ndiaye Abass Ndao Hospital Dakar Senegal Aristide Le Dantec Hospital Dakar Senegal Diamniadio Children’s Hospital Dakar Senegal Ziguinchor Peace Hospital Dakar Senegal Saint Louis Regional Hospital Dakar Senegal Albert Royer Children’s Hospital Dakar Senegal

Introduction: In Senegal, with the CDIC “Changing Diabetes In children” project, insulin has been made free. The objective of this study was to evaluate the accessibility and modalities of insulin therapy in the management of type 1 diabetes. Methodology: This was a retrospective study including patients followed for type 1 diabetes (T1DM) in hospital between April 2018 and December 2020. Results: 281 patients were included. The mean age was 14.22 years. The mean age at diagnosis was 11.28 years. Ketoacidosis was the main mode of discovery of diabetes at 51.6%. Premix and rapid insulins were most commonly used at 84.7% and 82.9% respectively, most often in combination. The most commonly used treatment regimen was three injections/day in 82.5% of cases. The average daily insulin dose was 0.62 IU/Kg/dr. Of the patients, 219 (78%) were self-monitoring of blood glucose. The average number of blood glucose checks was 1.78 per day. 76 patients (27%) went days without an insulin injection and up to 7 days in 51% of cases. The main reasons were forgetfulness, therapeutic errors and stock-outs. Hypoglycaemia was observed in 14.2%. The average glycated haemoglobin was 10%. Conclusion: Despite the efforts made, there are still challenges to improve access to insulin. The reinforcement of therapeutic education on insulin therapy is essential for a better quality of life of diabetic children and adolescents.

关键词： Diabetes Children Insulin Therapy Senegal

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Prevalence of Renal Failure in Children and the Need for Dialysis in Paediatric Nephrology in a Developing Country

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Open Journal of Nephrology 2022年第1期12卷 101-111页

作者： Younoussa Keita Aliou A. ndongo Fatou Ly Ndeye C. Cisse Liliane N. D. M. Yamba Babacar Niang Djiby Seck Amadou Sow Ndeye F. Sow Abou Ba Indou D. Ly Aliou Thiongane Amadou L. Fall Idrissa D. Ba modou Gueye Pape M. Faye Assane Sylla Pediatric Unit of Aristide Le Dantec Hospital Dakar Senegal Pediatric Unit of Pikine Hospital Dakar Senegal Pediatric Unit of Albert Royer Hospital Dakar Senegal Pediatric Unit of Abass Ndao Hospital Dakar Senegal Pediatric Unit of Dalal Diam Hospital Dakar Senegal

Background: Renal failure is among the major visceral failures responsible for morbidity and mortality in children. Epidemiological data on renal failure in children are limited in sub-Saharan Africa, including Senegal. We conducted this study to assess the prevalence of renal failure (RF) and the need for dialysis in the paediatric nephrology unit. Patients and methods: This was a retrospective and descriptive study in the pediatric nephrology unit from 1st January 2020 to 30 June 2021, including children with acute or chronic RF. The need for dialysis was judged to be met by its effectiveness in face of an indication. The data collected were analysed on sphinx plus 2017 software. Results: The prevalence of RF was 60% (n/N = 132/220). RF was acute in 59% (n/N = 78/132) of cases. The mean age was 6.53 ± 4.77 years with a sex ratio of 1.8. The mean serum creatinine level was 27.22 mg/L (240.9 μmol/L) and BUN at 0.85 g/L. The aetiologies were dominated by prerenal AKI (Acute Kidney Injury) complicating nephrotic syndrome (NS) in 37.2% (n/N = 29/78) and dehydration due to stomach flu in 17.6% (n/N = 9/51). Acute post-infectious glomerulonephritis including group A streptococcus and plasmodium falciparum accounted for 16.7% (n = 13/78) of intrinsic AKI. The need for dialysis was unmet in 50% (n/N = 7/14) with a mortality of 14.1% (n/N = 11/78). The mean age of the patients with chronic RF was 8.68 ± 4.74 years with a sex ratio of 2.6. The mean serum creatinine level was 36.56 mg/L (323.5 μmol/L) and the BUN level was 0.99 g/L. Half of the children were classified as having CKD stage II (early stage). The aetiologies were dominated by primary focal and segmental glomerulosclerosis (FSGS), 53.7% (n/N = 29/54), renal hypoplasia, 22.2% (n/N = 12/54) and reflux nephropathy, 29.4% (n/N = 5/17). The need for dialysis was unmet in 46.1% (n/N = 6/13). The overall mortality of chronic kidney disease (CKD) with RF was 29.6% (n/N = 8/27). Conclusion: The prevalence of RF was high i

关键词： Renal Failure Glomerulonephritis Hypodysplasia Dialysis Children

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