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A Hospital-Based Cross-Sectional Study Assessing the Relation between Time of Birth and Perinatal Outcome

Open Journal of Pediatrics 2020年第1期10卷 217-223页

作者： mouhamadou Wade Papa Moctar Faye Mame Diarra Ndiaye Mamour Gueye Simon Birame ndour Abdoulaye Diakhate Ndama Niang Khalifa Fall Moussa Diallo Omar Gassama Magatte Mbaye Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal Philippe Senghor Health Center Yoff Cheikh Anta Diop University Dakar Senegal

Objectives:?Investigating the relation between perinatal outcomes and?hospital working shifts.?Methods:?We conducted a cross-sectional study at Philippe Maguilen Senghor health center (PMSHC) in Dakar, Senegal from January, 1st?2011 to December, 31th 2018. The study population was comprised of all mothers who had delivered at PMSHC and their newborns after completing 22 weeks of gestation. Time of delivery was?divided into three periods of working hours: morning shift (deliveries occurred between 7 am and 4:59 pm);evening shift from 5 pm to 10:59 pm and night shift from 11?pm to 6:59 am.?Maternal outcomes were assessed by mode of delivery, epsisotomy and perineal injuries.?The Apgar scoring system was used to assess newborns at first minute after they were born. Other adverse perinatal outcomes included fresh stillbirth, neonatal referral and early neonatal death. Data were analyzed using Statistical Package for Social Science software (SPSS 24, Mac version).?Results:?A total of 48,270 mothers and their newborns met eligibility criteria. Caesarean section deliveries were less likely to occur during evening (OR 0.84, 95% CI;0.79?-?0.89, p = 0.001) and night shifts (OR 0.45, CI;0.47?-?0.53, p = 0.001).?Evening shift deliveries had 1.1 the odds of poor perinatal outcome (Apgar score ?- 1.18, p = 0.012). No significant difference was found in the odds of neonate referrals and deaths across the three shifts.?Night shift deliveries had 1.1 the odds of perineal injuries compared to morning shift deliveries (OR 1.11, 95% CI;1.04?- 1.18, p = 0.001, for episiotomy and OR, 1.14;95% CI, 1.04?- 1.26, p = 0.008, for perineal tears). Conclusion:?Off-hours deliveries, particularly during the night shift, were significantly associated with higher proportions of perineal injuries compared to morning shift.?However, no significant difference was found in the odds of neonate referrals and deaths across the three shifts.?Our findings suggest to set up a Neonatology unit at the CSPMS as

关键词： Perinatal Outcome Time of Birth Low-Resource Setting

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Renal Disease among HIV Positive Patients in Senegal

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Open Journal of Nephrology 2017年第4期7卷 101-106页

作者： Khodia Fall mouhamadou moustapha Cissé Ahmed Tall Lemrabott Maria Faye Mouhamed Cherif Dial Atoumane Faye Seynabou Fall moustapha Faye Alex Keita Mansour Mbengue Seynabou Diagne Niakhaleen Keita Bacary Ba Abdou Niang Boucar Diouf El Hadji Fary Ka Nephrology and Hemodialysis Department CHU Aristide Le Dantec Dakar Senegal Cytology and Histopathology Department Grand-Yoff General Hospital Dakar Senegal Internal Medicine Department CHU Aristide Le Dantec Dakar Sénégal

Introduction: Renal disease (RD) in human immunodeficiency virus (HIV) infection is a decisive turning point in the development and prognosis of this disease. In Africa, the prevalence varies between 2.5% and 48.6%. In Senegal, little data are available in the literature. The objective of our study was to describe the epidemiological, clinical, paraclinical, therapeutic and progressional aspects in patients living with HIV (PLWHIV). Patients and methods: This was a retrospective, descriptive and analytical study carried out over a 10-year period in the Department of Internal Medicine and Nephrology at the Aristide Le Dantec Hospital in Dakar, Senegal. We included all 15-year old and above PLHIV with available CD4 count and viral load. Results: Out of 248 PLHIV, 32 had kidney disease (KD), which means a hospital prevalence of 12.9%. The mean age was 51.22 ± 10 years (extremes of 36 and 77 years) with a sex ratio (male/female) of 1.28. Renal signs were dominated by glomerular nephropathy syndrome. It was present at 80%. Tubulo-interstitial nephropathy syndrome and chronic uremic syndrome accounted for 6.25% and 3.1% of cases, respectively. Renal function Impairment was present in 21 patients with 18 cases of acute kidney injury (85.7%) and 3 cases of chronic renal failure (14.3%), including 2 in stage 5 of chronic kidney disease. Renal biopsy (RB) was indicated and performed in 20 (62.5%) patients with glomerular signs in 12 patients (60%). Glomerular lesions were dominated by focal and segmental glomerulosclerosis (FSGS) in 6 cases, membraneous nephropathy (MN) in 4 cases and minimal change disease (MCD) in 2 cases. Tubulo-interstitial and vascular lesions were present in 45% and 12.5% of cases, respectively. In highly active antiretroviral therapy (HAART), 12 (37.5%) patients had total remission, 9 (28.12%) had partial remission. One (3.12%) death from severe metabolic acidosis on chronic renal failure was deplored. Conclusion: This study illustrates the high preval

关键词： Kidney Disease HIV HIVAN Senegal

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Non-Infectious Complications of Peritoneal Dialysis in Senegal

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Open Journal of Nephrology 2020年第1期10卷 43-49页

作者： Ahmed Tall Lemrabott Maria Faye moustapha Faye Abdoul Hassane Sanlé Traoré mouhamadou moustapha Cissé Khodia Fall Yaya Kane Zeinabou Maiga Moussa Tondi Mansour Mbengue Bacary Ba Niakhalee Keita Seynabou Diagne Abdou Niang Boucar Diouf El Hadji Fary Ka Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Department of Nephrology Thies University Thies Senegal Internal Medicine and Nephrology Assane Seck University Ziguinchor Senegal Department of Nephrology and Haemodialysis Faculty of Sciences and Health of the Abdou Moumouni University of Niamey Niamey Niger

Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the transfer of patients to haemodialysis. The aim of this study was to determine the prevalence and the different types of non-infectious complications in our context. Patients and Methods: This was a 5-year, descriptive, retrospective study of patients on chronic peritoneal dialysis for more than 3 months. Results: During the study period, 75 patients were included. The prevalence of non-infectious complications was 88%, including 45.3% mechanical complications and 76% metabolic complications. Catheter migration was the most common mechanical complication (55.9%), followed by catheter blockage (23.5%). Metabolic complications were dominated by hypoalbuminemia (76.3%). Dyslipidaemia and hypokalaemia affected more than 50% of patients, occurring in 59.3% and 56.9% of cases, respectively. Conclusion: In our study, non-infectious complications related to PD were frequent and varied. They remain a significant cause of technical failure. Mechanical complications are often the cause of permanent transfer to haemodialysis.

关键词： Peritoneal Dialysis Non-Infectious Complications Catheter Migration Hypoalbuminemia Hypokalaemia

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Peripheral Arterial Disease among Patient Undergoing Maintenance Hemodialysis in Dakar (Senegal)

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Open Journal of Nephrology 2021年第2期11卷 242-251页

作者： Habin Yabama Aida Lengani mouhamadou moustapha Cissé Hamadoun Yattara Alassane Mbaye Gérard Coulibaly Joseph Salvador Mingou El Hadj Fary Ka Abdou Niang Abdoul Kane Boucar Diouf Departement of Nephrology University Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso Departement of Nephrology University Hospital Aristide le Dantec Dakar Sénégal Departement of Nephrology University Hospital of Point G Bamako Mali Departement of Cardiology National Hospital Grand Yoff Dakar Sénégal Cheikh Anta Diop University Dakar Sénégal

Background: Peripheral arterial disease (PAD) is common in patients with chronic kidney disease (CKD). It is a surrogate marker of generalized atherosclerosis. In sub-Saharan Africa, PAD remains understudied in CKD. Ankle-brachial index (ABI) is a non-invasive and cost-effective tool to diagnose PAD. Objectives: Our aim was to determine the prevalence and associated risk factors for PAD in hemodialysis patients. Patients and Methods: We conducted a cross-sectional study from July 1 to December 31, 2012 in the department of Nephrology of the University Hospital Aristide le Dantec of Dakar. All consenting patients, aged above 18 years, on hemodialysis for at least 6 months were included. ABI measurements were performed using a handled pulse doppler. PAD was defined as an ABI of Results: A total of 53 patients with a mean age of 49.15 ± 15.18 were included. The sex ratio was 0.70. Hypertension (83.01%), low HDL-cholesterol (26.41%) and cigarette smoking (20.75%) were the main cardiovascular risk factors. Prevalence of PAD was 47.16%. Among patients with PAD, 52% had no suggestive symptoms. Lower pre-dialysis (p = 0.0384) and post-dialysis (p = 0.0447) diastolic blood pressure (BP) were significantly associated with PAD. The conventional risk factors (tobacco consumption, diabetes, alcohol consumption, dyslipidemia, hypertension, age), iPTH and CRP levels were not correlated with PAD. Conclusion: PAD is common among patients undergoing maintenance hemodialysis in Senegal. Early diagnosis and management of PAD should be routinely performed in CKD patients.

关键词： Ankle Brachial Index Peripheral Arterial Disease Hemodialysis

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Renewable Energy Powered Membrane Process for Removal of Excess Fluoride Ions and Safe Drinking Water Supply in Rural Areas in Senegal

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Journal of Environmental Science and Engineering(B) 2022年第6期11卷 241-247页

作者： Mohamad moustapha Dieme Saidou Nourou Diop mouhamadou Abdoulaye Diallo Amadou Dieye Amadou Lamine Diouf Courfia Kéba Diawara UFR Sciences et Technologies Universitéde Ziguinchor B.P 523 ZiguinchorSenegal Facultédes Science Technique UniversitéCheikh Anta DIOPB.P 5005 Dakar-FannSenegal

The analysis results made on drinking water from the rural areas of Kaolack,Diourbel and Fatick central region of Senegal showed the excess of fluoride and chloride *** on the area,the fluoride concentration in the water can reach 3.5 mg/*** values obtained are completely above of WHO(World Health Organization)*** objective of this study is to assess the performances of membrane filtration units powered by renewable energies for fluoride and salinity excess removal in remote village in *** membrane filtration units have been installed in rural areas of regions such as Kaolack,Fatick and *** membrane filtration units are equipped by the LPRO(Low Pressure Reverse Osmosis)membranes with 9 m^(2)of surface.A rejection rate of fluoride and chloride ions obtained is 99.33%and 95.25%*** conversion rates are ranged from 45%to 65%.These results clearly show that membrane processes can be used in Africa,especially in isolated rural areas,with the combination of renewable ***,more than twenty membrane filtration units are installed in Senegal and provide drinking water of very good quality for populations living in rural *** prospect is to expand it on a larger scale,which is already underway,with the construction of a desalination plant in Dakar.

关键词： Fluoride renewable energy LPRO membrane drinking water rural areas

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Antisynthetase Syndrome in Senegalese Patients: Report of Three Cases

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Open Journal of Internal Medicine 2019年第4期9卷 121-128页

作者： Baï dy Sy Kane moustapha Niasse Michel Assane ndour Awa Cheikh Ndao Boundia Djiba Mohamed Dieng Maï mouna Sow Nafissatou Diagne Atoumane Faye Souhaibou Ndongo Abdoulaye Pouye Department of Internal Medicine Cheikh Anta DIOP University Dakar Senegal Department of Rheumatology Cheikh Anta DIOP University Dakar Senegal

Introduction: Antisynthetase syndrome is an original entity and rare autoimmune myositis and systemic disease, characterized clinically by a wide spectrum of clinical manifestations and the presence of autoantibodies directed against aminoacyl RNAt synthetases. We describe this disease in 03 Senegalese patients. Observations: The first patient was a 49-years-old black woman who was referred in our department after 06-months of follow-up for a misdiagnosis of tuberculosis. The clinical examination revealed polyarthritis, muscle weakness, chronic cough with crackling rales at the pulmonary bases, Raynaud phenomenon and dry syndrome. The second patient, a 21-years-old black woman, had polyarthritis and a progressive muscle weakness. The clinical examination showed also cutaneous signs including an erythema on the dorsal part of the fingers and the presence of the heliotrope erythema on the eyes. The last patient was a 52 years-old black woman. His clinical examination showed polyarthritis, muscle weakness and an appearance of mechanics’ hands. The creatinine phosphokinase was at 6.26 × N, 40.3 × N and 33.64 × N respectively in our patients. The chest computer tomography revealed an interstitial lung disease with a pattern of non-specific interstitial pneumonia in all three patients. The autoantibodies anti-Jo1 was also positive in all patients. The diagnosis of antisynthetase syndrome was retained with an overlap of antisynthetase and Sj?gren’s syndrome in the first observation. The evolution was favourable in our 03 observations with a therapeutic combination including Prednisone-Azathioprine and Kinesitherapy. Conclusion: Antisynthetase syndrome has been exceptionally reported in sub-Saharan Africa. It must be particularly mentioned in front of the triad: myositis, arthritis and interstitial lung disease. The identification of an auto-antibody directed against RNA t synthetases, particularly anti-Jo1, is essential for its diagnosis. Prognosis is related to interstiti

关键词： Antisynthetase Syndrome Myositis Connective Tissue Disease Africa South of the Sahara

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Prognostic Aspects of Lupus Nephritis at Aristide Le Dantec University Hospital in Dakar

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Open Journal of Nephrology 2018年第4期8卷 124-132页

作者： Mbengue Mansour Faye Maria Cissé mouhamadou moustapha Lemrabott Tall Ahmed Fall Khodia Keita Alex Faye moustapha Ba Bakary Diagne Seynabou Keita Niakhaleen Ba Mamadou Aw Dieng Ameth Motula Latou Lot Niang Abdou Diouf Boucar Ka El Hadji Fary Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal

Introduction: Kidney injury is common in the course of lupus and affects the functional and vital prognosis. The risk of progression to end-stage renal failure can reach 40% to 60%. Thus we carried out this work for the purpose of an evaluation of the renal and vital prognosis and to deduce the factors of poor prognosis. Patients and method: This was a retrospective, descriptive and analytical study conducted over a period of 10 years from January 1, 2007 to December 31, 2016, performed in the Nephrology Department of Aristide Le Dantec Hospital in Dakar. Patients with lupus nephritis were included. The studied parameters were epidemiological, clinical, paraclinical and progression. We had done a crossover of the patients to look for the factors of poor renal and vital prognosis. Results: Out of 93 cases of lupus patients, 64 were included, a prevalence of 69%. The mean age of the patients was 31.97 ± 10.44 years old. There were 81% women and 19% men, a sex ratio of 0.23. Class III was found in 24 cases (37.5%), Class IV in 20 cases (31.25%), Class V in 15 cases (23.4%), Class II in 4 cases (6.25%) and Class I in 1 case (1.6%). The combination of corticosteroids and immunosuppressants was used in 56.25% of cases. After a follow-up of six months, 19 patients were in complete remission, 21 had resistance and 9 had partial remission. Of the 21 patients who had resistance, 8 were in chronic renal failure. Death was observed in 5 patients and the causes were in 3 patients: pulmonary embolism, bacterial meningitis and pulmonary tuberculosis. The cause of death was unknown in 2 patients. The factors of poor renal prognosis were lymphopenia, the presence of anti-native DNA antibodies, nephrotic syndrome, microscopic hematuria, tubular atrophy and interstitial fibrosis. Risk factors affecting renal survival were the presence of native anti-DNA antibodies, microscopic hematuria, leukocyturia and the presence of a proliferative class. The factors of poor prognosis were renal f

关键词： Remission Resistance Chronic Renal Failure Lupus Nephritis

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How to Avoid Primary Caesarean Section? A Five-Year Experience Report from a Level 2 Facility in Dakar Senegal

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Open Journal of Obstetrics and Gynecology 2017年第12期7卷 1174-1182页

作者： Mame Diarra Ndiaye Gueye Mamour Gueye Magatte Mbaye Abdelouahed Chraibi Aliou Diouf mouhamadou Wade Moussa Diallo Omar Gassama Mor Cisse Youssoupha Toure moustapha Thiam Jean Charles Moreau Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta DIOP University Dakar Senegal

Objectives: The aim of this study was to analyse key factors and main indications of primary caesarean sections and find out ways to reduce the rising rates. Patients and method: This was a longitudinal and retrospective study carried out from 1 January 2012 to 31 December 2016. The study included all patients in whom a primary CS was performed. A previous uterine scar was a non-inclusion criterion. We analysed the main indications and their trends during these five years, Apgar score at the 5th minute according to the course of caesarean section rate and the impact of daily audit. Data were collected retrospectively from 2012 to 2015, then prospectively in 2016 using a Filemaker database. Data were analysed with SPSS 21 software, Mac version. Averages were calculated for quantitative data and percentage for qualitative ones. The statistical tests used were the Pearson Chi2 test. The differences observed were considered significant when the p value was less than 0.05. Results: During the study period, we registered 21.308 deliveries and 6.292 caesarean sections (29.5%). Primary CS concerned 72.5% of overall CS. The main indications were suspicious of fetal distress (29.1%), obstructed or prolonged labour (21.7%), breech and twin delivery with respectively 8.2% and 5.2%. We registered more vaginal deliveries with induction of labour: 81.4% versus 75.2%. An obstetrical audit allowed better management of labour and decrease of CS rate. Conclusion: We need to focus on diagnosis of fetal distress, management of breech presentation in twin delivery and singleton. The induction of labour can be an effective alternative in some indications. An obstetrical audit is necessary to reverse caesarean section rate.

关键词： Caesarean Section Rate Indications Apgar Score Obstetrical Audit

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Tuberculosis among Chronic Hemodialysis Patients: A Senegalese Single Center Experience

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Open Journal of Nephrology 2015年第4期5卷 117-122页

作者： mouhamadou moustapha Cisse Rachid El Kabouss Yaya Kane Sidy Mouhamed Seck Ahmed Tall Lemrabott Maria Faye El Hadji Fary Ka Ansoumana Diatta Abdou Niang Boucar Diouf Nephrology Department of Teaching Hospital Aristide le Dantec Dakar Senegal Department of Nephrology Assane Seck University Ziguinchor Senegal Department of Nephrology Gaston Berger University Saint Louis Senegal

Summary: Tuberculosis is a common infectious disease in chronic hemodialysis due to alteration of the immune system associated with chronic kidney disease. The objectives of this study are to determine the prevalence of tuberculosis in chronic hemodialysis patients and to identify its diagnostic and therapeutic difficulties. Methods and patients: This was a descriptive retrospective study over a period of 20 years (1994-2014). It includes the records of periodic hemodialysis patients in the Nephrology Department of the Aristide Le Dantec University Teaching Hospital in Dakar which clinical symptoms and laboratory favor tuberculosis. Results: Of 258 chronic hemodialysis patients treated in Hospital Aristide Le Dantec hemodialysis center, 29 cases (11.4%) of tuberculosis disease are diagnosed. The mean age is 43.21 ± 12.48 years, and the sex-ratio is 0.8. The median time to onset of tuberculosis after initiation of hemodialysis is 22.86 ± 28.86 months. The diagnosis of tuberculosis is sure only in 17% of cases. Extra-pulmonary sites are found in 79% of cases. The average duration of treatment is 9.39 ± 1.64 months (6 - 13 months). Various treatment protocols are adopted. Mortality is 21%, 50% due to disseminated tuberculosis. Conclusion: The diagnosis of tuberculosis in the chronic hemodialysis patients is often difficult due to the atypical symptoms, the frequency of extra-pulmonary location and the lack of evidence of sure diagnosis.

关键词： Tuberculosis Hemodialysis Dakar

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Renal Cortical Necrosis: An Unusual Complication of <i>Plasmodium malariae</i>Malaria

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Open Journal of Nephrology 2015年第4期5卷 99-104页

作者： Ahmed Tall Lemrabott mouhamadou moustapha Cissé Sidy Mohamed Seck Elhadji Fary Ka Maria Faye Aliou Ndongo Cherif Dial Younoussa Keita Khodia Fall Abdou Niang Boucar Diouf Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Faculty of Medicine Gaston Berger University Saint-Louis Senegal Anatomo-Pathology Laboratory Grand-Yoff General Hospital Dakar Senegal

Renal cortical necrosis (RCN) is anecdotal in malaria. To our knowledge, RCN secondary to Plasmodium malariae has not yet been published. We report a case of severe malaria complicated by RCN. A 29 year old Senegalese patient was transferred to our department for anuria in a context of severe malaria. The diagnosis was RCN secondary to a severe Plasmodium malariae malaria. Physical examination showed anuria, anaemic syndrome, haemorrhagic syndrome and a generally impaired condition. There was a normocytic normochromic anaemia aplastic, thrombocytopenia leukocytosis of 11.580/mm3, serum creatinine of 12.45 mg/dl and blood urea of 252 mg/dl. The Plasmodium malariae had been shown to thick blood film with high parasite density. The molecular study was able to confirm the infestation of this parasite. Treatment consisted of four haemodialysis sessions and antimalarial molecules. Initial evolution was favourable with a recovery through diuresis and a partial improvement in renal function. Given the persistence of impaired renal function, a renal biopsy was performed. This confirmed the RCN. At last consultation, he had no symptoms and his last glomerular filtration rate (GFR) was 30 mL/min/1.73 m2.

关键词： Renal Cortical Necrosis Plasmodium malariae Acute Kidney Injury Malaria

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