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Frailty in People Living with Human Immunodeficiency Virus Aged 50 years and Older: Prevalence and Predictors

World Journal of AIDS 2024年第1期14卷 18-34页

作者： Alassane ndiaye nd.ye fatou ngom Kiné ndiaye Assiétou Gaye Elhadji Bara Diop Ahmadou Mboup Houlèye Saou Bessoume Sy Ababacar Niang Betty Fall Mame Awa Faye Outpatient Treatment Clinic (CTA) Dakar Senegal Medicine Department of Health and Sustainable Development/Research and Training Unit (UFRSDD) Alioune Diop University of Bambey Diourbel Senegal Health and Development Institute (ISED) Cheikh Anta Diop University Dakar Senegal Geriatrics and Gerontology Department Fann National Teaching Hospital Center Dakar Senegal

Introduction: Life expectancy improvement for people living with Human Immunodeficiency Virus (HIV) is coming up against the problems associated with aging and chronic diseases. Frailty is a concern affecting a growing number of patients, particularly the elderly in this population. Our study aimed to determine the prevalence of frailty and its predictors on people living with HIV aged 50 years and older followed at the Outpatient Treatment Clinic (CTA) in Dakar. Methodology: We conducted a cross-sectional study of descriptive and analytic purposes ranging from November 2022 to August 2023, in CTA, Dakar (Senegal). We included people living with HIV aged 50 years and older under antiretroviral therapy for at least 6 months (≥6 months). Frailty was considered according to Fried criteria with a score ≥3. To identify the predictors of frailty, we performed a multivariate logistic regression analysis using STATA software version 18. Results: We included 199 patients. The median age at the moment of the study was 58 years old [50 - 91] with a sex ratio (M/F) of 0.58. The most representative age group was that of [50 - 59] years (59.3%). HIV-1 profile was most common in 89.45%. The median duration under antiretroviral therapy was 180 months [6 - 284] and 94% of patients received a Tenofovir Disoproxil Fumarate (TDF)-containing regimen with 43% of them for at least 10 years. Viral load was undetectable (≤40 copies/ml) in 98% of cases. WHO Stage III was more common at inclusion and 55.78% had nadir TCD4+ Lymphocyte counts Conclusion: Our study confirms the high prevalence of frailty among older people living with HIV. Its prevention should consider the management of comorbidities and the implementation of non-pharmacological interventions such as nutrition.

关键词： Frailty HIV Senior Dakar

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Factors associated with mortality in congenital malformations of the gastrointestinal tract in a tertiary center in Senegal

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World Journal of Pediatric Surgery 2023年第1期6卷 24-29页

作者： Tshibwid A Zeng Papa Alassane Mbaye Doudou gueye nd.ye fatou Seck Ibrahima Bocar Wellé Rosalie Niang Youssouph Diedhiou Mbaye Fall nd.ye Aby nd.ye Aloïse Sagna Oumar ndour Gabriel ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital CenterUniversitéCheikh Anta Diop Facultéde Medecine Pharmacie d'Odonto-StomatologieDakarSenegal Department of Pediatric Surgery Aristide Le Dantec University Teaching HospitalUniversitéCheikh Anta Diop Facultéde Medecine Pharmacie d'Odonto-StomatologieDakarSenegal

Objective Patients with congenital malformations(CMs)of the gastrointestinal tract(GIT)have a very high ***,the literature on the factors associated with mortality in these patients is scarce in sub-Saharan *** aim of this study is to identify independent risk factors for mortality in patients with CMs of the GIT at our pediatric surgical *** We conducted a retrospective analysis of cases with CMs of the GIT managed at a tertiary center from 2018 to *** were subdivided into two groups based on the outcomes,and variables with a significant difference were analyzed by logistic *** Our review included 226 patients,63 of whom died(27.88%).Patient age ranged from 0 to 15 *** into account statistical significance,mortality was more frequent in neonates than in older patients(57.30%vs 6.15%),in patients coming out of the Dakar area than in those from the Dakar area(43.75%vs 19.18%),in patients with abnormal prenatal ultrasound than in those with normal ultrasound(100%vs 26.67%),in premature children than in those born at term(78.57%vs 21.87%),in patients with an additional malformation than in those with an isolated malformation(69.23%vs 25.35%),and in those with intestinal,esophageal,duodenal and colonic atresia than in those with other diagnoses(100%,89%,56.25%and 50%,respectively).Referred patients died more than those who changed hospitals or came from home(55.29%vs 25%and 9.09%,respectively).On multivariable logistic regression,two independent factors of mortality were identified:presence of associated malformation[odds ratio(OR)=13.299;95%Confidence interval(CI)1.370 to 129.137]and diagnosis of esophageal atresia(OR=46.529;95%CI 5.828 to 371.425).Conclusion The presence of an associated malformation or diagnosis of esophageal atresia increases mortality in patients with CMs of the GIT in our environment.

关键词： mortality diagnosis congenital

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Epidemiological, Clinical and Outcome Aspects of Care-Related Tetanus in Dakar, Senegal

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Advances in Infectious Diseases 2022年第2期12卷 230-240页

作者： Viviane Marie Pierre Cisse nd.ye fatou ngom gueye Louise Fortes Imelda Mickelina Thoo Aminata Massaly Khardiata Diallo Mbaye Daye Ka nd.ye Aissatou Lakhe Assane Diouf nd.ye Maguette Fall Daouda Thioub Aboubakry Sidikh Badiane Latyr Junior Diouf Alassane Sarr Sylvie Audrey Diop Cheikh Tidiane ndour Masserigne Soumaré Moussa Seydi Infectious and Tropical Diseases Department Fann Teaching University Hospital Dakar Senegal Department of Community Health Alioune Diop University Bambey Senegal Department of Health Thies University Thies Senegal

Introduction: Tetanus portals of entry are numerous. Amongst these, the carerelated portals of entry are rarely reported. The aim of the study was to describe the epidemiological, clinical and outcome aspects and identify the factors associated with death from care-related tetanus. Patients and Methods: This is a retrospective study of descriptive and analytical purposes. Data were collected from the medical records of patients admitted to the Infectious and Tropical Diseases Department of the National University Hospital Center (CHNU) of Fann in Dakar for care-related tetanus during the period ranging from 1 January 2009 to 31 December 2016. Care-related tetanus was defined as any case of tetanus occurring after a surgical procedure, including circumcisions performed even outside a health facility. Results: In eight years, 50 cases of care-related tetanus were recorded. Care-related tetanus accounted for 6.7% of hospitalized tetanus cases. The mean age of patients was 21 ± 22 years, with a male predominance (sex ratio: 6.14). The procedure had been performed in most cases, either in a health facility in 22 patients (44%) or at home in 16 patients (32%), and occurred after circumcision. In 62% of cases the portal of entry was urological, followed by orthopedic surgery (14%) and visceral surgery (10%). The procedures performed were dominated by circumcision (31 cases), limb amputation (3 cases) and inguinal hernia repair (2 cases). Tetanus was immediately generalized on admission in all patients. Eighty-four percent (84%) of patients were admitted with Mollaret stage II. Cardiovascular (11 cases), infectious (10 cases) and respiratory (9 cases) complications were the most frequent. The hospital case fatality rate was 24%. Factors associated with death were female gender (p = 0.03), age between 15 - 60 years (p = 0.02), incubation time Conclusion: Care-related tetanus remains a concern in poor income countries, particularly in Senegal. The drop of these cases will req

关键词： Tetanus Care Surgery Dakar Senegal

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From Myeloma to Plasma Cell Leukemia, Persistent Inequalities

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Open Journal of Blood Diseases 2023年第4期13卷 133-140页

作者： Mamadou Wague gueye Nata Dieng Maguette nd.ye Mor ngom Sokhna Moumi Mbacké Daffé Papa Silman Diawara Macoura Gadji nd.ye Marième Diagne Bécaye Fall Laboratory Federation H&#244pital Principal de Dakar (HPD) Dakar Senegal Onco-Hematology H&#244pital Principal de Dakar (HPD) Dakar Sénégal Biological and Oncological Hematology Department (BOHD) Centre National de Transfusion Sanguine (CNTS)/FMPOS-UCAD Dakar Sénégal

Multiple myeloma (MM) is both a complex and heterogeneous disease. Cytogenetic and molecular abnormalities lead to resistance to treatment and transformation to plasma cell leukemia, which is defined by the presence in circulating blood of plasma cells over 2 G/L, or more than 20% of leukocytes. It is an uncommon hematological malignancy with a poor prognosis. Against this backdrop, we report an observation of multiple myeloma transformed into plasma cell leukemia diagnosed at the Hôpital Principal de Dakar (HPD) that occurred on a 64-year-old man with a history of thyroidectomy followed for multiple myeloma presenting with Salmon et Durie stage IIIA and ISS stage I. Despite a marked improvement in management strategy, myeloma remains an almost invariably incurable disease. However, the development of genetic and molecular biomarkers is necessary to improve its prognosis.

关键词： Multiple Myeloma Plasma Cells Leukemia Personalized Medicine Risk Stratification

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Incidence and Factors Associated with the Switch to the Second Line Antiretroviral Treatment at the Ambulatory Treatment Center (CTA) in Dakar

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Health 2016年第14期8卷 1566-1575页

作者： nd.ye fatou ngom-gueye Gilbert Batista Abdoul Aziz ndiaye Assane Diouf KA. Daye Alioune Badara Tall Awa Diouf Kine ndiaye Makhtar ndiaga Diop Mountaga Dia Cheikh Tacko Diop Awa Gaye Cheikh Tidiane ndour Moussa Seydi Lamine gueye Bernard Marcel Diop Papa Salif Sow Ambulatory Treatment Center Fann University Teaching Hospital Dakar Senegal Department of Community Health Alioune Diop University Bambey Senegal Department of Infectious Diseases Fann University Teaching Hospital Dakar Senegal

Introduction: Over the past years, efforts have been made to expand access to antiretroviral combinations (cART) in low-income countries. However, major concerns are noted with drug resistance emergence, as treatment failure result and need to introduce a second line treatment, more expensive and difficult to implement. The objective was to study the incidence of switch to second line, reasons for switch and risk factors using a cohort of people living with HIV in an Ambulatory Treatment Center in Dakar. Methodology: This was a cohort study of people living with HIV under cART from January 2004 to December 2013. Naive patients monitored for at least six months, regardless of their profile and regimen with baseline CD4 counts Results: The median age of the 827 patients included was 44 [IQR = 18 - 78]. The switch to second-line treatment was observed in 72 patients (8.7%) after an average of 38.5 months of follow-up. The overall incidence rate of switch to second line of antiretroviral treatment was 1.59 per 100 persons-years. Most of changes in first-line treatment were motivated by virological failures (n = 60, 83.3%) under treatment with AZT/3TC/NVP (n = 25, 34.7%) or AZT/3TC/EFV21 (29.2%). 9.7% of switch occurred after immunological failure, 1.4% after clinical failure, 4.2% after severe toxicity and 1.4% was not documented. Predictive factors identifying failures at the end of the multivariate analysis were age Conclusions: In total, CTA identified a low incidence rate of treatment failure of the first line of treatment. Associated risk factors were age years, CD4 counts below 100 cells/mm3 and high viral load at treatment initiation.

关键词： Incidence Associated Factors Switch to 2nd Line cART CTA Dakar

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