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Low Socio-Economic Level: A Major Obstacle to Therapeutic Observation (Survey of 125 Diabetic Patients)

Open Journal of Preventive Medicine 2022年第1期12卷 1-9页

作者： Ousseynou Ka Djiby Sow Elhadji Mouhamadou Seck nd.ye fatou Ngom Guéye Martial Coly Bop Mountaga Elimane Dia Abdoul Aziz ndiaye Papa Gallo Sow Maimouna Mbaye ndour Community Health Department Faculty of Health and Sustainable Development Université Alioune Diop Bambey Senegal Medical Clinic II Centre Hospitalier Abass Ndao Université Cheikh Anta Diop Dakar Senegal Department of Medicine Faculty of Health and Sustainable Development Université Alioune Diop Bambey Senegal

Introduction: Diabetic patients adhering to their treatment are less likely to face complication from their disease. For this reason, we studied the compliance of diabetics with their treatment. Materials and Method: This was a comprehensive cross-sectional study of adherence in diabetic patients. All patients meeting the inclusion criteria were enrolled in the study. This study took place at a private pharmacy called “pharmacy Elhadj Seydou Nourou Tall” located in the city of Pikine during the period from April 1 to September 30, 2019. Results: In total, the study population was composed of 125 diabetics;frequency of 8.47%. The average age was 62.5 years and there were more women (58.4%). Of the patients, 87% had a low socioeconomic level and 72% a low educational level. Only 65.6% of the patients knew their diabetes type. Even though 97.6% of the patients were confident in the treatment but due to financial reasons 20.8% did not adhere to the prescribed treatment and 16.8% to their diets. Moreover, 15.2% of the patients had changed the dosage of the prescribed medication, 44.4% had forgotten to take their medication regularly. 78.4% of them thought they were taking too much medication. No factors were found to be statistically associated with poor adherence, but the proportion of poor adherence patients was higher in patients over 60 years of age, with low socio-economic status and low education. Conclusion: Low socio-economic status is the main barrier to good adherence. Recommendations have been formulated to improve this adherence.

关键词： Adherence Diabetes Socio-Economic Level Barrier Senegal

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Impact of Multifidus Muscle Morphometry on the Clinical Evolution of Chronic Low Back Pain

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Forensic Medicine and Anatomy Research 2023年第1期11卷 1-13页

作者： nd.ye Bigué Mar Aïnina ndiaye Abdoulaye nd.ye Diop Gor Side Diagne Babacar Diao Souleymane Diao Racky Wade Issa Dior Seck Karim Yacouba Garba Sokhna Astou Gawane Thiam Mamadou ndiaye Magaye Gaye Magatte Gaye Sakho Jean Marc ndiaga nd.ye Mamadou Diop Assane ndiaye Abdoulaye ndiaye Anatomy Laboratory/Joint Research and Diagnosis Unit Iba Der THIAM University of Thiès Thiès Senegal Laboratory and Organogen of Anatomy Cheikh Anta Diop University of Dakar Dakar Senegal Department of Radiology and Medical Imaging Gaston Berger University of Saint Louis Dakar Senegal Neurology Department Fann Hospital in Dakar Dakar Senegal Urology Service Ouakam Military Hospital Dakar Senegal Orthopedic Traumatology Service Idrissa Pouye Hospital of Grand Yoff-Dakar Dakar Senegal Neurosurgery Department Idrissa Pouye Hospital of Grand Yoff Dakar Senegal Anatomy Laboratory Assane Seck University of Ziguinchor Ziguinchor Senegal

Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty degeneration would be at the origin of the occurrence of chronic low back pain which constitutes a public health problem in Senegal. Taking into account its anatomy is essential for the etiopathogenic analysis and the treatment of low back pain. The purpose of our work was to investigate the impact of multifidus muscle morphometry on the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to May 2022. It involved 100 patients seen in the neurology department of Fann Hospital for chronic low back pain and who had already had a scanner falling within the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software to model and analyze the morphometric data of the multifidus muscle after physiotherapy and control lumbar scans. Results: The sex ratio was 2.23. The average age of the patients was 45 ± 7 years. On the initial CT scan, according to the Hadar classification, we noted a predominance of grade 2 with 56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the majority of patients, 67%, had grade 1. A conflicting circumferential disc bulge with the roots predominating in L5/S1 was present in 94% of men (p-value = 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm3 ± 39, after physiotherapy it was 203 mm3 ± 42 with a progression rate of 5.2%. Clinically, severe type pain had regressed from 86% before physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion: Taking into account the morphometry of the multifidus is an essential element in the management of chronic low back pain.

关键词： Morphometry Multifidus Low Back Pain Physiotherapy

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Quantitative Study on Individual Representations in Senegalese Patients Living with HIV (PLHIV)

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Open Journal of Psychiatry 2022年第1期12卷 23-36页

作者： Racky Wade-Kane Momar Camara El Hadji Makhtar Ba Idrissa Ba Sokhna Seck Abou Sy Ibrahima ndiaye Oumar Mamadou Samba nd.ye Dialé ndiaye ndongo Papa Lamine Faye Aida Sylla Mamadou Habib Thiam Department of Psychiatry and Medical Psychology National University Hospital Center of Fann Dakar Senegal Center for the Integrated Support of Addictions in Dakar (CEPIAD) National University Hospital Center of Fann Dakar Senegal

Context: HIV infection is an infectious, viral, chronic disease described as a public health problem. It has an impact on bio-psycho-social well-being. Thus, the objective of our study is to decrypt the representations of HIV infection in our patients. Methodology: 31 consecutively recruited HIV-infected patients participated in our study. The completed questionnaire included socio-demographic characteristics, association membership, psycho-social aspects of HIV infection, mode of transmission and adherence to antiretroviral treatment. Secondly, we proceeded to an assessment of the psychological state of the patient. Results: Almost 77% of HIV patients do not date peers in an association. At the time of the study, more than half of patients or 19/31 with HIV had a positive image of the disease. Before the diagnosis of the disease, more than 2/3 of patients with HIV, i.e. 25/31, have a negative image of the disease. The 31 PLHIV have been aware of their positive HIV status for an average of 11 years with extremes of 2 years and 21 years. Almost 21/31 of PLHIV have shared their positive serological status. The main barrier in patient communication was the risk of disclosure of HIV status. Most of the patients (45.2%) thought of death when they announced their positive HIV status, and 19.4% thought of their children. In 80.6% of cases, relationships with family, friends and neighbors were normal and remained unchanged for 74% of patients. The patients thought they had been infected through sexual intercourse in 84% of cases. Our study showed that 6 of the 31 PLHIV experienced stigma. Among these 6 patients, 3 had psychological repercussions and a voluntary interruption of treatment. Conclusion: The representations are dynamic. In Senegal, the eradication of discrimination among people living with HIV must imperatively involve a reconstruction of individual, collective and social representation

关键词： HIV Representations Stigma Senegal

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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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Primary Immune Deficiencies (PID): Diagnosis Challenges

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Open Journal of Pediatrics 2021年第3期11卷 388-392页

作者： Indou Deme/ly Awa Kane Mame Sokhna Gueye Ibrahima Diop Mame Tene ndiaye Abou Ba Idrissa Demba Ba Babacar Niang Aliou Thiongane Yaay Joor Dieng Yaye fatou Mbodj/Diop Ouafae Achnin Papa Moctar Faye Amadou Lamine Fall Ibrahima Diagne Tandakha ndiaye Dièye Ousmane ndiaye Albert Royer National Children’s Hospital Center Université Cheikh Anta Diop Dakar Senegal National Blood Transfusion Center Dakar Senegal Health Science Unit Gaston Berger University Saint -Louis Senegal

Background: Primary Immune Deficiencies (PID) are rare, under-determined diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. Aim: Our aim was to share the challenge of diagnosis and treatment in PID. Case Presentation: It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decreased level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants requires a substitution for life of immunoglobulin which is unavailable in our countries. Conclusion: PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.

关键词： Primary Immune Deficiencies Hypo-Gammaglobulinemia Infants

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Factors Associated with Full Vaccination of Children Aged 12 to 23 Months in the Commune of Thiomby (Kaolack/Senegal)

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Open Journal of Epidemiology 2023年第4期13卷 276-292页

作者： Boubacar Gueye Oumar Bassoum nd.ye Marième Diagne Martial Coly Bop Alioune Badara Tall Abdoul Aziz ndiaye Cheikh Tacko Diop Papa Gallo Sow Ousseynou Ka Ibrahima Seck Health and Sustainable Development Department Alioune Diop University Bambeye Senegal Preventive Medecine Department Cheikh Anta Diop University of Dakar Faculty of Medicine of Pharmacy and Odontostomatology Dakar Senegal Institut Santé et Développement Dakar Sénégal Medecine Department H&#244pital Principal de Dakar Dakar Sénégal

Introduction: Data on the complete vaccination of children in rural areas and the factors associated with it are poorly known. Knowledge of these factors is necessary for the adoption of effective vaccination strategies. The aim of our study was to determine the proportion of children aged 12 to 23 months fully vaccinated before the age of 12 months in the commune of Thiomby and to identify associated factors. Methods: A descriptive and analytical cross-sectional study was conducted from 15 January to 15 February 2020 in Thiomby among of children aged 12 to 23 months and their mothers/caregivers. The sampling was carried out in two-step clusters. Bivariate analysis was done with Epi-Info version 7.***.2.16. Results: The sample included 380 mothers/caregivers with children aged on average 24.7 years. Among them, 93.2% were housewives, 29.4% had attended school and 12.8% had a monthly income of more than 100,000 CFA francs. In total, 296 children were fully inoculated i.e. 77.9% of children aged 12 - 23 months had received all the appropriate vaccines by the age of 12 months. In addition, 42% of mothers and babysitters had a good level of knowledge about vaccination (benefits, side effects, etc.). The primary source of information for mothers about vaccination was the midwife, with 88 percent of women being informed through this channel. The age of mothers less than or equal to 30 years would significantly reduce (p Conclusion: Factors such as a good level of knowledge of mothers and access to information through midwives during prenatal and postnatal consultations contribute to an improvement in complete vaccination coverage among children aged 12 to 23 months.

关键词： Complete Vaccination Coverage Children Associated Factors Thiomby-Kaolack-Senegal

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Spirulina Supplementation in Pregnant Women in the Dakar Region (Senegal)

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Open Journal of Obstetrics and Gynecology 2017年第1期7卷 147-154页

作者： Khadim Niang Papa ndiaye Adama Faye Jean Augustin Diégane Tine fatou Bintou Diongue Maty Diagne Camara Mamadou Makhtar Leye Anta Tal-Dia Health and Development Institute (ISED) of Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal Public Health Department of Gaston Berger University (UGB) Saint-Louis Senegal

The fight against iron deficiency anemia in pregnant women is a public health priority, especially in sub-Saharan Africa. Spirulina is an alga very rich in iron, used as a dietary supplement. This research proposes to study its effect on the hemogloblobinaemia of pregnant women. This was a blind randomized cohort study with a supplemented group of spirulina (1500 mg/d) and a second supplemented with iron and folic acid supplementation (IFAS). Included in this study were pregnant women attending four health centers in the Dakar region, with pregnancy at 28th amenorrhea, agreeing to participate and not having complications or twin pregnancies. Follow-up of the two groups was identical throughout the study from the 28th week of amenorrhea to the 42nd postnatal day. The study was conducted among 920 women, evenly distributed among the groups. IFAS allowed a statistically significant increase in hemoglobinemia with an average gain of 0.3 g/dl between the 28th and 32nd weeks of amenorrhea (p = 0.022) and 0.2 g/dl between the 28th week and the delivery (p = 0.043). Spirulina supplementation showed statistically higher gains than those observed with IFAS. These gains were 0.48 g/dl between the 28th and 32nd weeks of amenorrhea and 0.36 g/dl between the 28th week and the delivery, with p values less than 0.001. Spirulina, more accessible to developing countries, is a good option to strengthen the arsenal of iron deficiency anemia control, and therefore maternal mortality.

关键词： Maternal Mortality Spirulina Iron Anemia Supplementation Senegal

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Enterobacterial Infections Diagnosed at the Clinic of Infectious Diseases of Fann Hospital (2013-2014) Dakar, Senegal

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Advances in Infectious Diseases 2018年第4期8卷 217-228页

作者： Khardiata Diallo Mbaye nd.ye Aissatou Lakhe Khadime Sylla Rahmatoulahi ndiaye Viviane Marie Pierre Cissé Diallo Daye Ka Aminata Massaly Alassane Dièye Louise Fortes Déguénonvo Cheikh Tacko Diop Cheikh Tidiane ndour Masserigne Soumaré Moussa Seydi Clinic of Infectious Diseases Fann National University Hospital Dakar Senegal Laboratory of Parasitology-Mycology Faculty of Medicine Cheikh Anta Diop University Dakar Senegal CommunityHealthDepartment Health and SustainableDevelopment Training Unit and Research Alioune Diop University Bambey Senegal

Introduction: Entero bacteria are mainly found in the gut of man and animals. The frequent acquisition of antibiotic resistance mechanisms explains why they are the bacteria most often implicated in human infectious pathology. It is estimated to be involved in 50% of sepsis, 60% of enteritis, 70% of urinary tract infection case. Objective: To determine the prevalence of enterobacterial infections diagnosed at Fann Infectious Diseases Clinic, and describe their epidemiological, clinical, therapeutic and evolutionary aspects. Patients and Methods: This is a retrospective and descriptive study, on patients hospitalized from January 2013 to December 2014, at Fann Infectious Diseases Clinic, with bacteriological confirmation of an enterobacteria infection. Results: A total of 129 cases were collected during the study period. The average age was 41 years, and female were predominant (60%) with a sex ratio of 0.67. Comorbidity was found in 88.4% of the cases, most of which were HIV infection. The most common clinical signs were infectious syndrome (53.49%) and general impairment (40.31%). The main gateway was urinary (55.8%). Samples were monomicrobial in 76.7% of cases. Klebsiella and Escherichia were the most common and 68.7% of the subjects had probabilistic treatment. Most enterobacterial strains were resistant to third generation cephalosporins (C3G), aminoglycosides to ciprofloxacin and cotrimoxazole. Aside from 4% of them, all were sensitive to imipenem. Conclusion: The advent of antibiotics has brought hope in the treatment of enterobacterial infections. However, an increase in their resistance to the usual antibiotics has been noted in recent years. As a result, the fight against antibiotic resistance must be a priority.

关键词： Dakar Enterobacteria Infections Senegal

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Immunological Status to Hepatitis B Virus of Pregnant Women in Dakar, Senegal

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Open Journal of Immunology 2017年第2期7卷 37-44页

作者： Maguette Sylla Niang Khadidiatou Sarr Fall Babacar Mbengue Moustapha Mbow ndiokhor nd. Diouf Ousseynou Boye Gora Lo Papa Madieye Guèye Rena Derwiche Amina Sow Sall Tandakha ndiaye Dieye Alioune Dieye Service of Immunology Faculty of Medicine Pharmacy and Odontology (FMPO) Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal Laboratory of Medical Biology General Hospital of Grand-Yoff Dakar Senegal Department of Biological and Pharmaceutical Applied Sciences Pharmacy and Odontology (FMPO) Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal

Objective: Evaluate the immunological status to hepatitis B virus of Senegalese pregnant women by screening HBs antigen. Material and methods: The selection criteria of women were presence at the laboratory for biological exams of pregnancy follow-up. All volunteers for the study were screened for HBs antigen (HBs Ag). Investigation of chronic hepatitis B markers (HBe Ag, anti-HBe, viral quantification) was performed in HBs Ag positive participants. The concentration of anti-HBs antibodies was assessed in HBs Ag negative women. Results: One hundred and fifteen (115) pregnant women were included in the study from July to October 2014. The mean age was 29 ± 6 years, ranging from 16 to 47. The seroprevalence of HBs Ag was 12% and the majority of women (90%) were not vaccinated. Any of the 14 HBs Ag-positive subjects did not express serum HBe Ag, (marker of active viral replication) and all were positive for anti-HBe antibodies. Their viral load (HBV DNA) was undetectable and serum transaminases were normal. The anti-HBs antibodies titrated in HBs-Ag negative women serum revealed that only 46 had protective levels against HBV whilst 55 of them were unprotected.

关键词： HBs Ag Pregnancy Senegal

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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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