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Characteristics, Management, and outcomes of Tetanus Cases in a Referral Center in Senegal, between 2010 and 2017

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Advances in Infectious Diseases 2023年第3期13卷 375-388页

作者： Daouda Thioub ndeye a.ssa.ou lakhe Khardiata Diallo Mbaye Papa Latyr Junior Diouf Catherine Sarr ndeye Amy Sarr Aboubakar Sidikh Badiane Mamadou Seck ndeye Maguette Fall Viviane Marie Pierre Cisse-Diallo Daye Ka Moussa Seydi Louise Fortes Department of Infectious and Tropical Diseases Fann National University Hospital Dakar Senegal Department of Infectious and Tropical Diseases Dalal Jamm National Hospital Guediawaye Senegal

Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiology and treatment, tetanus remains a real public health problem, particularly in developing countries. Tetanus in children and adults is still a frequent cause of hospitalization in the Infectious and Tropical Diseases Department (SMIT) of the Fann National University Hospital (CHNU). We conducted this study with the main objective of carrying out a situational analysis of tetanus at SMIT from 2010 to 2017. We recorded 706 cases of tetanus in a total of 8123 hospitalized patients. The median age of the patients was 23 years [1 - 90 years]. The sex ratio (M/F) was 4/1. More than half (58.78%) came from suburban areas. The population was most frequently made up of students (24%) or manual workers (22.1%). At least one comorbidity was present in 107 patients (15.15%). The absence of a vaccination record was found in 99.56%. The main portal of entry was integumentary (83.3%), post-circumcision (5.7%) and otogenous (4%). Tetanus was generalized in 93.9% of cases. The main signs of tetanus found were trismus and dysphagia. Patients were most frequently classified as stage II (78.7%). Antibiotic therapy was based on metronidazole (51.41%). Anti-tetanus serotherapy was carried out by sub-occipital administration in 97.6%. Tracheostomy was performed in 48 patients. Complications occurred in 226 patients (32.01%). The main complications were respiratory (53.98%), infectious (45.13%) and cardiovascular (41.59%). The average delay in hospitalization was 3.6 ± 3.4 days. The mean length of hospital stay was 11.9 ± 8.2 days. The hospital case-lethality rate was 18.98%. Despite the decline in cases over the years in our country, tetanus remains a public health problem because of its prevalence, severity, and lethality.

关键词： Tetanus Management outcomes Senegal

Neuro-meningeal Tuberculosis in Adult Senegalese Patients: Profile and outcome of Cases Diagnosed at a Referral Service, from 2015 to 2020

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Case Reports in Clinical Medicine 2023年第8期12卷 270-278页

作者： Daouda Thioub Viviane Marie Pierre Cisse-Diallo Papa Latyr Junior Diouf ndeye a.ssa.ou lakhe Agbogbenkou TeviDéla-dem Lawson Aboubakar Sidikh Badiane ndeye Maguette Fall Khardiata Diallo-Mbaye Daye Ka Sylvie Audrey Diop Moussa Seydi Infectious and Tropical Diseases Department of Fann National University Hospital Dakar Senegal Health Sciences Training and Research Unit Iba Der Thiam University Thiès Senegal

Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16 - 77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%). Meningeal signs were present in 94.55% of patients, and consciousness disorders and intracranial hypertension were present in 63.64% and 56.36% respectively. Nerve palsy was found in 38.18%. CSF was clear in 81.64%. GeneXpert MTB/RIF in CSF was performed in 33 patients and was positive in 4 patients. Brain CT was abnormal in 72.09% of cases. Tuberculoma, hydrocephalus and meningeal contrast enhancement were the main lesions. The neuro-meningeal localization was associated with a pulmonary form i

关键词： Neuro-meningeal outcome Profile Senegal Tuberculosis

Evaluation of Early Warning Indicators of ARV Resistance to HIV in the Hospital of Tivaouane from 2008 to 2016

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Advances in Infectious Diseases 2018年第2期8卷 54-63页

作者： Agbogbenkou Tévi Déla-dem Lawson ndeye Astou lakhe Haby Dione Papa Souleymane Toure Mamadou Ba ndeye Biram Niang Bernard Marcel Diop Sylvie Audrey Diop-Nyafouna Department of Health Thies University Thies Senegal Infectious and Tropical Diseases Department Fann Teaching University Hospital Dakar Senegal

Introduction: HIV resistance to antiretroviral is currently a global concern, and requires increased surveillance in a context of widespread ARV treatment. Objective: To evaluate early warning indicators of HIV resistance to ARVs in the Hospital of Tivaouane (Senegal) where viral load was not routinely available. Methods: This is a cross-sectional retrospective study from 2008-2016. The etraction tool (May 2010 version) was used to analyze the EWI. Results: We collected 360 HIV positive patients followed on average for 3.57 years ± 3.02. 2009, 2010 and 2012 recorded 100% ARV prescribing rates. Throughout the study period, the percentage of patients lost to follow-up during the first 12 months of treatment was less than 20%. Virtually, all patients were still under primary ARVT over 12-month treatment. All patients (100%) withdrew their ARV drugs on time. No stock storage regarding various classes of ARVs was noted during the study period. Conclusion: At the end of this study we recommend to maintain regular follow-up of EWI, and combine it with the achievement of viral load.

关键词： HIV Resistance EWI Tivaouane

Characteristics of Liver Abscess in Department of Infectious Diseases at Fann Teaching University Hospital in Dakar, Senegal

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Advances in Infectious Diseases 2018年第1期8卷 23-31页

作者： Viviane Marie Pierre Cisse Diallo Louise Fortes Deguenonvo Noel Magloire Manga Daye Ka Sylvie Audrey Diop Abdoulaye Seck ndeye a.ssa.ou lakhe Khardiata Diallo Mbaye Assane Diouf ndeye Mery Dia Badiane ndeye Fatou Ngom Gueye Cheikh Tacko Diop Masserigne Soumare Cheikh Tidiane Ndour Moussa Seydi Infectious and Tropical Diseases Department Fann Teaching University HospitalDakarSenegal Department of Health Ziguinchor UniversityZiguinchorSenegal Department of Health Thies UniversityThiesSenegal Pasteur Institute Dakar DakarSenegal Department of Health Gaston Berger UniversitySaint LouisSenegal Fann Teaching University Hospital in Dakar DakarSenegal

Introduction: Abscesses of the liver are due to an infection of bacterial, parasitic or fungal origin. Through amoebiological imaging and serology, their diagnosis was facilitated. The aim of this study was to determine the epidemiological, clinical, diagnostic and evolutionary aspects of these liver abscesses at the Department of Infectious and Tropical Diseases in Fann Teaching University Hospital. Patients and Methods: This was a retrospective and descriptive study, based on records of patients hospitalized for abscess of the liver over a period of 8 years, from January 1, 2008 to December 31, 2015. Results: We collected 20 cases of abscesses including 12 cases of confirmed amoebic abscesses and 5 cases of pyogenic abscesses. The mean age of the patients was 43.15 ± 15.12 years. There were 18 men and 2 women. The average hospital stay was 32 days. The most common clinical signs were abdominal pain (100%), fever (75%), hepatomegaly (80%). A leukocytosis greater than 12,000 Gb/mm3 was found in 13 patients. The amoebic serology was positive in 71% of cases and negative in 29% of cases. No germ was isolated from the blood culture. On hepatic ultrasound the abscess was unique in 90%. Treatment was exclusively medical in 11 patients (55%). The trend was favorable in 85% of cases. Conclusion: The incidence of liver abscesses has significantly decreased. It is important to develop diagnostic tools better in the case of pyogenic abscesses.

关键词： Amoebic Liver Abscess Pyogenic Abscess Dakar Senegal

Identifying uncertainty sources in measurements-A methodology

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Journal of Measurement Science and Instrumentation 2012年第4期3卷 307-312页

作者： Nitin K Mandavgade S B Jaju R R lakhe Mechanical Engineering Department Priyadarshni College of Engineering

The overall purpose of performing measurements in science is to increase knowledge and document about some physical *** measurand has a true value but,except for straightforward counting situations,the true value can never be fully *** a quantity is measured,the outcome depends on the measuring system,the measurement procedure,the skill of the operator,the environment and other *** practice the uncertainty on the result may arise from many possible sources,including examples such as incomplete definition,sampling,matrix effects and interferences,environmental conditions,uncertainties of weights and volumetric equipment,reference values,approximations and assumptions incorporated in the measurement method and procedure,and random *** objective of the paper is how to identify the sources of uncertainty in measurement and their importance on the result.

关键词：自动化系统数据处理数据收集自动分类

Tuberculosis Meningitis Associated with Poncet’s Disease: A Rare Case in a Young Senegalese Patient

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Case Reports in Clinical Medicine 2023年第7期12卷 223-226页

作者： Thioub Daouda Alassane Sarr Papa L. J. Diouf Aboubakar S. Badiane Seck Mamadou Ndèye A. lakhe Agbogbenkou T. D. Lawson Sylvie A. Diop Moussa Seydi Service des Maladies Infectieuses et Tropicales CHNU Fann Dakar Sénégal UFR des Sciences de la santé Université Iba Der Thiam de Thiès Thiès Sénégal

Described by Antonin Poncet in 1897, Poncet’s disease is a non-destructive (non-erosive) inflammatory arthritis secondary to a mycobacterial infection, without an identified infectious agent in the affected joints. Neuromeningeal localization of tuberculosis (TB) is rare but remains the most severe with hight mortality and permanent neurological damage. Association of Poncet’s rheumatism and TB is rare, even less a neuromeningeal localization. We report here a case of optic nerve compression syndrome complicating tuberculous meningitis associated with Poncet’s rheumatism characterized by a good outcome. This was an 18-year-old female with no reported pathological history, who was admitted for obnubilation. The symptoms started two weeks before her hospitalization and were marked by fever and headache. On admission, the examination revealed obnubilation, bilateral pyramidal deficit syndrome, right ptosis and areactive mydriasis predominating on the right, meningeal syndrome, and intense inflammatory polyarthralgia. The brain CT showed meningeal contrast enhancement with moderate dilatation of ventricles. GeneXpert MTB/rif in CSF was positive. Rheumatoid factors (latex and Waaler-Rose test) and anti-CCP antibodies were negative. Anti-nuclear, anti-native DNA and anti-NAS antibodies were negative. Ophthalmological examination revealed optic nerve compression syndrome associated with extrinsic and intrinsic oculomotor paralysis in the right eye. Orbito-encephalic MRI showed compression of the optic nerve, and hydrocephalus. Under antituberculosis treatment, we noticed disappearance of arthralgia in three weeks, regression of intracranial hypertension and improvement of vision.

关键词： Tuberculosis Meningitis Poncet’s Disease

Risk Factors for COVID-19 Related Death during the First Three Waves of the Pandemic in an Epidemic Treatment Center at Dakar, Senegal

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Advances in Infectious Diseases 2023年第2期13卷 117-131页

作者： Moustapha Diop Papa Samba Ba Viviane Marie Pierre Cisse Ndèye a.ssa.ou lakhe Betty Fall Moustapha Lo Ndong Essomba Bruce Wembulua Fatimata Wone Becaye Fall Khardiata Diallo-Mbaye Daye Ka Louise Fortes ousmane Faye Ndongo Dia Khalifa Ababacar Wade Abdou Rajack Ndiaye Amadou Alpha Sall Moussa Seydi Mame Thierno Dieng Epidemic Treatment Center Dakar Principal Hospital Dakar Senegal Infectious and Tropical Diseases Department FANN Teaching Hospital Dakar Senegal Psychiatry Department Dakar Principal Hospital Dakar Senegal Internal Medicine Department Deido District Hospital Douala Cameroon Dalal Jamm Hospital Dakar Senegal Federation of Laboratories Dakar Principal Hospital Dakar Senegal Pasteur Institute of Dakar Dakar Senegal Anesthesia-Resuscitation Department Dakar Principal Hospital Dakar Senegal Dakar Principal Hospital Dakar Senegal

Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of Dakar Principal Hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.

关键词： COVID-19 Waves Death Risk Factors Dakar

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 Ndèye Fatou Ngom Gueye Louise Fortes Imelda Mickelina Thoo Aminata Massaly Khardiata Diallo Mbaye Daye Ka Ndèye a.ssa.ou lakhe Assane Diouf Ndèye 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

MATHEMATICAL MODELING OF EFFECTS OF VARIouS FACTORS ON UNCERTAINTY OF MEASUREMENT IN MATERIAL TESTING

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MATHEMATICAL MODELING OF EFFECTS OF VARIOUS FACTORS ON UNCER...