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Immunovirological Discordance and Associated Factors among People Living with HIV under Antiretroviral Treatment at Hôpital de Jour de Donka, Guinea

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Open Journal of Medical Microbiology 2024年第2期14卷 93-104页

作者： Mariama Sadjo diallo Djiba Kaba Charles Tchibinda Delicat Issiaga diallo Boh Fanta Diane Doufin Traore Ousmane Niabaly oumar mouctar diallo Ouo-Ouo Yaramon Kolie Aly Patrice Kamano Pascal Koivogui Ahmed Sékou Keita Mohamed Macire Soumah Thierno Mamadou Tounkara Mohamed Cisse Facult des Sciences et Techniques de la Sant Universit Gamal Abdel Nasser de Conakry Conakry Guine Laboratoire de Biologie Molculaire Nestor Bangoura/Helene Labrousse Hpital de Jour Donka CHU Donka Conakry Guine Centre dExcellence Africain Pour la Prvention et le Contrle des Maladies Transmissibles Conakry Guine Service de Dermatologie-Vnrologie CHU Donka Conakry Guine

The antiretroviral treatment (ART) has significantly reduced the number of new HIV/AIDS infections and related deaths. However, cases of immunovirological discordance (IVD) are found in various locations. The objective of this study was to determine the profile of People living with HIV (PLHIV) with IVD and to identify associated factors. We conducted a cross-sectional study based on the records of PLHIV under ART for at least 6 months, followed at Hpital de Jour Donka from 2015 to 2017, and having both viral load (CV) and CD4 T-cell count. Prevalence of IVD was 34.57%, with 23.87% for immunological discordance (ID) and 10.7% for virological discordance (VD). Females were predominant (66.26%), and male gender influenced IVD with a statistically significant difference (p = 0.006) and was associated with VD (p = 0.007). The average age was 38.77 11.30 years. PLHIV were classified at WHO stages 3 and 4 (86.01%). The median initial haemoglobin level was 11.5 g/L [3.2 - 12]. The mean initial CD4 T-cell count was 272.84 cells/mm3 201.6. The median initial viral load (VL) was 147,337 copies/mL [1092 - 31,675,000]. The initial CD4 T-cell count 3 was associated with IVD with a statistically significant difference (p = 0.0009) and correlated with ID (p = 0.000). Prurigo was associated with IVD with a statistically significant difference (p = 0.003). Cerebral toxoplasmosis was not associated with IVD but was associated with ID (p = 0.04). This study allowed us to describe the profile of PLHIV with IVD. The main associated factors were male gender, initial CD4 T-cell count 3, toxoplasmosis, prurigo, and herpes zoster.

关键词： HIV Antiretroviral Treatment (ART) Immunovirological Discordance Donka Guinea

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Profile of Autoantibodies and Clinical Symptoms in Guinean Patients with Connective Tissue Diseases

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Open Journal of Immunology 2024年第1期14卷 1-10页

作者： Mariama Sadjo diallo Doufin Traore Adame Diouf Djiba Kaba Issiaga diallo Doudou Georges Massar Niang Alimou Camara oumar mouctar diallo Boh Fanta Diane Abdoulaye Barry Ouo-Ouo Yaramon Kolie Moustapha Mbow Aly Badra Kamissoko Djibril Sylla Babacar Mbengue Mohamed Cisse Faculté des Sciences et Techniques de la Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée Laboratoire de Biologie Moléculaire Nestor BANGOURA/Helene LABROUSSE H&#244pital de jour Donka CHU Donka Conakry Guinée Centre d’Excellence Africain Pour la Prévention et le Contrô le des Maladies Transmissibles Conakry Guinée Laboratoire d’Immunologie Université Cheikh Anta Diop Dakar Sénégal Service de Dermatologie-Vénérologie CHU Donka Conakry Guinée Service de Rhumatologie H&#244pital National Ignace Deen Conakry Guinée Service de Médecine Interne CHU Donka Conakry Guinée

Connective tissue diseases (CTDs) are Autoimmune diseases (AIDs) characterized by the appearance of autoantibodies, which are diagnostic markers. Investigations of these autoantibodies play a major role in the management of several autoimmune diseases. The objective of this study was to describe the profile of anti-ENA antibodies according to the clinical symptoms of mixed CTDs in Conakry teaching Hospital. We performed a cross-sectional study during six months. A total of 20 patients was recruited and we measured antibodies using the ELISA technique. The mean age of our patients was 36.5 years, with a predominance of females. Cutaneous and rheumatological signs were the main clinical manifestations. SLP was the most frequent CTDs;the threshold of ENA antibodies positivity was higher in scleroderma with and SLP. Anti-ENA identification reveals the frequency of anti-SSA (83.33%), anti-U1RNP (66.66%) and anti-histone (50%) antibodies. Antinuclear antibodies (ANA) react with various components of the cell nucleus. Their detection is of major interest in the diagnosis of CTDs. Our results highlight the importance of determining the specificity of these antibodies to guide differential diagnosis.

关键词： Autoantibodies Extractible Nuclear Antigen (ENA) Connective Tissue Diseases ELISA

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Profile of Autoantibodies and Clinical Symptoms in Guinean Patients with Connective Tissue Diseases

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Open Journal of Immunology（免疫学期刊） 2024年第1期 1页

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Epidemiology and Histopathology of Cancers of the Upper Aerodigestive Tract in the ENT and Head and Neck Surgery Department of the Ignace Deen National Hospital

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 259-274页

作者： Mamadou mouctar Ramata diallo Oumou Amadou diallo Raphan Madi Kaba Keita Ousmane Barry Abdoulaye Keita Alpha oumar diallo Department of Otorhinolaryngology and Head and Neck Surgery Mamou Regional Hospital Mamou Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Otorhinolaryngology and Head and Neck Surgery Ignace Deen National Hospital Conakry Guinea Department of Otorhinolaryngology and Head and Neck Surgery NZrkor Regional Hospital NZrkor Guinea Department of Otorhinolaryngology and Head and Neck Surgery Donka National Hospital Conakry Guinea

Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and histopathological aspects of head and neck cancers in the ENT-CCF department of Ignace Deen National Hospital. Materials and Methods: This was a descriptive retrospective study covering a period of 5 years from September 1, 2016, to September 30, 2021. Results: We collected 43 cases of head and neck cancers, representing a hospital frequency of 1.85%. The mean age was 45.21 ± 13.23 years. Males predominated, accounting for 65.12%, compared to 34.88% for females, with a male-to-female ratio of 1.87. Housewives accounted for 27.90%, followed by farmers at 23.26% and traders/merchants at 18.60%, with 41.86% being uneducated. The main risk factors were tobacco (37.21%) and alcohol (34.88%). Pain (53.49%), dysphonia (51.16%), and dyspnea (39.53%) were the main presenting symptoms. Squamous cell carcinoma (74.42%) and large cell lymphoma (18.60%) were the most commonly cited histological types. Conclusion: Head and neck cancers remain relatively common in our country. Improving prognosis depends on early diagnosis of the condition, resuscitation resources, and prompt management.

关键词： Cancer Head and Neck Histopathology Ignace Deen National Hospital

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Acute Otitis Media in Children Aged 0-5 Years, Epidemiological Aspects and Management in the Paediatrics Department of the Hospital National Ignace Deen (Conakry)

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Open Journal of Epidemiology 2024年第1期14卷 19-30页

作者： Oumou Amadou diallo M’bemba Traore Mamadou Cire Barry Mamadou mouctar Ramata diallo Hasmiou Dia Alpha oumar diallo ENT Department Ignace Deen National Hospital Conakry Guinea Paediatrics Department Ignace Deen National Hospital Conakry Guinea ENT Department Mamou Regional Hospital Mamou Guinea

Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.

关键词： Acute Otitis Media (AOM) Treatment Nasopharyngitis Eustachian Tube

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Causes and Prognosis of Cases of Acute Obstructive Renal Failure Managed at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2024年第2期14卷 136-146页

作者： Amadou Yaya diallo Mamadou mouctar diallo Mamadou Dian Barry Kadiatou Mamadou Bobo Barry Saikou oumar diallo Djenabou diallo Soriba Bangoura Mamadou Malal diallo Thierno Mamadou Oury diallo Mohamed Lamine Kaba Alpha oumar Bah Department of Nephrology-Hemodialysis CHU Donka Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of the Republic of Guinea Conakry Guinea Department of Urology-Andrology CHU Ignace Deen Conakry Guinea

Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.

关键词： Acute Obstructive Renal Failure Hemodialysis Prognosis Donka

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Infectious ENT Emergencies: A One-Year Experience at the ENT Department of Mamou Regional Hospital

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第5期13卷 359-372页

作者： Mamadou mouctar Ramata diallo Ibrahima diallo Oumou Amadou diallo Alsény Cisse Mamadou Bailo Sow Raphan Madi Kaba Keita Abdoulaye Keita Alpha oumar diallo ENT Department Mamou Regional Hospital Mamou Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea ENT Department Donka National Hospital Conakry Guinea ENT Department Ignace Deen National Hospital Conakry Guinea ENT Department Lab Regional Hospital Lab Guinea ENT Department NZrkor Regional Hospital NZrkor Guinea

Introduction: ENT infectious emergencies encompass all infectious pathologies affecting the ear, nose, sinuses, throat, and neck. A good understanding of these emergencies is essential for organizing appropriate care. In Guinea, few studies have described ENT infectious pathologies in rural areas. Objective: To study ENT infectious emergencies in the Otorhinolaryngology department of the Mamou Regional Hospital. Materials and Methods: This is a retrospective and prospective descriptive study, conducted from August 1, 2021, to July 31, 2022. All patients admitted to the ENT department of the Mamou Regional Hospital for an infectious emergency were included. Results: Among the 1854 recorded consultations, 261 cases involved ENT infectious emergencies, representing a prevalence of 14.07%. The most represented age group was 0 to 10 years (31.03%), with a majority of female patients (59%) and a predominantly urban origin (81.61%). Students accounted for 32.18% of the cases. The main reasons for consultation were odynophagia/dysphagia (32.42%) and otalgia (22.94%). The primary etiologies were tonsillitis (28.73%) and otitis (27.20%). Treatments administered included probabilistic antibiotic therapy (38.80%), analgesics (32.03%), and corticosteroid therapy (10.47%). The outcome was favorable in 98.85% of cases, with only 0.38% lost to follow-up. Conclusion: The results of our study confirm the frequency of ENT infectious pathologies. Their management requires joint actions for population awareness, staff training, and services equipment, particularly in rural areas.

关键词： ENT Infection Emergency Mamou Regional Hospital

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External Otitis: Epidemiological, Clinical, Etiological, and Therapeutic Aspects at the Oto-Rhino-Laryngology Department of Mamou Regional Hospital

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 213-224页

作者： Mamadou mouctar Ramata diallo Sayon Kourouma Oumou Amadou diallo Ibrahima diallo Francine Haba Alsény Cisse Raphan Madi Kaba Keita Abdoulaye Keita Alpha oumar diallo ENT Department Mamou Regional Hospital Mamou Guinea ENT Department Conakry Military Hospital Conakry Guinea ENT Department IgnaceDeen National Hospital Conakry Guinea ENT Department Donka National Hospital Conakry Guinea ENT Department Lab&#233 Regional Hospital Lab&#233 Guinea ENT Department N&#8217Z&#233r&#233kor&#233 Regional Hospital N&#8217Z&#233r&#233kor&#233 Guinea

Introduction: External otitis (OE) is an acute or chronic inflammation or infection of the external ear resulting from an imbalance in the external auditory canal secondary to microtrauma, maceration, eczema, or a foreign body in the external auditory canal. Objective: To study cases of external otitis at the Mamou Regional Hospital. Materials and Methods: This was a prospective descriptive study conducted over a period of six (6) months from July 1st to December 31st, 2016. It included all patients admitted to the ENT department of the Mamou Regional Hospital. Results: During the study period, 712 patients were admitted to the department for various pathologies, of which 103 met our selection criteria, representing a frequency of 14.46%. The mean age of the patients was 33.74 years with a range of 1 to 90 years. Males predominated in the sample, accounting for 59.22%. The vast majority of patients resided in urban areas, constituting 61.17% of the sample. In our study, all patients consulted for otalgia (100%), and over half (53.39%) for hypoacusis. We formally identified rhinitis in 66.66% of cases, while diabetes was found in only 4 patients (11.11%). Otomycosis was the most commonly identified condition (53.39%), followed by furuncles (33.98%). Ear drops containing antibiotics were administered to all patients, although 66.60% received antibiotic therapy. Conclusion: External otitis is a relatively common condition, particularly among children and the elderly. Diagnosis can be made based on pain upon traction of the pinna and pressure on the tragus.

关键词： External Otitis ENT Mamou Regional Hospital

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Otorhinolaryngological (ORL) and Cervicofacial Injuries Resulting from Road Accidents within the Otorhinolaryngology (ORL) Department of the Regional Hospital of Mamou

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第1期13卷 16-28页

作者： Mamadou mouctar Ramata diallo Ibrahima diallo Alsény Camara Mamadou Aliou diallo Raphan Madi Kaba Keita Abdoulaye Sow Alsény Cisse Sory Sacko Mamadou Gouraissiou diallo Abdoulaye Keita Alpha oumar diallo Ear Nose and Throat (ENT) Department Regional Hospital Mamou Mamou Guinea Ear Nose and Throat (ENT) Department National Hospital Donka Conakry Guinea Ear Nose and Throat (ENT) Department Regional Hospital N’zérékoré N’zérékoré Guinea Ear Nose and Throat (ENT) Department Regional Hospital Labé Labé Guinea Ear Nose and Throat (ENT) Department National Hospital Ignace Deen Conakry Guinea

Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidemiological and clinical analysis of ORL and cervicofacial injuries observed in victims of road accidents treated at the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. Materials and Methods: This prospective and descriptive study was conducted over a period of 12 months, from January 1st to December 31st, 2021, within the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. It included patients hospitalized for ORL and/or cervicofacial traumas resulting from road accidents during the study period. Results: A total of 348 cases were included, representing 36.22% of all traumas related to road accidents (AVP) within the Regional Hospital of Mamou. The average age of the patients was 26.44 years, with a sex ratio of 3.83, favoring males. The dominant socio-professional category was students, encompassing 32.47% of cases. Road accidents were mainly associated with motorcycle use (31.32% motorcycle-to-motorcycle, 24.43% motorcycle skidding, 13.51% motorcycle-pedestrian). Facial region injuries were the most common, accounting for 69.03% of cases, followed by rhinological injuries (17.28%) and otological injuries (13.69%). Associated injuries were predominantly closed head traumas (52.55%) and lower limb fractures (20.41%). Imaging was underutilized. Regarding surgical interventions, reconstructive surgery was the most predominant, accounting for 52.51% of cases, with a management timeframe of 30 minutes to 12 hours for 99.72% of patients. Conclusion: Road traffic accidents remain a serious public health issue, primarily affecting young males. Emphasis should be placed on road safety measures to reduce the frequency of these accidents.

关键词： ENT Injuries Road Accidents Regional Hospital of Mamou

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Review of 6 Years of Middle Ear Surgery in the ENT-Laryngology Department of the Donka National Hospital and a Literature Review

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Surgical Science 2024年第8期15卷 471-479页

作者： Mamadou Aliou diallo Ibrahima diallo Mamadou mouctar Ramata diallo Sayon Kourouma Alsény Camara Alsény Cissé Abdoulaye Bayo Barry Alpha oumar Sory Sacko Abdoulaye Keita Service dORL Hpital National Donka Conakry Guinea Service dORL Hpital Rgional de Mamou Mamou Guinea Service dORL Hpital Rgional de Lab Lab Guinea

Introduction: Middle ear surgery is increasingly performed in our department. Our goal was to take stock of this activity in the ENT department of the Donka National Hospital. Equipment and Methods: It was a descriptive and retrospective study;it involved 71 patients’ records operated from January 1, 2018 to December 31, 2023. We included the files of patients who had a middle ear surgery including the post-operative report and follow-up. Incomplete or illegible records were excluded. The parameters studied were epidemiological, otoscopic, tomodensitometric, surgical indications, surgical techniques and results. Results: We recorded 71 middle ear surgeries out of 548 ENT surgeries, the prevalence was 12.96%. The average age was 23 years (type-deviation = 17, 29 years) with extremes of 3 to 75 years. According to the preoperative audiometry, the deafness was medium (48.8%), mild (36.9%) and severe (14.3%). The operative indications were among others: perforation of the tympanic sequellar (52.5%), chronic otomastoiditis (23.8%), cholesteatoma (15%) and seromuqueous otitis (8.7%). We performed 70 tympanoplasties (90.9%), 50 mastoidectomies (64.9%) and 7 trans-tympanic aerators (9.1%). One month after surgery, the neotympanum was constituted in 86%, and the hearing gain was between 11 and 15 dB in 18.3% of cases. Conclusion: Middle ear surgery was infrequent. Young subjects are the most concerned. Tympanoplasty and mastoidectomy are the main surgical techniques. The anatomical and functional results are appreciable.

关键词： Surgery Ear Tympanoplasty Mastoïdectomie

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