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Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

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World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： youssouf Camara Hamidou Oumar Ba Ibrahima Sangaré Boubacar Sonfo Coumba Adiaratou Thiam Mahamadou Sékou Diakité Koniba Diarra Karamba Touré Massama Konaté Ichaka Menta Cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology Department University Hospital Gabriel Touré Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test Ischemic Heart Disease Mali

Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry

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Open Journal of Gastroenterology 2024年第4期14卷 125-138页

作者： Mamadou Sarifou Diallo Oumarou youssouf Abdoulatif Yaogo Djenabou Diallo Kadiatou Diallo Thierno Amadou Wann Ahmed Tidiane Diallo Mamadou Lamine Yaya Bah Mamdou Diakhaby Mamadou Aliou Kanté Djibril Sylla Department of Hepato-Gastroenterology The Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Internal Medicine Department Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic Department of Hepato Gastroenterology Angr&#233 University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital Conakry Guinea

Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined st

关键词： Cirrhosis Fibrosis Fibroscan/CAP Non-Alcoholic Hepatic Steatosis Steatosis CHU Conakry

Contribution of Imagery in the Diagnosis of Multisystemic Sarcoidosis in the Service Radiology Department of the Mother and Child Hospital “Le Luxembourg” in Bamako: A Case Report

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Open Journal of Medical Imaging 2024年第3期14卷 79-85页

作者： Mariko Mahamane Camara Mamoudou Keita Aboubacar Sidiki N’Diaye Mahamadou Camara Mody Abdoulaye Fofana youssouf Traoré Mohamed Maba Sidibé Siaka Sanogo Souleymane Keita Adama Diaman Department of Radiology Mother and Child Hospital Luxembourg Bamako Mali Medical Imaging Exploration and Diagnostic Center Conakry Guinea Assistant at the Faculty of Health Sciences and Techniques at the Gamal Abdel Nasser University of Conakry Department of Radiology Military Hospital of Bamako Bamako Mali Department of Radiology Mali Hospital Bamako Mali Department of Radiology Point G Hospital Bamako Mali

The aim of this study was to report a case of multi-visceral sarcoidosis at the Mother-Child Hospital Center (CHME) “Le Luxembourg” in Bamako, Mali. Observation: This is a patient aged 62 at the time of consultation, a housewife, residing in the Banconi district, who was referred to us for thoracic-abdominopelvic imaging for chronic liver disease. After several diagnostic errors, the thoracic-abdominopelvic CT scan and liver MRI performed in our center showed, at the thoracoabdominal level, bilateral diffuse pulmonary micronodules and bilateral mediastinal-hilar lymphadenopathy;on the abdominal level, a dysmorphic liver with plaques of steatosis and a granular appearance of the liver parenchyma without periportal fibrosis. These imaging data combined with those from the liver nodule biopsy and biology confirmed the diagnosis of sarcoidosis type II. Treatment with corticosteroids gave satisfactory results and the patient recovered after 18 months. Clinical and CT monitoring 2 years from the start of the disease and 2 months from the end of treatment showed complete resolution of the lesions. Conclusion: The multi-visceral location of sarcoidosis is an entity whose diagnosis remains difficult;diagnostic and interventional imaging has an important place in its management.

关键词： Sarcoidosis Multi Visceral Imaging CHME Luxembourg

Oesophageal Mycosis: Epidemiological and Clinical Aspects and Risk Factors for Occurrence in the Digestive Endoscopy Unit of the Donka National Hospital, Conakry CHU

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Open Journal of Gastroenterology 2024年第2期14卷 31-40页

作者： Diallo Mamadou Sarifou youssouf Oumarou Yaogo Abdoulatif Diallo Kadiatou Diallo Djéinabou Wann Thierno Amadou Bah Mamadou Lamine Yaya Diakhaby Mamadou Kanté Mamadou Aliou Sylla Djibril Hepato-Gastroenterology Department of the Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Centre Hospitalier Universitaire Communautaire de Bangui Internal Medicine Department Bangui République Centrafricaine Hepato-Gastroenterology Department Angré University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital Conakry Guinea

Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1st January to 31st December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factor

关键词： Endoscopy CHU Conakry Risk Factors Immunosuppression Oesophageal Mycosis

Immunoprophylaxis failure and vaccine response in infants born to mothers with chronic hepatitis B infection in Djibouti

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World Journal of Hepatology 2024年第7期16卷 1039-1050页

作者： Sahal Darar Dirir Ambroise D Ahouidi Aboubacry Drame Warsama Osman Abdi Guelleh youssouf Kayad Mohamed Houmed Aboubakar Makhtar Camara Coumba Toure Kane Halimatou Diop Ndiaye Laboratoire Medical de la Caisse National de SécuritéSocial de Djibouti Caisse National de SécuritéSocial de DjiboutiDjibouti BP 696Senegal Parasitology Institut de Recherche en santéde Surveillanceépidémiologique et de FormationDakar 7325Senegal Ecole Doctoral UniversitéAlioune Diop de BambeyDakar 7325Senegal Department of Des Soins Caisse National de Securite SocialDjibouti 696Senegal Centre de Soin Caisse National de Securite SocialDjibouti 696Senegal Laboratoire Medical Mer Rouge Djibouti 99399Senegal Centre Hospitalier Universitaire Aristide le Dantec Laboratoire Bactériologie-Virologie-Hôpital Aristide le DantecDakar 7325Senegal Department of Virology Institut de Recherche en Santéde Surveillanceépidémiologique et de FormationDakar 7325Senegal Bacteriology and Virology Laboratory Le Dantec University Teaching HospitalDakar BP 7325Senegal

BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected *** mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by *** screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive *** To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti *** We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their *** study ran from January 2021 to May 2022,and infants were followed up to 7 mo of *** serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at *** infants were closely monitored to assess their seroprotective response and for failure of *** logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine *** statistical analyses were performed with version 4.0.1 of the R *** Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 *** MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/*** the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA lev

关键词： Hepatitis B surface antigen Infants Hepatitis B immunoglobulin Hepatitis vaccine Djibouti

Evaluation of the “Helicobacter pylori” Eradication Rate by Bismuth Quadritherapy or Concomitant Quadritherapy in Black Africans

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Open Journal of Gastroenterology 2024年第3期14卷 69-79页

作者： Diallo Mamadou Sarifou youssouf Oumarou Yaogo Abdoulatif Diallo Kadiatou Diallo Djenabou Wann Thierno Amadou Bah Mamadou Lamine Yaya Diallo Ahmed Tidiane Diakhaby Mamadou Kanté Mamadou Aliou Sylla Djibril Hepato-Gastroenterology Department of the Donka National Hospital CHU Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Internal Medicine Department Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic Hepato Gastroenterology Department Angré University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital CHU Conakry Guinea

Introduction: Gastric infection by “Helicobacter pylori” remains a topical issue due to the evolving scientific data concerning its pathophysiology, the diseases and pathologies concerned, which now extend beyond the gastric or digestive sphere, and the treatment methods faced with the development of antibiotic resistance. Diagnosis of infection involves two inseparable aspects: identification of the bacterium itself and identification of the endoscopic and histological lesions caused by the bacterium. Objective: To evaluate the rate of eradication of Helicobacter pylori infection by bismuth quadruple therapy and concomitant treatment. Patients and methods: This was a prospective, cross-sectional, analytical study of all outpatients in the hepato-gastroenterology department during the study period from 1 January 2022 to 30 November 2023. All patients had undergone oeso-gastroduodenal fibroscopy and the diagnosis was made by histological examination of the gastric biopsy. Results: Our 113 patients comprised 68 men and 46 women. The sex ratio was 1.48 in favour of men. The mean age of our patients was 40.28 years, with extremes of 13 and 80 years. The clinical signs that prompted oeso-gastroduodenal fibroscopy were as follows: epigastralgia (69.91%), dyspepsia (14.16%), vomiting (7.08%), gastro-oesophageal reflux (6.19%) and altered general condition with weight loss (2.65%). The endoscopic lesions were: gastropathy (antral, fundic and diffuse: antro-fundial) (69.02%), bulbar ulcer (6.19%), gastric ulcer (5.31%). Helicobacter pylori infection was associated with chronic gastritis in all our patients;it was mild in 50%, moderate in 41% and severe in 9%. The eradication rate of Helicobacter pylori according to the treatment protocol used was 92.30% for bismuth quadruple therapy and 94.12% for concomitant quadruple therapy. Conclusion: The eradication rate of Helicobacter pylori in our study was 92.30% and 94.12% respectively for bismuth quadritherapy and concomitant the

关键词： “Helicobacter pylori” Eradication Quadritherapy Antibiotics Conakry

Evolution of Mother-to-Child HIV-1 Transmission Rate in Mali from 2009 to 2018

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Advances in Microbiology 2024年第5期14卷 256-267页

作者： Alou Sanogo Mohamed Ag Baraïka Maïga Aminata Demba Koita Mahamadou Abdou Mamadou Guindo Clémentine N’Diaye Fatoumata Namoudou Traoré Abdoulaye Bagayoko youssouf Diallo Flabou Bougoudogo Ibrehima Guindo National Institute for Public Health Bamako Mali Faculty of Pharmacy (FAPH) University of Science of Technical and Technology de Bamako Bamako Mali University Hospital Center (CHU)-Point G Bamako Mali Faculty of Medecine and Odonto-Stomatology University of Science of Technical and Technology de Bamako Bamako Mali Sector Unit for the Fight against AIDS Tuberculosis and Hepatitis Bamako Mali UNICEF (United Nations Children’ s Fund) Bamako Mali

Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess changes in the rate of mother-to-child transmission of HIV-1. We conducted a cross-sectional study between January 1, 2009 to December 31, 2018 (10 years) of early diagnosis activity in newborns and children born to HIV-1-positive mothers at the National Institute for Public Health (INSP). The samples came from health and referral centers in mali. All samples were received at the Laboratory of Molecular Biology at the INSP. Proviral DNA extraction was performed from a blood spot sample with a Roche DNA kit, Cobas AmpliPrep/Cobas TaqMan HIV-1 qualitative Test, V2.0 (Roche Molecular System, Inc, USA) following the company procedures. Molecular diagnosis was performed using the same kits using an algorithm of three identical PCRs. The Epi Info version 7 software was used for data analysis with a significance threshold of 5%. A total of 10,714 samples of infants and children born to HIV-positive mothers were analyzed by PCR. Ninety-six percent of mothers were on ARV prophylaxis (AZT 3TC NVP and AZT NVP) and 60% of newborns received the same ARV prophylaxis. Of these children, 956 tested positive with an overall transmission rate of 8.92%, varying between 7.27% in 2009 and 08.01% in 2018. This rate was relatively low among children receiving prophylaxis at 2.04% and remained high for children who received breastfeeding at 5.62%. However, the transmission rate remains low for those who have benefited from mixed and artificial breastfeeding at 1.58% and 1.27% respectively. A significant proportion of children remained infected by their mothers during pregnancy, childbirth or breastfeeding. This study shows the importance of early diagnosis of HIV in children using molecular technology.

关键词： Early Diagnosis Mothers-to-Child Newborns PCR DNA HIV-1

Postpartum Family Planning at the Timbuktu Hospital in Mali

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1074-1082页

作者： Kassogué Djibril Samaké Alou Dolo Akoro Sogoba Seydou Touré Lahaou Cissouma Assetou Kassogué Abdoulaye Maiga Mariam Mariko Souleymane Kantako Karamoko Ongoiba Oumar Sanogo Ooumar Traoré Bassirima Sidibé Idrissa Mandé Kassambara youssouf Traoré Halima Timbuktu Hospital Bamako Mali Commune VI Bamako District Hospital Bamako Mali CHU Point G Bamako Bamako Mali Sikasso Hospital Bamako Mali Nianankoro Fomba Sgou Hospital Bamako Mali

Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.

关键词： Family Planning Postpartum Counseling Contraceptive Methods Timbuktu Hospital

Serological Profile of Hepatitis D Virus (Hepatitis Delta) in the Hepato-Gastro-Enterology Department of Chu Gabriel Toure

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Open Journal of Gastroenterology 2024年第3期14卷 93-98页

作者： Sanra Déborah Sanogo Kadiatou Doumbia Hourouma Sow Moussa Younoussou Dicko youssouf Oumarou Abdoulaye Berthé Sabine Drabo Luc Sidibé Makan Siré Tounkara Abdoulaye Maiga Ouatou Mallé Ganda Soumaré Anselme Konaté Moussa Tièmoko Diarra Hepato-Gastroenterology Department CHU Point G Bamako Mali Hepato-Gastroenterology Department CHU Gabriel Touré Bamako Mali Department of Internal Medicine Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic

Infection with the defective hepatitis D virus (HDV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). Delta virus infection is relatively common. The seriousness of infection with the hepatitis D virus (HDV), a virus defective in a patient carrying the hepatitis B virus (HBV), lies in its aggravating effect on the associated viral hepatitis B. Our aim was to study the serological profile of HDV in HBsAg-positive patients. As this study was fragmentary, we initiated this study with the aim of investigating the serological profile of HDV in HBsAg-positive patients. This was a descriptive and analytical cross-sectional study that ran from March 2019 to February 2020, a 12-month period. It focused on the population of patients seen and screened positive for HBsAg. We obtained a frequency of 10%. The mean age of our patients was 41.8 ± 13.09 years. The sex ratio was 4.5. VHD RNA was detected in 50% of patients. In 100% of cases, the presence of VHD RNA was associated with advanced fibrosis according to the APRI score, but without any statistically significant link. All HBV-infected patients should be screened for anti-HDV Ac. HDV infection leads to rapid progression to complications of liver disease.

关键词： HBsAg VHD RNA Liver Disease