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therapeutic itinerary of Patients Followed for Connectivitis in the Internal Medicine Department of the CNHU-HKM of Cotonou (Benin)

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Open Journal of Internal Medicine 2021年第2期11卷 73-80页

作者： Angèle Azon-Kouanou Kouessi Anthelme Agbodande Eugénie Dansou Mahoutin Semassa Ghislain Missiho Yves Morel Sokadjo Armand Finagnon Wanvoegbe Janvier Kitumaini Kondoli Richard Oba Roberto Dossou Tores Kouassi Prudencio Djimon Marcel Zannou Fabien Houngbé Internal Medicine and Medical Oncology Department National Teaching Hospital (NTH) Hubert Koudougou Maga (HKM) Cotonou Bénin

Introduction: In black Africa, connectivites have been for a long time a source of diagnostic erraticity because of their clinical polymorphism. This study aims to determine the therapeutic itinerary of patients followed for connectivitis in the Internal Medicine Department of the CNHU HKM of Cotonou. Methodology: This is a cross-sectional study that included patients followed for connectivitis in the HKM-Cotonou Internal Medicine Department from January 2010 to October 2018. Results: Out of 3600 patients hospitalized in the study period, 21 had connectivitis, i.e. a hospital frequency of 0.58%. Of the 21 patients collected, 18 met the inclusion criteria. The mean age was 40 (±11) years old and the youngest was of 21 and the oldest 58. The sex ratio was 17.9. The “Fon” ethnic group was the most represented (33.3%) and 15 (83.3%) subjects were Christians. Systemic lupus erythematosus was the most frequent connectivitis (55.6%). The average time of consultation was 38 months. Witchcraft was the most incriminating cause (78%). Ten (55.5%) patients had resorted to self-medication as their first choice of treatment, 5 (27.8%) to traditional medicine treatment and 3 (16.7%) to prayer for healing. The reasons for the first choice of treatment were satisfaction (44.4%), financial problems (27.8%), trivialization of the disease (16.7%), and advice from family and friends (11.1%). The consultation at the CNHU followed a referral from a first contact health structure (61%) or an initiative of the patient (27.8%). Conclusion: Connectivitis is a source of diagnostic error in our context. Awareness must be raised among patients for an early consultation at the first symptoms.

关键词： Connectivitis therapeutic itinerary CNHU-HKM Cotonou

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therapeutic itinerary and Causes of Delay in Specialized Consultation of Patients Admitted for Diabetic Foot

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Journal of Diabetes Mellitus 2018年第4期8卷 125-130页

作者： Comlan Jules Gninkoun Mensah S.Attikleme Roberto Dossou Tores Prudencio Adebayo Sabi Cossi Alassani Francois Djrolo Endocrinology Metabolism and Nutrition UnitFaculty of Health Sciences of CotonouCotonouBenin University Clinic of Internal Medicine and Medical Oncology CotonouBenin Teaching Hospital of Borgou-Alibori ParakouBenin

Introduction: Amputation remains a common practice in patients admitted for diabetic foot. The delay in consultation is one of the main reasons. The objective of this work was to analyze patients’ itinerary care and to identify the causes of delay in consultation in patients admitted for diabetic foot. Method: This is a descriptive cross-sectional study, including all patients hospitalized for diabetic foot. A wait of at least seven (7) days before consulting the Endocrinology department of Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) after the foot injury occurred was considered as delay in consultation. The data were recorded and analyzed in the EPI INFO software. The description of the sample was made according to the usual statistics (frequency, average, standard deviation). Results: Seventy-six (76) diabetic foot cases were admitted during the period of the study. The mean age of the patients was 56.64 ± 10.71 years with extremes of 29 years and 84 years. Patients were most often received at an advanced stage of the foot injury, 3D stage of Texas classification in 87% of cases and Wagner grades 4 and 5 in 52% of cases. The amputation rate was 38.16%. An analysis of the first care places reveals that 90.8% of patients had consulted conventional medicine, 13.2% in traditional medicine;1.2% had religious practices and 18.7% had declared self-medication at home. Consultation period at CNHU HKM was more than 7 days in 80% of cases and less than 7 days in 20% of cases. The average consultation time was 44.08 ± 26.43 days with extremes of 1 and 480 days. The main reasons for the delay in seeking hospital care cited by diabetic patients were fear of amputation (47.8% of cases), economic difficulties (32.5% of cases) and awareness lack of the situation seriousness (22.4%). Conclusion: The therapeutic itinerary of patients with diabetic foot was particularly long. The main reasons of late appeal to specialized care were fear of amputation and economic difficulties.

关键词： therapeutic itinerary Diabetic Foot Delay Complication Amputation

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therapeutic itinerary of Patients Living with Viral Hepatitis B and C in Guinea

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Open Journal of Gastroenterology 2022年第10期12卷 299-306页

作者： Diallo Kadiatou Barry Fatoumata Diaraye Diallo Thierno Saidou Diallo Djenabou Sow Ousmane Diallo Mamadou Sarifou Sylla Mariétou Salifou Sylla Djibril Leno Niouma Nestor Diallo Alpha Amadou Sank Tounkara Thierno Mamadou Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Department of Internal Medicine and Hepato-Gastroenterology National Hospital Donka Conakry Guinea National Programme for the Fight against HIV and Viral Hepatitis Ministry of Health and Public Hygiene Conakry Guinea Inter-Army Medical and Surgical Centre Conakry Guinea Department of Dermatology-MST National Hospital Donka Conakry Guinea

Introduction: The therapeutic pathway affects the patient who changes care facilities. This change is linked to factors such as financial means, geographical accessibility of care facilities, quality of care and the socio-cultural perception of the patient. In countries with limited resources such as Guinea, the therapeutic itinerary remains multiple and hampered by obstacles. The objective of this study was to describe the therapeutic itinerary of patients living with hepatitis B and C at the Donka National Hospital. Material and methods: This was a retrospective, descriptive study lasting 43 months (24 January 2017 - 27 August 2020);it focused on patients living with hepatitis B or C or viral cirrhosis. We collected sociodemographic, clinical and treatment history variables. The data were analysed with SPSS software version 21.0. Results: Out of 5400 patients, the proportion of viral hepatitis B or C represented 393 patients (7.3%). The mean age of our patients was 35 ± 10 years, with extremes of 16 - 77 years. The sex ratio was 2.5. Three hundred and forty-two patients (87%) had recourse to modern medicine, mostly in private facilities (50.6%). One hundred and twenty-five patients (31.8%) had received previous treatment, half of whom (57.6%) had received inappropriate treatment. The delay in treatment was long in 45% of cases. The main reasons for delaying treatment were feeling unwell in 33.3%;not knowing to consult a specialist in 29.9% and feeling that they were being treated with useful drugs in 24.3%. Conclusion: The lack of training of general practitioners on the management of viral hepatitis and the scarcity of awareness campaigns on viral hepatitis contributed to the inadequacy of the management.

关键词： therapeutic itinerary Hepatitis B Hepatitis C Guinea

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Behaviour and therapeutic itinerary of epileptic patients in Marrakech city and surrounding regions in South Morocco

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Acta Epileptologica 2021年第1期3卷 189-194页

作者： Abdelaati El Khiat Najib Kissani Abdellatif Abbaoui Mohamed Chraa Mohamed Loukid Halima Gamrani Mohamed Kamal Hilali Neuroscience Pharmacology and Environment Unit(ENPE)Laboratory of Clinical and Experimental Neurosciences and Environmentfaculty of Medicine and PharmacyCadi Ayyad University4000 MarrakechMorocco Higher Instituate of Nursing Professions and Health Techniques Ministry of HealthB.P.45000 OuarzazateMorocco Neurology Department University Hospital Mohammed VIPrincipal،Avenue Ibn SinaB.P.2360 MarrakechMorocco Laboratory of Human Ecology Faculty of Sciences SemlaliaCadi Ayyad UniversityAvenue My AbdellahB.P2390 MarrakechMorocco

Background:Epilepsy is a chronic,universal disorder with various etiologies and *** is still laden with myths in the majority of the Moroccan *** the existence of well-established medicinal treatments and increasingly comprehensive care,access to antiepileptic care is still limited,especially for rural *** aim herein to identify the therapeutic itinerary of patients with epilepsy(or epileptic disorders)as well as the behaviour of patients and their families towards this disease in Marrakech and the surrounding region of ***:We carried out a retrospective study Questionnaire filled by 110 patients data was analysed with SPSS version ***:Our results showed that 69.96%of the patients believed in a supernatural origin of the disease and 76.4%attended for professional medical care after their first *** addition,more than half of our patients(51.8%)consulted a religious leader for the initial consultation,51.0%of whom were women and 49.0%were *** low socioeconomic status of patients with epilepsy,74.5%of whom were unemployed,impeded the effective management of this ***:These results suggest that the management of patients with epilepsy(or epileptic disorders)in Africa,and particularly in Morocco requires,in addition to the reinforcement of human and material resources,an effort to educate and positively influence the family and the social environment as a whole.

关键词： Beliefs Epilepsy Marrakech and south of Morocco Seizures therapeutic itinerary

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Socio-Cultural Representations and therapeutic Itineraries of Parents of Autistic Children Followed in the INSP’s Children’s Mental Health Services

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Open Journal of Psychiatry 2023年第1期13卷 1-9页

作者： Koffi Paulin Konan Brahim Samuel Traore Ettié Sylvie Kouassi Yao Etienne Kouadio Kouadio Régis Aymar Yao Yessonguilana Jean-Marie Yeo-Tenena Addictology and Mental Hygiene Department National Institute of Public Health (INSP) Abidjan Ivory Coast UFR Medical Sciences of Abidjan Felix Houphou&#235 t-Boigny University Abidjan Ivory Coast Child Guidance Center National Institute of Public Health (INSP) Abidjan Ivory Coast

Pervasive developmental disorders (PDD) remain little known to populations in developing countries. In black Africa their social representations remain strongly influenced by local belief systems. The general objective of this study was to understand the perceptions and representations of Ivorian parents vis-à-vis PDD. This was a mixed (qualitative and quantitative) prospective cross-sectional study with a descriptive aim that involved a sample of 49 parents. The sampling was of the qualitative type by multiple cases with reasoned choice by saturation. Our results showed that male parents were mostly aged between 40 - 49 years (48.98%) with a higher level of education (67.34%) while mothers were mostly aged between 30 - 39 (61.22%) and a higher level (30.61%). Autistic children were negatively perceived by their parents: either as a source of psychological suffering (82.85%), or as mysterious children who sacrificed their parents (44.66%), or as “bobo” children (mute children in common Ivorian language) (16.66%) or like rude children (13.34%). The supposed origin of the disorder according to the parents was mystical-religious (60.94%);natural (25%);hereditary (6.25%). In 6.25% of cases, PDD were assumed to be of unknown or iatrogenic origin attributable to vaccination (1.56%). 75.51% of parents said that in addition to conventional medical therapies, they also used traditional therapies. The use of this therapeutic alternative would be linked to the perceptions and beliefs that feed the socio-cultural representations of our respondents.

关键词： Pervasive Developmental Disorders Socio-Cultural Representation Parents therapeutic itinerary

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