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Associated Factors to Poor Blood Pressure Control in Hypertensives Followed Up at the Campus University Hospital of lome (Togo)

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World Journal of Cardiovascular Diseases 2024年第6期14卷 374-380页

作者： Soulemane Pessinaba Yaovi Mignazonzon Afassinou Wiyao Dieudonné Kaziga Komlavi Yayehd Kolani Lamboni Sélim Bolarinwa Mohamed Kpélafia Ekpe Togbossi Akpe Adzodo Machihude Pio Soodougoua Baragou Findibé Damorou Cardiology department University Hospital of Campus Lome Togo Cardiology department Sylvanus Olympio University Hospital Lome Togo Cardiology department Kara University Hospital Kara Togo

Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.

关键词： Hypertension Poor Control Associated factors Togo

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Physiotherapy Management of Rheumatic Diseases

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第1期14卷 37-47页

作者： Aly Badra Kamissoko Abdoulaye Barry Mamadou Lamine Diallo Boutros Cosme Nato Abdel Amide Gbadamassi Marie Traore Abèni Faouzyath Yaya Facely Traore Paul Eloundou Sory Diane Matènè Komara Halimatou Barry Moriba Toure Moriba Toure Kaba Conde Owonayo Oniankitan department of Rheumatology Ignace Deen University Hospital Conakry Guinea department of Rheumatology Sylvanus Olympio University Hospital Lome Togo Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Introduction: Physiotherapy is an integral part of the non-drug treatment strategy for rheumatological conditions. The evidence for its effects is not formal. The objective was to evaluate the impact of physiotherapy in the management of rheumatological disorders. Methods: 6-month case-control study (December 15, 2021 to June 20, 2022) at Ignace Deen University Hospital (Conakry). Patients with rheumatological disease who received drug therapy and physiotherapy were included in the case group. Age- and sex-matched controls had rheumatological conditions, treated without physiotherapy. The evaluation questionnaires were used: WOMAC (osteoarthritis), EIFEL (low back pain), NDI (neck pain), SPADI (shoulder). Patients with heart failure, respiratory failure and/or skin infection were not included. Results: We collected 773 patients (389 cases and 384 controls) with a mean age of 53.8 years ± 12.2 with female predominance (56.8%). Patients were mainly followed for osteoarthritis (65.2%). Rheumatological conditions managed were knee-based (119;30.6%), lumbar spine (220;56.6%), shoulders (27;6.9%) and cervical spine (23;5.9%). For an average duration of 53.4 ± 12.2 minutes per session, patients had benefited from a median of 19 physiotherapy sessions. After 3 months, the baseline mean VAS of 6/10 improved to 2.2 ± 1.6 for cases and 5.7 ± 1.2 for controls. Functional capacity was improved (WOMAC: 41.8 ± 22.7 vs. 18.3 ± 7.3). The satisfaction of patients treated with physiotherapy was 20 times higher than in controls. Conclusion: Physiotherapy performed in the management of rheumatological conditions significantly reduced pain and improved functional capacity.

关键词： Rheumatological Disease Physiotherapy WOMAC Guinea

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Risk Factors for Mortality in Acute Kidney Injury in Intensive Care Units in Togo

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Open Journal of Nephrology 2024年第1期14卷 37-47页

作者： Eyram Makafui Yoan Yawo Amekoudi Kossi Akomola Sabi Marcel David Keoula Badomta Dolaama Sarakawabalo Assenouwe Tabana Mouzou department of Nephrology Kara University Hospital University of Kara Kara Togo department of Nephrology and Haemodialysis Sylvanus Olympio University Hospital University of Lome Lomé Togo department of Anaesthesia and Intensive Care University Hospital of Kara University of Kara Kara Togo

Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. Methods and Material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (M/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. Mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.

关键词： AKI Intensive Care Unit Dialysis Epidemiology Togo

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Predictive Factors of Renal Failure in COVID-19 Patients at the Anti-COVID Center in lome, Togo

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Open Journal of Nephrology 2024年第2期14卷 125-135页

作者： Kossi Akomola Sabi Yoan Makafui Amekoudi Awéréou Kotosso Laune Odilon Blatome Badomta Dolaama Ayodélé Jonathan Sabi Oscar Gnirimi Gbahbang Loutou Ahoub-Laye Affo Béfa Noto-Kadou-Kaza Nephrology-Hemodialysis department of chu sylvanus olympio University of Lom Lom Togo Faculty of Health Sciences University of Lom Lom Togo Nephrology department of the chu Kara University of Kara Kara Togo Centre Hospitalier Universitaire Pointe--Pitre Pointe--Pitre Guadeloup

Background: Angiotensin-converting enzyme 2 has been identified as the receptor that allows the entry of SarsCov2 into the human cell. Its expression in the kidney is 100 times higher than in the lung;thus, making the kidney an excellent target for SarsCov2 infection manifesting as renal failure (RF). The objective of this study was to determine the predictive factors of RF during COVID-19 in the Togolese context. Patients and Methods: This was a retrospective descriptive and analytical study conducted at the Lomé Anti-COVID Center including the records of patients hospitalized for COVID-19, of age ≥ 18 years and having performed a creatinemia. RF was defined by a GFR 2 calculated according to the MDRD formula. Patients were randomized into 2 groups according to GFRResults: 482 patients were selected for this study with a mean age of 58.02 years. Sixty-five percent of the patients were men, i.e., a sex ratio of 1.88. Fifty-two patients had RF, i.e., a frequency of 10.8%.There were 65% men (315 cases), for a sex ratio (M/F) of 1.88. Risk factors for renal failure in COVID-19 were age ≥ 65 years (ORa 2.42;CIa95% [1.17 - 4.95];p = 0.016), anemia (ORa 2.49;CIa95% [1.21 - 5.26];p = 0.015), moderate (ORa 13;CIa95% [2.30 - 2.44];p = 0.017), severe (ORa 26.2;CIa95% [4.85 - 4.93];p = 0.002) and critical (ORa 108;CIa95% [16.5 - 21.76];p Conclusion: Renal failure would therefore be related to the severity of COVID-19 and is the most formidable factor, conditioning the course of the disease and the patient’s vital prognosis.

关键词： COVID-19 Renal Failure Risk Factors Togo

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Practice of Pediatric Spinal anesthesia in a Country with Limited Means: Example of Togo

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Open Journal of Anesthesiology 2023年第2期13卷 32-45页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe Pikabalo Tchetike Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim resuscitation anesthesia department at the Kara-chu Kara Togo chu-sylvanus olympio anesthesia resuscitation department in lome Lome Togo Medical resuscitation and Nephrology Service of the chu-Kara Kara Togo chu-Kara Traumatology department Kara Togo

Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in pediatric surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in pediatric surgery at chu SO de Lomé, in the operating room and hospital ward of chu Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.

关键词： Pediatric Surgery Spinal anesthesia Togo

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Early Postoperative Deaths in the Surgical Intensive Care Unit of chu-Kara

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Open Journal of Internal Medicine 2023年第1期13卷 32-50页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe Pikabalo Tchetike Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim department of anesthesia and Intensive Care at chu-Kara Kara Togo anesthesia resuscitation Service at chu-sylvanus olympio in Lomé Lomé Togo Medical resuscitation and Nephrology department of chu-Kara Kara Togo Trauma Service chu-Kara Kara Togo

Aim: Review of early postoperative deaths in the surgical intensive care unit at chu-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.

关键词： Mortality Early Postoperative Surgical resuscitation chu-Kara Togo

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Epidemiological and Diagnostic Aspects of Childhood Proptosis in lome (Togo) from 2010 to 2020

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Open Journal of Ophthalmology 2023年第4期13卷 333-340页

作者： Nidain Maneh Mawuli Ayodele Komi Santos Koffi Sylvain Kawilitetou Dadjo Amouzou Kossi Dzidzinyo Kokou Vonor Didier Koffi Ayena Patrice Komi Balo Ophthalmology department of chu-Campus University of Lome Lome Togo Ophthalmology department of CHP-Aneho University of Lome Aneho Togo Ophthalmology department of chu sylvanus olympio University of Lome Lome Togo Ophthalmology department CHR-Tomde University of Kara Kara Togo

Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and diagnostic aspects of childhood proptosis in lome (Togo). Methods: Retrospective cross-sectional study conducted from June 2010 to May 2020, which is 10 years, in the ophthalmology department of chu-campus of lome. Files of patients between the age of 0 and 15 who presented a proptosis during the study period were taken into account in the study. Patients with a false proptosis or incomplete records during the study period were not taken into account in the study. Results: The study considered 42 children with an age average of 7.63 years ± 4.96 [4 days;15 years] and a sex-ratio of 1.33. The frequency of proptosis was 0.5% with an average progression of 383.7 days before the first consultation. The proptosis was unilateral in 80.95% of cases. The orbito-cerebral CT scan was done in 47.62% of cases. The proptosis in these patients was predominantly of grade 3 in 45% of cases. The tumor pathologies were at the forefront in 35.71%, dominated by retinoblastoma, and followed by infectious and inflammatory diseases in 14.29%. Conclusion: Childhood proptosis is rare and often indicative of infectious and tumor pathologies in our context. Its diagnosis is delayed, which shows the importance of an early and effective diagnosis. .

关键词： Childhood Proptosis Tumors Infections lome

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Mortality in Cardiology in Sub-Saharan Africa: Case of the Cardiology department of the Teaching Hospital sylvanus olympio of lome

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World Journal of Cardiovascular Diseases 2023年第8期13卷 477-492页

作者： Afassinou Yaovi Mignazonzon Dola Kossi Edem Pessinaba Soulemane Atta Borgatia Pio Machihude Baragou Soodougoua Damorou Findibe Cardiology department Sylvanus Olympio Teaching Hospital of Lome Lome Togo Cardiology department Teaching Hospital Campus of Lome Lome Togo Medical department Sokode Regional Hospital Center Sokode Togo Cardiology department Kara Teaching Hospital Kara Togo

Background: Cardiovascular disease is the leading cause of death worldwide. The specificities of cardiology mortality in Togo are not well known. The objective of this study was to determine the profile of deaths in the cardiology department of the sylvanus olympio Teaching Hospital (chu SO) in lome. Materials and Methods: This was a cross-sectional study conducted over a period of 06 years, from January 1, 2015 to December 31, 2021, in the cardiology department of the sylvanus olympio Teaching Hospital in lome. In this study, we included all medical records of patients who died in hospital in the cardiology department during the study period. Results: During the study period, 2762 patients were hospitalized in the cardiology unit at chu SO. We recorded 112 deaths meeting our criteria, for an intrahospital mortality rate of 4.19%. The average age of patients was 53.79 ± 18.27 years. Hypertension was present in 47.3%. Sickness insurance coverage was not available for 94.64% of those who died. The major cardiovascular diseases observed were myocardium in 43.75% whose dilated cardiomyopathy accounted for 71.42%;and rhythmic lesions in 34.82%. Biological infectious syndrome (56.25%), renal failure (48.21%), anemia (47.27%), lung infection (32.14%), hyponatremia (33.04%) were the main comorbidities observed. Among the circumstances of death, sudden death was found in 32.14%, cardiogenic shock in 20.54% and septic shock in 13.39%. Conclusion: The profile of deaths in the cardiology department of the chu SO reveals that myocardial injuries are more present with circumstances of death dominated by sudden death.

关键词： Mortality Rate Cardiology chu sylvanus olympio

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Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases department at LoméUniversity Hospital

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Open Journal of Nephrology 2019年第3期9卷 55-64页

作者： Eyram Yoan Makafui Amekoudi Kossi Akomola Sabi Badomta Dolaama Komlan Georges Tona Bé fa Noto-Kadou-Kaza Epiphane Kola Bayaki Saka department of Nephrology and Hemodialysis CHU Sylvanus Olympio Lome Togo department of Dermatology and Venerology CHU Sylvanus Olympio Lome Togo

HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at sylvanus olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m2: 2.9% had an eGFR 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/μL [IQR = 72 - 274/μL];the median hemoglobin level was 10.4 g/dL [IQR = 8.8 - 11.9 g/dL];all patients had thrombocytopenia less than 100.000/mm3;8.5% had leukocytosis greater than 10.000/mm3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.

关键词： HIV Chronic Kidney Disease Epidemiology Togo

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Maxillofacial Trauma at Dapaong in Togo: About 208 Cases

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Journal of Biosciences and Medicines 2022年第9期10卷 160-166页

作者： Tamassi Bertrand Essobiyou Saliou Adam Michel Fabien Dargani Solim Uziel Roselin Boko Geremie Ananidjin Alexandre Palissam Keheou Mohamed Issa Haréfétéguéna Bissa department of General Surgery Dapaong Regional Hospital Center Dapaong Togo department of Stomatology Otorhinolaryngology Maxillofacial Head and Neck Surgery Sylvanus Olympio University Hospital Center Lome Togo department of Maxillofacial Surgery and Stomatology Bogodogo University Hospital Center Ouagadougou Burkina-Faso department of General Surgery Sylvanus Olympio University Hospital Center Lome Togo

Objective: We conducted a study to describe the problem of maxillofacial trauma in rural Africa. Background: the maxillofacial region is very much affected by trauma. These traumas, which are mainly related to public roads, are responsible for considerable mortality. In Africa, they mainly concern young men. Method: This was a monocentric, retrospective and descriptive study over 02 years from January 2019 to December 2021 in the surgical and stomatology departments of the Regional Hospital of Dapaong in Togo. All patients who received treatment for maxillofacial trauma in the said departments during the study period were included. Results: 208 cases of trauma were reported with an annual incidence of 104 cases. The average age was 31.4 years and the age groups most represented were 20 to 29 years (34.13%). Road traffic accidents were the main circumstance (70.14%) and involved mainly blue-collar workers (25.48%). Only standard X-rays were used to assess the injuries. Bone lesions concerned 92.79% of the patients with a predominance of mandibular fractures (34.60%). The main mode of management in the centre was orthopaedic treatment. Conclusion: Maxillofacial trauma is common in Togo. It involves young men and is essentially related to road accidents.

关键词： Trauma Maxillofacial Fracture Mandible Togo

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