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Severe Allergic Reaction Following Administration of Antivenom Serum for Snakebite: A Case Report from Togo

Case Reports in Clinical Medicine 2024年第8期13卷 297-303页

作者： Awèréou Kotosso Lidaw deassoua Bawe Akouda Akessiwe Patassi Lampouguini Nebona Cici Amouzou Esso-Essinam Félix Pissang Bawoubadi Abaltou Gnimdou Tchamdja Magnoudewa Poko Hassimou Bramah Majesté Ihou Wateba Facult des Sciences de la Sant Universit de Lom Lom Togo department of Infectious Diseases Centre Hospitalier Rgional Lom-Commune Lom Togo department of Infectious Diseases and Tropical Medicine Centre Hospitalier Universitaire Sylvanus Olympio Lom Togo department of General Medicine Centre Mdical des Armes de Sokod Lom Togo

Background: Ophidian envenomation is common in Sub-Saharan Africa, and its management is hampered by the lack of access to healthcare services in rural areas, in particular the availability and appropriate use of antivenom. Rare cases of serious side effects following the administration of antivenom have been reported. This is the case for a young farmer from the central region of Togo, who experienced a second snake bite within four years, and in whom antivenom serotherapy led to severe allergic manifestations. Case presentation: This 24-year-old patient, with a history of antivenom and tetanus serotherapy, was admitted to the centre hospitalier Régional (CHR) of Sokodé for a snakebite that occurred 45 minutes earlier while working in the field. Clinical assessment on admission revealed grade 1 envenomation, characterized by local pain in the right upper limb, with no sign of complication. He received an intravenous infusion of antivenom serotherapy, which rapidly relieved the pain, allowing him to be discharged after 24 hours of hospital monitoring. However, he was readmitted five days later for a skin rash associated with generalized pruritus and edema of the face and the neck, which prompted his evacuation to the Sylvanus Olympio University Hospital. He was diagnosed with a hypersensitivity-type allergic reaction to antivenom serum. Symptomatic treatment with antihistamines resulted in a favourable outcome after five days in the hospital. Conclusion: This young farmer developed a severe allergic reaction following a second course of antivenom serotherapy for low-grade ophidian envenomation. Although the efficacy of antivenom serum is undeniable in the management of snakebites, its use should be guided by a sound clinical assessment and framed by rigorous monitoring, especially in people sensitized to antivenom or antitoxin serotherapy. This highlights the importance of training healthcare staff alongside the availability of anti-venomous sera at peripheral healt

关键词： Snakebite Antivenom Allergic Reaction Sub-Saharan Africa Togo

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COVID-19 Vaccination Status and Severe Outcomes among Patients Hospitalized for COVID-19 in West Africa, Togo, 2021

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Advances in Infectious Diseases 2024年第1期14卷 87-104页

作者： Awèréou Kotosso Yao Rodion Konu Lidaw Déassoua Bawe Sarakawabalo Assenouwe Yawovi Mawufemo Tsevi Koffi Atsu Aziagbe Akouda Akessiwe Patassi Bawoubadi Abaltou Gnimdou Tchamdja Lampouguini Nebona Komi Séraphin Adjoh Didier Ekouevi Majesté Ihou Wateba Faculté des Sciences de la Santé Université de Lomé Lomé Togo centre hospitalier Régional lomé Commune Lomé Togo Service des Maladies Infectieuses Centre Hospitalier Universitaire Sylvanus-Olympio Lomé Togo Unité de Recherche Mixte 1219 Bordeaux Population Health Centre University of Bordeaux National Institute for Health and Medical Research (INSERM) Research Institute for Sustainable Development (IRD) Bordeaux France Département de Santé Publique Université de Lomé Lomé Togo Faculté des Sciences de la Santé Université de Kara Kara Togo Service d’Anesthésie et Réanimation Centre Hospitalier Universitaire Kara Kara Togo Service de Néphrologie et d’Hémodialyse Centre Hospitalier Universitaire Sylvanus-Olympio Lomé Togo Service de Pneumo-Phtisiologie Centre Hospitalier Universitaire Sylvanus-Olympio Lomé Togo

Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to describe the impact of COVID-19 vaccination on the prognosis of hospitalized patients. Methods: This was a retrospective cohort study of patients admitted to the centre hospitalier Régional lomé Commune (Togo) between June 1, 2021 and May 31, 2022. Primary outcomes (admission to the intensive care unit and death) were presented with frequency and proportion. Mortality rates were presented by sociodemographic and clinical characteristics and compared by appropriate statistical tests. Factors associated with inpatient death were described by performing a Cox proportional hazard regression. Results: A total of 604 patients were hospitalized (50.0% women). The mean age was 54.03 ±17.1 years. Only 55 patients were fully vaccinated (9.1%). ICU admission was significantly more frequent in unvaccinated patients than in vaccinated ones (63.0% vs. 38.2%;p Conclusion: COVID-19 vaccination had a significant benefit for patients with COVID-19 infection in terms of reducing the risk of death. Based on real-world data from sub-Saharan Africa, this information can help optimize the benefit of COVID-19 vaccination by raising community awareness and increasing vaccine coverage while reducing hesitancy.

关键词： COVID-19 Vaccination Prognosis Mortality Sub-Saharan Africa

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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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Knowledge, Attitudes and Practices of Health Care Staff about Glaucoma in lomé

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Open Journal of Ophthalmology 2021年第2期11卷 163-175页

作者： Messan Kokou Amedome Yao Ako Patrick Mensah Kokou Vonor Nidain Maneh Kossi Dzidzinyo Kassoula Batomaguéla Nonon Saa Koffi Didier Ayena Komi Balo centre hospitalier universitaire de Kara Kara Togo Hô pital de Bè lomé Lomé Togo centre hospitalier Régional de Kara-Tomdè Kara Togo centre hospitalier universitaire campus de lomé Lomé Togo centre hospitalier universitaire Sylvanus Olympio de lomé Lomé Togo

Introduction: Glaucoma is a major cause of irreversible blindness worldwide. Early detection and awareness are essential to reduce the impact on eye health. The aim of this study is to assess the knowledge, attitudes and practices of health care staff about glaucoma in lomé. Materials and Methods: This was a prospective cross-sectional and descriptive study including health care staff in lomé, from October 1st to december 31st, 2020, for a period of 3 months. After their agreement, the officers responded to questions based on a survey sheet. Results: A total of 169 agents from 3 centers in lomé, i.e. the Sylvanus Olympio University Teaching Hospital, the campus University teaching Hospital and the Bè Hospital were involved. 50.9% of the agents were male versus 49.1% female, i.e. a ratio of 1.04. The average age was 33.66 ± 10.45 years. 46.10% were doctors versus 53.90% paramedics. 58.60% had at most 5 years of experience against 41.40% who had more than 5 years of experience. 53.80% defined glaucoma as ocular hypertension while 17.20% defined it as optic nerve disease. 46.20% did not know that there were many types of glaucomas compared to 53.20% who knew that there are many types of glaucomas. 92.30% knew that glaucoma can lead to cause visual loss. Regarding attitudes and practices about glaucoma, 91.70% declared that the follow-up should be done by the ophthalmologist, 81.10% thought that it would be necessary to be checked by the doctor only every 6 months. Finally, 65.08% declared that they had to use eye drops for life for the treatment. Conclusion: Steps should be taken to educate staff more about glaucoma attitudes and practices and also plan for action in the population.

关键词： Knowledge Attitude Practice Glaucoma lomé

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Diagnosis of Large Papillary Excavations in developing Countries: From Automated Visual Field to OCT of the Ganglion Complex. About a Case

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Open Journal of Ophthalmology 2021年第2期11卷 143-151页

作者： Kokou Messan Amedome Kassoula Batomaguéla Nonon Saa Kossi Dzidzinyo Kokou Vonor Nidain Maneh Koffi Didier Ayena Komi Balo centre hospitalier universitaire de Kara Kara Togo centre hospitalier universitaire Sylvanus Olympio de lomé Lomé Togo centre hospitalier Régional de Kara Tomdè Kara Togo centre hospitalier universitaire campus de lomé Lomé Togo Hô pital de Bè lomé Lomé Togo

Background: Large papillary excavations constitute a true differential diagnosis of glaucoma in our environments. Aim: To present a clinical case of large papillary excavation simulating glaucomatous optic neuropathy in a young subject. Case Presentation: The ophthalmologic examination made it possible to note a visual acuity of LogMar 0.00, ocular hypertonia and a large papillary excavation in both eyes. The visual field noted bilateral perimetric involvement suggesting optic neuropathy. Optical coherence tomography (OCT) of the ganglion complex revealed an absence of involvement of the ganglion complex and the ganglion ridge essential to evoke optic neuropathy. An ocular hypotonizing treatment made it possible to normalize the intraocular pressure. Conclusion: The particularity of this observation lies in the fact that the perimeter involvement that preceded any involvement can simulate a glaucomatous involvement. Functional damage to the visual field must be correlated with structural damage to suggest glaucomatous damage in our ophthalmic patients.

关键词： Large Excavation Optic Neuropathy Glaucoma OCT Kara

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Place of Ocular Ultrasound in the Diagnosis of Optic Disc Druses in developing Countries: About a Case and Review of the Literature

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Open Journal of Ophthalmology 2021年第4期11卷 325-331页

作者： Kokou Messan Amedome Kokou Vonor Codjo Rodrigue Abel Assavédo Nidain Maneh Massaga Dagbe Kossi Dzidzinyo Koffi Didier Ayéna Komi Balo centre hospitalier universitaire de Kara Kara Togo centre hospitalier Régional de Kara Tomdè Kara Togo centre hospitalier Départemental Borgou-Alibori Parakou Benin centre hospitalier universitaire campus de lomé Lomé Togo centre hospitalier universitaire Sylvanus Olympio de lomé Lomé Togo Hô pital Secondaire de Bè Lomé Togo

Background: Druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. Aim: The aim of this study is to show the utility of ocular ultrasound in ophthalmology in underdeveloped countries for the characterization of optic disc druse. Case Presentation: Our study relates to a clinical observation of buried papillary druses diagnosed by ocular ultrasound. The ophthalmologic examination revealed an aspect of false papillary edema in the fundus. The ocular ultrasound revealed hyperechogenic deposits buried in the papillary margins, which suggests the deep papillary druses. Conclusion: Ocular ultrasound still has a prominent place in the diagnosis of certain eye conditions despite the new sophisticated means available to ophthalmology to date.

关键词： Ultrasound Druses Hyperechoic Globe

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Urological Endoscopy: Results of the First 15 Months, in Kara (Togo)

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Open Journal of Urology 2022年第9期12卷 492-498页

作者： Komi Hola Sikpa Gnimdou Botcho Messan Semefa Agbedey Essodina Padja Essomindelou Leloua Kossi Edem Gueouguede Pwerew Rodolphe Plante Edoe Viyome Sewa Kodjo Kevin Tengue Matchonna Tchilabalo Kpatcha centre hospitalier universitaire Kara Kara Togo centre hospitalier Regional Sokodé Sokodé Togo centre hospitalier universitaire Sylvanus Olympia Lomé Togo

Background: The urology department of the Teaching Hospital of Kara is the 2nd urology department in Togo, Kara being a semi-urban town located 400 km from lomé the capital. While for a long time only open surgery was used, the acquisition of urological endoscopic equipment in February 2021, has revolutionized the urological management of patients. Objective: Report the results of the first 15 months of urological endoscopy practice at the Kara Teaching Hospital, identify the particularities, announce the prospects. Patients and Methods. This was a retrospective and descriptive study, which took place in the urology department of the Kara Teaching Hospital, from February 2021 to April 2022, i.e. a period of 15 months. The register of operative reports and patient records were used for data collection. The following parameters were studied: age, sex, diagnosis, indication, diagnostic or therapeutic nature of the procedure, and results. EPI INFO 7.***.4.0 software was used for data analysis. Results: A total of 102 urological procedures (endoscopic and non-endoscopic) were performed during the study period;of the 102 interventions, 62 were endoscopic urological interventions, i.e., 60.7% of the interventions. The average age of patients treated was 55.5 years (±16.4) with extremes ranging from 28 to 87 years. Men accounted for 84% of patients treated. Prostatic hypertrophy was the most common urological pathology in our study, requiring endoscopic intervention in 40% of cases. Transurethral resection of the prostate was the most performed endoscopic procedure in our study with 43.5% of cases. The various endoscopic interventions resulted in success in 96.7% of cases. Conclusion: Urology nowadays cannot be done without endoscopy. At the Kara Teaching Hospital, the results are already promising after less than 24 months of endoscopic practice in urology. Advocacy must be made to political decision-makers, so that the situation is even better, for the good of both urologis

关键词： Urological Endoscopy Results Kara Togo

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Bilateral Iris Coloboma Revealed by a decreased Vision: About the First Case in Togo Observed in Kara University Teaching Hospital

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Open Journal of Ophthalmology 2021年第4期11卷 249-252页

作者： Kokou Messan Amedome Codjo Rodrigue Abel Assavédo Yao Ako Patrick Mensah Kossi Dzidzinyo Kokou Vonor Koffi Didier Ayéna Komi Balo centre hospitalier universitaire de Kara Kara Togo centre hospitalier départemental Borgou-Alibori Parakou Benin centre hospitalier universitaire Sylvanus Olympio Lomé Togo centre hospitalier Régional de Kara Tomdè Kara Togo Hô pital Secondaire de Bè Lomé Togo

Background: Ocular coloboma is the product of an error in the fetal fissure closure, normally occurring between the fifth and sixth weeks of gestation [1]. It may involve the cornea, iris, zonula, ciliary body, choroid, retina and optic nerve. The incidence of this syndrome is 0.7 per 10,000 live-births [1]. The aim of this observation is to present the first case of bilateral coloboma of the iris [1]. This case was associated with an ametropia causing a decrease in visual acuity. Case Presentation: This was a clinical observation concerning a young 12-year-old patient who consulted for blurring of vision which had progressed for approximately 2 years. The ophthalmologic examination revealed an ametropia with a bilateral notch of the pupillary rim suggesting a bilateral coloboma. There was no association with another coloboma such as chorioretinal coloboma which is quite common and is accompanied frequently by visual symptoms. Conclusion: A visual impairment of the child can indicate ametropia. However, other congenital anomalies can be discovered as was the case in this clinical observation.

关键词： Coloboma Iris decreased Vision Kara Togo

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Computed Tomography Evaluation of Tumor Response in Oncology in Togo

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Journal of Cancer Therapy 2021年第12期12卷 695-707页

作者： Abdoulatif Amadou Pihou Gbande Ablavi Adani-Ifè Massaga Dagbe Icael Youaleu Lantam Sonhaye Lama Kedigoma Agoda-Koussema Komlanvi Adjenou Radiology and Medical Imaging department Centre Hospitalier Régional Kara Kara Togo Radiology and Medical Imaging department Centre Hospitalier Régional de Sokodé Sokodé Togo department of Oncology Centre Hospitalier Universitaire Sylvanus Olympio Lomé Togo Radiology and Medical Imaging department Centre Hospitalier Universitaire de Kara Kara Togo Radiology and Medical Imaging department Centre Hospitalier Universitaire Sylvanus Olympio Lomé Togo

Cancer is common in our setting and represents a real public health concern in sub-Saharan Africa. This work aimed to assess the role of computed tomography in the follow-up of patients treated for cancer in Togo. This was a retrospective descriptive study carried out over a period of one year, on patients with cancer, treated in the medical oncology unit of CHU Sylvanus Olympio and having undergone at least two CT scans after cancer treatment. Computed tomography evaluation was performed according to the RECIST 1.1 guidelines. We had found 46 patients. The mean age of the patients was 54.22 years with a female predominance (sex ratio 1:2.5). Cancers mainly involved the urogenital system (60.8%) followed by the digestive system (28.3%). Carcinoma represented 93.5% of cases, mainly adenocarcinoma (45.7%). 74 target lesions were present at baseline, with 18.9% and 11.6% disappearing at the first and second assessments respectively. 36 non-target lesions were present at baseline, with 25% and 22.2% disappearing at the first and second assessments respectively. New lesions were found in the abdominal region in 54.5% of cases and in the thoracic region in 41.3% at the first and second assessments respectively. 58.7% of patients had a stable disease at the first assessment and 39.1% had progression at the second assessment. 50% of them had received chemotherapy in combination with surgery. Computed tomography using the RECIST 1.1 guidelines is a necessity in monitoring tumor extensions and in the follow-up of cancer patients.

关键词： Cancer Response Tumoral Computed Tomography RECIST 1.1 Togo

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Biochemical Profile of Patients Hospitalized for COVID-19 at the Infectious Disease Management centre in lomé in 2020

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Open Journal of Internal Medicine 2023年第4期13卷 271-294页

作者： Lochina Feteke Wemboo Afiwa Halatoko Mamadou Alpha Prateaux Aweréou Kotosso Fagdéba David Bara Komi Séraphin Adjoh Mounerou Salou Koumavi Didier Ekouevi Mohaman Djibril centre National de Transfusion Sanguine Lomé Togo Département de Biochimie Médicale Université de Lomé Lomé Togo Institut National D’Hygiène Lomé Togo centre Médico-Chirurgical Interarmé Conakry Guinée Département de Pneumologie Centre Hospitalier Universitaire Sylvanus Olympio Lomé Lomé Togo Unité de Recherche en Immunologie et Immunomodulation (UR2IM) Laboratoire de Microbiologie et de Contr&ocircle de Qualité des Denrées Alimentaires (LAMICODA) Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA) Université de Lomé Lomé Togo Services de Laboratoire Centre Hospitalier Universitaire Campus Lomé Togo Département de Santé Publique Université de Lomé Lomé Togo

Background: COVID-19, an infectious viral disease, has caused a global health crisis. Most cases remain asymptomatic. The majority of patients have mild symptoms while about 15% develop a severe form. The clinical spectrum of SARS-CoV-2 infection appears broad, encompassing asymptomatic infection, upper respiratory tract symptoms, and severe viral pneumonia with respiratory failure that can lead to death. Laboratory tests play an important role in the management of COVID-19 patients. In addition to being essential for the diagnosis, several biological analyses make it possible to identify the inflammatory processes and the potential complications of this disease. This study attempted to identify biochemical assays that could help in the prognosis of the disease to ensure early management. Methods: This was a descriptive study. It focused on patients hospitalized for COVID-19 from March 19, 2020, to January 26, 2021, at the Infectious Disease Management centre in lomé (Togo). Medians were compared using the (Mann-Whitney and Wilcoxon) test and frequencies were compared using the Chi-square test or Fisher’s exact test. Results: We included 782 patients. The median age was 41 years IQR from 32 to 55. We observed several biochemical abnormalities in varying proportions for all biochemical parameters studied. Compared to non-serious patients, critically ill patients at admission had more frequently elevated urea, creatinine, transaminases, TG, GGT, CRP and blood glucose. Also, they had more frequent decreases in total cholesterol, HDL-c, blood chloride, and blood calcium. As for patients who died during hospitalization, compared with healed patients, they had more frequent elevations of urea, creatinine, AST, ALT, GGT. CRP and blood glucose. They also had a more frequent decrease in total cholesterol, HDL-c, blood chloride, blood calcium, and blood glucose (p = 0.025). Conclusion: This study shows that COVID-19 is a multi-organ systemic inflammatory viral disease that sh

关键词： COVID-19 Biochemical Anomalies Togo 2022

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