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1.
HIV Med ; 24(8): 938-945, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37046178

RESUMEN

INTRODUCTION: Since the advent of HIV pre-exposure prophylaxis (PrEP), stigma has been shown to be a major barrier to its uptake and adherence. It is therefore essential to define the proportion of users who consider that PrEP can negatively impact their image and the factors associated with this perception. METHOD: We performed a multivariable logistic regression on data from the 2567 participants in the ANRS-PREVENIR study who answered the outcome question. RESULTS: Almost one-third of the sample (comprising mostly cisgender men who have sex with men [94.3%]) considered that taking PrEP could give others a negative image of them. Younger participants (adjusted odds ratio [aOR] 0.98; 95% confidence interval [CI] 0.97-0.99) and more psychologically vulnerable participants (i.e., lower self-esteem score [aOR 0.98; 95% CI 0.96-0.99] and higher depression score [aOR 1.02; 95% CI 1.00-1.03]) were also more likely to have this perception. In contrast, participants encouraged to take PrEP by their main partner (aOR 0.67; 95% CI 0.51-0.88) and friends (aOR 0.79; 95% CI 0.66-0.95), and those who protected themselves more because they had knowledge of their most recent sexual partner's HIV status (aOR 0.83; 95% CI 0.69-0.99) and systematic use of PrEP and/or condoms during intercourse in the previous 3 months (aOR 0.80; 95% CI 0.67-0.96) were less likely to have this perception. DISCUSSION: Given the strong interrelation between stigmatization (real or perceived), risky behaviours and adherence, our results emphasize the need for HIV prevention campaigns to promote a positive image of PrEP users. They also show that stigmatization and its effects need to be fully considered to improve HIV prevention offers to current and potential PrEP users who are most likely to be psychologically vulnerable.


Asunto(s)
Infecciones por VIH , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Masculino , Humanos , Homosexualidad Masculina , Infecciones por VIH/prevención & control , Infecciones por VIH/tratamiento farmacológico , Conducta Sexual , Percepción , Profilaxis Pre-Exposición/métodos
2.
Rev Epidemiol Sante Publique ; 69(5): 287-295, 2021 Oct.
Artículo en Francés | MEDLINE | ID: mdl-34272084

RESUMEN

BACKGROUND: Patient-centred care presupposes communication based on empathy, active listening and dialogue. Our study examines the effects of integrating mental health in multi-purpose health centres on health workers' communication with patients who consult for problems unrelated to mental health. The objective is to compare the quality of communication in health centres where staff have received specific training in the management of mental disorders (SM+) compared to those without such training (SM-). METHODS: The study was conducted among 18 health workers in charge of primary curative consultations in 12 non-governmental health centers in Guinea: 7 health workers in 4 SM+ health centers and 11 health workers in 8 SM- health centres. The study is based on mixed methods: observation, semi-structured and group interviews. The Global Consultation Rating Scale (GCRS) was applied to assess patient-centered communication. RESULTS: The SM+ GCRS scores obtained by SM+s during observations are generally higher than the SM- scores. The odds of having a "good quality" consultation are almost 3 times higher in SM+ than in SM- for some steps in the consultation process. The SM+ discourse is more patient-centered, and differs from the more biomedical discourse of SM-. SM- health workers do not consider all of the stages of a patient-centred consultation to be applicable and recommend "leapfrogging". On the contrary, SM+ health workers consider all stages to be important and are convinced that the integration of mental health has improved their communication through the training they have received and the practice of caring for persons with mental disorders. CONCLUSION: The integration of mental health into primary care provision represents an opportunity to improve the quality of care in its "patient-centred care" dimension. That said, optimal development of patient-centred care presupposes favorable structural conditions.


Asunto(s)
Salud Mental , Atención Dirigida al Paciente , Comunicación , Guinea , Personal de Salud , Humanos
3.
Rev Neurol (Paris) ; 177(6): 670-675, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33066995

RESUMEN

INTRODUCTION: Cerebral venous thrombosis (CVT) are underdiagnosed in sub-saharan Africa where publications are uncommon. Our study aim was to describe the CVT diagnostic and therapeutic features through a senegalese case series. PATIENTS AND METHOD: A monocentric retrospective and prospective study was conducted at the adult Neurology department of Fann Teaching Hospital in Dakar (Senegal), between January 01, 2013 and April 30, 2020. It had included all CVT cases diagnosed by neurovascular imaging. RESULTS: Seventy CVT cases were collected including 48 women (68.6%). The average age of the patients was 35.2±14 years. The main neurological signs were headache (92.8%) and motor deficit (41.4%), with subacute onset in 67.2% of cases. The superior sagittal sinus (54.3%) and the transverse sinus (38.6%) were the most affected with multiple involvements in 27 patients (38.6%). Thirty patients (42.8%) had indirect parenchymal signs such as venous infarction (15.7%), cerebral edema (11.4%) or intracerebral hemorrhage (12.8%). The etiological factors were mostly infectious (41.4%) with meningoencephalitis (12.8%) and otorhinolaryngological infection (10%). Gyneco-obstetric factors (27%) and Behçet's disease (7%) were the main aseptic factors. In the short-term clinical course, curative anticoagulation (98.6%) had enabled a favourable outcome (mRS 0-1) in half of the patients. CONCLUSION: Our study, the largest series in sub-saharan Africa to this date, confirms that CVT is a young women disease. Infectious etiology is the most frequent at the Fann national teaching hospital (41.4% in Dakar against 6.5% in Germaine Bousser's series) even if the etiological assessment is limited by financial constraints (no coagulopathy/thrombophilia check-up).


Asunto(s)
Trombosis Intracraneal , Neurología , Trombosis de la Vena , Adulto , África del Sur del Sahara , Femenino , Hospitales de Enseñanza , Humanos , Persona de Mediana Edad , Embarazo , Estudios Prospectivos , Estudios Retrospectivos , Senegal , Adulto Joven
4.
Electromagn Biol Med ; 39(3): 196-205, 2020 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-32401641

RESUMEN

Although an electrohypersensitivity (EHS) is reported in numerous studies, some authors associate hyperfrequencies (HF)-related pains with a nocebo effect while others suggest a biological effect. Therefore, we aimed to suggest hypotheses about the complex mechanisms of headaches related to HF-exposure. We crossed basic features of headaches with relevant studies (from the year 2000 up to 2018) emphasizing on the HF effects that may lead to pain genesis: neuroglial dysmetabolism, neuroinflammation, changes in cerebral blood perfusion, blood-brain barrier dysfunction and electrophysiological evidences of hyperexcitability. We privileged studies implying a sham exposure (for in vivo studies) and a specific absorption rate lower than 4 W/Kg. HF-induced headaches may involve an indirect inflammatory process (neurogenic, magnetogenic or thermogenic) as well as a direct biophysical effect (thermogenic or magnetogenic). We linked inflammatory processes to meningeal dysperfusion or primary neuroglial dysfunction triggered by non-thermal irradiation or HF-induced heating at thermal powers. In the latter case, HF-induced excitoxicity and oxidative stress probably play a crucial role. Such disorders may lead to vascular-trigeminal activation in predisposed people. Interestingly, an abnormal oxidative stress predisposition had been demonstrated in overall 80% of EHS self-reporting patients. In the case of direct effects, pain pathways' activation may be directly triggered by HF-irradiation (heating and/or transcranial HF-induced ectopic action potentials). Further research on HF-related headaches is needed.


Asunto(s)
Cefalea/etiología , Microondas/efectos adversos , Barrera Hematoencefálica/metabolismo , Barrera Hematoencefálica/efectos de la radiación , Cefalea/metabolismo , Cefalea/fisiopatología , Homeostasis/efectos de la radiación , Humanos , Permeabilidad/efectos de la radiación
5.
Heredity (Edinb) ; 119(2): 64-75, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28353686

RESUMEN

Knowledge of the genetic make-up and demographic history of invasive populations is critical to understand invasion mechanisms. Commensal rodents are ideal models to study whether complex invasion histories are typical of introductions involving human activities. The house mouse Mus musculus domesticus is a major invasive synanthropic rodent originating from South-West Asia. It has been largely studied in Europe and on several remote islands, but the genetic structure and invasion history of this taxon have been little investigated in several continental areas, including West Africa. In this study, we focussed on invasive populations of M. m. domesticus in Senegal. In this focal area for European settlers, the distribution area and invasion spread of the house mouse is documented by decades of data on commensal rodent communities. Genetic variation at one mitochondrial locus and 16 nuclear microsatellite markers was analysed from individuals sampled in 36 sites distributed across the country. A combination of phylogeographic and population genetics methods showed that there was a single introduction event on the northern coast of Senegal, from an exogenous (probably West European) source, followed by a secondary introduction from northern Senegal into a coastal site further south. The geographic locations of these introduction sites were consistent with the colonial history of Senegal. Overall, the marked microsatellite genetic structure observed in Senegal, even between sites located close together, revealed a complex interplay of different demographic processes occurring during house mouse spatial expansion, including sequential founder effects and stratified dispersal due to human transport along major roads.


Asunto(s)
Variación Genética , Genética de Población , Ratones/genética , Distribución Animal , Animales , Teorema de Bayes , ADN Mitocondrial/genética , Repeticiones de Microsatélite , Modelos Genéticos , Filogeografía , Senegal
6.
Morphologie ; 101(333): 105-109, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28528186

RESUMEN

Hernia is described as the protrusion of an organ into the wall of its normal containing cavity. Internal hernia (IH) involves protrusion of viscera through: a peritoneal or mesentery defect, a normal or abnormal compartment of the peritoneal cavity. Hernias occurring in the pelvis cavity are usually classified according to the fascial margins breached and include sciatic, obturator and those through the rectouterin pouch: elytrocele and enterocele. Those hernias are defined by the protrusion of a viscus through the wall of the pelvis due to weakness of the pelvic fascia and/or muscles. Pelvic hernia through the pouch of Douglas (PD) involves the genital tract in female (elytrocele and enterocele). Sometimes described in the literature as Douglas hernia, this type of hernia must be distinguished from the conventional IH. As defined before, the borders to be considered for IH is the peritoneal membrane, which is not a real solid wall but delimitates the peritoneal cavity; and there is no peritoneal defect in elytrocele or enterocele. A PubMed search for IH through a defect in the peritoneal PD revealed only five female cases, making this an extremely rare condition. To our knowledge, we have presented here the only published case in a male. This probably congenital and morphologic anomaly (defect) of pouch of Sir Douglas must be distinguished as the real "Douglas IH". Authors discuss the concept of a new and more detailed classification of IH.


Asunto(s)
Fondo de Saco Recto-Uterino/anomalías , Hernia/diagnóstico , Enfermedades del Íleon/diagnóstico por imagen , Obstrucción Intestinal/diagnóstico por imagen , Enfermedades Peritoneales/diagnóstico , Dolor Abdominal/etiología , Dolor Abdominal/cirugía , Anastomosis Quirúrgica , Vendajes , Estreñimiento/etiología , Estreñimiento/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Fondo de Saco Recto-Uterino/diagnóstico por imagen , Fondo de Saco Recto-Uterino/patología , Fondo de Saco Recto-Uterino/cirugía , Hernia/complicaciones , Humanos , Enfermedades del Íleon/etiología , Enfermedades del Íleon/patología , Enfermedades del Íleon/cirugía , Íleon/patología , Íleon/cirugía , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Masculino , Persona de Mediana Edad , Enfermedades Peritoneales/complicaciones , Enfermedades Peritoneales/cirugía , Infección de la Herida Quirúrgica/tratamiento farmacológico , Suturas , Tomografía Computarizada por Rayos X , Vómitos/etiología , Vómitos/cirugía
7.
J Viral Hepat ; 23(11): 897-904, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27353593

RESUMEN

Hepatitis B virus (HBV) is a major cause of chronic liver disease worldwide. HBV infection is diagnosed by serological tests, while real-time polymerase chain reaction (qRT-PCR) assays are used to quantify viral load, which is a crucial parameter to determine viral replication and to monitor antiviral treatments. However, measuring viral load in resource-limited countries remains nonsystematic, due to the high cost of commercial kits. Here, we describe the development, validation and implementation of a low-cost, in-house qRT-PCR assay to monitor HBV viral load in chronic carriers enrolled in the PROLIFICA programme in the Gambia and Senegal. Over 1500 HBsAg-positive patients, including 210 chronically infected HBV patients, who were given antiviral treatment (tenofovir), were monitored by qRT-PCR using the SYBR Green- and HBV-specific primers. Twenty-four tenofovir-treated patients were followed up and their viral load was tested every 3 months over the 12-month experimental time course. Compared to commercial assays, our in-house assay was shown to be (i) highly reliable, with good intra- and interassay reproducibility over a wide range (45-4.5 × 108 copies mL-1 ), (ii) very similar in the viral loads detected (R2  = .90), (iii) highly sensitive, as it detected loads as low as 30 copies mL-1 (~5 IU mL-1 ), (iv) cheaper (2- to 3-fold), (v) easier to implement and (vi) more rapid. Based on our experience, we recommend this assay as a reliable alternative to commercial assays, for monitoring HBV viraemia in resource-limited, highly endemic countries to reduce the cost and technical obstacles associated with commercial kits.


Asunto(s)
Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B Crónica/virología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Carga Viral/métodos , Antivirales , Benzotiazoles , Costos y Análisis de Costo , Cartilla de ADN/genética , ADN Viral/análisis , ADN Viral/genética , Diaminas , Monitoreo de Drogas/métodos , Estudios de Seguimiento , Gambia , Hepatitis B Crónica/tratamiento farmacológico , Humanos , Compuestos Orgánicos/metabolismo , Quinolinas , Reproducibilidad de los Resultados , Senegal , Sensibilidad y Especificidad , Coloración y Etiquetado/métodos , Tenofovir/administración & dosificación , Factores de Tiempo
9.
Rev Neurol (Paris) ; 170(10): 608-13, 2014 Oct.
Artículo en Francés | MEDLINE | ID: mdl-24953171

RESUMEN

INTRODUCTION: Epilepsy is a public health problem in Senegal and Africa because of its severity and its social importance. It occurs at any age sparing no sex. It can influence sexual life and reciprocally. Our aims were to study the effects of antiepileptic drugs on the sexual lives of women with epilepsy, the influence of these drugs on pregnancy and breastfeeding. METHODS: We conducted a prospective study from 1st March to 31st August 2011 in the neurological department of the Fann-Dakar teaching hospital Senegal. Only women with epilepsy were included. RESULTS: We collected 120 patients aged 16-64years with a mean age of 30.58years, 45% married, 44.16% were uneducated preponderant. All patients were taking antiepileptic drugs, 89.16% was alone. Fifty-five percent of our patients had epilepsy for at least 6years; 45.83% had generalized epilepsy; 44.17% of partial seizures. In our cohort, 64.16% were under phenobarbital, 69.16% had good adherence. As side effects of drugs, 90% had sexual problems. Seventy-five percent enjoyed an active sex life. A decrease in the number of sex per week for the disease [31/55=56.66%] was noted. In addition, 51.17% were using contraception, including 38.7% of oral kind and 64.86% had noticed an increase in seizure frequency during their pregnancies. Of the 74 women who had contracted a pregnancy, 41.89% had premature infants, 16.21% have made abortions and 61.17% had psychosocial life affected. DISCUSSION AND CONCLUSION: People with epilepsy often experience sexual problems that may be caused by epilepsy, antiepileptic and/or reactions of the partner and the other facing the diagnosis of epilepsy.


Asunto(s)
Anticonvulsivantes/farmacología , Anticonvulsivantes/uso terapéutico , Epilepsia/tratamiento farmacológico , Salud Reproductiva , Sexualidad/efectos de los fármacos , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Senegal , Adulto Joven
10.
HIV Med ; 13(3): 156-65, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22107342

RESUMEN

OBJECTIVES: Voluntary counselling and testing (VCT) for HIV infection is an important tool for prevention of HIV infection and AIDS in high-risk groups. Our goal was to describe the acceptability and consequences of VCT among a stigmatized and vulnerable group, female sex workers (FSWs), in Conakry, Guinea. METHODS: Acceptance of the test and return for test results at baseline and consequences of testing 1 year later were described. The perceived risk of HIV infection and perceived benefits and barriers to testing were examined using quantitative and qualitative methods. RESULTS: All 421 FSW participants agreed to undergo VCT and most participants (92%) returned for their results. The main reason cited for VCT acceptance was the wish to know their HIV status. However, some managers of FSW worksites urged FSWs to be tested, curtailing FSWs' free decision-making. One year later, status disclosure was common (90% of the 198 individuals who knew their results among those who participated in the follow-up part of the study). Positive consequences of testing were far more frequently reported than negative consequences (98% vs. 2%, respectively). Negative life events included banishment from the worksite (one case) and verbal abuse (two cases). CONCLUSION: Acceptability of VCT appears high in the FSW population in Conakry as a consequence of both perceptions of high individual risk and social pressures.


Asunto(s)
Consejo/organización & administración , Infecciones por VIH/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Trabajadores Sexuales/estadística & datos numéricos , Violencia/estadística & datos numéricos , Adolescente , Adulto , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Guinea/epidemiología , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Humanos , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Autorrevelación , Trabajadores Sexuales/psicología , Violencia/psicología , Adulto Joven
11.
Rev Epidemiol Sante Publique ; 60(6): 489-96, 2012 Dec.
Artículo en Francés | MEDLINE | ID: mdl-23121995

RESUMEN

BACKGROUND: In sub-Saharan Africa, problems of access to relevant and high-quality facility-based statistics hinder the assessment of safe motherhood programs. The objective of this study was to assess the quality of data collected in referral hospitals in Mali and Senegal after the routine information system (RIS) was strengthened. METHODS: This was a multicenter observational study conducted during the pre-intervention period of a randomized controlled trial (trial QUARITE). The RIS was strengthened based on technical, organizational and behavioral factors. We included all women who gave birth in the 46 referral hospitals from October 1, 2007 to October 30, 2008. The completeness, completion and accuracy rates were monitored every 3 months in each hospital. The cost of investment needed to strengthen the existing RIS was also determined. RESULTS: The mean completeness rate ranged from 94 to 97% depending on the study period. The completion and accuracy rates increased during the study period from 72% and 79% to 87% and 93%, respectively (significant differences). The average investment per hospital was less than 1% of state subsidies for public hospitals. CONCLUSION: Strengthening the existing information system has set up an economically and technologically appropriate system for monitoring maternal and perinatal health in Senegal and Mali. We encourage policy makers and researchers from countries with limited resources to invest in RIS to improve and monitor the performance of health systems.


Asunto(s)
Sistemas de Información en Salud/normas , Bienestar Materno/estadística & datos numéricos , Atención Perinatal/normas , Adolescente , Adulto , Países en Desarrollo , Femenino , Sistemas de Información en Salud/estadística & datos numéricos , Humanos , Malí , Atención Perinatal/estadística & datos numéricos , Embarazo , Senegal
12.
Rev Neurol (Paris) ; 168(3): 216-20, 2012 Mar.
Artículo en Francés | MEDLINE | ID: mdl-22340866

RESUMEN

Senegal, like many African countries is facing the so-called demographic and epidemiological transition leading to the development of neurological diseases. These diseases dominated by stroke and status epilepticus are public health priorities with a high prevalence, high lethality and high cost of care. These diseases are managed at the department of neurology, Fann Teaching Hospital, Dakar-Senegal (the only one) with a 65 beds capacity. Unfortunately, access care to the clinic is lately associated with human and material resource scarcity. To improve the management of patients at the clinic, it is important to increase resources (human and material), sensitize the population on early access to health services and prevention of risk factors.


Asunto(s)
Servicios Médicos de Urgencia/organización & administración , Enfermedades del Sistema Nervioso/terapia , Lesiones Encefálicas/complicaciones , Lesiones Encefálicas/terapia , Coma/etiología , Coma/terapia , Demografía , Países en Desarrollo , Humanos , Parálisis/terapia , Convulsiones/terapia , Senegal , Accidente Cerebrovascular/terapia
13.
Med Trop (Mars) ; 71(2): 176-8, 2011 Apr.
Artículo en Francés | MEDLINE | ID: mdl-21695878

RESUMEN

Cryptococcal meningitis is much less common in children than adults. The purpose of this report is to describe 3 cases of cryptococcal meningitis observed in children admitted to the Neurology Department of the Fann University Hospital Center in Dakar, Senegal between July 2003 and November 2008. There were 2 girls whose ages were 8 and 15 years and one 9-year-old boy. All 3 patients presented acute or chronic meningoencephalitis. Diagnosis was based on direct microscopic examination of India ink preparations of cerebrospinal fluid (CSF) showing Cryptococcus neoformans at direct exam. Two patients were immunocompromised including one presenting severe protein-caloric malnutrition and one infected by HIV-1. The third patient was immunocompetent. All 3 patients were treated by intravenous Fluconazole. The immunocompetent boy died after 1 month of hospitalization due to cardiovascular and respiratory insufficiency. Both girls survived with severe neurosensory sequels. Cryptococcal meningitis that is relatively frequent in adulthood may be underestimated in children and should be tested for in any children presenting meningoencephalitis of undetermined cause.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Cryptococcus neoformans/aislamiento & purificación , Huésped Inmunocomprometido , Meningitis Criptocócica/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Infecciones Oportunistas Relacionadas con el SIDA/virología , Adolescente , Fármacos Anti-VIH/uso terapéutico , Antifúngicos/uso terapéutico , Niño , Quimioterapia Combinada , Resultado Fatal , Femenino , Fluconazol/uso terapéutico , Estudios de Seguimiento , Humanos , Masculino , Desnutrición/complicaciones , Meningitis Criptocócica/líquido cefalorraquídeo , Meningitis Criptocócica/tratamiento farmacológico , Meningitis Criptocócica/microbiología , Factores de Riesgo , Resultado del Tratamiento
14.
Med Trop Sante Int ; 1(1)2021 03 31.
Artículo en Francés | MEDLINE | ID: mdl-35586632

RESUMEN

Uterine rupture is a common obstetrical drama in our delivery rooms that has become exceptional in developed countries. In developing countries including Guinea, this tragedy is one of the major concerns of the obstetrician. The objectives of this work were: to evaluate the frequency of uterine rupture in the department, to describe the socio-demographic and clinical characteristics of the patients, to identify the factors favoring the occurrence of uterine rupture, to evaluate the maternal-fetal prognosis and propose a prevention strategy to reduce maternal and fetal morbidity and mortality by uterine rupture. This was a descriptive study with data collection in two phases, one retrospective lasting 18 months from July 1, 2017 to December 31, 2018 and the other prospective, lasting 18 months also from January 1, 2019 to June 30, 2020 both carried out at the maternity ward of the Ignace Deen National Hospital. We collected 84 cases of uterine rupture out of 18,790 deliveries, i.e. a frequency of 0.44%. During the same time 10,067 cesarean sections were realized, i.e. one laparotomy for uterine rupture for 120 cesarean sections. The average age of the patients was 28.14 years with a standard deviation of 2 years and the average profile is that of a housewife (51.8%), multiparous (44.6%), evacuated from peripheral maternity (85.5%) and having an insufficient number of antenatal consultations (82.6%). In 93.1% of cases, the uterine rupture had occurred in delivery centers, peripheral maternity hospitals and on the way, the uterine ruptures were mostly spontaneous (65.1%), and occurred in a healthy uterus (59.0%). Uterine rupture was more frequently complete (83.33%). Surgical treatment was more frequently conservative with hysterorrhaphy (88.1%). We recorded 12 maternal deaths, i.e. a case fatality rate of 14.6%. On admission, almost all of the women showed no signs of fetal life. To reduce the frequency of uterine ruptures, better organization of emergency obstetric and neonatal care and better screening for risk factors for obstructed labor during prenatal consultations should be encouraged.


Asunto(s)
Rotura Uterina , Adulto , Femenino , Guinea/epidemiología , Maternidades , Humanos , Recién Nacido , Embarazo , Estudios Prospectivos , Estudios Retrospectivos , Rotura Uterina/epidemiología
15.
Med Trop Sante Int ; 1(1)2021 03 31.
Artículo en Francés | MEDLINE | ID: mdl-35586633

RESUMEN

Objective: The purpose of this study was to analyse the socio-anthropological determinants (representations, beliefs, practices and perceptions of health services) of the high prevalence of obstetric fistulas in Guinea. Patients and methods: From January 15 to February 15, 2018, we carried out a qualitative study in three health centres (one urban and two rural). The study focused on biological mothers who attended the centres to get vaccinated their children. The data were collected by semi-structured individual interview. Results: None of the 42 respondents could link the occurrence of obstetric fistulas and obstructed labour. Participants at all three study sites believed that obstructed labour and obstetric fistula have a mystical origin. In Kissidougou, the respondents thought that obstructed labour and obstetric fistulas are caused either by soubaya, sorcery in Malinké or the evil spell korte in Malinké cast by an enemy, or the bad behaviour of the parturient which means either she practices adultery or if she behaves disrespectfully towards elders. In Dubréka, the respondents linked the occurrence of labour dystocia and obstetric fistula to witchcraft koromikhi in Sousou. In Labé, some respondents thought that obstructed labour and obstetric fistula are due to divine punishment in local dialect lette Allah when the woman does not respect her husband or has contracted the pregnancy out of the legal union. Others deemed that childbirth is difficult because of the narrowness of the delivery route in Fulani lawol ngol no faadhi in parturients who do not have sex during pregnancy or when the woman had not adequately had female circumcision, in local dialect o suuwaaki laabhi which means, part of the clitoris was left in place during the excision. The majority of respondents had a poor perception of health services (male staff, lack of privacy, poor hygiene, abuse). Several cultural practices (early wedlocks, genital mutilations, dietary restrictions, home deliveries) also induce obstetric fistulas. Conclusion: Respondents' cultural beliefs and practices regarding childbirth limit women's attendance at maternity hospitals during childbirth and favour obstetric fistulas.


Asunto(s)
Distocia , Fístula Rectal , Anciano , Niño , Femenino , Guinea/epidemiología , Humanos , Masculino , Parto , Embarazo , Prevalencia
16.
Arch Pediatr ; 28(4): 307-310, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33715933

RESUMEN

INTRODUCTION: Childhood type 1 diabetes (T1D) is a chronic condition with serious repercussions on both the quality of life of the child and the family. Insulin therapy is the cornerstone of optimal blood sugar control. The main objective of our study was to assess the level of knowledge of physicians about insulin therapy in diabetes. METHODS: This was a multicenter survey over a period of 5 months (from March 5 to August 2, 2018). It took place in five reference university hospital centers in the Dakar region. RESULT: The number of doctors interviewed in our study was 82, 47.6% of whom were confirmed pediatricians or pediatricians in the process of specialization. The number of years of experience in the field of diabetes was on average 3 years. Fast-acting regular insulins were recommended by 75.6% of doctors and mixtures of insulin (intermediate and rapid-acting) by 50% of doctors. Overall, 91% of doctors recommend a variation in insulin injection sites. The "basal bolus" treatment regimen with insulin analogs was recommended by 50% of doctors, while 31.7% recommended it with human insulin. Regarding adapting insulin doses for leisure and sports activities, more than half (54.9%) of the doctors had to reduce the doses. CONCLUSION: This study enabled us to assess the level of knowledge of insulin therapy among doctors caring for children with diabetes in Senegal, which proved to be limited. We recommend the reinforcement and follow-up of training on the management of T1D for providers at the different facilities.


Asunto(s)
Diabetes Mellitus Tipo 1/tratamiento farmacológico , Conocimientos, Actitudes y Práctica en Salud , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Pediatras , Calidad de Vida , Adulto , Niño , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 1/psicología , Femenino , Hemoglobina Glucada/análisis , Encuestas de Atención de la Salud , Humanos , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Masculino , Persona de Mediana Edad , Senegal/epidemiología , Encuestas y Cuestionarios , Resultado del Tratamiento
17.
Ann Cardiol Angeiol (Paris) ; 70(2): 102-105, 2021 Apr.
Artículo en Francés | MEDLINE | ID: mdl-33071020

RESUMEN

The new coronavirus pandemic (COVID-19) is the main global health crisis of our time and the greatest threat we have faced in this century. According to the National Health Security Agency (ANSS), which is the national body responsible for managing epidemics and pandemics, 1927 cases of COVID-19 were confirmed, 11 deaths with more than 4000 contact subjects. The objective of this study was to assess the impact of the COVID-19 pandemic on the activities of the cardiology department of the Ignace Deen National Hospital at the Conakry University Hospital. This was a descriptive retrospective study from January 2020 to April 2020, focusing on consultation and hospitalisation activities in the cardiology department of Ignace Deen National Hospital at Conakry University Hospital. The study consisted of assessing the impact of the pandemic on patient use of the service during the first weeks of the pandemic. We recorded the frequency of consultations and hospitalisations from March to April 2020, which we compared to the frequency of consultations and hospitalisations in January and February 2020. During this study from March to April 2020, we identified 130 patients in consultation against 450 patients for the two months preceding the official declaration of the pandemic in Guinea, a drop of 71.1% (320 patients). The same remark was made in hospitalisation with a drop of 75% (35 patients against 140 for the two months preceding the pandemic). At the start of the COVID-19 pandemic in Guinea, it is clear that there has been a rapid and significant drop in the effective use of the cardiology service.


Asunto(s)
COVID-19 , Cardiología/organización & administración , Departamentos de Hospitales/organización & administración , Hospitales Universitarios/organización & administración , Guinea , Humanos , Estudios Retrospectivos
18.
Bull Soc Pathol Exot ; 103(4): 230-2, 2010 Oct.
Artículo en Francés | MEDLINE | ID: mdl-20431984

RESUMEN

A central nervous system infection due to Morganella morganii is uncommon. We report a case diagnosed at the neurological department of Fann teaching hospital in Dakar, Senegal. A 12-year-old boy was hospitalized for acute meningoencephalitis. The CT scan was normal and the study of cerebrospinal fluid (CSF) revealed cytological and biochemical abnormalities and M. morganii. HIV and syphilitic serologies were negative and blood CD4 lymphocyte count showed 354 per mm(3). The treatment with cefotaxime associated with gentamicin for 6 weeks was successful. The outcome of infection depends on many factors such as the onset and quality of treatment, the virulence of the germ and the status of immune system.


Asunto(s)
Cefotaxima/uso terapéutico , Infecciones por Enterobacteriaceae/diagnóstico , Gentamicinas/uso terapéutico , Meningoencefalitis/microbiología , Morganella morganii , Antibacterianos/uso terapéutico , Linfocitos T CD4-Positivos/inmunología , Niño , Quimioterapia Combinada , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/inmunología , Humanos , Masculino , Meningoencefalitis/tratamiento farmacológico , Meningoencefalitis/inmunología , Senegal , Resultado del Tratamiento
19.
Rev Sci Instrum ; 91(12): 124504, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33379980

RESUMEN

A multi-beam ultra-high vacuum apparatus is presented. In this article, we describe the design and construction of a new laboratory astrophysics experiment-VErs de NoUvelles Synthèses (VENUS)-that recreates the solid-state non-energetic formation conditions of complex organic molecules in dark clouds and circumstellar environments. The novel implementation of four operational differentially pumped beam lines will be used to determine the feasibility and the rates for the various reactions that contribute to formation of molecules containing more than six atoms. Data are collected by means of Fourier transform infrared spectroscopy and quadrupole mass spectrometry. The gold-coated sample holder reaches temperatures between 7 K and 400 K. The apparatus was carefully calibrated and the acquisition system was developed to ensure that experimental parameters are recorded as accurately as possible. A great effort has been made to have the beam lines converge toward the sample. Experiments have been developed to check the beam alignment using reacting systems of neutral species (NH3 and H2CO). Preliminary original results were obtained for the {NO + H} system, which shows that chemistry occurs only in the very first outer layer of the deposited species, that is, the chemical layer and the physical layer coincide. This article illustrates the characteristics, performance, and future potential of the new apparatus in view of the forthcoming launch of the James Webb Space Telescope. We show that VENUS will have a major impact through its contributions to surface science and astrochemistry.

20.
J Fr Ophtalmol ; 43(1): 31-34, 2020 Jan.
Artículo en Francés | MEDLINE | ID: mdl-31761318

RESUMEN

PURPOSE: To study the topography of retinal breaks and their agreement with Lincoff's rules. MATERIALS AND METHODS: We performed a retrospective descriptive study of patients with recent rhegmatogenous retinal detachments followed on the ophthalmology service of Abass Ndao Hospital from January 2006 through December 2016. Patients with no prior retinal treatment were included. RESULTS: Over 11 years, we reviewed 97 patients with 107 eyes with retinal detachments. The mean age of our patients was 51.7 years, range 23-79 years. There were 69 male patients, for a male:female ratio of 2.46. Refraction revealed that 38.1% of patients were myopes. Fourteen percent (14%) of patients had experienced trauma to the eye with the detachment. The right eye was involved in 54.6% of patients. The onset was insidious in 54.6% of cases and sudden in 23.7% of cases. All patients had decreased visual acuity, associated with a scotoma in 26.8% of cases. Visual acuity was decreased to light perception through 7/10. In 64.9% of cases, Lincoff's rules were observed. DISCUSSION: Lincoff's rules are still relevant for localization of the breaks in retinal detachments. CONCLUSION: Diagnosis of a retinal detachment is an essential step, since it determines the treatment. Lincoff's rules still have a role in finding the retinal break in retinal detachments.


Asunto(s)
Técnicas de Diagnóstico Oftalmológico , Desprendimiento de Retina/diagnóstico , Perforaciones de la Retina/diagnóstico , Adulto , Anciano , Topografía de la Córnea/métodos , Estudios Transversales , Técnicas de Diagnóstico Oftalmológico/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Miopía/complicaciones , Miopía/diagnóstico , Miopía/patología , Reproducibilidad de los Resultados , Desprendimiento de Retina/complicaciones , Desprendimiento de Retina/patología , Perforaciones de la Retina/complicaciones , Perforaciones de la Retina/patología , Estudios Retrospectivos , Pruebas de Visión , Adulto Joven
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