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Article in English | AIM | ID: biblio-1353236


Background: Newly qualified medical practitioners in South Africa (SA) are part of the frontline health care workers who face Africa's most severe coronavirus disease 2019 (COVID-19) pandemic. The experiences of interns during the pandemic reflect SA's preparedness to respond in a crisis and inform strategies that could be adopted to balance training and service in resource-challenged contexts. Aim: To explore the strengths, weaknesses, opportunities and threats posed during the first wave of the COVID-19 pandemic as reflected on by interns within the clinical training platforms in SA. Setting: Public hospitals in KwaZulu-Natal. Methods: An online questionnaire consisting of eight open-ended questions based on the SWOT framework related to personal and professional perspectives to clinical training during the COVID-19 pandemic was developed using SurveyMonkey. All data were collected remotely via social media platforms. Data were thematically analyzed. Results: Forty-six interns reflected on personal and systemic challenges as the major threats and weaknesses in intern training during the COVID-19 pandemic. Extrapolating on strengths and opportunities, there were three overarching learnings interns reflected on. These related to being a medical professional, communities of practice and the development and enhancement of clinical and non-clinical competencies. Existing challenges in the environment exacerbated the threats posed by COVID-19 and innovative strategies related to improving support, feedback, broadening the intern curriculum and online training. Conclusion: Although the clinical environment where interns learn and work is often stressful and overpowered by high service burdens, there are unique opportunities to enhance self-directed learning and graduate competencies, even in the midst of the COVID-19 pandemic.

Humans , Male , Female , Education, Medical, Continuing , COVID-19 , Internship and Residency , Mental Health
Niger. J. Dent. Res. (Online) ; 7(1): 35-44, 2022.
Article in English | AIM | ID: biblio-1354437


Objective: There was a lot of panic when the COVID-19 pandemic started because a lot was not known about it. However, as the disease unfolded, proven scientific universal precautions are recommended to curb its spread. Methods: This was a cross-sectional online survey of people living in Nigeria. Questionnaires were distributed to consenting participants using the SurveyMonkey and data was collected on sociodemographic knowledge of the aetiology and prevention of COVID-19. Analysis was done with the SPSS version 25. Results: Eighty-five participants with age ranging from 18 to 60 years took part in the study. The mean age was 37.35 ± 11.7years. Forty-seven (47%) had knowledge that COVID-19 infection is from a virus. 29.4% thought it is caused by biological weapons, 1.2% from 5G internet, 7.1% as government's ploy to embezzle money and 9.4% conspiracy theory from the world leaders to reduce world's population. All participants knew that hand washing is a preventive measure against the spread of COVID-19 and majority agreed to the use of sanitizers, social distancing and disinfection of surfaces. Only 30.6% agreed that wearing of facemasks will serve as a preventive measure. Over 90% of the participants agreed that dissemination of appropriate information, use of universal precautions, isolation and intensive treatment of those infected can help prevent the spread of COVID-19. 11.8% of participants knew that additional precautions are needed for aerosol generating procedures. Conclusion: The knowledge of COVID-19 aetiology is poor among the populace and the need to wear face masks as a preventive measure in curtailing the spread of COVID-19 needs to be emphasized.

Humans , Male , Female , Public Opinion , Knowledge , Personal Protective Equipment , COVID-19 , Public Health , Disease Management
Article in English | AIM | ID: biblio-1361415


Background. SARS-CoV-2 viral loads may aid in the risk stratification of patients with COVID-19. Methods. 486 patients tested positive for SARS Cov2 by real time RT-PCR were included in this study. All the tests were performed on nasopharyngeal swabs during the first week after symptom onset using Sansure Biotech™ SARS Cov2 real time RT-PCR kits. Patient's condition was monitored over a period of one month after the onset of symptoms. Results. The mean Ct value in the group of patients who developed acute respiratory distress syndrome (ARDS +) was 18.27 (95% CI: 17.43-19.10) while for the ARDS group it was 33.06 (95% CI: 32.77-33.34). Discussion. The Ct values in the group of patients who developed ARDS (ARDS +) were significantly lower than those observed in the ARDS- group. By setting a cut-off value, the determination Ct values (on a qualitative technique) from nasopharyngeal swabs performed during the first week after symptom onset will assist clinicians in risk-stratifying patients. Conclusion. Our data show that the determination of SARS CoV2 RTPCR cycle threshold values from nasopharyngeal swabs performed during the first week after symptom onset may aid in the risk stratification of patients with COVID-19

Humans , Respiratory Distress Syndrome, Newborn , SARS Virus , COVID-19 Nucleic Acid Testing , COVID-19
Article in English | AIM | ID: biblio-1362835


Background: Since its discovery in late 2019, COVID-19 has claimed approximately three million lives worldwide, causing a significant economic burden and strain on health care delivery and services. Therefore, the COVID-19 vaccine may offer the potential to promote global recovery. Objective: To determine the acceptability of the COVID-19 vaccine among Nigerian doctors and the factors influencing the acceptance. Methods: Using a cross-sectional design, an anonymous online survey was administered to medical doctors across the six geopolitical zones in Nigeria between 13 January and 31 January 2021, using the health belief model (HBM). Results: Out of 830 respondents, 38.8% were willing to take the COVID-19 vaccine, 36.0% were unsure, while the remaining 26.5% refused to take the vaccine. Following adjustments, males were more likely to take the vaccine (OR = 3.357; 95% CI 2.009-5.610; p = 0.0001), whereas increasing age, higher perceived viral virulence and perceived viral infectivity were observed to be significantly associated with less likelihood of accepting the vaccine. Respondents who believed in the efficacy of ivermectin were much less likely to receive the vaccine (OR = 0.217; 95% CI 0.108-0.436; p=0.001). Concerns on vaccination safety were the main barriers to vaccine acceptability. Hypothetically addressing these concerns increased vaccine acceptance rates by approximately a third (34.6%) (p < 0.001). Conclusion: The proposed nationwide distribution of the COVID-19 vaccine may be met with poor vaccine acceptability among Nigerian medical practitioners. Measures specifically addressing vaccine safety concerns should be provided to allay fears and enhance the acceptability of the vaccine.

Humans , Male , Female , Physicians , Medication Adherence , COVID-19 Vaccines , Mass Vaccination
Ethiop. j. health sci. (Online) ; 32(2): 229-234, 2022.
Article in English | AIM | ID: biblio-1366924


BACKGROUND: Acute ischemic stroke has been reported to occur in a significantly higher number of COVID-19 patients as compared to healthy controls with variable proposed pathophysiologic mechanisms. To our knowledge, sufficient data regarding this subject is lacking in Ethiopia and the African continent at large. In this case series, we report the clinical characteristics and management of 5 cases with COVID-19 infection and acute ischemic stroke to shed light on the diagnostic and therapeutic challenges in resource-limited setups. METHODS: This is a case series including data collected from the medical records of 5 participants with confirmed RT-PCR positive COVID-19 infection and radiologically confirmed acute ischemic stroke, admitted at Eka Kotebe General Hospital Intensive Care Unit (ICU) in Addis Ababa, Ethiopia from June 10, 2020, to November 04, 2020. RESULTS: Cryptogenic stroke was documented in 4/5 participants included in this series with the most common vascular risk factors identified for stroke being hypertension and diabetes mellitus. The median time from onset of COVID-19 symptoms to the identification of stroke was 07 days. Two fifth of the participants in this series died during their ICU admission with the immediate cause of deaths reported to be related to the severe COVID-19 infection but not stroke. CONCLUSION: Cryptogenic stroke was documented in 4/5 patients in this series despite the presence of vascular risk factors for other stroke subtypes. The overall prevalence, subtypes, and outcomes of stroke in COVID-19 patients in Ethiopia and the African continent as a whole needs additional research to elucidate the local burden of the disease and define the predominant pathophysiologic mechanisms for stroke in COVID-19 in the region

Humans , Male , Female , Clinical Diagnosis , Ischemic Stroke , COVID-19 , Disease Management
Ethiop. j. health sci. (Online) ; 32(2): 279-288, 2022. figures, tables
Article in English | AIM | ID: biblio-1366927


BACKGROUND: Preeclampsia is among the leading causes of maternal and perinatal morbidity and mortality, and it continues as a global health concern. Therefore, this study was aimed to assess the magnitude of pre-eclampsia and its determinant factors among women attending delivery services in Debre Tabor Comprehensive Specialized Hospital Northwest Ethiopia. METHODS: Institutional-based cross-sectional study was conducted among 261 women from January 1- 30, 2021. A systematic sampling technique was applied. Data were collected using a structured and pre-tested questionnaire. The collected data were entered using Epi-data version 4.2 and analyzed by statistical package for social science (SPSS) version 23. A significant association was declared at a p-value of < 0.05 with a 95% Confidence interval. RESULTS: Overall 15,7% of women had preeclampsia. Age at menarche (10-15 years) (AOR=4.79; 95% CI: 2.07-15.27), unwanted pregnancy (AOR:1.29; 95% CI: 1.59-8.44), history of chronic hypertension (AOR:2.93; 95% CI: 1.00-6.20), BMI ≥ 30 Kg/m2 (AOR:1.79; 95% CI: 1.06-3.65), and alcohol consumption (AOR:2.12; 95% CI: 4.00-14.14) were significantly associated with preeclampsia. CONCLUSION: This study showed that the magnitude of preeclampsia was significantly high compared with previous national reports. Early menarche age, the status of current pregnancies, history of chronic hypertension, BMI, and alcohol consumption were significantly associated with preeclampsia. Therefore, the government and respective stakeholders should be strengthening antenatal care services to early identify and manage women with preeclampsia. Besides, health education and promotion should be strengthened regarding the maintenance of appropriate body weight and alcohol intake before pregnancy

Humans , Female , Adult , Middle Aged , Pre-Eclampsia , Pregnant Women , Hypertension, Pregnancy-Induced , Maternal Death , Risk Factors , Richter Scale
Ann. afr. méd. (En ligne) ; 15(2): e4605-e4613, 2022. figures
Article in French | AIM | ID: biblio-1366667


Contexte et objectif. L'endométriose est une maladie gynécologique caractérisée par la présence des glandes et du stroma endométrial en dehors de la cavité utérine. Elle serait influencée par la nutrition. Cette maladie touche 10 à 15 % des femmes en âge de procréer et a comme composante essentielle l'inflammation chronique. Les symptômes les plus fréquents sont la douleur et l'infertilité. La littérature actuelle fait état des effets bénéfiques des aliments antiinflammatoires et antioxydants sur l'endométriose. L'objectif de la présente mini revue est d'établir des pistes de réflexion sur le bénéfice d'une supplémentation nutritionnelle dans l'endométriose. Méthodes. Nous avons effectué une recherche avec les bases de données de Pubmed, Cinahl, Cochrane Library et Embase pour identifier les articles et essais cliniques randomisés dont sept ont été retenus pour l'analyse. Résultats. La supplémentation en souches probiotiques, en vitamine E et en vitamine C a une influence positive sur les symptômes liés à l'endométriose. De plus, un ensemble des composés contenant des vitamines, sels minéraux, ferments lactiques et oméga 3 et 6 ainsi qu'une alimentation de type anti-inflammatoire et les aliments pauvres en glucides fermentés cibles auraient également une influence positive sur les symptômes. En revanche, la vitamine n'aurait aucun effet significatif. Conclusion. Une prise en charge nutritionnelle, notamment axée sur une supplémentation en antioxydants, anti-inflammatoires et en souches probiotiques constitue une piste prometteuse pour la prise en charge de l'endométriose

Context and objective. Endometriosis is a gynecological disease which is characterized by the presence of endometrial glands and stroma outside the uterine cavity and might be influenced by nutrition. It affects 10 to 15 % of women of childbearing age and has chronic inflammation as an essential component. The most common symptoms are pain and infertility. Current literature reports the beneficial effects of antiinflammatory and antioxidant foods on endometriosis. The present paper reviews the benefits of nutritional supplementation in endometriosis. Methods. A search was performed using the Pubmed, Cinahl, Cochrane Library and Embase database engines to identify articles and randomized clinical trials, of which seven were selected for analysis. Results. Supplementation with probiotic strains, vitamin E and vitamin C has a positive influence on the symptoms associated with endometriosis. In addition, a set of compounds containing vitamins, minerals, lactic ferments and omega 3 and 6 as well as an antiinflammatory type diet and foods low in fermentable carbohydrates would also have a positive influence on the symptoms. In contrast, vitamin D did not have any significant effect. Conclusion. Nutritional management, in particular focusing on supplementation with antioxidants, anti-inflammatory drugs and probiotic strains, is a promising avenue for the management of endometriosis.

Humans , Female , Signs and Symptoms , Vitamin E , Dietary Supplements , Endometriosis , Antioxidants , Ascorbic Acid
Ann. afr. méd. (En ligne) ; 15(2): e4543-e4549, 2022. figures, tables
Article in English | AIM | ID: biblio-1366652


Context and objective. The steady increase in the number of chronic hemodialysis patients in sub-Saharan Africa (SSA) calls for improved management of those patients. The present study aimed to determine the frequency of hepatitis C virus (HCV) infection, the prevalent genotypes, and the risk factors associated with HCV in hemodialysis patients in Kinshasa (DR Congo). Methods. A cross-sectional study was conducted from February to June 2018 in all hemodialysis centers in Kinshasa. Blood samples were collected from 127 chronic hemodialysis patients and tested for the presence of antibodies against HCV. The HCV genotype was identified by real-time polymerase chain reaction (RT- PCR). Results. Twenty-two (17.3 %) patients were positive for anti-HCV antibodies, ranging from 0 % to 52.9 % in different centers. Genotype 4 was detected in 18/22 (81.8 %), followed by genotype 2 in 2/22 (9.1%), and both genotypes 2 and 4 in one patient (4.5%). One patient had an undetermined genotype (4.5 %). Having received at least 4 transfusions [7,21 (1,09- 10,61); p=0.040)], not being under EPO treatment [5,81(1,47-12,96); p=0.012)], being on hemodialysis for at least 14 months [3,63(1,60-5,05); p=0.035)]and being dialyzed in an overloaded center [2,06(0,83-5,86); p=0.073)] were associated with a greater risk of HCV infection. Conclusion. This high HCV prevalence (17.3 %) represents a substantial health burden in HD patients from Kinshasa, DR Congo. It is largely driven by the number of blood transfusions, the duration time in hemodialysis. Observations from the present study underscore the need of reducing the number of blood transfusions in people on dialysis through the administration of erythropoietin, given the unaffordable cost of HCV therapy for most individuals in DR Congo.

Contexte et Objectifs. Le nombre des patients hémodialisés en Afrique subsaharienne en constante augmentation ; justifiant de ce fait une meilleure prise en charge de ces patients. La présente étude détermine la prévalence de l'infection par le virus de l'hépatite C en en determinant les génotypes ainsi que les facteurs y associés dans ce groupe de patients. Méthodes. 127 patients hémodialisés chroniques ont subis des tests sérologiques à la recherche des anticorps anti-VHC dans plusieurs centres de Kinshasa de février à juin 2018. Le génotype viral a été déterminé par la RT-PCR. Résultats. La fréquence des anticorps anti-VHC a varié de 0 à 52,9 % dans ce groupe. Les génotypes le plus fréquents ont été le 4 (18/22) et le 2 (2/22) ; étant sumultanément rétrouvé chez un patient, et indéterminé chez un autre sujet. Avoir reçu au moins 4 transfusions [7,21 (1,09-10,61; p=0.040)], ne pas être sous EPO [5,81(1,47-12,96); p=0.012)], être en hémodialyse depuis au moins 14 mois [3,63(1,60- 5,05); p=0.035)] et être dialysé dans un centre surchargé [2,06 (0,83-5,86); p=0.073)] étaient associés à un risque plus élevé d'infection par le VHC. Conclusion. Ses principaux déterminants sont : le nombre des transfusions sanguines et la durée d'HD ; d'où la nécessité de réduire les transfusions sanguines chez les sujets dialysés par l'administration d'EPO, étant donné le coût prohibitif du traitement contre le VHC dans notre contexte

Humans , Male , Female , Epidemiologic Factors , Hepacivirus , Genotype , Prevalence , Renal Dialysis
Ann. afr. méd. (En ligne) ; 15(2): e4589-e4595, 2022. figures, tables
Article in French | AIM | ID: biblio-1366404


Contexte et objectif. Le risque d'accident vasculaire cérébral (AVC) augmente avec l'âge. Notre objectif était d'identifier les caractéristiques épidémiologiques, cliniques et les facteurs liés au pronostic vital des sujets âgés hospitalisés pour AVC ischémique (AVCI) au Centre Hospitalier Universitaire Sourô Sanou de Bobo-Dioulasso. Méthodes. Il s'est agi d'une étude rétrospective portant sur une période allant du 1er janvier 2017 au 31 décembre 2019 et concernant tous les patients âgés de 65 ans et plus hospitalisés pour AVCI. Résultats. Au total, 153 dossiers médicaux ont été colligés. L'âge moyen était de 73,9 ans. Le sex-ratio M/F était de 1,25. Les facteurs de risque cardiovasculaire étaient principalement l'hypertension artérielle chronique (61,4 %), l'alcoolisme (21,5 %), le diabète (14,3 %), et l'antécédent d'AVC (13,7 %). Le déficit moteur était le principal motif de consultation. La pathologie athéromateuse était la principale étiologie. La durée moyenne d'hospitalisation était de 16,2 jours. Le taux de mortalité intrahospitalière était de 16,9 %. La médiane de survie était de 53 jours. Les facteurs prédictifs de la mortalité étaient l'âge (p= 0,017; HR= 2,81; IC 95 %: 1,21-6,54) et le coma (p= 0,010; HR= 4,68; IC 95 %: 2,05- 43,94). Conclusion. L'AVCI chez la personne âgée à BoboDioulasso est marqué par une mortalité intrahospitalière élevée. L'optimisation de la prise en charge des patients âgés pourrait contribuer à la réduction significative de la mortalité des AVC.

Context and objective. Strokes risk increases with age. The most common one is ischemic stroke. Our objective was to identify epidemiological, clinical features and the factors linked to the prognosis for survival of older patients hospitalized for ischemic stroke in Sourô Sanou Teaching Hospital of Bobo-Dioulasso. Methods. This was an analytical historical study on older patients aged ≥ 65 years, hospitalized for ischemic stroke at Sourô Sanou Teaching Hospital of Bobo-Dioulasso during the period from January 1st , 2017 to December 31st, 2019. Results. A total of 153 patients has been involved in this study. The intrahospital ischemic stroke frequency was 68. 61 % of all strokes in elderly. The average age was 73.98 years. The sex ratio M/F was 1.25. Chronic high blood pressure (61.43 %), alcoholism (21.56 %), diabetes (14.37 %), and history of stroke (13.72 %) were the most frequent cerebrovascular risk factors in past medical history. The motor deficit represented the main reason for consultation. Atheromatous pathology was the main etiology. The mean duration of hospitalization was 16.21 days. The intrahospital mortality was 16. 99 %. Median survival was 53 days. The predictive factors of mortality were the age (p= 0.017; HR= 2.81; IC 95 %: 1.21-6.54) and coma (p= 0.010; HR= 4.68; IC95 %: 2.05-43.94). Conclusion. Stroke in the elderly at Bobo-Dioulasso is responsible for a high death rate. Optimization of management for elderly patients could contribute to a significant reduction of stroke mortality

Humans , Male , Female , Aged , Epidemiology , Mortality , Stroke , Diagnosis , Prognosis
Ann. afr. méd. (En ligne) ; 15(2): e4596-e4603, 2022. tables
Article in French | AIM | ID: biblio-1366403


Contexte et objectif. La toxoplasmose est une anthropozoonose ubiquitaire qui occupe une large place en médecine humaine et vétérinaire. Mais les données y relatives chez la femme enceinte sont paradoxalement fragmentaires. L'objectif de cette étude était de déterminer la séroprévalence de la toxoplasmose chez les femmes enceintes. Méthodes. Il s'agissait d'une étude transversale réalisée, à la maternité de l'Hôpital du District de Bossembelé, entre juin et septembre 2020. La population d'étude était constituée de femmes enceintes se présentant au laboratoire du District pour la sérologie toxoplasmique. Résultats. Au total, les données sérologiques de 50 femmes enceintes ont été analysées. L'âge moyen était de 25 ± 6 ans (extrème 16 et 40 ans). Les femmes au premier geste (n=20 soit 40 %) et les primipares (n= 30 soit 60 %) étaient prépondérantes. La sérologie était positive chez 15 patientes (30 %). Selon les caractéristiques sociodémographiques, la séroprévalence de la toxoplasmose était plus élevée chez les femmes de 20 à 35 ans (35,2 %), les femmes ayant été enceintes trois fois (88,8 %) et les femmes qui habitent le quartier Onoguia (66,66%). Les IgM étaient plus élevées chez les patients de la tranche d'âge de 20 à 35 ans (n=12), les femmes au 3e geste (n=8), les multipares (n=9) et chez celles habitant Bodoukpa (n=6). Les IgG étaient élevées chez les femmes enceintes de 20 à 35 ans (n=13), les femmes au 3e geste (n=7), les primipares (n=14) et celles habitant le quartier Bodoukpa (n=6). Parmi les patientes étudiées, 16 (32 %) étaient immunisées contre la toxoplasmose. Des 50 femmes, 4 avaient connu un avortement spontané durant les grossesses précédentes. Conclusion. Dans la présente étude, la séroprévalence de la toxoplasmose chez la femme enceinte est très fréquente. Une sensibilisation sur les risques de contamination, une surveillance sérologique systématique et des mesures d'hygiène devraient être proposées lors des consultations prénatales

Context and objective. Toxoplamosis is a ubiquitous anthropozoonosis that occupies a large place in human and veterinary medicine. The objective of the present study was to determine the seroprevalence of toxoplasmosis in pregnant women. Methods. This was a cross sectional study involving pregnant women presenting at the laboratory of the Bossembele District Hospital, Central African Republic between June and September 2020 for toxoplasmic serology. Results. A total of 50 pregnant women were examined. The age of patients varied from 16 to 40 years. The average age was 25 ± 6 years. Primigravida (n=20; or 40%) and primiparous women (n=30; or 60%) were more preponderant. Serology was positive in 15 patients (30 %). According to sociodemographic characteristics, the seroprevalence of toxoplasmosis was higher among women aged 20 to 35 (35.2 %), women who had been pregnant three times (88.8 %) and women who lived in the Onoguia neighborhood (66.6 %). IgM was higher in patients aged 20 to 35 years (n=12), in 3rd gravida women (n=8), in multiparous (n=9) and in those living in Bodoukpa (n=6). IgG was high in pregnant women aged 20 to 35 years (n=13), in 3rd gravida women (n=7), in primiparous women (n=14) and in those living in the Bodoukpa neighbourhood (n=6). Of the patients in the study, 16 turned out to be immune to toxoplasmosis. Among 50 women, 4 experienced spontaneous abortions during previous pregnancies. Conclusion. The seroprevalence of toxoplasmosis in the present study is common. Awareness on the risks of contamination, the systematic serological monitoring and the hygiene measures should be raised during antenatal consultations

Humans , Female , Adult , Seroepidemiologic Studies , Toxoplasmosis, Congenital , Pregnant Women , Abortion, Habitual , Risk Factors
Ann. afr. méd. (En ligne) ; 15(2): e4577-e4588, 2022. figures, tables
Article in French | AIM | ID: biblio-1366402


Contexte et objectif. Le syndrome d'apnées hypopnées obstructives du sommeil (SAHOS) est une pathologie fréquente, mais méconnue. L'objectif de cette enquête était d'évaluer les connaissances ainsi que les habitudes diagnostique et thérapeutique des médecins généralistes (MG) vis-à-vis le SAHOS. Méthodes. Etude transversale, déclarative, observationnelle menée auprès des MG de la ville de Kinshasa, à partir d'un questionnaire anonyme n'ayant pas précisé au préalable l'objet de l'étude. Les réponses aux questions et le nombre des répondants sont exprimés en fréquence et en pourcentage. Résultats. Sur 177 MG ayant répondu au questionnaire, près de 70% avaient obtenu leur diplôme après l'année 2009. Le cursus universitaire avait été la principale source d'information. La majorité des MG de l'enquête (62%) n'était pas familiarisée avec le SAHOS. Les symptômes cardinaux (ronflements, apnées nocturnes, somnolence diurne) avaient été cités par plus de moitié des MG mais sans leur donner de signification réelle dans leur pratique médicale. L'obésité a été largement citée comme un facteur associé au SAHOS par 68 % de MG, cependant les autres facteurs ont été méconnus ou à peine cités. Plus de la moitié des MG (54,2 %) ne connaissait pas les répercussions et les complications des apnées nocturnes sur l'individu et son environnement. La polysomnographie comme examen clé du SAHOS avait été citée par 56 % des MG. Le niveau des connaissances révélé par l'ensemble des résultats s'est avéré globalement faible. Conclusion. Le SAHOS est une pathologie fréquente, méconnue et très peu intégrée dans les pratiques professionnelles médicales à Kinshasa. Cette situation appelle un approfondissement de la formation des médecins par l'enseignement universitaire et la formation médicale continue

Context and objective. Obstructive sleep apneahypopnea syndrome (OSAHS) is a frequent pathology. The objective was to assess the knowledge as well as the diagnostic and therapeutic habits of general practitioners (GPs) concerning the OSAHS. Methods. A crosssectional, observational study was conducted among GPs using an anonymous questionnaire that did not specify the purpose of the study beforehand. Results. Out of 177 GPs who answered the questionnaire, almost 70 % had graduated after 2009. University education had been the main source of information. The majority of GPs in the survey (62%) were not familiar with OSAHS. Cardinal symptoms of OSAHS (snoring, nocturnal apnea, daytime sleepiness) had been cited by more than half of GPs but without giving them any real significance in their medical practice. Half of them had never discussed the diagnosis of OSAHS with their patients. Obesity was widely cited as a factor associated with OSAHS by 68% of GPs, however other factors were either unrecognized or barely mentioned. More than half of GPs (54.2%) did not know the repercussions and complications of night apnea on the individual and his environment. Polysomnography as a key examination for OSAHS was cited by 56% of GPs. The existence of care was also indicated by a large number of them (87%) but without knowing the terms. Conclusion. OSAHS is a pathology affecting the population of Kinshasa, but little integrated into professional medical practices. Its cardinal symptoms, complications and diagnostic and therapeutic modalities are little known to GPs. This situation calls for further training of doctors through university education and continuing medical education.

Humans , Male , Female , Signs and Symptoms , Health Knowledge, Attitudes, Practice , Sleep Apnea, Obstructive , Diagnosis , General Practitioners
Ann. afr. méd. (En ligne) ; 15(2): 4561-4576, 2022. figures, tables
Article in French | AIM | ID: biblio-1366401


La République démocratique du Congo (RDC), frappée par la pandémie de la COVID-19, a mis en place un plan de riposte national au regard du premier objectif de ce plan pendant la première année de crise. Cette étude a passé en revue les différentes composantes de la surveillance et certains piliers du système de santé, éléments critiques pour la compréhension des résultats de la riposte aujourd'hui et future. Un manque d'efficience a été observé dans les chaines internes de communication lié à une faible coordination des intervenants et de leurs interventions ; et des ressources financières insuffisantes. Malgré ces faiblesses la RDC a évité la catastrophe annoncée. Divers facteurs liés à l'environnement, à la structure d'âge de sa population, au niveau de circulation du virus au sein de cette population et d'autres à élucider dans les recherches futures pourraient contribuer à la compréhension de la situation actuelle et influencer la gestion future de gestion des épidémies. Il est évident qu'une meilleure coordination et mobilisation des ressources, ainsi qu'un système de santé résiliant, permettront une meilleure surveillance et une gestion moins stressante des crises sanitaires à venir.

The Democratic Republic of Congo (DRC), hit by the COVID-19 pandemic, has put in place a national response plan. We reviewed the organization of the response in light of the first objective of this plan during the first year of the crisis. This study reviewed the different components of surveillance and some pillars of the health system, which are critical to understanding the results of the response today and in the future. There was a lack of efficiency in internal communication chains due to poor coordination of stakeholders and their interventions; and insufficient financial resources. Despite these weaknesses, the DRC has avoided the announced disaster. Various factors related to the environment, the age structure of its population, the level of circulation of the virus within this population and others to be elucidated in future research could contribute to the understanding of the current situation and influence the future management of epidemics. It is clear that better coordination and resource mobilization, as well as a resilient health system, will allow for better surveillance and less stressful management of future health crises.

Humans , Male , Female , Primary Health Care , Public Health , Disease Management , Delivery of Health Care , COVID-19 , Pandemics
Mediterr J Pharm Pharm Sci ; 2(1): 100-108, 2022. tables
Article in English | AIM | ID: biblio-1366192


Petroleum refineries are largest chemical industries that are responsible for emission of several pollutants into the atmosphere. Benzene and its metabolites are regarded as the most hazardous compounds that are emitted by petroleum refineries. These contribute to toxic oxidants, which cause many serious health risks to petroleum refineries workers. This study was aimed to analyze the effects of chemical exposure on hematological and biochemical parameters among workers at Zawia oil refinery and Mellituh oil and gas refinery companies. A total of 200 workers participated in this study which consisting of two equal groups (each group: n = 100). The first group consists of petroleum refineries workers and the second group consists of non-oil work civil servants serving were recruited as exposed and control subjects, respectively. The results of blood picture, liver enzymes and kidney functions were compared between the groups. Mean white blood cells counts, platelet counts, and hematocrit count were significantly higher, while the mean red blood cells count was insignificantly changed in petroleum refineries workers. While the mean hemoglobin and corpuscular hemoglobin concentration levels were significantly lower, whereas the mean corpuscular volume and mean corpuscular hemoglobin levels were insignificantly changed in petrol refineries workers. Liver enzymes and renal functions were significantly higher in petrol refineries workers. The present findings indicate that occupational exposure to benzene causes significant alterations in hematological and biochemical parameters and workers are at high risk of developing blood, hepatic or renal related disorders. Protection and frequent medical attention should be given to petroleum refineries workers.

Petroleum , Occupational Exposure , Biological Control Agents , Hematologic Agents , Benzene , Hazardous Substances
Mediterr J Pharm Pharm Sci ; 2(1): 55-64, 2022.
Article in English | AIM | ID: biblio-1366191


Aging seldom comes alone and it is considered to be the major factor for many diseases and comorbidities and disabilities. The objectives of the study are to examine demographic characteristics and prevalence of comorbidities and polypharmacy of elderly patients who were admitted at Sebha Medical Center according to the selected period. This study is descriptive and retrospective cross-sectional study conducted in Sebha during 2021. From 195 participants of the study, the highest rate of patients was from the age group of 65 - 74 years which accounted for 86 participants (44%) and followed by those age group of 75 - 84 years which was reported by 65 participants (33%). The majority of elderly patients have hypertension, (n = 116, 59%) and over one-third of the patients (n = 73, 37%) have diabetes mellitus while nearly one-quarter of patients have both diseases at the same time (n = 47, 24%). Nearly, three-quarters of patients have electrolytes imbalance (n = 142,72%). Nearly, two-thirds of the patients had three to five comorbidity diseases (n = 122, 63%). Whereas, over one-third of the patients had just one or two comorbidities (n = 70, 36%). Almost all the participants have polypharmacy (n = 187, 96%). Just above half of the patients have five - ten medications (n = 100, 51%) compared with 45% of the patients from those who have more than ten medications (n = 87). This study showed that there is a strong relationship between the prevalence of polypharmacy and the number of comorbidities. A Spearman correlation test indicated that rate of comorbidities was related to polypharmacy with a significant correlation (P < 0.01). The present study found high prevalence of comorbidities and polypharmacy among elderly inpatients. Based on this high prevalence, practicing pharmaceutical care could play an effective role to reduce the risk of inappropriate polypharmacy among hospitalized elderly patients through encouraging clinical pharmacist to engage in clinical activities in hospitals

Students, Medical , Vitamin D Deficiency , Prevalence , Vitamin D
Mediterr J Pharm Pharm Sci ; 2(1): 46-54, 2022. figures, tables
Article in English | AIM | ID: biblio-1366088


Epilepsy is a chronic neurologic disease that comes third after cerebrovascular and Alzheimer's disease. Anti-epileptic drugs may affect certain hematological parameters of epileptic patients. Few researches investigated hematological adverse effects of antiepileptic drugs in Libya. Thus, the aim was to evaluate hematological parameters in epileptic children who are on antiepileptic drugs. This retrospective study included 83 pediatric patients with epilepsy recruited from Benghazi Children Hospital, Department of Neurology, from December 2017 to April 2018. Data collected included demographic characteristics, types of epilepsy, anti-epileptic drugs and serum hematological parameters. Hematological parameters recorded included: hemoglobin, hematocrit, platelet, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and white blood cell count. In all treated patients, regardless of the number of antiepileptic drugs therapy used, the average levels of hematological parameters were significantly lower in treated group compared to control group (11.64 gm per dl, 34.53%, 27.74 pg and 33.13 gm per dl, respectively). A significant increase (12.12109 per l) in white blood cell counts in treated group was found. Average hemoglobin, hematocrit and mean cell hemoglobin concentration levels were significantly lower in patients on poly-therapy compared to mono-therapy and control groups. Average white blood cell counts were significantly increased in patients on anti-epileptic drugs. In sodium valproate users, levels of hematological parameters were significantly decreased but significantly increased in white blood cell counts. In diazepam users, significant increases in white blood cells and platelet but no difference in other parameters observed. There were no differences in all hematological parameters among patients using carbamazepine except for platelet counts (significantly decreased). In conclusion, there is substantial effect of the anti-epileptic drugs, especially sodium valproate, on hematological parameters of children despite the effects were not critical as the changes were still in the normal range.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Drug Therapy , Drug-Related Side Effects and Adverse Reactions , Epilepsy , Anticonvulsants , Hematologic Agents
Mediterr J Pharm Pharm Sci ; 2(1): 91-99, 2022.
Article in English | AIM | ID: biblio-1364046


By January 2020, severe acute respiratory syndrome coronavirus-2 has spread internationally to a pandemic that mainly targets the respiratory system. The relevant infectious disease has been identified as coronavirus disease-2019 (COVID-19) by World Health Organization and declared as a global pandemic. In Libya, National Center for Disease Control reported the first case of coronavirus disease-2019 on 24th March, 2020. The authorities decided to close borders and activate designated treatment centers to deal with COVID19 cases and contain the outbreak of SARS-COV-2. This study aimed to assess and evaluate the pharmaceutical situation of medications used in pharmacological management of hospitalized COVID-19 patients in Tripoli, Libya. Three WHO availability indicators were selected to be studied and reported. A comprehensive list of medicines used in the management of hospitalized COVID-19 patients was constructed after reviewing and comparing seven national and international pharmacological management protocols and guidelines for hospitalized COVID-19 patients. This comparison revealed that nearly 50 medications are intended for use in COVID-19 inpatient pharmacological management. They all agreed about the use of three medications, representing one from each main class. This list was used to cross check their availability at the chosen designated COVID-19 treatment center. This study proved that local treatment center's protocol is more in line with international guidelines than the national treatment guideline. The later was issued on March 2020. The Libyan National Essential Medicines' List contained 25 out of 50 medications of the comprehensive list based on the last update in April 2019. This study recommends that national treatment guidelines and National Essential Medicines' list require updating. Not all medications used in COVID-19 inpatient management were available in local treatment centers, although, the Emergency Management Department of Ministry of Health in Libya is responsible for the supply of the required medical supplies and medications to the COVID-19 treatment centers.

Humans , Male , Female , Clinical Protocols , Severe Acute Respiratory Syndrome , COVID-19 , Inpatients , Drug Therapy , SARS-CoV-2 , Hospitalization
Mediterr J Pharm Pharm Sci ; 2(1): 83-90, 2022. figures, tables
Article in English | AIM | ID: biblio-1363908


Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for healthcare system. The current study aimed to determine the presentation, the clinical feature and cardio-vascular risk factors in patients with diabetes. A retrospective observational study had been conducted in out-patients department at Almustaqpal Almosherq Centre during September, 2013 till September, 2020, the total number of attended out-patients department were 1 024, 820 patients who were selected for this study. A special perform was completed for every patient, which included details about patient's demographics, points in clinical history, relevant investigations and clinical examinations were recorded. The study reported that out of 820 patients, 66% (n = 538) was female and their age range was between 14 - 87 years with a mean age of 56.53 ± 13.49 years, 96% (n = 791) were clinically diagnosed as type II diabetes, 07% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46% (n = 379) of the studied population were more than 10 years diabetes duration, 70% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes also different in the studied sample, were absent of anti-diabetic medications in 30% (n = 248) of the patients, they refused to start glucose lowering drugs, 34.6% (n = 284) of them have morbid obesity (body mass index is more than 40), 80% (n = 662) have high HBA1c (more than 8 g%), 40.3% (n = 240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n = 682/713) were controlled on treatment of lipid lowering drugs. This study showing the presentation of diabetes were the common, type II diabetes, at age group between 41 - 66 years about 65%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients were occurring at a high frequency in younger adults, where longer duration of illness could increase the risk of developing more complications in later life. The rate of coexist cardiovascular risk factors (hypertension, dyslipidaemia and obesity) in Libyan patients with diabetes is highlighted.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Body Mass Index , Diabetes Mellitus , Heart Disease Risk Factors , Obesity , Hyperlipidemias
Mediterr J Pharm Pharm Sci ; 2(1): 65-72, 2022. figures, tables
Article in English | AIM | ID: biblio-1363903


Abstract: Vitamin D is a hormone which plays a vital role in immune response regulation, including the prevention of inflammation and autoimmunity. Insufficient vitamin D may increase the risk of infection. Vitamin D deficiency is not the only factor linked to an elevated risk of COVID-19 infection. Recent studies have discovered a link between SARS-COV-2 infection risk and blood type. This study was aimed to examine the association of vitamin D and blood groups with the severity of COVID-19. A retrospective study was conducted on 224 confirmed COVID-19 patients, aged between 18 and 89 years old. Patients were divided into three groups (asymptomatic, moderate, and severe cases), and serum 25(OH)D concentration and blood group were analyzed for all the patients. Data of the severe cases were obtained from Souq Althalath Isolation Center, Tripoli, Libya, while moderate and asymptomatic cases were obtained from Abushusha Polyclinic and Aldahmani COVID Filtration Center, during 22nd February 2021 and 28th April 2021 and serum 25(OH)D concentration and blood group were statistically analyzed for all the patients. The percentages of males andfemales were found to be 47.3% and 52.7%, respectively. Disease severity was distributed as follows: 12.5% asymptomatic, 44.6 % moderate and 42.9% severe. Most of the severe cases had vitamin D deficiency (88.5%). Among the severely ill patients, 39.6% had blood group A and 09.4% had group O, while 22.9%, and 28.1% had blood group B and AB, respectively. In contrast, among the asymptomatic patients, only 7.1% had group A and 85.7% had group O. Overall, the difference in the distribution pattern of blood group in the three severity categories was highly significant (p < 0.001). The prevalence of Rh positivity among asymptomatic, moderate and severe cases was 78.6%, 76.0%, and 60.4%, respectively. This study concludes that insufficient vitamin D levels might influence the severity of COVID-19. COVID-19 patients with blood group A and those who are Rh-positive could be more vulnerable to developing COVID-19 severity

Humans , Male , Female , Blood Group Antigens , SARS-CoV-2 , COVID-19 , Severity of Illness Index
Mediterr J Pharm Pharm Sci ; 2(1): 38-45, 2022. figures, tables
Article in English | AIM | ID: biblio-1363883


Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection caused more than five million deaths throughout the world and more than five thousand deaths in Libya, a little is known about the mortality rate and the risk factors for death from this serious infectious disease in Libya. Thus, it is aimed in this study to identify the potential risk factors for mortality from SARS-CoV-2 infections among 176 Libyan COVID-19 patients in Zawia city. This research is a retrospective cohort study that was conducted on 176 randomly selected volunteers who had been infected with SARS-CoV-2 during a period of December2020 to February 2021 in Zawia city, Libya. Following filling the prepared validated questionnaire by COVID-19 patients, the data was analyzed to determine the previously mentioned risk factors. The mean age(SD) of the total 176 participated COVID-19 patients was 45.06 (± 17.7) and the mortality rate among these total involved cases (mild to severe cases) was 10.8%. It is found that the mortality among the severe COVID19 cases was 41.3% and the mean age (SD) of COVID-19 deaths was 69.1 years (13.8) and 73.7% of them were 60 years old or older. In addition, it is found that 63.2% of the SARS-CoV-2 deaths were females and 78.9% of them had a positive history of chronic diseases. Moreover, it was found that the most common chronic diseases among COVID-19 deaths are diabetes mellitus and hypertension (73.3% and 53.3%, respectively). Collectively, it is concluded that COVID-19 elderly female patients aging 60 years or older with a positive history of chronic disease are more likely at high risk for death from SARS-CoV-2 infection among the participated COVID cases

Humans , Male , Female , Middle Aged , Aged , Chronic Disease , Risk Factors , Mortality , SARS-CoV-2 , COVID-19 , Diabetes Mellitus , Hypertension