Drug quality analysis through high performance liquid chromatography of isometamidium chloride hydrochloride and diminazene diaceturate purchased from official and unofficial sources in Northern Togo.

Trypanocidal drugs remain the most accessible and thus commonly used means of controlling tsetse transmitted animal African trypanosomosis. In Togo, trypanocides are sold on official as well as unofficial markets, but the quality of these trypanocides is undocumented so a drug quality assessment study was conducted from May 2013 to June 2014. Trypanocides supplied by European, Indian and Chinese pharmaceutical companies and sold on official and unofficial markets in Togo were purchased. In total fifty-two trypanocides were obtained, 24 of these samples from official markets and 28 from unofficial markets made up of a total of 36 diminazene diaceturate and 16 isometamidium chloride hydrochloride samples. The samples were analysed in the reference laboratory of the OIE (World Organisation for Animal Health), Laboratory for the Control of Veterinary Medicines (LACOMEV) in Dakar which uses galenic testing and high performance liquid chromatography (HPLC) testing as standard reference analysis methods. The results revealed a high proportion of trypanocides of sub-standard quality on the Togolese market: 40% were non-compliant to these quality reference standards. All of the HPLC non-compliant samples contained lower amounts of active ingredient compared to the concentration specified on the packaging. Non-compliance was higher in samples from the unofficial (53.57%) than from the official markets (25%; p=0.04).The main drug manufacturers, mostly of French origin in the study area, supply quality drugs through the official legal distribution circuit. Products of other origins mostly found on illegal markets present a significantly lower quality.

[Epidemiology and prognostic value of organ failure during severe malaria in the Principal Military Teaching Hospital of Dakar, Senegal]. / Épidémiologie et valeurs pronostiques des défaillances viscérales au cours du paludisme grave à l'hôpital d'instruction des armées principal de Dakar, Sénégal

We report the results of a retrospective study in the medical intensive care unit of the Principal Military Teaching Hospital of Dakar. The objectives were to determine the epidemiological and clinical aspects of severe malaria and to evaluate the prognostic values of the failure of different organs. Eighty-seven patients were admitted for severe malaria. Their average age was 35 ± 18.53 with a sex-ratio of 1.71 for men. Mortality was 33.3% and concerned mainly young adults. Neurological failure was the most frequent (79.3%). Hemodynamic failure was the most relevant prognostic factor for mortality, followed by hypoglycemia, respiratory and renal failure. The Simplified Acute Physiology Score II (SAPS II) was reliable in predicting mortality. The mean SAPS II was 44.85, with an expected mortality of 32.6%.

[Outcome of elderly patients in an intensive care unit in Dakar, Senegal]. / Devenir des sujets âgés en réanimation à Dakar (Sénégal).

OBJECTIVES: To determine the frequency of admission and its reasons, severity and outcome among elderly patients in our intensive care unit (ICU) and compare them with those for younger subjects. METHODOLOGY: Retrospective study covering a 5-year period (January 1, 2005, through December 31, 2009) in the ICU of the principal hospital in Dakar. We included as elderly patients all those aged at least 65 years and compared them with the young patients, that is, those younger than 65 years. RESULTS: During the study period, 2196 patients were admitted to the ICU, 374 of them elderly. The ratio of men to women was 1.43. The mean age among the elderly was 74.4 ± 6.5 years, and their mean duration of ICU stay was 5.6 ± 4.67 days. Nearly 80% had a serious medical history or preexisting condition, most often, myocardial infarction, stroke, or lung disease. The older patients were more seriously ill than the younger ones (p<0.01), but their care was less complex. Mortality was higher among the older, compared with the younger, subjects (42.80% vs. 28.4%). The only mortality-related factor that appeared to vary with age was cardiogenic pulmonary edema. CONCLUSION: The management of elderly subjects remains a problem in intensive care. High mortality is generally not directly related to their age but rather to their overall condition.