[Syndromic management of sexually transmitted infections in health care facilities in Togo: cases reported, 2005-2009]. / Prise en charge syndromique des infections sexuellement transmissibles dans les structures de soins au Togo : étude des cas notifiés de 2005 à 2009.

OBJECTIVE: The aim of this study was to evaluate trends in sexually transmitted infections (STI) in Togo. METHOD: This retrospective descriptive study included all STI cases reported from 2005 through 2009. RESULTS: During the study period, 241,561 STI cases were recorded in the six health regions of Togo, for an annual frequency of 48,312 cases. The mean age of patients was 27.4 ± 12.6 years, and those aged from 20 to 30 years accounted for 55.4% of all cases. The sex ratio (male/female) was 0.3. The most common STI syndrome was vaginal discharge (57.2%), followed by pelvic inflammatory disease (24%), urethral discharge (12.1%), and genital ulcer disease (5%). During the study period, the proportion of cases involving urethral discharge increased significantly, rising from 4.2‰ in 2005 to 4.5‰ in 2009 (p = 0.02), while the proportion involving genital ulcer disease remained stable (1.6‰ in 2005 and 2009). The proportion of cases involving vaginal discharge and pelvic inflammatory disease decreased significantly. CONCLUSION: Overall, this study shows that the number of STI cases reported by health facilities in Togo was stable from 2005 to 2009. Continued epidemiological surveillance is important to document STI trends as part of the HIV control program.

[Biological profile of adult patients infected with HIV at initiation of antiretroviral therapy in Togo]. / Profil biologique des patients adultes infectés par le VIH à l'initiation du traitement antirétroviral au Togo.

OBJECTIVE: The study's objective was to determine the CD4 count and laboratory abnormalities in adults infected with HIV at initiation of antiretroviral therapy (ART) in Togo. METHODS: A retrospective and descriptive study was made of all patients on HAART in 2009 in Togo. RESULTS: A total of 5106 patients were included with a median age of 35 years. 68.6% were female patients. HIV1 infection was predominant (97.5%). The mean CD4) count at treatment initiation was 134 cells/µl. Among these patients, 22.1% had a CD4 count below 50 cells/µl and 73.8% had a CD4 count below 200 cells/µl. The median hemoglobin level was 10.4 g/dl. Transaminase level was elevated (grade 1 and above) in 55.9% of patients for AST, and in 29.8% of patients for ALT. Mean serum creatinine was 9.6 ± 5 mg/l. CONCLUSION: Initiation of ART is late in Togo, consequently a significant proportion of patients present with severe immunosuppression on initiation of treatment. Improving strategies for mass screening should increase the number of patients treated early to better meet WHO 2009 recommendations.