[Impact of the COVID-19 pandemic on the activities of the cardiology department of the Ignace Deen National Hospital at the Conakry University Hospital]. / Impact de la pandémie de COVID-19 sur les activités du service de cardiologie de l'hôpital national Ignace Deen du CHU de Conakry.

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.

Embolie pulmonaire mimant un syndrome coronarien aigu ST+ en antéro septal chez une Guinéenne

L'objectif de cette étude était de décrire la ressemblance des manifestations cliniques de l'embolie pulmonaire à celles du syndrome coronarien aigu.Il s'agissait d'une patiente de 60 ans hypertendueadmise pour douleur thoracique d'allure angineuse,dyspnée d'effort évoluant depuis deux jours. Par ailleurs la patiente rapportait une notion de voyage routier récent de plus de 6 heures. Tension artérielle à 170/100mmhg, fréquence cardiaque à 120bpm, fréquence respiratoire à 18cycles/mn , température à370C, SaO2 à 98% à l'air ambiant. L'examen physique est sans particularité. L'électrocardiogramme inscrivait une tachycardie sinusale à 121 cycles/mn,un sus décalage du segment ST en V1, V2 et V3 puis un sous décalage en V5, V6 ,DI ,DII et AVF, une hypertrophie ventriculaire gauche. L'angioscanner thoracique objectivait une embolie pulmonaire de l'artère pulmonaire droite. L'embolie pulmonaire étant la grande simulatrice des pathologies thoraciques en général et en particulier le syndrome coronarien aigu, la vigilance du clinicien est mise à rude épreuve pour ne pas confondre ces deux pathologies qui sont toutes des urgences cardiovasculaires avec une prise en charge bien distincte. Nous mettons ici en exergue les similitudes entre l'embolie pulmonaire et le syndrome coronarien aigu

[Impact of care pathway on the delay for initiation of antituberculosis treatment in Conakry, Guinea]. / Influence des parcours de soins sur le début du traitement antituberculeux à Conakry (Guinée).

Complex care pathways can result in detrimental treatment delay particularly in tuberculosis patients. The purpose of this retrospective study was to assess the care pathways followed by tuberculosis patients prior to diagnosis and to assess impact on the delay for initiation of treatment in Conakry, Guinea. A total of 112 patients were interviewed at the time of first admission for pulmonary tuberculosis with positive bacilloscopy. Based on interview data, pathways were classified as conventional (use of health care facilities only) and mixed (use of health care facilities, self-medication, and traditional medicine). The correlation between patient characteristics and type of pathway was assessed by univariate and multivariate analysis and the two groups, i.e., conventional vs. mixed, were compared with regard to delay for initiation of treatment. The care pathway was classified as mixed in two out of three patients. Multivariate analysis showed that this type of pathway was only correlated with schooling (p=0.02). The mean delay for treatment was similar, i.e., 13.4 and 12.8 weeks for conventional and mixed pathways respectively (p<0.68). The percentage of pathways including three consultations at health care facilities was significantly higher in the conventional than mixed group (72% vs. 30%, p<0.001). The main reasons given for delayed use of health care facilities were poor knowledge of tuberculosis symptoms (26%) and high cost of care (12%). The findings of this study indicate that tuberculosis patients follow a variety of care pathways that can lead to delayed treatment. An information campaign is needed to increase awareness among the population and care providers.

Influence des parcours de soins sur le debut du traitement antituberculeux a Conakry (Guinee)

Les parcours de soins sont souvent complexes et peuvent induire des retards de traitement; avec des effets particulierement deleteres en cas de tuberculose. Nous avons cherche a identifier de facon retrospective; les parcours de soins des patients avant le diagnostic de tuberculose et l'influence de ces parcours sur les delais de traitement a Conakry-Guinee.Nous avons interroge 112 nouveaux patients a leur enregistrement pour tuberculose pulmonaire a bacilloscopie positive. Ont ete distingues les parcours conventionnels (recours aux seules structures sanitaires) et mixtes (associant structures sanitaires; automedication et medecine traditionnelle). L'influence des caracteristiques des patients sur le type de parcours a ete testee en analyses uni et multivariees et les delais de mise sous traitement ont ete compares pour les deux types de parcours. Deux patients sur trois ont suivi un parcours mixte. Ce type de parcours n'etait lie; en analyse multivariee; qu'au niveau de scolarisation (p=0;02). Les delais moyens de traitement etaient similaires (respectivement 13;4 et 12;8 semaines pour les parcours conventionnels etmixtes; p=0;68). La proportion de parcours comportant plus de trois recours aux structures sanitaires etait significativement plus elevee pour les parcours conventionnels que pour les parcours mixtes (72vs 30; p0;001). Les principales raisons invoquees pour l'utilisation tardive des structures sanitaires etaient l'ignorance des signes de la tuberculose (26) et le cout eleve des soins (12). Les parcours des patients sont multiples et peuvent induire des retards a la mise sous traitement antituberculeux. Une sensibilisation de la population et des soignants est necessaire

Diabetes and impaired fasting glucose in rural and urban populations in Futa Jallon (Guinea): prevalence and associated risk factors.

AIM: The authors present the results of the first survey conducted among the population of the Futa Jallon province in Guinea on the prevalence of diabetes mellitus (DM) and impaired fasting glucose (IFG) and associated risk factors for diabetes. METHOD: A random sample of the study population selected by cluster house sampling method included 1537 Guineans (807 women and 730 men) aged 35 years and above in urban (Labé) and rural (Fellö Koundoua-Tougué) areas. Participants were examined and administered a capillary whole blood glycemia test. RESULTS: The mean age of subjects was 49.4 years. Participation rate was 77%. Overall crude diabetes and IFG prevalence were 6.1% and 13.4%, respectively. The age-adjusted prevalence of diabetes using the standardized age distribution of Segi was 6.7% (95% CI: 5.5-7.9%). Subjects in the urban area had twice as much DM as in the rural area (OR 2.0, 95% CI: 1.3-3.2). Out of the 94 subjects with DM, 66 had no prior history of disease. Urban location, age, waist to hip ratio, excess waist circumference, hypertension, raised systolic and diastolic blood pressures were significantly positively associated with DM. In multivariate analysis, only age (P=0.002) and waist circumference (P<0.05) remained independently associated with DM. CONCLUSION: The prevalence of DM was higher than expected in urban and rural areas. The data support the conclusion that prevalence of DM is expected to increase with the aging of the population. The factors associated with diabetes are potentially modifiable. Therefore, primary prevention through lifestyle modifications may play a critical role in the control of DM.