Tetanus in women of childbearing age in the infectious disease department in the national hospital of Conakry (Guinea).

OBJECTIVES: This study aimed to determine the hospital prevalence rate of tetanus in women of childbearing age in the infectious disease department of Donka CHU in Conakry and to describe their sociodemographic characteristics and outcomes. METHODOLOGY: This descriptive retrospective study examined the records of all patients aged 15 to 495 years hospitalized for tetanus over a 10-year period. RESULTS: During the study period, 74555 patients were hospitalized - 239 for tetanus. In all, 22 woman of childbearing age had tetanus, that is, 9.2%. Their mean age was 325 years. Most of the women were married (13/22) and lived in Conakry (18/22); 165 were housewives, and 65 patients had begun but not completed the required vaccinations. The incubation period was >75 days for 165 patients. Tetanus infection resulted from medical procedures for 9 women and trauma for 6. We recorded 125 deaths. The average duration of hospitalization was 215 days. CONCLUSION: Preventing tetanus requires a reinforcement of vaccination drives and especially the implementation of policies for booster reminders.

[Causes of lymphocytic meningitis in people with HIV admitted to the Infectious Disease department of Conakry]. / Étiologies des méningites lymphocytaires chez les personnes vivant avec le VIH suivies dans le service des maladies infectieuses de Conakry.

OBJECTIVES: The advent of HIV infection has significantly changed the distribution of the causes of lymphocytic meningitis. The objective of this study was to identify these causes among persons with HIV hospitalized in the infectious disease department of the CHU of Conakry. MATERIALS AND METHODS: This retrospective study examined hospital records of patients with HIV infection admitted for lymphocytic meningitis over a 10-year period. RESULTS: Of the 8649 hospitalizations in the department during the study period, 3167 patients had HIV infection, and 85 of the latter were diagnosed with lymphocytic meningitis. Slightly more than half were male (sex ratio M/F = 1.1). Their mean age was 32 years. Of these 85 patients, 73 were positive for HIV-1 only and 12 for HIV1+2. A CD4 count was performed only in 13/85 patients and averaged 140 cells/mm3. The main causes associated with lymphocytic meningitis were cryptococcosis (58%), toxoplasmosis (5%), and tuberculosis (2%). Streptococcus pneumoniae, Neisseria meningitidis, and Hæmophilus influenzae were also identified in 16% of cases. In 18% of cases no microbe was identified. The overall lethality rate was 68%; it reached 100% for tuberculous meningitis and for the cases without any identified cause and was 75%-76% for the patients with toxoplasmosis and cryptococcosis. The survival rate was 100% for all bacterial causes. CONCLUSION: A cause for lymphocytic meningitis was identified in more than 81% of the patients in our series, and the most common microbe was Cryptococcus neoformans. A better microbiological technical platform and improved accessibility to treatment would enable us to provide more relevant results and treatment.

[Epidemiology of bacillary pulmonary tuberculosis according to HIV status of patients followed in the department of infectious diseases Conakry (Guinea)]. / Épidémiologie de la tuberculose pulmonaire bacillifère selon le statut VIH des patients suivis dans le service des maladies infectieuses de Conakry (Guinée).

Despite many efforts of prevention and the availability of free treatment, TB/HIV co-infection is still rampant in Guinea. The objective of this study was to describe the epidemiology of smear positive pulmonary tuberculosis according to HIV status among patients hospitalized in the infectious diseases department of Conakry University Hospital. This was a descriptive and analytical retrospective study of patient records admitted for pulmonary tuberculosis from January 2003 to December 2012. During this period, 1953 cases of tuberculosis were collected of which 346 (17.7%) were smear positive. There was a marked male predominance (59.7%). The average age was 38 ± 11 years. The majority of patients originated from the suburbs of Conakry and its surrounding prefectures (76.7%). People without profession were most represented (40.7%). A level of primary education was the most frequently reported (39.7%). Out of 325 patients tested for HIV, the serology was positive in 185 patients (56.9%). A contact with a TB patient was reported in 21.4% of HIV negative patients, and in 6.5% of the HIV-positive group (p = 0.0006). There was no difference between the two groups regarding clinical signs and symptoms. The mean CD4 count was comparable in both groups (p = 0.05). Lethality was higher among co-infected patients (30.4% against 15.56%; p = 0.00037). Strengthening the prevention of TB among PLWHA by the administration of isoniazide seems necessary and warrants further study on this subject in Guinea.

[Knowledge and attitudes of medical personnel in blood transfusion in Bamako, Mali]. / Connaissances et attitudes du personnel médical en matière de transfusion sanguine au Mali.

PURPOSE OF THE STUDY: We undertook a study to determine the level of knowledge and practice of medical staff personnel on transfusion medicine in Mali at Bamako and Kati. PATIENTS AND METHODS: The study was conducted from January to April 2010 in the three main teaching hospitals of Bamako and Kati and in the six referral health centers of the district of Bamako. Medical staff knowledge and practice were assessed using a questionnaire. The study population consisted of specialized practitioners (15%), general practitioners (21.4%), nurses (41.6%), and midwives (22%). RESULTS: Overall, 70.9% of the staff did not receive any training in blood transfusion since their graduation. The general knowledge about blood transfusion was insufficient in 53.9% of staff and excellent in 46.1%. Only 42.9% of medical staff has a good basic knowledge of blood products, their indications, and related accidents. CONCLUSION: Our study showed weaknesses in the transfusion system in Bamako, with insufficient knowledge of the medical staff in blood transfusion and little experience.