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INTRODUCTION: The Xpert MTB / RIF assay has a dual advantage on the one hand, the rapid diagnosis of even difficult cases by the standard technique of direct microscopic examination and on the other hand by the detection of resistance to rifampicin. Our objective was to determine the contribution of the Xpert test in the diagnosis of tuberculosis of all forms. MATERIALS AND METHOD: retrospective, descriptive and analytical study carried out in the Pneumophtisiology department of the CHRU of Saint-Louis. All suspected tuberculosis cases who had received an Xpert test from 2018 to 2020 were included. The parameters studied were socio-demographic, clinical and biological data. RESULTS: 524 patient records included in the study with a sex ratio of 1.3. The mean age of the patients was 37 +/-15 years. There were 285 positive GeneXpert samples, of which 224 were of pulmonary origin and 61 of extra-pulmonary origin. The number of rifampicin resistant samples was five, all of respiratory origin. CONCLUSION: the Xpert test is a new molecular technique recommended by the WHO in the diagnosis of pulmonary tuberculosis.
INTRODUCTION: le test Xpert MTB/RIF présente un double avantage d'une part le diagnostic rapide des cas mêmes difficiles par la technique standard de l'examen direct à la microscopie et d'autre part par la détection de la résistance à la rifampicine. Notre objectif était de déterminer l'apport du test Xpert dans le diagnostic de la tuberculose toutes formes confondues. MATÉRIELS ET MÉTHODE: étude transversale, descriptive à collecte rétrospective menée dans le service de Pneumophtisiologie de CHRU de Saint-Louis. Tous les cas suspects de tuberculose qui avaient bénéficié d'un test Xpert de 2018 à 2020avec un dossier médical accessible et exploitable ont été inclus. Les paramètres étudiés étaient les données sociodémographiques, cliniques et biologiques. RÉSULTATS: Nous avions colligés 524dossiers de malades avec un sex-ratio de 1,3. L'âge moyen des patients était de 37 ans+/-15 ans. Il y'avait 285 prélèvements positifs au GeneXpert dont 224 d'origine pulmonaire et 61d'origine extra pulmonaire. Le nombre d'échantillons résistants à la rifampicine était de cinq, tous d'origine respiratoire. CONCLUSION: le test Xpert est une nouvelle technique moléculaire recommandée par l'OMS dans le diagnostic de la tuberculose pulmonaire. Toutefois il doit être évaluer dans le diagnostic de la tuberculose extra pulmonaire.
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Pneumothorax is defined as the presence of air in the pleural space. There is a paucity of data on pneumothorax in Senegal. The purpose of this prospective study conducted over a 18-month period was to determine the etiological and clinical characteristics of spontaneous pneumothorax in Senegal. This study was conducted in the respiratory disease unit of Dakar University Hospital between June 2005 and November 2006. All patients over the age of 15 years admitted with a diagnosis of spontaneous pneumothorax were included. Sociodemographic, clinical, radiological and biological data were recorded for all patients. Of the 1,053 patients admitted to the unit during the study period, 73 (6.93%) presented spontaneous pneumothorax that was classified as primary in 8 cases and secondary in 65. Median patient age was 32 years (range, 16 to 86). The male-to-female ratio was 3.6/1. The most common cause of secondary spontaneous pneumothorax was pulmonary tuberculosis followed by emphysema. The findings of this study indicate that secondary spontaneous pneumothorax is predominant in Senegal. Pulmonary tuberculosis that is endemic in the country is the main cause of secondary spontaneous pneumothorax and accounts for almost 3/4 of cases.
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Pneumotórax/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Enfisema Pulmonar/complicações , Senegal , Tuberculose Pulmonar/complicações , Adulto JovemRESUMO
We have undertaken a transverse study of smoking among students at the National School of Health and Social Development (ENDSS) and the Health Service Institute (ISS) in Senegal. 683 out of 1142 students were questioned. 609 (89%) replied, of whom 313 (52%) were at the ENDSS and 293 (48%) at the ISS. Senior technical students were most strongly represented at 37.8%, followed by student nurses (27.4%) and midwifery students (23.3%). There were more women (n=378) than men with a sex ratio of 0.61. The average age of the population was 27.5 +/- 6.8 years (range 15 to 58). The average age was 26.2 +/- 5.6 years in the women and 29.6 +/- 8 in the men. The group aged 25-34 was significantly the most affected in both men and women (p=0.0000). The population comprised 502 non-smokers (82.4%), 62 ex-smokers (10.2%) and 45 smokers (7.4%).We found variable alcohol consumption in 119 subjects (19.2%) and 5 students admitted using cannabis. The 62 ex-smokers made up 10.2% of the population. The average age was 31.4 years. 25 ex-smokers (40.3%) drank alcohol, with a sex ratio of 1.95. The reasons for stopping smoking were illness and guilt in 27.4% of cases respectively, economic in 24.2%, medical statements on the effects of smoking on health in 17.7% and personal wishes in only 11.3%. The smokers, numbering 45 (7.4%), had an average age of 27.6 +/- 6.6 years with a sex ratio of 2 (p=0.00000). The age of starting smoking was 20.7 +/- 4.2 years for the women and 19.9 +/- 2.9 years for the men. The latter had smoked for an average of 9.2 years. Cigarettes were used by the great majority of smokers. It was associated with alcohol consumption in 35.6% and cannabis in 11.1% of cases. In the men the motives for starting smoking were stress (60%), pleasure (55.2%) and social influence (53.3%). By contrast, among the women, the two main reasons were stress and fashion in 60% (p=0.04). Our students smoked mostly in public places and in their homes. 34 smokers (75.6%) wished to stop (p=0.02) but only 27 of them expressed the need for medical or psychological support to do this. Dependence, quantified by the Fagerström Score, was medium (score 5-6) in 60% (n=27) and strong (score 7-10) in 31.1% (n=14).The estimated monthly cost of smoking increased with the degree of dependence. It was, on average, 12,143 F CFA (18.5euro) in cases of high dependence, representing 37% of the minimum wage in Senegal which is 33000F CFA (50euro). The students understood well the diseases caused by smoking (whether they were smokers, ex-smokers or non-smokers). These comprise mainly pulmonary diseases (96.2%) and cardio-vascular diseases (78.3%) All the recommended methods of the fight against smoking presented in the media, the publicity, national anti-smoking campaigns, personal contact and consultation, received more than 60% of favourable opinions among the total population studied.
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Fumar/epidemiologia , Estudantes de Enfermagem , Adolescente , Adulto , Fatores Etários , Estudos Cross-Over , Coleta de Dados , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tocologia/educação , Senegal/epidemiologia , Fatores Sexuais , Fumar/economia , Abandono do Hábito de Fumar/estatística & dados numéricos , Prevenção do Hábito de Fumar , Inquéritos e QuestionáriosRESUMO
For many patients, a history of tuberculosis is synonymous with disabling sequelae, impaired quality of life, and high morbidity and mortality. This retrospective study reviewed the files of patients hospitalized for sequelae of thoracic tuberculosis during 2017, to assess its various manifestations and their impact on quality of life. Of the 176 patients included, 75 % were aged from 35 to 65 years. They were predominantly male, with a sex ratio of 3.76. The socioeconomic level was mostly low (70 %). Only one episode of tuberculosis sufficed to cause sequelae in 89.8 % of cases. Smoking was often noted (52.3 %). Functional signs were dominated by coughs (90.3 %) and dyspnea (72.7 %). Pulmonary sequelae with fibrous scarring were observed in 52.2 % of the patients. Bacterial and/or viral superinfection was the leading cause of hospitalization (50 %). The death rate during hospitalization was 19 %. An improvement followed by discharge was observed for 81 %, 14.2 % of them with chronic respiratory insufficiency. In all, 13.28 % of the discharged patients died within the 6 months that followed. The sequelae of thoracic tuberculosis should be considered as long-term chronic conditions and deserve the same treatment.
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Qualidade de Vida , Tuberculose Pulmonar/complicações , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
INTRODUCTION: According to global data for 2002, one quarter of new cases of primary bronchopulmonary cancer were non-smokers. We undertook this study with the aim of describing the epidemiological characteristics of non-smokers with primary bronchopulmonary cancer in the Dakar region of Senegal. METHODS: A multicenter descriptive study that included all non-smokers who presented with primary bronchopulmonary cancer between January 1st 2014 and December 31st 2015. The data were captured on an Excel file and then transferred to Epi InfoTM 7 software for analysis. RESULTS: The rate of diagnosis for primary bronchopulmonary cancers was 72.1 %. The prevalence of non-smokers was 33.3 %. The sex ratio was 1.27. The average age was 54.6 years. More than a third of the sample were housewives. Carpenters and craftsmen exposed to metals predominated. Exposure to cooking oils was reported in one case. Three patients presented sequelae of pulmonary tuberculosis. Adenocarcinoma was the most common histological type and predominated in young subjects. CONCLUSION: The proportion of primary bronchopulmonary cancers diagnosed among non-smokers is increasing in Dakar. An analytical study of suspected risk factors would be helpful for prevention.
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Neoplasias Pulmonares/epidemiologia , não Fumantes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Exposição Ambiental/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Senegal/epidemiologia , Adulto JovemRESUMO
The aim of the present study was to describe the clinical, biological and the chest-X ray presentations of newly diagnosed pulmonary tuberculosis. A retrospective study of 200 patients was performed from January to October 2004 in the respiratory diseases unit of Dakar's University Teaching Hospital. Among the 200 cases, 140 (70%) were male, giving a sex ratio of 2.3. The mean age of our patients was 35.5 years (range: 14-81 years). The group age of 20 to 39 years was the most affected (55,5% of patients). The median diagnostic delay was 4 months (range: 7 days to 2 years). Haemoptysis revealed the disease in 27% of cases. The chest X-ray showed bilateral lesions in 65% of cases. When they were unilateral, the right side was the most concerned. Of the 200 patients, the lesions interested all parts of at least one lung in 106 (53%). Among our patients, 153 (76.5%) had cavitations and 145 (72.5%) had infiltrates. A pleural effusion was associated to the lung lesions in 10% of the patients. Biologically, we reported 80% cases (n=160) of hypochromic microcytic anaemia. Of the 27 HIV tests done, 18 (66.7%) were positive all for HIV1. Delay in the diagnosis of pulmonary tuberculosis was very long and our data illustrate the need for improved education of the community and event of healthcare workers about the benefit of early diagnosis of tuberculosis.
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Pulmão/diagnóstico por imagem , Tuberculose Pulmonar/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Infecções por HIV/epidemiologia , Hemoptise/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/microbiologia , Radiografia , Estudos Retrospectivos , Senegal/epidemiologia , Tuberculose Pulmonar/epidemiologiaRESUMO
INTRODUCTION: Tobacco smoke alters lung defense mechanisms against infections and so increases the risk of mycobacterium tuberculosis infection. OBJECTIVE: To determine the particular clinical features of tuberculosis in smokers and identify risk factors. METHODS AND PATIENTS: We conducted a prospective, cross-sectional study over a period of nine months in Dakar, Senegal. The Chi-square test and multiple logistic regression were used to identify differences between smokers and non-smokers and to identify factors associated with clinical outcomes. RESULTS: We included 165 patients with active pulmonary tuberculosis (59 smokers versus 106 never-smokers). The average age of smokers was 43.8±12.7 versus 32.1±13.1 years (P<0.0001). Smokers were overwhelmingly male (98.3% versus 1.8%, P<0.0001). The average delay to consultation was longer among smokers (90 days [30-120] versus 60 days [30-90] ; P<0.0001). In multivariate analysis, alcohol abuse, increasing age, male sex, and an unknown retroviral status were independent risk factors for pulmonary tuberculosis. Haemoptysis was observed more frequently in smokers (49.1% versus 31.1%, P=0.017). With regards to chest X-ray features, smokers presented with more advanced, bilateral and cavitating lung lesions. CONCLUSION: Diagnostic delay and haemoptysis are important characteristics of the pulmonary tuberculosis in tobacco smokers.
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Fumar/epidemiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Radiografia Torácica , Fatores de Risco , Senegal/epidemiologia , Fumantes/estatística & dados numéricos , Escarro/microbiologia , Tuberculose Pulmonar/microbiologia , Adulto JovemRESUMO
INTRODUCTION: The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe drug-induced reaction. CASE REPORT: We report the case of a 35-year-old man treated by RHEZ for a first episode of a smear positive pulmonary tuberculosis and who developed a DRESS syndrome due to pyrazinamide after twenty days of treatment, associated with a viral reactivation to Human Herpes Virus 6 (HHV6). He had a skin eruption, liver involvement and hypereosinophilia. He fully recovered after drug withdrawal, associated with local and general corticosteroids. He died two weeks after discharge. CONCLUSIONS: Discovery of DRESS syndrome during tuberculosis treatment is an uncommon complication and requires a searching for the responsible drug. That should be difficult because tuberculosis drugs are often given as fixed-dose combination. Physicians have to bear in mind the potential role of pyrazinamide.
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Antituberculosos/efeitos adversos , Síndrome de Hipersensibilidade a Medicamentos/diagnóstico , Pirazinamida/efeitos adversos , Tuberculose Pulmonar/tratamento farmacológico , Corticosteroides/uso terapêutico , Adulto , Coinfecção/tratamento farmacológico , Herpesvirus Humano 6/isolamento & purificação , Humanos , Masculino , Infecções por Roseolovirus/complicações , Infecções por Roseolovirus/tratamento farmacológico , Tuberculose Pulmonar/complicaçõesRESUMO
The plasma disposition kinetics of ivermectin following a single subcutaneous administration of 0.2 mg/kg was investigated in male and female Senegalese Peulh sheep. Ten clinically healthy animals (5 males and 5 females) weighing 38-45 kg were used in this trial. Blood samples were collected by jugular puncture at different times between 0.5 h and 30 days post treatment. After plasma extraction and derivatization, samples were analysed by HPLC with fluorescence detection. Computerized kinetic analysis was carried out and mean parameters were statistically compared with the Mann-Whitney U-test. The area under the concentration-time curve (AUC) was significantly higher (p < 0.0027) in females than in males. Although the differences in maximum concentration (C (max)), mean residence time (MRT) and half-life of elimination (t (1/2el)) between males and females did not achieve statistical significance, values tended to be higher in females. Sex differences may be parallel with the level of storage in fat. Further investigations are required to improve the use of ivermectin in Senegalese sheep and findings may be used to predict optimal anthelmintic strategies for management of African species depending on the parasites present in a production system.
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Anti-Helmínticos/farmacocinética , Ivermectina/farmacocinética , Ovinos/metabolismo , Animais , Anti-Helmínticos/sangue , Cromatografia Líquida de Alta Pressão/veterinária , Feminino , Ivermectina/sangue , Masculino , Senegal , Fatores SexuaisRESUMO
INTRODUCTION: This is a prospective study of 30 cases of smear positive pulmonary tuberculosis, with at least two sputum positive members of the family, seen in the respiratory clinic between January 2003 and June 2004. METHODS: They constitute the index cases who represent 3.5% of the cases of tuberculosis (n=850) and 2.9% of hospital admissions (n=1034) during the same period. Four patients were HIV positive. In the family circle, all contacts received an intradermal tuberculin test (IDTT) of 10 IU and/or a chest x-ray and/or sputum examination for AFB. RESULTS: Of the 601 contacts 359 (60%) had a positive IDTT with a mean diameter of 13 mm. Active pulmonary tuberculosis was found in 16 contacts giving a prevalence of 2.7% and an incidence of 4.5% (16/359). 67% of the contacts were adults aged 16-87 with a mean age of 35 years. The IDTT was positive with a mean diameter of 12.3 mm. The chest x-ray was abnormal in 40 adults (16.7%) and sputum examination confirmed pulmonary tuberculosis in 14 cases. 33% of the contacts were children (n=119) aged from 3 months to 15 years with the majority (85%) aged under 10. The IDTT was positive with a mean diameter of 12 mm and the chest x-ray was abnormal in 22 cases (18.5%). Two children of 15 years had active tuberculosis. CONCLUSION: The contacts identified were treated according to the tuberculosis protocol of Senegal (2RHEZ/6EH) with the intensive phase dispensed in hospital. It is of major importance therefore to develop effective strategies of information, education, diagnosis and management for cases of infectious pulmonary tuberculosis.
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Busca de Comunicante , Saúde da Família , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológicoRESUMO
INTRODUCTION: We performed a retrospective case control study for the period between 1st January 1999 and 31st August 2004, comparing the radiological appearances of tuberculosis in 100 diabetics to those in patients matched for age and sex, with pulmonary TB alone presenting to The Chest clinic of the National Hospital of Fann. METHODS AND RESULTS: Diabetes was present in 4.7% of the 2116 patients hospitalized for pulmonary tuberculosis during the period of study and occurred more commonly in men (60%) with an average age of 51 years (73%). 82% had type II, non-insulin dependent diabetes. The various types of radiological lesions classically described in tuberculosis were found in nearly identical proportions in the two groups of patients, with parenchymal shadowing the most frequent appearance in both diabetics (N=86) and controls (N=88). Cavitation occurred significantly less frequently in diabetics (72%) than controls (88%) (p=0.04). Where radiological abnormalities were bilateral, they were worse on the left in the diabetics (27% versus 15% in controls). There was a trend for basal lesions to occur more frequently in diabetics (15%) than controls (3%) (p=0.06). CONCLUSION: Mortality was higher in diabetics (18%) than controls (6%), with death generally occurring within the first 24 hours of hospitalization.
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Complicações do Diabetes , Tuberculose Pulmonar/complicações , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Complicações do Diabetes/diagnóstico por imagem , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico por imagem , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Feminino , Hospitalização , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Senegal , Fatores Sexuais , Teste Tuberculínico , Tuberculose Pleural/complicações , Tuberculose Pleural/diagnóstico por imagem , Tuberculose Pulmonar/diagnóstico por imagemRESUMO
INTRODUCTION: Tuberculosis is a scourge in our region; it is particularly dangerous in young children, above all those of tuberculous mothers. The object of this study is to evaluate the prevalence of tuberculosis in the children of tuberculous mothers and to determine how to increase their chances of survival and healthy development. METHODS: Between 1 January and 31 July 2002, 45 women were admitted to hospital with a child of less than 5 years. They received (mothers and children) an intradermal tuberculin test (IDTT) of 10 i.u., chest x-ray, and sputum examination for the mothers. RESULTS: 45 women (aged from 18 to 45 years) were hospitalised for sputum positive tuberculosis, an average IDTT of 13 mm and a high bacterial load (1 to>10 bacilli/hpf). Almost all (96%) presented with cavitating parenchymatous disease. We found no cases positive for HIV. Progress was satisfactory in 43 mothers treated with SRHZ. There were 2 deaths. In the children who were systematically examined, 82% (37) were less than 20 months old, there were 23 boys (51%), and 26 children (58%) were symptomatic at the first consultation. All the children were breast fed, explaining their admission with their mother. Evidence of tuberculous contact was found, 6 times with the father and 4 times with the grandparents. The most common physical signs were fever (92%) cough and weight loss (77%), malnutrition (69%). The IDTT was positive in 38/45 (84.5%) and pustular in 16/38 (42%). The chest x-ray was normal in 16/45 (35.6%), revealed mediastinal adenopathy in 19/29 (65.5%), accompanied by ipsilateral ventilatory problems in 11/29 (38%) and by parenchymal involvement in 3/29 (10.3%). Progress was satisfactory in 44 children on antituberculous treatment (RHE). There was one death on account over severe malnutrition. CONCLUSION: Treatment of tuberculosis in the mother and child is a guarantee of recovery for the mother and healthy development for the child. S: streptomycin, R: rifampicin, H: isoniazid, E: ethambutol, Z: pyrazinamide.
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Tuberculose/epidemiologia , Adolescente , Adulto , Antituberculosos/uso terapêutico , Feminino , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Senegal/epidemiologia , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/transmissãoRESUMO
INTRODUCTION: The long diagnostic delay is responsible for the extension of radiological lesions and spread of TB in the community. These radiological lesions can leave significant scars responsible for respiratory disability. OBJECTIVE: The aim of the study is to characterize radiologic features according to tuberculosis diagnostic delay. METHODS: We conducted a prospective cross-sectional study, about 66 patients with positive sputum. RESULTS: The average diagnostic delay was 16 (±15) weeks; whether 22 (±14.1) weeks in the female gender versus 14.6 (±14.3) weeks in the male gender (P=0.10). The first care use was respectively health centers (62.1%), drugstores (51.9%), and traditional medicine (28.7%). Only 27.2% of patients used the marabouts care. Bilateral radiographic abnormalities in bivariate analysis were associated with consultation at the health center (66.7% versus 33.3%; P<0.031), as is the extension of the lesions (70.2% versus 29.8% RP=1.66 [1.05 to 2.91]; P<0.03). Lake of knowledge of the symptoms of TB was associated with the use of marabouts care (12.5% versus 87.5; PR=0.35 [0.11 to 1.08], P<0.04). CONCLUSION: These results should prompt consideration in an emergency, appropriate control interventions, advocacy, patient information and medical personnel on the reality of tuberculosis to prevent its spread often causing respiratory disability with radological effects.
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Procedimentos Clínicos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/terapia , Adolescente , Adulto , Criança , Procedimentos Clínicos/normas , Procedimentos Clínicos/estatística & dados numéricos , Estudos Transversais , Diagnóstico Tardio/estatística & dados numéricos , Feminino , Hospitais Públicos/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Microscopia , Pessoa de Meia-Idade , Radiografia Torácica , Senegal/epidemiologia , Escarro/microbiologia , Inquéritos e Questionários , Tuberculose Pulmonar/epidemiologia , Adulto JovemRESUMO
We report the case of a 31-year-old immunocompetent woman residing in Senegal, with localized microscopy-proved pulmonary tuberculosis, complicated by macrophage activation syndrome and associated with viral hepatitis B, identified due to hepatic cytolysis and a bicytopenia.
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Antituberculosos/administração & dosagem , Hepatopatias/etiologia , Hepatopatias/patologia , Síndrome de Ativação Macrofágica/etiologia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Quimioterapia Combinada , Feminino , Humanos , Senegal , Fatores de TempoRESUMO
BACKGROUND: Smoking represents a major threat to public health, being responsible for considerable morbidity and mortality. We undertook this study to establish the prevalence of smoking among personnel at the Centre Hospitalier National de Fann, their smoking habits and the attitude of staff to the problems caused by smoking as well as their understanding of their role in promoting smoking cessation. METHODS: A prospective study was undertaken between February and April 2004 in which a standardised, anonymous, self-completion questionnaire in French was administered to 262 medical and paramedical staff at the CHN de Fann. RESULTS: The response rate was 95%. The biggest single group of respondents came from the infectious diseases service (24.5%). 63% of participants were paramedical and 54% of respondents were male. The mean age of respondents was 39.2 for men and 35.9 for women. 11.6% were smokers and 13.3% were ex-smokers. The mean age of ex-smokers was 43.8 years with a male/female ration of 7.25 to 1. Among the ex-smokers 51.7% had stopped smoking within the last 10 years with health problems the most commonly cited reason for quitting (24.2%), followed by guilt (21.2%). Smokers had a mean age of 38.6 with a male to female ratio of 8.6 to 1. Mean age at which they had started to smoke was 14.3 for women and 21 for men with a mean duration of smoking of 21 in women and 17 in men. 96.6% smoked cigarettes with 31% smoking > 20 cigarettes per day. 75.9% of our smokers had tried to quit at least three times. 86.2% wished to stop but only 48.3% considered getting medical and or psychological support to help them to quit. The Fagerström score showed a high level of dependency in 27.6% of smokers. More than half the total population studied (65.6%) thought that healthcare workers should help others to stop smoking and 75.5% thought that they had influence to do this. CONCLUSION: Healthcare workers in Senegal have an opportunity and a responsibility to promote smoking cessation. Legislative proposals and smoking cessation clinics should help to combat the tobacco epidemic.
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Pessoal Técnico de Saúde , Corpo Clínico , Fumar/epidemiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Senegal , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Tobacco smoking is truly a modern plague. The WHO estimates that there are 1.3 billion smokers worldwide, about a third of the world's population. In various studies in Senegal the prevalence of smoking has varied between 16 and 36%. The risks associated with smoking are well established. However it is also well established that 'knowledge of risks alone is not sufficient to modify behaviour.' We undertook a study to assess knowledge of the risks of smoking among patients admitted to The Pulmonology Clinic of the Centre Hospitalier National de Fann de Dakar. PATIENTS AND METHODS: All patients admitted to the clinic between 1st December 2003 and 31st May 2004 were enrolled into this prospective, cross-sectional study. A questionnaire in French was administered together with the Fagerstrom test of clinical addiction. RESULTS: Of 343 patients admitted 75 (22%) were smokers. Only 2 (2.6%) of the smokers were female. As in previous studies, smoking was associated with social disadvantage. 34.7% of smokers had attended school to primary level only and 33.3% had had no schooling at all. Mean age of starting smoking was 16 (range 9 to 38 years). The monthly cost of smoking to individuals was estimated at between 2 and 45% of the Guaranteed Minimum Wage (SMIG). 44% of smokers also consumed alcohol and 2.6% smoked cannabis. More than two thirds of patients (68%) thought that smoking caused ill health. The majority of subjects (93.3%) had stopped smoking, at least since admission, though 6.7% continued to smoke. Previous consumption was estimated as a mean of 20 pack-years. Nicotine dependence was defined as medium in 37 patients (49.3%). CONCLUSION: Certain diseases such as malaria, tuberculosis and AIDS exist at endemic levels producing considerable morbidity and mortality. We should not allow the epidemic of smoking to continue. Collective action, particularly by pneumologists is required.
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Conhecimentos, Atitudes e Prática em Saúde , Fumar/efeitos adversos , Adulto , Idoso , Atitude Frente a Saúde , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , Estudos Prospectivos , Senegal/epidemiologia , Fumar/epidemiologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Bronchoscopy is recommended into the exploration of chronic lung diseases. This one is expensive and invasive. We conducted this study in order to assess the benefit of the bronchoscopy in the etiologic diagnosis of chronic lung diseases. PATIENTS AND METHODS: This study was retrospective, descriptive and analytical, using medical records of outpatients and in patients who has done the bronchoscopy in Pneumology Clinic, Fann hospital, Dakar from January 2010 to December 2014. RESULTS: We have reported 159 cases. The sex ratio was 2.2. Middle age was 44 years. Fever was found in 32.7%. Alveolar syndrome was found in 64.8%. The white blood cells (WBC) were normal in 80.7%. Bronchoscopy was contributive in 74.1%. Specimen analysis isolated banals germs in 69.2%, mainly bacteria in 51.6%. Parasitology of the fluid of broncho-alveolar lavage was positive in 28.6%. CONCLUSION: Bronchoscopy stills a use full exploration while diagnosing chronic lung diseases. It should be systematic in chronic lung diseases with or not fever, this, when sputum microscopy a sputum PCR are negative.
Assuntos
Broncoscopia , Pneumopatias/diagnóstico , Fibras Ópticas , Infecções Respiratórias/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Broncoscopia/instrumentação , Broncoscopia/métodos , Criança , Progressão da Doença , Feminino , Humanos , Pneumopatias/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Infecções Respiratórias/patologia , Estudos Retrospectivos , Senegal , Adulto JovemRESUMO
Plasma disposition kinetics of ivermectin was evaluated in a West African cattle breed. Five clinically healthy zebu Gobra cattle (Bos indicus) weighing 220-270 kg were treated (0.2 mg kg-1) with a commercially available ivermectin formulation for cattle. Blood samples were collected by jugular puncture at different times between 0.5 h and 40 days post-treatment. After plasma extraction and derivatization, samples were analysed by HPLC with fluorescence detection. Ivermectin was detected in plasma between 30 min and 20 days post-treatment. The observed peak plasma concentration (Cmax) was 46.3+/-13.8 ng ml-1 and the time to reach Cmax (t(max)) was 0.9+/-0.2 day. The values for the absorption half-life (t1/2ab) and the elimination half-life (t1/2el) were 0.3+/-0.2 and 2.8+/-0.7 days, respectively. The calculated area under the concentration-time curve (AUC) was 185.2+/-12.1 ng day ml-1 and the mean residence time (MRT) was 4.2+/-1.3 days. The availability of ivermectin is low in zebu Gobra in comparison to other breeds cattle but equivalent to that reported in the yak and is likely to be due to physiological characteristics of this breed.
Assuntos
Anti-Helmínticos/farmacocinética , Bovinos/metabolismo , Ivermectina/farmacocinética , Animais , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/sangue , Área Sob a Curva , Clima Desértico , Meia-Vida , Injeções Subcutâneas/veterinária , Ivermectina/administração & dosagem , Ivermectina/sangue , SenegalRESUMO
INTRODUCTION: Tobacco smoke is a global health problem, and the largest avoidable cause of death in the world. The objective of our study was to determine the prevalence of tobacco smoking in schools in Dakar area (Senegal). MATERIEL AND METHODS: This descriptive and analytical cross-sectional study was performed from September 2011 to June 2012 in 27 schools of the Dakar area. RESULTS: We questioned 1654 students over a 9-month school period. The mean age was 15±2.5years (range 11-22). The sample included 848 boys (51.3 %), therefore a sex ratio of 1.05. There were 68 smokers (4.1 %) and 60 ex-smokers (3.6 %). The mean age of the smokers was 16.9±2.2years (range 11-22) with a male preponderance of 70.6 % (n=48). Smoking in family members was the initiating factor most frequently reported by smokers (25 %). The average age of ex-smokers was 16.4±2years. Fear of parents' reactions was the most frequently invoked reason for stopping smoking (41.7 %). CONCLUSION: This study confirms the reality of smoking among school children in Senegal and highlights the urgency of the installation of a prevention policy near the young people.
Assuntos
Comportamento do Adolescente , Comportamento Infantil , Fumar/epidemiologia , Adolescente , Criança , Estudos Transversais , Saúde da Família , Feminino , Humanos , Masculino , Motivação , Relações Pais-Filho , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Senegal , Abandono do Hábito de Fumar , Inquéritos e Questionários , Tabagismo/epidemiologia , Adulto JovemRESUMO
A primitive neuroectodermal tumour (PNET) replacing the thalamus was discovered in an 18-month-old Prim'Holstein heifer. Microscopical examination of the tumour showed large sheets of densely packed cells with occasional Homer-Wright and perivascular rosettes. Neoplastic cells were small with ill-defined borders, scant cytoplasm and ovoid, irregularly shaped nuclei. Immunolabelling was positive for vimentin and neuron-specific enolase, in agreement with previous reports of PNETs in human beings and animals. This appears to be the first report of cerebral PNET in cattle.