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Touré A, Cissé D, Kadio K, Camara A, Traoré FA, Delamou A, Sididé S, Kouyaté C, Bangoura IS, Diallo MM, Tounkara TM, Traoré F, Sow MS, Khanafer N, Cissé M. [Factors associated to loss of follow-up in patients underwent antiretroviral therapy in an ambulatory HIV treatment center at Conakry]. Rev Epidemiol Sante Publique 2018; 66:273-279. [PMID: 29807718 DOI: 10.1016/j.respe.2018.04.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 01/26/2018] [Accepted: 04/13/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry. METHODS A retrospective cohort study was conducted in HIV patients aged over 15 years and who receiving antiretroviral therapy. Between August 1, 2008 and July 31, 2015, all patients managed by the ambulatory treatment center of the Guinean Women Association against AIDS and sexually and transmissible infection were included. Loss of follow-up was defined as no follow-up visit within 3 months. Kaplan-Meier curves and multivariate Cox regression models were used to analyze factors associated with loss of follow-up. Analyses were performed by using Stata 13 software. RESULTS 614 patients aged 36.3±11.2 years, mainly females (68.4%) and living in Conakry (80.5%) were included. Among them, 104 were loss to follow-up, corresponding to a proportion rate of 16.9% (95% CI: 14.2-19.7%) or 5.79/100 person-years. The results of multivariate analyses showed that factors independently associated with loss of follow-up were malnutrition (AHR=7.05; 95% CI: 2.05-24.27; P=0.002) and CD4 cells account at the initiation of AHR (2.35; 95% CI: 1.61-6.39; P=0.016) in patients with 201-350 CD4/μL and 5.83 (95% CI: 2.85-11.90; P<0.001) in patients with less than 150CD4/μL. CONCLUSION Despite efforts of health care workers and free antiretroviral therapy, many patients were loss to follow-up. Multivariate analysis showed that malnutrition and low CD4 account were independently associated with loss to follow-up.
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Affiliation(s)
- A Touré
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée.
| | - D Cissé
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - Kjjo Kadio
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - A Camara
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - F A Traoré
- Service de maladies infectieuses et tropicales, hôpital national Donka, Conakry, Guinée
| | - A Delamou
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - S Sididé
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - C Kouyaté
- Association des femmes de Guinée pour la lutte contre les IST et le sida (ASFEGMASSI), Guinée
| | - I S Bangoura
- Association des femmes de Guinée pour la lutte contre les IST et le sida (ASFEGMASSI), Guinée
| | - M M Diallo
- Solidarité thérapeutique et initiative pour la santé (Solthis), Guinée
| | - T M Tounkara
- Service de dermatologie-vénérologie-MST, hôpital national Donka, Conakry, Guinée
| | - F Traoré
- Institut national de santé publique, Conakry, Guinée
| | - M S Sow
- Service de maladies infectieuses et tropicales, hôpital national Donka, Conakry, Guinée
| | - N Khanafer
- Epidemiology and Infection Control Unit, Edouard-Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - M Cissé
- Service de dermatologie-vénérologie-MST, hôpital national Donka, Conakry, Guinée
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Dicko A, Safi T, Tounkara TM, Fofana Y, Tall K, Touré S, Karabinta Y, Traore B, Traoré A, Lamissa C, Guindo B, Martin L, Faye O. [Prevalence of infantile haemangiomas on black skin]. Mali Med 2017; 32:18-20. [PMID: 30079645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Hemangiomas are regenerative benign vascular tumors of the child, which may be of interest to all organs, most often located on the skin. The aim of our study is to determine the prevalence of haemangiomas on black skin. It is a descriptive cross-sectional study that took place from November 2015 to August 2016 at CNAM, in the department of dermatology-leprology- Venereology of Mali. RESULTS Of 14,810 patients seen in consultation, we received 17 cases of hemangioma, ie 0,11%. The average age was 5 months with extremes of 1 month and 60 months. Tuberous angiomas represent 82,35% of clinical forms, subcutaneous angiomas 11,76% and mixed angiomas 5,89%. In 4/17 of our patients there was an infectious complication, following an ulceration on the first day of the consultation. The average lesion size was 3,25cm with extreme 0.5cm and 8cm. The number of lesions per patient was 1 in 16 patients and 2 in 1 patient. In 10/17 patients the lesions were localized at the cephalic level, 3/17 at the trunk level, and 4/17 at the perineum. CONCLUSION Infantile hemangioma is a poorly reported condition on black skin. The demands for care are motivated either by the character showing lesions or by ulcerative complications. Sensitization of populations and ongoing training of health workers are needed to detect hemangiomas.
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Affiliation(s)
- A Dicko
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
| | - T Safi
- Faculté de médecine et d'odontostomatologie
| | | | - Y Fofana
- Faculté de médecine et d'odontostomatologie
| | - K Tall
- Faculté de médecine et d'odontostomatologie
| | | | - Y Karabinta
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
| | - B Traore
- Faculté de médecine et d'odontostomatologie
| | - A Traoré
- Faculté de médecine et d'odontostomatologie
| | - C Lamissa
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
| | - B Guindo
- Faculté de médecine et d'odontostomatologie
| | - L Martin
- Faculté de médecine d'Angers (France)
| | - O Faye
- Centre national d'appui à la lutte contre la maladie
- Faculté de médecine et d'odontostomatologie
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Cissé M, Sako FB, Diaby B, Soumah MM, Tounkara TM, Diane BF, Balde H, Camara AD, Camara A. [Evaluation of antiretroviral treatment in HIV infected adult in the department of dermatology venereology of the Donka national hospital]. Mali Med 2015; 30:16-20. [PMID: 29927129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED If the use of highly active antiretroviral therapies (HAART) have largely improved survival, morbidity and the quality of life of the people living with HIV in Northern countries as well as Southern countries and particularly in Africa, many obstacles have slowed down their use. Thus the follow-up of the patients under HAART in certain developing countries is still limited even non-existent. OBJECTIVE The objective of this work was to bring the therapeutic outcomes obtained after a minimal six months period of follow-up among HIV+ patients admitted in external consultations or following hospitalizations. MATERIAL AND METHODS We carried out a retrospective and descriptive study concerning patients followed from January 1st, 2004 to December 31st, 2008 (5 years). RESULTS Our study concerned 275 patients including 61.41% women with a sex-ratio (M/W) of 0.62. The average age of our patients was of 36.83 [rage: 18-70]. The initial average weight of our patients was 59.88 kg [range: 30-107] with the majority (66.91%) at the stage III of the WHO clinical classification. The serologic profile was dominated by HIV1 (97.09%) with a number of average CD4 of 210.99 cells/mm3 at the initiation of the ARV treatment. The evolution under treatment was marked clinically by an average ponderal gain of 7,45kg, with weight increasing from 59.88 kg to 67.33 kg between M0 and M54. Biologically, the number of average CD4 increased from 210.99 to 643 between M0 and M48 with an average gain of 432.01 cells/mm3. On the virological level, the plasmatic viral load was carried out for 64 patients out of 275. It was undetectable in 31 patients, be it 48.44%. CONCLUSION In conclusion, the therapeutic outcomes of the patients under HAART was good at the end of this study with a satisfactory clinical issue, marked by an increase in the average weight which corroborates a good immunological and virological response.
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Affiliation(s)
- M Cissé
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - F B Sako
- Maladies Infectieuses et Tropicales CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - B Diaby
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - M M Soumah
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - T M Tounkara
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - B F Diane
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - H Balde
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - A D Camara
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - A Camara
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
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Sako FB, Bangoura EF, Traoré FA, Soumah MM, Tounkara TM, Djessanglar R, Baldé H, Baldé O. [Scorpion envenomation treated in the Infectious and Tropical Diseases at the Donka National Hospital, Guinea]. ACTA ACUST UNITED AC 2014; 107:323-6. [PMID: 25158841 DOI: 10.1007/s13149-014-0385-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 06/17/2014] [Indexed: 11/25/2022]
Abstract
A retrospective descriptive study was conducted from 1(st) October 2010 to 30 November 2012 on the records of patients admitted for scorpion envenomation in the Department of Infectious and Tropical Diseases at the Donka National Hospital. The objective of this study is to describe the epidemiological profile and clinical characteristics of scorpion envenomation in Maritime Guinea, from scorpion stings recently covered in this service. We collected 75 cases of scorpion envenomation. The median age was 21.5 with interquartile 8 and 20 and sex ratio was 1.29. The upper limbs were involved in 55% of cases, followed by the lower limbs (35%), trunk (6%), head and neck (4%). We observed 63% of patients with local signs, 30% mild and general clinical signs of 7% severe systemic symptoms. All patients received an analgesic and a heterologous antitoxin, associated with an antibiotic (87% of patients), a corticosteroid (72%), diazepam (13%) and furosemide (34.6%). The incidence of scorpion envenomation is not negligible despite underreporting of cases, most often treated in traditional medicine.
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Affiliation(s)
- F B Sako
- Service des maladies infectieuses et tropicales de l'hôpital national Donka, Donka, République de Guinée,
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Cisse M, Sako FB, Diaby B, Soumah MM, Tounkara TM, Diane BF, Balde H, Camara AD, Camara A. [Evaluation of antiretroviral treatment in HIV infected adult in the department of dermatological venereology of the Donka National Hospital]. Mali Med 2013; 28:20-24. [PMID: 29925216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED If the use of highly active antiretroviral therapies (HAART) have largely improved survival, morbidity and quality of life of the people living with HIV in Northern and Southern countries, and particularly in Africa, many obstacles have slowed down their use. Thus the monitoring of patients under HAART in certain developing countries is still very low, if not non-existent. OBJECTIVE The objective of this study was to bring the therapeutic outcomes obtained after a minimal six months period of monitoring among HIV positive patients admitted in external consultations or following hospitalizations. MATERIAL AND METHODS We carried out a retrospective descriptive study concerning patients monitored from January 1st, 2004 to December 31st, 2008, that is to say 5 years. RESULTS Our study consisted of 275 patients including 61.41% women with a man:woman sex-ratio of 0.62. The average age of our patients was of 36.83 [ranging from 18 to 70]. The initial average weight of our patients was 59.88 kg [range: 30-107] with the majority (66.91%) at stage III of the WHO clinical classification. The serologic profile was dominated by the HIV1 (97.09%) with a CD4 average of 210.99 cellules/mm3, the the start of the HAART. The evolution under treatment was marked clinically by an average ponderal gain of 7,45kg, with average weight going from 59.88 kg to 67.33 kg between M0 and M54. Biologically, the CD4 average went from 210.99 to 643 between M0 and M48 or an average gain of 432.01 cells/mm3. On the virological level, the plasmatic viral load carried out on 64 patients out of 275, was undetectable in 31 patients or 48.44% of cases. CONCLUSION Our findings show that the therapeutic outcomes for patients under HAART was good and with a satisfactory clinical response, marked by an increase in the average weight which indicates a good immunological and virological response.
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Affiliation(s)
- M Cisse
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - F B Sako
- Maladies Infectieuses et Tropicales CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - B Diaby
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - M M Soumah
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - T M Tounkara
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - B F Diane
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - H Balde
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - A D Camara
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
| | - A Camara
- Dermatologie-MST CHU Donka, Université Gamal Abdel Nasser de Conakry (Guinée)
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Camara A, Diaby B, Sako FB, Camara AD, Baldé H, Keita M, Doumbouya A, Kaba H, Tounkara TM, Soummah MM, Diané BF, Cissé M. [Causes and characteristics of patient death under ARV at the Dermatology-Venereology Department of the Donka National Hospital, GUINEA]. Mali Med 2012; 27:29-34. [PMID: 30049077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The antiretroviral treatments led to a spectacular reduction of morbidity and mortality of HIV-infected patients, transforming it into a chronic infection. HIV infection remains potentially lethal and requires a long term treatment to obtain an immunological and virological control. The goal of this work was to describe the characteristics of the deaths during the ARV treatment. MATERIALS AND METHOD We led a descriptive retrospective study of a 4 year period, from July 2004 to August 2007 which looked at 429 patient under ARV followed in the dermatology - venereology department of the Donka national hospital and whose death during hospitalization occurred for the study period. We excluded the patients who suffered loss of sight or who died during the ARV treatment period. RESULTS On 429 included patients, recorded death rate was of 27,7%. The mean age of included patients was 42 ± 6.5 years old. Patients at the stage 3 and 4 of the WHO classification recorded the greatest number of death. There was no patient at stage I. More half of the patients were immunosuppressed with a count of CD4 < 200/mm3. In our study 66 patients died with a rate of CD4 < 200/mm3 21 patients with a rate of CD4 ranging between 200 and 499 or 17,6%. Only one patient had a rate of CD4 > 500/mm3 while 31 other patients did not have a CD4 at the time of the death. We recorded 57 deaths in the first 6 months of HAART (among which 32 occurred within the first 3 months) and 24 after. The leading causes of death were tuberculosis (47,05%) including 64,28% of pulmonary localization and 35,71% of extrapulmonary localization, followed by cerebral toxoplasmosis (19,62%) and Kaposi disease (15,12%). The other causes of death found were hepatitis B (4,20%) and neuro-meningeal cryptococcosis (2,52%). A socio-economic unstable situation was found at half of the patients For 14 case the cause of death remained unknown. There no was death due to side effects of the ARV therapy. 89,1% of the patients deceased were under protocol 2 INTI + 1 INNTI which represents the layout of first line in our country. CONCLUSION The mortality of the infection by HIV remains high in spite of the introduction of ARV treatment into our service. The patients who passed away were mainly characterized by a low level of CD4 and a very advanced stage of the evolution of the infection to the initiation of the ARV. The leading causes of death were opportunist infections. An early tracking of the infection by HIV and an early and optimal assumption of responsibility of the opportunist infections could contribute to reverse the tendencies in Guinea.
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Affiliation(s)
- A Camara
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - B Diaby
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - F B Sako
- Service des maladies infectieuses et tropicales, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - A D Camara
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - H Baldé
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - M Keita
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - A Doumbouya
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - H Kaba
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - T M Tounkara
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | | | - B F Diané
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
| | - M Cissé
- Service de Dermatologie-MST, CHU Donka
- Université Gamal Abdel Nasser de Conakry, Guinée
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Cisse M, Keita M, Magassouba NF, Camara A, Tounkara TM. [Fatal basidiobolous mycosis in a Guinean child infected with HIV]. Med Trop (Mars) 2007; 67:234. [PMID: 17784672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- M Cisse
- Service de dermatologie-MST, CHU Donka, Conakry, Guinée.
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