Introduction: HIV resistance to antiretroviral is currently a global concern, and requires increased surveillance in a context of widespread ARV treatment. Objective: To evaluate early warning indicators of HIV resist...Introduction: HIV resistance to antiretroviral is currently a global concern, and requires increased surveillance in a context of widespread ARV treatment. Objective: To evaluate early warning indicators of HIV resistance to ARVs in the Hospital of Tivaouane (Senegal) where viral load was not routinely available. Methods: This is a cross-sectional retrospective study from 2008-2016. The etraction tool (May 2010 version) was used to analyze the EWI. Results: We collected 360 HIV positive patients followed on average for 3.57 years ± 3.02. 2009, 2010 and 2012 recorded 100% ARV prescribing rates. Throughout the study period, the percentage of patients lost to follow-up during the first 12 months of treatment was less than 20%. Virtually, all patients were still under primary ARVT over 12-month treatment. All patients (100%) withdrew their ARV drugs on time. No stock storage regarding various classes of ARVs was noted during the study period. Conclusion: At the end of this study we recommend to maintain regular follow-up of EWI, and combine it with the achievement of viral load.展开更多
Introduction: Malaria, the first parasitical endemic disease in the world, is a serious disease with 407,000 deaths in Africa in 2016. It is the main cause of morbidity and mortality in Senegal [1] [2]. Methods: Our r...Introduction: Malaria, the first parasitical endemic disease in the world, is a serious disease with 407,000 deaths in Africa in 2016. It is the main cause of morbidity and mortality in Senegal [1] [2]. Methods: Our retrospective study carried out from 1st January 2010 to 31 December 2013, at the department of internal medicine in the regional hospital of Thies was aimed at studying the epidemiological, clinical, paraclinical and prognostic profile of severe malaria in the autochthonous adults with 15 years and more. Results: Over this 3-year period, 57 patients were hospitalized in 1275 patients due to severe malaria that is to say a hospital prevalence of 4.47%. The average age was 64.21. A clear male predominance has been observed, around 61% (34/57) against 39% (23/57) with a sex ratio of 1.6. The highest malarial infestation rate was found at the end of the rainy season and at the beginning of the dry season (September to November). The clinical picture which predominates is the neurological affection which represented 33.3% of the cases. The different aspects of this neurological affection were of coma type, convulsion and prostration in 87%;21.7% and 8.6% respectively. The cerebral malaria was associated or not with other symptoms of severity that are anemia in 41.6%;icterus was represented in 21% of the cases, cardio-vascular collapse in 15.8% and hypoglycemia in 5.5% of the cases. The complications were observed during the hospitalization in 73.6% of the cases with the type of bacterial pneumonia (47.6%) and urinary infections (26.2%). The curative treatment was based on quinine salts through intravenous track in 100% of the case with a shift to the Artemisinin combination therapy (ACT) associated with intense care measures. In our study the whole lethality is 17%. Conclusion: The results of our study shows that the severe forms of malaria are still affecting our tropical endemic area, in spite of the prevention efforts made to fight against this plague. This research illustrates the difficulties to provide optimum medical care when combining antimalarial treatment and resuscitative measures in the decentralized reception facilities.展开更多
文摘Introduction: HIV resistance to antiretroviral is currently a global concern, and requires increased surveillance in a context of widespread ARV treatment. Objective: To evaluate early warning indicators of HIV resistance to ARVs in the Hospital of Tivaouane (Senegal) where viral load was not routinely available. Methods: This is a cross-sectional retrospective study from 2008-2016. The etraction tool (May 2010 version) was used to analyze the EWI. Results: We collected 360 HIV positive patients followed on average for 3.57 years ± 3.02. 2009, 2010 and 2012 recorded 100% ARV prescribing rates. Throughout the study period, the percentage of patients lost to follow-up during the first 12 months of treatment was less than 20%. Virtually, all patients were still under primary ARVT over 12-month treatment. All patients (100%) withdrew their ARV drugs on time. No stock storage regarding various classes of ARVs was noted during the study period. Conclusion: At the end of this study we recommend to maintain regular follow-up of EWI, and combine it with the achievement of viral load.
文摘Introduction: Malaria, the first parasitical endemic disease in the world, is a serious disease with 407,000 deaths in Africa in 2016. It is the main cause of morbidity and mortality in Senegal [1] [2]. Methods: Our retrospective study carried out from 1st January 2010 to 31 December 2013, at the department of internal medicine in the regional hospital of Thies was aimed at studying the epidemiological, clinical, paraclinical and prognostic profile of severe malaria in the autochthonous adults with 15 years and more. Results: Over this 3-year period, 57 patients were hospitalized in 1275 patients due to severe malaria that is to say a hospital prevalence of 4.47%. The average age was 64.21. A clear male predominance has been observed, around 61% (34/57) against 39% (23/57) with a sex ratio of 1.6. The highest malarial infestation rate was found at the end of the rainy season and at the beginning of the dry season (September to November). The clinical picture which predominates is the neurological affection which represented 33.3% of the cases. The different aspects of this neurological affection were of coma type, convulsion and prostration in 87%;21.7% and 8.6% respectively. The cerebral malaria was associated or not with other symptoms of severity that are anemia in 41.6%;icterus was represented in 21% of the cases, cardio-vascular collapse in 15.8% and hypoglycemia in 5.5% of the cases. The complications were observed during the hospitalization in 73.6% of the cases with the type of bacterial pneumonia (47.6%) and urinary infections (26.2%). The curative treatment was based on quinine salts through intravenous track in 100% of the case with a shift to the Artemisinin combination therapy (ACT) associated with intense care measures. In our study the whole lethality is 17%. Conclusion: The results of our study shows that the severe forms of malaria are still affecting our tropical endemic area, in spite of the prevention efforts made to fight against this plague. This research illustrates the difficulties to provide optimum medical care when combining antimalarial treatment and resuscitative measures in the decentralized reception facilities.
