https://www.ajol.info/index.php/pamj/issue/feed Pan African Medical Journal 2023-02-23T11:22:02+00:00 Dr Raoul Kamadjeu raoul.kamadjeu@gmail.com Open Journal Systems <p>We publish original scientific studies, comments on currents health initiatives, project and work reports, personal experiences, reviews of current health initiatives, educational articles and paper commenting on clinical, social, political, economical and all other factors affecting health. We are particularly interested in receiving articles and comments reflecting the point of view and experience of professionals working in Africa related to the impact of currents public health initiatives on their daily routine. The Journal is available online here: <a href="http://www.panafrican-med-journal.com/" target="_blank" rel="noopener">www.panafrican-med-journal.com/</a></p> <p><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning ></w:PunctuationKerning> <w:ValidateAgainstSchemas ></w:ValidateAgainstSchemas> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables ></w:BreakWrappedTables> <w:SnapToGridInCell ></w:SnapToGridInCell> <w:WrapTextWithPunct ></w:WrapTextWithPunct> <w:UseAsianBreakRules ></w:UseAsianBreakRules> <w:DontGrowAutofit ></w:DontGrowAutofit> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Font Definitions */ @font-face {font-family:Tahoma; panose-1:2 11 6 4 3 5 4 4 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:1627421319 -2147483648 8 0 66047 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0pt; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-ansi-language:EN-GB;} span.apple-style-span {mso-style-name:apple-style-span;} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 90.0pt 72.0pt 90.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!-- [if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0pt 5.4pt 0pt 5.4pt; mso-para-margin:0pt; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif] --></p> https://www.ajol.info/index.php/pamj/article/view/212287 Syndrome congénital d´obstruction des voies aériennes supérieures (syndrome du CHAOS): à propos d'un cas 2021-08-10T16:23:58+00:00 Kamal El Moussaoui Dr.elmoussaouikamal.gyn.obst@gmail.com Aziz Slaoui Dr.elmoussaouikamal.gyn.obst@gmail.com Aziz Baidada Dr.elmoussaouikamal.gyn.obst@gmail.com Aicha Kharabch Dr.elmoussaouikamal.gyn.obst@gmail.com <p>Le syndrome congénital d'obstruction des voies aériennes supérieures est une malformation rare qui est mortelle pour le nouveau-né après la naissance. Elle est définie comme une obstruction complète ou presque complète des voies aériennes supérieures. L'incidence réelle de la CHAOS est inconnue. Nous rapportons le cas d´une patiente de 24 ans, primipare sans antécédents médicaux ou chirurgicaux dont l´échographie de premier trimestre était sans anomalies. Au cours du deuxième trimestre l´examen échographique a montré un important œdème sous-cutané, avec un poumon hyperéchogène et hypertrophié, un cœur hypoplasique et une ascite importante associée à une oligoamnios sévères. Après avoir écarté les causes les plus fréquentes: l'iso-immunisation (Coombs indirecte négatifs), les infections (sérologies négatives) sans pouvoir disposer d'un caryotype, en raison du refus de la patiente, les résultats de l'échographie nous ont fait réfléchir à la possibilité d'un hydro-foetal secondaire au syndrome CHAOS, étant l'imagerie pathognomonique de l'hypertrophie pulmonaire avec inversion ou convexité des diaphragmes. Une IRM a été demandée montrant un probable syndrome CHAOS associé à d'autres malformations: atrésie laryngée, microphtalmie avec hypertélorisme et déviation de la cloison nasale avec absence de visualisation du tissu thymique, non identification claire de la vessie, Absence de rein droit et un rein gauche hypoplasique. L´évolution de la grossesse a été marquée par la survenue À la 24<sup>e</sup>&nbsp;semaine d´aménorrhée un accouchement prématuré qui a donné la naissance d´un nouveau-né avec un poids de naissance de 1475g, polymalformés présentant une ambiguïté sexuelle, avec un abdomen distendu et une polydactylie. Le nouveau-né est décédé à 3 min du post partum. Un caryotype était réalisé montrant un profil 46XX.</p> 2021-01-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212288 Common hepatic artery arises from superior mesenteric artery: bipode celiac trunk 2021-08-10T16:32:19+00:00 Danilo Coco webcostruction@msn.com Silvana Leanza webcostruction@msn.com <p>Classic Common Hepatic Artery (CHA) from the celiac artery and the proper hepatic artery into right and left is seen in 55-60% of the population. A classification method was described by Michel&nbsp;<em>et al.</em>&nbsp;in 1955: I: standard anatomy ~60% (range 55-61%), II: replaced Left Hepatic Artery (LHA) ~7.5% (range 3-10%) III: replaced Right Hepatic Artery (RHA) ~10% (range 8-11 %) IV: replaced RHA and LHA ~1%,V: accessory LHA from Left Gastric Artery(LGA) ~10% (range 8-11%),VI: accessory RHA from Superior Mesenteric Artery (SMA) ~5% (range 1.5-7%),VII: accessory RHA and LHA ~1%,VIII: accessory RHA and LHA and replaced LHA or RHA ~2.5%, IX: CHA replaced to SMA ~3% (range 2-4.5%), X: CHA replaced to LGA ~0.5%. We present a case report of an 82 years old Caucasian man who suffered from left colic tumor with a CHA, LHA, RHA arising from SMA: IX Michel Classification. Angio-CT Abdominal Scan demonstrated absence of complete celiac trunk. Bipode and CHA, LHA, RHA arising from SMA. 3D image: SMA+CHA, celiak bipode.</p> 2021-01-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212365 Dealing with vaccine hesitancy in Africa: the prospective COVID-19 vaccine context 2021-08-11T13:20:53+00:00 Aanuoluwapo Adeyimika Afolabi afoannade@gmail.com Olayinka Stephen Ilesanmi afoannade@gmail.com <p>The outbreak of the novel coronavirus disease (COVID-19) has resulted in many cases of morbidity and mortality across the globe, and the lack of the COVID-19 vaccine has contributed greatly to this experience. COVID-19 vaccines have currently been rolled out, and are available in some countries. However, strategies need to be put in place to prevent COVID-19 vaccine hesitancy (VH) especially in Africa; a continent where VH has been previously reported following the introduction of new vaccines. For this cause, we, therefore, recommend optimal community involvement in the structure and modalities for the delivery of the prospective COVID-19 vaccine. Also, feedback mechanisms for the acknowledgement of community efforts in previous health interventions should be improved upon to encourage the acceptance of the prospective COVID-19 vaccine. In addition, improved multi-sectoral collaboration should be initiated and promoted to enhance the acceptance of COVID-19 vaccines through the provision of more resources required to address COVID-19 VH. Furthermore, integration of the COVID-19 vaccine into the routine immunization schedule would strengthen the health system, improve uptake of the COVID-19 vaccine, and improve the health of all persons living on the African continent.</p> 2021-01-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212369 Imagerie des tumeurs brunes maxillo-mandibulaires multiples: à propos d´un cas 2021-08-11T13:33:15+00:00 Asmaa Adnane adnaneasmaa24@gmail.com Aicha Merzem adnaneasmaa24@gmail.com Meryem Harmak adnaneasmaa24@gmail.com Hasnaa Belgadir adnaneasmaa24@gmail.com Omar Amriss adnaneasmaa24@gmail.com Naima Moussali adnaneasmaa24@gmail.com Naima Elbenna adnaneasmaa24@gmail.com <p>Les tumeurs brunes sont des lésions ostéolytiques rares, survenant chez 1,5 à 1,7% des patients en insuffisance rénale chronique terminale. Elles sont le produit d´un remodelage osseux sous l´effet de la parathormone. Nous rapportons l´observation d´une jeune femme suivie pour insuffisance rénale chronique terminale sous hémodialyse et qui présentait des tuméfactions maxillo-mandibulaires indolore apparues 7 mois avant sa consultation. L´examen clinique a retrouvé une déformation faciale avec à la palpation deux masses maxillaires et mandibulaires. Le bilan biologique a révélé une hypocalcémie, une hyperphosphatémie avec une hyperparathyroïdie. Le scanner de la face a révélé de multiples masses ostéolytiques au niveau de l´os maxillaire et de la mandibule avec importante raréfaction de la trame osseuse et des signes de résorption osseuse diffuse. Le diagnostic de tumeurs brunes multiples de la face a été retenu sur un faisceau d´arguments cliniques, biologiques et radiologiques. Les tumeurs brunes sont une entité rare dont l´atteinte maxillo-mandibulaire est fréquente chez l´insuffisant rénale chronique. Elle doit être connue du praticien d´où l´intérêt de cette observation.</p> 2018-01-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212373 Petersen´s space hernia 2021-08-11T13:39:50+00:00 Danilo Coco webcostruction@msn.com Silvana Leanza webcostruction@msn.com <p>Petersen´s space hernia was first described in 1900 by Walther Petersen MD. It is an internal hernia, arising after any type of gastrojejunostomy, in particular, after Roux-en-Y anastomosis. A 49-years-old Caucasian woman was admitted to Emergency Room of our institution complaining of epigastric abdominal crampy pain and alimentary vomiting. Her past medical history pointed out Roux-Y Gastric Bypass for morbid obesity and weight loss of 60kg. Her abdominal physical examination revealed Blumberg sign. Vital signs were normal. White blood tests were in normal range. Body temperature was 36.2°C. CT scan demonstrated a “twist” in the mesentery with “whirlpool sign” of the jejunum. The patient was referred to operating theatre. We performed an exploratory laparotomy, disclosing an incarcerated Petersen´s space hernia of the common limb, with obstruction of the jejunum. The incarcerated bowel was repositioned and there was no irreversible ischemia, no resection being required. The Petersen´s space was closed with a suture. The post-operative period was unremarkable and the patient was discharged at the fourth post-operative day.</p> 2021-01-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212376 The challenges of COVID-19 testing in Africa: the Ethiopian experience 2023-02-22T08:14:53+00:00 Andargachew Mulu getachew.tesfaye@ahri.gov.et Amsalu Bekele getachew.tesfaye@ahri.gov.et Alemseged Abdissa getachew.tesfaye@ahri.gov.et Taye Tolera Balcha getachew.tesfaye@ahri.gov.et Meseret Habtamu getachew.tesfaye@ahri.gov.et Adane Mihret getachew.tesfaye@ahri.gov.et Dawit Hailu Alemayehu getachew.tesfaye@ahri.gov.et Getachew Tesfaye Beyene getachew.tesfaye@ahri.gov.et Abebe Genetu Bayih getachew.tesfaye@ahri.gov.et <p>Novel coronavirus disease (COVID-19) is spreading rapidly and creating a huge economic, social and public health challenge worldwide. Although currently an effective vaccine is ready, its distribution is limited, and hence the only currently available lever to reduce transmission is to identify and isolate individuals who are contagious. Thus, testing for SARS CoV-2 has a paramount importance. However, testing in many African countries including Ethiopia has multidimensional growing challenges. Here, we tried to identify, categorize and summarize the challenges of COVID-19 testing in Africa from Ethiopian experience.</p> 2021-01-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212380 Psychosocial correlates of risky sexual behaviour amongst students in Niger Delta University, Bayelsa 2021-08-11T14:01:23+00:00 Ikenna Ebuenyi Ikenna.ebuenyi@mu.ie Uzoechi Eze Chikezie Ikenna.ebuenyi@mu.ie Eunice Anyalewechi Nwoke Ikenna.ebuenyi@mu.ie <p><strong>Introduction:&nbsp;</strong>globally young people constitute one quarter of the population. They are the most vibrant and productive sector, but they are also prone to more risky sexual behaviour (RSB) with attendant negative consequences. In the Niger Delta region of Nigeria, persistent conflicts and socioeconomic difficulty predisposes young people to risky conducts including RSB. The aim of this study is to explore the psychosocial correlates of risky sexual behaviour amongst students in the Niger Delta University, Bayelsa.</p> <p><strong>Methods:&nbsp;</strong>we undertook a descriptive cross-sectional survey of students in the university. A multistage random sampling technique was used to recruit 400 students who completed a self-administered questionnaire. The data collected was analyzed using SPSS version 20.0.</p> <p><strong>Results:&nbsp;</strong>out of the 400 students, 64.3% (257) engaged in RSB and 46.8% (187) were currently engaging in RSB. Rates of self-reported depression, suicidal ideation and attempt were 62.3% (249), 18.0% (72) and 14.3% (54) respectively. Independent correlates of RSB include being older than 19 years (aOR. 2.82; 95% C.I. 1.44 -5.51), male gender (aOR. 1.70; 95% C.I. 1.08-2.66), having depression (aOR. 1.83; 95% C.I. 1.15-2.92), being diagnosed with a sexually transmitted disease (STD)/HIV (aOR. 2.08; 95% C.I. 1.12-3.86), and having been taught about condoms (aOR. 1.80; 95% C.I. 1.13-2.86).</p> <p><strong>Conclusion:&nbsp;</strong>risky sexual behaviours have negative psychosocial and health implications. Regular and continuous health education targeted at young people is essential to reduce the social and health effects associated with RSB.</p> 2021-01-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212385 Ileosigmoid knot in a patient with Down syndrome: a unique surgical emergency 2021-08-11T14:10:26+00:00 Said Boussaidane saidboussaidane87@gmail.com Abderrahim Samlali saidboussaidane87@gmail.com Asma Hamri saidboussaidane87@gmail.com Youssef Narjis saidboussaidane87@gmail.com Benomar Ridouan Benelkhaiat saidboussaidane87@gmail.com <p>The ileosigmoid knot (ISK) or double ileosigmoid volvulus is a wrapping of the small intestine around the base of the sigmoid colon. We report an unusual case in the digestive surgery department of the Ibn Tofail Hospital of CHU Mohammed VI Marrakech of a 28-year-old man with Down's syndrome who presented with symptoms and signs of intestinal obstruction. Abdominal CT scan revealed a whirl sing and significant distension of the sigmoid loop. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. The surgical procedure was a necrotic digestive segments resection, with a double-barrelled ileostomy and a Hartmann procedure. One month afterwards, the patient was operated on to reestablish of the continuity. Through this observation and a review of the literature we define the diagnostic, therapeutic and prognosis aspects of this rare clinical entity.</p> 2021-01-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212388 Thrombocytopenia induced by glycoprotein (GP) IIb-IIIa antagonists: about two cases 2021-08-11T14:22:40+00:00 Salma Abdeladim salma.abdeladim56@gmail.com Mahassine Elharras salma.abdeladim56@gmail.com Amal Elouarradi salma.abdeladim56@gmail.com Ilham Bensahi salma.abdeladim56@gmail.com Sara Oualim salma.abdeladim56@gmail.com Fatimazahra Merzouk salma.abdeladim56@gmail.com Mohamed Sabry salma.abdeladim56@gmail.com <p>In this paper, we report two cases of induced thrombocytopenia after the infusion of glycoprotein (GP) IIb/IIIa receptors antagonists, following a coronary angioplasty. The first patient is a 65-year-old woman, admitted with acute coronary syndrome requiring percutaneous angioplasty with stenting. The patient was given tirofiban + unfractionated heparin (UFH). Ten hours later, the patient revealed very severe thrombocytopenia and went into hemorrhagic shock (hematemesis and hematoma at the injection site). The patient was transfused with nine units of red blood cells (RBCs), 24 platelets pellets and 4 units of fresh frozen plasma (FFP). The second patient is a 76-year-old woman. She was admitted to hospital for acute coronary syndrome necessitating percutaneous angioplasty with stenting and a glycoprotein IIb/IIIa receptor antagonists, tirofiban + unfractionated (UFH). Four hours later, the patient presented with gingivorrhagia associated thrombocytopenia. She received six platelet pellets transfusion with well clinical and biological improvement. These two observations raise the significance of a close monitoring of platelet count after the initiation of GP IIb/IIIa antagonists infusion, which are sometimes responsible for life-threatening adverse events.</p> 2021-01-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212396 Clinical indications for total abdominal hysterectomy among women seen in Dar es Salaam regional referral hospitals, Tanzania: a prospective, observational hospital-based study 2021-08-11T14:33:32+00:00 Godfrey Jacob Chale celsius_lx@yahoo.co.uk Rashid Mohammed Salim celsius_lx@yahoo.co.uk Kelvin Melkizedeck Leshabari celsius_lx@yahoo.co.uk <p>Total abdominal hysterectomy is among the commonest gynaecologic surgeries observed in Africa. However, there exists a gap in published data to support this hypothesis. Information on hysterectomies reported from sub-Saharan Africa reflects mostly obstetric indications. A prospective hospital-based study was conducted in Dar es Salaam, Tanzania from March-October 2017. Women attending the facilities with clinical conditions necessitating abdominal hysterectomies were the target population. Each woman was followed from the time of planning for surgery until at most 72-hours post-surgery or discharge from the wards whichever came first. Continuous variables were summarized using median (with corresponding inter-quartile range). Categorical variables were summarized using frequency (%). Data outputs were created using SAS version 9.4. Verbal informal consent was sought from each individual prior to inclusion to this study. We recruited and prospectively followed-up 107 patients. Median age of participants was 42 (IQR: 37-47) years. Uterine leiomyoma (84.1%) was the leading indication for hysterectomy. Only about a third (30.8%) of followed-up women had provisional diagnoses at the time of surgery. None of the study participants reported receipt for confirmatory histological findings of her uterus up to the hospital discharge time post-surgery.</p> 2021-01-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212402 Distribution of variations in anatomy of the circle of Willis: results of a cadaveric study of the Malawian population and review of literature 2021-08-11T15:42:22+00:00 Charles Nyasa cnyasa@medcol.mw Anthony Mwakikunga cnyasa@medcol.mw Lackson Tembo cnyasa@medcol.mw Charles Dzamalala cnyasa@medcol.mw Amadi Ogonda Ihunwo cnyasa@medcol.mw <p><strong>Introduction:&nbsp;</strong>the circle of Willis is an anatomical structure of clinical importance particularly in the evaluation of neurovascular diseases. Individuals show considerable variations in the anatomical configuration of the circle of Willis. A cross-sectional study was conducted to determine the distribution of morphological variations of the circle of Willis in Malawians and compare with other ethnic groups.</p> <p><strong>Methods:&nbsp;</strong>brains were collected from twenty-four recently deceased black Malawians during autopsy at Queen Elizabeth Central Hospital, a referral teaching hospital in Blantyre, Malawi and fixed in 10% buffered formalin. Digital images of the interpeduncular region (exposing the circle of Willis) were taken with an 18.4 megapixels camera from the base of the brain. Whole-circle and segmental parameters of the circle of Willis were assessed using the Osiris computer programme and classified based on a 22-type classification scheme.</p> <p><strong>Results:&nbsp;</strong>the following morphological variations were observed: hypoplasia, aplasia, asymmetry and accessory vessels. Typical circle of Willis was seen in 26% of the cases. Only six of the original twenty-two types were observed. Consistent with most previous studies, types 1, 3, 4, 6, 8 and 9 were common while types 10-22 were rare. Three variants not previously described in the original scheme (unilateral PcoA aplasia, AcoA duplication, and PcoA aplasia with contralateral PcoA hypoplasia) were observed in this study.</p> <p><strong>Conclusion:&nbsp;</strong>anatomical variations of the circle of Willis in Malawians seem to be distributed in similar frequencies and patterns as in other more-diverse populations. Circle of Willis variants with potential predilection for atherogenesis and aneurysm formation exist in the Malawian population. These should be considered in clinical practice.</p> 2021-01-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/212403 An 80 years old woman with acute gastric volvulus 2021-08-11T15:50:38+00:00 Danilo Coco webcostruction@msn.com Silvana Leanza webcostruction@msn.com <p>Gastric volvulus is an abnormal rotation of the stomach around itself. It is a life-threatening condition due to the risk of abs ingestis pneumonia or strangulation and gangrene/perforation of the stomach. Imaging as X-ray transit of the first digestive tract or Thoracic CT Scan is usually diagnostic. The population affected ranges from pediatric age group to elderly with multiple co-morbidities. The mortality from acute gastric volvulus is now 15%-20%. An 80-year-old Caucasian man was admitted to Emergency Room of our institution for dysphagia, vomiting and epigastric pain. His past medical history was negative for previous gastrointestinal disease or surgery. He referred only dysphagia for solid food and mild retrosternal pain. On physical examination, the patient was in slight distress. Oxygen saturation on pulse oximetry was 85%, blood pressure (BP) was 90/75 mmHg while supine, heart rate was 100/min and the temperature was 36°C. On auscultation, he had breath sounds were bilaterally reduced. His abdominal physical examination was unremarkable. The abdomen was soft, non-tender, mildly distended. White blood tests were in normal range. Computed Tomography (CT) scan showed the displacement of the stomach above the gastro esophageal junction; the stomach appeared upside-down with the antrum showing huge gastric distension with no free fluid or air. We performed an exploratory laparoscopy which confirmed the intra-thoracic rotation of the stomach. We proceed to release it from its adherence from the thorax to the abdomen and complete the operation with a laparoscopic Nissen Fundoplication. Postoperative recovery was uneventful. Esophagus transit was normal. At the 3-day, the patient was in good clinical condition and he was discharged.</p> 2021-01-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221601 Management of COVID-19 infection in patients undergoing hemodialysis 2022-02-16T14:37:49+00:00 Boushab Mohamed Boushab bboushab@gmail.com Noukhoum Koné bboushab@gmail.com Sidi El-Wafi Ould Baba bboushab@gmail.com Mohamed Jeddou Ould Mohamed El Mokhtar Bellattv bboushab@gmail.com Mohamed Moustava Ould Ahmed bboushab@gmail.com Houssein Ould Habiboullah bboushab@gmail.com El-Vak Ould Ahmed Baba bboushab@gmail.com Oumar Ould Sidi Mohamed bboushab@gmail.com Leonardo Kishi Basco bboushab@gmail.com <p>Coronavirus disease 2019 (COVID-19), a pandemic affecting the world's population, is particularly threatening to dialysis patients. The purpose of this study was to propose recommendations for prevention and containment of COVID-19 in hemodialysis center situated in a regional hospital in Mauritania. Both COVID-19-infected (n = 11) and -uninfected (n = 16) dialysis patients were hospitalized up to three weeks to improve patient management. All COVID-19-infected patients were cured. Patient care and hygiene in a safe environment are the key factors for a favorable outcome, even in resource-limited settings.</p> 2021-01-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221606 About a rare cause of calf pain in an athlete: the popliteal artery entrapment syndrome (a case report) 2022-02-16T14:49:37+00:00 Ameni Ammar ameniammar777@gmail.com Mahmoud Smida ameniammar777@gmail.com Mohamed Samir Daghfous ameniammar777@gmail.com <p>Claudication of the young patient is a very rare symptom for orthopaedic surgeons and it is often overlooked. We report a rare case of popliteal artery entrapment syndrome (PAES), discovered during a vascular claudication following post-traumatic anterior instability of the knee. The diagnosis was confirmed by CT angiography which showed a PAES, with a pathway in the inter-condylar notch. The patient had a releasing of the trapped vessel by myomectomy, with disappearance of vascular symptoms six months later. Through this case, we wanted to draw the attention of orthopaedic surgeons to the fact that the PAES can be asymptomatic. Its symptomatology can be triggered by a traumatic instability of the knee. Its presence represents a risk of lesion of the popliteal artery during arthroscopic ACL reconstruction. Therefore, it is important to think about this disease if a calf pain occurring after a ligament injury of the knee.</p> 2021-01-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221609 COVID-19 and its implications for obstetrics and gynecology practice in Africa 2022-02-16T14:54:52+00:00 Timothy Abiola Olusesan Oluwasola bellodoyin@yahoo.com Oluwasomidoyin Olukemi Bello bellodoyin@yahoo.com <p>Having to cope with corona virus disease 2019 (COVID-19) is likely to create imbalances in health care provision in the obstetrics and gynecology practices in Africa where most countries still battle with high rate of maternal morbidities and mortalities as well as poor or inadequate quality gynecological care. COVID-19 has spread to the continents of the world including all African nations since it was first reported in Wuhan, China in December 2019. Its impact and implications on the obstetrics and gynecology practice in Africa are yet to be fully explored. Routine essential services are being disrupted; therefore, giving rise to the need to redeploy the already limited health personnel across health services in Africa. This is an attempt to discuss the potential implications for obstetrics and gynecologic practice in Africa.</p> 2021-01-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221611 Encéphalopathie de Gayet-Wernicke avec taux de thiamine normale: à propos d´un cas 2022-02-16T15:12:08+00:00 Assia El Berhoumi assia.aemc@gmail.com Dalale Laoudiyi assia.aemc@gmail.com Meriem Doumiri assia.aemc@gmail.com Hayat Lhajoui assia.aemc@gmail.com Mohamed Labied assia.aemc@gmail.com Kamilia Chbani assia.aemc@gmail.com Siham Salam assia.aemc@gmail.com Lahcen Ouzidane assia.aemc@gmail.com <p>L'encéphalopathie de Gayet-Wernicke est une urgence neuropsychiatrique sur carence en thiamine (vitamine B1), secondaire à plusieurs facteurs. Nous rapportons un cas d'encéphalopathie de Gayet-Wernicke chez une patiente de 43 ans non éthylique, se présente pour trouble de conscience et diplopie, avec un taux de thiamine normal. La triade clinique classique et l'imagerie par résonance magnétique (IRM) jouent un rôle important, notamment dans le diagnostic des encéphalopathies de Wernicke non alcooliques même avec un taux de thiamine normal.</p> 2021-01-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221613 Febrile neutropenia following with single-low-dose methotrexate for the treatment of ectopic pregnancy: a case report 2022-02-16T15:17:55+00:00 Burak Bayraktar drburakbayraktar@gmail.com <p>Methotrexate (MTX) is an effective, economical and safe drug used in the treatment of ectopic pregnancy. Complications are very rare. Herein, we reported a case of febrile neutropenia following single low-dose methotrexate for the treatment of ectopic pregnancy. Febrile neutropenia developed on day 4 of single-dose methotrexate administered intramuscularly. Although methotrexate single-dose regimen is quite effective and safe in ectopic pregnancy, febrile neutropenia can occur very rarely.</p> 2021-01-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221614 Ghana beyond the epi-curve: initial lessons learned from the implementation of infection prevention and control measures in the COVID-19 response 2022-02-16T15:21:50+00:00 Mary Eyram Ashinyo mary.ashinyo@ghsmail.org <p>Infection prevention and control (IPC) measures remain crucial to breaking transmission of the virus in the wake of inconclusive efforts underway to find an effective vaccine and treatment. While acknowledging that many lessons evolve as the pandemic unfolds, an initial understanding and recognition of the complexities that surround IPC policy implementation and adherence is vital for effective control of on-going pandemic in particular and to inform national IPC policies beyond the epi-curve. This short communication therefore seeks to unravel initial thoughts, themes and concepts that have unfolded in the implementation of IPC policies and guidelines in the context of the ongoing outbreak response in Ghana. A rapid desk review was done. Reflexive journals, field notes, observations and workshop experiences were compiled and overlapped with authors’ experience as a member of the COVID-19 national response team for Infection Prevention and Control (IPC). Thematic content analysis was then used to categorize the lessons into common themes. While aligning with global strategies, the concept of ‘looking within’ for initial solutions and strengths have proven useful for a public health emergency response in Ghana. Future IPC policies must inculcate perspectives from the politics and economics of IPC practices and employ varieties of multidisciplinary approaches required to broaden the scope of IPC practice.</p> 2021-01-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221651 A giant fibroadenoma in a mature woman: diagnosis and treatment in a limited resource environment (a case report) 2022-02-17T14:06:45+00:00 Médard Kakule Kabuyaya fabricelele@gmail.com Fabrice Lele Mutombo fabricelele@gmail.com Francine Mbonga Moseka fabricelele@gmail.com Kasereka Kihemba fabricelele@gmail.com Neil Wetzig fabricelele@gmail.com Justin Paluku Lussy fabricelele@gmail.com <p>We report an extremely rare case of a 40-year-old woman with a giant fibroadenoma of 30cm in diameter that was accompanied by ulceration and bleeding. We document the onset, the clinical presentation, as well as the challenge encountered in the diagnosis and managing in a limited resource environment.</p> 2021-01-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221656 Illicit substances identified in the urine of 11.170 suspected drug users in north Tunisia 2022-02-17T14:36:24+00:00 Nadia Chaouali chaoualinadia@gmail.com Bilel Moslah chaoualinadia@gmail.com Kamel Ben Salem chaoualinadia@gmail.com Dorra Amira chaoualinadia@gmail.com Abderazzek Hedhili chaoualinadia@gmail.com Nabil Ben Salah chaoualinadia@gmail.com <p><strong>Introduction:&nbsp;</strong>according to the latest World Drug Report, 271 million people worldwide (5.5% of the global population) aged 15-64 years are drug users. Drug addiction and trafficking became an urgent public health problem that affects human health and social life. Aim: a cross-sectional study was conducted from January 2016 to December 2018, to identify the socio-demographic profile of drug users captured by the anti-narcotics squad in north of Tunisia (North African country) and to type, through toxicological analysis, the nature of the substances consumed.</p> <p><strong>Methods:&nbsp;</strong>data were collected from expertise files of 11170 suspected drug users. Fresh urine samples were collected from suspected drugs users and submitted in the toxicology laboratory of the center for Urgent Medical Assistance (Tunis) for forensic urinalysis. Drugs screening was carried out by immunochemical methods. Positive samples were analyzed with gas chromatography coupled to mass selective detector (GC-MS) for confirmation.</p> <p><strong>Results:&nbsp;</strong>the investigation revealed that drug users were mainly males 97.4% (sex ratio 37), the median age was 29 ± 7.91 years, 91.3% were singles and 79% were daily workers. On a total of 11170 urine samples screened, 5 409 (48.4%) were positives for illicit drugs. The prevalence of positive samples was 55.4% in 2016; 50.45% in 2017 and 40.8% in 2018. Cannabis was the most widely consumed drug (95%), followed by Benzodiazepines (1.2%), Buprenorphine (1%), cocaine (0.95%), MDMA (0.24%) and opiates (0.13%). Polydrug abuse was observed in 79 specimens (1.5%).</p> <p><strong>Conclusion:&nbsp;</strong>this study provides an overview of the illicit drug consumption in the north of Tunisia (knowing that nowadays epidemiological data are almost same since 2016) in order to set up an effective policy to fight against drugs and addictive behaviors and to provide health professionals with the epidemiological elements necessary for better medical care of drug users.</p> 2021-01-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221658 Etude du syndrome métabolique et l´activité physique chez une population de la ville de Marrakech, au Maroc 2022-02-17T15:02:13+00:00 Zineb Hannoun zineb.hannoun@gmail.com Khouloud Harraqui zineb.hannoun@gmail.com Rachmat Attoumane Ben Ali zineb.hannoun@gmail.com Kamar Tahiri zineb.hannoun@gmail.com Omar Ben Smail zineb.hannoun@gmail.com Fatine El Arabi zineb.hannoun@gmail.com Abdellatif Bour zineb.hannoun@gmail.com <p><strong>Introduction:&nbsp;</strong>le but de cette étude était de faire une corrélation entre le syndrome métabolique et le niveau de l'activité physique chez une population de Marrakech, au Maroc.</p> <p><strong>Méthodes:&nbsp;</strong>l'étude a été menée à l'Hôpital régional Ibn Zohr de Marrakech. L'indice de masse corporelle (IMC) a été calculé pour évaluer le degré d'obésité de chaque sujet. Pour déterminer le niveau d'activité physique, nous avons utilisé la version courte du questionnaire IPAQ (International Physical Activity Questionnaire); Les paramètres sanguins ont été mesurés par un automate de biochimie. Toutes les analyses statistiques ont été effectuées à l'aide du logiciel SPSS.</p> <p><strong>Résultats:&nbsp;</strong>au total, 300 sujets ont participé à l'étude, dont 57,3% de femmes et 42,7% d'hommes avec un sex-ratio de 0,74. L'âge moyen de notre population était de 51,6 ± 13,42 ans. Soixante-dix-neuf des participants (26,3%) avaient un syndrome métabolique, avec une prédominance féminine: 60 femmes (34,9%) et 19 hommes (14,8%). Il existe une relation significative entre le niveau d'activité physique et la présence de syndrome métabolique (p = 0,002), entre le niveau d'activité physique et l'IMC et le tour de taille (p &lt; 0,001) et (p = 0,003) respectivement.</p> <p><strong>Conclusion:&nbsp;</strong>les résultats approuvent l´association significative entre l´obésité, le syndrome métabolique et le niveau de l´activité physique, ce qui nous inciterait à encourager l´application des règles hygiéno-diététiques, notamment l´activité physique, qui reste l´une des meilleures actions de prévention contre cette pathologie.</p> 2021-01-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221663 Unmet need for family planning and associated factors among women living with HIV in Gondar city, Northwest Ethiopia: cross-sectional study 2022-02-17T15:08:42+00:00 Mihret Dejen Kassie hsimegnew@yahoo.com Yohannes Ayanaw Habitu hsimegnew@yahoo.com Simegnew Handebo Berassa hsimegnew@yahoo.com <p><strong>Introduction:&nbsp;</strong>all women, including those living with HIV, have the right to choose the timing, spacing, and number of their births and need access to family planning services. This study aimed at assessing the prevalence and factors associated with an unmet need for family planning among women receiving Antiretroviral Therapy (ART) services.</p> <p><strong>Methods:&nbsp;</strong>a facility-based cross-sectional study was conducted from March to April 2018 in Gondar city, Ethiopia. A systematic random sampling technique was used to recruit 441 reproductive-age women on ART. The data were collected using a pretested structured questionnaire. The bivariate and backward multivariable logistic regression model was fitted to identify factors associated with the unmet need for family planning.</p> <p><strong>Results:&nbsp;</strong>the prevalence of the unmet need for family planning among women living with HIV was 24.5%. Increase in women´s age (AOR: 0.90, 95% CI (0.85, 0.95)), having more than three children (AOR: 0.13, 95% CI (0.04, 0.38)), intention to have more children (AOR: 0.09, 95% CI (0.03, 0.23)), not disclosing sero-status to partner (AOR: 0.40, 95% CI (0.20, 0.82)) and having no experience of contraception use (AOR:0.43, 95% CI (0.21, 0.90)) were protective factors against unmet need for family planning. Rural residence (AOR: 2.17, 95% CI (1.05, 4.46)) was associated with increased odds of unmet need for family planning.</p> <p><strong>Conclusion:&nbsp;</strong>one in every four women living with HIV had an unmet need for family planning. So, continuous awareness-raising activities on family planning for women on ART should be given by emphasizing the rural and younger age women.</p> 2021-01-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221665 Fournier´s gangrene: its management remains a challenge 2022-02-17T15:17:37+00:00 Faiez Boughanmi enn.farouk92@gmail.com Farouk Ennaceur enn.farouk92@gmail.com Ibtissem Korbi enn.farouk92@gmail.com Amina Chaka enn.farouk92@gmail.com Faouzi Noomen enn.farouk92@gmail.com Khadija Zouari enn.farouk92@gmail.com <p>Fournier's gangrene (FG) is a rapidly progressive necrotizing bacterial dermo-hypodermitis of the perineum and external genitalia. It represents a real medical and surgical emergency requiring multidisciplinary care. Our study was based on the retrospective analysis of 18 cases of FG, collected in the Department of General and Visceral Surgery of Fattouma Bourguiba University Hospital in Monastir over an 18-year period extending from January 2000 to December 2018. Our series included 18 cases of FG collected over an 18-year period, an annual incidence of one case per year. The average age of our patients was 58 years (36 to 77). The male prevalence was clear. Diabetes and old age were found to be the major risk factors. The treatment was based on an aggressive surgical debridement remains to be the cornerstone of therapy and is commonly preceded by patient preparation for the surgical act by perioperative resuscitation and broad-spectrum antibiotic therapy, possibly accompanied by hyperbaric oxygen therapy (HBOT). The vaccum assisted closure (VAC) therapy is also used, which is a non-invasive system that promotes open wound healing. Healing techniques can be once the septic risk is controlled. Dressings topical treatments, such as fatty substances or calcium alginate, in addition to skin grafts, musculo-neurotic or musculo-cutaneous cover flaps can be used. During the follow-up period, no reccurrence occurred in 14 out of the 18 cases (2 patients were lost to follow-up and 2 patients died). A colostomy was closed in 10 out of 11 cases with simple follow-ups. Restorative surgery (partial thickness skin graft) at the perineal level was performed in only one case. Despite the better understanding of its etiopathogenesis, the advent of targeted antibiotic therapy, the establishment of a better codification of surgical procedures, the contribution of hyperbaric oxygenation and reconstruction techniques, mortality rates are still high and FG remains a real health threat, thus constituting a real medical and surgical emergency.</p> 2021-01-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221667 Diagnosis of latent tuberculosis among HIV infected patients in Ilorin, Nigeria using tuberculin skin test and interferon gamma release assay 2022-02-17T15:54:36+00:00 Adeniyi Olatunji Aladesanmi niyialadesanmi@gmail.com Olutobi Babatope Ojuawo niyialadesanmi@gmail.com Olutosin Olukemi Aladesanmi niyialadesanmi@gmail.com Ademola Emmanuel Fawibe niyialadesanmi@gmail.com Olufemi Olumuyiwa Desalu niyialadesanmi@gmail.com Ayotade Boluwatife Ojuawo niyialadesanmi@gmail.com Christopher Muyiwa Opeyemi niyialadesanmi@gmail.com Mosunmoluwa Obafemi Adio niyialadesanmi@gmail.com Victoria Oluwaloniola niyialadesanmi@gmail.com Alakija Kazeem Salami niyialadesanmi@gmail.com <p><strong>Introduction:&nbsp;</strong>Latent Tuberculosis Infection (LTBI) screening is recommended for individuals with a known risk factor for progression to active disease especially in the setting of HIV infection. This will ensure early diagnosis and prompt treatment. The purpose of our study was to compare tuberculin skin test (TST) with Interferon Gamma Release Assay (IGRA) in the diagnosis of LTBI among patients with known HIV infection at University of Ilorin Teaching Hospital (UITH), Ilorin.</p> <p><strong>Methods:&nbsp;</strong>this was a hospital based cross-sectional study at the Highly Active Antiretroviral therapy (HAART) Clinic and medical wards of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 282 consenting patients with HIV infection were recruited. Sociodemographic and clinical information was obtained using a well-structured questionnaire. The screening for LTBI was done using Tuberculin skin test (TST) and Interferon Gamma release assay (IGRA).</p> <p><strong>Results:&nbsp;</strong>the prevalence of LTBI among HIV infected patients was 40.6% and 53.1% using TST and QFT-IT respectively, while the overall prevalence considering positivity to either of the test was 66%. There was mild agreement (κ: 0.218) between TST and QFT-IT in the diagnosis of LTBI among patients with HIV infection. The association between CD4 count and TST was not statistically significant (p value = 0.388) but there was strong association between CD4 cell count and QFT results (p = 0.001).</p> <p><strong>Conclusion:&nbsp;</strong>the prevalence of LTBI is quite high among patients with HIV infection in our locality. There is a need to encourage screening of at-risk individuals to forestall the morbidity and mortality associated with TB in this population.</p> 2021-01-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221670 Clinical and epidemiological characteristics of 646 hospitalised SARS-Cov-2 positive patients in Rivers State Nigeria: a prospective observational study 2022-02-17T16:31:14+00:00 Datonye Alasia datonye.alasia@uniport.edu.ng Golden Owhonda datonye.alasia@uniport.edu.ng Omosivie Maduka datonye.alasia@uniport.edu.ng Ifeoma Nwadiuto datonye.alasia@uniport.edu.ng Godswill Arugu datonye.alasia@uniport.edu.ng Charles Tobin-West datonye.alasia@uniport.edu.ng Esther Azi datonye.alasia@uniport.edu.ng Victor Oris-Onyiri datonye.alasia@uniport.edu.ng Inwon Joseph Urang datonye.alasia@uniport.edu.ng Victor Abikor datonye.alasia@uniport.edu.ng Ayo-Maria Olofinuka datonye.alasia@uniport.edu.ng Obelebra Adebiyi datonye.alasia@uniport.edu.ng Abiye Somiari datonye.alasia@uniport.edu.ng Hope Avundaa datonye.alasia@uniport.edu.ng Aloni Alali datonye.alasia@uniport.edu.ng <p><strong>Introduction:&nbsp;</strong>the knowledge of epidemiologic and clinical variables in patients with SARS- CoV-2 infection provides evidence and lessons that are useful for the pandemic response, with consideration of National and sub-National variations. The objective of this study was to characterize and describe the clinical and epidemiologic features of all the hospitalised patients with COVID-19 in Rivers State Nigeria, from March to August 2020.</p> <p><strong>Methods:&nbsp;</strong>a prospective descriptive multi-center study of patients with positive SARS-CoV-2 RT PCR, who were hospitalised for treatment and self-isolation in four treatment centers in Rivers state, Nigeria.</p> <p><strong>Results:&nbsp;</strong>the mean age of all the patients was 39.21 ± 12.31 years, with a range of 2 to 77 years. The majority of patients were in the 31 to 40-year (33.0%), 41 to 50-year (23.1%) and 18-to 30-year (22.0%) age groups. The patient population included 474 (73.4%) males and 172 (26.6%) females, with 93 (14.4%) healthcare workers. A history of contact and travel was established in 38.5% and at least one comorbid disease condition was present in 32.8% of patients. Patients with severe disease were 61 (9.45%), while the overall case fatality rate was 2%. The leading comorbid disease conditions were Hypertension in 23.8% and diabetes in 7.7% of patients. Fever (26.0%), dry Cough (17.6%), dyspnoea (12.7%), anosmia (12.7%) and headache (9.9%) were the most common symptoms. The presence of comorbidity and increasing age predicted death from COVID-19.</p> <p><strong>Conclusion:&nbsp;</strong>the clinical and epidemiologic characteristics of this cohort of hospitalised patients show significant similarities with existing trends from previously reported studies, with contextual peculiarities.</p> 2021-01-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221672 Evaluation of prevention of mother-to-child transmission national health information system for HIV/AIDS, in southern region of Mozambique, April to November 2016 2022-02-17T16:43:11+00:00 Auria Ribeiro Banze auria.lanice28@gmail.com Benilde Pedro Homo auria.lanice28@gmail.com Tufária Nazimo Mussá auria.lanice28@gmail.com Cynthia Semá Baltazar auria.lanice28@gmail.com Makini Aida Boothe auria.lanice28@gmail.com <p><strong>Introduction:&nbsp;</strong>Mozambique has a generalized HIV epidemic, among pregnant women, HIV prevalence is estimated at 15.8% with a vertical transmission rate of 14%, more than double global targets. We evaluate electronic national health information system (SIS-MA) performance to verify if the data flow procedures met its objectives and evaluated the prevention of mother-to-child transmission (PMTCT) surveillance system to access its attributes and usefulness.</p> <p><strong>Methods:&nbsp;</strong>we conducted a descriptive, cross-sectional evaluation of the PMTCT surveillance system in eight facilities in Gaza and Inhambane provinces using the centers for disease control and prevention guidelines (2001). For data quality, we cross-referenced patient registries from health facilities against the SIS-MA. We also interviewed 34 health technicians, using a Likert scale, to assess the following attributes of the PMTCT surveillance system: simplicity, stability, flexibility, acceptability, timeliness and data quality, usefulness of the system and knowledge of PMTCT.</p> <p><strong>Results:&nbsp;</strong>regarding the simplicity measure, we verified that the registry books contain more than 30 variables. The system was 83% flexible in maintaining functionality with the introduction of new health facilities in the system. The completeness of the data was 50% and concordance of data from the register book and monthly reports was 89%.</p> <p><strong>Conclusion:&nbsp;</strong>the PMTCT SIS-MA is useful in supporting the collection, analysis, interpretation and continuous and systematic dissemination of health data that are used to define and monitor public health policies in Mozambique. However, continued efforts are needed to improve data quality to ensure that the SIS-MA can adequately monitor the PMTCT program and contribute to reduced vertical transmission.</p> 2021-01-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221673 A scoping review of the impact of long-distance truck drivers on the spread of COVID-19 infection 2022-02-17T16:55:25+00:00 Thobile Malinga Thobile.Malinga@mrc.ac.za Charles Shey Wiysonge Thobile.Malinga@mrc.ac.za Duduzile Ndwandwe Thobile.Malinga@mrc.ac.za Joseph Chukwudi Okeibunor Thobile.Malinga@mrc.ac.za Ambrose Otau Talisuna Thobile.Malinga@mrc.ac.za <p><strong>Introduction:&nbsp;</strong>long-distance truck drivers have been identified as a high-risk group for coronavirus disease (COVID-19) infection. Thus, the aim of this scoping review is to map out the existing evidence on the impact of long-distance truck drivers on the spread of COVID-19 and measures that countries can implement to mitigate this route of spread in the African region.</p> <p><strong>Methods:&nbsp;</strong>we searched the PubMed database and the website of the World Health Organization (WHO) in March 2020 for eligible studies.</p> <p><strong>Results:&nbsp;</strong>the search strategy identified 669 citations, of which six met the inclusion criteria. The most frequently reported interventions were maintaining hand hygiene, social distance, testing truck drivers, regulation of trade and transport e.g. only trucks with the food, medical supplies, fuels, agricultural supplies will be allowed to operate in interstate operations and regulating and controlling trucks carrying essential goods and services e.g. truck drivers are required to declare their final destination and are urged to stop only at designated points. Two studies from the African region reported about border closures and entry and exit screening, two studies from the US reported about the threat for public safety and risks and mitigation plans and 2 guidelines reported about harmonisation and facilitation of cross border in the context of the COVID-19 outbreak.</p> <p><strong>Conclusion:&nbsp;</strong>this review highlights the countries response to mitigate the impact of the pandemic by implementing measures to facilitate safe cross-border trade and adopting regional harmonization of trucking regulations.</p> 2021-01-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221674 COVID-19 control pitfalls and challenges and drivers of SARS-CoV-2 transmission in Zimbabwe 2022-02-17T17:12:55+00:00 Grant Murewanhema gmurewanhema@yahoo.com <p>Despite numerous public health interventions introduced by the Zimbabwean government, the COVID-19 burden continues to grow. The number of confirmed cases increased from less than 600 to over 6000 in a period of two months, and the fatalities now exceed 150. The source of infection has significantly changed from imported cases to community transmission. The greatest burden of COVID-19 is in the country’s two biggest provinces, Harare and Bulawayo, and differentiated approaches are urgently required to curb further transmissions whilst allowing other aspects of the population’s livelihood to continue. We discuss some of the pitfalls and challenges for COVID-19 control, and the possible drivers of SARS-CoV-2 community transmission in the country. An urgent multi-sectoral intersection to effectively deal with these caveats is required, and political commitment to deal with the crisis remains an indispensable variable.</p> 2021-01-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221676 Myocardial performance after coronary re-implantation in pediatric patients assessed with conventional echocardiographic and 2D-speckle tracking analysis: a case-control study 2022-02-18T09:05:26+00:00 Salma Charfeddine Selma_charfeddine@yahoo.fr Dorra Abid Selma_charfeddine@yahoo.fr Rania Hammami Selma_charfeddine@yahoo.fr Rania Gargouri Selma_charfeddine@yahoo.fr Leila Abid Selma_charfeddine@yahoo.fr Faten Triki Selma_charfeddine@yahoo.fr Samir Kammoun Selma_charfeddine@yahoo.fr <p><strong>Introduction:&nbsp;</strong>reduced exercise capacity, coronary artery abnormalities and reversible myocardial ischemia have been demonstrated after arterial switch operation (ASO) and coronary reimplantation. Despite this, indices of systolic function, assessed by standard and doppler echocardiography, are within the normal range. The aim of this study was to highlight the long-term changes in myocardial function following coronary reimplantation using Doppler and speckle-tracking imaging (STI) echocardiography.</p> <p><strong>Methods:&nbsp;</strong>this observational case control study included 36 patients and 20 gender and age-matched healthy controls. A group study was performed using patients who were followed for at least 6 months after the operation and who visited the pediatric cardiology outpatient between October 2015 and May 2016. Systolic and diastolic parameters, left ventricle (LV) and right ventricle (RV) myocardial performance were assessed in each group.</p> <p><strong>Results:&nbsp;</strong>the LV global peak strain parameters revealed a significant decrease in the longitudinal and circumferential strain components. The LV global longitudinal strain (GLS) values were lower in both groups of operated patients than controls (-19.9 ± 2.2% (group 1) versus -20.9 ± 1.6% (group 2) versus -22.9 ± 2.3% (group 3), p&lt;0.001). The patients with coronary reimplantation had the lowest values. The LV global circumferential strain was also decreased in the group 1 patients as compared with the 2 other groups (-16.6 ± 4.1% (group 1) versus -19.4 ± 3.9% (group 2) versus -19.8 ± 4.0% (group 3), p&lt;0.001).</p> <p><strong>Conclusion:&nbsp;</strong>although global LV function, assessed with conventional echocardiographic parameters, was normal, the 2D-STI analysis showed slight but significant decrease in the global and segmental longitudinal and circumferential LV strain during the long-term follow-up after coronary arteries reimplantation.</p> 2021-01-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221684 A unique association of bifacial weakness, paresthesia and vestibulocochlear neuritis as post-COVID-19 manifestation in pregnant women: a case report 2022-02-18T09:16:59+00:00 Jehanne Aasfara j.aasfara@gmail.com Amal Hajjij j.aasfara@gmail.com Hatim Bensouda j.aasfara@gmail.com Hamid Ouhabi j.aasfara@gmail.com Fouad Benariba j.aasfara@gmail.com <p>SARS-CoV-2 is an infection due to a novel virus belonging to the coronavirus family. Since December 2019, first human cases of COVID-19 have been identified in Wuhan (China) and rapidly has been progressed to a global pandemic declared by the world health organization (WHO) on March 11<sup>th</sup>&nbsp;2020. The major complication of COVID-19, is pneumonia, but other presentations like cardiovascular and neurological complications have been reported. Herein, we report a first case of pregnant women presented with bifacial weakness and paraesthesia (BFP) associated to a vestibulocochlear neuritis as post-COVID-19 manifestation. This is a 36-year-old Moroccan female patient with a history of SARS-CoV-2 positive 6 weeks before admission. She presented to the emergency department with rapid bifacial paralysis, bilateral lower extremity paresthesia, vertigo, nausea, vomiting and right auricular pain. An acute stroke was ruled out after neurological examination and brain MRI. Clinical presentation, neurophysiological, audiometry and videonystagmography workup additionally to CSF findings were suggestive of a variant of Guillain Barré Syndrome (GBS), which is BFP associated to right vestibulocochlear neuritis. The patient was treated with Intravenous immunoglobulins (IVIG) therapy associated with intravenous steroids. The patient made a complete recovery of the right facial palsy and the sensorineural hearing loss but still have tingling in lower limbs and left facial palsy at 2 weeks´ follow-up. BFP can be induced by COVID-19 as a postinfectious immune-mediated complication. Regarding the pathophysiology of vestibular neuritis, is probably similar to other viral infection causing nerve damage. Clinicians should consider the association of vestibulocochlear neuritis and BFP as a post SARS-CoV-2 manifestation.</p> 2021-01-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221686 Prévalence de la fibrillation atriale non valvulaire et de l´accident vasculaire cérébral ischémique et facteurs associés à la fibrillation atriale non valvulaire chez les patients hypertendus: étude observationnelle à propos de 2887 patients 2022-02-18T09:44:49+00:00 Amine Bahloul amin.bahloul.cardiologie@gmail.com Nadia Bouattour amin.bahloul.cardiologie@gmail.com Faten Triki amin.bahloul.cardiologie@gmail.com Rania Hammami amin.bahloul.cardiologie@gmail.com Selma Charfeddine amin.bahloul.cardiologie@gmail.com Tarek Ellouze amin.bahloul.cardiologie@gmail.com Chokri Mhiri amin.bahloul.cardiologie@gmail.com Leila Abid amin.bahloul.cardiologie@gmail.com Samir Kammoun amin.bahloul.cardiologie@gmail.com <p><strong>Introduction:&nbsp;</strong>l´hypertension artérielle (HTA), la fibrillation auriculaire (FA) et l´accident vasculaire cérébral (AVC) sont trois problèmes de santé publique. A travers cette étude nous avons cherché à déterminer la prévalence de la FA et de l´AVC ischémique chez les patients hypertendus et déterminer les facteurs associés à la survenue de la FA non valvulaire chez ces patients.</p> <p><strong>Méthodes:&nbsp;</strong>nous avons utilisé les données recueillies dans le service de cardiologie de l´hôpital universitaire de Sfax dans le cadre du registre national tunisien d´HTA. Nous avons étudié les associations entre les différentes variables sociodémographiques, cliniques, paracliniques et thérapeutiques et la FA chez les hypertendus en utilisant des modèles de régression logistique.</p> <p><strong>Résultats:&nbsp;</strong>notre échantillon comprenait 2887 patients avec un sexe ratio à 0,95. L´âge moyen était de 65 ans (±11). La FA était notée chez 230 patients (8%), alors que l´AVC ischémique chez 152 patients (5,3%). Au décours de l´analyse multivariée, les facteurs indépendants associés à une augmentation de la prévalence de la FA étaient: l´âge avancé (p=0,001, Odds Ratio(OR) = 1,647, Intervalle de confiance (IC) à 95%: 1,1227-2,213), la présence d´une hypertrophie ventriculaire gauche (HVG) à l´échographie cardiaque(p = 0,004, OR = 2,140, IC95%: 1,281-3,576), et la fraction d´éjection du ventricule gauche (FEVG) &lt; 50% (p &lt; 0,001, OR = 4,677, IC95%: 2,715-8,057).</p> <p><strong>Conclusion:&nbsp;</strong>nous avons confirmé qu´il existe une relation directe et indépendante entre l´HTA, l´âge avancé, l´HVG et la FA. L´installation d´une FA au cours de l´HTA constitue un tournant évolutif de la maladie par majoration du risque d´AVC ischémique. Un contrôle optimal de la pression artérielle tensionnelle être hautement prioritaire chez les hypertendus, en particulier âgés, afin de prévenir le risque de la FA et de l´AVC.</p> 2021-01-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221690 Dietary pattern and nutritional status of female adolescents in Amai Secondary School, Delta State, Nigeria 2022-02-18T10:11:28+00:00 Otovwe Agofure agofureotovwe@yahoo.com Stella Odjimogho agofureotovwe@yahoo.com Oghenenioborue Okandeji-Barry agofureotovwe@yahoo.com Votapwa Moses agofureotovwe@yahoo.com <p><strong>Introduction:&nbsp;</strong>there is an existing variability in eating patterns between adolescents and children. Consequently, with the adoption of westernised way of life, this translates to a change in eating habits and food choices. This study was designed to investigate the dietary patterns and nutritional status of the female adolescents in Amai Secondary Commercial School, Delta State, Nigeria.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional study was conducted among 201 adolescent female students (12-18 years) using simple random sampling techniques. A self-administered questionnaire was used to obtain the information while anthropometric measurement was carried out to obtain the height and weight of the respondents. Data generated were analysed using SPSS version 22.0.</p> <p><strong>Results:&nbsp;</strong>majority of the respondents 129 (64.20%) were between the ages of 16-18 years. Measurement of nutritional status confirmed that 46.80% and 31.80% of the respondents were underweight and healthy weight respectively. In addition, the dietary pattern of the respondents demonstrated that they consumed proteinous, carbohydrate, and snacks occasionally. Factors that motivated respondents for good food choices include; nutritional status 71 (35.30%), taste 54 (26.90%), and popularity 15 (7.50%).</p> <p><strong>Conclusion:&nbsp;</strong>under nutrition remains a challenge among rural adolescent girls in Amai community. Therefore sustained strategic nutritional campaigns should be carried out among female adolescents in Amai community in order to improve their nutritional status.</p> 2021-01-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221692 The impact of the COVID-19 pandemic on the continuity of transfusion care for thallasemic patients: a case report 2022-02-18T10:21:23+00:00 Sabah Bouhou sabahbouhou@hotmail.com Mohammed Benajiba sabahbouhou@hotmail.com Azlarab Masrar sabahbouhou@hotmail.com <p>The COVID-19 pandemic could have a major impact on the capacity of health systems to continue the delivery of essential health service. While health systems around the world are being challenged by increasing demand for care of COVID-19 patients, it is critical to maintain preventive and curative services, especially for the most vulnerable populations such people living with chronic conditions like thallasemics. In this context and since the start of the SARS-CoV-2 health crisis, the National Blood Transfusion Center of Morocco has ranked among its priorities the need to maintain transfusion management for chronic polytransfused patients, particularly those with thalassemia. We report in this paper, the case of a thallasemic patient whose transfusion management was disrupted by the restrictive measures introduced by the Moroccan authorities and for which the National Blood Center of Morocco provided effective support.</p> 2021-01-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221695 SARS-CoV-2, recurrent ischemic strokes and carotid macrothrombosis: the other face of the cytokine storm (a case report) 2022-02-18T10:45:42+00:00 Jehanne Aasfara j.aasfara@gmail.com Said Jidane j.aasfara@gmail.com Aziza Laarje j.aasfara@gmail.com Khalid El Yamani j.aasfara@gmail.com Lahcen Belyamani j.aasfara@gmail.com Youssef Tijani j.aasfara@gmail.com <p>Since December 2019, the world has experienced the emergence in China of a new infection called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This infection quickly has progressed to a global pandemic since March 2020, with very high human-to-human transmission rate. Besides lung injury, COVID-19 is also associated with cardio and neurovascular complications. Herein, we report the case of a 77-year-old female who presented with non-severe COVID-19 and multiple ischemic strokes secondary to an extensive carotid thrombosis. The ischemic stroke was supposed to have been caused by the cytokine storm related to COVID-19. The possibility of hemorrhagic transformation, based on the assessment of bleeding score, limited the use of anticoagulation, and probably explained the stroke recurrence and poor outcome in our patient. The pathogenic mechanism and the management of this complex situation are still lacking and further studies are needed.</p> 2021-01-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221697 Assessing baseline knowledge and practices of injection safety among primary health care workers in Cross River State, Nigeria: a cross-sectional urban-rural comparative study 2022-02-18T11:08:19+00:00 Obaji Etaba Akpet ekobadec2201@yahoo.com Nnette Okon Ekpenyong ekobadec2201@yahoo.com Nkese Effiong Mkpanam ekobadec2201@yahoo.com Soter Ameh ekobadec2201@yahoo.com Angela Ekanem Oyo-Ita ekobadec2201@yahoo.com Chikaike Ogbonna ekobadec2201@yahoo.com Bassey Maundy Ikpeme ekobadec2201@yahoo.com <p><strong>Introduction:&nbsp;</strong>unsafe injection practices are commonplace in low-income countries, and place health care workers at risk of blood-borne infections. A safe injection strategy requires a synchronized approach to deal with change in behavior of users and service providers towards safer practice. There is general lack of data on injection safety practices in Cross River State. This was a baseline study to compare the knowledge and practice of safe injection practices among primary health care (PHC) workers in urban and rural health facilities in Cross River State, Nigeria.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional comparative study among PHC workers in randomly selected rural and urban Local Government Areas (LGAs). Using multistage sampling technique, a total of 320 respondents: 160 from the urban LGAs and 160 from the rural LGAs were interviewed. Semi-structured interviewer administered questionnaires were used to obtain data. Data analysis was done using STATATM version 14.0. Associations were tested using Chi square, and multivariate logistic regression analysis.</p> <p><strong>Results:&nbsp;</strong>in this study, there was no difference in the baseline knowledge (58.8% vs. 55.0%, P=0.499) and practice (33.1% vs. 34.4%, P=0.813) of injection safety between PHC workers in the urban and rural locations. In the multivariate logistic regression model, the senior health workers had a two-fold increased odds of practicing safe injection compared to their junior counterparts [OR=2.21 (95% CI: 1.28,3.84)].</p> <p><strong>Conclusion:&nbsp;</strong>in both the urban and rural locations, there was good knowledge but poor practice of injection safety among respondents in the LGAs; hence, the need to organize periodic injection safety training and retraining of PHC workers targeting junior workers to improve on the practices of injection safety.</p> 2021-01-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221700 Retroperitoneal dermoid cyst in a young boy 2022-02-18T11:16:15+00:00 Saket Kumar krsaketsingh@gmail.com Venkat Rao Chidipotu krsaketsingh@gmail.com <p>A 12-year-old boy presented with history of pain in the right flank for last the 6 months. He had no associated urinary or bowel complains. Abdominal palpation revealed a non-tender lump was felt in the right lumbar region. Lump was firm with a well-defined margin and was not moving with the respiration. The blood investigations were within normal limits. An abdominal CT scan was obtained that showed a well-defined, heterogeneous mass in right suprarenal region measuring 11.5 x 11 cm. The lesion contained fat and soft tissue attenuation along with areas of calcification. The right kidney was displaced inferiorly and the right adrenal gland was not seen separately from the lesion. Based on the physical examination and radiological findings a provisional diagnosis of retroperitoneal dermiod cyst was made. Surgical resection of the retroperitoneal dermoid cyst was performed. The lesion was placed between the right hepatic lobe and the right kidney; however, the right adrenal gland could not be defined during the operation. The tumor was composed of mature tissues such as hair, bones, and teeth along with turbid yellowish fluid and pultaceous material. Histopathology was consistent with the diagnosis of a mature cystic teratoma without malignant components. Patient recovered uneventfully and was discharged on post-operative day 5.</p> 2021-01-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/221711 Spontaneous pneumomediastinum and subcutaneous emphysema in a non-intubated COVID-19 patient: a case report 2022-02-18T14:57:38+00:00 Tahir Ahmed Jatoi anosh.9412@gmail.com Anosh Aslam Khan anosh.9412@gmail.com Osama Mohiuddin anosh.9412@gmail.com Muhammad Saad Choudhry anosh.9412@gmail.com Farah Yasmin anosh.9412@gmail.com Sumeen Jalees anosh.9412@gmail.com <p>The development of spontaneous pneumomediastinum and subcutaneous emphysema are few of the rare clinical manifestations observed in coronavirus disease-19 (COVID-19) patients which are yet to be fully understood. Most cases of spontaneous pneumomediastinum arise due to factors causing high intra-alveolar pressure. Herein, we report a case of a COVID-19 positive elderly male, who presented with spontaneous pneumomediastinum and subcutaneous emphysema unrelated to high-pressure ventilatory measures, detected on chest computed tomography (CT). Despite acute medical care, the patient progressed towards a more serious clinical course. Male gender and diffuse alveolar damage caused by COVID-19 seems to be the most relevant association in this case. However, we have enlightened other possible pathological mechanisms and their association with severity index of COVID-19.</p> 2021-01-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/222542 Perception of tooth colour and appearance among patients seen in a tertiary hospital, South-West, Nigeria 2022-03-08T05:45:31+00:00 Deborah Mojirade Ajayi md_ajayi@yahoo.com Shakeerah Olaide Gbadebo md_ajayi@yahoo.com Gbenga Emmanuel Adebayo md_ajayi@yahoo.com <p><strong>Introduction:&nbsp;</strong>patients´ satisfaction with their dental appearance and tooth colour is often influenced by certain factors which need to be addressed periodically among different populations.</p> <p><strong>Methods:&nbsp;</strong>a self-administered questionnaire consisting of sociodemographic data, questions on patients´ satisfaction with tooth colour, perceived malalignment of teeth, non-aesthetic anterior tooth-coloured restoration and presence of tooth fracture were distributed. Data collected was analysed using Statistical Package for Social Sciences (IBM, SPSS version 20). Chi square was used to test the statistical differences at a significance of p&gt; 0.05.</p> <p><strong>Results:&nbsp;</strong>a total of 410 patients (M=147, F=263) participated in the study. About 73% had tertiary education while 36.3% were within the modified ISCO-08 Group 2. The respondents that were satisfied with the general dental appearance and tooth shade were 66.3% and 63.5% respectively. More males (65.1%) than females (62.7%) were satisfied with tooth colour while more females (69.1%) were satisfied with dental appearance. The older age group were more satisfied with dental appearance and tooth colour. Awareness of tooth whitening (Over 80%) and the desire to undergo tooth whitening was more among the post-secondary individuals. More of dental patients (73.1%) than medical (59.2%) were satisfied with teeth appearance (p=0.003).</p> <p><strong>Conclusion:&nbsp;</strong>patients are increasingly aware of their dental appearance/tooth colour and the need to improve it with tooth bleaching and/or orthodontic treatment. Female were more dissatisfied with their tooth colour but more satisfied with their dental appearance than the male. Older people were more satisfied with their dental appearance and tooth colour compared to younger age group.</p> 2021-01-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/222544 Zoonotic and reverse zoonotic transmission of severe acute respiratory syndrome coronavirus 2: a review and implications for Africa 2022-03-08T06:07:17+00:00 AbdulAzeez Adeyemi Anjorin odetokun.ia@unilorin.edu.ng Oluwaseyi Sedowhe Ashaka odetokun.ia@unilorin.edu.ng Sodiq Olawale Tijani odetokun.ia@unilorin.edu.ng John Oluwayomi Openibo odetokun.ia@unilorin.edu.ng Ismail Ayoade Odetokun odetokun.ia@unilorin.edu.ng <p>There is an urgent need to properly understand the transmission dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the event of continuous rise in morbidity in both humans and animals as well as an increase in the mortality rate in man. Since the novel SARS-CoV-2 emerged in Wuhan, China with its global spread in over 200 countries, several studies have been published on the epidemiology of the virus in man with limited information on the roles of animals and the possibility of reverse zoonosis. We therefore collected published research literature on COVID-19 from public search engines for information on SARS-CoV-2 in animals and reverse zoonosis from man. A critical and thorough study appraisal/evaluation was performed to include recent quality publications that focus on the scope of this write-up including zoonosis and reverse zoonosis of SARS-CoV-2. We highlighted what is known about SARS-CoV-2 in animals, identify gaps for future research, summarized possible reverse zoonotic transmission of SARS-CoV-2 from man to animals and included the likely implications of our summary for Africa, despite the dearth of information in Africa on the key concepts of this study.</p> 2021-01-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/223495 Characterization of high risk human papilloma virus genotypes associated with oropharyngeal cancers in a Nigerian population 2022-03-31T05:25:26+00:00 Benjamin Idemudia Akhiwu bakhiwu@yahoo.com Helen Oluwadamilola Akhiwu bakhiwu@yahoo.com Tolulope Afolaranmi bakhiwu@yahoo.com Nyam Chuwang bakhiwu@yahoo.com Ambrose Elugbe bakhiwu@yahoo.com Acheng Shedrach bakhiwu@yahoo.com Pam Luka bakhiwu@yahoo.com Patricia Odumosu bakhiwu@yahoo.com Patrick Oladele Olorunfemi bakhiwu@yahoo.com Samuel Agida Adoga bakhiwu@yahoo.com Olugbenga Silas bakhiwu@yahoo.com Benjamin Tagbo Ugwu bakhiwu@yahoo.com Akinola Ladeinde bakhiwu@yahoo.com Godwin Eremwan Imade bakhiwu@yahoo.com Atiene Solomon Sagay bakhiwu@yahoo.com <p><strong>Introduction:&nbsp;</strong>head and neck cancers have essentially been a disease of the elderly but recent studies are beginning to demonstrate their increasing incidence in young people with infections such as human papilloma virus (HPV). This study was carried out to determine the prevalence of high risk Human papilloma virus (hrHPV) related oropharyngeal carcinoma and its prevalent genotypes as well as their strength of association with HIV in adult Nigerian subjects.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional study of 41 patients with oropharyngeal carcinomas seen over a 2-year period. Patients had incisional and/or excisional biopsy done under anesthesia. A portion of the specimen from which the DNA was extracted was placed in Digene HC2 DNA collection device while the 2<sup>nd</sup>&nbsp;portion for histopathological analysis was fixed using 10% Neutral Buffered Formalin (NBF) and embedded in paraffin blocks. Oropharyngeal cancer HPV genotyping was done using HPV genotypes 14 real-tm quant kit (SACACE, Italy). The data was analyzed using SPSS version 23.</p> <p><strong>Results:&nbsp;</strong>prevalence of HPV was 17.1% with a male to female ratio of 2.7:1. The identified genotypes were 16, 33, 35 and 52 with 28.6% of patients having more than one genotype. Most of the age groups studied were affected. Squamous cell carcinoma and ameloblastic carcinoma were the cancers associated with HPV. HPV was not identified in the HIV positive patients.</p> <p><strong>Conclusion:&nbsp;</strong>high-risk human papilloma virus genotypes 16, 33, 35 and 52 are associated with oropharyngeal carcinoma in Nigeria but were not found in HIV patients. This finding provides a strong evidence for the use of the 9-valent prophylactic vaccine for the prevention of oropharyngeal cancer in Nigeria. Public awareness and HPV prevention strategies should reduce significantly the incidence of oropharyngeal carcinomas in our environment.</p> 2021-01-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/223503 Drépanocytose en République Démocratique du Congo: quels sont les obstacles à un traitement par hydroxyurée? 2022-03-31T06:59:13+00:00 Benoît Mbiya Mukinayi benoit.mbiya@um.ac.cd Guelord Kalombo Cibeyibeyi benoit.mbiya@um.ac.cd Ghislain Disashi Tumba benoit.mbiya@um.ac.cd Béatrice Gulbis benoit.mbiya@um.ac.cd <p><strong>Introduction:&nbsp;</strong>l´hydroxyurée est le seul produit dont l´efficacité a été prouvée pour prévenir les complications de la drépanocytose et approuvé par la «&nbsp;<em>Food and Drug Administration</em>&nbsp;». Pour pouvoir offrir ce traitement aux patients atteints de drépanocytose, il doit être prescrit, disponible et à un prix abordable. L´objectif de cette étude est de déterminer la disponibilité et le coût de l´hydroxyurée sur le marché en République Démocratique du Congo (RDC) et comparer les deux aspects entre une ville reculée, à savoir Mbujimayi, et une grande ville, à savoir, Lubumbashi.</p> <p><strong>Méthodes:&nbsp;</strong>il s´agit d´une étude transversale réalisée dans le cadre d´une enquête face-à-face menée du 1<sup>er</sup>&nbsp;avril au 1<sup>er</sup>&nbsp;septembre 2017 auprès de 188 pharmacies congolaises.</p> <p><strong>Résultats:&nbsp;</strong>hydroxyurée était disponible dans 41/188 (22%) pharmacies participantes, mais plus fréquemment dans celles d´une grande ville que dans celles d´une ville reculée (34/96 contre 7/92). La plupart des patients ont reçu une ordonnance médicale (36/41; 88%). Le prix moyen de l´hydroxyurée était de 15 $ (10 $ à 35 $) pour une boîte de 25 gélules; ce prix est supérieur au pouvoir d´achat de la majorité des patients drépanocytaires. L´hydroxyurée reste encore un produit importé de l´Europe, des États-Unis ou d´Asie.</p> <p><strong>Conclusion:&nbsp;</strong>l´hydroxyurée est l´un des principaux traitements permettant d´améliorer l´évolution de la maladie chez les patients drépanocytaires. Néanmoins, en République Démocratique du Congo, sa disponibilité pourrait être améliorée, en particulier dans une ville reculée, et son prix reste trop élevé pour être payé par la population locale.</p> 2021-01-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/223505 Empoisonnement criminel au Maroc: données du Centre Antipoison et de Pharmacovigilance du Maroc, 1980-2014 2022-05-18T03:32:55+00:00 Sara Boukhorb sara.boukhorb@uit.ac.ma Naima Rhalem sara.boukhorb@uit.ac.ma Soumaia Hmimou sara.boukhorb@uit.ac.ma Abdelmajid Soulaymani sara.boukhorb@uit.ac.ma Abdelrhani Mokhtari sara.boukhorb@uit.ac.ma Rachida Soulaymani-Bencheikh sara.boukhorb@uit.ac.ma Rachid Hmimou sara.boukhorb@uit.ac.ma Hinde Hami sara.boukhorb@uit.ac.ma <p><strong>Introduction:&nbsp;</strong>les intoxications intentionnelles constituent un problème majeur de santé publique, aussi bien dans les pays développés que dans les pays en développement. L´objectif de la présente étude est de décrire le profil épidémiologique des intoxications criminelles au Maroc.</p> <p><strong>Méthodes:&nbsp;</strong>il s'agit d'une étude rétrospective de tous les cas d'intoxications criminelles recensés par le Centre Antipoison et de Pharmacovigilance du Maroc (CAPM) entre 1980 et 2014.</p> <p><strong>Résultats:&nbsp;</strong>durant la période d'étude, 611 cas d'empoisonnements criminels ont été enregistrés, soit 2,1% de l'ensemble des intoxications intentionnelles déclarées durant la même période. L'âge moyen des intoxiqués était de 26,4±14,3 ans. Plus d'un quart des cas étaient des enfants de moins de 15 ans (28,6%). D'après les résultats de l'étude, 55,9% étaient de sexe masculin, avec un sex-ratio (M/F) de 1,3. La majorité des cas, soit 89,4% étaient survenus en milieu urbain. Les intoxications ont été collectives dans 24,4% des cas. Les produits les plus fréquemment utilisés étaient les pesticides (19,1%) et les plantes (19%). Les signes présentés étaient variables suivant le ou les toxiques en cause, la quantité ingérée et le délai écoulé avant le traitement. Toute une gamme de troubles digestifs, neurologiques, respiratoires et cardio-vasculaires a été retrouvée. Parmi les 440 cas pour lesquels on disposait de données sur l´évolution, 27 sont décédés. Les autres cas ont survécu avec ou sans séquelles.</p> <p><strong>Conclusion:&nbsp;</strong>l'empoisonnement criminel reste un problème non négligeable. Le nombre de cas est probablement sous-estimé du fait du nombre important de cas non diagnostiqués ou non déclarés.</p> 2021-01-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225325 Human papillomavirus, gene mutation and estrogen and progesterone receptors in breast cancer: a cross-sectional study 2022-05-18T04:05:10+00:00 Abdallah Mohammed Elagali histotata@yahoo.com Ahmed Abdelbadie Suliman histotata@yahoo.com Mohammed Altayeb histotata@yahoo.com Anas Ibrahim Dannoun histotata@yahoo.com Narasimha Reddy Parine histotata@yahoo.com Hader Ibrahim Sakr histotata@yahoo.com Howayda Saeed Suliman histotata@yahoo.com Moustafa Elsaeid Motawee histotata@yahoo.com <p><strong>Introduction:&nbsp;</strong>recent studies show a good relationship between breast cancer (BC) and human papillomaviruses (HPV) wich is responsible for about 18% of BC cases. This study aimed to assess the relationship between different genotypes of HPV and the expression of P53 and retinoblastoma (RB) genes and estrogen and progesterone receptors in BC among Sudanese women.</p> <p><strong>Methods:&nbsp;</strong>one hundred and fifty tissue blocks were obtained from females diagnosed with BC. Positive samples were used to determine genotypes with an applied biosystem (ABI 3730XL) genetic analyzer for sequencing and immunohistochemistry.</p> <p><strong>Results:&nbsp;</strong>13/150 samples showed HPV DNA. High-risk HPV-16 was detected in 5 cases, high-risk-HPV-58 was found in four cases, and HPV-18 was detected in three cases. Low-risk-HPV-11 was detected in a single invasive lobular carcinoma (ILC) case. P53 and RB gene mutations were detected in 35 and 30 BC cases, respectively. P53 gene mutation was frequently identified in grade (III) BC while RB gene mutation was positive in grade (II). Grade (II) BC had a higher incidence of HPV-16 and 58. On the other hand, HPV-18 had a higher incidence in grade (III). Estrogen and progesterone receptors were expressed in 94 and 79 HPV cases among the study group, respectively.</p> <p><strong>Conclusion:&nbsp;</strong>this study elucidates the associations between HPV genotypes and BC. A statistically significant association was observed among p53 and RB gene mutations and different BC histological types. On the other hand, there was a statistically insignificant association between HPV genotyping and different BC gradings, BC histological types, P53 and RB genes mutations, and estrogen and progesterone receptor expression. Also, there was a statistically insignificant association among estrogen and progesterone receptors expression and BC grading. RB gene mutation was significantly associated with different BC grades. On the other hand, there was a statistically insignificant association between progesterone receptor expression and BC.</p> 2021-01-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225324 Knowledge, attitudes and perception of communities on mosquitoes and its control practices in Lagos State, Nigeria 2022-05-18T03:45:40+00:00 Ifeoluwa Kayode Fagbohun fagbohunife@gmail.com Emmanuel Taiwo Idowu fagbohunife@gmail.com Ayooluwa Olumide Onafuwa fagbohunife@gmail.com Adeniyi Kazeem Adeneye fagbohunife@gmail.com Adedapo Olufemi Adeogun fagbohunife@gmail.com Otubanjo Olubunmi Adetoro fagbohunife@gmail.com <p><strong>Introduction:&nbsp;</strong>evidence-based mosquito control strategy is important for efficient and effective delivery of mosquito control interventions. This is hinged on effective community participation and thorough understanding of the Knowledge Attitude and Practices (KAPs) to achieve desired result. Such community dynamics are often understudied. We designed this study to assess the perception of four local communities on aspects of mosquito behavior, prevention and control in Lagos State, Nigeria.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional survey was carried out using pretested semi-structured questionnaires to assess socio-demographic factors and KAPs in Kosofe, Alimosho, Ibeju-Lekki and Badagry Local Government Areas of Lagos State, Nigeria. Data analysis was carried out using IBM SPSS version 23.</p> <p><strong>Results:&nbsp;</strong>a total of 746 questionnaires were analyzed. Socio-demographic profile of the sampled population reveals that majority of the study population (73.1%) was between 18 and 40 years which constitute 49% males and 51% females. The knowledge of mosquito as a disease vector was high among the respondents which correlates with their level of education (P&lt;0.05). The use of insecticide aerosols and Insecticides Treated Nets (ITNs) are the main control measures employed for mosquito control by respondents. Cost, convenience of usage and awareness majorly influenced the type of control measures that respondents adopt. Reasons such as not being easy to setup, skin irritation and the filling of being caged are reasons why some individuals do not use ITNs. Indoors, 32.4% of the respondents indicate the use of dichlorvos (DDVP) for household control of mosquitoes.</p> <p><strong>Conclusion:&nbsp;</strong>the knowledge of mosquito control is high among middle aged individuals in Lagos State. Insecticide aerosols and ITNs are two major mosquito control methods used with DDVP insecticides frequently used indoors. This can inform the design of appropriate control methods in Lagos State.</p> 2021-01-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225326 Left ventricular myocardial function in hemodialysis patients: the effects of preload decrease in conventional, Doppler and speckle tracking echocardiography parameters 2022-05-18T04:26:47+00:00 Salma Charfeddine selma_charfeddine@yahoo.fr Leila Abid selma_charfeddine@yahoo.fr Rania Hammami selma_charfeddine@yahoo.fr Amine Bahloul selma_charfeddine@yahoo.fr Faten Triki selma_charfeddine@yahoo.fr Samir Kammoun selma_charfeddine@yahoo.fr <p><strong>Introduction:&nbsp;</strong>our aim was to investigate the value of conventional echocardiography, pulsed Doppler and speckle tracking imaging (STI) analysis in the assessment of the left ventricular (LV) myocardial function in hemodialysis (HD) patients with preserved LV ejection fraction and to evaluate the effect of a single HD session on the LV systolic and diastolic functions.</p> <p><strong>Methods:&nbsp;</strong>the study population consisted of 30 chronic HD patients. Echocardiography and Doppler studies were performed before and after HD. The LV global longitudinal, circumferential and radial strains were measured with two and three-dimensional STI.</p> <p><strong>Results:&nbsp;</strong>after HD, LV dimensions, left atrium (LA) area, systolic pulmonary arterial pressure and inferior vena cava diameter decreased significantly. The peak mitral E velocity, the E/A ratio of the mitral inflow and the lateral E/E´ ratio decreased also significantly. The LV and LA volumes index and LV mass index (LVMi) decreased remarkably after HD. The 3D- LV and LA ejection fractions were unchanged after HD. Although, 3D-estimated LVEF seemed to be preserved in the HD patients, the 2D and 3D- strain rates were decreased in all directions. The global strain values improved in all directions after a single HD session. Inverse correlations were found between the LVMi, serum BNP and LV global longitudinal strain.</p> <p><strong>Conclusion:&nbsp;</strong>in HD patients with preserved LV ejection fraction, the STI analysis may add important information concerning the subclinical LV dysfunction.</p> 2021-01-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225327 Prévalence de l´infertilité masculine dans un hôpital universitaire au Maroc 2022-05-18T04:44:54+00:00 Mohammed Frikh frikmed@yahoo.fr Mostafa Benaissa frikmed@yahoo.fr Jalal Kasouati frikmed@yahoo.fr Yassine Benlahlou frikmed@yahoo.fr Omar Chokairi frikmed@yahoo.fr Malika Barkiyou frikmed@yahoo.fr Meryama Chadli frikmed@yahoo.fr Adil Maleb frikmed@yahoo.fr Mostafa Elouennass frikmed@yahoo.fr <p><strong>Introduction:&nbsp;</strong>l´infertilité du couple est devenue ces dernières années un problème de santé publique, dont l´origine peut être féminine, masculine ou mixte. L´origine masculine est incriminée dans 40% des cas. Au Maroc, la plupart des publications ont été axées sur les étiologies et les facteurs de risque de l´infertilité masculine. L´objectif de notre étude est l´évaluation de la prévalence de l´infertilité masculine et le profil des paramètres spermatiques chez les hommes infertiles ou à risque d´infertilité au sein d´un hôpital tertiaire à Rabat.</p> <p><strong>Méthodes:&nbsp;</strong>analyse de 482 patients adressés pour bilan d´infertilité du couple ou dans le cadre du bilan préopératoire d´une varicocèle ou d´une ectopie testiculaire. Les données démographiques, les facteurs de risque d´infertilité, le caractère primaire ou secondaire de l´infertilité ont été enregistrées pour chaque patient. Les paramètres spermatiques ont été étudiés et interprétés selon les normes actualisées de l´OMS en 2010 avec études des facteurs associés à leur perturbation.</p> <p><strong>Résultats:&nbsp;</strong>l´âge moyen des patients était de 35,35±8,81 ans. L´infertilité était primaire dans 61,8%. Les facteurs de risque d´infertilité les plus fréquemment retrouvés sont le tabac suivi par la varicocèle et l´infection. Le spermogramme était perturbé dans 53,1%. L´anomalie la plus fréquente était la perturbation de la vitalité (36,9%) suivie par la concentration spermatique (29,7%) et la morphologie (29,3%). L´âge était le seul facteur ayant un impact significatif sur le spermogramme (p=0,002). Les anomalies de la mobilité se voient à partir de 31 ans, la vitalité est perturbée à 34 ans, la morphologie à 35 ans et la concentration à 37 ans. L´azoospermie a été retrouvée dans 16,4% essentiellement associée à l´infertilité primaire. L´oligo-asthéno-tératospermie était l´association la plus représentée (26,2%).</p> <p><strong>Conclusion:&nbsp;</strong>l´infertilité masculine est fréquente dans notre contexte, l´âge étant son principal facteur de risque. La mobilité est le paramètre le plus précocement atteint.</p> 2021-01-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225328 Perineal endometriosis: a rare case of a unique sizeable nodule 2022-05-18T04:57:32+00:00 Hana Hakim hakimhana1@gmail.com Sawssan Ben Halima hakimhana1@gmail.com Ahmed Zouari hakimhana1@gmail.com Dora Trabelsi hakimhana1@gmail.com Mohamed Derbel hakimhana1@gmail.com Kais Chaabane hakimhana1@gmail.com Sahbi Kebaili hakimhana1@gmail.com <p>Endometriosis is the presence of endometrial tissue in abnormal locations outside the uterine cavity. These locations are usually the ovaries, the peritoneum, and the uterine ligaments. Less frequently, the endometrial tissue can affect the perineum especially after surgical procedures or obstetric lesions. In this case report, we describe the case of a patient suffering from pain and swelling, with a sizeable nodule in an old episiotomy scar. Clinical examination, ultrasonography (USG) and magnetic resonance imaging (MRI) helped evoke the diagnosis of perineal endometriosis, and there were no signs of other endometriosis locations. Hormonal treatment was provided at first, but there was no clinical improvement after three months, so the treatment had to be surgical. Histopathological examination of the endometriotic mass confirmed the diagnosis. There were no immediate postoperative complications, and no clinical symptoms or recurrence signs six months and one year after.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225329 Stercoral perforation of the colon: a mortal consequence of chronic constipation in the elderly (a case report) 2022-05-18T05:13:19+00:00 Bouali Mounir lafkih27@gmail.com Lafkih Oussama lafkih27@gmail.com Abbad El Andaloussi Zineb lafkih27@gmail.com El Bakouri Abdelilah lafkih27@gmail.com El Hattabi Khalid lafkih27@gmail.com Bensardi Fatima-Zahra lafkih27@gmail.com Fadil Abdelaaziz lafkih27@gmail.com <p>The stercoral perforation is a mortal condition. It affects elderly patients who have a long history of chronic and severe constipation as well as constitutes a surgical emergency whose prognosis, often grim, depends on the early diagnosis and treatment. We report the case of a stercoral colon perforation which occurred in an 89-year-old patient. The clinical symptomatology was that of an acute peritonitis evolving for four days. The diagnosis was only made intraoperatively and the surgical gesture was a resection of the involved left colon segment and Bouilly Volkmann colostomy. The consequences were unfortunately marked by a resistant septic shock resulting in the death of the patient on the 1<sup>st</sup>&nbsp;postoperative day. The diagnosis of stercoral colon perforation, which is often difficult and delayed, must be known by all physicians who manage an increasingly older patient population.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225331 L´hypothèse génétique de la maladie de Haglund, et son association avec la spondyloarthrite ankylosante: à propos d´un cas 2023-02-23T11:22:01+00:00 Hicham Douma hicham.douma@edu.uca.ac.ma Abdelkrim El Hassani hicham.douma@edu.uca.ac.ma Faycal Rifki hicham.douma@edu.uca.ac.ma Ouahb Azriouil hicham.douma@edu.uca.ac.ma Basma Dihi hicham.douma@edu.uca.ac.ma Houda El Madkouri hicham.douma@edu.uca.ac.ma Laila Liqali hicham.douma@edu.uca.ac.ma Khalid Koulali Idrissi hicham.douma@edu.uca.ac.ma <p>La maladie de Haglund est une pathologie caractérisée par une excroissance osseuse postéro-supérieure du calcanéum, induisant un conflit avec le tendon d´Achille, et se manifestant principalement par une talalgie postérieure. Nous rapportons l´observation d´une jeune femme de 28 ans suivie pour spondylarthrite ankylosante, avec une maman suivie pour la même maladie systémique, et une tante maternelle opérée pour maladie de Haglund. La patiente a trop trainée pour avoir le diagnostic vu que la talalgie a été considérée comme enthésite de sa maladie de système. La patiente ne s´est pas améliorée sous traitement médical. La chirurgie nous a donné des résultats satisfaisants. Ce qui soulève les hypothèses du caractère génétique et héréditaire du syndrome de Haglund, et sa relation avec la réponse au traitement médical.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225333 A review of computed tomography patterns of metastatic breast cancer patients undergoing treatment at a private oncology centre in Ghana 2022-05-18T06:31:20+00:00 Yaw Boateng Mensah ybmensah@yahoo.com Clement Edusa ybmensah@yahoo.com Josephine Nsaful ybmensah@yahoo.com Naa Adjeley Mensah ybmensah@yahoo.com <p><strong>Introduction:&nbsp;</strong>breast cancer is the commonest malignant disease in Ghanaian women and accounts for 17% of cancer-related deaths in the country. It has been classified into molecular subtypes depending on the presence or absence of hormone receptors and the human epidermal growth factor receptor 2. Computed tomography is often the preferred modality for monitoring metastatic disease due to its ability to determine the extent of local and metastatic disease.</p> <p><strong>Methods:&nbsp;</strong>this was a retrospective study conducted at Sweden Ghana Medical Centre (SGMC). Hospital records and chest and abdominal computed tomography (CT) scan images of breast cancer patients who had been managed at SGMC between June 2016 and August 2019 were used to document age, gender, histological group, type of surgical intervention done, molecular subtypes of the disease and imaging findings. Microsoft Excel 2016 and SPSS version 20.0 were used to summarise the data obtained into tables, charts and to test for significant associations.</p> <p class="ParagraphSeparator">&nbsp;</p> <p><strong>Results:&nbsp;</strong>the most common site of breast cancer metastasis was lymph nodes. The three commonest sites of distant metastases were the lung seen in 44 patients (55.3%), bone in 37 patients (44.6%) and liver in 33 patients (39.8%). Chi square test for association between the molecular subtypes of the breast cancer and proportion of patients that showed a particular type of metastases revealed that, the differences noted for lung, pleural and cardiac metastases were statistically significant, that for bone and liver were not.</p> <p><strong>Conclusion:&nbsp;</strong>breast cancer commonly metastasised to lymph nodes, lung, bone, liver, pleura and heart in descending order. The commonest CT patterns for metastases were multiple nodules for lung, effusion for pleura and heart and osteolytic lesions for bone.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225334 Assessment of delayed tuberculosis diagnosis preceding diagnostic confirmation among tuberculosis patients attending Isiolo county level four hospital, Kenya 2022-05-18T06:41:52+00:00 David Majuch Kunjok davidmajuch@gmail.com John Gachohi Mwangi davidmajuch@gmail.com Susan Mambo davidmajuch@gmail.com Salome Wanyoike davidmajuch@gmail.com <p><strong>Introduction:&nbsp;</strong>delayed diagnosis of Mycobacterium tuberculosis infection leads to accelerated individual to individual transmission. This study evaluated this aspect of delayed diagnosis among patients visiting Isiolo level four hospital in northern Kenya.</p> <p><span style="font-size: medium;"><strong>Methods:&nbsp;</strong>this was a cross-sectional cohort study conducted during January, 2018-January, 2019 with systematically sampled 172 tuberculosis (TB) patients. Epidemiological and clinical characteristics were abstracted from records to serve as independent variables. Outcome variable was delayed diagnosis dichotomised into &lt; 21 or &gt; 21 days and treated as a binary outcome. Pre-tested interviewer-administered questionnaires, focused group discussions, and key informant interview guides were used to collect relevant information.</span></p> <p><span style="font-size: medium;"><strong>Results:&nbsp;</strong>most (n=89, 57.8%) of the TB diagnosis fell in the category of &gt; 21 day delay. Overall, among all patients, delay in days constituted a median of 27.6, a mean of 37.3 ± 57 days (range 0-414 days). Factors associated with delayed diagnosis (happening &gt; 21 days) included (i) use of dispensary and private health facilities, (OR=4.3, 95% CI: 1.44,13.14; P=0.009) and (OR= 4.9, 95% CI: 1.64, 14.73; P=0.004), respectively (ii) self-employed individuals (OR=21.7, 95% CI: 2.47,190.93; P=0.006) and employed individuals (OR=9.9, 95% CI: 1.14, 85.80; P=0.038) (iii) secondary-level education (OR=0.03, 95% CI: 0.01,0.21; P=0.000) and tertiary education (OR=0.033, 95% CI: 0.01, 0.23; P=0.001).</span></p> <p><span style="font-size: medium;"><strong>Conclusion:&nbsp;</strong>delayed diagnosis of TB was found to be associated with health-seeking behaviour of TB patients, proxied by diagnosis facility, occupation, and education levels in our study area. Curtailment of local transmission of M. tuberculosis needs intensified health promotion and education in affected communities complemented with active case findings.</span></p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225335 Kawasaki disease shock syndrome complicated by coronary aneurysms: a case report 2022-05-18T06:53:03+00:00 Ahmed Rassas ahmedrassas87@gmail.com Rihab Guizani ahmedrassas87@gmail.com Amina Werdani ahmedrassas87@gmail.com Nesrine Jammeli ahmedrassas87@gmail.com Bahri Mahjoub ahmedrassas87@gmail.com <p>Kawasaki disease is a generalized systemic vasculitis, which primarily affects medium-sized arteries. Kawasaki disease shock syndrome is a rare but severe presentation of this disease. This report describes a case of delayed diagnosis of Kawasaki disease shock syndrome in a 13-year-old boy who presented with cervical adenophlegmon, persistent fever, injected conjunctiva, rash, and hypotension. Echocardiography revealed the presence of bilateral coronary aneurysms. Early recognition of Kawasaki disease shock syndrome can be difficult; however, delay in diagnosis and treatment can increase the risk of coronary artery disease.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225336 Ulcère de cornée chronique révélant un syndrome de Parry-Romberg: à propos d´un cas 2022-05-18T07:06:50+00:00 Sara El Maroufi sara.elmaroufi@hotmail.com Ahmed Bennis sara.elmaroufi@hotmail.com Fouad Chraibi sara.elmaroufi@hotmail.com Meriem Abdellaoui sara.elmaroufi@hotmail.com Idriss Benatiya Andaloussi sara.elmaroufi@hotmail.com <p>Le syndrome de Parry-Romberg, est une entité clinique rare, il est caractérisé par une atrophie hémifaciale progressive et associé à diverses manifestations systémiques, notamment ophtalmologiques, neurologiques et maxillo-faciales dont la prise en charge doit être multidisciplinaire. A travers cette observation nous rapportons le cas d´un syndrome de Parry Romberg diagnostiqué chez un patient adressé pour prise en charge d´un ulcère de cornée chronique suite à une hypoesthésie selon une atteinte rare et difficile à traiter.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225337 Predictors of adherence to option B+ approach for the prevention of mother to child transmission of human immunodeficiency virus in Abuja, 2017 2022-05-18T07:30:48+00:00 Augustine Olajide Dada austeendada@gmail.com Aisha Abubakar austeendada@gmail.com Adebobola Bashorun austeendada@gmail.com Patrick Nguku austeendada@gmail.com Abisola Oladimeji austeendada@gmail.com <p><strong>Introduction:&nbsp;</strong>option B+ ART is a lifelong regimen of ART using a combination of 3 ARVs and adherence to this regimen can reduce risk of MTCT to 1-2% as against 15-40% without treatment. To achieve an undetectable viral load and prevent the development of drug resistance, a person on ARV drugs need to take at least 95% of prescribed doses on time. This study assessed the level of adherence to Option B+ PMTCT program and its predictors among HIV+ Pregnant women accessing antenatal care in health facilities Abuja.</p> <p><strong>Methods:&nbsp;</strong>we enrolled 284 HIV positive pregnant women and lactating mothers in a hospital-based cross-sectional study. We sampled respondents using two-staged sampling technique. We collected data on socio-demographic characteristics, level of adherence, patients and healthcare related factors affecting adherence, knowledge of clients on HIV, ART and MTCT. Focused group discussion guide, data abstraction form and key informant interview guide were used for PMTCT focal persons. We conducted bivariate analysis and logistic regression using Epi-Info version 7 at 5% level of significance.</p> <p><strong>Results:&nbsp;</strong>the mean age of respondents was 30.12 years (SD±4.86) with mean knowledge score of 16.7 and 75.5%% of them had good knowledge. The level of good adherence was 83.3%. Independent factors associated with non-adherence to ART included: Forgetfulness (OR 20.02; 95% CI 6.42-62.48), having side effects (OR 39.6; 95% C.I: 4.46-352.32), lack of food (OR 34.76; 95% C.I: 2.37-509.33), disclosure of HIV status (OR 2.51; 95% CI 1.22-5.15), being too busy (OR 13.96; 95% CI 3.89-49.98). Encountering challenge in ART initiation (OR 2.05; 95% CI 1.01-4.72) and level of Knowledge (OR 2.12; 95% CI 1.06-5.42).</p> <p><strong>Conclusion:&nbsp;</strong>the level of adherence would improve study if the Public health department of Federal Ministry of Health (FMOH), Federal Capital Development Authority (FCDA) and National Agency for the Control of AIDS (NACA) through the media which may help reduce stigma and encourage voluntary HIV status disclosure. Reminders should be used by patients to help them overcome forgetfulness.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225338 Dépistage sérologique de SARS-CoV-2 chez une population de personnel de santé à Nouakchott-Mauritanie 2022-05-18T07:49:11+00:00 Mohamed Lemine Ould Salem medleminesalem@yahoo.fr Mohamed Ahmed Med Mahmoud Sidiya medleminesalem@yahoo.fr Ahmed Baba Ahmedou Eibih medleminesalem@yahoo.fr Mohamed Mahmoud Maouloud medleminesalem@yahoo.fr Brahim Hamad Ngaide medleminesalem@yahoo.fr Leila Dedy medleminesalem@yahoo.fr Lalla Mariem Hamza medleminesalem@yahoo.fr Fatimetou Yacoub medleminesalem@yahoo.fr <p>La première flambée de contagion respiratoire due à une étiologie inconnue a été signalée dans la ville chinoise de Wuhan décembre 2019. L´Organisation Mondiale de la Santé (OMS), a utilisé le terme « nouveau coronavirus 2019 » le 29 Décembre 2019. Cette épidémie qui est actuellement appelée Coronavirus 2 du syndrome respiratoire aigu sévère (SARS-CoV-2), la maladie causée par le SARS-CoV-2, a été par la suite appelée par l´OMS: maladie à Coronavirus 2019 ou COVID-19. L´objectif était de déterminer la prévalence des anticorps anti SARS-CoV-2 chez tous les employés du centre hospitalier national de Nouakchott (CHN). L´étude a été menée pendant la semaine du 20/05/2020 au 27/05/2020 chez 853 employés tous grades confondus (médecins, pharmaciens, infirmiers, secrétaires, personnels de sécurité, administrateurs...) dont 504 de sexe masculin et 331 de sexe féminin soit un sex- ratio de 1,52 avec un âge moyen de 39 ans et des extrêmes d´âge de 20 ans et 60 ans. Ce dépistage à la recherche des anticorps IgG et IgM anti-SARS-CoV-2 a été réalisé par la technique immuno-chromatographique Biotime (Xiamen Biotime BiotechnologyCo., Ltd.). Parmi les 835 employés inclus dans notre étude, 14 étaient positifs (soit 1.67%) dont 12 avaient des anticorps anti-SARS-CoV-2 de type IgM et IgG et deux (2) n´avaient que des IgM isolées. La réaction de polymérisation en chaîne (PCR) sur écouvillonnage naso-pharyngé, a été réalisée chez ces 14 patients et s´est révélée positive chez six. Si la PCR constitue le gold standard pour le diagnostic du SARS-CoV-2, les tests sérologiques à la recherche des anticorps anti SARS-CoV-2 particulièrement les tests de diagnostic rapide (TDR) constituent un complément diagnostic du COVID-19. Ils ont l´avantage de la facilité de réalisation, de leur sécurité aussi bien dans le laboratoire, dans les services cliniques ou en ville. Les TDR nous ont permis de détecter des porteurs du SARS-CoV-2 au sein des employés au CHN, ce qui a permis de les prendre en charge et de les isoler, en fonction des résultats de leurs PCR, pour protéger les patients ainsi que leurs entourages.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225339 La prostatectomie radicale: résultats carcinologiques au Centre Hospitalier Universitaire Aristide Le Dantec 2022-05-18T08:20:02+00:00 Ndiaga Seck Ndour matarsn803@gmail.com Yaya Sow matarsn803@gmail.com Babacar Sine matarsn803@gmail.com Modou Ndiaye matarsn803@gmail.com Alioune Sarr matarsn803@gmail.com Amath Thiam matarsn803@gmail.com Cyrille Zé Ondo matarsn803@gmail.com Ndèye Aissatou Bagayogo matarsn803@gmail.com Aboubacar Traoré matarsn803@gmail.com Samba Thiapato Faye matarsn803@gmail.com Abdoulaye Ndiath matarsn803@gmail.com Ousmane Sow matarsn803@gmail.com Boubacar Fall matarsn803@gmail.com Babacar Diao matarsn803@gmail.com Alain Khassim Ndoye matarsn803@gmail.com <p>Le but était d´évaluer les résultats carcinologiques de la prostatectomie radicale. Il s´agissait d´une étude rétrospective monocentrique au service d´urologie-andrologie de l´Hôpital Aristide Le Dantec de Dakar du 1<sup>er</sup>&nbsp;juin 2010 au 31 mai 2016. Nous avons colligé 60 cas de prostatectomie radicale par voie rétropubienne associée à un curage ganglionnaire ilio-obturateur. Après la prostatectomie radicale (PR), le taux de&nbsp;<em>prostate specific antigen</em>&nbsp;(PSA) était indétectable (&lt;0,1 ng/ml) chez 20 patients (33,3%). Onze malades (18,3%) qui avaient une récidive biochimique, ont une hormonothérapie complémentaire. Une réponse a été obtenue après instauration du traitement avec un taux de PSA total redevenu indétectable après un suivi de 8 mois. La durée moyenne de la survie globale était de 17,5 mois avec une médiane de 9,49. Le taux de survie globale cumulé à 1 an, 3 ans et 4 ans étaient respectivement de 42,4, 13,6 et 6,8%. La durée moyenne de la survie sans récidive était de 17,3 mois avec une médiane de survie sans récidive biochimique qui était de onze (11) mois. La durée moyenne de la survie spécifique était de 8,1 mois avec une médiane de 3 mois. Les marges de résection étaient positives chez sept (7) patients soit un taux de 11,6%. Quatre(4) patients avaient un envahissement ganglionnaire. La prostatectomie radicale indiquée dans quelques cas dans notre pratique, est une méthode thérapeutique efficiente avec de bons résultats carcinologiques.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225341 Child sexual abuse and COVID-19 pandemic: another side effect of lockdown in Morocco 2022-05-18T08:34:46+00:00 Nour Mekaoui n.mekaoui@um5s.net.ma Hanae Aouragh n.mekaoui@um5s.net.ma Youssef Jeddi n.mekaoui@um5s.net.ma Houda Rhalem n.mekaoui@um5s.net.ma Badr Sououd Benjelloun Dakhama n.mekaoui@um5s.net.ma Lamya Karboubi n.mekaoui@um5s.net.ma <p class="ArticleParagraph">The World Health Organization has declared SARS-CoV-2 (COVID-19) a pandemic in March 11, 2020. The Kingdom of Morocco declared a state of health emergency from March 20 to June 24, 2020 and strict containment measures have been implemented including schools closure and suspension of extra-curricular activities. While the number of pediatric medical emergency consultations has significantly decreased during that period, we have seen an increase in the number of child abuses in our consultation. Social isolation is known to be a risk factor for child abuse. Researchers have found that all types of child abuse become more common during school vacations, summer vacations, and natural disasters (epidemics, hurricanes, etc.). Thus, containment measures taken to halt the spread of SARS-CoV-2 made us expect an increase in cases of child abuse. We collected data of children under the age of 18 who were sexually abused attending the Pediatric Medical Emergency Department of the Children´s Hospital of Rabat (Morocco) during the lockdown period of March 30 to June 2020.</p> <p class="ArticleParagraph">Fourteen children who were victims of sexual abuse consulted the pediatric medical emergency department; this number is 2.3 times the number who consulted during the same period in 2019. Although the rate is increased by 2.3, it certainly remains underestimated due to the difficulties by families of accessing hospitals and social structures. Sexual violence mostly concerned children under 13 years old, seven victims were under five years of age and male victims represented half of the cases seen. The parental couple and the extended family were most often responsible for the cases of child abuse: ten of the victims reported a predominance touching compared to sexual penetrations. The physical examination was unremarkable in 70% of the abused children. Thirty percent presented either a digestive symptomatology or an abnormality on the anogenital examination. Sexual assault on minors in the family environment is a frequent phenomenon and is still by far underestimated in our country. The number of cases of child sexual abuse increased dramatically during confinement compared to the same period last year, despite difficult access to hospitals. The child is isolated, often confined with the potential perpetrator. Reporting systems for abused children are not optimal in our context and require us to introduce more measures for active screening for sexual assaults on minors in our context.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225342 A case report of Arnold Chiari type 1 malformation in acromesomelic dwarf infant 2022-05-18T08:45:12+00:00 Miteshkumar Rajaram Maurya mitesh.maurya4@gmail.com Renju Ravi mitesh.maurya4@gmail.com Sona Ajit Pungavkar mitesh.maurya4@gmail.com <p>Arnold Chiari malformation is one of the commonest cause of congenital hydrocephalus. Cause of fetal development of cerebellar tonsils remains unknown and may be diagnosed at later in life. The association of Arnold Chiari malformation with acromesomelic dwarfism is not known. We report male infant diagnosed with acromesomelic dwarfism at end of gestation period on basis of antenatal ultrasonography findings. An ultrasound scan of infant head at fifth month of birth was performed in view of increasing head circumference that revealed aqueductal stenosis with dilated posterior horn of lateral ventricles in brain.</p> 2021-01-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225343 Epidermoid cyst of the clitoris 2022-05-18T08:50:42+00:00 Ahmed Ibrahimi ahmed.ibrahimi@um5s.net.ma Adil Kallat ahmed.ibrahimi@um5s.net.ma <p>An epidermoid cyst is a benign cyst resulting of implantation of superficial epidermal tissue into the dermis or subcutaneous tissue. They are commonly found on the scalp, face, neck, trunk and extremities; and rarely seen in the clitoral or vulvar region, most often associated with prior trauma or surgery to the area, particularly female genital mutilation. Epidermoid cyst of the clitoris is a very uncommon pathological entity, it can be spontaneous present at birth or develop later in life, or often secondary to surgery or trauma at the clitoral region. Herein, we report a case of 33-year-old multiparous woman, without past medical history of vulvar trauma or genital surgery, presented to the emergency department with a history of slowly growing clitoral mass over 11 months, which recently became responsible of sexual discomfort and difficulty in urination, without fever, vaginal discharge or other complaints. On perineal examination a painless midline cystic mass of 5 × 3 cm was noted; it extended from the clitoral region up to the labia minora; the mass was mobile, nontender, well-circumscribed and with a smooth surface (A, B). The labia minora and majora were normal, and both the urethral and vaginal openings were normal in position and shape (B). There was no associated bleeding or discharge. The remainder of the physical examination was otherwise unremarkable. Ultrasound testing revealed normal internal genital and urinary tract without communication between the cystic structure and the urethra. The patient underwent a complete surgical excision of clitoral cyst under spinal anesthesia, without compromising the clitoral neurovascular bundle or hood. Histopathological examination revealed an epidermoid cyst lined with stratified squamous epithelium and filled with keratinous material. The final pathologic diagnosis was of a spontaneous nontraumatic epidermoid cyst of the clitoris. The patient´s postoperative course was completely uneventful and she was discharged from the hospital on the 2<sup>nd</sup>&nbsp;postoperative day without any complication. No recurrence of the cyst was noted 6 months later at a follow-up visit, and she had a normal cosmetic appearance of the external genitalia, with complete disappearance of genital and urinary complaints.</p> 2021-01-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225344 Bibliometric profile of the African Academy of Sciences medical and health sciences fellows 2022-05-18T08:59:10+00:00 Joseph Balogun jbalogun@csu.edu Efe Mamuzo jbalogun@csu.edu Friday Okonofua jbalogun@csu.edu Adetutu Balogun jbalogun@csu.edu Adetoyeje Oyeyemi jbalogun@csu.edu <p>The African Academy of Sciences (AAS) is the preeminent science academy on the African continent, but there is currently no information on the academic productivity of the fellowship members. This study investigated the bibliometric parameters of the AAS medical and health sciences fellows. The demographic information (year of induction, gender, and region of employment in Africa) of the 80 medical and health sciences fellows were obtained from the AAS website. Subsequently, the bibliometric information (total number of publications, H-index scores, citation, and co-authorship counts) were extracted from the Scopus database. The majority of the fellows were from the East (36%) and West (33%) African regions (χ² = p &lt; 0.001); the North (6%) and Central (4%) regions were vastly underrepresented. Although only 34% of the AAS fellows were women, there was no statistically significant difference (p &gt; 0.05) in the bibliometric parameters of both genders. The year of induction as a fellow and region of employment in Africa significantly (p &lt; 0.05) influenced the bibliometric parameters. For all the fellows combined, their H-index mean (SD) score is 27.9 (17.0), while the median score for the total number of publications is 100, H-index is 27.5, and the citation and co-authorship count is 2,894 and 446, respectively. The fellows from the West African region had the highest number of publications (Mean = 212), citations (Mean = 9,437), and co-authorship count (Mean = 975), and the South African fellows had the highest H-index score (Mean = 40.8). The data presented provide insight into the bibliometric productivity of African scientists compared with their peers from other science academies around the world. Similarly, the data may assist burgeoning scientists aspiring to be AAS fellow set realistic goals toward achieving the stipulated H-index benchmarks.</p> 2021-01-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225345 Large irritation fibroma of hard palate: a case report of a rare clinical entity 2022-05-18T09:08:50+00:00 Alexios Tsikopoulos alextsikop@yahoo.gr Charalampos Festas alextsikop@yahoo.gr Athanasios Fountarlis alextsikop@yahoo.gr Varvara Sidiropoulou alextsikop@yahoo.gr Nikolaos Chaitidis alextsikop@yahoo.gr Asterios Symeonidis alextsikop@yahoo.gr Angeliki Kotsiafti alextsikop@yahoo.gr Theano Papazi alextsikop@yahoo.gr <p>Fibromas are benign tumors of connective tissue common in the oral cavity but rare on hard palate. This paper reports on an asymptomatic, slowly growing mass on the hard palate of a 90-year-old lady, with a reported use of denture for two decades. The patient presented with a 2.2cm, smooth-surfaced, well-circumscribed nodule attached with a stalk to the palatal mucosa. After excision, the histopathological examination revealed a mass of fibrous connective tissue, covered by stratified squamous epithelium with focal low-medium grade hyperplasia and hyperkeratosis. These findings were consistent with irritation fibroma of hard palate, a rare entity, which should be considered as a possible diagnosis for tumors of the area by every physician.</p> 2021-01-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225346 Hospital-based ciprofloxacin use evaluation in Eastern Ethiopia: a retrospective assessment of clinical practice 2022-05-18T09:31:10+00:00 Tigist Gashaw Tekalign g.besufikad@yahoo.com Mekonnen Sisay Shiferaw g.besufikad@yahoo.com Tewodros Tesfa Hailegiyorgis g.besufikad@yahoo.com Yohannes Baye Embiale g.besufikad@yahoo.com Firehiwot Amare Abebe g.besufikad@yahoo.com <p><strong>Introduction:&nbsp;</strong>ciprofloxacin is a second-generation fluoroquinolone, which has been used as one of the top three antibacterial agents prescribed in Ethiopia. However, its use has deviated from the recommendation of standard treatment guidelines resulting in a gradual increase in antimicrobial resistance. Therefore, this study aimed to evaluate the annual use of ciprofloxacin in 2016 based on the standard Ethiopian treatment and World Health Organization guidelines, in governmental hospitals, in Eastern Ethiopia from 1<sup>st</sup>&nbsp;May to 30<sup>th</sup>&nbsp;June 2018.</p> <p><strong>Methods:&nbsp;</strong>a hospital-based retrospective cross-sectional study was conducted to evaluate medical records of patients who had taken ciprofloxacin in 2016. The total sample size (n=522) was proportionally allocated to each hospital based on the respective consumption data. A simple random sampling method was employed to collect the required sample. The collected data were entered into SPSS version 21 and analyzed using descriptive analysis.</p> <p><strong>Results:&nbsp;</strong>in this study, 522 medical records were reviewed, with a male to female ratio of 1.03:1. Ciprofloxacin was indicated in 478 (91.6%) participants whose age was greater than eighteen years. The majority were treated in the medical and emergency outpatient departments (n=477, 91.4%). Urinary tract infections (n=224, 42.9%), acute febrile illnesses (n=68, 13.0%), and typhoid fever (n=54, 10.4%) were the top indications to which ciprofloxacin was prescribed. Non-steroidal anti-inflammatory drugs (NSAIDs) (n=241, 34.7%) and antimicrobials (n=135, 19.6%) were among the most frequently co-indicated agents. Based on the standard Ethiopian treatment guidelines, therapy was appropriate in 30% (n= 159) of patients. The major reason for inappropriate utilization (95%) was the wrong duration of antibiotic use (n=228). Evaluation based on World Health Organization criteria showed that indication, dose, and frequency were in line with the recommendation.</p> <p><strong>Conclusion:&nbsp;</strong>ciprofloxacin was primarily indicated for urinary tract infections. The drug was appropriately used in less than one-third of patients, with the wrong duration being the main reason for overall inappropriate utilization. This trend may potentially impose a high risk to the emergence of drug-resistant microorganisms. To this end, further studies addressing the susceptibility pattern of bacterial isolates towards ciprofloxacin should be carried out.</p> 2021-01-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225347 Bilateral polyotia: case of a rare and atypical congenital malformation in a three-month-old infant 2022-05-18T09:41:13+00:00 Roger Christian Meva'a Biouélé roger.mevaa@fmsb-uy1.cm Emmanuel Choffor-Nchinda roger.mevaa@fmsb-uy1.cm <p>Polyotia is an extremely rare congenital malformation of the external ear, characterised by the development of an accessory auricle. It is more often unilateral. We report the case of a Cameroonian infant whom we received at the age of three months. The infant's mother had noticed a deformity concerning both ears since birth and did not observe any other associated symptom. On physical examination, we found an additional auricle fusing with the tragus on both sides. This unusual structure consisted of skin and cartilage. Their greater diameters measured 2.5cm and 2cm on the left and right respectively. Otoscopic evaluation and general physical examination were normal. A computerized tomography (CT)-scan of the temporal bones as well as an abdominal ultrasound scan were requested to explore other possibly associated anomalies. These imaging studies were normal. The diagnosis of isolated bilateral polyotia was made. An ear reconstructive surgery was proposed to the parents. An informed consent was obtained from the parents, pre-operative work-up was requested and the procedure was planned. A bilateral otoplasty was done under general anaesthesia. The procedure was simple, consisting of excision of the excess tissue to give a natural aesthetic result. Post-operative evolution was favourable, with good scarring on day 10, as illustrated in the figure. Nine months following the procedure, the parents seemed satisfied with the aesthetic result. Polytia is a rare congenital malformation. Management requires adequate and comprehensive investigations to exclude enchondroma or associated malformations, prior to ear reconstructive surgery.</p> 2021-01-20T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225348 Malformations anorectales: revue de 6 ans aux Cliniques Universitaires de Lubumbashi 2022-05-18T10:29:20+00:00 Trésor Kibangula Kasanga kibangulakasanga@gmail.com Didier Tshibangu Mujinga kibangulakasanga@gmail.com Florent Tshibwid Zeng kibangulakasanga@gmail.com Manix Ilunga Banza kibangulakasanga@gmail.com Augustin Kibonge Mukakala kibangulakasanga@gmail.com Eric Mbuya Musapudi kibangulakasanga@gmail.com François Katshitsthi Mwamba kibangulakasanga@gmail.com Prince Muteba Katambwa kibangulakasanga@gmail.com Dimitri Kanyanda Nafatalewa kibangulakasanga@gmail.com Christelle Ngoie Ngoie kibangulakasanga@gmail.com Vincent De Paul Kaoma Cabala kibangulakasanga@gmail.com Nathalie Dinganga Kapessa kibangulakasanga@gmail.com Sébastien Mbuyi-Musanzayi kibangulakasanga@gmail.com <p>Les malformations anorectales (MAR) sont des dysgénésies de la filière anogénitale comprenant plusieurs variétés anatomopathologiques. Leur diagnostic précoce permet une prise en charge précoce, laquelle réduit la morbi-mortalité y associée, surtout dans les pays en développement. L´objectif de cette étude est d´analyser les aspects épidémio-cliniques, thérapeutiques et évolutifs des malformations anorectales (MAR) aux Cliniques Universitaires de Lubumbashi. Il s´agit d´une étude descriptive transversale, ayant concerné 24 patients de 0 à 1 an admis dans notre service pour MAR. Sont exclus para cliniques dans notre série, les patients âgés de plus d'une année et non porteurs des examens demandés. Les données ont été recueillies sur base d´une fiche d´enquête reprenant les différents paramètres: l´âge au moment de la consultation, le sexe, le poids de naissance, la circonstance de découverte, la variété anatomique, le type de traitement et évolution des malades. La fréquence était de 24 cas (20,68%) des MAR sur 116 cas des malformations congénitales. L´âge médian était de 2 jours, le sexe-ratio de 1/3 en faveur des filles. L´occlusion intestinale était le diagnostic à l´admission le plus fréquent (50%). Les MAR basses étaient les plus fréquentes (11 patients soit 45,7%) dont 10 sans fistule. L´atrésie intestinale a été la malformation associée la plus fréquente (3 patients). L´anoplastie par abaissement abdomino-périnéal couplée aux dilatations anales postopératoires a été faite chez 13 patients, soit dans 54,1% des cas. Six patients sont décédés de causes inconnues et 6 autres ont été perdus de vues. Pour le résultat fonctionnel, sur les 12 des 24 patients pris en charge qui se sont présentés à la réévaluation 3 mois après sortie de l´hôpital, 3 d´entre eux ont présenté des signes d´incontinence, et 9 d´entre eux étaient continents parmi lesquels 8 étaient diagnostiqués avec MAR basse et 1 avec MAR haute. Les MAR sont une réalité dans notre milieu, cependant, le diagnostic n´est majoritairement posé qu´au décours des occlusions intestinales. Le taux des décès reste élevé et des mesures devrait être prises pour permettre des évaluations à long terme, lesquelles sont encore difficiles à faire vu le nombre des perdus de vue.</p> 2021-01-20T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225351 The occurrence of long COVID: a rapid review 2022-05-18T10:41:23+00:00 Chinwe Juliana Iwu chinwelolo@gmail.com Chidozie Declan Iwu chinwelolo@gmail.com Charles Shey Wiysonge chinwelolo@gmail.com <p>The long-term effects of the severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) are not well understood. This rapid review was aimed at synthesizing evidence on the long-term effects of the SARS-CoV-2 infection among survivors. We considered both randomised controlled trials and non-randomised studies eligible for inclusion in this review. The following databases were searched: PubMed, Scopus, Cochrane library, Google Scholar, and the World Health Organization (WHO) COVID-19 database. The reference lists of all the included studies were also searched. Two authors independently screened the search outputs and reviewed full texts of potentially eligible articles. Data extraction was done by one author and checked by a second author. A meta-analysis was not conducted due to heterogeneity among the included studies. Results are presented narratively. Eleven studies met our inclusion criteria. All these studies were conducted in high-income countries. Study findings demonstrate that COVID-19 survivors can experience persistent symptoms after recovering from their initial illness, especially among previously hospitalized persons. The majority of symptoms reported were fatigue, shortness of breath, cough, and sleep disorders. Mental conditions, such as depression and anxiety disorders, were also reported. In conclusion, this study showed that COVID-19 survivors can experience persistent symptoms after recovering from their initial illness. Therefore, there is a need for a long-term follow-up of COVID-19 patients and rehabilitation services for survivors. More research is needed in this area, especially in Africa.</p> 2021-01-20T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225485 Biochemical changes in tuberculosis 2022-05-20T13:37:05+00:00 Chinyelu Uchenna Ufoaroh ufoarohcu@yahoo.com Chidimma Adaobi Onwurah ufoarohcu@yahoo.com Victor Ahaoma Mbanuzuru ufoarohcu@yahoo.com Chidimma Ifeyinwa Mmaju ufoarohcu@yahoo.com Shirley Nneka Chukwurah ufoarohcu@yahoo.com Chukwudi Christian Umenzekwe ufoarohcu@yahoo.com Iloduba Nnaemeka Aghanya ufoarohcu@yahoo.com Simon Nkpeh Ushie ufoarohcu@yahoo.com Arthur Ebelenna Anyabolu ufoarohcu@yahoo.com Emeka Hyacinth Enemuo ufoarohcu@yahoo.com Ernest Ndukaife Anyabolu ufoarohcu@yahoo.com Prince Udegbunam Ele ufoarohcu@yahoo.com <p><strong>Introduction:&nbsp;</strong>tuberculosis (TB) remains a global health issue with high morbidity and mortality rates especially in the developing countries. It is a multi-organ disease and can influence biochemical changes. This study sought to determine the influence of tuberculosis and its drug treatment on serum biochemical parameters in patients in Nigeria.</p> <p><strong>Methods:&nbsp;</strong>it was a descriptive observational cohort study on 150 subjects whose blood samples were analyzed for serum albumin, serum sodium, and serum potassium. The subjects were grouped into 3: TB group= 50 new TB subjects not on treatment, F group= 50 TB subjects on treatment for 2/12 or more and C group= 50 non-TB control subjects. These biochemical variables were compared between the 3 groups.</p> <p><strong>Results:&nbsp;</strong>male/female ratio was 1:1.5, mean age 37.1±0.92 years, and range 18-65 years. The differences in mean values of serum albumin, calcium and sodium between the three groups were significant (p&lt;0.001), whereas that of serum potassium was not significant (p=0.056). Those patients with new case TB had a significantly lower serum sodium, serum albumin and serum calcium than the control group and those on treatment, p&lt;0.001. There was significant positive correlation between serum albumin and serum calcium (r=0.0.420, p&lt;0.001) as well as serum sodium (r=0.310, p&lt;0.001) in the study population. Similarly, the correlation between serum calcium and serum sodium was positive and significant (r=0.200, p=0.014). In contrast, the correlation between serum potassium and serum albumin and that between serum potassium and serum calcium was not significant.</p> <p><strong>Conclusion:&nbsp;</strong>tuberculosis with or without anti-tuberculous medications was associated with significant reduction in serum albumin, serum sodium and serum calcium in this study.</p> 2021-01-20T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225488 Allo-immunisation fœto-maternelle sévère: à propos d'un cas et revue de la littérature 2022-05-20T13:46:02+00:00 Sara Ait Souabni sarahbelhaddad1@gmail.com Belhaddad El Habib sarahbelhaddad1@gmail.com Ihsane Oubahha sarahbelhaddad1@gmail.com Jihane El Baqali sarahbelhaddad1@gmail.com Abderrahim Aboulfalah sarahbelhaddad1@gmail.com Abderraouf Soummani sarahbelhaddad1@gmail.com <p>Avant les années 1970, l´allo-immunisation fœto-maternelle était la principale cause de décès périnatal. Actuellement elle est devenue plus rare, grâce à un dépistage des grossesses à risque et à un meilleur suivi de celles-ci. L´avènement du Doppler intracrânien a constitué un véritable tournant dans le suivi de ces grossesses, vu qu´il représente un moyen diagnostic fiable et non invasif du degré d´anémie fœtale, ce qui permet de prendre la décision de transfusion in-utéro. L´immunoprophylaxie anti-D a également joué un rôle important dans la prévention des anémies hémolytiques fœtales et néonatales, et son administration est actuellement bien codifiée. Une prise en charge adéquate permet d´éviter les conséquences de l´allo-immunisation sur le fœtus et le nouveau-né, ainsi que de diminuer les risques de cette affection sur les grossesses ultérieures. Nous rapportons le cas d´une allo-immunisation fœto-maternelle rhésus grave sur grossesse non suivie compliquée d´anasarque fœto-placentaire.</p> 2021-01-20T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225489 Expanding molecular diagnostic capacity for COVID-19 in Ethiopia: operational implications, challenges and lessons learnt 2022-05-20T14:08:30+00:00 Adisu Kebede adisukebede78@yahoo.com Betty Lanyero adisukebede78@yahoo.com Berhane Beyene adisukebede78@yahoo.com Mayur Lalji Mandalia adisukebede78@yahoo.com Daniel Melese adisukebede78@yahoo.com Feven Girmachew adisukebede78@yahoo.com Adamu Mekonnen adisukebede78@yahoo.com Gonfa Ayana adisukebede78@yahoo.com Nebiyou Yemanebirhan adisukebede78@yahoo.com Getnet Hailu adisukebede78@yahoo.com Habtamu Asrat adisukebede78@yahoo.com Negash Nurahmed adisukebede78@yahoo.com Andargachew Gashu adisukebede78@yahoo.com Kirubel Eshetu adisukebede78@yahoo.com Zewdu Assefa adisukebede78@yahoo.com Aschalew Abayneh adisukebede78@yahoo.com Emmanuel Musa adisukebede78@yahoo.com Ebba Abate adisukebede78@yahoo.com <p>Efforts towards slowing down coronavirus (COVID-19) transmission and reducing mortality have focused on timely case detection, isolation and treatment. Availability of laboratory COVID-19 testing capacity using reverse-transcriptase polymerase chain reaction (RT-PCR) was essential for case detection. Hence, it was critical to establish and expand this capacity to test for COVID-19 in Ethiopia. To this end, using a three-phrased approach, potential public and private laboratories with RT-PCR technology were assessed, capacitated with trained human resource and equipped as required. These laboratories were verified to conduct COVID-19 testing with quality assurance checks regularly conducted. Within a 10-month period, COVID-19 testing laboratories increased from zero to 65 in all Regional States with the capacity to conduct 18,454 tests per day. The success of this rapid countrywide expansion of laboratory testing capacity for COVID-19 depended on some key operational implications: the strong laboratory coordination network within the country, the use of non-virologic laboratories, investment in capacity building, digitalization of the data for better information management and establishing quality assurance checks. A weak supply chain for laboratory reagents and consumables, differences in the brands of COVID-19 test kits, frequent breakdowns of the PCR machines and inadequate number of laboratory personnel following the adaption of a 24/7 work schedule were some of the challenges experienced during the process of laboratory expansion. Overall, we learn that multisectoral involvement of laboratories from non-health sectors, an effective supply chain system with an insight into the promotion of local production of laboratory supplies were critical during the laboratory expansion for COVID-19 testing. The consistent support from WHO and other implementing partners to Member States is needed in building the capacity of laboratories across different diagnostic capabilities in line with International Health Regulations. This will enable efficient adaptation to respond to future public health emergencies.</p> 2021-01-20T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225492 Suicide epidemic in Malawi: what can we do? 2022-05-20T14:18:10+00:00 Gift Treighcy Banda cmthunzi@stud.medcol.mw Natasha Banda cmthunzi@stud.medcol.mw Anthony Chadza cmthunzi@stud.medcol.mw Chisomo Mthunzi cmthunzi@stud.medcol.mw <p>Suicide continues to be a global health concern, affecting all continents. Although some studies have associated it with mental disorders such as severe depression, research also shows that a significant number of cases occur due to emerging life stresses. It is one of the leading causes of death among young people and is steady on the rise in Malawi. Malawi’s suicide cases disproportionately affect young males from rural areas. These cases are also higher than those of neighbouring countries. During the lockdown period to mitigate the impact of the COVID-19 pandemic between April and September 2020, Malawi saw a rise in suicide cases, most of which were due to the resulting financial hardship. There is need to tackle the suicide epidemic holistically, on all tiers of intervention. People need to be equipped with socially acceptable coping mechanisms which are easily adaptable to a low resource setting. There is a need for initiative to be taken in training individuals who can manage mental ill health without overwhelming the health system. The entire health system and health policies should acknowledge the importance of mental ill-health and its consequences. Malawi needs to prioritise mental health issues, realising that indeed, there is no health, without mental health.</p> 2021-01-20T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/225493 Fractures du bassin occasionnant une plaie du vagin 2022-05-20T14:35:53+00:00 Kouamé Innocent M´Bra mbrainos@yahoo.fr Kouamé Jean Eric Kouassi mbrainos@yahoo.fr Bada Justin Leopold Niaore Sery mbrainos@yahoo.fr Loukou Blaise Yao mbrainos@yahoo.fr Aya Adélaïde Natacha Kouassi mbrainos@yahoo.fr Yao Aboh Ganyn Robert Arnaud Asséré mbrainos@yahoo.fr Pierre Germain Jr Ochou mbrainos@yahoo.fr Régis Akobé mbrainos@yahoo.fr Koffi Léopold Krah mbrainos@yahoo.fr <p>Les fractures du bassin surviennent le plus souvent au décours d´un traumatisme violent. Malgré ce contexte de haute vélocité, ces lésions sont rarement associées à des plaies du vagin et les données sur l´évolution sont rares. L´objectif de notre étude était de décrire les lésions anatomocliniques, le traitement et l´évolution de ces lésions. Nous avons observé cinq cas de plaies du vagin au cours d´une fracture du bassin chez la femme au cours de ces dix dernières années. Les patientes avaient un âge moyen de 23,6 ans. Le motif principal était les accidents de la voie publique. Deux patientes présentaient des plaies linéaires et trois présentaient des plaies délabrantes. Des sutures vaginales ont été réalisées chez toutes les patientes. Au recul moyen de deux ans, l´évolution a été favorable avec cicatrisation de la plaie vaginale et de l´os. Les activités génitales et obstétricales n´ont pas été compromises. Ce sont des lésions qui passent le plus souvent inaperçues. Il faudra y penser devant tout traumatisme du bassin chez la femme.</p> 2021-01-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228444 Cause rare d'occlusion mécanique chez l'enfant: à propos d'un cas 2022-07-22T08:54:10+00:00 Amina Mouffak mouffak.amina@gmail.com Siham Salam mouffak.amina@gmail.com Amine Fahl mouffak.amina@gmail.com Kamilia Chbani mouffak.amina@gmail.com Dalal Laoudiyi mouffak.amina@gmail.com Lahcen Ouzidane mouffak.amina@gmail.com <p>Les bézoards correspondent à la concrétion de substances ingérées non digestibles dans le tractus gastro-intestinal. Le trichobézoard est la forme la plus fréquente des bézoards, et correspond à l'ingestion de cheveux, poils ou fibres de tapis ou moquette. Principalement de localisation intra-gastrique, il existe des formes rares d'extension duodénale ou à l'intestin grêle définies par le syndrome de Rapunzel. L'imagerie notamment scanographique est typique et joue un double rôle diagnostique et pronostique. Nous rapportons le cas d'une enfant âgée de 13 ans hospitalisée pour un syndrome occlusif sur un trichobézoard.</p> 2021-01-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228448 Factors that affect vaccines availability in public health facilities in Nairobi City County: a cross-sectional study 2022-07-22T09:09:57+00:00 Lucy Wanjiku Kanja wanjikukanja2014@gmail.com Peter Ndirangu Karimi wanjikukanja2014@gmail.com Shital Mahindra Maru wanjikukanja2014@gmail.com Pierre Claver Kayumba wanjikukanja2014@gmail.com Regis Hitimana wanjikukanja2014@gmail.com <p><strong>Introduction:&nbsp;</strong>over 1.5 million children die from vaccine-preventable diseases yearly. To avert these deaths and improve their livelihood, vaccine availability is important. The study assessed the availability of the vaccine, injection accessories and the associated factors in public health facilities in Nairobi City County and provided valuable data to contribute to improving healthcare infrastructure, stock management and vaccine distribution.</p> <p><strong>Methods:&nbsp;</strong>a descriptive cross-sectional study was conducted in 68 randomly selected public health facilities at Nairobi City County in Kenya. Data was collected using a researcher-administered structured questionnaire and more information abstracted from the Vaccines management tools. The analysis was carried out using STATA version 14.</p> <p><strong>Results:&nbsp;</strong>most facilities had experienced vaccines and accessories stock out at the time of the study and in the preceding twelve months. The most affected vaccines were tetanus (88%), measles-rubella (81%) and oral polio (79%). The causes of stockouts were rationing (82%), unavailability at the depot (93%), lack of transport (55%) and poor forecasting (50%). The majority (91%) of the facilities used the public transport system and only 1% had reliable government utility vehicles for delivery of vaccines and other logistics. Those near the vaccine depots preferred walking.</p> <p><strong>Conclusion:&nbsp;</strong>the public health facilities in Nairobi City County experienced frequent stockouts of vaccines and accessories thereby exposing the residents to vaccine-preventable diseases.</p> 2021-01-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228454 The risk perception of COVID-19 and practice of precautionary measures amongst healthcare workers in the National Health Insurance Scheme Clinic of a tertiary hospital in Nigeria 2022-07-22T09:38:05+00:00 Osahon Enabulele osahoncmavp@gmail.com Aihevba Esther osahoncmavp@gmail.com <p><strong>Introduction:&nbsp;</strong>the novel coronavirus (SARS-CoV-2), the causative virus for coronavirus disease 2019 (COVID-19), was identified following the report of a cluster of cases of viral (atypical) pneumonia in Wuhan City of China. Healthcare workers are at high risk of contracting the infection from COVID-19 patients and also spreading it unknowingly to their families, especially if they do not take adequate precautionary measures. This study assessed the risk perception of COVID-19 and practice of precautionary measures against its spread amongst healthcare workers practicing in the National Health Insurance Scheme (NHIS) Clinic of a tertiary hospital in Nigeria.</p> <p><strong>Methods:&nbsp;</strong>this was a descriptive cross-sectional study conducted amongst healthcare workers in the National Health Insurance Scheme (NHIS) Clinic of a tertiary hospital in Nigeria. It employed the use of a pre-tested semi-structured questionnaire to obtain data from the participants. Data analysis was done using the IBM SPSS statistics version 22.0 (Chicago, IL, USA) statistical software.</p> <p><strong>Results:&nbsp;</strong>there were 49 study participants with all of them aware of COVID-19. Only 11(22.4%) respondents reported receiving training on infection prevention and control against COVID-19. Most of them received training from their workplace/hospital (12.2%), while 10.2% were trained via webinars. More of the respondents had moderate risk perception (n=17, 34.7%) while a majority of them had good practice of precautionary measures against COVID-19 (n=28, 57.1%).</p> <p><strong>Conclusion:&nbsp;</strong>most of the study participants had moderate risk perception and good practice of precautionary measures. Risk perception was not a significant predictor of practice of precautionary measures.</p> 2021-01-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228470 Boerhaave's syndrome after pentazocine-induced vomiting in a 21-year-old male with asthma: a case report 2022-07-22T11:16:48+00:00 Oyindamola Ibukun Awofisoye dammiet@yahoo.com Olaleye Emmanuel Olalekan dammiet@yahoo.com Ndubuisi Anumenechi dammiet@yahoo.com Frankilin Onwukpa dammiet@yahoo.com <p>Boerhaave's syndrome is an uncommon syndrome characterized by spontaneous rupture of the oesophagus with a high mortality rate. While excessive alcohol intake and binge-eating are the classic precipitants of this syndrome, medication-induced vomiting causing Booerhave's is quite uncommon. Traditionally managed operatively, conservative management is being increasingly reported in selected cases. We report the case of 21-year-old male with who developed sudden onset chest pain and dyspnoea after pentazocine induced vomiting. He was referred after lack of response to initial treatment for acute severe asthma. A chest CT scan showed pneumomediastinum, subcutaneous emphysema and oesophageal tear. He was managed conservatively with oxygen therapy, nil per mouth and antibiotics with improvement of symptoms and discharge after 8 days.</p> 2021-01-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228472 Basic neonatal resuscitation: retention of knowledge and skills of primary health care workers in Port Harcourt, Rivers State, southern Nigeria 2022-07-22T11:26:45+00:00 Datonye Christopher Briggs datonyebriggs2007@gmail.com Augusta Unoma Eneh datonyebriggs2007@gmail.com Edward Achinike Daniel Alikor datonyebriggs2007@gmail.com <p><strong>Introduction:&nbsp;</strong>birth attendants' retention of knowledge and skills of neonatal resuscitation post-training can prevent birth asphyxia by repeatedly applying neonatal resuscitation guidelines. This study assessed primary healthcare workers' retention of knowledge and skills of basic neonatal resuscitation.</p> <p><strong>Methods:&nbsp;</strong>in 28 primary health centres, 106 birth attendants had their knowledge and skills assessed following a one-day neonatal resuscitation training. The evaluation was before, immediately after training, at three months (a subset of participants) and six months. Paired t-tests were used to compare mean scores at two different evaluation times.</p> <p><strong>Results:&nbsp;</strong>the mean baseline knowledge and skills scores were 35.22% ± 12.90% and 21.40% ± 16.91% respectively. Immediately after training, it increased to 81.48% ± 7.05% and 87.40% ± 13.97% respectively (p=0.0001). At three months, it decreased to 55.37% ± 20.50% and 59.11% ± 25.55% respectively (p=0.0001), at six months it was 55.77% ± 14.28% and 60.38% ± 19.79% respectively (p=0.0001). Following immediate post-training at 6 months, knowledge and skills scores increased to 94.91 ± 7.28% and 96.02 ± 4.50% respectively (p=0.0001). No participant had adequate knowledge and one had adequate skills at baseline. The proportion of those with adequate knowledge and skills markedly increased immediate post-training but decreased remarkably at three-month and at six-month evaluations respectively. 99.1% had adequate knowledge and all had adequate skills immediate post-training at 6 months.</p> <p><strong>Conclusion:&nbsp;</strong>neonatal resuscitation training led to an improvement in knowledge and skills with suboptimal retention at three to six months post-training. Re-training improved knowledge and skills. We recommend that the retention of knowledge and skills could improve by retraining and mentoring at least 3-6 monthly.</p> 2021-01-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228473 Assessment of occupational health and safety practices at government mortuaries in Gauteng Province: a cross-sectional study 2022-07-22T11:38:12+00:00 Mapula Luckyjane Molewa molewa.mapula@gmail.com Thokozani Patrick Mbonane molewa.mapula@gmail.com Joyce Shirinde molewa.mapula@gmail.com Daniel Masilu Masekameni molewa.mapula@gmail.com <p><strong>Introduction:&nbsp;</strong>hospital mortuaries are responsible for the receipt and storage of deceased people. This exposes mortuary workers to a variety of health and safety hazards, which include physical, chemical, ergonomics, biological and psychosocial hazards/stressors. The aim of this study was to assess occupational health and safety practices (OHS) among government mortuary workers in Gauteng province.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional descriptive study design was conducted between the year 2017 and 2018. A convenient sampling technique was used to sample 11 government hospitals in Gauteng Province. A total of 46 employees participated in the study. Data was collected using structured questionnaires and observational checklists. Ethical clearance and permission to conduct the study were obtained prior to the commencement of the study. Data was analyzed using Statistical Package for the Social Science (SPSS) version 25 software.</p> <p><strong>Results:&nbsp;</strong>thirty-one (67%) of the respondents did not know the concept of hazard. Observations indicated that 5 out of 11 (45%) facilities were well maintained with only 2 (18%) of the facilities had the participants wearing the required PPE on duty. There was no association between working experience and having a knowledge of the existing hazards. However, there was a high correlation (P&lt;0.05) between training and adherence to safe practices.</p> <p><strong>Conclusion:&nbsp;</strong>the OHS practices were poor amongst operational employees. The study highlights the significance of developing and implementing Occupational Health and Safety programmes. We recommend that these programmes should focus on occupational health and safety education, training, supervision, medical surveillance and monitoring strategies must be developed and implemented.</p> 2021-01-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228474 Les infections ostéo-articulaires chez les drépanocytaires à Lubumbashi: étude épidémiologique, étiologie et prise en charge 2022-07-22T12:18:16+00:00 Manix Ilunga Banza manixbanza1988@gmail.com Nathalie Dinganga Kapessa manixbanza1988@gmail.com Augustin Kibonge Mukakala manixbanza1988@gmail.com Christelle Ngoie Ngoie manixbanza1988@gmail.com Yannick Tietie Ben N´Dwala manixbanza1988@gmail.com Vincent De Paul Kaoma Cabala manixbanza1988@gmail.com Trésor Kibangula Kasanga manixbanza1988@gmail.com Erick Wakunga Unen manixbanza1988@gmail.com <p><strong>Introduction:&nbsp;</strong>les complications infectieuses constituent la première cause de morbi-mortalité chez le drépanocytaire surtout avant l´âge de 5 ans. Le but de cette étude est de ressortir les aspects épidémiologiques, les étiologies et la prise en charge des infections ostéo-articulaires chez les drépanocytaires à Lubumbashi.</p> <p><strong>Méthodes:&nbsp;</strong>il s´agissait d´une étude descriptive transversale et rétrospective réalisée au centre de recherche de drépanocytose de Lubumbashi (CRDL) sur une période de trois ans soit de juin 2014 à juin 2017. Elle a porté sur tous les patients drépanocytaires suivis au CDRL ayant développé une infection ostéo-articulaire. La récolte des données s´était réalisée sur base d´une fiche d´enquête reprenant comme paramètres d´étude l´âge du patient, l´âge de la première consultation, le sexe, le motif de consultation, les antécédents, les signes physiques, le diagnostic posé, les bilans paracliniques, le traitement.</p> <p><strong>Résultats:&nbsp;</strong>nous avions répertorié 35 cas d´infections ostéo-articulaires sur un total de 380 patients drépanocytaires soit une fréquence 9,2%. La tranche d´âge la plus touchée était celle de moins de 5 ans (37,1%); l´âge moyen était de 10,9±9,5 ans pour des extrêmes de 8 mois et 37 ans. Il y a une légère prédominance féminine avec 51,4% des cas (sexe ratio de 1,06 en faveur des femmes). Les antécédents majeurs étaient la transfusion (16,6%) et la splénectomie (8,6%). Le motif de consultation était dominé par la douleur des membres (84%). Vingt patients (57,1%) avaient des conjonctives bulbaires ictériques et 26 (74,3%) étaient pâles. A l´inspection, la tuméfaction des membres et la plaie étaient retrouvées respectivement chez 27 patients (77,1%) et 19 patients (54,3%). La splénomégalie cliniquement palpée chez 6 patients (17,1%). Trois types d´infections ostéo-articulaires avaient été décelés, dominés par l´ostéomyélite avec 24 cas (68,57%) suivi de l´ostéite avec 7 cas (20%) et l´arthrite suppurée avec 4 cas (11,43%). Sur les 24 cas d´ostéomyélites, 18 étaient aiguës (75%) et 6 étaient chroniques (25%) dont 4 hyperostosantes et 2 fistulisantes. Le tibia a été l´os le plus touché (18 cas), la radiographie était dominée par des images d´ostéolyse avec 27 cas (77,1%) puis de réaction périostée avec 15 cas (42,9%). Le type homozygote était retrouvé chez 88,6% des cas. L´hémoculture a été réalisée chez 17 patients sur les 35 et la salmonelle a été isolée dans 15 cultures sur les 17 soit (88,23%) alors que la pyoculture réalisée chez 10 patients avaient isolées également d´autres germes. Le bilan inflammatoire avait été réalisé chez 21 patients dont 15 avaient une hyperleucocytose, 13 une formule leucocytaire pathologique, tous avaient une vitesse de sédimentation accélérée (supérieure à 20mm à la 1<sup>ère</sup>&nbsp;heure). Concernant le calendrier vaccinal, les vaccins du PEV étaient suivis par 62,86% des patients alors que le taux de vaccination spécifique pour les drépanocytaires était de 17,14%. Sur le plan thérapeutique, tous nos patients avaient reçu un traitement médical, 6 chirurgicaux (17,14%) ayant consisté en une séquestrectomie et la majorité des patients avaient été traités orthopédiquement (25 cas).</p> <p><strong>Conclusion:&nbsp;</strong>l´infection osseuse chez les drépanocytaires reste une réalité très préoccupante dans notre milieu pauvre ou la plupart n´ont pas une vaccination préventive spécifique aux drépanocytaires.</p> 2021-01-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228475 The effect of umbilical cord cleansing with chlorhexidine gel on neonatal mortality among the community births in South Sudan: a quasi-experimental study 2022-07-22T12:32:26+00:00 Christopher Vunni Draiko chrissvunni@gmail.com Kevin McKague chrissvunni@gmail.com Judith Draleru Maturu chrissvunni@gmail.com Sitima Joyce chrissvunni@gmail.com <p><strong>Introduction:&nbsp;</strong>the use of chlorhexidine antiseptic gel for umbilical cord care in unhygienic settings has been shown to reduce infection and neonatal mortality in Asia, leading to the revision of WHO guidelines. However, few studies exist in the African context and none have been undertaken in conflict-affected settings. We aimed to assess the effectiveness of applying chlorhexidine gel to the umbilical cord stump on cord sepsis and neonatal mortality rates in the Republic of South Sudan.</p> <p><strong>Methods:&nbsp;</strong>our pre/post quasi-experimental study recruited 3,143 pregnant women from six rural communities in Jubek County, South Sudan: 1,825 women in the treatment group and 1,318 women in the control group. Neonates in the treatment group had chlorhexidine applied to the umbilical cord stump within 24 hours of birth and daily for seven days. No chlorhexidine gel was applied in the control group, instead they were encouraged to practice dry cord care. Data was collected at enrolment and at each antenatal visit at 3, 7, 14 and 28 days. Our primary outcomes of interest were incidence of neonatal umbilical cord sepsis and neonatal mortality, which were analyzed on an intention-to-treat basis. The study is registered with Pan African Clinical Trial Registry, Number PACTR201808694484456.</p> <p><strong>Results:&nbsp;</strong>the neonatal cord infection rate among the treatment group was 17.0%, compared to 38.9% in the control group (P&lt;0.05), which was statistically significant. Neonatal mortality was least in the intervention (1.3%) and highest in the control (13.3%) group, which was also statistically significant.</p> <p><strong>Conclusion:&nbsp;</strong>our evidence showed that chlorhexidine gel application contributed to the reduction of cord sepsis and neonatal mortality in conflict-affected South Sudan where the majority of births happen at home in unsanitary conditions. Chlorhexidine gel should be added to the essential medicines list in South Sudan and a costed plan for scale-up of chlorhexidine gel application should be developed by the Ministry of Health.</p> 2021-01-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228476 Les anomalies congénitales oculaires au Centre Hospitalier Universitaire-Campus de Lomé, Togo 2022-07-22T12:51:51+00:00 Bénédicte Marèbe Diatewa bene.diat@gmail.com Nidain Maneh bene.diat@gmail.com Aboubakr Sidik Domingo bene.diat@gmail.com Koboyo Esso-Issinam Gnansa bene.diat@gmail.com Yannick Francis Amah Ayikoue bene.diat@gmail.com Komi Patrice Balo bene.diat@gmail.com <p><strong>Introduction:&nbsp;</strong>les anomalies congénitales oculaires sont des entités cliniques rares dans le monde. Le but de cette étude est de décrire les aspects épidémiologiques et cliniques des anomalies congénitales oculaires au Centre Hospitalier Universitaire-Campus de Lomé.</p> <p><strong>Méthodes:&nbsp;</strong>une étude rétrospective a été réalisée de janvier 2016 à décembre 2018 (3 ans) dans le service d´ophtalmologie du Centre Hospitalier Universitaire-Campus de Lomé. Elle a concerné les enfants porteurs d´anomalies congénitales oculaires. Les variables d´étude ont été: le sexe; l´âge au moment du diagnostic; le type d´anomalies congénitales oculaires; la latéralité.</p> <p><strong>Résultats:&nbsp;</strong>sur 2621 enfants examinés durant la période d´étude, 103 (3,9%) étaient porteurs d´anomalies congénitales oculaires. Des 103 patients, il y avait 60 (58,2%) garçons et 43 (41,8%) filles. L´âge moyen de diagnostic était de 16 ± 5,2 mois (extrêmes: 1 mois et 5 ans). L´anomalie congénitale oculaire la plus fréquente était la cataracte (53,4 %). Les atteintes unilatérales étaient prépondérantes (56,3%). Les anomalies congénitales oculaires étaient: isolées (82,5%) ; associées aux anomalies systémiques (11,7%); associées entre elles (5,8%).</p> <p><strong>Conclusion:&nbsp;</strong>ces résultats indiquent que les caractéristiques épidémiologiques et cliniques des anomalies congénitales oculaires se rapprochent de celles rapportées dans la littérature. Cependant, dans notre milieu, la fréquence des anomalies congénitales oculaires et l´âge de diagnostic sont élevés. Il est important de diagnostiquer tôt les anomalies congénitales oculaires dans le but d´assurer la prise en charge et de préserver la fonction visuelle.</p> 2021-01-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228477 Outcomes of craniotomies for chronic subdural hematoma in Sierra Leone 2022-07-22T13:03:27+00:00 James Baligeh Walter Russell jamesbwrussell@yahoo.com M'Baimba Lamin Baryoh jamesbwrussell@yahoo.com Victor Conteh jamesbwrussell@yahoo.com Len Gordon-Harris jamesbwrussell@yahoo.com Durodami Radcliffe Lisk jamesbwrussell@yahoo.com <p><strong>Introduction:&nbsp;</strong>chronic subdural hematoma (cSDH) is not uncommon in sub-Saharan Africa and has a striking morbidity and mortality if not managed adequately. With the limited number of neurosurgeons in resource poor countries, general surgeons should be trained in the skills of craniotomy and burr-hole craniostomy.</p> <p><strong>Methods:&nbsp;</strong>we conducted a retrospective review of all medical records of patients with cSDH, who underwent flap craniotomy at the Choithrams Memorial Hospital, Sierra Leone, between January 2016 and March 2018. The case notes, operative records and computerized axial tomography (CT) scans were reviewed and all pertinent data extracted. All patients were jointly managed post operatively by medical (neurological) and surgical teams in an intensive care unit.</p> <p><strong>Results:&nbsp;</strong>a total of 23 patients had surgical drainage of the chronic subdural hematoma. The mean age of the patients was 65.8 years (ranging from 54-78) with a male: female ratio of 3:2:1. The main predisposing risk factors were head trauma (60.9%) and antiplatelet medications (21.7%). Hypertension was the most common comorbidity, followed by diabetes mellitus. Ten (62.5%) out of sixteen patients referred for Head CT-scan by the primary physicians, had an initial missed clinical diagnosis until computerized tomography (CT) scan confirmation report of chronic subdural hematoma (cSDH) was obtained. Flap craniotomy under general anesthesia with a subdural drainage left in situ (100%) was done for all patients. Mean duration of Intensive Care Unit (ICU) admission was 10.6 days (range 6-16 days). Twenty-one (91.3%) patients made a full recovery. There was no mortality.</p> <p><strong>Conclusion:&nbsp;</strong>flap craniotomy for cSDH was safely performed by a traumatologist/general surgeon in a developing country where there is no neuro-surgical service. The outcome of the patients was favorable as there was co-management with the surgical and medical team.</p> 2021-01-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228478 Asymmetric buttocks: think of vascular malformation 2022-07-22T13:12:08+00:00 Khadija Elboukhari elboukharikhadija89@gmail.com Mohammed Ouadoud elboukharikhadija89@gmail.com <p>Vascular malformations are rare vascular diseases leading to severe deformity. They are difficult to diagnose and manage. We here report the case of a 17-year-old female patient with no significant pathological history with congenital patch in the glutes which had been complicated since adolescence leading to a swelling involving the entire homolateral gluteal region, without neurological signs or other signs. Dermatological examination showed gluteal asymmetry and the presence of a large purple angiomatous plaque involving the two-thirds of the internal portion of the right buttock. Clinical examination showed no thrill but a slight increase in local heat on palpation compared with the contralateral side. Flat angioma associated with venous malformation or angiodysplasia was suspected. Doppler ultrasound showed malformation made up of small veins with hypertrophy of the fat tissue. Subsequently, after exlusion of endopelvic involvement, the patient underwent plastic surgery for reduction of fat tissue in the right buttock. In another study that we conducted, involving 120 patients, vascular malformations in the gluteal region were not uncommon. Out of 20 patients 16 had gluteal asymmetry. These malformations were related to age, their prevalence among adolescents (P) between the ages of 11 to 16 was 0,045.</p> 2021-01-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228479 Sonde de Dormia enclavée dans le cholédoque: une complication peu connue 2022-07-22T13:29:27+00:00 Khalil Maamar maamarkhalil@gmail.com Mohammed Bouziane maamarkhalil@gmail.com <p>Le traitement conventionnel de la lithiase de la voie biliaire principale (VBP), consiste en une sphinctérotomie endoscopique suivie d´une extraction du ou des calculs au ballon et/ou à l´anse de Dormia. Plusieurs facteurs de risques d´échec d´extraction d´un calcul de la voie biliaire principale sont connus. Le facteur probablement le plus important est la taille du calcul supérieur à 15 mm ou lorsque le diamètre du bas de la VBP est inférieur à celui du calcul où il faut veiller à ne pas impacter le calcul dans le sphincter d´Oddi ou dans la Dormia afin de ne pas compromettre la suite de l´extraction. Parmi les complications liées à l'utilisation de la sonde de Dormia, les plaies biliaires, constituent un problème bien connu des chirurgiens, mais les lésions spécifiquement liées à l'utilisation de la sonde le sont moins et paraissent sous-estimées. Nous rapportons une image où la sonde de Dormia est restée enclavée dans le choledoque autour d´un calcul qui est resté lui-même fixé sans possibilité de la retirer après exploration endoscopique chez un patient de 60 ans en angiocholite lithiasique nous obligeant à faire une extraction chirurgicale par choledocotomie.</p> 2021-01-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228637 Une cholécystite lithiasique ectopique avec hernie de la ligne blanche: association rare révélée par inflammation pariétale abdominale 2022-07-28T07:33:40+00:00 Khalil Maamar maamarkhalil@gmail.com Mohammed Bouziane maamarkhalil@gmail.com <p>À l'inverse de la variante anatomique qui constitue une déviation fonctionnellement adaptée, l'anomalie congénitale est susceptible d'avoir une expression pathologique ou, du moins, d'engendrer une problématique clinique ou paraclinique. L'existence d'ectopies vésiculaires peuvent être isolées ou associées à une anomalie du développement hépatique: hypertrophie d'un lobe, existence d'un lobe surnuméraire ou encore agénésie d'un lobe du foie. À côté de son siège habituel dans l'hypocondre droit, sous la face inférieure du lobe hépatique droit, la vésicule peut occuper d'autres sites comme le flanc droit, l'épigastre, la région péri-ombilicale, la fosse iliaque droite et même l'hypocondre gauche: cette dernière situation est même la règle en cas de situs inversus abdominal. L´association a une hernie de la ligne blanche n´as jamais été rapporté, et a engendré une problématique clinique et une difficulté d´abord chirurgicale. Nous rapportons un cas rare d´association de cholécystite lithiasique de siège ectopique épigastrique faisant hernie de la ligne blanche chez un patient de 65 ans admis aux urgences pour douleur abdominales diffuses, l´examen abdominal montre une tuméfaction épigastrique avec signe inflammatoire (A). Les explorations radiologiques ont révélé une cholécystite lithiasique de siège ectopique (B,C). Le patient a bénéficié d´une cholécystectomie par abord médiane. L´examen anatomopathologique de la pièce de résection a confirmé le diagnostic.</p> 2021-01-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228641 Estimate cost of providing methadone maintenance treatment at a methadone clinic in Nairobi Kenya: direct costs 2022-07-28T07:45:24+00:00 Brenda Mogaka Sarahkiburi@gmail.com Sarah Kanana Kiburi Sarahkiburi@gmail.com Mirriam Mutinda Sarahkiburi@gmail.com Maxwel Kendagor Sarahkiburi@gmail.com <p>Methadone maintenance treatment is reported as cost-effective in treatment of opioid use disorder. Estimated cost of providing methadone varies widely in different regions but there is no data regarding cost of methadone treatment in Kenya. The aim of this study was to estimate the cost of methadone maintenance treatment at a methadone maintenance treatment clinic in Nairobi, Kenya from the perspective of the government, implementing partner and the clients. Data was collected for the period of February 2017 to September 2018 for 700 enrolled clients. The cost of providing methadone treatment was estimated as the sum of salaries, laboratory test, methadone and other commodities costs. The outcome was daily cost of methadone per client. The costs are given in Kenya Shillings (Ksh). The cost of treating one client is approximately Ksh. 149 (US$1.49) per day which amounts to Ksh 4500 (US$ 45) per month. This is from the estimated direct costs such as salaries which accounted for 86.4%, methadone 9.6%, tests and other consumables at 4%. The estimated average dose per patient per day is 60mg.This excludes indirect costs such as capital and set up cost, maintenance cost, training, drug import and distribution and other bills. The findings of this study show that the estimate cost of providing methadone at Nairobi, Kenya is comparable to that in other centers. This can help to inform policy makers on continued provision of methadone treatment in the country.</p> 2021-01-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228646 Breast cancer molecular subtypes and receptor status among women at Potchefstroom Hospital: a cross-sectional study 2022-07-28T08:02:52+00:00 Baudouin Kongolo Kakudji mwilaprincekas@gmail.com Prince Kasongo Mwila mwilaprincekas@gmail.com Johanita Riétte Burger mwilaprincekas@gmail.com Jesslee Melinda du Plessis mwilaprincekas@gmail.com Kanishka Naidu mwilaprincekas@gmail.com <p><strong>Introduction:&nbsp;</strong>this study aimed to determine the prevalence of receptor status and molecular subtypes in women with breast cancer treated at Potchefstroom Regional Hospital, South Africa and to analyze the association of molecular subtypes with some clinicopathologic characteristics of the tumor.</p> <p><strong>Methods:&nbsp;</strong>the study population for this cross-sectional study consisted of 116 women with primary invasive breast cancer, treated at the hospital from 1<sup>st</sup>&nbsp;January 2012 to 31<sup>st</sup>&nbsp;December 2018. Molecular subtypes were classified by immunohistochemical surrogates as luminal A (estrogen receptor (ER) positive and/or progesterone receptor (PR) positive, HER2-; Ki-67 &lt;30%), luminal B HER2- (ER+ and/or PR+, HER2-; Ki-67 ≥30%), luminal B HER2+ (ER+ and/or PR+, HER2+; any Ki-67), HER2 enriched (ER- and PR-, HER2+; any Ki-67), or triple-negative (ER-, PR-, HER2-, any Ki-67).</p> <p><strong>Results:&nbsp;</strong>the proportions of breast cancer receptor status of ER+, PR+ and HER2-, were 71.6%, 64.7% and 75.9%, respectively. The molecular subtypes of 29.3% of patients were luminal A-type, 24.1% were luminal B HER2-, 22.4% were triple-negative, 18.1% were luminal B HER2+ and 6% were HER2-enriched. Molecular subtypes were significantly associated with tumor grade (p &lt;0.001; Cramér's V=0.337), but independent of age (p=0.847), menopausal status (p=0.690), histology type (p=0.316), cancer stage (p=0.819), lymph node status (p=0.362), or tumor size (p=0.255).</p> <p><strong>Conclusion:&nbsp;</strong>the study has revealed that most of the breast cancer in our setting was receptor-positive; approximately one-quarter were triple-negative. Furthermore, the study showed that luminal type A and B are the preponderant molecular subtypes. Molecular subtypes were associated with tumor grade but independent of age and menopausal status. The current study may assist in guiding the therapeutic strategy for patients with breast cancer in the Potchefstroom hospital catchment area.</p> 2021-01-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228649 Adipsic hypernatremia in a young Sudanese child, challenges in a limited-resource setting: a case report 2022-07-28T08:11:44+00:00 Mohammed Abdulrahman Alhassan ma.alhassan@psau.edu.sa Asmahan Tagelsir Abdalla ma.alhassan@psau.edu.sa Samar Sabir Hassan ma.alhassan@psau.edu.sa Mohamed Ahmed Abdullah ma.alhassan@psau.edu.sa <p>Adipsia is a rare condition characterized by a lack of thirst due to a defect in specific osmoreceptors located in the hypothalamus. The disorder is characterized by failure to maintain the body’s normal plasma osmolality (POSM), resulting in chronic or recurrent severe hypernatremia and dehydration. Adipsia is usually accompanied by central diabetes insipidus (DI). Isolated adipsia (without DI) is very rare, with causes ranging from congenital central nervous system malformations to acquired anterior hypothalamic lesions. The diagnosis and management of the condition are considerably challenging for both clinicians and patients/parents, especially in a resource-limited setting. We here in present the first case report of adipsia from Sudan; a young child with isolated adipsia, diagnosed after recurrent severe hypernatemic dehydration episodes. The report portrays the unique challenges in suspecting, diagnosing, and managing the condition in a limited-resource setting.</p> 2021-01-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228651 Outcomes of closed interlocking intramedullary nailing of the tibia without fluoroscopy in resource-limited settings: experience from two hospitals in Cameroon 2022-07-28T08:21:41+00:00 Freddy Mertens Bombah bombahstick@hotmail.fr Guemse Emmanuel Mohamadou bombahstick@hotmail.fr Théophile Nana bombahstick@hotmail.fr Boukar Yannick Ekani bombahstick@hotmail.fr Celestin Danwang bombahstick@hotmail.fr Marc Leroy Guifo bombahstick@hotmail.fr <p><strong>Introduction:&nbsp;</strong>closed static interlocking nailing with c-arm guidance is the standard procedure for the treatment of closed diaphyseal leg fractures. It is still very difficult to carry out such procedures in a low-income setting because of few or absent image intensifiers (c-arm) despite the necessity. The aim of this study was to describe the outcomes of patients with tibial fractures treated with closed interlocking intramedullary nails without c-arm guidance in a Cameroonian population.</p> <p><strong>Methods:&nbsp;</strong>this was a prospective study including adult patients treated for tibial fractures without a c-arm in two regional hospitals.</p> <p><strong>Results:&nbsp;</strong>finally, 22 patients were included. The mean age was 34 ± 12.6 years with a male predominance (16 males and 6 females). Ninety percent of the fracture lines were simple or with a wedge fragment grade 42A or 42B respectively according to the AO classification. The mean surgery time was 1 hour 26 ± 34 minutes. The various aspects evaluated were the nail entry point which was good in 19 (86.4%) cases; proper nail driving which was considered good in 15 (68%) cases; the distal locking which was missed in 6 (27.3%) cases. Bone consolidation was obtained in an average of 4 ± 1.2 months in all 22 cases.</p> <p><strong>Conclusion:&nbsp;</strong>in resource constraints settings where c-arm are not always available, closed interlocked nail of tibia without c-arm guidance still gives overall good results. Nevertheless, there is a need to improve equipment in sub-Saharan African hospitals to make trauma surgery with c-arm a gold standard as currently recommended.</p> 2021-01-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228655 Prevalence and prognosis of molecular phenotypes in breast cancer patients by age: a population-based retrospective cohort study in western Algeria 2022-07-28T08:31:53+00:00 Amina Belhadj belhadj_ami@yahoo.fr Sonia Seddiki belhadj_ami@yahoo.fr Adel Belhadj belhadj_ami@yahoo.fr Badra Zakmout belhadj_ami@yahoo.fr Abd El Kader Amine Araba belhadj_ami@yahoo.fr Tewfik Sahraoui belhadj_ami@yahoo.fr <p><strong>Introduction:&nbsp;</strong>breast cancer is related to age. The young age remains a controversial issue as a prognostic factor and have more aggressive clinical behavior with poor outcome. We aimed for the first time in Algeria to explore on a large cohort of patients the prevalence of the molecular phenotypes and to describe their clinical characteristics and survival.</p> <p><strong>Methods:&nbsp;</strong>medical record of 1140 Algerian patients were analysed and categorized into three age groups: "young" when women were aged below 40 years; "middle-age" when women were aged from 41 to 54 years old and "elder" when women were over 54 years. Baseline categorical variables were analysed using the Chi-square test and survival curves were constructed using Kaplan Meir method.</p> <p><strong>Results:&nbsp;</strong>the distribution of the various prognostic factors did not differ significativelly by age groups except for histological types, hormone receptors status and molecular phenotypes. Most patients were luminal A, indeed, young and intermediate age patients were most likely to be luminal A whereas the aged patients were triple negative with the highest mean DFS. Elsewhere young women are considered as human epidermal growth factor receptor 2 (HER2+) or triple negative molecular subtypes involving more rigorous therapeutic monitoring. The high rate of triple negative breast cancer in aged patients may due to genetic predispositions.</p> <p><strong>Conclusion:&nbsp;</strong>this study sheds light on the histoclinical and molecular characteristics of breast cancer in young patients, which has a good prognosis than their older counterparts. Our results are therefore surprisingly different from what the literature suggests. A further study should understand this uncommon finding.</p> 2021-01-27T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228658 Blunt trauma to abdominal solid organs: an experience of non-operative management at a rural hospital in Zambia 2022-07-28T08:40:29+00:00 Sergiy Karachentsev sergek69@yahoo.co.uk <p><strong>Introduction:&nbsp;</strong>although non-operative management of patients with blunt trauma to abdominal solid organs has become standard care, the role of peripheral hospitals remains poorly defined. This study reviews treatment and outcomes in patients with liver and spleen injuries at a regional hospital over a 10-year period.</p> <p><strong>Methods:&nbsp;</strong>a retrospective review of prospectively collected data was performed and supplemented by case notes retrieval. All patients with solid visceral injuries managed between 2009 and 2019 at a rural surgical hospital in Zambia were included. On admission, the patients were offered either urgent laparotomy or non-operative management (NOM) depending on their haemodynamic status. Continuous variables were expressed as median and mean ± standard deviation; categorical data were expressed as percentages. Statistical evaluation of data was performed by two-sample t-test. Statistical significance was assigned at p&lt;0.05.</p> <p><strong>Results:&nbsp;</strong>fourty-three patients were included. The majority of victims sustained isolated spleen or liver injury. Twenty-three patients were urgently operated due to haemodynamic instability. Splenectomy performed in 17 patients, liver laceration sutured in 5 patients. One patient underwent concomitant splenectomy and liver repair. Conservative management was attempted in 20 (47%) patients and was successful in 18 (42%). In two patients NOM failed and splenectomy was performed urgently. Two patients died postoperatively. There were no deaths in NOM group.</p> <p><strong>Conclusion:&nbsp;</strong>NOM of patients with injury to solid abdominal organs could be safely initiated in rural hospitals provided there is uninterrupted monitoring of patients' condition, well-trained staff and unrestricted access to the operating theatre (OT).</p> 2021-01-27T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228661 Factors influencing maternal health choices among women of reproductive age in Hausa communities in Ibadan, Nigeria: an exploratory study 2022-07-28T08:49:24+00:00 Titilayo Dorothy Odetola odetolatitilayo@yahoo.com Ruth Ashadzi Salmanu odetolatitilayo@yahoo.com <p><strong>Introduction:&nbsp;</strong>decision making is a vital aspect of women's reproductive life. In an attempt to fulfil the desire to procreate, women's lives are lost especially in developing countries where medical care is still inadequate. The researchers sought to explore the Hausa people's culture as regards maternal health choices concerning modern family planning methods, delivery places and parity.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional study using mixed methods was conducted among women of reproductive age (N=253) in three Hausa communities in Ibadan. Based on the objectives, semi-structured questionnaire and in-depth interview guide were used for data collection. Quantitative data were analysed using Chi-square and the level significance set at 0.05 while qualitative data were analysed thematically.</p> <p><strong>Results:&nbsp;</strong>over fifty percent respondents had more than 3 children and about one third (33.9%) preferred having more than 4 children. Nearly all participants (94%) were aware of modern family planning methods but only 49.0% used them. The most widely used methods are injectables (22.0%) and condoms (20.6%). Almost half of the study population (46.5%) delivered their babies at home with assistance from other residents with most preferring home delivery for various reasons.</p> <p><strong>Conclusion:&nbsp;</strong>although the level of awareness about family planning methods is quite satisfactory, however, the level of contraceptive uptake is still sub-optimal. Most Hausa women prefer home delivery which predisposes them to associated complications. Findings further identified various reasons for maternal health choices and provided insights on viable nursing interventions that can be adopted to promote skilled birth delivery to reduce maternal morbidity and mortality.</p> 2021-01-27T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228664 Influence de l'intensité de l'intoxication tabagique sur les paramètres de sévérité des exacerbations aiguës de la broncho-pneumopathie chronique obstructive traitées en milieu hospitalier 2022-07-28T09:04:06+00:00 Ahmed Ben Saad ahmedbensaad28@yahoo.fr Ali Adhieb ahmedbensaad28@yahoo.fr Asma Migaou ahmedbensaad28@yahoo.fr Saousen Cheikh Mhamed ahmedbensaad28@yahoo.fr Nesrine Fahem ahmedbensaad28@yahoo.fr Naceur Rouatbi ahmedbensaad28@yahoo.fr Samah Joobeur ahmedbensaad28@yahoo.fr <p><strong>Introduction:&nbsp;</strong>le tabagisme constitue le principal facteur de risque de la broncho-pneumopathie chronique obstructive (BPCO). Le cours évolutif de cette maladie est caractérisé par la survenue des exacerbations aiguës (EA). L'objectif de notre travail est d'évaluer l´impact de l´intensité de l´intoxication tabagique (en paquets-années (PA)) sur les différents paramètres de sévérité des EA des patients BPCO non sevrés hospitalisés.</p> <p><strong>Méthodes:&nbsp;</strong>c´est une étude rétrospective, monocentrique, portant sur 685 patients porteurs de BPCO, tabagiques non sevrés ayant été hospitalisés au moins une fois pour une EA entre 1990 et 2017. Nous avons défini 2 groupes de patients (G1: &lt; 30PA, et G2: ≥ 30PA). Nous avons comparé les différents paramètres de sévérité des EA BPCO entre les deux groupes.</p> <p><strong>Résultats:&nbsp;</strong>l´âge moyen de nos patients était de 66 ans. Il n'y avait pas de différence significative entre les deux groupes concernant l´importance du syndrome inflammatoire biologique, la durée de l´hospitalisation et celle de l´antibiothérapie. Le G2 était caractérisé par une PaO2 plus basse au cours des EA (G1: 63,5, G2: 59,3, p:0,007), avec plus d'hospitalisation en réanimation (p &lt; 0,001), plus de recours à la ventilation non invasive (p: &lt; 0.001) et à la ventilation invasive (p:0,008). Le G2 avait plus d'EA/an (G1: 2,06, G2: 2,72/patient/an, p: 0,001) avec un délai moyen de survenue d'EA sévère plus court (p: 0,038).</p> <p><strong>Conclusion:&nbsp;</strong>l´intensité de l´intoxication tabagique a un impact négatif sur plusieurs paramètres de sévérité des EA sévères de BPCO. D´où l´intérêt de sevrage tabagique pour prévenir la maladie et ses complications.</p> 2021-01-27T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228667 Mésothéliome malin de l´ovaire: à propos d´un cas 2022-07-28T09:22:16+00:00 Imane Ouafki ouafkiimane@gmail.com Lamyae Nouiakh ouafkiimane@gmail.com Raihana Boujarnija ouafkiimane@gmail.com Afaf Amarti ouafkiimane@gmail.com Lamiae Amaadour ouafkiimane@gmail.com Karima Oualla ouafkiimane@gmail.com Zineb Benbrahim ouafkiimane@gmail.com Samia Arifi ouafkiimane@gmail.com Nawfel Mellas ouafkiimane@gmail.com <p>Le mésothéliome malin primitif de l´ovaire (MMPO) est une tumeur extrêmement rare qui peut se développer à partir des cellules mésothéliales. Cette néoplasie est causée principalement par une exposition à l´amiante ou à d´autres agents cancérigènes. Un bilan d´extension préopératoire comportant une tomodensitométrie, une imagerie par résonance magnétique et une tomographie par émission de positons est essentiel pour la stadification de la maladie. Le diagnostic positif anatomopathologique repose sur un panel immunohistochimique. Le MMPO reste une maladie exceptionnelle impliquant une stratégie thérapeutique multidisciplinaire, au sein de laquelle la chimiothérapie a permis d´améliorer la prise en charge et le pronostic de ces malades. Nous présentons dans cet article le cas d´une patiente ayant subi une chirurgie suboptimale, complétée par une chimiothérapie adjuvante, aboutissant à une réponse complète radiologique, avec une survie sans maladie de plus d´une année.</p> 2021-01-27T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228670 Séroprévalence des anticorps anti-SARS-CoV-2 parmi les voyageurs et travailleurs dépistés à la clinique Saint Luc de Bukavu, à l´Est de la République Démocratique du Congo, de mai en août 2020 2022-07-28T09:34:45+00:00 Philippe Bianga Katchunga philkatch@yahoo.fr Aimé Murhula philkatch@yahoo.fr Prince Akilimali philkatch@yahoo.fr Jean Claude Zaluka philkatch@yahoo.fr Racine Karhikalembu philkatch@yahoo.fr Mack Makombo philkatch@yahoo.fr Justin Bisimwa philkatch@yahoo.fr Eugene Mubalama philkatch@yahoo.fr <p><strong>Introduction:&nbsp;</strong>les tests sérologiques anti-SARS-CoV-2 pourrait jouer un rôle majeur dans l´estimation de la prévalence de la COVID-19. L´objectif était d´estimer la prévalence de la COVID-19 dans la ville de Bukavu, à l'Est de la République Démocratique du Congo, parmi les voyageurs et travailleurs.</p> <p><strong>Méthodes:&nbsp;</strong>entre mai et août 2020, les tests rapides Cellex qSARS-CoV-2 IgG/IgM (Cellex, Inc., USA), test immunologique à flux latéral, ont été utilisés pour détecter et différencier des anticorps anti-SARS-CoV-2 chez les voyageurs et les travailleurs en quête d´un certificat médical.</p> <p><strong>Résultats:&nbsp;</strong>parmi 684 habitants de la ville de Bukavu dépistés de la COVID-19 (4,2% hispaniques, 2,8% autres africains, 0,9% asiatiques), la séroprévalence anti-SARS-CoV-2 était de 40,8% (IgG+/IgM+: 34,6%; IgG+/IgM-: 0,5%; IgG-/IgM+: 5,4%). La séroprévalence cumulée des IgG anti-SARS-CoV-2 est passée de 24,5% à 35,2% de mai à août 2020. Les prédicteurs indépendants des anticorps anti-SARS-CoV-2 étaient l´âge &gt; 60 ans [OR ajusté= 2,07(1,26-3,38)] et la non-appartenance au personnel médical [OR ajusté= 2,28(1,22-4,26)]. Treize virgule neuf pour cent (13,9%) des séropositifs pour les SARS-CoV-2 étaient symptomatiques et hospitalisés.</p> <p><strong>Conclusion:&nbsp;</strong>la présente étude montre une séroprévalence très élevée des anticorps anti-SARS-CoV-2 dans la ville de Bukavu, à l´Est de la République Démocratique du Congo, parmi les voyageurs et travailleurs, pouvant impacter positivement sur l´immunité communautaire de la population étudiée. Ainsi, la prise en charge de la COVID-19 devrait être contextualisée en fonction des réalités de chaque région.</p> 2021-01-27T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228674 Etude cas-témoins des facteurs associés à l´insuffisance pondérale à la naissance au Centre Hospitalier de Kingasani, Kinshasa (République Démocratique Congo) 2022-07-28T09:41:03+00:00 Jean Claude Kaka Tshinzobe tshinz2011@gmail.com Denise Kwango Ngaya tshinz2011@gmail.com <p><strong>Introduction:&nbsp;</strong>l´insuffisance pondérale à la naissance est considérée comme l´un des plus importants indicateurs de chances de survie d´un nouveau-né et un risque majeur de morbidité, de mortalité périnatale et infantile. L´objectif de cet article est d´étudier les facteurs associés à l´insuffisance pondérale à la naissance au Centre Hospitalier de Kingasani, à Kinshasa.</p> <p><strong>Méthodes:&nbsp;</strong>une étude rétrospective de type cas-témoins a été réalisée. Les informations sur les parturientes et leurs enfants nés du 1<sup>er</sup>&nbsp;janvier au 31 décembre 2016 ont été collectées dans le registre de la maternité du Centre Hospitalier Kingasani. Quatre cent cinquante-huit (458) cas (moins de 2500 grammes) ont été comparés aux 458 témoins (2500-4000 grammes). L´analyse multivariée a été faite à l´aide de la régression logistique binaire pour identifier les facteurs associés au faible poids de naissance.</p> <p><strong>Résultats:&nbsp;</strong>en 2016, 3451 naissances vivantes ont été enregistrées et la prévalence de l´insuffisance pondérale a été estimée à 13,27%. Il a été trouvé, dans l´analyse bivariée, que la parité, le terme de grossesse, le type de grossesse et le sexe du nouveau-né sont des variables significativement associées à l´insuffisance pondérale à la naissance. Après ajustement sur les variables intégrées dans l´analyse multivariée, la parité, le terme de grossesse et le type de grossesse sont demeurés significativement associées à l´insuffisance pondérale à la naissance.</p> <p><strong>Conclusion:&nbsp;</strong>de ces résultats, nous suggérons la promotion des études intégrant tous les paramètres impliqués dans la survenue de l´insuffisance pondérale à la naissance pour suivre l´évolution régulière de ce problème et des facteurs associés.</p> 2021-01-27T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228676 Etude de l´incidence des infections nosocomiales et facteurs de risque dans les maternités de la ville de Mbujimayi, République Démocratique du Congo 2022-07-28T09:59:37+00:00 Jean Christophe Bukasa jcbukasa4@gmail.com Pascal Muteba jcbukasa4@gmail.com André Kazadi jcbukasa4@gmail.com Didier Lepelletier jcbukasa4@gmail.com Félicien Ilunga jcbukasa4@gmail.com André Mutombo jcbukasa4@gmail.com Axel Ngoyi Kamanya jcbukasa4@gmail.com Angélique Bandimuna jcbukasa4@gmail.com Senghor Ngoyi Mbo jcbukasa4@gmail.com Wembonyama Stany jcbukasa4@gmail.com <p><strong>Introduction:&nbsp;</strong>cette étude vise à déterminer l´incidence des infections nosocomiales et les facteurs de risque chez les accouchées et les nouveau-nés dans les maternités de la ville de Mbujimayi en République Démocratique du Congo.</p> <p><strong>Méthodes:&nbsp;</strong>il s´agit d´une étude descriptive longitudinale d´incidence et facteurs de risque des infections nosocomiales dans les 231 maternités, qui a été réalisée chez les sujets indemnes de la pathologie au départ qu´on devrait suivre en utilisant la collecte hebdomadaire des données pendant 6 mois. Les critères utilisés pour la collecte des données étaient ceux de l´Organisation Mondiale de la Santé (OMS) basés sur les définitions simplifiées pouvant être utiles pour certains établissements n´ayant pas accès à des techniques diagnostiques poussées.</p> <p><strong>Résultats:&nbsp;</strong>l´incidence globale des infections nosocomiales chez les accouchées est de 24,8% et de 22,3% chez les nouveau-nés. Les facteurs de risque significatif d´infection nosocomiale au couple étaient les manœuvres instrumentales (p=0,005; OR=2,7; IC95% [1,3-5,4]), la césarienne faite en urgence (p=0,000; OR=2,3; IC95% [1,7-3,9]), l´utilisation d´un même flacon de collyre chez tous les bébés (p=0,004; OR=2,7; IC95% [1,4-5,5]) et l´élevage du prématuré hors couveuse (p=0,000; OR=2,61; IC95% [1,73-3,92]).</p> <p><strong>Conclusion:&nbsp;</strong>la réalisation d'enquêtes d'incidence (ou à défaut de prévalence) régulières est indispensable pour évaluer les effets des actions d'information, de sensibilisation et de formation qui pourront être mises en place pour lutter contre les infections acquises à l'hôpital.</p> 2021-01-28T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228680 Orthopaedic surgeons' perceptions and attitudes on COVID-19 related changes in practice: an international cross-sectional survey 2022-07-28T10:12:06+00:00 Nadhir Meraghni nadhir.meraghni@gmail.com Hichem Bouyoucef nadhir.meraghni@gmail.com Redouane Si Larbi nadhir.meraghni@gmail.com Nacim Soal nadhir.meraghni@gmail.com Riad Benkaidali nadhir.meraghni@gmail.com Mohamed Derradji nadhir.meraghni@gmail.com Zoubir Kara nadhir.meraghni@gmail.com Amine Hamza nadhir.meraghni@gmail.com <p><strong>Introduction:&nbsp;</strong>the purpose of this study was to assess the orthopaedic surgeons' perceptions and attitudes on COVID-19 related changes in their practice.</p> <p><strong>Methods:&nbsp;</strong>an online survey was shared with orthopaedic surgeons practicing in different countries.</p> <p><strong>Results:&nbsp;</strong>this study showed that orthopaedic surgery plan management was adapted to respond more effectively to the COVID-19 pandemic while maintaining the continuity of health care and ensuring protection of medical staff and patients. Among the introduced measures, elective surgery was postponed to free-up beds for suspected or COVID-19 positive patients requiring hospitalization. Additionally, the number of outpatient visits was considerably decreased and non-urgent visits were postponed to reduce the flow of patients in and out of hospitals and therefore minimize the risk of contamination. Interestingly, data revealed the willingness of orthopaedic surgeons to take care of COVID-19 positive patients and support their colleagues in intensive care units, if needed.</p> <p><strong>Conclusion:&nbsp;</strong>orthopaedic surgery departments have adapted their programs to face the unprecedented challenges due to the COVID-19 pandemic. Quick measures were taken to reduce the risk of contamination in patients, medical staff and to allow hospitals to free up beds for treatment of patients with positive or suspected COVID-19.</p> 2021-01-28T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228687 Simulation debriefing: a perspective from emergency medical care students at three South African Higher Education Institutions 2022-07-28T10:17:35+00:00 Andrew William Makkink amakkink@uj.ac.za Devin John Dreyer amakkink@uj.ac.za <p><strong>Introduction:&nbsp;</strong>simulation-based learning (SBL) is an educational technique that is used to create lifelike experiences within a controlled setting. Feedback and debriefing have been described as most important components in healthcare simulation. Providing feedback or debriefing loses its efficacy if it is not performed correctly. The results of poor feedback or debriefing practice may negatively affect future student performance. It is important to identify both positive and negative current practice so as to better understand the potential effects on student learning. There is a paucity of evidence relating to debriefing within the resource-constrained environment.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional design collected data using a purpose-designed, paper-based questionnaire that was validated using a pilot study. We collected data from three South African higher education institutions (HEI) offering emergency medical care qualifications. Questionnaires were distributed on-site at each HEI by an academic staff member and were returned to the researchers via courier. Participants were recruited from the second, third and fourth academic years of study. Responses were captured manually and imported into Microsoft Excel for analysis.</p> <p><strong>Results:&nbsp;</strong>we collected 153 completed questionnaires from three South African Higher Education Institutions (HEIs). Student perceptions of debriefing practices were generally positive. There were general feelings of psychological safety and an understanding between students and facilitator related to why debriefing took place. Linking debrief and learning outcomes was perceived as making debriefing meaningful to students. Question-asking techniques by facilitators were mixed, but were generally asked in a manner that encouraged self-reflection. Peer-led debriefing was perceived as good practice and a single facilitator was preferred to multiple facilitators.</p> <p><strong>Conclusion:&nbsp;</strong>several strategies related to effective feedback and debriefing were identified by the student participants as already being employed by facilitators. The potentially negative effect of multiple facilitators was highlighted by participants who indicated that they preferred a single debriefer for the entire academic year. Peer-led debriefing was perceived as a positive practice and has a number of advantages and disadvantages that should be considered and mitigated by the facilitator.</p> 2021-01-28T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228693 Aetiologies of profound bilateral sensorineural hearing loss among children in Ekiti State, South Western Nigeria 2022-07-28T10:38:14+00:00 Oyebanji Anthony Olajuyin oyebanjiolajuyin@yahoo.com Oladele Simeon Olatunya oyebanjiolajuyin@yahoo.com Toye Gabriel Olajide oyebanjiolajuyin@yahoo.com Ademola Busayo Olajuyin oyebanjiolajuyin@yahoo.com Adebola Ayotomiwa Olajuyin oyebanjiolajuyin@yahoo.com Adefunke Olarinre Babatola oyebanjiolajuyin@yahoo.com Akinwumi Kolawole Komolafe oyebanjiolajuyin@yahoo.com <p><strong>Introduction:&nbsp;</strong>a strong need exists for the knowledge of aetiologies of diseases as this will guide the clinicians on the strategies for their treatment and prevention. In this study, we determined the aetiologies of profound bilateral sensorineural hearing loss (pbSNHL) with a view to provide the relevant data needed for preventive and therapeutic intervention among children in Ekiti State, South Western Nigeria.</p> <p><strong>Methods:&nbsp;</strong>medical records of children with pbSNHL seen over a ten-year period were analysed.</p> <p><strong>Results:&nbsp;</strong>in all, records of 142 children with pbSNHL were analysed. The results showed spectrum of aetiologies that were similar to those reported decades ago with the 'unknown' assuming a recurring decimal. Of the known (acquired) cases, measles takes up the largest 'chunk' with a prevalence of 45.8%. Twenty-eight (32.2%) of those with febrile illnesses had treated their fever with ototoxic antibiotics. Late diagnosis was characteristic of the pbSNHL.</p> <p><strong>Conclusion:&nbsp;</strong>this study shows that there hasn't been any significant shift in the common causes of pbSNHL. Of great concern is the persistence of the 'unknown' causes which assumes a recurring decimal in this and previous studies. Also worrisome is the high prevalence of measles-induced pbSNHL despite the availability of anti-measles vaccine. We therefore suggest effective immunization against measles and other vaccine-preventable causes of pbSNHL. The need for intensive research on the unknown causes of pbSNHL is hereby stressed. Also recommended is routine hearing assessment for survivors of febrile conditions so as to detect, if any, hearing loss promptly.</p> 2021-01-28T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228705 Hepatocellular carcinoma in Senegal: epidemiological, clinical and etiological aspects about 229 cases at Hôpital Principal de Dakar 2022-07-28T10:50:13+00:00 Ibrahima Diallo idiallo601@yahoo.fr Bineta Ndiaye idiallo601@yahoo.fr Mouhamed Touré idiallo601@yahoo.fr Abdoul Sow idiallo601@yahoo.fr Ababacar Mbengue idiallo601@yahoo.fr Papa Silman Diawara idiallo601@yahoo.fr Sara Boury Gning idiallo601@yahoo.fr Papa Saliou Mbaye idiallo601@yahoo.fr Fatou Fall idiallo601@yahoo.fr Mouhamadou Mbengue idiallo601@yahoo.fr <p>Hepatocellular carcinoma (HCC) is a major public health problem in Senegal, and the third most common cancer in terms of incidence. However, there are no recent data on the characteristics of this pathology in our country. The aim was to describe the epidemiological, clinical, aetiological and therapeutic aspects of HCC at&nbsp;<em>Hôpital Principal de Dakar</em>, Senegal. We did a descriptive retrospective study including patients hospitalized, from January 2012 to December 2017. We included 229 patients. The mean age was 47.4 years (21 - 88 years), and 77 patients (33.6%) were under 40 years of age. The sex ratio was 6.6. Twelve patients (5.2%) had a family history of 1<sup>st</sup>&nbsp;degree cirrhosis or HCC. Ten patients (4.4%) were previously treated with nucleotide analogues. The most common clinical sign at diagnosis was abdominal pain (91.7%). Alpha-fetoprotein level was normal in 12.2% of patients, and greater than 400 ng/ml in 68.1% of cases. Abdominal ultrasound found nodular HCC in 122 patients (68.2%), infiltrative HCC in 19 patients (10.6%), and was normal in 38 cases (21.2%). Subjacent cirrhosis was detected in 71.3% of cases. Abdominal computed tomography (CT) scan showed compatible HCC lesions in 88.8% of cases. A histological diagnosis was obtained in 2 patients (0.9%). The most common etiological factor was hepatitis B virus (69.4%), characterized mostly by a younger age (p = 0.001). In 20.9% of cases, no aetiology was found. An advanced or terminal stage (BCLC C/D) was found in 217 cases (94.8%). The treatment was curative in 12 patients (5.2%), and palliative in 7 cases (3.1%). The evolution at one year was favourable in 6 patients (2.6%). Hepatocellular carcinoma (HCC) is a disease that mainly affects young male adults in Senegal. The main aetiological factor remains HBV infection. The diagnosis is made at an advanced stage and the prognosis very bad.</p> 2021-01-28T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228712 Emergency department utilization for sickle cell disease in St. Vincent and the Grenadines 2022-07-28T11:00:42+00:00 Shelly-Ann Williams shellyannw@gmail.com Shakel Henson shellyannw@gmail.com Shenese Trimmingham shellyannw@gmail.com Jill Newman shellyannw@gmail.com Julie Kanter shellyannw@gmail.com <p><strong>Introduction:</strong>&nbsp;sickle cell disease (SCD) is a chronic illness. Individuals affected by this disease are at risk for lifelong complications including episodes of acute pain, chronic pain and multi-organ injury that leads to reduced quality of life and a shortened life span. There is a wealth of data on acute care utilization for SCD in the United States. However, data from the Caribbean region is limited. The objective of this study is to explore Emergency Department (ED) utilization for SCD in St. Vincent and the Grenadines by describing: i) the characteristics of SCD related ED encounters; ii) the urgency of these encounters as defined by resource utilization; iii) the disposition for these ED encounters.</p> <p><strong>Methods:&nbsp;</strong>the study was a cross-sectional study utilizing data from the ED log books at the Milton Cato Memorial Hospital (MCMH) during non-consecutive time periods between January 1<sup>st</sup>, 2012 - December 31<sup>st</sup>, 2016.</p> <p><strong>Results:&nbsp;</strong>there were 666 SCD-related ED encounters during the study period. Thirty-four percent of encounters resulted in hospitalization and 66% of encounters met criteria for an urgent visit. The most commonly reported diagnosis was vaso-occlusive crisis and accounted for 84% of all encounters. The most frequently documented age group was the 18-30 age category at 43%.</p> <p><strong>Conclusion:&nbsp;</strong>although SCD comprised less than 2% of all ED visits, the majority of these visits could be classified as urgent visits based on resource utilization. This study adds to the emerging data on the burden of this disease in this St. Vincent and the Grenadines.</p> 2021-01-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228716 Profil épidémiologique de la dermatomyosite et de la polymyosite: expérience du service de rhumatologie de Marrakech 2022-07-28T11:08:40+00:00 Souhil Errafia Errafios@gmail.com Ahmed Mougui Errafios@gmail.com Imane El Bouchti Errafios@gmail.com <p>La dermatomyosite (DM) et la polymyosite (PM) sont des affections rares mais graves. Le but de ce travail est d'étudier, à travers la revue d'une série hospitalière, leur profil épidémiologique, clinique et évolutif. Il s´agit d´une étude rétrospective, conduite sur une période de 15 ans, entre janvier 2004 et décembre 2019. Ont été retenus les cas où le diagnostic était certain ou probable selon les critères de Bohan et Peter. Un total de 14 patients ont été inclus (8 DM et 6 PM), l´âge moyen était de de 48,7 ans. La sex-ratio était de 13F/1H. Les signes généraux existaient dans 71%. Le déficit moteur touchait les muscles des ceintures dans 71% des cas; 85,7% avaient des arthralgies et 14% des arthrites. L´érythème et l´œdème périorbitaire étaient les signes cutanés prédominants. Au bilan, la vitesse de sédimentation était accélérée chez tous les malades et les enzymes musculaires augmentées dans 80%. Les anticorps anti-nucléaires étaient positifs dans 63%. La biopsie musculaire a retrouvé une myosite inflammatoire dans 75%. L'atteinte cardiaque existait dans 14% des cas et pulmonaire dans 21%. Un cancer était associé dans 21,4% des cas. Tous les patients ont reçu une corticothérapie. L´évolution s´est faite vers l´amélioration dans 88%, avec une rechute chez 4 patientes. Dans notre contexte, la DM est plus fréquente que la PM, avec nette prédominance féminine. L'atteinte pulmonaire reste une complication lourde. L´association aux cancers semble fréquente d´où la nécessité d´un bilan systématique de néoplasie au moment du diagnostic et lors du suivi.</p> 2021-01-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228718 Hypercholesterolemia and related risk factors in a cohort of patients with diabetes and hypertension in Maputo, Mozambique 2022-07-28T11:31:09+00:00 Fausto Ciccacci fausto.ciccacci@unicamillus.org Noorjehan Majid fausto.ciccacci@unicamillus.org Sandro Petrolati fausto.ciccacci@unicamillus.org Mustafa Agy fausto.ciccacci@unicamillus.org Cacilda Massango fausto.ciccacci@unicamillus.org Stefano Orlando fausto.ciccacci@unicamillus.org Giovanni Guidotti fausto.ciccacci@unicamillus.org Paola Scarcella fausto.ciccacci@unicamillus.org Maria Cristina Marazzi fausto.ciccacci@unicamillus.org <p><strong>Introduction:&nbsp;</strong>some studies reported that 25.5% of African population presents hypercholesterolemia; however, epidemiology of hypercholesterolemia in Africa is poorly described. Mozambique is experiencing a constant growth of non-communicable diseases, but scarce data are available about hypercholesterolemia. Our study aims at describing the prevalence of hypercholesterolemia in patients with diabetes and hypertension in Mozambique and investigate possible risk factors.</p> <p><strong>Methods:&nbsp;</strong>we conducted a cross-sectional study involving all the patients diagnosed with hypertension and/or diabetes from June 2018 to November 2020 in the Zimpeto DREAM Centre (Maputo, Mozambique). For each patient, anthropometric, clinical and laboratory data were collected. Hypercholesterolemia was defined as total blood cholesterol &gt;200 mg/dL. Univariable and multivariable analysis were perfumed.</p> <p><strong>Results:&nbsp;</strong>a total of 885 patients were included, 76.2% (n=674) female. Hypertension alone was diagnosed in 670 (75.7%) patients, diabetes in 109 (12.3%) patients and 106 (11.9%) both diseases. Hypercholesterolemia was present in 410 (46.3%) patients and it was more prevalent in patients diagnosed with both diabetes and hypertension (52.8%), as compared to the patients diagnosed with hypertension (46.9%) or diabetes alone (36.7%). In the multivariable analysis, the only factors independently associated with hypercholesterolemia were female sex (aOR 1.77, 95% CI 1.26-2.48, p=0.001) and a body mass index &gt;25kg/m<sup>2</sup>&nbsp;(aOR 1.50, 95% CI 1.11-2.04, p=0.008).</p> <p><strong>Conclusion:&nbsp;</strong>our results highlight the need for a specific focus on female and obese/overweight patients, especially if diagnosed with both hypertension and diabetes, to promptly detect metabolic disorders and establish temporary preventive measures for cardiovascular events.</p> 2021-01-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228725 Influence of hepatitis B virus co-infection on virological and immunological response to antiretroviral treatment among HIV patients attending comprehensive care clinics in Makueni County, Kenya 2022-07-28T11:41:57+00:00 Geoffrey Mutisya Maitha geoffreymaitha55@gmail.com Gideon Kikuvi geoffreymaitha55@gmail.com Peter Wanzala geoffreymaitha55@gmail.com Fredrick Kirui geoffreymaitha55@gmail.com <p><strong>Introduction:&nbsp;</strong>the effect of hepatitis B virus (HBV) infection on the natural history of human immunodeficiency virus (HIV) disease remains uncertain. Therefore, this study was conducted to determine the association of HBV co-infections with CD4 count and viral load levels in response to antiretroviral treatment among HIV patients attending comprehensive care clinics in Makueni County (Kenya).</p> <p><strong>Methods:&nbsp;</strong>this was a prospective case-control study among patients seeking HIV services in three hospitals of Makueni County (Kenya). Newly diagnosed HIV mono-infected patients (controls) and HIV/HBV co-infected (cases), 18 years and above who had not started antiretrovirals (ARVs) participated. A total of 258 patients gave informed consent and participated. HIV mono-infected (controls) produced 129 while HIV/HBV (cases) gave 129 participants. P values ≤ 0.05 were considered significant.</p> <p><strong>Results:&nbsp;</strong>the majority (164, 63%) of the study participants were females for both arms of the study. The mean age of the participants was 31±0.402 years and majority of them were between the age of 26-30years old. At the beginning and end of the study the mean viral load for HIV/HBV co-infected individuals was (30169 and 1731) copies/ml while that of CD4 count was (327 and 459) cells/ul, and that of HIV mono-infected was (21860 and 1689) copies/ml and CD4 count of (421 and 437) cells/ul respectively. After enrolling them into antiretroviral therapy (ART) treatment and after six months of follow-up there was significant drop in viral load and significant increase in CD4 count for both groups at p&lt;0.001 using logistic regression.</p> <p><strong>Conclusion:&nbsp;</strong>HIV patients co-infected with hepatitis B virus had high viral load and low CD4 count compared to HIV monoinfected patients however with introduction of ARVs there was improvement in both groups with the highest noticed among the HIV/HBV co-infected patients.</p> 2021-02-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228728 A mass mimicking pancreatic adenocarcinoma, should hepatobiliary surgeons keep it in mind? a case report 2022-07-28T12:00:22+00:00 Maria Sotiropoulou marosotiropoulou@gmail.com Panagiotis Metaxas marosotiropoulou@gmail.com Michail Vailas marosotiropoulou@gmail.com Georgios Kyriakopoulos marosotiropoulou@gmail.com Paraskevi Alexakou marosotiropoulou@gmail.com Michail Psarologos marosotiropoulou@gmail.com Charilaos Kyzeridis marosotiropoulou@gmail.com Dimitrios Stergiou marosotiropoulou@gmail.com Stamatina Koskolou marosotiropoulou@gmail.com Stylianos Kapiris marosotiropoulou@gmail.com <p>Isolated metastasis to pancreas from lung cancer is an extremely rare entity, usually reported in case series and case reports in the medical literature; estimated to account for up to 3-5% of all pancreatic lesions. Herein, we describe a case of a male patient suffering from metachronous metastatic lesion to the tail of the pancreas secondary to non small cell lung carcinoma treated 4 years prior to his presentation. The patient underwent pancreatic resection due to high clinical suspicion for the malignant nature of the mass, which was proved to be secondary lesion from its prior primary tumor. To the best of our insight this is one of the few reported cases of such type of pancreatic metastasis that may be misleading for hepatobiliary surgeons during preoperative evaluation.</p> 2021-02-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228730 Aspects épidémiocliniques et suites judiciaires des abus sexuels chez les mineurs à Monastir, Tunisie 2022-07-28T12:17:50+00:00 Rim Ben Soussia rimbensoussia@gmail.com Rim Gniwa Omezzine rimbensoussia@gmail.com Walid Bouali rimbensoussia@gmail.com Mouna Zemzem rimbensoussia@gmail.com Sarra Bouslah rimbensoussia@gmail.com Lazhar Zarrouk rimbensoussia@gmail.com Lotfi Gaha rimbensoussia@gmail.com <p><strong>Introduction:</strong>&nbsp;les abus sexuels chez les mineurs constituent une réalité troublante et un problème majeur de santé publique. En effet, il s´agit d´un sujet qui a été longtemps considéré comme tabou, aux conséquences dramatiques sur la santé physique, psychique et le bien-être social des victimes. L´objectif est de préciser les aspects épidémiologiques et cliniques des abus sexuels chez les mineurs, et d´en étudier les aspects juridiques.</p> <p><strong>Méthodes:</strong>&nbsp;une étude rétrospective descriptive a été réalisée à la consultation externe de pédopsychiatrie à l´hôpital universitaire de Monastir durant la période de 12 ans et 6 mois. Nous avons inclus tous les enfants dont l´âge était inférieur à 18 ans et chez qui une agression sexuelle a été suspectée ou retenue.</p> <p><strong>Résultats:</strong>&nbsp;au total, 93 mineurs victimes d´abus sexuels ont été colligés. L´âge moyen des mineurs était de 10 ans avec un écart-type de 3,9 ans. Le sex-ratio (G/F) était de 0,9. Pour les modalités de contact sexuel, les attouchements sexuels étaient les plus fréquents dans 47,3% des cas. La majorité des abuseurs étaient de sexe masculin (93,5%). Dans plus que la moitié des cas (53,8%), ils étaient une personne de l´entourage de l´enfant et dans 28% cas, l´abus était intrafamilial. L´évaluation psychiatrique initiale a objectivé des troubles mentaux dans 70% des cas.</p> <p><strong>Conclusion:</strong>&nbsp;l´abus sexuel est un champ très vaste des agressions de nature et d´intensité très diverses. Même si l´impact physique de cet acte peut manquer dans certaines formes d´abus sexuel, l´impact émotionnel et psychologique est omniprésent avec des expressions cliniques variables.</p> 2021-02-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228732 L´intérêt de la piézochirurgie dans le traitement d´une dysplasie cémento-osseuse surinfectée par actinomycose: à propos d´un cas 2022-07-28T12:32:56+00:00 Imen Cherni cherniimen274@gmail.com Hajer Hentati cherniimen274@gmail.com Rim Hadhri cherniimen274@gmail.com Adel Bouguezzi cherniimen274@gmail.com Abdellatif Chokri cherniimen274@gmail.com Jamil Selmi cherniimen274@gmail.com <p>La dysplasie cémento-osseuse est une lésion fibro-osseuse non néoplasique qui touche l´os alvéolaire. Elle peut se présenter sous l´une des trois formes: périapicale, focale ou floride. Elle est souvent asymptomatique de découverte fortuite lors d´un examen radiologique de routine. Cependant, elle peut devenir symptomatique suite à une surinfection, une fois exposée à la flore bactérienne buccale. Nous rapportons un cas de dysplasie cémento-osseuse floride associée à une actinomycose osseuse chez une femme tunisienne de 53ans. Cette surinfection est rarement évoquée dans la littérature; une recherche sur PubMed utilisant la formule booléenne « cemento-osseous dysplasia AND actinomyces » a révélé un seul article (Smith&nbsp;<em>et al</em>. 2011). Le traitement de l´infection actinomycosique nécessite souvent une antibiothérapie de longue durée parfois associée à une chirurgie de débridement comme dans ce cas où la piézochirurgie a été utilisée dans l´élimination de la dysplasie et de l´os nécrotique.</p> 2021-02-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228736 Clinical and therapeutic outcomes of COVID-19 intensive care units (ICU) patients: a retrospective study in Ghana 2022-07-28T12:44:41+00:00 Jane Afriyie-Mensah padjei@ug.edu.gh Elvis Twumasi Aboagye padjei@ug.edu.gh Vincent Jessey Ganu padjei@ug.edu.gh Samuel Bondzi padjei@ug.edu.gh Dennis Tetteh padjei@ug.edu.gh Ernest Kwarteng padjei@ug.edu.gh Joseph Akamah padjei@ug.edu.gh Alfred Doku padjei@ug.edu.gh Patrick Adjei padjei@ug.edu.gh <p>The COVID-19 pandemic had caused significant morbidity and mortality, with over a million deaths recorded to date. Mortality recorded among severe-critically ill patients admitted to intensive care units (ICU) has been significantly high, especially in most COVID-19 epicenters. Reports on the unique clinical characteristics and outcomes from the ICU admissions are on-going with isolated studies in Africa. This study was a retrospective single-centre study involving all polymerase chain reaction (PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients admitted to the medical intensive care unit (MICU) of the department of medicine and therapeutics, Korle-Bu Teaching Hospital, over the period of 13<sup>th</sup>&nbsp;April - 28<sup>th</sup>&nbsp;June 2020. Twenty-two (22) patients in total fulfilled the inclusion criteria and are included in this report. Patients' socio-demographic characteristics, clinical and laboratory parameters outcomes as well as treatment modalities employed were extracted from their respective medical records and analyzed using STATA version 14. Dyspnoea, fever and cough were most common associated symptoms. The mean duration of admission at the ICU was 4.1 ± 3.0 days with five deaths (22.7%). About 91% (20/22) had at least one comorbidity with hypertension as the most prevalent. The median oxygen saturation/fraction of inspired oxygen (SpO<sub>2</sub>/FiO<sub>2</sub>) level was significantly higher in persons with only COVID-19 pneumonia compared to those with complicated respiratory failure (p&lt;0.001). Six (27.3%) out of the 22 patients had non-invasive ventilation, with only 1/22 (4.5%) receiving mechanical ventilation. Although non-significant, the mean duration of ICU stay was relatively shorter in patients who received therapeutic doses of anticoagulation (p=0.32). Duration of treatment with methylprednisolone was significantly associated with patient outcomes (p=0.04) and serum ferritin levels had a tendency to negatively affect outcome (p=0.06). Clearly there are still no specific targeted medications for COVID-19 treatment, except for empirically symptoms-guided treatments and management of mild to critically ill patients. Early use of systemic corticosteroids for severe to critically ill patients in the ICU using S/F ratio and CRP levels may improve outcomes.</p> 2021-02-02T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228739 Exploring factors associated with breast cancer screening among women aged 15 - 49 years in Lesotho 2022-07-28T12:52:03+00:00 Kanono Thabane thabane.kanono@gmail.com Yolisa Mashologu thabane.kanono@gmail.com Lehana Thabane thabane.kanono@gmail.com <p><strong>Introduction:&nbsp;</strong>breast cancer is associated with serious morbidity, low quality of life and mortality. Prevention through early screening remains one of the most optimal strategies against breast cancer. The primary objective of this analysis was to determine the prevalence of breast cancer screening using the clinical breast examination (CBE) and breast self-examination (BSE) methods among women aged 15-49 years, and the secondary objective was to explore demographic and socio-economic factors associated with clinical breast examination (CBE) and breast self-examination (BSE) breast cancer screening methods.</p> <p><strong>Methods:&nbsp;</strong>the study used Demographic Health Survey data collected in 2014. The study participants were Basotho women aged 15-49 years. STATA 17 was employed for developing logistic regressions and weighting for sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance.</p> <p><strong>Results:&nbsp;</strong>variables that were associated with significantly increased odds of having you had a breast cancer either self-examination or clinical test in last 12 months were: i) visiting a health centre in the past 12 months [odd ratio (OR): 1.21 (95% confidence interval [CI]:1.02, p = 1.43); p = 0.025]; ii) completion of primary level education [1.27 ((1.10; 1.49); 0.001]; iii) being aware of breast cancer [2.18 (1.78;2.65); 0.001]; and iv) age [35-39 years: 1.40 (1.10;1.78);0.007]; while district of origin [Butha - Buthe: 0.63 (0.46; 0.85); 0.003] was significantly associated with decreased odds of the outcome.</p> <p><strong>Conclusion:&nbsp;</strong>our findings suggest that raising awareness about breast cancer is the most effective method of improving breast cancer screening among women in Lesotho.</p> 2021-02-02T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228742 Macrophage activation syndrome revealing Hodgkin´s lymphoma: a case report 2022-07-28T12:58:30+00:00 Mustapha Mechtoune dr.mechtoune@gmail.com Rajae Tissir dr.mechtoune@gmail.com Ilias Tazi dr.mechtoune@gmail.com <p>Macrophage activation syndrome (MAS) is a rare immunologic syndrome, rapidly fatal in the absence of specific etiological treatment. It is defined by clinical, biological and cyto-histological criteria. Numerous etiologies have been described in MAS, the association with Hodgkin lymphoma (LH) is exceptional. We report the case of a young woman in whom a macrophage activation syndrome reveals a Hodgkin's lymphoma.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228744 Poland´s syndrome with dextroposition and paradoxical breathing 2022-07-28T13:05:19+00:00 Ng Kian Seng sars2509@gmail.com Sarvesh Seger sars2509@gmail.com <p>An asymptomatic 60-year-old woman presented to our outpatient clinic for a routine health screening as part of a government welfare program. Her medical history was unremarkable, however physical examination revealed hypoplasia of the left chest wall muscles, breast tissue, nipple, absence of axillary hair, absence of the costal cartilages of upper ribs on the left side of the chest and brachydactyly in the left hand. There was also paradoxical breathing at the levels of the 2<sup>nd</sup>, 3<sup>rd</sup>&nbsp;and 4<sup>th</sup>&nbsp;rib of the left chest. The rest of the examination was unremarkable. The chest radiograph revealed reduced upper left hemithorax volume with partial rib agenesis of the 2<sup>nd</sup>, 3<sup>rd</sup>&nbsp;and 4<sup>th</sup>&nbsp;rib, bilateral cervical ribs, dextroposition of the heart and mid thoracic scoliosis with convexity to the left. A 12-lead electrocardiogram revealed a sinus rhythm with a normal axis, lead 1 has upright P, QRS, and T waves and aVR is globally negative. The precordial leads show normal R Waves in V1-4, deep S waves in V1-2, small S waves in V3-4 and no S waves in V5-6. There is diminution of the precordial complexes in V3, 4, 5 and 6. These findings are consistent with a dextroposition of the heart. The blood investigations were unremarkable. The findings from physical examination, chest radiograph and 12 lead electrocardiogram are consistent with Poland´s Syndrome. As the patient was otherwise well and not bothered by her condition, no treatment was initiated for her.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228751 Cou Cou, flying fish and a whole exome please... lessons learned from genetic testing in Barbados 2022-07-28T13:22:14+00:00 Morris Hilary Scantlebury morris.scantlebury@ahs.ca Karlene Tanechia Barrett morris.scantlebury@ahs.ca Simeona Jacinto morris.scantlebury@ahs.ca David Orlando Christopher Corbin morris.scantlebury@ahs.ca Marina Kerr morris.scantlebury@ahs.ca Aneal Khan morris.scantlebury@ahs.ca <p>Millions of patients, with suspected complex neurogenetic disorders, living in resource limited regions around the world have no access to genetic testing despite the rapidly expanding availability and decreasing costs of genetic testing in first world nations. The barriers to increasing availability of genetic testing in resource limited nations are multifactorial but can be attributed, in large part, to a lack of awareness of the power of genetic testing to lead to a rapid, cost-effective, diagnosis that potentially will have profound clinical implications on treatment and patient outcomes. We report our experience with whole exome sequencing (WES) done for the first time in 5 patients of African descent with a suspected neurogenetic disorder living in a resource limited setting on the Eastern Caribbean island of Barbados. A diagnostic pathogenic mutation was found in 3 patients in the&nbsp;<em>SCN1A, STXBP1 and SCN4A</em>, who clinically were diagnosed with Dravet syndrome, Lennox-Gastaut syndrome, paramytonia and seizures respectively. A variant of undetermined significance was found in a patient with global developmental delays, hypotonia, with abnormal eye movements. In one patient WES was non-diagnostic. This result highlights the high yield of WES in carefully selected patients with a neurologic disease and the need for increase access to genetic testing in resource limited settings globally.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228756 Clustering of cardiometabolic risk factors in sub-Saharan Africans 2022-07-28T13:30:40+00:00 Jean Jacques Noubiap noubiapjj@yahoo.fr <p>Dyslipidemia, defined as abnormalities in circulating concentrations of total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides, is a major risk factor for cardiovascular disease (CVD). It is associated with heightened risk of stroke, myocardial infarction, and is a major contributor to global disability and mortality. According to the global burden of disease study, in 2019, high LDL cholesterol caused 4.4 million deaths (7.8% of total deaths) and 98.6 million disability-adjusted life-years (DALYs) (3.9% of total DALYs) globally, representing the fifth and eighth risk factor for mortality and disability, respectively.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228759 Sudden death complicating a coronary arteritis: polyarteritis nodosa (case report) 2022-07-28T13:43:43+00:00 Mayssem Gabsi cheniksarra@gmail.com Sarra Chenik cheniksarra@gmail.com Houaida Mahfoudhi cheniksarra@gmail.com Karima Taamallah cheniksarra@gmail.com Nadhem Hajlaoui cheniksarra@gmail.com Wafa Fehri cheniksarra@gmail.com <p>Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. Data on the optimal choice of acute myocardial infarction (AMI)´s revascularization in the context of polyarteritis nodosa (PAN) is limited to case reports and is still an open question. The present report describes a rare case of a young male patient followed for PAN presenting with acute myocardial infarction (AMI). Coronary angiography revealed multiple severe aneurysmal and stenotic changes. Based on clinical feature and angiographic findings, it was strongly suspected that the AMI was a complication of his vasculitis. This case indicates that coronary artery involvement should be carefully monitored during the chronic phase of PAN. The pathophysiology of AMI in PAN patients should be kept in mind and the interventional approach must be performed according to the angiographic findings to avoid complications.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228825 Nitroglycerin patch use in digital ischemia secondary to sepsis: a case report 2022-07-29T09:50:00+00:00 Devendrasing Vijaysing Jadhav dvndrjdhv@yahoo.com Derek Mendonca dvndrjdhv@yahoo.com Suresh Kotinatot dvndrjdhv@yahoo.com Shiva Shankar dvndrjdhv@yahoo.com Munira Al Mazmi dvndrjdhv@yahoo.com <p>Sepsis results in intense disturbances in homoeostasis and is responsible for considerable morbidity and mortality in early infancy. Owing to insufficiency on part of infant to develop adequate inflammatory response to localize the infection, they usually progress to disseminated systemic infection, pneumonia and/or meningitis. We present the case of a 26 weeks preterm boy with acute digital ischemia in right index finger progressing to impending gangrene as a manifestation of septicemia. Use of topical nitroglycerin patch with meticulous monitoring successfully alleviated the impending peripheral gangrene without any adverse effects.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228830 Malignant nodular melanoma of the vulva: a rare and aggressive tumour of the female genital tract (case report) 2022-07-29T09:56:11+00:00 Moshawa Calvin Khaba ckhaba@yahoo.co.uk Matsiane Luciah Lekala ckhaba@yahoo.co.uk Setheme Daniel Mosehle ckhaba@yahoo.co.uk <p>Malignant melanoma of the vulva is a rare and aggressive tumour with dismal prognosis. It tends to recur and metastasize early. Surgical excision with or without regional lymph node dissection is still the treatment of choice with adjuvant therapy decided on a case by case. Furthermore, HIV infection has been associated with more aggressive disease. Herein we present a 45-year-old HIV-infected female patient on antiretroviral therapy who presented with vulval ulcer for one year. On examination, she had ulcerated nodule on the labia majora. Radiology showed vulvovaginal tumour without involvement of the adjacent organs. Malignant melanoma was confirmed on both the incisional biopsy and vulvectomy. She responded poorly to radiotherapy. Furthermore, she presented with recurrence and metastatic disease a month after surgery. She was lost to follow-up clinic.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228832 Unusual type of diabetes: fibrocalculous pancreatic diabetes 2022-07-29T10:06:36+00:00 Natnicha Houngngam snabboon@yahoo.com Thiti Snabboon snabboon@yahoo.com <p>A 34-year-old Thai man complained about recurrent upper abdominal pain, polyuria and a 5kg weight loss in 6 months. He had no history of steatorrhea, jaundice, gallstones, alcohol intake, or cassava consumption. Physical examination was unremarkable except for his body mass index of 17.6 kg/m². The plasma glucose level was 672 mg/dL with normal serum amylase and lipase. Laboratory investigation showed serum osmolality of 287 mOsm/kg, bicarbonate 22 mEq/L and negative for serum ketone. Fibrocalculous pancreatic diabetes (FCPD) was diagnosed from a plain abdominal X-ray study showing multiple large calcifications over a pancreatic area (A). Computerized tomography of the abdomen revealed a large tubular calcification in dilated pancreatic duct during entering the duodenum (B). Scattered calcifications along the pancreatic duct were also noted (C). A genetic study revealed a SPINK1 N34S heterozygous mutation. His hyperglycemia responded well to insulin therapy. FCPD, a late stage of tropical chronic pancreatitis (TCP), is classified as a secondary cause of diabetes resulting from pancreatic dysfunction. The clinical picture consists of a triad of pancreatic calcification, abdominal pain, and diabetes. Its distinctive features are young age at onset, lean or underweight, ketosis-resistant diabetes, presence of large intraductal pancreatic calculi, and reported mainly in tropical developing countries. An etiology was previously thought to relate to malnutrition; however, a strong association with SPINK1 mutation is noted. The major morbidities are recurrent abdominal pain, steatorrhea, and malnutrition, while the majority of death is associated with diabetic nephropathy and pancreatic cancer. Treatment includes pancreatic enzyme supplementation, insulin therapy, and surgical drainage.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228837 Giant primary dural lymphoma with vault involvement 2022-07-29T10:20:24+00:00 Mohamed Moutaoukil brahimjebouri@gmail.com Brahim Eljebbouri brahimjebouri@gmail.com <p>A 52-year-old immunocompetent man presented with frontal headaches. Physical examination showed a painful frontal hump (A). Computed tomography (CT) and magnetic resonance imaging (MRI) scans revealed a giant bifrontal extra-axial tumor (B, C). He benefited from total removal of the tumor. Pathological examination of the resected mass led to the diagnosis of anaplastic large B-cell lymphoma (cell immunopositivity for CD30 and anaplastic lymphoma kinase) (D). He was transferred to the oncology unit for chemo and radiotherapy with good clinical evolution. Primary dural lymphoma (PDL) is extremely rare, accounting for 7% of all primary central nervous system lymphomas. PDL usually involves sites that are rich in meningothelial cells, and results in a localized mass or plaque-like thickening of the dura that radiologically resembles a number of other diseases, such as meningioma or subdural hematomas. Although there is as yet no optimal treatment for PDL, surgical excision followed by radiotherapy and chemotherapy are recommended.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228841 Les stomies digestives: quel impact professionnel? 2022-07-29T13:08:48+00:00 Rached Bayar mzeineb@yahoo.com Seifeddine Baccouche mzeineb@yahoo.com Zeineb Mzoughi mzeineb@yahoo.com Abdelkoddous Chelbi mzeineb@yahoo.com Nafaa Arfa mzeineb@yahoo.com Lassad Gharbi mzeineb@yahoo.com Hafedh Mestiri mzeineb@yahoo.com Mohamed Taher Khalfallah mzeineb@yahoo.com <p><strong>Introduction:&nbsp;</strong>les stomies digestives constituent l´aboutissement d´un certain nombre d´interventions chirurgicales. Elles peuvent être temporaires ou définitives. Le patient porteur de stomie se trouve confronté à des aléas d´ordre physique et psychologique. Il nécessite donc une adaptation aux changements et une acceptation de la situation qu´elle soit temporaire ou définitive. Le but de ce travail est d´évaluer l´impact des stomies digestives sur la qualité de vie des patients et leur retentissement professionnel.</p> <p><strong>Méthodes:&nbsp;</strong>il s´agit d´une étude rétrospective, menée de janvier 2010 à décembre 2014. Au cours de cette période 115 patients avaient eu des stomies digestives. Parmi ces patients, soixante étaient en âge d´activité professionnelle, avaient un emploi fixe et avaient repris leurs travail; ils constituent l´effectif de notre étude. Le recueil des données était réalisé par un questionnaire spécifique: le questionnaire généraliste SF-36 réalisé en post opératoire.</p> <p><strong>Résultats:&nbsp;</strong>le score moyen pour la qualité de vie globale pour les patients stomisés était 41. Quarante patients avaient une mauvaise qualité de vie avec un score SF-36 qui était inférieur à 50. Notre étude a démontré que les patients stomisés ont éprouvé des difficultés de fonctionnement dans des situations de travail. Quarante-huit patients décrivaient une gêne directement liée à la stomie lors de l´exercice de leurs activités professionnelles. Les causes évoquées étaient d´ordre physique dans 6 cas et d´ordre psychologique dans 3 cas. Six patients étaient mutés vers des postes plus adaptés à leur situation.</p> <p><strong>Conclusion:&nbsp;</strong>l´objectif de la prise en charge des patients porteurs de stomie digestive doit être la réintégration sociale et professionnelle adéquate. Ceci ne peut se concevoir qu´en impliquant le médecin de travail, le psychologue, le stomathérapeute et les associations dans cette prise en charge.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228860 Organisation d´une campagne de masse et gratuite de distribution des moustiquaires imprégnées d´insecticides à longue durée d´action dans le contexte de la COVID-19 au Niger 2022-07-29T13:22:51+00:00 Fatima Aboubakar charles.wiysonge@mrc.ac.za Hadiza Jackou charles.wiysonge@mrc.ac.za Blanche-Philomene Melanga Anya charles.wiysonge@mrc.ac.za Boubé Hamani charles.wiysonge@mrc.ac.za Patrick Katoto charles.wiysonge@mrc.ac.za Charles Shey Wiysonge charles.wiysonge@mrc.ac.za <p>Les moustiquaires imprégnées d´insecticides à longue durée d´action (MILDA) sont nécessaires dans la lutte anti vectorielle du paludisme. Cependant, leur distribution n´est pas encore optimale en région sub-saharienne. Selon les projections, la pandémie de COVID-19 retarderait davantage la distribution des MILDA. Au Niger, une campagne de distribution des MILDA avec une approche multi-sectorielle (Etat-partenaire-société civile) a été organisée dans le respect de mesure barrières contre la COVID-19. La stratégie porte-à-porte dans les ménages a été retenue pour l´organisation de cette campagne pour éviter les espaces clos et garder l´aspect communautaire. Un total de 13,994,681 personnes a bénéficié de MILDA (soit un taux de réussite de 101%) dans six régions ciblées. Un effort collectif est nécessaire pour pérenniser la lutte contre le paludisme dans l´ère COVID-19.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228863 Assessment of knowledge, attitudes and practices towards anthrax in Narok County, Southern Kenya 2022-07-29T13:34:50+00:00 Josephat Mutiso Mbai alfsmbooni@gmail.com Jack Owiti Omolo alfsmbooni@gmail.com Dominic Wamamba alfsmbooni@gmail.com Daniel Maritim alfsmbooni@gmail.com Zeinab Gura alfsmbooni@gmail.com Mark Obonyo alfsmbooni@gmail.com <p><strong>Introduction:&nbsp;</strong>anthrax is endemic in some parts of Kenya causing mortalities in livestock and morbidity in humans. On January 20<sup>th</sup>, 2018, news media reported suspected anthrax in a remote southern Kenyan village after villagers became ill following consumption of meat from a dead cow that was confirmed, by microscopy, to have died of anthrax. We assessed community knowledge, attitude and practices (KAP) to identify intervention gaps for anthrax prevention.</p> <p><strong>Methods:&nbsp;</strong>we conducted a KAP survey in randomly selected households (HHs) in villages from selected wards. Using multi-stage sampling approach, we administered structured questionnaire to persons aged ≥15 years to collect KAP information from February 11<sup>th</sup>-21<sup>st</sup>, 2018. From a set of questions for KAP, we scored participants’ response as “1” for a correct response and “0” for an incorrect response. Univariate analysis and Chi-square tests were performed to explore determinants of KAP. Concurrently, we gathered qualitative data using interview guides for thematic areas on anthrax KAP from key informant interviews and focus group discussions. Qualitative data were transcribed in Ms Word and analyzed along themes by content analysis.</p> <p><strong>Results:&nbsp;</strong>among 334 respondents: 187/334 (56%) were male; mean age, 40.7±13.6 years; 331/334 (99.1%) had heard of anthrax and 304/331 (91.8%) knew anthrax to be zoonotic. Transmission was considered to be through eating dead-carcasses by 273/331 (82.5%) and through contact with infected tissue by 213/331 (64.4%). About 59% (194/329) regularly vaccinated their livestock against anthrax, 53.0% (174/328) had slaughtered or skinned a dead-animal and 59.5% (195/328) practiced home slaughter while 52.9% (172/325) treated sick-animals by themselves. Sex (p≤0.001), age (p=0.007) and livestock-rearing years (p≤0.001) were significantly associated with knowledge and practice.</p> <p><strong>Conclusion:&nbsp;</strong>there were differences in knowledge and practices towards anthrax by age-group and sex. Enhanced public health education and targeted interventions by relevant government agencies is recommended.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228867 Connaissances, attitudes et pratiques des adolescents et des enseignants en matière de contraception: résultats d´une étude qualitative réalisée en République Démocratique du Congo 2022-07-29T13:43:56+00:00 Dieudonné Mpunga Mukendi mpungadieudonn@yahoo.fr Faustin Chenge Mukalenge mpungadieudonn@yahoo.fr Mapatano Mala Ali mpungadieudonn@yahoo.fr Thérèse Mambu Nyangi Mondo mpungadieudonn@yahoo.fr Gilbert Wembodinga Utshudienyema mpungadieudonn@yahoo.fr <p><strong>Introduction:&nbsp;</strong>notre objectif était d´analyser les connaissances, attitudes et pratiques des adolescents et des enseignants sur la planification familiale (PF).</p> <p><strong>Méthodes:&nbsp;</strong>en s´appuyant sur la théorie d´action raisonnée publiée en 2011 par Fishbein et Ajzen, une étude qualitative était conduite en 2018 auprès de sept enseignants et 62 adolescents de 15-19 ans. Les données étaient collectées à travers six focus groups (FG) des adolescents et sept interviews semi-structurées des enseignants. Elles étaient analysées à l´aide du logiciel Atlas Ti suivant une approche déductive.</p> <p><strong>Résultats:&nbsp;</strong>l´abstinence périodique, les préservatifs masculins et les pilules étaient les seules méthodes contraceptives citées. Les adolescents et les enseignants avaient de l´appréhension pour utiliser les méthodes contraceptives artificielles en dehors du préservatif masculin utilisé irrégulièrement. Les filles préfèrent les méthodes naturelles, craignant les effets secondaires. La majorité d´adolescents désirent être informés sur la PF à l´école; cependant, ils estiment insuffisant le contenu du cours d´éducation à la vie (EVIE) et fustigent le manque d´ouverture des enseignants. Les pairs, les frères, les sœurs et l´internet étaient les principales sources d´information. Les mères étaient une source importante d´information surtout pour les filles contrairement aux pères en général moins appréciés.</p> <p><strong>Conclusion:&nbsp;</strong>les connaissances sur la PF sont faibles. Les idées fausses sur la contraception entrainent le recours aux pratiques peu efficaces pour prévenir les grossesses non désirées. Pour améliorer ces connaissances, un programme de formation des enseignants devrait être élaboré; le contenu du cours d´EVIE formalisé et réglementé.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228869 Congenital segmental dilatation of the jejunum in an African child: a case report 2022-07-29T13:54:17+00:00 Trésor Kibangula Kasanga tshibwidflo@gmail.com Florent Tshibwid Zeng tshibwidflo@gmail.com Stéphane Jampy-Biaya tshibwidflo@gmail.com Anatole Nyembwe Mbuyi tshibwidflo@gmail.com Sébastien Mbuyi-Musanzayi tshibwidflo@gmail.com <p>Congenital segmental dilatation of the intestine is a rare disease. It is rarely located in the jejunum and its etiology is still unknown despite many theories suggesting its mechanism. We report a case of a 17 months girl who experienced nonspecific symptoms (abdominal pain, constipation and loss of appetite) since early her infancy. She had no growth retardation and had moderate abdominal distension on physical examination. Investigations undertaken could not increase suspicion of congenital segmental dilatation of the intestine (CSDI). The diagnosis was made peroperatively and a resection was done, followed by end-to-end jejunal anastomosis. There were no postoperative complications and the patient is doing well after four months. One should think of CSDI in children with chronic subocclusion or digestive hemorrhage.</p> 2021-02-03T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/242215 Méningiome chordoïde extra-axiale: à propos d´un cas 2023-02-23T11:15:56+00:00 Mohammed Guini drguini.mohammed@gmail.com Mohammed Khoulali drguini.mohammed@gmail.com Nabil Raouzi drguini.mohammed@gmail.com Noureddine Oulali drguini.mohammed@gmail.com Service de Neurochirurgie, Centre Hospitalier Universitaire Mohammed VI, Oujda, Maroc drguini.mohammed@gmail.com <p>Une découverte fortuite d'une lésion de novo chez une patiente de 45 ans, la tomodensitométrie cérébrale réalisée montre une lésion ptérionale gauche intra-diploïque isodense avec une lyse osseuse, qui se rehausse de façon homogène après injection de produit de contraste, l'imagerie par résonnance magnétique montre une lésion hypointense en T1 et spontanément hyperintense en T2 FLAIR, et se rehausse très fortement après injection de Gadolinium. Une résection complète de la tumeur a été réalisée. Le diagnostic histologique était de méningiome chordoïde.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/228872 Healthcare providers' knowledge and perceptions regarding the use of modern contraceptives among adolescent girls in Umlazi township, KwaZulu-Natal province, South Africa 2022-07-29T14:07:42+00:00 Mbuzeleni Hlongwa hlongwa.mbu@gmail.com Boikhutso Tlou hlongwa.mbu@gmail.com Khumbulani Hlongwana hlongwa.mbu@gmail.com <p><strong>Introduction:&nbsp;</strong>the phenomenon of unintended adolescent pregnancy continues to be a reproductive and public health concern in sub-Saharan Africa. Healthcare providers play an important role in influencing the use of contraceptives among adolescent girls. This study assessed knowledge and perceptions of healthcare providers regarding the use of modern contraceptives among adolescent girls in Umlazi township, KwaZulu-Natal province, South Africa.</p> <p><strong>Methods:&nbsp;</strong>this was a descriptive study involving 35 healthcare providers covering all 10 primary healthcare clinics in Umlazi township. Data collected through a structured questionnaire were coded, entered into Epi data manager (version 4.6) and exported to STATA (version 15.0) for analysis.</p> <p><strong>Results:&nbsp;</strong>of the thirty-five healthcare providers that participated in this study, professional nurses (54.3%) and enrolled nurses (17.1%) constituted the majority. The mean age of the participants was 42.11 years, with 88.6% being females. More than a third (37.1%) of healthcare providers did not know whether or not modern contraceptives make users promiscuous, while more than half (57%) had negative attitudes towards adolescents exploring contraceptive methods. Healthcare providers viewed health systems challenges, such as poor working conditions, long queues, and contraceptives stock-outs, as deterrents towards the provision of quality sexual behaviour counselling and modern contraceptive education to users.</p> <p><strong>Conclusion:&nbsp;</strong>poor health systems and negative behaviours by healthcare providers influences the delivery of family planning services in primary healthcare clinics and serve as barriers to quality family planning services provided to younger women.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/230975 Acute pulmonary embolism in a child following SARS-CoV-2 infection: a case report 2022-08-31T15:17:31+00:00 Amal El Ouarradi amal.elouarradi@gmail.com Nabila Chekhlabi amal.elouarradi@gmail.com Mahassine Elharras amal.elouarradi@gmail.com Ilham Bensahi amal.elouarradi@gmail.com Sara Oualim amal.elouarradi@gmail.com Fatimazahr Merzouk amal.elouarradi@gmail.com Salma Abdeladim amal.elouarradi@gmail.com Mohammed Sabry amal.elouarradi@gmail.com Nouzha Dini amal.elouarradi@gmail.com <p>In children, coronavirus disease 2019 infection is rarely symptomatic. Severe forms with respiratory distress are rare, thromboembolic complications are exceptional. We report a rare case of a 14 years old girl with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was admitted to the hospital for bilateral pulmonary embolism with intracardiac thrombus. The girl progressed well on anticoagulation.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/230982 Mothers of adolescent girls and Human Papilloma Virus (HPV) vaccination in Western Kenya 2022-08-31T15:44:56+00:00 Hillary Mabeya mabeya4@gmail.com Jack Odunga mabeya4@gmail.com Davy Vanden Broeck mabeya4@gmail.com <p><strong>Introduction:&nbsp;</strong>human papilloma virus (HPV) which is preventable is the main cause of cervical cancer and it targets mostly young adolescents. The study was to determine the practice desire, attitude and knowledge of mothers of adolescent girls on HPV vaccination in Western Kenya.</p> <p><strong>Methods:&nbsp;</strong>this was a descriptive cross-sectional study design. Data was obtained using semi-structured questionnaires and analyzed using both descriptive and inferential statistics at 95% confidence level using the SPSS software version 22. A p-value ≤ 0.05 was considered statistically significant.</p> <p><strong>Results:&nbsp;</strong>ninety five percent of the mothers had intentions to vaccinate their daughters and also had a positive attitude and their response to HPV vaccination was significantly lower than those without intentions p=0.02, 95% CI, OR=0.48 (0.90-0.89). Vaccination against HPV was low at 9.4% with a mean age of 34 years. Our results found a high level of cervical cancer awareness (85.0%), HPV and vaccine awareness respectively (62.0%, and 64.0%). “Vaccination of my daughters will prompt early sexual activity and the cost of HPV vaccination being a barrier to vaccination” had a statistically significant influence on the practice of vaccination. Negative attitude to daughters´ early onset of sexual activity significantly reduced up take while positive attitude to cost of HPV vaccine significantly increased up take of HPV vaccination with p value of 0.007 and 0.04 respectively.</p> <p><strong>Conclusion:&nbsp;</strong>awareness of HPV and HPV vaccine prevention is low among mothers of adolescent girls in Western Kenya. There was a positive attitude and high desire towards the use of HPV vaccination therefore a need for awareness, policy and unify efforts to reduce cervical cancer burden.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/230984 Pulmonary infarction mimicking a lung mass: a case report 2022-08-31T15:59:02+00:00 Balakrishnan Jayakrishnan drjayakrish@hotmail.com Saif Musabah Al-Mubaihsi drjayakrish@hotmail.com Nisrien Elfatih Elhassan drjayakrish@hotmail.com Rashid Fuad Al-Sukaiti drjayakrish@hotmail.com Jojy George drjayakrish@hotmail.com Younis Said Al-Alawi drjayakrish@hotmail.com Adil Hashim Al-Kindi drjayakrish@hotmail.com <p>Pulmonary infarction usually appears as a wedge-shaped opacity with its base placed laterally. Rarely, pulmonary infarctions may appear as a well-defined rounded opacity mimicking lung cancer and surgical lung biopsy may often be required for definitive diagnosis. We report a patient who was admitted with submassive pulmonary embolism who had an incidental finding of a well-defined opacity in computed tomography (CT) scan. The lesion was avid on positron emission tomography (PET) scan and the patient was a smoker. So, we investigated him further with a percutaneous and later a thoracoscopic lung biopsy. Tumour-like pulmonary infarction is often a challenge for the clinicians.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231619 Profil histologique et évolution des tumeurs intra rachidiennes opérées 2022-09-09T08:45:34+00:00 Sylvain Denléwendé Zabsonre drjayakrish@hotmail.com Augustin Tozoula Bambara drjayakrish@hotmail.com Souleymane Ouattara drjayakrish@hotmail.com Adama Traore drjayakrish@hotmail.com Adeline Julie Kyelem Kafando drjayakrish@hotmail.com Alfred Aselme Dabilgou drjayakrish@hotmail.com Stéphane Klamadji drjayakrish@hotmail.com Yacouba Haro drjayakrish@hotmail.com Ibrahim Dao drjayakrish@hotmail.com Boureima Kinda drjayakrish@hotmail.com Abel Kabre drjayakrish@hotmail.com <p>Les tumeurs intrarachidiennes sont peu fréquentes. Leur diagnostic positif est basé sur l´imagerie médicale surtout l´IRM. L´anatomopathologie apporte la certitude du diagnostic. La chirurgie est le traitement de choix pour la plupart d´entre elles. Le pronostic est fonction de la nature histologique et de l´état clinique initial du patient. Nous rapportons le profil histologique et l´évolution des tumeurs intra rachidiennes opérées dans notre service. Il s´agissait d´une étude rétrospective sur une période 10 ans. Ont été inclus les cas opérés confirmés à l´histologie (23 cas). Quatre dossiers non exploitables ont été exclus. Les patients ont consulté en moyenne 79 jours après les premiers symptômes pour un syndrome de compression médullaire lente dans 11 cas. Sept TDM et 14 IRM permettaient d´objectiver 4 tumeurs intramédullaires, 9 intradurales, 1 extra durale et 5 localisations non précises. L´histologie concluait à un méningiome dans 11 cas, un neurinome dans 3 cas. Elle a conclu au même diagnostic que l´imagerie médicale dans 7 cas (4 TDM et 3 IRM). L´exérèse était macroscopiquement complète dans 14 cas, partielle dans 5 cas. Après un recul de 6 mois, 6 patients avaient récupéré totalement, 9 partiellement. Le diagnostic était tardif. L´IRM décrivait mieux la lésion, mais était limitée dans l´approche histologique. Les méningiomes dominaient. L´exérèse était le plus souvent complète. Les suites opératoires étaient favorables.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231622 A report on the development of COVID-19 guidelines for rehabilitation professionals in African settings 2022-09-09T09:10:26+00:00 Etienne Ngeh Ngeh kesekedy2008@yahoo.com Nnenna Nina Chigbo kesekedy2008@yahoo.com Zillah Whitehouse kesekedy2008@yahoo.com Emelie Moris Anekwu kesekedy2008@yahoo.com Lela Mukaruzima kesekedy2008@yahoo.com Lungile Mtsetfwa kesekedy2008@yahoo.com Rogers Kitur kesekedy2008@yahoo.com Mary Wetani Agoriwo kesekedy2008@yahoo.com Priscillah Ondoga kesekedy2008@yahoo.com Maurice Douryang kesekedy2008@yahoo.com Lynn Cockburn kesekedy2008@yahoo.com <p>COVID-19 is the disease caused by SARS-COV-2, one of a large family of coronaviruses. Severe forms of the disease can lead to respiratory failure with multiple organ failure necessitating rehabilitation in both acute and long-term care. With the increasing prevalence of COVID-19 and rehabilitation needs, the African Rehabilitation Network (AFRENET) produced a guidance document to assist in reducing variation in clinical practice among rehabilitation professionals in the Africa Region. This report outlines the process of the guideline development.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231625 Evaluation of the Ebola Virus Disease (EVD) preparedness and readiness program in Uganda: 2018 to 2019 2022-09-09T09:20:57+00:00 Peter Nsubuga pnsubuga@globalphsolutions.com Ben Masiira pnsubuga@globalphsolutions.com Christine Kihembo pnsubuga@globalphsolutions.com Jayne Byakika-Tusiime pnsubuga@globalphsolutions.com Caroline Ryan pnsubuga@globalphsolutions.com Miriam Nanyunja pnsubuga@globalphsolutions.com Raoul Kamadjeu pnsubuga@globalphsolutions.com Ambrose Talisuna pnsubuga@globalphsolutions.com <p><strong>Introduction:&nbsp;</strong>the Democratic Republic of Congo (DRC) declared its 10<sup>th</sup>&nbsp;outbreak of Ebola virus disease (EVD) in 42 years on August 1<sup>st</sup>&nbsp;2018. The rapid rise and spread of the EVD outbreak threatened health security in neighboring countries and global health security. The United Nations developed an EVD preparedness and readiness (EVD-PR) plan to assist the nine neighboring countries to advance their critical preparedness measures. In Uganda, EVD-PR was implemented between 2018 and 2019. The World Health Organization commissioned an independent evaluation to assess the impact of the investment in EVD-PR in Uganda. Objectives: i) to document the program achievements; ii) to determine if the capacities developed represented good value for the funds and resources invested; iii) to assess if more cost-effective or sustainable alternative approaches were available; iv) to explore if the investments were aligned with country public health priorities; and v) to document the factors that contributed to the program success or failure.</p> <p><strong>Methods:&nbsp;</strong>during the EVD preparedness phase, Uganda's government conducted a risk assessment and divided the districts into three categories, based on the potential risk of EVD. Category I included districts that shared a border with the DRC provinces where EVD was ongoing or any other district with a direct transport route to the DRC. Category II were districts that shared a border with the DRC but not bordering the DRC provinces affected by the EVD outbreak. Category III was the remaining districts in Uganda. EVD-PR was implemented at the national level and in 22 category I districts. We interviewed key informants involved in program design, planning and implementation or monitoring at the national level and in five purposively selected category I districts.</p> <p><strong>Results:&nbsp;</strong>Ebola virus disease preparedness and readiness was a success and this was attributed mainly to donor support, the ministry of health's technical capacity, good coordination, government support and community involvement. The resources invested in EVD-PR represented good value for the funds and the activities were well aligned to the public health priorities for Uganda.</p> <p><strong>Conclusion:&nbsp;</strong>Ebola virus disease preparedness and readiness program in Uganda developed capacities that played an essential role in preventing cross border spread of EVD from the affected provinces in the DRC and enabled rapid containment of the two importation events. These capacities are now being used to detect and respond to the COVID-19 pandemic.</p> 2021-02-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231626 Reduced cervical cancer screening in Zimbabwe as an indirect impact of the COVID-19 pandemic: implications for prevention 2022-09-09T09:27:01+00:00 Grant Murewanhema gmurewanhema@yahoo.com <p>The COVID-19 pandemic has brought unprecedented challenges to healthcare for women, including disruption of cervical cancer screening services. Zimbabwe is a high cervical cancer burden country, with the cancer being the leading malignancy among women. The disruptions in screening could have long-term negative impacts on cervical cancer burden reduction in Zimbabwe. Factors related to institutions, policy, clients and healthcare workers have contributed to the decline in screening and need to be addressed urgently to restore this essential service.</p> 2021-02-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231627 The positive effect of eugenol on acute pancreatic tissue injury: a rat experimental model 2022-09-09T09:51:23+00:00 Alexandra Tsaroucha mike_vailas@yahoo.com Vasileios Kaldis mike_vailas@yahoo.com Michail Vailas mike_vailas@yahoo.com Dimitrios Schizas mike_vailas@yahoo.com Maria Lambropoulou mike_vailas@yahoo.com Apostolos Papalois mike_vailas@yahoo.com Christina Tsigalou mike_vailas@yahoo.com Apostolos Gaitanidis mike_vailas@yahoo.com Michael Pitiakoudis mike_vailas@yahoo.com Constantinos Simopoulos mike_vailas@yahoo.com <p><strong>Introduction:&nbsp;</strong>we present a rat experimental model used to evaluate the possible reduction in the extent of pancreatic tissue injury in acute pancreatitis cases, after administration of eugenol.</p> <p><strong>Methods:&nbsp;</strong>one hundred and twenty Wistar rats were used, which were randomly assigned in 3 groups: sham (n=20), control (n=50) and eugenol (n=50). Acute pancreatitis was induced by biliopancreatic ligation in the control and eugenol groups, but not in the Sham group. In the eugenol group, eugenol was administered per-os. Five histopathological parameters, such as edema, inflammatory infiltration, duct dilatation, hemorrhage and acinar necrosis were evaluated.</p> <p><strong>Results:&nbsp;</strong>at 72 h from acute pancreatitis induction, the total histological score was diminished in the eugenol group (p&lt;0.0005) and duct dilatation and inflammatory infiltration were reduced compared to the control group (p&lt;0.05). In addition, at 72 h, eugenol reduced pancreatic myeloperoxidase activity (p&lt;0.0005).</p> <p><strong>Conclusion:&nbsp;</strong>eugenol, a highly free radical scavenger agent, may have a preventive role in acute pancreatic injury, as it was evident in our rat experimental model.</p> 2021-02-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231629 Secondary syphilis mimicking tinea cruris in an HIV infected patient: a case report 2023-02-22T10:32:48+00:00 Cyntia Yuylana yulyanacyntia@gmail.com Muji Iswanty yulyanacyntia@gmail.com Idrianti Idrus Paturusi yulyanacyntia@gmail.com <p>Syphilis is known as the great imitator with various clinical presentations which often lead to confusion and misdiagnosis. A 28-year-old male presented with non-pruritic and painless erythematous patches around the anus and scrotum. Initial differential diagnosis with tinea cruris. Fungal examination was negative. Serological tests for syphilis were positive and anti-HIV screening was reactive. A diagnosis of secondary syphilis was established and the patient was given intramuscular injection of 2.4 million unit of benzathine penicillin. The skin lesions improved significantly 1 week after treatment, confirming a diagnosis of secondary syphilis with HIV. Annular skin lesions in secondary syphilis are uncommon and often misleading. This case emphasizes the importance of considering secondary syphilis in the differential diagnosis of annular lesions.</p> 2021-02-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231631 Impact de la pandémie COVID-19 sur la vaccination des enfants au Maroc: enquête électronique auprès de 103 pédiatres 2022-09-09T10:18:29+00:00 Nabila Chekhlabi chekhlabi@gmail.com Raja Arrab chekhlabi@gmail.com Said Ettair chekhlabi@gmail.com Nouzha Dini chekhlabi@gmail.com <p><strong>Introduction:&nbsp;</strong>nul ne peut nier les résultats protecteurs satisfaisants de la vaccination contre plusieurs maladies graves dans le monde et particulièrement au Maroc. L´extension de la pandémie COVID-19 dans notre pays a entrainé une baisse importante de la vaccination des enfants, ce qui pourrait causer des flambées épidémiques dans le futur. D´où l´intervention du ministère de la santé pour pallier à cette situation. L´objectif était de montrer l´ampleur du relâchement de la vaccination en temps COVID-19 et sortir avec des recommandations visant à rétablir ce changement.</p> <p><strong>Méthodes:&nbsp;</strong>il s´agit d´une étude transversale sur l´impact de cette pandémie sur le suivi vaccinal des enfants. Nous avons mené une enquête nationale auprès des pédiatres sous forme d´un questionnaire électronique via Google Forms. Nous avons procédé à la collecte, l´analyse et l´interprétation des résultats.</p> <p><strong>Résultats:&nbsp;</strong>cent trois pédiatres marocains ont répondu au questionnaire. Plus de 2 tiers des pédiatres exercent au secteur privé et pratiquent tout le calendrier vaccinal. La majorité des pédiatres (95%) ont reçu des questions émanant des craintes des parents sur la vaccination. Nous avons noté que 82,5% des parents hésitent à venir au cabinet et 5,8% refusent de faire la vaccination pendant cette période. Environ 22% des pédiatres ont arrêté totalement la vaccination et 72,8% ont décalé les vaccins d´un mois.</p> <p><strong>Conclusion:&nbsp;</strong>il est essentiel de maintenir la confiance de la population dans la vaccination. Une évaluation continue de la couverture vaccinale, des recommandations claires et une large sensibilisation du grand public seront nécessaire pour répondre aux changements vaccinaux durant la pandémie de COVID-19.</p> 2021-02-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231633 Emergency embolization for breast pseudoaneurysm following vacuum-assisted biopsy: a case report 2022-09-09T10:37:51+00:00 Nguyen Thai Binh bsnguyenminhduc@pnt.edu.vn Nguyen Minh Duc bsnguyenminhduc@pnt.edu.vn Thieu-Thi Tra My bsnguyenminhduc@pnt.edu.vn Le Viet Dung bsnguyenminhduc@pnt.edu.vn Doan Tien Luu bsnguyenminhduc@pnt.edu.vn Le Tuan Linh bsnguyenminhduc@pnt.edu.vn <p>Vacuum-assisted breast biopsy (VABB) is a minimally invasive procedure and has become an important treatment method. Although VABB is a minimally invasive procedure, it might cause complications, particularly those associated with blood vessels. In this article, we aimed to describe a 35-year-old female who experienced pseudoaneurysm post-VABB and was successfully treated with embolization. She presented to the hospital with a suspected left breast tumor. The pathology report after biopsy confirmed fibroadenoma, and the patient underwent VABB to remove the tumor. One hour after VABB, the patient described pain and swelling at the location of the removed tumor. Breast ultrasound revealed a hematoma and pseudoaneurysm. The bleeding did not stop following the application of manual compression. Breast hemorrhage was controlled by endovascular embolization. Pseudoaneurysm is an uncommon complication of VABB, and embolization represents an effective method for the management of breast pseudoaneurysm.</p> 2021-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231639 La péritonite encapsulante sclérosante idiopathique: à propos d´un cas 2022-09-09T10:55:04+00:00 Nizar El Bouardi nizar154@yahoo.fr Moulay Youssef Alaoui Lamrani nizar154@yahoo.fr Meriam Haloua nizar154@yahoo.fr Badrredine Alami nizar154@yahoo.fr Meryem Boubou nizar154@yahoo.fr Mustapha Maaroufi nizar154@yahoo.fr <p>La péritonite encapsulante sclérosante est une entité pathologique très rare. C´est une affection fibroinflammatoire chronique du péritoine aboutissant à la formation d´une coque péritonéale fibreuse diffuse engainant totalement ou localement les viscères abdominaux, notamment le tube digestif. Les signes cliniques sont peu spécifiques et trompeurs. L´imagerie médicale, notamment la tomodensitométrie assoie aisément le diagnostic en mettant en évidence une fine membrane péritonéale englobant un agglutinant d´anses digestives. Les formes secondaires (post dialyse péritonéale, tuberculeuse, médicamenteuse, post chimiothérapie intra péritonéale) sont assez fréquentes, cependant la forme idiopathique reste très rare et peu de cas ont été rapporté par la littérature. Nous rapportons, à travers d´une observation, le cas d´une forme idiopathique chez une femme de 53 ans.</p> 2021-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231646 Treatment of chronic hepatitis C with sofosbuvir in a hemodialysis patient: a case report 2022-09-09T12:22:20+00:00 mtchoups@gmail.com mtchoups@gmail.com Hanen Chaker mtchoups@gmail.com Mona Boudabbous mtchoups@gmail.com Salma Toumi mtchoups@gmail.com François Pegdebamba Kissou mtchoups@gmail.com Saba Gargouri mtchoups@gmail.com Khawla Kammoun mtchoups@gmail.com Faiçal Jarraya mtchoups@gmail.com Nabil Tahri mtchoups@gmail.com Soumaya Yaich mtchoups@gmail.com Mohamed Ben Hmida mtchoups@gmail.com <p>The treatment of chronic hepatitis C virus (HCV) infection in chronic hemodialysis patients remains an issue of great concern for nephrologists. In 2008 the kidney disease improving global outcomes working group suggested the use of pegylated interferon in end stage kidney disease patients treated by dialysis. Since then, series and some clinical trials on different direct-acting antiviral agents have shown better efficacy and tolerance than interferon-based regimens. Data on the efficacy, tolerance and the right dose of sofosbuvir in this population are still unclear. We report a case of chronic HCV genotype 1b infection in a 47-year-old patient on maintenance hemodialysis successfully treated by a combination of sofosbuvir and ledipasvir for 12 weeks. Evolution was marked by the complete regression of the hepatic cytolysis, a complete and sustained virologic response with HCV viral load undetectable for a 24 months follow-up period. No adverse reaction was found. The treatment of HCV genotype 1 or 4 infection in patients on maintenance hemodialysis is possible with sofosbuvir based regimens with a good efficacy/safety ratio in the absence of current recommended drugs for patients with eGFR&lt;30ml/min/1.73m<sup>2</sup>. The prescription of sofosbuvir should be encouraged amongst this population in this setting.</p> 2021-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/231655 Megaesophagus 2022-09-09T12:37:31+00:00 Danilo Coco webcostruction@msn.com Silvana Leanza webcostruction@msn.com <p>Achalasia is a disorder of the primary motility of the esophagus characterized by insufficient relaxation of the lower part esophageal sphincter and absence of esophageal peristalsis, clinically it presents dysphagia for solids and liquids and "bird-beak" appearance on endoscopic and radiological studies. A 77-year-old man presented at our emergency room with a ten year history of dysphagia for solids and liquids, regurgitation and substernal chest pain after meals. He reported vomiting. Her medical history included arterial hypertension. She had no a previous surgical history of any type of surgery. In the past, he had refused any kind of treatment. He had a Glasow coma scale (GCS) of 15. His vital signs showed hypertension with arterial blood pressure of 180/100 mmHg, not tachycardia and not fever. Routine blood investigations not showed leukocytosis, normal hemoglobin and protein chain reaction (PCR) in the range. Arterial blood gas was normal. Upon physical examination, thoracic auscultation revealed decreased vesicular breath sounds in both hemithorax. Abdominal examination was unremarcable. A chest radiography revealed an air-fluid level. Thoracic-abdominal computed tomography (CT) scan demonstrated mega-esophagus with an air-fluid levels, a dilated and tortuous esophageal lumen and numerous food ingestis. Upper gastrointestinal endoscopy showed a dilated esophagus, food ingestis and mucosal ulcers. The patient refused operation but we made a multidisciplinary meeting to discuss how to treat other future cases like this.</p> 2021-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232544 Encephalopathy and COVID-19: a case report 2022-09-27T08:24:51+00:00 Mohamed Lazraq benhamzasabah5@gmail.com Sabah Benhamza benhamzasabah5@gmail.com Soufiane Saadaoui benhamzasabah5@gmail.com Salah Hayar benhamzasabah5@gmail.com Mounir Louardi benhamzasabah5@gmail.com Hind Moujahid benhamzasabah5@gmail.com Abdelhak Bensaid benhamzasabah5@gmail.com Youssef Miloudi benhamzasabah5@gmail.com Najib El Harrar benhamzasabah5@gmail.com <p>Case numbers reported in literature with neurological manifestations potentially linked to COVID-19 is constantly increasing. Most often it is sudden anosmia, headache, encephalopathy or stroke. Pathophysiology of this neurological involvement is still poorly understood. While viral genome is very rarely detected in cerebrospinal fluid, inflammatory involvement is often very significant. We report a case of SARS-CoV-2 encephalopathy without respiratory distress or cytokine storm.</p> 2020-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232546 Management and outcome of hypertrophic obstructive cardiomyopathy in pregnant women: a case report 2022-09-27T08:33:34+00:00 Maryem Assamti maryem.smt@gmail.com Ramia Bougrine maryem.smt@gmail.com Nabila Ismaili maryem.smt@gmail.com Noha El Ouafi meryem.bouhamida@uit.ac.ma <p>Hypertrophic cardiomyopathy (HCM) is a common inherited cardiomyopathy, with an estimated prevalence of 1 in 500 people. Despite overall favorable outcomes with modern treatment and early diagnosis of disease, adverse complications could occur during times of physiological stress like pregnancy. Complications of HCM include sudden cardiac death, heart failure, and arrhythmia. We report the case of a 32-year-old pregnant woman with obstructive HCM, presenting with recurrent episodes of ventricular arrhythmia despite medical therapy. This case exhibits how close monitoring and proper management during pregnancy according to the latest recommendations, resulted in a successful and uneventful delivery.</p> 2020-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232547 Constrictive pericarditis: 21 years' experience and review of literature 2022-09-27T08:40:48+00:00 Taamallah Karima cardiokarima@yahoo.fr Ben Zaied Nesrine cardiokarima@yahoo.fr Lahdhili Hatem cardiokarima@yahoo.fr Ben Omrane Skander cardiokarima@yahoo.fr Denguir Raouf cardiokarima@yahoo.fr Chenik Selim cardiokarima@yahoo.fr <p>To the best of our knowledge there are no publications about Tunisian experience in constrictive pericarditis (CP); the aim of this study was therefore to review our twenty-one years’ experience in terms of clinical and surgical outcomes and risk factors of death after pericardiectomy. An analytic bicentric and retrospective study carried out on 25 patients (20 male) with CP underwent pericardiectomy, collected over a 21-years period. The mean age was 40.46±16.74 years [7.5-72]. The commonest comorbid factor was tabagism (52%). The most common etiology was tuberculosis (n = 11, 44%). Dyspnea was the most common functional symptom (n = 21, 84%). Pericardiectomy was performed in all our patients within 2.9±3.19 months after confirmation of diagnosis. It was subtotal in 96% of cases. The commonest postoperative complications are pleural effusion (20%). Dyspnea was regressed within 1.8 months in 80% of cases and clinical signs of right heart failure within a mean duration of 1.62 months in 53% of cases. Perioperative mortality was 12% (3 deaths), late mortality was 4% (1 patient). Cardiopulmonary bypass, New York Heart Association (NYHA) over class II and right ventricular dysfunction are the prognostic factors of mortality (p = 0.001, 0.046, 0.019). Tuberculosis as etiology of CP had no impact on mortality. CP is a rare disease, with non-specific clinical signs. Pericardiectomy is effective with a significant improvement of the functional status of patients and favorable outcome at short and long term nevertheless hospital mortality is not negligible and depends on many factors.</p> 2021-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232548 A giant spontaneous subcapsular hematoma of the liver revealing a COVID-19 infection, a coincidence? (A case report) 2022-09-27T08:51:04+00:00 Anisse Tidjane tidjane.anisse@univ-oran1.dz Amel Laredj tidjane.anisse@univ-oran1.dz Nabil Boudjenan-Serradj tidjane.anisse@univ-oran1.dz Salim Bensafir tidjane.anisse@univ-oran1.dz Benali Tabeti tidjane.anisse@univ-oran1.dz <p>Hemorrhagic manifestations during COVID-19 infections are increasingly described in the literature. We report the first case of spontaneous subcapsular hematoma of the liver revealing a COVID-19 infection in a 44-year-old woman with no underlying health condition history, a computerized tomography evaluation showed an aspect of lung ground-glass opacities, with moderate impairment estimated at about 20%. Reverse transcription-polymerase chain reaction confirmed the diagnosis of COVID-19 infection. During the COVID-19 pandemic, non-traumatic bleeding such as spontaneous hematomas in patients with no coagulation disorder could be a manifestation of COVID-19 infection.</p> 2021-02-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232549 Résultats thérapeutiques des carcinomes nasopharyngés: étude monocentrique à l´hôpital universitaire Fattouma Bourguiba de Monastir en Tunisie 2022-09-27T09:09:34+00:00 Amel El Korbi elkorbiamel@gmail.com Sarra Ben Tkhayat elkorbiamel@gmail.com Rachida Bouatay elkorbiamel@gmail.com Mehdi Ferjaoui elkorbiamel@gmail.com Naourez Kolsi elkorbiamel@gmail.com Khaled Harrathi elkorbiamel@gmail.com Jamel Koubaa elkorbiamel@gmail.com Jamel Koubaa elkorbiamel@gmail.com <p><strong>Introduction:&nbsp;</strong>les carcinomes nasopharyngés (CNP) sont relativement fréquents dans le pourtour méditerranéen. La survie a été largement améliorée avec les nouvelles techniques d´irradiation et les nouvelles molécules de chimiothérapie. L´objectif de notre étude est d´analyser les résultats thérapeutiques et décrire les facteurs pronostiques des CNP. <strong>Méthodes:&nbsp;</strong>il s´agit d´une étude rétrospective menée entre janvier 1995 et décembre 2014, des observations de patients traités et suivis dans notre service pour un carcinome du nasopharynx. Le recueil des données a été réalisé à partir d´une fiche type. L´analyse statistique a été réalisée à l´aide du logiciel SPSS. La survie a été calculée selon la méthode de Kaplan-Meier. <strong>Résultats:&nbsp;</strong>soixante-treize cas de CNP ont été colligés. L´âge moyen était de 48 ans. Une prédominance masculine a été notée. La majorité des tumeurs (56%) étaient localement avancées (T3-T4). Après un recul moyen de 45,5 mois, le taux de récidives locorégionales était de 19,4%. Trois patients (4%) ont présenté des métastases osseuses. La survie globale à 5 ans était de 65%. Les facteurs influençant positivement la survie globale à l´analyse étaient le stade TNM précoce et le fractionnement de 1,8 Grays/séance de la radiothérapie. Les taux de récidives locales et ganglionnaires étaient respectivement de 13,8% et 5,5%, essentiellement pour des tumeurs classées T4 N2. Les séquelles thérapeutiques étaient dominées par les otites séromuqueuses (42,7%), le trismus (38,7%) et la xérostomie (32%). <strong>Conclusion:&nbsp;</strong>la survie globale des CNP s´est améliorée particulièrement avec l´avènement de la radio-chimiothérapie concomitante. Néanmoins, la toxicité tardive invalidante demeure non négligeable. Les facteurs de bon pronostic retrouvés dans cette étude étaient le stade tumoral précoce ainsi que la modalité de fractionnement de la radiothérapie.</p> 2020-02-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232695 Carcinome épidermoïde de la vésicule biliaire compliquant une dilatation kystique de la voie biliaire principale (VBP) et du canal cystique: à propos d´un cas 2022-09-28T06:15:19+00:00 Mohamed Boudou boudoumohmed0@gmail.com Rachid Jabi boudoumohmed0@gmail.com Christine Kora boudoumohmed0@gmail.com Achraf Miry boudoumohmed0@gmail.com Imane Kamaoui boudoumohmed0@gmail.com Mohammed Bouziane boudoumohmed0@gmail.com <p>La maladie kystique congénitale de l´arbre biliaire est considérée parmi les facteurs de risque connus du cancer de la vésicule biliaire. Nous rapportons le cas d´un carcinome épidermoïde de la voie biliaire (VB) compliquant une dilatation kystique des voies biliaires chez une femme de 54 ans qui a été hospitalisée pour pancréatite biliaire avec un scanner abdominal montrant un épaississement nodulaire du fond vésiculaire et une dilatation fusiforme du canal cystique et de la voie biliaire principale (VBP) avec une lésion de la queue du pancréas évoquant en premier lieu un cystadénome mucineux. Une cholécystectomie élargie au lit vésiculaire emportant la voie biliaire distale, anastomose cholédoco-duodénal avec une spléno-pancréatectomie caudale + drainage étaient réalisées. L´histopathologie de la masse de la vésicule biliaire a révélé un carcinome épidermoïde modérément différencié invasif sans infiltration du parenchyme hépatique. La patiente a commencé une chimiothérapie adjuvante. Notre patiente ne présentait pas les symptômes typiques du cancer de la vésicule biliaire et la radiologie était nécessaire pour son diagnostic. La chirurgie reste la meilleure option thérapeutique pour le cancer de la vésicule biliaire à un stade précoce, tandis que la chimio-radiation adjuvante peut également être bénéfique. La cholécystectomie et la résection de la dilatation kystique de la voie biliaire chez les patients à haut risque constituent le moyen de prévention le plus performant.</p> 2021-02-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232552 An asymptomatic neoformation on the hard palate 2022-09-28T06:03:55+00:00 Valentino Natoli ginzia.85@hotmail.it Cinzia Casu ginzia.85@hotmail.it <p>A 70-year-old patient with positive anamnesis of hypertension and arthritis, went to our observation for an asymptomatic localized lesion on the hard palate. The lesion has been present for about seven years and initially appeared as a slight swelling at the midline of the hard palate. He reported a slow and constant expansion but remained asymptomatic. The objective examination revealed poor oral hygiene conditions, previous periodontal disease and prosthetic and endodontic treatments. On the anterior third of the hard palate in a central position there were multiple pink rounded neoformations, the bigger of about 1 cm in diameter and of elastic consistency. The patient confirmed the habit of tapping the tip of the pen on the palate. Palpation of the laterocervical lymph nodes was negative. There was no leakage of liquid to compression.</p> 2021-02-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232553 Pleomorphic adenoma of hard palate: a case report 2022-09-27T09:39:07+00:00 Zemmouri Yousra zemmouri.yousra@gmail.com Chbicheb Saliha zemmouri.yousra@gmail.com <p>Pleomorphic adenoma is a benign mixed tumor, which is composed of myoepithelial and epithelial cells. A fibrous capsule separates these cells from the surrounding tissues. Pleomorphic adenoma is the most common salivary gland tumour accounting for 40-70% of all major and minor salivary gland tumours. It is also the commonest minor salivary gland benign tumours accounting for 70% of all tumours. Hard palate is the commonest site followed by upper lip, buccal mucosa, tongue, floor of mouth, retromolar trigone. This case report discusses a case of pleomorphic adenoma of hard palate in an old man after complete excision of the tumour, which was confirmed by a biopsy specimen.</p> 2021-02-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232554 The silent giant 2022-09-27T09:50:46+00:00 Sofia Pina sofiampina@gmail.com Susana Rodrigues sofiampina@gmail.com <p>A 61-year-old male, with history of cardiovascular disease, entered the Emergency Department due to jaundice, pruritus and acholia with 1 week evolution. The physical examination revealed a large mass in the right hypochondrium, with no pain or defense on palpation. Analytically, there was no increase in inflammatory parameters, but total bilirubin value was 14.9mg/dL, direct bilirubin 8.0mg/dL and there was a slight increase in transaminases (AST 99U/L and ALT 64U/L) along with an increase in GGT (472U/L). He was submitted to an abdominal computed tomography (CT) scan that revealed a large liquid mass (189mm of larger diameter) that extended through the right hypochondrium and right flank, with a cranial pole at the level of the hepatic hilum. This was causing dilation of the hepatic channels and intrahepatic bile ducts as well as compression of the nearby structures (pancreatic head). Due to obstructive jaundice, the patient was admitted and went into surgery. Intraoperatively, we saw a gallbladder with approximately 20cm long axis. He was submitted to a cholecystectomy with resection of the main bile duct and Roux-en-Y hepaticojejunostomy. In the postoperative period there was the need for a prolonged admission in the intensive care unit (ICU) due to septic shock with multiorgan dysfunction but with progressive recovery. The patient was discharged after 45 days of hospitalization. The anatomy of the specimen revealed an adenocarcinoma involving the main bile duct and the gallbladder, G1, pT3Nx stage.</p> 2021-02-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/232556 Clinicopathological and ultrasound features of endometrial cancer in postmenopausal women: a retrospective study in a single institute in South Korea 2022-09-27T10:10:06+00:00 Hyen Chul Jo gmfather@gmail.com Jong Chul Baek gmfather@gmail.com Seon Mi Lee gmfather@gmail.com Ji Eun Park gmfather@gmail.com In Ae Cho gmfather@gmail.com Joo Hyun Sung gmfather@gmail.com <p><strong>Introduction:&nbsp;</strong>endometrial cancer is the most common type of cancer in the female genital tract. Most patients are diagnosed during postmenopausal periods. This study aimed to investigate the demographic characteristics as well as cutoff value of endometrial thickness and ultrasound characteristics of endometrial cancer in postmenopausal patients. <strong>Methods:&nbsp;</strong>we retrospectively analyzed 244 postmenopausal women who underwent endometrial sampling from February 2016 to December 2019. Information of patients was obtained through medical records. The patients were divided into two groups according to histopathological results. Group A included patients with endometrial cancer and group B included patients with non-malignant lesions. Data were summarized based on demographic and ultrasound characteristics. <strong>Results:&nbsp;</strong>hypertension and history of endometrial hyperplasia were associated with the incidence of endometrial cancer in this study. Endometrial cancer was diagnosed in all ranges when the endometrial thickness was ≥5 mm. Endometrial fluid collection, with increased endometrial thickness, was a risk factor associated with endometrial cancer. <strong>Conclusion:&nbsp;</strong>regardless of symptoms and risk factors, endometrial histological confirmation in postmenopausal women should be conducted immediately if endometrial abnormalities such as an endometrial thickness ≥5 mm or endometrial fluid collection are detected by transvaginal ultrasound.</p> 2021-02-10T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/233983 Fibrose rétropéritonéale au CHU Ibn Sina de Rabat: à propos de 18 cas 2022-10-13T11:03:23+00:00 Abdoulazizi Bilgo bilgoabdoulazizi@yahoo.com Moussokoro Hadja Koné bilgoabdoulazizi@yahoo.com Youssef Lamzaf bilgoabdoulazizi@yahoo.com Anissa Benjafaar bilgoabdoulazizi@yahoo.com Amine Saouli bilgoabdoulazizi@yahoo.com Tarik Karmouni bilgoabdoulazizi@yahoo.com Khalid El Khader bilgoabdoulazizi@yahoo.com Abdellatif Koutani bilgoabdoulazizi@yahoo.com Ahmed Ibn Attya Andaloussi bilgoabdoulazizi@yahoo.com <p>La fibrose rétropéritonéale (FRP) est une pathologie rare caractérisée par la formation d´une plaque fibro-inflammatoire dans l´espace rétropéritonéale en avant de l´aorte abdominale, responsable d´un engainement des uretères. Le tableau clinique n´est pas spécifique et la pathologie est souvent révélée par une uropathie obstructive. Nous avons mené une étude descriptive rétrospective étendue sur 10 ans, de janvier 2006 à décembre 2016, réalisée dans les services d´urologie B et de néphrologie du Centre Hospitalier Universitaire Ibn Sina. Nous avons inclus 18 patients dans l´étude dont 11 hommes et 7 femmes, avec un âge moyen de 51,4 ans ± 11,2. Le diagnostic a été révélé par des douleurs lombaires chez 14 patients. L´insuffisance rénale obstructive était présente chez 15 de nos patients et le diagnostic de FRP a été posé par l´uroscanner. Le bilan étiologique notait des antécédents de néoplasies pour 2 patients, de pathologies inflammatoires pour 2 autres patients et une chirurgie rétropéritonéale chez un patient. On notait l´association de prises médicamenteuses chroniques chez plus de la moitié des patients. Le traitement comportait un double volet: une sonde double J systématique chez tous les patients et un traitement systémique par de la corticothérapie et des immunosuppresseurs selon le profil évolutif. Le traitement par urétérolyse a été réalisé d´emblée chez 3 patients. L´évolution a été favorable avec une nette amélioration de la fonction rénale chez 12 patients. La rechute est survenue chez 2 patients après 2 ans de suivi. L´association de signes généraux à une insuffisance rénale obstructive doit faire évoquer le diagnostic de FRP. La recherche de causes secondaires devrait être systématique, avec un accent particulier à mettre sur le syndrome d´hyper IgG4 et les pathologies néoplasiques.</p> 2021-02-10T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/233985 Right sided Bochdalek diaphragmatic hernia appeared as a life-threatening event in an infant: a case report 2022-10-13T11:18:39+00:00 Charikleia Demiri harademiri@hotmail.com Vasilios Mouravas harademiri@hotmail.com Vasilios Lambropoulos harademiri@hotmail.com Chrysostomos Kepertis harademiri@hotmail.com Kleanthis Anastasiadis harademiri@hotmail.com Ioannis Spyridakis harademiri@hotmail.com <p>We report a case of a 5-month-old female infant who presented with a cardiorespiratory distress and shock. After thoracic computed tomography (CT) scan, a right sided Bochdalek hernia was diagnosed with massive herniation of the abdominal viscera causing mediastinal shift. The girl underwent emergency laparotomy, which confirmed the right sided diaphragmatic hernia with herniation of small bowel and colon. After reduction of herniated contents, the defect in the diaphragm was closed. The patient had an uneventful post-operative cause. This case demonstrates that an undiagnosed Bochdalek hernia can appear with such a severe, life-threatening and misleading presentation.</p> 2021-02-10T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/233987 Isolated common iliac artery aneurysm 2022-10-13T11:30:42+00:00 Othman Zahdi othman_zahdi@um5.ac.ma Brahim Lekehal othman_zahdi@um5.ac.ma <p>A 67-year-old male consulted for abdominal pain dating back one month. The patient had as cardiovascular risk factors smoking and arterial hypertension. The physical examination found a pulsatile abdominal mass, in the right iliac fossa, the peripheral pulses were palpated bilaterally and symmetrically. A computerized tomography (CT scan) angiography revealed an isolated aneurysm of the right common iliac artery measuring 40mm in diameter, without proximal neck, and extended to the iliac bifurcation (A). The surgical indication was justified by the high risk of rupture. An open surgical repair was preferred to endovascular repair given the anatomical layout. After a midline laparotomy, the aneurysm was individualized carefully by a transperitoneal approach, and the aorta and the distal iliac arteries were controlled (B). The aneurysm was opened, an arterial reconstruction was done using a bifurcated pollster graft (16/8mm), with an aortic proximal end to end anastomosis below the inferior mesenteric artery. Two distal end to end anastomosis on the left common iliac artery, and right hypogastric artery, with reimplantation of the external artery laterally on the right leg of the graft (C). The postoperative course was uneventful, and the patient was discharged on the 5<sup>th</sup>&nbsp;day. He was reviewed at three months' follow-up, with good patency of the arterial restoration.</p> 2021-02-10T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/233992 Corrigendum: Meryem Lemsanni et al. Fractures sus et inter-condyliennes de l´humérus distal chez l´adulte doi: 10.11604/pamj.2020.36.346.24516 2022-10-13T12:53:35+00:00 Meryem Lemsanni lemsani.meryam@hotmail.com Rachid Chafik lemsani.meryam@hotmail.com Mohamed Madhar lemsani.meryam@hotmail.com Hanane Elhaoury lemsani.meryam@hotmail.com Youssef Najeb lemsani.meryam@hotmail.com <p>Ce corrigendum modifie l´article "Fractures sus et inter-condyliennes de l´humérus distal chez l´adulte".&nbsp;<a href="https://www.panafrican-med-journal.com/content/article/37/362/full/"><em><strong>Access corrected manuscript</strong></em></a>&nbsp;<a href="https://www.panafrican-med-journal.com/content/article/36/346/full/">Pan African Medical Journal. 2020; 36: 346</a>. doi :&nbsp;<a href="https://doi.org/10.11604/pamj.2020.36.346.24516">10.11604/pamj.2020.36.346.24516</a>.</p> 2021-01-10T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/233993 The Moroccan medical file between practice and politics: a cross-sectional study 2022-10-13T13:08:16+00:00 Naouadir Rajae cheikh.amine@gmail.com Cheikh Amine cheikh.amine@gmail.com Ajaja Mohamed Rida cheikh.amine@gmail.com Bouatia Mustapha cheikh.amine@gmail.com Naji Saida cheikh.amine@gmail.com El Hassani Amine cheikh.amine@gmail.com <p><strong>Introduction:&nbsp;</strong>the medical file is a key element of quality, reflecting good hospital management. Many steps have been taken through its history leading up to computerization. This Process allows the sharing of files with both the health staff and patients, while respecting the professional confidentiality between parties. However, in Morocco, as is the case in other countries that are unable to computerize all their hospitals, it is necessary to study first the medical file in paper before proceeding with its computerization. The purpose of our study is to describe the state of the hard copy medical record in our Host University and international hospital, Cheikh Zaid in Morocco. <strong>Methods:&nbsp;</strong>that is a cross-sectional study that lasted for three months in Cheikh Zaid hospital. The collection of data from this institution was based on the evaluation of 100 medical records of inpatients, seeing as they respond to our study criteria and requirements better than outpatients. Said evaluation was inspired by a clinical audit grid recommended by the High Authority for Health (HAS). Extraction of the results is done using the SPSS 13.0, Microsoft Excel, and Microsoft Visio software. In addition, we used the observation method to correct the errors found. <strong>Results:&nbsp;</strong>the results showed that 75% of the files are in good condition and well organized. However, administrative documents were missing in 70% of the cases (national identity card, health insurance card and copy of the patient's consent form). Moreover, in 83% of cases, the identity of the person to be notified in case of complications and the consent form were missing. It is also the case for the discharge report. The latter is incomplete in 97% of the cases. Also, the file transfer data from one service to another were missing in 82% of the medical files. <strong>Conclusion:&nbsp;</strong>according to the results, improving the medical file is necessary both administratively and medically. Thus, all parties, including doctors and nurses must be aware of their tasks and roles in this process. Despite the advances in the computerization of the medical file in several hospitals in Morocco, the maintenance of the hard copy version remains unavoidable and still necessary, to protect the rights of both the patient and his medical staff.</p> 2021-02-10T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/233995 Myofibroblastome extramammaire de localisation pelvienne: à propos d'un cas 2022-10-13T13:21:12+00:00 Kanta Ka ka.kanta04@gmail.com Mamadou Lassana Foba ka.kanta04@gmail.com Sidy Ka ka.kanta04@gmail.com Mamadou Moustapha Dieng ka.kanta04@gmail.com Papa Macoumba Gaye ka.kanta04@gmail.com Ahmadou Dem ka.kanta04@gmail.com <p>Un myofibroblastome de type mammaire est une tumeur molle rare; les myofibroblastomes extramammaires sont particulièrement rare. Un homme de 78 ans s'est présenté en consultation pour des douleurs pelviennes soulagées par la défécation ou les urines. Le toucher rectal retrouve une masse en avant de la paroi rectale antérieure. L'imagerie par résonance magnétique (IRM) montre une masse de 10 x 6 x 8cm, bien circonscrite et hétérogène, située en arrière de la vessie qu'elle refoule vers l'avant, en avant du recto-sigmoïde. L'immunohistochimie montre des cellules tumorales co-exprimant CD34 et la desmine de façon diffuse, expression de Rb dans la majorité des cellules, expression des récepteurs aux œstrogènes, expression intense et diffuse de la P16, un index de prolifération avec le ki67 estimé à 25%. Il n'y a pas eu de récidive après 8 mois de radiothérapie d'induction suivie de chirurgie. Un myofibroblastome de type mammaire est une tumeur rare et bénigne. La récidive n'est quasiment pas observée après traitement local. Ce cas permet de mettre en avance la possibilité d'utiliser la radiothérapie afin de faciliter la chirurgie.</p> 2021-02-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/233996 Diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility in a referral clinical setting: a Port Harcourt, Nigeria experience 2022-10-13T13:27:14+00:00 Emeka Ray-Offor erayoffor@yahoo.com Tamunomie Kennedy Nyengidiki erayoffor@yahoo.com <p><strong>Introduction:&nbsp;</strong>intrauterine pathologies were traditionally evaluated by blind dilatation and curettage along with hysterosalpingography. Hysteroscopy is a veritable tool for evaluation of uterine cavity pathologies with an increasing availability in Nigeria. The study aims to report the diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility from a Nigerian metropolis. <strong>Methods:&nbsp;</strong>a retrospective cross-sectional study of consecutive cases of infertile women referred for hysteroscopy to an ambulatory care endoscopy facility in Port Harcourt, Nigeria. The variables collated included age, parity, past gynaecological history, indication, hysteroscopy findings and interventions. Statistical analysis was performed using SPSS version 25. <strong>Results:&nbsp;</strong>included in study were 75 patients undergoing a total of 124 hysteroscopic procedures. The age range of patients was 25 to 56 years (mean 40.7 ± 5.9 years). A positive diagnostic yield of 93.3% with non-visualization of intracavitary uterine pathology in 5 patients was recorded. The most common pathologies were submucous myoma-25(31.3%), endometrial polyps- 18(22.5%) and intrauterine adhesions-18(22.5%). There was no statistical difference between the mean age of patients with or without polyp, myoma and intrauterine adhesions (P = 0.185, P = 0.510 and P = 0.619 respectively) but a non-linear relationship between age and polyp detection (Eta2 = 0.024). Operative hysteroscopies were all performed on out- patient basis but staged in 30(40.0%) patients. <strong>Conclusion:&nbsp;</strong>benign uterine growths and intrauterine adhesions are frequent causes of uterine factor infertility. A high successful completion rate of hysteroscopic interventions was achieved.</p> 2021-02-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234184 Predictors of contraceptive method mix in the Cameroon development corporation plantation camps 2022-10-17T10:04:24+00:00 Agbor Nathan Emeh nsaghads@hotmail.com Dickson Shey Nsagha nsaghads@hotmail.com Hermann Ngouakam nsaghads@hotmail.com <p><strong>Introduction:&nbsp;</strong>low socioeconomic status is a risk factor for maternal death and contraceptive use has been shown to reduce maternal deaths in those poor settings. Despite the tremendous benefits of contraceptives in the regulation of reproductive health indicators, its use in less developed countries continue to remain unacceptably low. The purpose of this study was primarily to assess the contraceptive method mix and then determine the predictors of contraceptive use in the Cameroon Development Corporation (CDC) plantation camps.</p> <p><strong>Methods:&nbsp;</strong>mix sampling was used. Firstly, two CDC camp localities (Tiko and Pena Mboko) were purposively selected. Pre-existing clusters within these localities were then randomly selected and then eligible participants within the sampled clusters systematically selected. Using the main street junction as starting point, direction of sample collection was determined by spinning a plastic bottle. From the start of street junction and moving in direction of the bottle pointer, all households left to the principal investigator were visited in search of eligible participants which were sexually active women aged 15-49 years who gave consent/assent. One participant was selected per household. We used pretested interviewer-administered questionnaires that covered information on socio-demographic characteristics, reproductive health and contraceptive use. Statistical significance was set at p-value ≤ 0.05.</p> <p><strong>Results:&nbsp;</strong>six hundred and thirty four (634) sexually active women aged 15-49 years were included in the study; majority were 25-35 years (246; 38.8%). The current contraceptive prevalence was 63.1% [59.3-66.8] (400); of which 312 participants (78%) used a single method while 88 (22%) participants used contraceptives in combination. The most common methods in use were rhythm (196; 49%), male condom (109; 27.2%) and implants (63; 15.8%). When adjusted, statistically significant determinants for contraceptive use were age range and marital status such that odds of using contraceptives was lower in women &lt; 35 years and those cohabiting (AOR= 0.71 [0.50-1.00] and AOR=0.62 [0.44-0.87] respectively).</p> <p><strong>Conclusion:&nbsp;</strong>current contraceptive practice in the CDC plantation camps is geared toward less effective traditional methods than the more effective modern methods. More health education is needed to adjust this paradigm.</p> 2021-02-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234186 Assessment of hospitalized patients awareness of their rights: a cross-sectional descriptive study 2022-10-17T10:18:57+00:00 Dildar Muhammad dildarmuhammad999@gmail.com Anayat Jan dildarmuhammad999@gmail.com Sehrish Naz dildarmuhammad999@gmail.com <p><strong>Introduction:&nbsp;</strong>in this modern era and in the speedily changing atmosphere of health care, health care practice and patients has affected by many factors. These days, in many states the patient rights has become the pivot of the national attention in medical culture. Awareness of health rights is important to achieve the best level of health care. The study was aimed to assess the awareness of hospitalized patients about the rights.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional descriptive study was conducted in different wards of public sector tertiary care hospitals of Peshawar, over four months duration from February to May 2018. Hospitalized patients who were being admitted for at least two days from 17 to 70 years of age were included. Before asking the patients to answer the questionnaire, consent from the patients was acquired. A self-administered semi-structured questionnaire was adopted. Data analysis was done through SPSS version 22.</p> <p><strong>Results:&nbsp;</strong>among 200 participants 46% were male and 54% were female, 35.5% were from urban and 64.5% were from rural areas. Patients were less aware of their individual rights, like 65.5% of clients were not cognizant of the patients special bill of rights while 59% were aware to receive non-discriminatory and timely health services.</p> <p><strong>Conclusion:&nbsp;</strong>most of the clients were not conscious of their individual health rights. About half of the sample knew that the patients will receive respectful care and the patients will receive care in clean and medically safe environment.</p> 2021-02-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234189 Exposure to parental and sibling smoking and future intentions to smoke among 13-15 years old school age children in Saudi Arabia 2022-10-17T10:31:36+00:00 Sudhakar Vundavalli dr.sudhakar.vundavalli@jodent.org Ahmed Ali Alfawzan dr.sudhakar.vundavalli@jodent.org Vardharajula Venkata Ramaiah dr.sudhakar.vundavalli@jodent.org Moataz Alruwaithi dr.sudhakar.vundavalli@jodent.org AbdulMajeed AlMogbel dr.sudhakar.vundavalli@jodent.org Merin Mathew dr.sudhakar.vundavalli@jodent.org <p><strong>Introduction:&nbsp;</strong>prevalence of smoking in school children is alarming in Saudi Arabia and little is well-known about the aspects stimulating such behaviours in secondary school children. The aim of this study was to assess the association between influence of parent/sibling/peer smoking and future intentions to initiate smoke among 13-15 years old school children in Al Ras town, Saudi Arabia.</p> <p><strong>Methods:&nbsp;</strong>a cross sectional survey was conducted in Al Ras city during first quarter of 2019. Data was collected from 492 secondary school children who were selected through multistage stratified cluster sampling. Pretested, self-administered Arabic questionnaire was used to collect data about socio-demographic and prevalence of current smoking behaviours and associated factors. Descriptive statistics was done initially, following by binomial regression to assess the predictors of current smoking and future smoking intentions.</p> <p><strong>Results:&nbsp;</strong>the overall prevalence of smoking in respondents was 22.7% and statistically significant difference in smoking prevalence's between boys and girls was observed (40% vs 5.6%). Among the predictors of current smoking, smoking habits in siblings and getting pocket money over 200 Saudi riyals are found to be significant. Siblings smoking (odds ratio: 6.4) and poor academic performance (odds ratio: 3.2) were the two most important factors influencing children's intentions of smoking.</p> <p><strong>Conclusion:&nbsp;</strong>smoking prevalence in secondary school children of Al Ras was similar to national data. Since, influence of siblings, getting more pocket money and poor academic performance were found to important predictors of children smoking behaviours and attitudes, health education programs should address these factors to be effective.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234192 Use of geographic information systems web mapping application to support active case search to guide public health and social measures in the context of COVID-19 in Zimbabwe: a preliminary report to guide replication of methods in similar resource setting 2022-10-17T11:03:41+00:00 Isah Mohammed Bello isahbelloh@yahoo.com Thandekile Ntombikayise Moyo isahbelloh@yahoo.com Manes Munyanyi isahbelloh@yahoo.com Godwin Ubong Akpan isahbelloh@yahoo.com Irene Isibor isahbelloh@yahoo.com Lincoln Charimari Sunganai isahbelloh@yahoo.com Abubakar Sadiq Umar isahbelloh@yahoo.com Ravi Shankar Santhana Gopala Krishnan isahbelloh@yahoo.com Kebba Touray isahbelloh@yahoo.com Maxwell Rupfutse isahbelloh@yahoo.com Portia Manangazira isahbelloh@yahoo.com Alex Gasasira Ntale isahbelloh@yahoo.com Daniel Fussum isahbelloh@yahoo.com Pascal Mkanda isahbelloh@yahoo.com <p><strong>Introduction:&nbsp;</strong>the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in December 2019, causing severe acute respiratory syndrome (SARS) has fast spread across the entire globe, with most countries struggling to slow and reduce the spread of the virus through rapid screening, testing, isolation, case management, contact tracing, implementing social distancing and lockdowns. This has been shown to be a major factor in countries that have been successful in containing COVID-19 transmission. Early detection of cases is important, and the use of geospatial technology can support to detect and easily identify potential hotspots that will require timely response. The use of spatial analysis with geographic information systems (GIS) had proved to be effective in providing timely and effective solutions in supporting epidemic response and pandemics over the years. It has developed and evolved rapidly with a complete technological tool for representing data, model construction, visualization and platform construction among others.</p> <p><strong>Methods:&nbsp;</strong>we conducted a geospatial analysis to develop a web mapping application using ArcMap and ArcGIS online to guide and support active case search of potential COVID-19 cases, within 500m radius of COVID-19 confirmed cases to improve detection and testing of suspected cases.</p> <p><strong>Results:&nbsp;</strong>the web mapping application tool guides the active case search teams in the field, with clear boundaries on the houses to be visited within 500-meter radius of confirmed positive cases, to conduct active case search of all cases of severe acute respiratory illnesses (SARI), acute respiratory illnesses (ARI), pneumonia etc, to detect and test for COVID-19 towards containing the pandemic.</p> <p><strong>Conclusion:&nbsp;</strong>the use of GIS and spatial statistical tools have become an important and valuable tool in decision-making and, more importantly, guiding health care professional and other stakeholders in the response being carried out in a more coherent and easy manner. It has proven to be effective in supporting the active case search process to rapidly detect, test and isolate cases during the process, towards containing the COVID-19 pandemic.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234204 Kyste synovial de la bourse retro achilléenne: localisation rare 2022-10-17T11:08:41+00:00 Hicham Douma hicham.douma@edu.uca.ac.ma El Hassani Abdelkrim hicham.douma@edu.uca.ac.ma <p>Le kyste synovial rétro-achilléen est une formation kystique développée à partir de la bourse rétro-achilléenne. Il représente une étiologie rare de talalgies. Il est très peu rapporté dans la littérature. Nous rapportons le cas d'une jeune femme de 22 ans, souffrant de talalgies gauches rebelles au traitement médical. La radiographie de profil du pied gauche a montré une excroissance osseuse pointue et saillante en haut et en arrière de la grosse tubérosité calcanéenne. L'angle de Chauvaux était à 16 degrés et l'angle de Fowler-Philip était à 82 degrés. Le diagnostic de la maladie de Haglund a été retenu. Au bloc opératoire, l'abord chirurgical était fait par voie dorsale. Une formation kystique retro-achilléenne a été retrouvée et envoyée pour examen anatomo-pathologique. Ce dernier a confirmé la nature de la formation: un kyste synovial. Le geste a été complété par une résection de l'excroissance osseuse. L'évolution clinique était favorable. Notre cas est original car il montre une localisation rare et inhabituelle d'un kyste synovial en extra-articulaire, compliquant la maladie de Haglund.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234206 Valsalva retinopathy in a teenager treated with Nd:YAG laser posterior hyaloidotomy 2022-10-17T11:13:42+00:00 Omar Mahmoud Solyman o.solyman@rio.edu.eg Ahmed Abdelfatah Ghalwash o.solyman@rio.edu.eg <p>A 14-year-old otherwise healthy male patient presented with acute left loss of vision for 3 hours following weightlifting. Examination showed dense pre-macular sub-hyaloid hemorrhage (A). The patient and his parents did not like to wait for gradual spontaneous resolution of the hemorrhage. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior hyaloidotomy was performed with quick drainage of blood into the vitreous cavity (B, C, D). He maintained stable vision and retinal exam over 20 months of follow-up. Valsalva retinopathy can affect pediatric as well as adult age groups. Nd:YAG laser posterior hyaloidotomy is minimally invasive and safe procedure that provides rapid visual rehabilitation in cooperative patients.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234209 Spinocerebellar ataxia Type 7: clinical and genetic study of a new Moroccan family (case report) 2022-10-17T11:26:37+00:00 Fatima Zahra Bouzid dr.fatimazahraebouzid@gmail.com Maria Mansouri dr.fatimazahraebouzid@gmail.com Chaikhy Abdelaziz dr.fatimazahraebouzid@gmail.com Nisrine Louhab dr.fatimazahraebouzid@gmail.com Sablonniere Bernard dr.fatimazahraebouzid@gmail.com Isabelle Strubi-Vuillaume dr.fatimazahraebouzid@gmail.com Kenza Dafir dr.fatimazahraebouzid@gmail.com Nisrine Aboussair dr.fatimazahraebouzid@gmail.com <p>Spinocerebellar ataxia type 7 (SCA7) is a rare autosomal dominant neurodegenerative disease. Its clinical presentation is a progressive cerebellar ataxia associated with cone and retinal dystrophy. The CAG repeat expansion in the ataxin-7 gene (ATXN7) causes spinocerebellar ataxia type 7 - a mutation that results in the degeneration of the brain stem cells, retina and cerebellum. We report in this study the clinical and genetic features of a new Moroccan family of SCA7, from the South of Morocco. We performed the molecular genetic testing to confirm the diagnosis of SCA7. The objective of this study is to report a new Moroccan case of SCA7 and to illustrate the role of the geneticist in the diagnosis, management and development of genetic counseling of SCA7 disease.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234213 Mortality and morbidity in COVID-19 orthopedic trauma patients: is early surgery the keystone? 2022-10-17T11:36:40+00:00 Pietro Domenico Giorgi paolocapitani.dr@gmail.com Enrico Gallazzi paolocapitani.dr@gmail.com Paolo Capitani paolocapitani.dr@gmail.com Elena Biancardi paolocapitani.dr@gmail.com Federico Bove paolocapitani.dr@gmail.com Umberto Mezzadri paolocapitani.dr@gmail.com Dario Capitani paolocapitani.dr@gmail.com Giuseppe Rosario Schirò paolocapitani.dr@gmail.com <p>In the pandemic disease caused by SARS-CoV-2 virus, trauma surgery continued the management of patients with fractures. The purpose of the study is to evaluate mortality and morbidity in orthopedic trauma patients surgically treated with a diagnosis of COVID-19 infection, comparing them to a control group of COVID-19 negative. We retrospectively identified patients admitted to our Emergency Room from March 8<sup>th</sup>&nbsp;to May 4<sup>th</sup>&nbsp;2020 (time frame corresponding to the first wave of the pandemic peak, one of the most severe in the world at that time) with a diagnosis of fracture that were subsequently surgically treated. We applied a dedicated pathway for the management of COVID-19 trauma patients allowed to perform an early surgery and short hospitalization. For each patient included demographics, clinical, laboratory, radiological data and type of treatment for COVID-19 infection were collected. Sixty-five (65) patients were identified. Of those, 17 (6 women and 11 men, mean age 63.41 years old, mean ASA grade 2.35) were COVID-19 positive (study group), while the others were control group (mean age 56.58 years old, mean ASA grade 2.21). In the study group, the preoperative laboratory tests showed leukocytosis in six and lymphopenia in 15 cases. Fourteen patients had a high level of C-reactive protein. Fifteen patients had an abnormal level of D-dimer. The mortality recorded was 5.8% and 4.1% in the study and control group respectively. Perioperative adverse events were registered in 5 cases (29.4%) in the study group and in 8 (16.6%) in the control group (p&gt;0.05). Dedicated COVID-19 trauma pathway with the aim of an early surgery could be key for a better result in terms of mortality and morbidity. Age and ASA grade could represent independent risk factors for perioperative complications.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234215 Implementation of integrated supportive supervision in the context of coronavirus 19 pandemic: its effects on routine immunization and vaccine preventable surveillance diseases indicators in the East and Southern African countries 2022-10-17T11:45:23+00:00 Isah Mohammed Bello isahbelloh@yahoo.com Emmaculate Lebo isahbelloh@yahoo.com Messeret Eshetu Shibeshi isahbelloh@yahoo.com Godwin Ubong Akpan isahbelloh@yahoo.com Jethro Chakauya isahbelloh@yahoo.com Balcha Girma Masresha isahbelloh@yahoo.com Fussum Daniel isahbelloh@yahoo.com <p><strong>Introduction:&nbsp;</strong>the coronavirus disease (COVID-19) global pandemic has caused serious disruption to almost all aspect of human endeavor forcing countries to implement unprecedented public health measures aimed at mitigating its effects, such as total lockdown (inter and intra), travel bans, quarantine, social distancing in an effort to contain the spread of the virus. Supportive supervision is a functional component of the immunization systems that allows identification of existing gaps, provides an opportunity for onsite training, and document real-time findings for improvement of the program. The control measures of COVID-19 pandemic have also resulted in limitation of operations of the immunization system including supportive supervision. This has limited many aspects of supportive supervision for surveillance and routine immunization monitoring system in the East and Southern African countries. The aim of this study is to identify the effects of COVID-19 on Integrated Supportive Supervision visits for expanded programme on immunization (EPI) and how it influences the immunization and vaccine preventable disease (VPD) surveillance indicators, and its short-term effect towards notification of increase or decrease morbidity and mortality.</p> <p><strong>Methods:&nbsp;</strong>we reviewed the integrated supportive supervision (ISS) data and the routine administrative coverage from 19 countries in the East and Southern Africa (ESA) for the period January to August 2019 to analyze the trends in the number of visits, vaccine-preventable diseases (VPD), and routine immunization (RI) indicators using t-test, and compare with the period January to August 2020 during the months of the COVID-19 pandemic.</p> <p><strong>Results:&nbsp;</strong>thirteen countries out of the 19 considered, had shown a decline in the number of integrated supportive supervision (ISS) visits, with 10 (77%) having more than 59% decrease during the January-August 2020 as compared to the same period 2019. Eleven (57%) of the countries have shown a decrease (p-value &lt; 0.05). Ethiopia and Kenya had the highest drop (p-value &lt; 0.000). Six (32%) had an increase in the number of visits, with Madagascar, Zambia, and Zimbabwe having &gt;100% increase in the number of visits. Sixty-seven percent (67%) of the countries that have decreased in the number of ISS visits have equally witnessed a drop in DPT3 administrative coverage. Countries with a low proportion of outreach sessions conducted in the period of January - August 2020, have all had sessions interruption, with more than 40% of the reasons associated with the lockdown.</p> <p><strong>Conclusion:&nbsp;</strong>countries have experienced a decrease in the number of supportive supervision visits conducted, during the period of the COVID-19 pandemic and, this has influenced the routine immunization and vaccine-preventable diseases surveillance (VPD) process indicators monitored through the conduct of the visits. Continuous decrease in these performance indicators pose a great threat to the performance sustained and the functionality of the surveillance and immunization system, and consequently on increased surveillance sensitivity to promptly detect outbreaks and aiming to reducing morbidity and mortality in the sub-region.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234217 Developmental delay in congenital hypothyroidism 2022-10-17T11:53:21+00:00 Chanan Goyal chanangupta@gmail.com Waqar Naqvi chanangupta@gmail.com <p>We report the case of a 5-month-old male, born out of a nonconsanguineous marriage, who presented with an inability to hold neck. As per the parents, he had diminished spontaneous movements since birth and described him as lethargic. He was clinically diagnosed with cretinism by a pediatric neurologist. He was referred by to the department of physiotherapy for evaluation and advice for the associated motor delay. On observation, the infant displayed peculiar clinical features of sparse hair, periorbital edema and macroglossia (A). Irritability, hoarse cry, abdominal distension and frog leg position was observed in supine lying position (B). Examination revealed generalized hypotonia, wide fontanelles, feeding difficulties and global developmental delay. He was neither able to roll over from supine to prone nor was he able to hold neck adequately. He had head lag during pull to sit test. Due to financial constraints, they were not willing to attend physiotherapy sessions on a regular basis. Thus, parents were educated about the home exercise program that included active assisted rolling, neck extensor muscles facilitation against gravity while lying prone on forearm, active assisted reaching out for objects while lying, neck flexor muscles facilitation in gravity minimized plane and active neck rotations to look at objects of interest while side lying on forearm support. Congenital hypothyroidism is still a common cause of developmental delay in newborns of the developing countries. Awareness, universal newborn screening, prompt recognition and medical treatment along with physiotherapy can minimize adverse effect on the physical and neurocognitive development.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/234219 Orbital inflammatory disease secondary to epidemic keratoconjunctivitis in an adult patient: case report 2022-10-17T11:58:36+00:00 Temiloluwa Moyosoreoluwa Abikoye temilolu2000@gmail.com <p>Orbital inflammatory disease, sequel to epidemic keratoconjunctivitis is an uncommon finding in adult patients. A 36-year-old male presented at the clinic with a 4-day history of left ocular pain and a one-month history of left eye redness and watering. Visual acuity in the eye was 6/5, with reduced red-color saturation and light brightness appreciation. Left eye examination showed periorbital fullness, a palpably enlarged and tender lacrimal gland, conjunctival follicles with pseudomembranes, and restriction of extraocular motility. Magnetic resonance imaging showed homogenous enhancement of the left lacrimal gland, lateral rectus muscle, pre and post-septal soft tissues. A diagnosis of left orbital inflammatory disease secondary to epidemic keratoconjunctivitis was made and patient was treated with high dose oral steroids over the course of 7 weeks, with complete resolution of clinical symptoms. In conclusion, orbital inflammatory disease can develop following epidemic keratoconjuctivitis in adults with good clinical response to oral steroids. Clinicians should have a high index of suspicion when assessing adult patients for orbital inflammatory disease.</p> 2021-02-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236288 Learning style among family medicine residents, Qatar 2022-11-16T10:09:51+00:00 Amal Abdulla Al Ali m_salem1973@yahoo.com Mohamed Salem Nasrallah m_salem1973@yahoo.com Mostafa Hamdy Rashed m_salem1973@yahoo.com Yosaf Abdo Ibrahim m_salem1973@yahoo.com Rafea Muftah Rasheed m_salem1973@yahoo.com Hassan Mahmoud El-Meedani m_salem1973@yahoo.com Mohamed Soliman Abdel-Hamid m_salem1973@yahoo.com Hisham Al-Mahdi Mustafa m_salem1973@yahoo.com <p>Different learning style among family medicine residents is important to adjust the educational program that meet their needs and make the educational process fruitful to improve their academic performance. This study is aiming to assess learning styles among family medicine residents in Qatar. This cross-sectional descriptive study was conducted at the West Bay family medicine training center, Doha, Qatar, where all family medicine residents were invited to participate using self-administered validated questionnaire based on David Kolb model of experiential learning that has been extensively used in medical education research. Demographic data were assessed and analyzed as the predictor variables. Data were collected from 38 residents with response rate 76% revealing that the predominant pattern in postgraduate year one (PGY1) is activist in 65% and theorist in 55% while PGY2 tends to be reflector in 45% and theorist in 35% and in PGY3-4 changed to be 70-75% activist and 40-55% (reflector and pragmatic). General learning style pattern among all residents tend to be in the following order: activist 60.5%, then reflector 44.7%, followed by pragmatism 34.2% and finally theorist 36.8%. Learning style assessment is important and can be used to determine which teaching modalities will be best accepted and most effective for family medicine residents which should be considered while planning, designing, and implementing their educational program.</p> 2021-02-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236299 Timing of onset of symptom for COVID-19 from publicly reported confirmed cases in Uganda 2022-11-16T10:19:44+00:00 Alex Riolexus Ario riolexus@musph.ac.ug Bernadette Basuta Mirembe riolexus@musph.ac.ug Claire Biribawa riolexus@musph.ac.ug Lilian Bulage riolexus@musph.ac.ug Daniel Kadobera riolexus@musph.ac.ug Robert Wamala riolexus@musph.ac.ug <p><strong>Introduction:&nbsp;</strong>incubation period for COVID-19, 2-14 (average 5-6) days. Timing of onset of COVID-19 signs and symptoms amongst cases in Uganda is however not known.</p> <p><strong>Methods:&nbsp;</strong>we utilized data on real-time reverse transcription polymerase chain reaction (RT-PCR) confirmed cases to investigate symptom onset timing, from 21<sup>st</sup>&nbsp;March to 4<sup>th</sup>&nbsp;September 2020. Since timing of COVID-19 symptom onset is highly likely to be an interval rather than a point estimate, we generated 3-tertile categories: 1<sup>st</sup>, 2<sup>nd</sup>&nbsp;and 3<sup>rd</sup>&nbsp;tertile denoting symptom presentation within 3, 4 to 6 and at least 7 days. We considered all signs and symptoms in the database and analysed using Chi-square test and multinomial logistic regression, controlling for age and sex.</p> <p><strong>Results:&nbsp;</strong>we analysed a total of 420 symptomatic case-patients; 72.0% were males, median age of 33 years. Common symptoms were cough (47.6%), running nose (46.2%), fever (27.4%), headache (26.4%) and sore throat (20.5%). We utilized 293 cases with clinical symptom onset date recorded. Most of the patients, 37.5%, presented symptom within 3 days, 31.4% had symptoms in the 2<sup>nd</sup>&nbsp;and 31.4% in 3<sup>rd</sup>&nbsp;tertile, denoting 4 to 6 days and at least 7 days after exposure. Running nose (RRR=0.45, 95%CI:0.24-0.84) and chest pain (RRR=0.64, 95%CI:0.09-0.72) were more likely to occur in 3<sup>rd</sup>&nbsp;tertile than 1<sup>st</sup>&nbsp;or 2<sup>nd</sup>&nbsp;tertile. Cases aged ≥20 years were less likely to have symptoms in the 1<sup>st</sup>&nbsp;and 2<sup>nd</sup>&nbsp;tertile compared to ≤20 years (p&lt;0.05).</p> <p><strong>Conclusion:&nbsp;</strong>our study provides empirical evidence for epidemiological characterization of cases by signs and symptoms which complements current proposals for the length of active monitoring of persons exposed to SARS-CoV-2.</p> 2021-02-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236303 Pleurodesis with povidone iodine in patients with malignant pleural effusion in a tertiary center in Nigeria 2022-11-16T10:25:24+00:00 Benjamin Irene Omoregbee benjaminomoregbee@yahoo.com Stanley Okugbo benjaminomoregbee@yahoo.com <p><strong>Introduction:&nbsp;</strong>malignant pleural effusion occurs as a consequence of a primary or metastatic malignant process involving the pleura. The aim of pleurodesis is to prevent re-accumulation of the effusion and avoid the need for repeated hospitalization. Povidone iodine has been used in other climes for pleurodesis with good results. The aim of this study is to assess the efficacy and safety of povidone iodine in producing pleurodesis as compared to tetracycline.</p> <p><strong>Methods:&nbsp;</strong>the study is a prospective experimental study. The patients are randomized into two groups A (tetracycline-control) and B (povidone iodine). All patients are assessed with chest X-ray after 1 week and 1 month. The responses were ascribed as complete, partial or failure.</p> <p><strong>Results:&nbsp;</strong>thirty patients were recruited into this study, 15 patients in each group A (tetracycline) and B (povidone iodine). The mean age was 45.7±14.24 years. The commonest primary malignancy was Breast cancer (70%) followed by bronchogenic cancer (10%). Seventy three (73%) of the patients in this study had complete response and in 7% pleurodesis failed whilst 20% has partial response. In the povidone group the success rate was 93.4% and in the tetracycline group was 93.3% with a p-value of 0.716. There was no statistical difference in the responses based on the agents used.</p> <p><strong>Conclusion:&nbsp;</strong>malignant pleural effusion is a devastating condition as it heralds the end-of-life processes of a primary malignancy. Povidone iodine is a safe, cheap, effective, widely available and effective pleurodesing agent for use in patients with malignant pleural effusion.</p> 2021-02-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236306 The clinical and endoscopic aspects of peptic ulcers secondary to the use of nonsteroidal anti-inflammatory drugs of various origins 2022-11-16T10:43:31+00:00 Oumar Traoré barouta77@gmail.com Abdoul Salam Diarra barouta77@gmail.com Oumar Kassogué barouta77@gmail.com Tawfiq Abu barouta77@gmail.com Aguissa Maïga barouta77@gmail.com Moussa Kanté barouta77@gmail.com <p><strong>Introduction:&nbsp;</strong>currently, the non-steroid anti-inflammatory drugs constitute a veritable object of auto medication throughout the world. The goal of this study was to evaluate the endoscopic and clinical aspects of gastro-duodenal ulcer secondary to taking of non-steroid anti-inflammatory of various sources.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional study which was conducted between July 2016 and December 2017. All adult patients admitted to hospital for clinical symptoms suggestive of gastroduodenal involvement after taking anti-inflammatory drugs and having undergone upper digestive endoscopy were included in this study. Data analysis was done with Epi-info version 7 Software.</p> <p><strong>Results:&nbsp;</strong>a total of 114 patients were included, the mean age was 47.18±26 years with a male predominance (64.9%). Among the patients, only 1.75% had taken a non-steroid anti-inflammatory (NSAIDs) from pharmacy. The NSAIDs used were of different types: diclofenac, aceclofenac, aspirin and non-selective NSAIDs. For each drug used, more than half were derived from the streets. Clinically we noted: the dyspepsia (38.58%), hemorrhages (11.40%), the ulcerous syndrome (77.19%), haematemesis (19.29%), haematemesis associated with melena (37.71%), and the rectorrhagia in 6.14 of cases. The specific endoscopic lesions were bulbar ulcer (45.61%), gastric ulcers (20.17%), antral ulcerations (5.26%) and acute gastritis (9.64%), esophagitis (7.89%), esophageal varices (6.14%), and uncomplicated hiatal hernia in 7.01% of cases.</p> <p><strong>Conclusion:&nbsp;</strong>the serious gastroduodenal lesions observed in this study and due to use of NSAIDs are mainly attributable to unauthorized molecules due to safety concerns. It would be necessary to conduct sensitization days at the community level and in each health facility.</p> 2021-02-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236308 Miliary red papules in a newborn: a rare neonatal hemangiomatosis 2022-11-16T10:49:56+00:00 Nour Mekaoui n.mekaoui@um5s.net.ma Lamya Karboubi n.mekaoui@um5s.net.ma <p>Hemangiomatosis is the efflorescence of 5 or 6, and up to several hundred, infantile hemangiomas.Several predisposing factors have been isolated: female gender, Caucasian origin, low birth weight and prematurity (these two factors are closely linked and it is above all the birth weight which seems to be the most significant factor). We describe the case of a 15 days old newborn, from a followed up full term pregnancy with a low birth weight at 2200g; admitted for respiratory distress. The examination found more than a hundred angiomas scattered all over the body (A), the head and the mucous membranes (B) whose diameter was less than one centimeter. The examination also showed respiratory distress without hepatomegaly or heart murmur. These cutaneous hemangiomas are often associated with visceral hemangiomas, the most frequent localization of which is the liver. The natural course of these hepatic hemangiomas is parallel to that of skin hemangiomas. They will evolve, like skin forms, towards spontaneous regression, without any treatment. However, they can also; because of intense vascularity, lead to heart failure due to high flow, sometimes severe. A complete clinical examination of the child for signs of heart failure, hepatomegaly, hepatic murmur and the practice of an abdominal ultrasound and doppler. There is no consensus on the number of lesions required to speak of multiple hemangiomas, as well as to provide the indication for a liver ultrasound. Regular monitoring every 2-3 weeks is necessary.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236310 Perianal condylomata acuminata in pregnancy 2022-11-16T10:55:50+00:00 Damaskini Polychroni damaskinipl@gmail.com Asterios Nidimos damaskinipl@gmail.com <p>A 23-year-old woman of low socioeconomic status presented to our obstetric department reporting pain in the perineal area, occasional bleeding during defecation and discomfort at the sitting position. The woman was nulliparous, at the 34<sup>th</sup>&nbsp;week of gestation and had an unattended pregnancy, since she had never visited a healthcare provider the last three years. Physical examination revealed multiple, irregular vegetative lesions covering the perianal region. These cauliflower-like masses where hard and painless with maximum diameter 10cm, while vagina and vulva were free of warts. The patient was scheduled for elective caesarean section at the 38<sup>th</sup>&nbsp;week of pregnancy, because large warts were blocking the natural birth canal. She was referred to a tertiary health care unit for further counselling and treatment after postpartum period.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236312 Fréquence élevée de l´ischémie myocardique asymptomatique dans une population de patients infectés par le VIH à Bobo-Dioulasso, Burkina Faso 2022-11-16T11:07:57+00:00 Jean-Baptiste Tougouma tougjb@yahoo.fr Arsène Aimé Yaméogo tougjb@yahoo.fr Nobila Valentin Yaméogo tougjb@yahoo.fr Arsène Hema tougjb@yahoo.fr Hervé Hien tougjb@yahoo.fr Yibar Kambiré tougjb@yahoo.fr Armel Poda tougjb@yahoo.fr Jacques Zoungrana tougjb@yahoo.fr Patrice Zabsonré tougjb@yahoo.fr <p><strong>Introduction:&nbsp;</strong>les complications cardiovasculaires sont devenues la 3<sup>e</sup>&nbsp;cause de décès et le 4<sup>e</sup>&nbsp;motif d´hospitalisation des patients infectés par le VIH. L´objectif de ce travail était de déterminer la fréquence de l´ischémie myocardique asymptomatique chez les patients infectés par le VIH sous traitement antirétroviral.</p> <p><strong>Méthodes:&nbsp;</strong>étude transversale descriptive qui s´est déroulée en novembre 2015. Ont été inclus les patients infectés par le VIH1, sous traitement ARV, asymptomatiques suivis dans l´unité d´Hôpital de Jour du service des Maladies Infectieuses du CHU Souro Sanou de Bobo-Dioulasso. Les patients inclus ont bénéficié d´un recueil des facteurs de risque cardiovasculaire, de deux mesures en consultation de la pression artérielle en position assise après 10 minutes de repos et d´un électrocardiogramme 12 dérivations de repos.</p> <p><strong>Résultats:&nbsp;</strong>au total, 123 patients infectés par le VIH1 avec un âge médian de 42 ans (IIQ: 36-50) et composés à 79% de sujets de sexe féminin ont été inclus. Les facteurs de risque cardiovasculaire retrouvés se répartissaient comme suit: HTA (31,7%), obésité (33%), dyslipidémies (10,57%), tabagisme actif (0,8%), diabète (0,8%). Tous les hypertendus connus (5,7%) étaient insuffisamment traités. La durée médiane d´exposition aux ARV était de 5,3 années (IIQ: 3-7,7). Les troubles de la repolarisation étaient observés dans 26 cas (21,13%). Ils se répartissaient en ischémie sous épicardique dans 20 cas (16,26%), lésion sous endocardique dans 2 cas (1,63%) et en séquelle de nécrose dans 4 cas (3,25%). L´hypertrophie ventriculaire gauche (HVG) était observée dans 12 cas (9,76%) et était observée chez les patients hypertendus. Le QTc était allongé chez 7 patients (5,69%) indépendamment de la classe d´ARV administré.</p> <p><strong>Conclusion:&nbsp;</strong>dans cette étude sur les patients infectés par le VIH1, il ressort que l´ischémie myocardique asymptomatique est fréquente. Il conviendrait de renforcer son dépistage par des tests d´ischémie plus performants afin de mieux préciser sa gravité dans cette sous population au risque cardiovasculaire accru.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236314 A case of multisystem inflammatory syndrome in an African adolescent male: case report 2022-11-16T11:15:25+00:00 Pramodhini Moodley pramonemoodley@gmail.com Jacob Merika Letlhoo Tsitsi pramonemoodley@gmail.com Denasha Lavanya Reddy pramonemoodley@gmail.com Mohith Debising pramonemoodley@gmail.com Claudia Ickinger pramonemoodley@gmail.com <p>Since late April 2020, a syndrome now termed Multisystem Inflammatory Syndrome in Children (MIS-C) has been seen in children and adolescents in association with COVID-19 infection. The definition of MIS-C involves fever, organ dysfunction and laboratory confirmation of inflammation in the context of laboratory or epidemiological evidence of SARS-CoV-2 infection in a patient under 21 years of age. Notably, cases are now being identified in adults termed Multisystem Inflammatory syndrome in Adults (MIS-A). Few cases have been reported in sub-Saharan Africa. We report a case of a young African male presenting with a maculopapular rash, persistent fever, elevation in inflammatory markers and a sudden, significant deterioration in cardiac function resulting in cardiogenic shock. The patient responded to intravenous steroids, intravenous immunoglobulin and background inotropic support. The recognition of this disease entity proves even more crucial now amidst the ongoing global wave of COVID-19 infection. It is paramount to identify these patients early, leading to prompt treatment avoiding further morbidity and mortality.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236316 Isolated renal hydatid disease: laparoscopic approach to an uncommon entity (case report) 2022-11-16T11:23:13+00:00 Saket Kumar krsaketsingh@gmail.com Saurabh Singla krsaketsingh@gmail.com Ausaf Ahmad krsaketsingh@gmail.com Nishant Kurian krsaketsingh@gmail.com Venkat Rao Chidipotu krsaketsingh@gmail.com <p>Hydatidosis is a parasitic disease, endemic in various parts of the World. It frequently involves liver and lungs and, rarely, other organs as well. Isolated renal hydatidosis is a rare entity that accounts for less than 3% of all hydatid cases. Surgery remains the mainstay of treatment. We hereby report a case of isolated renal hydatid cyst involving left kidney that was managed by laparoscopic approach.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236319 Unprotected sexual practices and associated factors among adult people living with HIV on ART in Public Hospitals of Kembata Tembaro Zone, Southern Ethiopia 2022-11-16T11:30:21+00:00 Dereje Laloto Anore teketelermias@gmail.com Bezatu Mengistie teketelermias@gmail.com Teketel Ermias Geltore teketelermias@gmail.com <p><strong>Introduction:&nbsp;</strong>Antiretroviral therapy (ART) significantly increases the life expectancy of HIV positive people by improving quality of life as well as enabling them to resume sexual activity. A growing number of people living with HIV became a source of exposure to sexually transmitted infections, including other strains of HIV that place others at risk unless they consistently use condoms. This study assessed the magnitude of unprotected sexual practices and associated factors among adult people living with HIV on ART in public hospitals of the Kembata Tembaro Zone, Southern Ethiopia.</p> <p><strong>Methods:&nbsp;</strong>a facility-based cross-sectional study was conducted among adult people living with HIV on ART in public hospitals of the zone from March 1-30, 2016. Data were collected by a pretested and structured questionnaire. Binary logistic regression was used to investigate variables, independently associated with the outcome variable. The adjusted odds ratio with 95% CI used to show the strength of the association and a P-value &lt; 0.05 was used to declare the cut-off point in determining the level of significance.</p> <p><strong>Results:&nbsp;</strong>the study revealed that 40.9% of respondents practiced unprotected sexual intercourse. On multivariate logistic regression analyses, being females, having more than one sexual partner, mean monthly income of &lt;530 Ethiopian birrs/ month, those who had a seropositive partner, a partner of unknown serostatus, and respondents who had insufficient knowledge of HIV transmission and prevention were statically significant with the outcome variable.</p> <p><strong>Conclusion:&nbsp;</strong>the scarcity of knowledge on HIV transmission, negative attitude towards condom use, non-disclosure status and having more than one sexual partnership increased likelihood of have unprotected sex among the respondents.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236320 Rétraction - double publication de l´article: Prise en charge anesthésique des cardiopathies congénitales opérées sous circulation extra - corporelle au Centre de Chirurgie Cardiaque Pédiatrique Cuomo (Sénégal) par Farid Pingwindé Belem et al (doi: 10.116 2022-11-16T11:36:35+00:00 Pan African Medical Journal olivia.tsague@panafrican-med-journal.com <p>Cet article rétracte l´article “Prise en charge anesthésique des cardiopathies congénitales opérées sous circulation extra - corporelle au Centre de Chirurgie Cardiaque Pédiatrique Cuomo (Sénégal)”. Farid Pingwindé Belem, El Hadji Boubacar Ba, Papa Alassane Leye, El Hadji Ndiassé Diop, Ibrahima Gaye, Mamadou Diawo Bah, Etienne Birame Sène, Marie Victoire Sène, Mohamed Lamine Fall, Amadou Gabriel Ciss, Oumar Kane. The Pan African Medical Journal. 2020;37:3362. (doi:10.11604/pamj.2020.37.362.17659)”.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236321 Cutaneous candidiasis caused by Candida kefyr 2022-11-16T11:45:07+00:00 Rosani Sri Camelia Nurdin rosani.ppds@gmail.com Sri Vitayani rosani.ppds@gmail.com Safruddin Amin rosani.ppds@gmail.com Dirmawati Kadir rosani.ppds@gmail.com Widyawati Djamaluddin rosani.ppds@gmail.com Anni Adriani rosani.ppds@gmail.com <p>Candidiasis is an acute or subacute fungal infection caused by fungi that belongs to candida genus, with&nbsp;<em>Candida albicans</em>&nbsp;being the most frequent causative agent.&nbsp;<em>Candida kefyr</em>&nbsp;is a rare cause of candidiasis which has been reported in systemic candidiasis and deep infections. However, to date, it has never been reported as a cause in dermatophytosis. We report a case of candidiasis caused by&nbsp;<em>Candida kefyr</em>&nbsp;in a 72-year-old woman with a chief complaint of pruritic erythematous rash on the back from one day prior to admission. Diagnosis was established based on clinical features, direct microscopic examination with 10% potassium hydroxide solution, gram staining. The fungal species was determined by carbohydrate fermentation test which showed a positive result for&nbsp;<em>Candida kefyr</em>. The patient was treated with miconazole cream and fusidic cream and showed significant clinical improvement.</p> 2021-02-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236322 Prévalence de la coronaropathie chez les survivants d´accident vasculaire cérébral à Parakou (Bénin) en 2019 2022-11-16T11:54:11+00:00 Yessito Corine Nadège Houehanou yessito_fr@yahoo.fr Mendinatou Agbetou yessito_fr@yahoo.fr Oyéné Kossi yessito_fr@yahoo.fr Kamal Zacari yessito_fr@yahoo.fr Fiath Yemadjro yessito_fr@yahoo.fr Thierry Adoukonou yessito_fr@yahoo.fr <p><strong>Introduction:&nbsp;</strong>la coronaropathie serait fréquente chez les survivants d´accident vasculaire cérébral (AVC). L´objectif de l´étude était de déterminer la prévalence de la coronaropathie chez les survivants d´AVC suivis au Centre Hospitalier Universitaire Départemental Borgou-Alibori (CHUD-B/A).</p> <p><strong>Méthodes:&nbsp;</strong>il s´est agi d´une étude transversale menée du 1<sup>er</sup>&nbsp;mars au 31 août 2019. Elle a inclus tous les patients victimes d´AVC, d´âge ≥ 18 ans, reçus dans l´unité de neurologie du CHUD-B/A entre janvier 2012 et juillet 2019, ayant survécu à la phase aiguë, et chez qui le consentement éclairé écrit ou celui d´un tuteur (patients sévèrement handicapés) a été obtenu. Un entretien individuel, des mesures anthropométriques, un examen physique, un électrocardiogramme et une revue du dossier médical ont été effectués. La présence de coronaropathie a été définie par un antécédent documenté, des anomalies ST/T et/ou Q évocatrices (critères de Minnesota) ou un questionnaire de dépistage de l´angine de poitrine positif. Les facteurs associés à la coronaropathie ont été recherchés par une régression logistique.</p> <p><strong>Résultats:&nbsp;</strong>un total de 101 patients était inclus avec un âge moyen de 57,2±10,5 ans. Le délai médian depuis la survenue de l´AVC était de 11 mois [2,0-23,5]. Les AVC ischémiques prédominaient (57,4%). La prévalence de la coronaropathie était estimée à 49,5%. Les facteurs associés à la coronaropathie étaient la non-scolarisation (p=0,036), l´obésité (p=0,036) et le tabagisme ancien (p=0,044).</p> <p><strong>Conclusion:&nbsp;</strong>cette étude montre une fréquence élevée de coronaropathie chez les survivants d´AVC. Il est important de dépister la coronaropathie dans cette cible afin d´optimiser la prise en charge.</p> 2021-02-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/236323 Cancer du sein et grossesse: à propos de 15 cas colligés au centre de maternité de Monastir, Tunisie 2022-11-16T12:06:23+00:00 Ahmed Hajji ahmedhajji01@gmail.com Houda El Mhabrech ahmedhajji01@gmail.com Amira Daldoul ahmedhajji01@gmail.com Nada Toumia ahmedhajji01@gmail.com Awatef Hajjaji ahmedhajji01@gmail.com Manel Njima ahmedhajji01@gmail.com Fethi Jebali ahmedhajji01@gmail.com Raja Faleh ahmedhajji01@gmail.com <p>Le but de cette étude était de décrire les caractéristiques cliniques, radiologiques, histologiques et thérapeutiques du cancer du sein diagnostiqué au cours de la grossesse. Nous avons effectué la revue de tous les cancers du sein diagnostiqués au cours de la grossesse dans le centre Maternité et de Néonatologie de Monastir -Tunisie, sur une période allant de 2004 à 2019. Nous avons ainsi colligé 15 cas. L'âge moyen des patientes était de 34 ans. La plupart des cancers du sein associés à la grossesse (CSAG) était diagnostiquée en post-partum. Le carcinome canalaire infiltrant était le type histologique majeur (93% de cas), un cas rare de carcinome sécrétoire a été observé. Le stade clinique était dominé par les formes T2 et T4. Les récepteurs hormonaux étaient négatifs dans 40% des cas, le récepteur HER2 était positif dans 26,6% des cas. Le traitement incluait la chirurgie, radiothérapie, chimiothérapie et palliative. La moyenne de survie est de 32,2 mois. Le cancer du sein associé à la grossesse est une entité rare. Son pronostic est globalement mauvais en raison de l'âge jeune de survenue et d´un diagnostic souvent tardif. La décision thérapeutique constitue une contrainte difficile, par nécessité, multidisciplinaire à laquelle participera la patiente. La thérapie ciblée reste le grand espoir des nouvelles thérapies.</p> 2021-02-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237341 Predictors of adverse drug reaction among adult HIV-infected patients on antiretroviral therapy in government hospitals of Kaffa Zone, Ethiopia; November 2018: a retrospective cohort 2022-12-02T07:15:41+00:00 Ayanaw Ambachew Mitkie mitkiea@gmail.com Fanuel Belayneh Bekele mitkiea@gmail.com Alemu Tamiso Debiso mitkiea@gmail.com <p><strong>Introduction:&nbsp;</strong>incidence of adverse drug reactions (ADR) associated with antiretroviral therapy (ART) was higher in developing countries. In two teaching hospital in Ethiopia: Debremarkose 23% and Yirgalem 73.2% of study participants reported at least one ADR. Since there was limited information about ADR in the study area; we aimed to determine its incidence-rate and predictors.</p> <p><strong>Methods:&nbsp;</strong>we conducted retrospective cohort study using medical records of HIV-infected patients enrolled on ART between 2006 and 2017 in government hospitals of Ethiopia. ADR was defined as report of at least one unwanted response to ART. We run descriptive and cox regression analysis (CRA).</p> <p><strong>Results:&nbsp;</strong>incidence-rate of ADR was 4.1 per 100 person-years (py). Hazards of ADR among patients living at rural was almost two times than at urban; [Adjusted hazard ratio (AHR): 1.94(95% (CI):1.18, 3.20)]. Stavudine (D4T)-Lamivudine (3TC)-Nevirapine (NVP) had about two times [AHR: 1.78(95%CI:1.03, 3.08)], Zidovudine(AZT)-3TC-NVP had about two times [AHR: 2.34 (95%CI: 1.20, 4.57)], D4T-3TC-Efaviranze(EFV) had about three times [AHR: 2.86(95%CI: 1.38, 5.95)] and AZT-3TC-EFV had about two times [AHR: 2.16(95%CI: 1.21,3.90)] hazards of ADR than Tenofovir(TDF) based regimens. Being WHO clinical stage III had about two times hazard of ADR [AHR: 2.46 (95%CI: 1.22, 4.95)] and IV had about four times hazard of ADR [AHR: 4.32 (95%CI: 1.88, 9.93)] than stage I.</p> <p><strong>Conclusion:&nbsp;</strong>risk of ADR was higher among adult HIV-infected patients on ART living in rural, WHO clinical stage III and IV, and patients on AZT and D4T based regimen. AZT should not be given as an alternative treatment, increase access of TDF regimens.</p> 2021-02-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237343 Mitral shifting in arythmia complicated with bilateral renal infarction 2022-12-02T07:20:08+00:00 Chtioui Mamoun mamoun.mc@gmail.com Benameur Brahim mamoun.mc@gmail.com <p>We report the case of a 30-year-old woman with no individual's history, suffering from chest pain recently discovered; admitted to our department for dyspnea of rest. The clinical examination finds signs of global heart failure, with auscultatory signs of mitral stenosis in atrial fibrillation. The electrocardiogram records an arrhythmia tachycardia by atrial fibrillation (A). Trans-thoracic echocardiography demonstrated tight fibrous mitral stenosis, atrial dilatation and discrete left ventricular (LV) dysfunction, the right heart is without abnormality (B). As soon as she was put on treatment by digitalo-duiretic, and anticoagulated, the patient presented a brutal of intense bilateral abdominal pain radiating towards the flanks. An injected abdominopelvic computed tomography (CT) showed a bilateral acute occlusion of both renal arteries on the right (C). The patient had endovascular treatment with thromboaspiration. The interest of this observation is the rarity of this thromboembolic complication of mitral valve disease.</p> 2021-02-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237346 The first biological choice in patients with rheumatoid arthritis: data from the Moroccan register of biotherapies 2022-12-02T07:42:48+00:00 Meryem Eddaoudi mery.eddaoudi@gmail.com Samira Rostom mery.eddaoudi@gmail.com Ihsane Hmamouchi mery.eddaoudi@gmail.com Imane El Binoune mery.eddaoudi@gmail.com Bouchra Amine mery.eddaoudi@gmail.com Redouane Abouqal mery.eddaoudi@gmail.com Lahsen Achemlal mery.eddaoudi@gmail.com Fadoua Allali mery.eddaoudi@gmail.com Imane El Bouchti mery.eddaoudi@gmail.com Abdellah El Maghraoui mery.eddaoudi@gmail.com Imad Ghozlani mery.eddaoudi@gmail.com Hasna Hassikou mery.eddaoudi@gmail.com Taoufik Harzy mery.eddaoudi@gmail.com Linda Ichchou mery.eddaoudi@gmail.com Ouafae Mkinsi mery.eddaoudi@gmail.com Redouane Niamane mery.eddaoudi@gmail.com Rachid Bahiri mery.eddaoudi@gmail.com <p><strong>Introduction:&nbsp;</strong>the aim of our study is to determine, from data of the Moroccan register of biotherapies, the factors influencing the choice of the first prescribed biological treatment.</p> <p><strong>Methods:&nbsp;</strong>cross-sectional multicenter study including rheumatoid arthritis patients who were initiated the first biological treatment either: Rituximab, an anti-TNF, or Tocilizumab. The determinants related to the patient and disease have been gathered. A univariate and then multivariate analysis to determine the factors associated with the choice of the first bDMARDs was realized.</p> <p><strong>Results:&nbsp;</strong>a total of 225 rheumatoid arthritis patients were included in the Moroccan registry. The mean age was 52 ± 11 years, with female predominance 88% (n = 197). The first prescribed biological treatment was Rituximab 74% (n = 166), the second one was Tocilizumab, 13.6% (n = 31) then comes the anti-TNF in 3<sup>rd</sup>&nbsp;position with 12.4% (n = 28). The factors associated with the choice of Rituximab as the first line bDMARDs prescribed in univariate analysis were: the insurance type, the positivity of the rheumatoid factor. In multivariate analysis, only the insurance type that remains associated with the choice of Rituximab as the first biological drugs. The Tocilizumab was associated with shorter disease duration and was more prescribed as mono-therapy compared to non Tocilizumab group. TNFi was associated with the insurance type.</p> <p><strong>Conclusion:&nbsp;</strong>our study suggests that Rituximab and TNFi are associated with the type of insurance and Tocilizumab is the most prescribed biologic mono-therapy in RA patients. Further studies are needed to confirm these results.</p> 2022-02-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237351 Artificial Intelligence (AI) in medicine as a strategic valuable tool 2022-12-02T07:50:41+00:00 Andreas Larentzakis alarentz@med.uoa.gr Nik Lygeros alarentz@med.uoa.gr <p>Humans' creativity led to machines that outperform human capabilities in terms of workload, effectiveness, precision, endurance, strength, and repetitiveness. It has always been a vision and a way to transcend the existence and to give more sense to life, which is precious. The common denominator of all these creations was that they were meant to replace, enhance or go beyond the mechanical capabilities of the human body. The story takes another bifurcation when Alan Turing introduced the concept of a machine that could think, in 1950. Artificial intelligence, presented as a term in 1956, describes the use of computers to imitate intelligence and critical thinking comparable to humans. However, the revolution began in 1943, when artificial neural networks was an attempt to exploit the architecture of the human brain to perform tasks that conventional algorithms had little success with. Artificial intelligence is becoming a research focus and a tool of strategic value. The same observations apply in the field of healthcare, too. In this manuscript, we try to address key questions regarding artificial intelligence in medicine, such as what artificial intelligence is and how it works, what is its value in terms of application in medicine, and what are the prospects?</p> 2021-02-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237352 Late pulmonary embolism in a patient with non-severe COVID-19: case report, value of antithrombotic prophylaxis and literature review 2022-12-02T07:59:35+00:00 Phany Brunelle Issanga Maloumbi phanymaloumbi@gmail.com Ayoub Hassouni phanymaloumbi@gmail.com Junior Rocyr Ibara-Onguema phanymaloumbi@gmail.com Bouchra Maatof phanymaloumbi@gmail.com Franck Bienvenu Ekoba-Othende phanymaloumbi@gmail.com Abdelmajid Bouzerda phanymaloumbi@gmail.com <p>Since the onset of the COVID-19 pandemic, several small cohorts have reported the recurrent occurrence of venous thromboembolic disease (VTE), particulary pulmonary embolism, in serious patients hospitalized in intensive care units. We report the case of a patient who presented a minor COVID-19 infection treated on an outpatient basis with good clinical resolution. She developed a pulmonary embolism three weeks after the onset of symptoms. When she was admitted to the emergency room, the two real time reverse transcription polymerase chain reactions (RT-PCRs) performed were negative, moreover the anti-SARS-CoV-2 Immunoglobulin Gs (IgGs) serological test was positive and the chest scanner without and with injection of contrast product showed specific images of COVID-19 with intermediate pulmonary embolism according to the classification of the European society of cardiology (ESC). This observation is interesting since there are not many studies which address the question of the occurrence of late pulmonary embolism in patients with non-severe COVID-19 and raises the discussion on the criteria for the initiation of thromboembolic prophylaxis treatment at the first diagnosis of the disease and duration of that treatment.</p> 2021-02-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237356 Probiotics potentials in mitigating coronavirus disease (COVID-19) pandemic 2022-12-02T08:06:51+00:00 Rine Christopher Reuben reubenrine@yahoo.com Makwin Danladi Makut reubenrine@yahoo.com Lillian Yami Adogo reubenrine@yahoo.com <p>Despite the adoption and use of different infection prevention and control measures, the coronavirus disease (COVID-19) pandemic keeps surging on with globally increasing morbidities and mortalities. The lack of a specific therapeutic intervention against COVID-19 warrants the use of non-conventional potent alternatives. In recent times, probiotics have shown to mitigate numerous health challenges, including animal and human infectious diseases through competitive exclusion or antagonism of pathogens, modulation of host-microbiota, secretion of antimicrobial compounds and stimulation of immune responses. The presentation of COVID-19 as severe respiratory distress leading to gastrointestinal tract involvement could be mitigated through probiotics administration which beneficially modulates the microbiota and immune responses with an attendant reduction in morbidities, hence curtailing the COVID-19 pandemic.</p> 2021-02-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237358 Ossiculoplasties: à propos de 30 cas et revue de la littérature 2022-12-02T08:13:15+00:00 Khalid Bouhafs khalidbouhafs7910@gmail.com Azeddine Lachkar khalidbouhafs7910@gmail.com Abderrahim Benallal khalidbouhafs7910@gmail.com Drissia Benfadil khalidbouhafs7910@gmail.com Mohammed Rachid Ghailan khalidbouhafs7910@gmail.com <p>L'objectif était d'évaluer les résultats fonctionnels des ossiculoplasties. Il s'agissait d'une étude rétrospective, au sein du service d'Otorhinolaryngologie (ORL) et de chirurgie cervico-faciale (CCF) au centre hospitalier universitaire (CHU) Mohammed VI d'Oujda, étalée sur une durée allant du mois d'octobre 2018 au mois de mars 2020, ayant pu regrouper 30 patients parmi 45 otites séquellaires qui ont été opérés pour ossiculoplastie par une voie transméatale endoscopique. La moyenne d'âge des patients était de 31,8 ans avec un sex-ratio F/H de 1,5. L'exploration de la caisse du tympan a montré, selon la classification d'Austin, 18 cas type A, 5 cas type B, 3 cas type C et 4 cas type D. Soixante-dix pourcent (70%) des oreilles opérées avaient un déficit audiométrique entre 30 et 40 dB et 30% des patients ont un déficit audiométrique ≥40 dB. L'ossiculoplastie type II a été la plus pratiquée dans 26 cas avec utilisation du cartilage tragal dans 18 cas, interposition d'enclume autologue et mise en place d'une PORP en titane dans 4 cas pour chacune alors que l'ossiculoplastie type III a été pratiquée dans 4 cas avec mise en place d'une opération de reconstruction totale des osselets (TORP) en titane. Le groupe d'ossiculoplastie type II avait un gain auditif ≥20 dB dans tous les cas alors que celui d'ossiculoplastie type III ne l'avait que dans un seul cas. Le taux de réussite était de 90%. L'analyse de ces résultats montre que globalement les résultats sont légèrement moins bons dans les ossiculoplasties type III que dans les ossiculoplasties type II. Cependant, les études comparatives entre différents montages, entre prothèses et autogreffes ou entre différents types de matériaux n'objectivent que des différences minimes pour un même auteur ou pour une même équipe. Il semble pour beaucoup d'auteurs que la préservation du manche du marteau permette de meilleurs résultats fonctionnels.</p> 2021-02-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237361 Congenital hepatic fibrosis: case report and review of literature 2022-12-02T08:22:36+00:00 Brahim El Hasbaoui zainabrifai89@gmail.com Zainab Rifai zainabrifai89@gmail.com Salahiddine Saghir zainabrifai89@gmail.com Anas Ayad zainabrifai89@gmail.com Najat Lamalmi zainabrifai89@gmail.com Rachid Abilkassem zainabrifai89@gmail.com Aomar Agadr zainabrifai89@gmail.com <p>Congenital hepatic fibrosis (CHF) is a rare autosomal recessive disease derived from biliary dysgenesis secondary to ductal plate malformation; it often coexists with Caroli’s disease, von Meyenburg complexes, autosomal dominant polycystic kidney disease (ADPKD), and autosomal recessive polycystic kidney disease (ARPKD). Although CHF was first named and described in detail by Kerr&nbsp;<em>et al</em>. in 1961. Its pathogenesis still remains unclear. The exact incidence and prevalence are not known, and only a few hundred patients with CHF have been reported in the literature to date. However, with the development of noninvasive diagnostic techniques such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), CHF may now be more frequently detected. Anatomopathological examination of liver biopsy is the gold standard in diagnosis of CHF. Patients with CHF exhibit variable clinical presentations, ranging from no symptoms to severe symptoms such as acute hepatic decompensation and even cirrhosis. The most common presentations in these patients are splenomegaly, esophageal varices, and gastrointestinal bleeding due to portal hypertension. In addition, in younger children, CHF often is accompanied by renal cysts or increased renal echogenicity. Great variability exists among the signs and symptoms of the disease from early childhood to the 5<sup>th</sup>&nbsp;or 6<sup>th</sup>&nbsp;decade of life, and in most patients the disorder is diagnosed during adolescence or young adulthood. Here, we present two cases of congenital hepatic fibrosis in 2-years-old girl and 12-year-old male who had been referred for evaluation of an abdominal distension with persistent hyper-transaminasemia and cholestasis, the diagnostic was made according to the results of medical imaging (CT or MRI), a liver biopsy, and genetic testing.</p> 2021-02-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237363 AB thymoma revealed by a huge intraparenchymal lung mass: a case report 2022-12-02T08:31:29+00:00 Btissame Es-sabbahi ibtissamessabbahi@gmail.com Mounia Serraj ibtissamessabbahi@gmail.com Baderdine Alami ibtissamessabbahi@gmail.com Mohammed Elbiaze ibtissamessabbahi@gmail.com Mohammed Chakib Benjelloun ibtissamessabbahi@gmail.com Bouchra Amara ibtissamessabbahi@gmail.com <p>Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum. Unusually it can be found in other locations as well. Ectopic thymoma rarely presents as an intrathoracic tumor. We report a case of ectopic thymoma presenting as a giant right intrathoracic tumor, the patient was 51-year-old, and who was presented with heaviness in chest and breathlessness. Detailed investigation including chest computed tomography scan revealed a well-defined large solid tumor in the right thoracic cavity, in this case, immunohistochemical analysis demonstrated a thymome AB. The tumor was metastatic to the lung. Patient received a neoadjuvant chemotherapy, with favorable evolution.</p> 2021-02-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237365 Road traffic accident and management outcome among in Adama Hospital Medical College, Central Ethiopia 2022-12-02T08:39:44+00:00 Eskindir Deresse kedir.t.roba@gmail.com Meyrema Abdo Komicha kedir.t.roba@gmail.com Tesfaye Lema kedir.t.roba@gmail.com Shemsedin Abdulkadir kedir.t.roba@gmail.com Kedir Teji Roba kedir.t.roba@gmail.com <p><strong>Introduction:&nbsp;</strong>road traffic injuries represent accounts for significant cause of morbidity and mortality around the globe, particularly in developing countries like Ethiopia. Poor pre-hospital care system and delays in hospitals before getting aids added to the woes of mortality. However, there are no study that determine the types of injury, management and outcome of road traffic accidents and associated factors in this study area.</p> <p><strong>Methods:&nbsp;</strong>a hospital based retrospective cross sectional study was conducted among patients attending to Adama Hospital Medical College with accidental injuries from January to December 2015. Data were retrieved from 556 patients registry selected by systematic random sampling from 11,120 injuries visiting the hospital. Data were coded, cleaned and entered to SPSS version 20 for analysis. Factors associated with the management outcome of injury related to road traffic accident were analyzed and statistical significance was declared with p &lt; 0.05 with CI of 95%.</p> <p><strong>Results:&nbsp;</strong>out of 556 trauma victims, 304 (54.7%) were due to road traffic accidents followed by personal violence (24%) and falling accident (10.3%). The majorities (74.8%) of patients were male and urban residents (55%). Soft tissue injury was the most frequent type of injury (51%) followed by extremity fracture and dislocation (26%). Delay to come to hospital (over 24 hours), severity of injuries and management types were factors influencing management outcome of injuries related to traffic accidents. About 90.1%, 4.6% and 5.3% of the patients were discharged without any prominent disability, permanent disability and died respectively.</p> <p><strong>Conclusion:&nbsp;</strong>road traffic accidents are preventable causes of morbidity and mortality. Practices of strict road safety measures and appropriate use of roadways by pedestrians should be in place, while establishing and strengthening early access to hospital and pre-hospital care to save life of injuries.</p> 2021-02-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237367 Assessing the prevalence and effect of adverse drug reactions among patients receiving first line anti-tubercular medicines in the Tamale Teaching Hospital, Ghana 2022-12-02T08:48:50+00:00 Anthony Amalba amalbaanthony@yahoo.com Amos Adapalala Bugri amalbaanthony@yahoo.com <p><strong>Introduction:&nbsp;</strong>tuberculosis (TB) remains a global major health problem, especially in developing countries. Although treatment regimen for TB has been highly effective, treatment-related adverse effects account for significant morbidity leading to reduced effectiveness of therapy and high default rate. This study evaluated the nature and occurrence of Adverse Drug Reactions (ADRs) in patients receiving first line antitubercular therapy (ATT) in Tamale Teaching Hospital (TTH) and its effects on adherence.</p> <p><strong>Methods:&nbsp;</strong>the study was a cross-sectional study for a period of six months. A total of 66 participants who were on first line antituberculotic therapy consented for the study. Data was collected using a questionnaire and analysed using SPSS version 22.0.</p> <p><strong>Results:&nbsp;</strong>about 77% (n=51) of the participants had experienced ADRs. Gastrointestinal symptoms were the most commonly reported symptoms of ADR (80%, n=41). Regarding adherence, over half (51.0%, n=26) said the occurrence of the Adverse Drug Reaction had affected the manner in which they take their medications. Of these, 84.6% (n=22) of the participants indicated that they skipped/missed their medications and 15.4% stopped the medication entirely. About 39.2% (n=20) reported ADRs to a healthcare practitioner and 60.8% did not. All the reported cases were managed by a health practitioner using another medication.</p> <p><strong>Conclusion:&nbsp;</strong>the study showed that ADRs are common among patients receiving first line ATT. Gastrointestinal tract (GIT) related ADRs were the most common. Adherence to first line antitubercular therapy is poor as a result of adverse drugs reaction.</p> 2021-02-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237370 Multiple cardiovascular complications of COVID-19 infection in a young patient: a case report 2022-12-02T08:56:08+00:00 Hammam Rasras h.rasras@hotmail.com Abdelaziz Boudihi h.rasras@hotmail.com Anass Hbali h.rasras@hotmail.com Nabila Ismaili h.rasras@hotmail.com Noha El Ouafi h.rasras@hotmail.com <p>COVID-19 infection is responsible for many complications, which can lead to a high risk of mortality in some patients. Among them are cardiovascular complications which are classified as the most severe. We report a case of a young woman, with no relevant pathological history, admitted for COVID-19 infection, complicated by myocarditis with severe ventricular dysfunction, cardiogenic shock and a large thrombosis into the left ventricle (LV) that was responsible for a left lower limb ischemia associated with a deep venous thrombosis of right lower limb.</p> 2021-02-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237372 Knowledge, attitudes, practice and barriers of physicians to provide tobacco dependence treatment: a cluster analysis 2022-12-02T09:03:24+00:00 Moon Fai Chan moonf@squ.edu.om Yaqoub Alsaidi moonf@squ.edu.om Sana Al-Sumri moonf@squ.edu.om Buthaina Al-Maskari moonf@squ.edu.om Hajer Al-Hamrashdi moonf@squ.edu.om <p><strong>Introduction:&nbsp;</strong>in Oman, there is a need to understand the profile of primary care physicians’ (PCP) knowledge, attitude, and practice, and barriers (KAPB) towards tobacco dependence treatment (TDT). Their profile will directly affect their consultation and contribution to health care educators to develop an appropriate educational program for the PCPs. The aim of this study is to determine profiles in a cohort of PCP with regards to factors associated with physicians’ perceived KAPB of providing TDT.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional survey was conducted for four months from September to December 2019. A sample of 226 (response rate is 71.2%) PCPs working for Muscat's health centers, the capital of Oman, was collected. A 2-step cluster method was used to separate the sample into sub-groups according to their demographic and KAPB scores.</p> <p><strong>Results:&nbsp;</strong>cluster analysis revealed two groups of PCPs who are different in demographics and KAPB scores. The PCPs in cluster B (27.4%) have higher educational levels, senior ranking, more males and older. They labeled as the&nbsp;<em>“good knowledge, positive attitudes, and highly practices”</em>&nbsp;group. The PCPs in cluster A comprised 72.6% of our samples. There are more females, younger, and with a junior ranking. This cluster was identified as the&nbsp;<em>“lack of knowledge, moderate attitudes, and rarely practices”</em>&nbsp;group.</p> <p><strong>Conclusion:&nbsp;</strong>findings might help primary health care authorities to address this preventable issue and plan interventions to establish well-structured TDT clinics in the future.</p> 2021-02-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237377 Immunisation program reviews in East and Southern Africa (2012-2018): key lessons 2022-12-02T09:31:03+00:00 Messeret Eshetu Shibeshi eshetum@who.int Balcha Girma Masresha eshetum@who.int Fussum Daniel eshetum@who.int <p><strong>Introduction:&nbsp;</strong>The World Health Organisation (WHO) recommends that countries conduct comprehensive national immunisation program reviews regularly to help them identify systems wide-barriers or gaps and monitor performance against the set targets.</p> <p><strong>Methods:&nbsp;</strong>we reviewed reports from the latest national immunisation program reviews conducted in the 20 countries in the sub-region in the course of 2012-2018. We generated descriptive analysis of the findings across the sub-region.</p> <p><strong>Results:&nbsp;</strong>the 20 program reviews included field observations to the subnational levels as well as interviews with program staff and stakeholders. At the time of the reviews, only 11 countries had functional National Immunisation Technical Advisory Groups. Operational funding was inadequate in half of the countries. The reviews documented the cancellation of outreach services, supportive supervision visits and maintenance of cold chain equipment due to the lack of fuel or operational funding. Immunisation programs in 10 countries had major human resource gaps. Vaccine stock management tools were not effectively used in 10 countries, and stock out of vaccines and supplies was documented in 9 countries during the review. The full components of the RED strategy were implemented in only 3 of the 20 countries. Twelve countries reported challenges with the availability and accuracy of target populations. Four countries had documented the presence of vaccine hesitant groups at the time of the reviews.</p> <p><strong>Conclusion:&nbsp;</strong>the reviews demonstrated challenges in various aspects of the programs in different countries. The implementation of the review recommendations should be built into the annual program plans, as well as into coasted multi-year plans, in order to address the gaps and helps the program to attain the set targets. With the rapid evolution of the scope and complexity of the immunisation programs in recent years, countries should invest their efforts in building the capacity of their human resources as well as updating their logistics and data systems.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237379 Prise en charge des larges fistules bilio-kystiques lors de la chirurgie conservatrice du kyste hydatique du foie 2022-12-02T09:56:20+00:00 Aymen Trigui ayman.trigui@gmail.com Haitham Rejab ayman.trigui@gmail.com Jihene Krichene ayman.trigui@gmail.com Ahmed Tlili ayman.trigui@gmail.com Jihene Trabelsi ayman.trigui@gmail.com Ahmed Kachoua ayman.trigui@gmail.com Salah Boujelbene ayman.trigui@gmail.com Rafik Mzali ayman.trigui@gmail.com <p><strong>Introduction:&nbsp;</strong>le traitement des larges fistules kysto-biliaires ne fait pas l'unanimité des auteurs en l'absence de consensus ou de niveau de preuve élevé. Les méthodes chirurgicales sont controversées entre traitement radical permettant de suturer la fistule en zone saine et le traitement conservateur qui pose des problèmes de réparation. Le but de cette étude est de comparer les différentes techniques chirurgicales du traitement conservateur des larges fistules kysto-biliaires.</p> <p><strong>Méthodes:&nbsp;</strong>étude rétrospective de 54 fistules larges, menée au service de chirurgie générale du CHU Habib Bourguiba à Sfax durant 9 ans (2010 - 2018).</p> <p><strong>Résultats:&nbsp;</strong>il s'agit de 44 patients. L'échographie abdominale a permis de suspecter une ouverture dans les voies biliaires dans 18 cas (47,4%) alors que la tomodensitométrie (TDM), a suspecté une ouverture chez 28 patients (68.3%). Le traitement des fistules était réalisé par la technique du DITFO dans 18 cas (33,3%), de PERDROMO dans 11 cas (20,4%) et le drainage bipolaire dans 25 cas. Le taux de morbidité chirurgicale spécifique était de 31,5% dominé par une fistule biliaire post opératoire dans 18,5% des cas. La technique de DITFO était associée à un séjour hospitalier le plus court (p=0,028) et une morbidité plus basse (22,2%) sans différence statistiquement significative.</p> <p><strong>Conclusion:&nbsp;</strong>la technique de DITFO représente la technique de choix dans le traitement des fistules kysto-biliaires (FKB), elle a une morbidité moins élevée et le séjour hospitalier le plus court.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237380 The need for a balanced hospital-based care (HBC) and home- and community-based care (HCBC) approach for mitigating COVID-19 pandemic in sub-Saharan Africa 2022-12-02T10:04:21+00:00 Harris Onywera do79harris@gmail.com Lamech Malagho Mwapagha do79harris@gmail.com Nei-Yuan Hsiao do79harris@gmail.com <p>The onslaught of COVID-19 pandemic has greatly overwhelmed some of the best healthcare systems in the world. Medical practitioners working in hospitals at the epicenters of COVID-19 pandemic have emphasized on the need to manage mildly ill and convalescent COVID-19 patients at home or community facilities rather than at hospitals during a pandemic. In this article, we highlight that a standardized home- and community-based (HCBC) approach for management of COVID-19 patients will be a key component for preparing hospitals in sub-Saharan Africa (SSA) for a potential surge in COVID-19 cases. So far, based on the trajectory of infection, we think that SSA seems to have a window of opportunity, albeit narrowing, for implementing HCBC. However, there are challenges that will need to be addressed in order to implement and maintain HCBC. Successful implementation and maintenance of HCBC in SSA will require international agencies and key donors to work closely with the national governments; providing them with policy, technical, and financial assistance. Home- and community-based care (HCBC) is also important because it can play a role in advocacy, education, training, and health promotion during COVID-19 pandemic. We further underscore the need for a delicate balance between HCBC and hospital-based care (HBC) approach as well as with COVID-19 mitigation and suppression measures in order to reduce the risk of SARS-CoV-2 community transmission and allow optimal continuity of the HBC. We conclude by emphasizing once again that, for countries in SSA to adequately prepare for the worst-case scenario of COVID-19 pandemic in the absence of a cure, policy makers of member states need to act collectively and fast.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237381 Facility and patient barriers in the implementation of isoniazid preventive therapy for people living with HIV attending Care and Treatment Centers, Songea Municipality, Tanzania 2022-12-02T10:18:29+00:00 Festo Faustine Komba gasto.frumence65@gmail.com Gasto Frumence gasto.frumence65@gmail.com <p><strong>Introduction:&nbsp;</strong>isoniazid preventive therapy for people living with HIV is an essential public health intervention in low-income countries with high tuberculosis and HIV burden. Despite available evidence that it is efficacious, its implementation is still low in many countries. This study was designed to determine its implementation coverage and explore barriers for suboptimal implementation in Songea municipality in Tanzania.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional descriptive study design using both quantitative and qualitative approaches of data collection was employed. A review of 2148 records of people living with HIV eligible for isoniazid preventive therapy (IPT) was done to determine its implementation coverage. Twenty-one (21) in-depth interviews and 5 observations were conducted to explore barriers in the implementation. Quantitative data was analyzed using Statistical Package for the Social Science (SPSS) for windows version 20 statistical software. Descriptive statistics (frequencies and percentage) were employed and data were visualized using tables and bar graphs. All interviews were audio-recorded and analyzed using thematic analysis approach.</p> <p><strong>Results:&nbsp;</strong>overall, isoniazid preventive therapy coverage at Songea municipality was estimated to be 45%. Insufficient drug supply and stock out, shortage of staff, lack of service privacy, long waiting time, drug side effects, pills burden, distance and cost of transport were the main reported barriers hindering full scale implementation of isoniazid preventive therapy.</p> <p><strong>Conclusion:&nbsp;</strong>implementation of isoniazid preventive therapy in Songea municipality had low coverage. The study recommends that tuberculosis and HIV stakeholders must be part of the solutions by ensuring that the identified barriers are addressed.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237387 Challenges in healthcare financing for surgery in sub-Saharan Africa 2022-12-02T12:10:40+00:00 Juliet Siena Okoroh jokoroh@gmail.com Robert Riviello jokoroh@gmail.com <p>One-third of the global burden of disease is attributed to surgical conditions yet, 5 billion people globally, lack access to surgery. The Lancet Commission on Global Surgery, Obstetrics, and Anesthesia (LCOGS) published guidelines for improving access by reducing catastrophic health expenditures (CHEs) by 2030. This is especially important in sub-Saharan Africa (SSA) where 90% of the extreme poor reside. In this paper, we provide a narrative review of four studies on CHEs for surgical care in SSA published since 2015. We discuss healthcare financing in the countries and summarize the authors´ key findings of out-of-pocket payments (OOP) and CHEs. Briefly, the studies enrolled 130 to 300 patients and collected direct OOPs via chart review of health costs or patient interviews. Indirect costs were calculated from lost wages and transportation costs. CHEs were defined as health costs exceeding 10% of the GDP per capita or the household income. Despite healthcare being reported as free in all studies, 60%-90% of surgical patients had CHEs with all costs considered. OOPs persists for medicines and anesthesia that should be covered under any health insurance scheme. In some cases, indirect costs associated with transportation and wages were major drivers of CHEs for surgery. Without addressing these gaps in coverage, more people will risk impoverishment in seeking surgical care in SSA.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237389 Knowledge, risk perception and adherence to COVID-19 prevention advisory among police officers in Makurdi Metropolis Benue State, 2020 2022-12-02T12:27:47+00:00 Ubong Akpan Okon itdo4christ@gmail.com Christiana Onche itdo4christ@gmail.com Simeon Whenayon Ajisegiri itdo4christ@gmail.com Uche Katchy itdo4christ@gmail.com Peter Onyema itdo4christ@gmail.com Charles Uwazie itdo4christ@gmail.com Isika Anastasia itdo4christ@gmail.com Araga Abdullahi itdo4christ@gmail.com Muhammad Shakir Balogun itdo4christ@gmail.com <p><strong>Introduction:&nbsp;</strong>the current pandemic of coronavirus disease (COVID-19) caused by a novel strain (SARS-CoV-2) is enormous and continues to pose a threat to the lives of people. In Nigeria, as of 21<sup>st</sup>&nbsp;April 2020, 668 confirmed cases, 22 deaths and 188 recoveries have been reported. Police officers are at the forefront of enforcing advisories to ensure public compliance. However, there is a paucity of data on knowledge, risk perception, and adherence to COVID-19 advisories issued by the Health authorities particularly among the police officers. We, therefore, assessed the knowledge, risk perceptions and adherence to NCDC recommended advisory on COVID-19.</p> <p><strong>Methods:&nbsp;</strong>we conducted a two-stage sampling cross-sectional study among different cadres of police officers in Benue State, Nigeria using a pretested, semi-structured, interviewer-administered questionnaire. The results of the study were presented in frequencies and proportions. Chi-square test was used for an association between variables at p-value &lt; 0.05.</p> <p><strong>Results:&nbsp;</strong>the mean age of the 305 participants was 39.1 ± 8.4 years and most, 124 (40.7%) of the participants were within age-group 30-39 years, 19 (64.3%.8) were male, 250 (82.0%) were married and 160 (52.5%) had secondary education as the highest qualification. Majority of the participants, 301 (98.7%) have heard about COVID-19 and the commonest source of information was via television/radio, 230 (76.4%). Most participants demonstrate a good knowledge of COVID-19 infection, 302 (99.0%) and positive risk perception of COVID-19, 303 (99.3%) but few demonstrated good adherences on COVID-19 prevention practices, 133 (43.6%). Participants’ academic qualification (X² = 10.98, p = 0.001) and cadre (X² = 112.5, p = 0.001) were found to be associated with good adherence.</p> <p><strong>Conclusion:&nbsp;</strong>while most participants had a good knowledge of COVID-19 transmission dynamics, and positive risk perception about COVID-19, good adherence to public health advisories were low. We recommended periodic training, provision of adequate PPE and personal hand-sanitizers as a strategy to improve adherence.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237391 A study of HER2 expression in endometrial carcinoma: a single centre experience 2022-12-02T12:36:41+00:00 Mariani Hashim su_hayati@ppukm.ukm.edu.my Nur Maya Sabrina Tizen su_hayati@ppukm.ukm.edu.my Nurwardah Alfian su_hayati@ppukm.ukm.edu.my Hasmah Hashim su_hayati@ppukm.ukm.edu.my Azmawati Mohammed Nawi su_hayati@ppukm.ukm.edu.my Suria Hayati Md Pauzi su_hayati@ppukm.ukm.edu.my <p><strong>Introduction:&nbsp;</strong>endometrial carcinoma (EC) is the seventh most common cancer in females in Malaysia, of which the majority is composed of lower grade type I EC. Although less prevalent, type II EC which is of higher grade has poorer outcome and prognosis. Human epidermal growth factor receptor 2 (HER2) is one of the possible prognostic molecular markers which can be a target for immunotherapy. This study aimed to assess the expression of HER2 in common type of EC in the local population and to determine its correlation with the clinicopathological features.</p> <p><strong>Methods:&nbsp;</strong>a total of 53 cases of endometrioid type of EC were selected within a six-year period comprising of 22 cases of grade 1, 25 cases of grade 2 and six cases of grade 3 carcinoma. The selected whole tumour tissue sections were immune-stained with HER2 antibody. The scoring was semi-quantitatively analyzed based on 2013 American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAPs) guidelines for the scoring of HER2 in breast cancer.</p> <p><strong>Results:&nbsp;</strong>all cases regardless of grades of endometrioid carcinoma showed negative expression of HER2 (score 0).</p> <p><strong>Conclusion:&nbsp;</strong>there was no significant HER2 expression in endometrioid carcinoma. However, a follow-up study with a larger number of samples from different type of endometrial carcinoma is needed. Testing of several tumour tissue blocks to assess possible tumour heterogeneity, as well as correlation with HER2 gene amplification status by in-situ-hybridisation, are also recommended.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237396 Magnitude and risk of neonatal death in neonatal intensive care unit at referral hospital in Godeo Zone: a prospective cohort study 2022-12-02T12:53:48+00:00 Akine Eshete akine.eshete@yahoo.com Henok Tadesse akine.eshete@yahoo.com Tizalegn Tesfaye akine.eshete@yahoo.com Silesh Abiy akine.eshete@yahoo.com <p><strong>Introduction:&nbsp;</strong>even though newborn health is apriority agenda in Ethiopia, neonates’ risk of dying is unacceptable and one of the ten countries which accounts to two-third of global neonatal death. The magnitude and risk of death in the referral care facility was not well studied in the study area. This study was aimed to estimate neonatal death and its determinant.</p> <p><strong>Methods:&nbsp;</strong>a prospective cohort study was conducted from November 2016 to January 2018 among neonates admitted to Dilla University Referral Hospital Neonatal Intensive Care Unit. We generated descriptive statistics and Cox-proportional hazard model to identify independent risk factors of neonatal death.</p> <p><strong>Results:&nbsp;</strong>we identified 913 neonates with 6836 person-days of follow-up. Overall, 11.6% (n = 106) deaths of neonates were recorded. The estimated hazard ratios of neonatal death were higher among neonates whose mothers did not attend ANC follow up (HR=3.23), delivery assisted by TBA (HR=2.19), and maternal age ≥ 30 years at birth (HR=2.04). Urban residence [HR=0.54], family size of ≤ 3 (HR=0.47) and family size of 4 - 6 (HR=0.49), absence of abortion (HR=0.55), absence of illness during pregnancy (HR=0.47), iron folate intake (HR=0.29), birth weight ≥ 2500 grams (HR=0.43) were found to be protective factors.</p> <p><strong>Conclusion:&nbsp;</strong>neonatal death at referral neonatal intensive care unit was relatively high. Early management of complications, improving quality of services at neonatal intensive care unit and ensuring maternal continuum of care are recommended to increase survival of neonates. Besides, maternal and neonatal health-related factors were among the independent risk factors that need to design context-based policy and interventions.</p> 2021-02-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237398 Ventriculoperitoneal shunt fracture in a child 2022-12-02T12:58:25+00:00 Prastiya Indra Gunawan prastiya_ig@yahoo.co.id Uuk Riuh Kusuma Wardana prastiya_ig@yahoo.co.id <p>Ventriculoperitoneal shunt (VPS) fracture is one of malfunction shunt. In pediatric cases, catheter fractures are observed most frequently in the growing period of the patient along with increasing height. Most fractures are reported on the connection side or the side with intense fibrosis because of the repeated pressure. Fracture shunt can be caused by immune reaction, calcification and abrasion leading to shunt dysfunction. A 5-years-old boy presented with headache, vomiting, non-specific abdominal discomfort, high fever, seizure and decrease of consciousness. He was previously hydrocephalic with large head size since birth. A VPS was already inserted twice in 3 months and 5 years old. Neurological examination showed the patient somnolent and Babinski reflexes were positive. Routine hematological investigation revealed leukocytosis. Cerebrospinal fluid (CSF) culture revealed&nbsp;<em>Staphylococcus aureus</em>&nbsp;and CSF analysis showed bacterial infection. A contrast-enhanced computed tomography (CT) scan showed left ventriculomegaly and pneumoventricular lateral ventricle, agenesis septum pellucidum, left subdural hygroma in regio fronto-parieto-occipito temporalis. From Plain abdominal X-ray showed of fractured VP shunt tip in abdominal cavity. Emergency surgery was performed to evacuate VPS and antibiotic given based on CSF culture result. The patient was hospitalized about one month and improved leaving neurological sequalae.</p> 2021-02-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237402 Prevalence of rifampicin resistance tuberculosis among HIV/TB coinfected patients in Benue State, Nigeria 2022-12-02T13:15:49+00:00 Francis Enenche Ejeh enenchefrancis@yahoo.com Ann Undiandeye enenchefrancis@yahoo.com Kenneth Okon enenchefrancis@yahoo.com Kazeem Haruna Moshood enenchefrancis@yahoo.com <p><strong>Introduction:&nbsp;</strong>the emergence of HIV/TB co-infection has changed the global health landscape, particularly in sub-Saharan Africa and Asia with a high prevalence rate. It has further worsened and compound patient diagnosis, treatment/management approach and infection control. Rifampicin resistance TB (RR-TB) is a good indicator of treatment failure and infection control in the community. This study determines the prevalence of RR-TB among HIV/TB coinfected patients in Benue State, Nigeria.</p> <p><strong>Methods:&nbsp;</strong>the case-control study was carried out at Federal Medical Centre, Makurdi and General Hospital, Otupko, between January 2017 and February 2018. One thousand and ten suspected tuberculosis and HIV patients were enrolled in the study, diagnosed according to WHO guidelines. Sputum samples were collected and then analyzed by acid-fast bacilli smear test and GeneXpert MTB/RIF assay.</p> <p><strong>Results:&nbsp;</strong>overall prevalence of tuberculosis by acid-fast test was 74 (7.3%), 171 (16.93%) by GeneXpert assay and 2.18% by RR-TB test respectively. Significant difference was observed between the detection technique and demographic variables, high prevalence among urban patient compared to rural (8.85%vs 5.40%; Χ²= 4.38; P = 0.036) and ethnic background of the patients (Χ²= 23.21; P = 0.000) by acid fast test. With GeneXpert, high prevalence recorded among patient within age-group15-45years (Χ²= 8.01; P = 0.046) and ethnic group (Χ²= 6.30; P = 0.044). The occurrence of HIV/TB co-infection was less associated with Idoma ethnic group (COR; 0.440; 95% C.I; 0.246 – 0.786).</p> <p><strong>Conclusion:&nbsp;</strong>the relatively high prevalence of HIV/TB co-infection and RR-TB is a tremendous public health threat, considering society's attendant implication. Further surveillance studies are needed to evaluate the situation in Benue State better.</p> 2021-02-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237406 Nature and outcome of malignant goiter: a revisit 2022-12-02T13:23:19+00:00 Mohamed Yasser Ibrahim Daoud mdaoud70@yahoo.com <p><strong>Introduction:&nbsp;</strong>the aim of this retrospective study is to review patients with malignant goiter, as regards their nature, demographic characterization, clinical presentation and preoperative histopathological data.</p> <p><strong>Methods:&nbsp;</strong>the study focused on a period of 4 years from December 2015 to January 2019. Patients´ demographic data, clinical presentation, Intra-operative findings, Pre and postoperative histopathological staging and grading were all recorded. Postoperative follow up whether early or late were also included.</p> <p><strong>Results:&nbsp;</strong>a total of 100% (n = 65) patients underwent surgery. The female to male ratio was found to be 5:1 (48 females and 17 males). Solitary nodule was the main clinical presentation in 80% (n = 52) of cases while 20% (n = 13) were multinodular swellings. Papillary carcinoma was recorded in 80% (n = 52) of patients while in 15.4% (n =10) of patients were having follicular carcinoma. The remaining 4.6% (n = 3)suffered of lymphoma; no medullary or anaplastic tumors were reported.</p> <p><strong>Conclusion:&nbsp;</strong>thyroid cancer is the most commonly encountered endocrinal malignancy at our institute. Fine Needle Aspiration Cytology (FNAC) showed a high percentage of reliability in diagnosing thyroid cancer among our series. It is recommended to adapt this technique in initial screening of goiter patients in our local setting.</p> 2021-02-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237408 Predictive factors of mortality in patients with COVID-19 in Guinea: analysis of the first 140 cases admitted to intensive care unit 2022-12-02T14:12:07+00:00 Joseph Donamou donamoujoseph@gmail.com Abdoulaye Touré donamoujoseph@gmail.com Amadou Yalla Camara donamoujoseph@gmail.com Djiki Camara donamoujoseph@gmail.com M´mah Lamine Camara donamoujoseph@gmail.com Abdourhamane Dine Traoré donamoujoseph@gmail.com Mariame Mohamed Camara donamoujoseph@gmail.com Almamy Bangoura donamoujoseph@gmail.com Boubacar Atigou Dramé donamoujoseph@gmail.com Luc Kouessi Sossa donamoujoseph@gmail.com Jean-Marc Roméo Abékan donamoujoseph@gmail.com Axel Irvin Edemessi donamoujoseph@gmail.com Sow Mamadou Saliou donamoujoseph@gmail.com <p><strong>Introduction:&nbsp;</strong>the objective was to identify the predictive factors contributing to COVID-related deaths in Intensive Care Unit.</p> <p><strong>Methods:&nbsp;</strong>this was a 4-month (12<sup>th</sup>&nbsp;March to 12<sup>th</sup>&nbsp;July 2020) cross sectional study carried out in the intensive care unit of the COVID treatment center of Donka National Hospital, the only hospital with a COVID intensive care unit in Guinea.</p> <p><strong>Results:&nbsp;</strong>during our period of study 140 patients were hospitalized in the COVID intensive care unit and 35 patients died (25%). In univariate analysis, the occurrence of death was associated with: confusional syndrome (p&lt;0.001), time to admission (p&lt;0.001), use of an inotropic or vasopressor (p&lt;0.001), Brescia score ≥ 2 (p=0.004), non-invasive ventilation (p=0.011), stroke (p=0.014), Acute Respiratory Distress Syndrome (ARDS) (p=0.015), male (p=0.021), provenance (p=0.021), acute renal failure (p=0.022), pulmonary embolism (p=0.022), invasive ventilation (p=0.022), and age &gt; 60 years (p=0.047). In multivariate analysis, the factors predictive of mortality were: Acute Respiratory Distress Syndrome (ARDS) (OR= 6.33, 95% CI [1.66-29]; p=0.007), a Brescia score ≥ 2 (OR =5.8, 95% CI [1.7-19.2]; p=0.004) and admission delay (OR =5.6, 95% CI [1.8-17.5]; p=0.003).</p> <p><strong>Conclusion:&nbsp;</strong>our study shows that the acute respiratory distress syndrome, then the Brescia score ≥ 2, and finally the time to admission to intensive care were all associated with an increased risk of death for patients. These results are different from those reported in Asia, Europe and North America.</p> 2021-02-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237528 Risks of cardio-vascular diseases among highly active antiretroviral therapy (HAART) treated HIV seropositive volunteers at a treatment centre in Lagos, Nigeria 2022-12-05T08:38:34+00:00 Oloruntoba Ayodele Ekun ayodele1619.oe@gmail.com Emmanuel Olusesan Fasela ayodele1619.oe@gmail.com David Ayoola Oladele ayodele1619.oe@gmail.com Gideon Odemakpore Liboro ayodele1619.oe@gmail.com Toyosi Yekeen Raheem ayodele1619.oe@gmail.com <p><strong>Introduction:&nbsp;</strong>highly active antiretroviral therapy (HAART) has led to a decline in HIV-induced morbidity and mortality in recent years. However, it has been opined that this has led to elevated risks of cardiovascular diseases (CVDs). This study assessed the risks of CVDs among HAART experienced individuals living with HIV.</p> <p><strong>Methods:&nbsp;</strong>a cross sectional study involving 196 adults consisting of 118 HAART experienced and 78 HAART naïve was conducted. Anthropometric and blood pressure measurements were recorded for all participants. Blood samples obtained from the volunteers were used to determine glucose, creatinine, HIV viral load, CD4 count and lipid profile using standard methods. Lipid ratios, atherogenic indices and QRISK3 risk score were calculated.</p> <p><strong>Results:&nbsp;</strong>the median CD4 lymphocyte, mean body mass index (BMI) and HDL-c in HAART experienced participants were higher (P&lt;0.05) than HAART naive individuals. The QRISK3 risk score and creatinine were higher (p&lt;0.05) among HAART experienced group. In HAART experienced group, the risk of hypertension, increased low-density lipoprotein (LDL-c), atherogenic index of plasma (AIP) and QRISK3 were 3.7, 2.0, 2.38 and 3.85 times (p&lt;0.05) higher respectively than in HAART naive. Atherogenic coefficient (AC) increase was more prevalent among male (p&lt;0.05) participants. Risk of chronic renal disease (eGFR), hypertension and CVD (as measured by QRISK3) was higher (p&lt;0.05) among the female and older participants respectively.</p> <p><strong>Conclusion:&nbsp;</strong>the risk of CVDs and renal disease appeared to be higher among HAART experienced volunteers and older (&gt;45 years) volunteers. The risk of renal disease appeared higher in females.</p> 2021-02-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237530 Acute myocardial infarction in a 41-year-old woman due to elevated factor VIII: a case report 2022-12-05T08:44:09+00:00 Falmata Laouan Brem miloubb1993@gmail.com Hammam Rasras miloubb1993@gmail.com Noha El Ouafi miloubb1993@gmail.com Zakaria Bazid miloubb1993@gmail.com <p>Myocardial infarction is a life-threatening emergency with a high mortality rate. A high plasma level of factor VIII is an established risk for both arterial and venous thrombotic events. In this mini-review, we report the case of a 41-year-old woman without cardiovascular risk factors or a previous history of thrombotic events, admitted for ST-elevation myocardial infarction, in whom coronary angiography showed a thrombotic occlusion in the left anterior descending artery. The patient underwent primary percutaneous coronary intervention (PCI), with GPIIB-IIIA antagonist administration, then a pre-dilation with a semi-compliant balloon-catheter, followed by implantation of 2 stents. The etiological assessment revealed a high level of coagulation factor VIII (FVIII). She underwent anticoagulation therapy (with acenocoumarol) with well-controlled international normalised ratio (INR).</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237531 Cause rare d'hémorragie digestive haute: rupture d'un faux anévrisme de l'artère gastroduodénale 2022-12-05T08:48:28+00:00 Issam Loukil issamloukilyoussef@gmail.com Amine Zouari issamloukilyoussef@gmail.com <p>Une patiente âgée de 69 ans, diabétique et hypertendue sous traitement, consulte aux urgences pour des hématémèses. Elle rapporte des douleurs épigastriques intermittentes évoluant depuis quelques jours. L´examen clinique trouve seulement une sensibilité épigastrique. La biologie a révélé une anémie sévère (Hb=8.3 gr/dl) normochrome normocytaire, une amylasémie normale, avec conservation de la fonction hépatique et de la coagulation. L´évolution a été marquée par la chute du taux d´hémoglobine et altération de l´état hémodynamique malgré un bon remplissage vasculaire et transfusion sanguine. Devant la non disponibilité d´une endoscopie digestive immédiate, un angioscanner abdominal a décrit l´image d´un faux anévrysme de l´artère gastroduodénale de 6mm de grand axe sans signes de fuite active ni d´épanchement intrapéritonéal, associée à un aspect de fistule cholédocoduodénale. On a retenu le diagnostic d´une hémorragie digestive haute de grande abondance secondaire à une rupture d´un faux anévrysme de l´artère gastroduodénale. La patiente a été opérée en urgence, devant le non disponibilité d´un geste d´embolisation artérielle, par une ligature vasculaire. L´évolution a été favorable avec stabilisation des chiffres d´hémoglobine et de l´état hémodynamique.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237533 Several cases of arterial thrombosis of the limbs revealing asymptomatic and paucisymptomatic COVID-19 infection 2022-12-05T08:54:58+00:00 Ibrahima Niang niangibrahimaniang@gmail.com Daouda Thioub niangibrahimaniang@gmail.com Mamadou Ly niangibrahimaniang@gmail.com <p>The COVID-19 pandemic, which has been in progress for more than a year, has consistently demonstrated its multi-systemic nature, with its varied effects affecting all the body's systems [<a href="https://www.panafrican-med-journal.com/content/article/38/209/full/#ref1">1</a>]. The cardiovascular system is far from being an exception and the main cardiovascular events reported, associated with COVID-19, concern venous thromboembolic diseases (VTED) [<a href="https://www.panafrican-med-journal.com/content/article/38/209/full/#ref2">2</a>,&nbsp;<a href="https://www.panafrican-med-journal.com/content/article/38/209/full/#ref3">3</a>]. While VTED can quickly become life-threatening, arterial thrombosis of the limbs is just as urgent and deleterious because of the risk of compromising the functional prognosis, which can lead to amputation [<a href="https://www.panafrican-med-journal.com/content/article/38/209/full/#ref2">2</a>,&nbsp;<a href="https://www.panafrican-med-journal.com/content/article/38/209/full/#ref3">3</a>]. Indeed, COVID-19 infection leads to blood hypercoagulability, which causes arterial and venous thrombosis at the peripheral (upper and lower limbs) and central (cerebral, pulmonary, coronary...) levels [<a href="https://www.panafrican-med-journal.com/content/article/38/209/full/#ref4">4</a>]. This high risk of thrombosis is now known in patients diagnosed with COVID-19, who are receiving anticoagulant treatment combined with other preventive measures to limit thromboembolic events.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237535 Évaluation du modèle de gouvernance de la couverture médicale de base au Maroc 2022-12-05T09:00:10+00:00 Karsi Mohammed mohammed.karsi@gmail.com Bennana Ahmed mohammed.karsi@gmail.com <p><strong>Introduction:&nbsp;</strong>cette étude évalue le modèle de la gouvernance de la couverture médicale de base au Maroc. L´objectif principal est de trouver un référentiel d´évaluation et l´appliquer sur le modèle marocain afin de proposer des recommandations d´amélioration.</p> <p><strong>Méthodes:&nbsp;</strong>la méthodologie se repose sur l´analyse documentaire et des entretiens avec les représentants des parties prenantes sur la base d´un référentiel relatif à l´évaluation de la gouvernance des systèmes de la couverture médicale de base (CMB).</p> <p><strong>Résultats:&nbsp;</strong>le modèle de gouvernance de la CMB a connu plusieurs changements depuis le lancement de la loi 65-00, l´évaluation a montré qu´il y a un effort considérable pour les dimensions: intervention des parties prenantes et la cohérence et la stabilité du système, cependant, les dimensions: supervision et régulation, cohérence de la structure de prise de décision et transparence et accès à l´information contiennent des problèmes structurants qui nuisent au bon fonctionnement du système.</p> <p><strong>Conclusion:&nbsp;</strong>le modèle de gouvernance de la CMB au Maroc, nécessite une restructuration et une convergence des caisses de gestion pour un seul organisme qui centralise la gestion. Un effort à fournir aussi pour le volet régulation via l´Agence Nationale de l´Assurance Maladie qui a montré ses limites.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237537 Involvement in family planning service utilization and associated factors among married men at Debre Tabor town, Northwest Ethiopia, 2017 2022-12-05T09:06:23+00:00 Tadesse Wuletaw Demissie twuletaw2015@gmail.com Enatinesh Mesfin Tegegne twuletaw2015@gmail.com Araya Mesfin Nigatu twuletaw2015@gmail.com <p><strong>Introduction:&nbsp;</strong>men´s involvement in family planning (FP) can be either as a user of male contraceptive methods and/or support of the male partners. In some developing countries, levels of communication on this issue is low for decision-making. Unmet need for FP suggested that unwanted pregnancy and unsafe abortion are the main causes of maternal mortality in Ethiopia. Men’s involvement in family planning is very important to improve women´s health in particular and reproductive health in general.</p> <p><strong>Methods:&nbsp;</strong>the community based cross-sectional study design was conducted to assess men´s involvement in family planning service and associated factors among married men at Debre Tabor town. A simple random sampling method was used to include 382 married males. Data were collected by face-to-face interview using a structured questionnaire. The data were entered into Epi Info 7 and were analyzed using SPSS version 21 statistical software package.</p> <p><strong>Results:&nbsp;</strong>from three hundred and eighty-two participants, 373 participated yielding a 97.6% response rate. The age range of the participants´ was from 20 to 65 years, the mean age was 38.6 with the standard deviation of ±7.8. The majority of the participants were Orthodox followers 358 (96%). About 33.2% of them were greater than secondary education level. The magnitude of male involvement in family planning was 254 (68.1%), 370 (99.2%) of the participants had information on different family planning methods. Adjusting all other factors for the final model, educational status AOR = 2.39 [1.084, 5.260], source of information AOR [95%CI] = 1.88 [1.016, 3.485], men’s approval AOR [95%CI] = 0.07 [0.036, 0.134], ever used contraceptive AOR [95%CI] = 0.21 [0.064, 0.705] were found to be associated with men’s involvement.</p> <p><strong>Conclusion:&nbsp;</strong>the level of male involvement was moderate, but their actual utilization is low.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237539 Carcinome sarcomatoïde: prise en charge thérapeutique et profil pronostique à propos d´une localisation maxillaire inhabituelle (à propos d´un cas) 2022-12-05T09:13:13+00:00 Zahra Sayad zahra.sayad999@gmail.com Bouchra Dani zahra.sayad999@gmail.com Rajaa El Azzouzi zahra.sayad999@gmail.com Hafsa Elouazzani zahra.sayad999@gmail.com Nadia Cherradi zahra.sayad999@gmail.com Salma Benazzou zahra.sayad999@gmail.com Malik Boulaadas zahra.sayad999@gmail.com <p>Le carcinome sarcomatoïde est une tumeur maligne rare, agressive de mauvais pronostic à pouvoir récidivant très élevé. Sa localisation au niveau du sinus maxillaire est extrêmement rare. Nous rapportons le cas d´une femme de 42 ans, qui présentait un processus du maxillaire gauche dont une biopsie faite revenant en faveur d´un carcinome sarcomatoïde agressif à métastase ganglionnaire. La patiente a bénéficié d´une exérèse chirurgicale, un évidement ganglionnaire suivi d´une radiothérapie avec une bonne évolution. La rareté de cette tumeur en particulier en cette localisation pose une problématique diagnostique et de prise en charge à temps; cette dernière qui reste à ce jour la controversée. Cependant, une exérèse chirurgicale large reste le meilleur traitement. A travers ce cas nous avons mis le point sur les particularités anatomo-cliniques et surtout pronostiques de cette tumeur.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237545 Diverticular disease of the small bowel: a rare cause of the duodenojejunal flexure obstruction (a case report) 2022-12-05T09:29:43+00:00 Arwa Guediche arwaguediche@yahoo.fr Soumaya Ben Amor arwaguediche@yahoo.fr Walid Mnari arwaguediche@yahoo.fr Mabrouk Abdelaali arwaguediche@yahoo.fr Waad Farhat arwaguediche@yahoo.fr Houcem Ammar arwaguediche@yahoo.fr Mohamed Amine Said arwaguediche@yahoo.fr Mejda Zakhama arwaguediche@yahoo.fr Wided Bouhlel arwaguediche@yahoo.fr Om Keltoum Sellem arwaguediche@yahoo.fr Nabil Ben Chaabene arwaguediche@yahoo.fr Mondher Golli arwaguediche@yahoo.fr Ali Ben Ali arwaguediche@yahoo.fr Leila Safer arwaguediche@yahoo.fr <p>The small bowel is the least common site for diverticula in the entire gastrointestinal tract. Chronic upper intestinal obstruction due to diverticula is very rare. We report a case of multiple small bowel diverticula causing mechanical obstruction of the duodenojejunal flexure.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237549 Experience with the management of anorectal malformations in Ibadan, Nigeria 2022-12-05T09:35:08+00:00 Olakayode Olaolu Ogundoyin kayogundoyin@gmail.com Dare Isaac Olulana kayogundoyin@gmail.com Taiwo Akeem Lawal kayogundoyin@gmail.com <p><strong>Introduction:&nbsp;</strong>anorectal malformation is a multi-systemic birth defect of the distal gastrointestinal tract, the management of which is challenging to the surgeons, the patients and the parents. The presence of associated congenital malformations may worsen the outcome with consequent psychosocial effects on the patients and the parents. The characteristics of anorectal malformations with the challenges associated with their management and the outcomes are therefore presented here.</p> <p><strong>Methods:&nbsp;</strong>all patients managed for anorectal malformations from January 2003 to December 2017 were studied. Patients´ demography, clinical presentations, types of malformations, associated anomalies, procedures performed, post-operative complications and management outcome were obtained and analysed.</p> <p><strong>Results:&nbsp;</strong>eighty-eight children with anorectal malformations comprising 61 (69.3%) boys and 27 (30.7%) girls were studied with 76 (86.3%) patients presenting within the first year of life. Low anorectal malformation was observed in 14 (15.9%) patients, 71 (80.7%) patients had intermediate or high malformations and cloacal malformation was present in 3 (3.4%) patients. Associated congenital malformations were observed in 18 (20.5%) patients with 10 (55.6%) patients associated with intermediate or high malformations and urogenital system was the most common system whose anomalies were associated with anorectal malformations in 12 (13.6%) patients. Anoplasty was performed on 14 (15.9%) patients, posterior sagittal anorectoplasty was performed on 67 (76.1%) patients, abdominosacroperineal pull through on 4 (4.6%) patients and posterior sagittal anorectovaginourethroplasty on 3 (3.4%) patients. Six (6.8%) neonates died.</p> <p><strong>Conclusion:&nbsp;</strong>immediate post-operative outcome was good; however, good functional outcome can only be assessed in an atmosphere of good follow-up which is still a problem in our environment.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237552 Les résultats de la technique de Latarjet dans l´instabilité antérieur de l´épaule en fonction de la position radiologique de la butée coracoïdienne 2022-12-05T09:40:52+00:00 Oueslati Achraf oueslati.achraf@yahoo.com Rafrafi Abderrazzek oueslati.achraf@yahoo.com Znagui Talel oueslati.achraf@yahoo.com Saadi Saber oueslati.achraf@yahoo.com Nouisri Lotfi oueslati.achraf@yahoo.com <p>L´instabilité antérieure de l´épaule suite à une luxation traumatique chez l´adulte jeune est une complication fréquente. La procédure de Latarjet est la technique la plus utilisée pour traiter cette instabilité consiste à réaliser une butée coracoïdienne au niveau du bord antérieur de la glène. Cependant, l´exposition articulaire au cours de cette technique est souvent limitée et rend le positionnement de la butée difficile. Pour évaluer l´effet de la position de la butée coracoïdienne sur la qualité du résultat fonctionnelle à court et moyen termes. Nous avons étudié chez 70 patients la position de la butée coracoïdienne sur la radiographie standard post-opératoire et le résultat fonctionnel par le score du Duplay et le taux de satisfaction. L´âge moyen était de 25 ans et demi, le sex-ratio était de neuf et le recul moyen était de 6,5 ans. L´étude radiologique a montré que la butée coracoïdienne était en position sus équatoriale ou non affleurante du rebord glénoïdien antérieur (trop interne ou saillante en intra-articulaire) dans 20% des cas. Ce groupe a présenté une baisse du score moyen de stabilité par 7,68 points, de la douleur par 10,04 points et du score global de Duplay par 13,3 points, ainsi qu´une augmentation significative du taux d´arthrose gléno-humérale. Ainsi, une butée coracoïdienne en position sus équatoriale ou non affleurante a un effet délétère sur la qualité des résultats fonctionnels de la technique de Latarjet.</p> 2021-02-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237554 Prevalence and factors associated with hypertension among people living with HIV/AIDS on antiretroviral therapy in Uganda 2022-12-05T09:49:52+00:00 Gloria Lubega Gloria.Lubega@mrcuganda.org Billy Mayanja Gloria.Lubega@mrcuganda.org Joseph Lutaakome Gloria.Lubega@mrcuganda.org Andrew Abaasa Gloria.Lubega@mrcuganda.org Rebecca Thomson Gloria.Lubega@mrcuganda.org Christina Lindan Gloria.Lubega@mrcuganda.org <p><strong>Introduction:&nbsp;</strong>antiretroviral therapy (ART) has improved survival of People Living with HIV (PLWH); however, this has resulted in an increasingly high prevalence of non-communicable diseases (NCD) like hypertension. Hypertension is a major risk factor for cardiovascular and cerebral vascular disease, which are both associated with high morbidity and mortality rates. We studied the prevalence and factors associated with hypertension among PLWH on ART.</p> <p><strong>Methods:&nbsp;</strong>we conducted a retrospective data analysis of PLWH on ART enrolled between 2011 and 2014 into a randomized double-blinded placebo-controlled trial investigating the safety of discontinuing cotrimoxazole prophylaxis (COSTOP) among PLWH in Central Uganda. We used the mean blood pressure (BP) measurements of the first four monthly clinic visits to define hypertension. Patients were categorised as: having normal BP (≤120/80mmHg), elevated BP (systolic &gt;120-129, and diastolic ≤80), Stage 1 hypertension (systolic 130-139, or diastolic &gt;80-89) and Stage 2 hypertension (systolic ≥140 or diastolic ≥90). Multiple logistic regression was used to evaluate factors associated with hypertension.</p> <p><strong>Results:&nbsp;</strong>data from 2026 COSTOP trial study participants were analysed, 74.1% were women and 77.2% were aged 35 years and above. The overall prevalence of hypertension was 29%, of whom 19.5% had Stage 1 hypertension and 9.5% had Stage 2 hypertension. About 21.4% were overweight or obese. Factors independently associated with hypertension among PLWH on ART included increasing age (p≤0.001) and high body mass index (p≤0.001). Efavirenz (p≤0.001) and lopinavir/ritonavir (p=0.036) based regimen had lower odds of hypertension than Nevirapine based regimens.</p> <p><strong>Conclusion:&nbsp;</strong>PLWH on ART have a high prevalence of hypertension, which rises with increasing age and body mass index (BMI) and among those on nevirapine-based ART. Implementation of hypertension prevention measures among PLWH on ART and integration of NCD and HIV care to improve patients’ management outcomes are required.</p> 2021-02-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237559 Clinical characteristics of patients infected with SARS-CoV-2 in North Wollo Zone, North-East Ethiopia 2022-12-05T10:04:53+00:00 Alene Geteneh aleneget@gmail.com Birhan Alemnew aleneget@gmail.com Selamyhun Tadesse aleneget@gmail.com Abebe Girma aleneget@gmail.com <p><strong>Introduction:&nbsp;</strong>severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the causative agent of coronavirus disease 2019 (COVID-19), pandemics has remained to be a public health emergency of international concern. This ongoing pandemic has resulted in the death of millions of people globally. About one and a half thousand people have died due to this illness in Ethiopia. The clinical presentations of the disease vary with geography and populations. We therefore aimed at investigating the clinical characteristics of patients infected with SARS-CoV-2 in North-East Ethiopia.</p> <p><strong>Methods:&nbsp;</strong>real time polymerase chain reaction (PCR) was conducted for 18,112 individuals suspected of SARS-CoV-2 infection during June 27 to October 20, 2020, at Woldia university COVID-19 testing center. Recorded data of 372 Ethiopians who tested positive for SARS-CoV-2 infection at Woldia university COVID-19 testing center were retrospectively extracted and analyzed using SPSS v25.0. A P-value of &lt; 0.05 was considered statistically significant.</p> <p><strong>Results:&nbsp;</strong>nearly 2.1% of the screened participants were found positive for SARS-CoV-2 infection. Among them, three fourth of SARS-CoV-2 infected patients were male, with an overall median age of 30 years. About 85% of the patients were asymptomatic. The most common clinical manifestations were cough (14.2%), followed by fever (11.0%) and headache (8.6%), whereas hypertension (1.6%), human immunodeficiency virus (HIV) (1.6%) diabetes mellitus (1.1%), and chronic respiratory diseases (1.1%) were relatively the most common comorbidities noted. The case-fatality ratio was found at 1.6%. Age and underlying comorbidities had a statistically significant association with severity and poor outcome of patients (P &lt; 0.001).</p> <p><strong>Conclusion:&nbsp;</strong>the finding from this study indicated that older age and people with underlying comorbidities are at high risk of having the severe disease and poor outcomes. Hence, appropriate care and priority should be given to these people to decrease the morbidity and mortality caused by this illness. The presence of higher asymptomatic infection is the possible indicator of potential asymptomatic transmissions within the community. This highlights the need for widespread testing, and contact tracing to flatten the transmission curve.</p> 2021-02-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237560 Primary membranoproliferative glomerulonephritis in Sfax, Tunisia: epidemiologic profile and prognostic factors 2022-12-05T10:24:45+00:00 Ikram Agrebi ikram_agrebi@yahoo.fr Khawla Kammoun ikram_agrebi@yahoo.fr Najla Dammak ikram_agrebi@yahoo.fr Jamil Hachicha ikram_agrebi@yahoo.fr Tahya Boudawara ikram_agrebi@yahoo.fr Faiçal Jarraya ikram_agrebi@yahoo.fr Mohamed Ben Hmida ikram_agrebi@yahoo.fr <p><strong>Introduction:&nbsp;</strong>membranoproliferative glomerulonephritis (MPGN) is a rare kidney disease with a poor prognosis as 50% of patients attend the end stage renal failure after 10 years of follow up. Several factors have been described associated with poor renal prognosis. The aim of our study is to determine the epidemiologic profile and to identify prognostic factors of MPGN.</p> <p><strong>Methods:&nbsp;</strong>our study is retrospective over a period of 16 years (January 1996 - December 2011) including all cases of primary MPGN aged more than 15 years, collected at the nephrology department of Hedi Chaker University Hospital, Sfax, Tunisia.</p> <p><strong>Results:&nbsp;</strong>we collected 118 cases of primary MPGN, with mean age of 45 (SD 19) years. The incidence of MPGN has decreased from 10 cases/year between 1996 and 1999 to 5 cases/year between 2008 and 2011. Seventy-nine percent of patients (n=93) had renal failure at the moment of diagnosis (e-GFR less than 60 ml/min/1.73m²;). After a mean follow-up of 51.9 (SD 44) months, progression to end stage renal failure was observed in 43.5% of followed cases (n=20). On univariate analysis, factors associated with death or progression to end stage renal failure were initial renal failure and sclerotic glomeruli (respectively p at 0.040 and 0.032). Multivariate analysis indicated that initial renal failure was significantly correlated with death or progression to end stage renal failure (HR:0.14, 95% CI (0.033-0.593), p=0.008).</p> <p><strong>Conclusion:&nbsp;</strong>there has been a decline in the number of cases of MPGN diagnosed in our hospital. The presence of renal failure at diagnosis was associated with death or progression to end stage renal failure.</p> 2021-02-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237562 Small residual patent ductus arteriosus after surgical ligation in young adult: to close or not to close - a dilemmatic case report 2022-12-05T10:44:16+00:00 Alexander Edo Tondas edotondas@fk.unsri.ac.id Rido Mulawarman edotondas@fk.unsri.ac.id Monica Trifitriana edotondas@fk.unsri.ac.id Moza Guyanto edotondas@fk.unsri.ac.id Raymond Pranata edotondas@fk.unsri.ac.id Komaria edotondas@fk.unsri.ac.id <p>Percutaneous transcatheter closure has gained acceptance for patent ductus arteriosus (PDA) management ever since its introduction, including the management residual left- to-right shunt following surgical ligations. It is preferred than the more invasive surgical closure. While large PDA is closed to prevent heart failure, the decision to close a small hemodynamically insignificant PDA is still a debatable issue. We present a case of percutaneous transcatheter closure of small residual left-to-right shunt PDA using HeartR™ Lifetech PDA occluder with instantaneous closure in an asymptomatic adult patient. The justification of closure was made based on the previous history of infective endocarditis, followed by PDA ligation and endarterectomy surgery, at 1.5 year before admission.</p> 2021-02-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237564 Medication adherence in Elderly during COVID-19 pandemic: what role can the emergency department play? 2022-12-06T10:27:26+00:00 Nourelhouda Nouira nouira_n1_h2@yahoo.fr Wided Bahria nouira_n1_h2@yahoo.fr Dhekra Hamdi nouira_n1_h2@yahoo.fr Amira Lahouegue nouira_n1_h2@yahoo.fr Wiem Demni nouira_n1_h2@yahoo.fr Maamoun Ben Cheikh nouira_n1_h2@yahoo.fr <p><strong>Introduction:&nbsp;</strong>elderly frequently present a poly-pathology recurring polypharmacy. Therefore, strict medication adherence is essential to avoid poor health outcomes especially during health crises like the current COVID-19 pandemic. The aims of our study were to identify the predictors of medication non-adherence in elderly and to expose the role of the emergency department (ED) to improve the therapeutic adherence during COVID-19 pandemic.</p> <p><strong>Methods:&nbsp;</strong>it was a two steps study. Primary, an observational, prospective survey over one month, including 100 elderly patients consulting to the emergency department. Medication adherence was assessed by Morisky's 4-questions scale; predictors of non-adherence have been identified. Secondary, a report of elderly medication management by the emergency physicians during the COVID-19 pandemic confinement.</p> <p><strong>Results:&nbsp;</strong>first step: 100 patients, mean age of 73±8 years. The average number of drugs was 4±2. Medication non-adherence was reported in 39%, predictors of therapeutic non-adherence were: polypharmacy (OR=2.41; CI95% [1.60;3.61]), rural origin (OR=6.72; CI95% [1.47;30.63]) and metabolic diseases history (OR=5.24; CI95% [1.48;18.53]). In the second step, 816 elder lies were enrolled, mean age: 73±7 years. The therapeutic attitude in the emergency department was to prescribe the same treatment (60%) to adjust the doses of the drugs prescribed (14%) to stop one or more drugs (13%) or to indicate new treatments (13%). Thirty-five percent of patients were admitted for short-term hospitalization.</p> <p><strong>Conclusion:&nbsp;</strong>medication non-adherence is common in elderly, due to several factors. During the COVID-19 pandemic, the emergency services in Tunisia played an important role in the follow-up and therapeutic continuity of these elderly patients.</p> 2021-02-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237640 Daniel Noni Lantum 2022-12-06T04:18:36+00:00 The Pan African Medical Journal editor@panafrican-med-journal.com <p>Professor Daniel Noni Lantum, an African public health giant is no more. A native of Cameroon, Prof Lantum was born in 1934 in Kumbo, a city in the North West Region of Cameroon and died on 15 February 2021 at the age of 87 years. At the time of his death, he was a Professor Emeritus of the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I (Cameroon).</p> 2021-02-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237641 Central adrenal insufficiency and diabetes insipidus as potential endocrine manifestations of COVID-19 infection: a case report 2022-12-06T04:25:55+00:00 Abu Baker Sheikh abubaker.sheikh@gmail.com Muhammad Ali Javaid abubaker.sheikh@gmail.com Abdul Ahad Ehsan Sheikh abubaker.sheikh@gmail.com Rahul Shekhar abubaker.sheikh@gmail.com <p>SARS-CoV-2 infection, responsible for the coronavirus disease-2019 (COVID-19) has rapidly spread, causing a global pandemic. COVID-19 can affect any organ system in the body due to overwhelming dysregulated immune response and long-term effects of the disease is still unknown. Endocrine complications associated with COVID-19 is exceedingly rare. Here we present a unique case of a 44-year-old female who developed adrenal insufficiency and central diabetes insipidus following COVID-19 infection.</p> 2021-02-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237642 Performance of quality improvement teams and associated factors in selected regional referral hospitals in Tanzania: a cross-sectional study 2022-12-06T04:30:55+00:00 Godfrey Kacholi gkacholi@gmail.com Albino Kalolo gkacholi@gmail.com Ozayr Haroon Mahomed gkacholi@gmail.com <p><strong>Introduction:&nbsp;</strong>quality improvement teams facilitate improvement in the performance of the health facilities and simultaneously improving the quality of health services. There is scanty information on the factors associated with performance of quality improvement teams. This study aimed to assess the perceptions of members of the quality improvement teams on the factors influencing the performance of quality improvement teams in regional referral hospitals in Tanzania.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional study was conducted in four regional referral hospitals in Tanzania. We used self-administered questionnaires to collect data from 61 members of quality improvement teams. Descriptive statistics were used to assess the perceived factors influencing team performance. Bivariate and multivariate logistic regression was used to test the association between perceptions of the team members and factors associated with team performance.</p> <p><strong>Results:&nbsp;</strong>the overall mean perception score on team performance was high at 27.51 ± 4.62. Five factors namely: training (83.6%); communication (75.1%); team cohesiveness (71.5%); clarity of roles and responsibility (70.2%); team size and composition (65.5%); and self-assessment and learning (56.2%) were considered as the main drivers of team performance. Inadequate management support obtained the lowest score (36.1%). Multivariable regression analysis established a significant association between training, communication, clarity of roles and responsibilities, team size and composition, self-assessment and learning, management support and team performance.</p> <p><strong>Conclusion:&nbsp;</strong>inadequate management support to the team was found to be a barrier to team performance. Managerial interventions should focus on provision of coaching and mentoring to the team while addressing resource challenges affecting the team performance.</p> 2021-02-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237643 Recognition and reporting of neglected tropical diseases by primary health care workers in Ibadan, Nigeria 2022-12-06T04:35:58+00:00 Daniel Chukwuyere Emeto d.emeto@yahoo.com Adetokunbo Taophic Salawu d.emeto@yahoo.com Mobolaji Modinat Salawu d.emeto@yahoo.com Olufunmilayo Ibitola Fawole d.emeto@yahoo.com <p><strong>Introduction:&nbsp;</strong>neglected tropical diseases (NTDs) are serious public health problem worldwide. Primary healthcare (PHC) workers are important in the prevention and control of these diseases. Accurate diagnosis and timely reporting are essential for effective public health response. The study assessed the knowledge of PHC workers on NTDs and identified factors influencing its recognition and reporting.</p> <p><strong>Methods:&nbsp;</strong>the study was a hospital based cross-sectional survey. A multistage sampling technique was used to select 327 healthcare workers from sixty-six PHC facilities in Ibadan, Oyo State, Nigeria. A semi-structured, self-administered questionnaire was used to elicit information on respondent´s socio-demographic characteristics, knowledge, recognition and reporting of NTDs. Data analysis were done using independent sample t-test, analysis of variance and logistic regression with p-value set at 0.05.</p> <p><strong>Results:&nbsp;</strong>one hundred and eighty seven (57.2%) respondents had good knowledge of NTDs. The NTDs most known were; Schistosomiasis (78%), Rabies (64.5%), and Onchocerciasis (57.2%). Urban healthcare workers had higher knowledge score on NTDs (p= 0.018). Young age (AOR= 3.40, CI= 1.20 -9.63), length of practice (AOR=4.65, CI= 1.20-18.09) and previous training on NTDs (AOR = 7.09, CI= 3.15 - 15.93) significantly predicted NTDs recognition, while availability of reporting forms (AOR= 3.17, CI=1.07 - 9.35), training on disease reporting (AOR= 3.41, CI= 11.17 - 9.92) and feedback on previous diseases reported (AOR= 4.12, CI= 1.32-12.80) were significant predictors of reporting NTDs.</p> <p><strong>Conclusion:&nbsp;</strong>the healthcare workers knowledge on NTDs was inadequate. Periodic training and continued education on NTDs are recommended. PHC workers also require supportive supervision.</p> 2021-02-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237644 What would be the impact of COVID-19 on liver function of a patient with chronic hepatitis B? About a case and literature review 2022-12-06T04:42:26+00:00 Khoury M'bodj khoury.mbodj@usmba.ac.ma Hakima Abid khoury.mbodj@usmba.ac.ma Najdi Adil khoury.mbodj@usmba.ac.ma Mohammed El Abkari khoury.mbodj@usmba.ac.ma Nourdin Aqodad khoury.mbodj@usmba.ac.ma <p>Liver damage during COVID-19 disease has been described in numerous studies. Its mechanism is poorly understood. It is mainly reserved for severe forms and is manifested by abnormalities of the hepatic assessment and more particularly cytolysis. Particular attention must be paid to patients with chronic liver disease, both in terms of follow-up and treatment. We wanted to know the evolution of COVID-19 and its treatment, on the liver function of a 27-year-old patient followed for chronic non-cirrhotic hepatitis B at the Hassan II University Hospital in Fez. Our patient had stopped the antiviral B treatment and presented COVID-19 infection with minimal to moderate impairment. The initial evaluation showed cytolysis at 4 times upper limit of normal (ULN). Management consisted in the immediate resumption of Tenofovir in combination with hydroxychloroquine (HCQ) and azythromycin with good clinical and biological evolution.</p> 2021-03-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237646 Late-onset of pulmonary embolism following hospitalization for COVID-19 despite thromboprophylaxis: a report of two cases 2022-12-06T05:02:57+00:00 Falmata Laouan Brem miloubb1993@gmail.com Zakariae Missaoui miloubb1993@gmail.com Mohammed Arghal miloubb1993@gmail.com Hammam Rasras miloubb1993@gmail.com Narjisse Aichouni miloubb1993@gmail.com Imane Skiker miloubb1993@gmail.com Noha El Ouafi miloubb1993@gmail.com Bazid Zakaria miloubb1993@gmail.com <p>The global pandemic caused by the SARS-CoV-2 has resulted in an increased incidence of venous thromboembolism among hospitalized COVID-19-patients, especially those who required intensive care, despite thromboprophylaxis. This has resulted in the use of higher doses of thromboprophylaxis or therapeutic anticoagulation therapy even in the absence of thrombotic events. However, after their hospital discharge, authors and current guidelines are not unanimous about extended anticoagulant therapy in patients with COVID-19. Here, we report two pulmonary embolism cases following hospitalization for COVID-19, despite intermediate doses of thromboprophylaxis. These rare cases suggest that there may be a residual thrombotic risk following hospitalization for COVID-19 and highlight questions about extended prophylactic-anticoagulation therapy after hospital discharge of patients with COVID-19.</p> 2021-03-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237656 In vitro antifungal susceptibility of yeasts and molds isolated from sputum of tuberculosis relapse and retreatment patients 2022-12-06T05:48:46+00:00 Josephat Tonui kipjoston@gmail.com Marianne Mureithi kipjoston@gmail.com Walter Jaoko kipjoston@gmail.com Christine Bii kipjoston@gmail.com <p><strong>Introduction:&nbsp;</strong>opportunistic fungal infections due to immunosuppression coupled with antifungal drug resistance are an emerging challenge globally. The present study examined the antifungal susceptibility of yeasts and molds from sputum of tuberculosis retreatment and relapse patients at selected reference facilities in Kenya.</p> <p><strong>Methods:&nbsp;</strong>a total of 340 sputa samples from patients who gave written informed consent were examined. Fungal culture was done on sabouraud dextrose agar (SDA). Molds were identified by macroscopic and microscopic features while yeasts were inoculated on CHROM<sup>TM</sup>agar&nbsp;<em>Candida</em>&nbsp;and confirmed using API 20C AUX<sup>TM</sup>. Itraconazole (ICZ), voriconazole (VCZ), fluconazole (FCZ) and amphotericin B (AMB) were tested using broth micro-dilution methods according to Clinical and Laboratory Standards Institute (CLSI).</p> <p><strong>Results:&nbsp;</strong>out of the 340 samples, 14.4% (n=49) and 15.6% (n=53) were positive for yeasts and molds respectively.&nbsp;<em>Candida albicans</em>&nbsp;and&nbsp;<em>C. krusei</em>&nbsp;were the most predominant isolates constituting 49.0% (n=24) and 20.4% (n=10) of the total yeasts respectively.&nbsp;<em>Aspergillus spp.</em>&nbsp;were the most frequent (22.6%) molds and isolates with MICs ≥4μg/ml on the antifungal agents were noted. All the molds except two (n=2) isolates of&nbsp;<em>Scedosporium aspiopermum</em>&nbsp;exhibited MICs &gt;4μg/ml for fluconazole. Overall, molds were more sensitive to AMB and VCZ.&nbsp;<em>Candida albicans</em>&nbsp;had MIC<sub>50</sub>&nbsp;&lt;0.06μg/ml, and MIC<sub>90</sub>&lt;4μg/ml. There was a statistically significant difference (F=3.7, P=0.004&lt;0.05) in the overall sensitivity pattern of molds for the four antifungal agents while there was no significant difference (F=1.7, P=0.154&gt;0.05) in sensitivity exhibited by the yeasts.</p> <p><strong>Conclusion:&nbsp;</strong>the study demonstrates the significance of fungal colonization in presumptive tuberculosis retreatment or relapse with evidence of triazole resistance. There is need to strengthen fungal diagnostic and clinical management capabilities in susceptible populations.</p> 2021-03-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237663 Laparoscopic-assisted excision of a huge polycystic omental lymphangioma in a 3 year old patient presenting with acute abdomen: case report and review 2022-12-06T06:03:16+00:00 Maria Tsopozidi tmarion88@hotmail.com Chrysostomos Kepertis tmarion88@hotmail.com Dimitrios Godosis tmarion88@hotmail.com Vasilios Mouravas tmarion88@hotmail.com Charikleia Demiri tmarion88@hotmail.com Ioannis Spyridakis tmarion88@hotmail.com <p>Lymphangioma is a rare benign neoplasm affecting mainly children. In this report we present a complicated case of polycystic omental lymphangioma in a 3 year old female presenting with acute abdomen. The patient underwent a laparoscopic-assisted excision of the lesion and had an excellent postoperative course. We discuss the effectiveness and advantages of this laparoscopic surgical approach in children and elaborate on the current literature.</p> 2021-03-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237668 Incidence and factors associated with unfavourable treatment outcome among patients with rifampicin-resistant pulmonary tuberculosis in Yaoundé, Cameroon 2022-12-06T06:13:03+00:00 Alain Kuaban kuabanallen@yahoo.com Adamou Dodo Balkissou kuabanallen@yahoo.com Marie Christine Essadi Ekongolo kuabanallen@yahoo.com Marie Christine Essadi Ekongolo kuabanallen@yahoo.com Eric Walter Pefura-Yone kuabanallen@yahoo.com Christopher Kuaban kuabanallen@yahoo.com <p><strong>Introduction:&nbsp;</strong>in Cameroon patients with multidrug/rifampicin resistant pulmonary tuberculosis (MDR/RR-PTB) are treated with a 9-11 month standardised shorter treatment regimen. Despite its effectiveness, factors associated with the occurrence of an unfavourable treatment outcome in this group of patients are not known. Determine the incidence and identify factors associated with an unfavourable treatment outcome among patients with rifampicin resistant pulmonary tuberculosis (RR-PTB) in Yaoundé.</p> <p><strong>Methods:&nbsp;</strong>we conducted a retrospective record review of all consecutive patients with bacteriologically confirmed RR-PTB followed up at the specialised MDR/RR-TB treatment centre of the Jamot Hospital in Yaoundé (JHY) from January 2013 to November 2019. A patient was classified as having an unfavourable outcome if he/she had treatment failure, died or was lost to follow-up during the course of treatment.</p> <p><strong>Results:&nbsp;</strong>a total of 242 RR-PTB patients with a mean age of 35.59 ± 12.02 years including 144 (59.5%) males were registered. Forty-nine (49) of the 242 patients had an unfavourable treatment outcome giving a cumulative incidence of 20.20% (95% confidence interval (95% CI): 15.40-25.90%). Multivariable analysis revealed that patients with an unfavourable outcome were more likely to be males (odds ratio (OR): 2.94; 95% CI: 1.24-7.00, p= 0.015), HIV infected (OR: 2.67; 95% CI: 1.17-6.06, p = 0.019), and have a baseline haemoglobin level ≤ 10g/dl (OR: 2.87; 95% CI: 1.25-6.58, p = 0.013).</p> <p><strong>Conclusion:&nbsp;</strong>the rate of an unfavourable treatment outcome among patients with RR-PTB at the specialised MDR/RR-TB treatment centre of the JHY is relatively high. The male sex, HIV infection and moderate to severe anaemia are independent factors associated with an unfavourable treatment outcome.</p> 2021-03-02T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237672 When it is available, will we take it? Social media users´ perception of hypothetical COVID-19 vaccine in Nigeria 2022-12-06T06:19:35+00:00 Yusuff Adebayo Adebisi adebisiyusuff23@yahoo.com Aishat Jumoke Alaran adebisiyusuff23@yahoo.com Obasanjo Afolabi Bolarinwa adebisiyusuff23@yahoo.com Wuraola Akande-Sholabi adebisiyusuff23@yahoo.com Don Eliseo Lucero-Prisno III adebisiyusuff23@yahoo.com <p><strong>Introduction:&nbsp;</strong>COVID-19 pandemic is a global public health threat facing mankind. There is no specific antiviral treatment for COVID-19, and many vaccine candidates are currently under clinical trials. This study aimed to understand the perception of social media users regarding a hypothetical COVID-19 vaccine in Nigeria.</p> <p><strong>Methods:&nbsp;</strong>we conducted a cross-sectional survey among social media users in Nigeria in August 2020 using an online questionnaire. The questionnaire includes sections on the demographic characteristics of the respondents and their perception regarding a hypothetical COVID-19 vaccine. A total of 517 respondents completed and returned the informed consent along with the questionnaire electronically. Data were coded and abstracted into Microsoft Excel spreadsheet and loaded into the STATA 14 software for final analysis.</p> <p><strong>Results:&nbsp;</strong>the results showed that more than half of the respondents were male 294 (56.9%). Most of the respondents 385 (74.5%) intend to take the COVID-19 vaccine when it becomes available. Among the 132 respondents that would not take the COVID-19 vaccine, the major reason for non-acceptance was unreliability of the clinical trials 49 (37.1%), followed by the belief that their immune system is sufficient to combat the virus 36 (27.3%). We found a significant association between the age of the respondents and the COVID-19 vaccine acceptance&nbsp;<em>(P-value=0.00)</em>&nbsp;as well as geographical location and COVID-19 vaccine acceptance&nbsp;<em>(P-value=0.02)</em>.</p> <p><strong>Conclusion:&nbsp;</strong>it was observed that most of the respondents were willing to take the COVID-19 vaccine. Our findings also reiterate the need to reassure the public the benefits an effective and safe COVID-19 vaccine can reap for public health. There is a need for national health authorities in Nigeria to ensure public trust is earned and all communities, including the marginalized populations, are properly engaged to ensure an optimal COVID-19 vaccine acceptance.</p> 2021-03-02T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237675 Synchronous volvulus of the transverse and sigmoid colon: a rare case of large bowel obstruction 2022-12-06T06:25:02+00:00 Abderrahim Samlali samlali.abderrahim@gmail.com Said Boussaidane samlali.abderrahim@gmail.com Asma Hamri samlali.abderrahim@gmail.com Youssef Narjis samlali.abderrahim@gmail.com Ridouan Benelkhaiat Benomar samlali.abderrahim@gmail.com <p>Colonic volvulus usually occurs as a single event that can affect various parts of the colon. The usual sites affected being the sigmoid colon (75%) and the caecum (22%). The phenomenon of multiple sites simultaneously undergoing volvulus is an extremely rare occurrence. We report a rare case of simultaneous sigmoid and transverse colon volvulus in a 52-year-old female. The clinical presentation and the radiological findings were that of large bowel obstruction. A subtotal colectomy and colocolic anastomosis were performed and the postoperative period was uneventful. Though rare the development of transverse and sigmoid volvulus in the same patient must always be considered in the differential diagnosis, when dealing with recurrent intermittent abdominal pain or acute intestinal obstruction.</p> 2021-03-02T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237677 Masse géante de l´ovaire en périménopause: à propos d´un cas 2022-12-06T06:31:46+00:00 Hamza Messaoudi hamzamessaoudi8@gmail.com Khalid Guelzim hamzamessaoudi8@gmail.com Moad Belouad hamzamessaoudi8@gmail.com Abdelhamid Benlghazi hamzamessaoudi8@gmail.com Jaoud Kouach hamzamessaoudi8@gmail.com <p>Le diagnostic des tumeurs ovariennes géantes survient généralement à un stade avancé surtout dans les pays en voie de développement et peut poser des difficultés opératoire, l´examen anatomopathologique est primordiale pour faire le diagnostic en gros. La valeur du marqueur tumoral CA125 chez une femme périménopause avec une masse pelvienne a été largement débattue.</p> 2021-03-02T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237679 Private sector initiatives to tackle the burden of COVID-19: experiences from the Nigerian frontline 2022-12-06T06:39:08+00:00 Akaninyene Otu akanotu@yahoo.com Emmanuel Effa akanotu@yahoo.com Victor Umoh akanotu@yahoo.com Nicholas Maxwell akanotu@yahoo.com Andrew Ekpenyong akanotu@yahoo.com <p>Across Africa, there is some evidence of COVID-19 private sector activities to tackle COVID-19 which include the development of rapid diagnostic kits, deployment of e-health platforms for bespoke health workforce training, disease surveillance, reporting, auto-screening and advisories. Inequities in living and access to care by disadvantaged populations in the rural areas have been ameliorated by multi-pronged responses such as that mounted by the Joseph Ukpo Hospitals and Research Institute (JUHRI) in Nigeria. The provision, production and donation of personal protective equipment (PPE), the production of hand sanitizers and the engagement of the local community in the process represents an effective strategy to contain COVID-19, protect health workers and provide pathways for economic support for people whose sources of income have been upended during the pandemic. The JUHRI experience underpinned by Catholic medical ethics provides concrete evidence of the value of private sector participation in dealing with public health emergencies.</p> 2021-03-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237681 Comparing knowledge, attitudes and practices regarding COVID-19 amongst Cameroonians living in urban versus rural areas 2022-12-06T06:44:38+00:00 Atabong Emmanuel Njingu aenjingu@yahoo.com Fombo Enjeh Jabbossung aenjingu@yahoo.com Tambe Emilia Ndip-Agbor aenjingu@yahoo.com Ankwatia Guisilla Dedino aenjingu@yahoo.com <p><strong>Introduction:&nbsp;</strong>adherence to preventive measures to curb the spread of COVID-19 depends on the people´s knowledge, attitudes and practices (KAP) towards COVID-19. Living in rural areas may be associated with poor KAP towards COVID-19. This study compares the KAP regarding COVID-19 of people living in rural and urban areas in Cameroon.</p> <p><strong>Methods:&nbsp;</strong>this was a comparative cross-sectional study, using data obtained through an online survey of 1,345 Cameroonians amongst which were 828 urban and 517 rural dwellers. The survey questionnaire consisted of; demographic characteristics, 10 questions on Knowledge, 4 on attitudes and 3 on practices. Data was analyzed using SPSS version 25.</p> <p><strong>Results:&nbsp;</strong>overall, about two-thirds of participants had correct knowledge of COVID-19. The mean knowledge score for urban dwellers was about twice that of rural dwellers (15.77 ± 5.25 vs 8.86 ± 7.24 respectively, p &lt; 0.001). Furthermore, when compared to people who live in urban areas, rural inhabitants are less optimistic about COVID-19 pandemic in Cameroon (OR = 3.43, P&lt;0.001), less likely to accept a trial vaccine for COVID-19 (OR = 1.14, P&lt;0.05), less likely to avoid going to crowded places (OR = 7.42, P&lt;0.01), less likely to wear face mask outdoor (OR = 11.84, P&lt;0,001), and less likely to practice hand hygiene (OR = 1.13, P&lt;0.05).</p> <p><strong>Conclusion:&nbsp;</strong>our findings suggest a big gap in COVID-19 related knowledge, attitudes, and practices between rural and urban inhabitants in Cameroon. This highlights the need for increase sensitization of Cameroonians, especially rural dwellers on COVID-19 related knowledge, attitudes and appropriate practices.</p> 2021-03-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237682 Evaluation of the knowledge, attitudes and practices of students at the University of Abomey-Calavi on rabies in Benin Republic, West Africa 2022-12-06T06:50:02+00:00 Philippe Sessou sessouphilippe@yahoo.fr Nestor Noudeke sessouphilippe@yahoo.fr Deborah Janine Thomson sessouphilippe@yahoo.fr David Salako sessouphilippe@yahoo.fr Souaïbou Farougou sessouphilippe@yahoo.fr <p><strong>Introduction:&nbsp;</strong>rabies is a vaccine-preventable viral zoonotic disease. Once clinical symptoms appear, rabies is fatal in almost 100% of cases. The objective of this study was to evaluate the knowledge, attitudes and practices of students at the University of Abomey-Calavi in Benin on rabies in order to explore the factors that promote the occurrence of this zoonosis.</p> <p><strong>Methods:&nbsp;</strong>for this purpose, a descriptive cross-sectional survey was conducted among 263 randomly-selected students. The collected data were analyzed by R software with logistic regression.</p> <p><strong>Results:&nbsp;</strong>out of all the 263 respondents, 53.2% (n=140) of the students claimed to have heard of canine rabies, compared to 47.5% (n=125) for human rabies. Stray dogs were recognized by 49.0% (n=129) as a prevailing source of rabies infection in people; bites from these dogs were considered as a means of rabies contagion (41.4%; n=109) and vaccination of dogs was considered by 32.7% (n=86) as a means of rabies control in both people and dogs. In case of a dog bite, 60.5% (n=159) of respondents would visit a western medicine human clinic first. For the fate of the biting dog, 18.6% (n=49) and 27.4% (n=72) of respondents, respectively, prefer to euthanize the dog or take the dog to the veterinarian for observation. Regarding the perceived consequences of inaction after a dog bite, 58.2% (n=140) mentioned the risk of rabies. Students in human or animal health were 3 times more aware on rabies.</p> <p><strong>Conclusion:&nbsp;</strong>this study identifies the gaps in students´ knowledge, attitudes and practices about effective rabies prevention and control. It will therefore be necessary to intensify awareness and education campaigns among students who could be a good relay of information to other members in their communities.</p> 2021-03-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237684 Toxic epidermal necrolysis-like acute cutaneous lupus erythematosus: two cases report 2022-12-06T06:55:06+00:00 Asmae Abdelmouttalib abdelmouttalibasmae@gmail.com Mariame Meziane abdelmouttalibasmae@gmail.com Karima Senouci abdelmouttalibasmae@gmail.com <p>Toxic epidermal necrolysis-like acute cutaneous lupus erythematosus (TEN-like ACLE) is a rare manifestation of systemic lupus erythematosus (SLE). Because of its rarity, little is known about this entity. In this report, we describe a case of two women previously diagnosed with SLE that presented TEN-like skin lesions. The common elements in both patients were the initial disposition of the lesions on the photoexposed areas, the positivity of Nikolsky´s sign, the discrete mucosal attrition compared to that observed during TEN, and the simultaneous appearance of dermatological lesions with an extra-cutaneous flare of lupus disease. The skin biopsy in both cases showed epidermal necrosis with an identification of lupus band on direct immunofluorescence. Systemic corticosteroids were used with a good evolution after 2 weeks. Skin damage is an indicator of disease activity, and careful search for extracutaneous involvement is obligatory to prevent further complications.</p> 2021-03-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237686 Vitamin B12 deficiency: case report and review of literature 2022-12-06T07:01:27+00:00 Brahim El Hasbaoui nadia.mebrouk@hotmail.com Nadia Mebrouk nadia.mebrouk@hotmail.com Salahiddine Saghir nadia.mebrouk@hotmail.com Abdelhkim El Yajouri nadia.mebrouk@hotmail.com Rachid Abilkassem nadia.mebrouk@hotmail.com Aomar Agadr nadia.mebrouk@hotmail.com <p>Vitamin B12 deficiency in early childhood is an important cause of neurodevelopmental delay and regression. Most of these cases occur in exclusively breast-fed infants of deficient mothers. Symptoms and signs of vitamin B12 deficiency appear between the ages of 2 to 12 months and include vomiting, lethargy, failure to thrive, hypotonia, and arrest or regression of developmental skills. Approximately one half of this cases exhibit abnormal movements, variously described as tremors, twitches, chorea, or myoclonus. Urinary concentrations of methylmalonic acid and homocysteine are characteristically elevated in vitamin B12 deficiency. Hyperglycinuria is sometimes present. The early diagnosis and treatment of vitamin B12 deficiency is crucial for significant neurological impairment and long-term prognosis. Treatment with vitamin B12 corrects these metabolic abnormalities very rapidly (within a few days). Vitamin B12 supplementation of pregnant women may prevent neurological and neuroradiological findings of the infants. Because of the importance of vitamin B12 in the development of the foetal and neonatal brain, vegetarian and vegan mothers should be aware of the severe and not fully-reversible damages caused by insufficient nutritional intake of vitamin B12 during pregnancy and lactation. Therefore, efforts should be directed to prevent its deficiency in pregnant and breastfeeding women on vegan diets and their infants. It is also important to take the nutritional history of both infants and their mothers for the early prevention and treatment. Here an interesting case of vitamin B12 deficiency in a 10-month-old boy presented with psychomotor regression, hypotonia and lethargy.</p> 2021-03-04T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237688 Pneumomédiastin spontané, syndrome de Boerhaave, emphysème sous-cutanée: à propos d´un cas 2022-12-06T07:06:38+00:00 Fatima Zahra Yousfi Yousfifatimazahra112@gmail.com Sofia Guerrouj Yousfifatimazahra112@gmail.com Afafe Thouil Yousfifatimazahra112@gmail.com Hatim Kouismi Yousfifatimazahra112@gmail.com <p>Le pneumomédiastin spontané se définit par la présence d´air au niveau du médiastin survenant en dehors de tout contexte traumatique, iatrogène ou d´une maladie pulmonaire sous-jacente. C´est une affection rare, qui survient chez le jeune adulte et l´adolescent. Son principal risque est d´être confondu avec un tableau de fistule aéro-digestive, conduisant parfois à la réalisation d´investigations et de mesures thérapeutiques inutiles, voire délétères. Nous rapportons le cas d´un pneumomédiastin spontané survenu chez une femme jeune au décours d´un effort de vomissement.</p> 2021-03-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237692 Corrigendum: Laina Ndapewa Angula et al. External auditory canal haemorrhage as the first sign of internal carotid artery pseudoaneurysm, a rare case: a case report doi: 10.11604/pamj.2020.37.163.21968 2022-12-06T07:11:50+00:00 Laina Ndapewa Angula xin_wang0431@hotmail.com Le Sun xin_wang0431@hotmail.com Ning Fang xin_wang0431@hotmail.com Xin Wang xin_wang0431@hotmail.com <p>This corrigendum modifies article “External auditory canal haemorrhage as the first sign of internal carotid artery pseudoaneurysm, a rare case: a case report” and its publication reference i.e. The Pan African Medical Journal. 2020; 37:163.&nbsp;<a href="https://www.panafrican-med-journal.com/content/article/37/163/full/"><em><strong>Access corrected manuscript</strong></em></a>&nbsp;<a href="https://www.panafrican-med-journal.com/content/article/37/163/full/">Pan African Medical Journal. 2020; 37: 163</a>. doi:&nbsp;<a href="https://doi.org/10.11604/pamj.2020.37.163.21968">10.11604/pamj.2020.37.163.21968</a>. PubMed PMID: 33425196. PubMed Central PMCID: PMC7757232. Epub 2021/01/12. eng.</p> 2021-03-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237694 Digital health and COVID-19: challenges of use and implementation in sub-Saharan Africa 2022-12-06T07:30:17+00:00 Yidnekachew Girma Mogessie yidnekachewmogessie@gmail.com Blaise Ntacyabukura yidnekachewmogessie@gmail.com Dawit Tesfagiorgis Mengesha yidnekachewmogessie@gmail.com Mohamed Babiker Musa yidnekachewmogessie@gmail.com Marie-Claire Wangari yidnekachewmogessie@gmail.com Nsabimana Claude yidnekachewmogessie@gmail.com Nit Buntongyi yidnekachewmogessie@gmail.com Don Eliseo Lucero-Prisno III yidnekachewmogessie@gmail.com <p>COVID-19 is a global health emergency that exposed the gaps in health systems globally, especially in sub-Saharan Africa home to many fragile healthcare systems and a region beset with a large burden of disease. Various mitigation strategies have been put in place to stop the spread of COVID-19 and management of patients in sub-Saharan Africa. However, much still need to be done. Digital health provides the promise for the continent to bridge the gap in decreasing the negative impact of COVID-19 and effectively mitigate the pandemic. This commentary argues how countries in sub-Saharan Africa need to embrace the use of digital health in public health interventions to vigorously mitigate the COVID-19 pandemic and to contribute towards attaining universal health coverage (UHC).</p> 2021-03-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237704 Unusual retrorectal ganglioneuroma: a case report of laparoscopic assisted approach 2022-12-06T08:15:40+00:00 Ahmed Bouzid drbouzidahmed89@gmail.com Anis Belhadj drbouzidahmed89@gmail.com Ahmed Saidani drbouzidahmed89@gmail.com Ziad Bokal drbouzidahmed89@gmail.com Fahd Khefacha drbouzidahmed89@gmail.com Faouzi Chebbi drbouzidahmed89@gmail.com <p>Ganglioneuromas are benign slow-growing lesions that arise from sympathetic ganglion cells. They are usually found incidentally. Ultrasound and magnetic resonance imaging (MRI), provides only an unspecified diagnosis and it has to be confirmed by pathologic studies. Complete surgical excision is believed to be the curative treatment for symptomatic lesions. In the literature, the pelvic location reported is exceptional. We report a case of laparoscopic assisted excision of a retrorectal presacral ganglioneuroma for 22-year-old female patient.</p> 2021-03-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237712 Prevalence of rheumatic heart disease among school children in East Africa: a systematic review and meta-analysis 2022-12-06T08:46:05+00:00 Melaku Bimerew mebiget@gmail.com Biruk Beletew mebiget@gmail.com Addisu Getie mebiget@gmail.com Adam Wondmieneh mebiget@gmail.com Getnet Gedefaw mebiget@gmail.com Asmamaw Demis mebiget@gmail.com <p><strong>Introduction:&nbsp;</strong>conducting researches and estimating the prevalence of rheumatic heart disease in school children is crucial to develop school-based strategies targeted to decrease the prevalence of this disease. Therefore, this systematic review and meta-analysis were aimed to estimate the overall prevalence of rheumatic heart disease (RHD) among school children in East Africa.</p> <p><strong>Methods:&nbsp;</strong>PubMed/MEDLINE, Google Scholar, Cochrane review, African Journals Online and African Index Medicus databases were searched to identify relevant research articles. The overall prevalence of rheumatic heart disease was pooled based on the weighted inverse variance random-effects model at a 95% confidence interval. The presence of heterogeneity, sensitivity analysis and presence of publication bias was tested. Results were presented with narrative synthesis, tables and forest plots.</p> <p><strong>Results:&nbsp;</strong>a total of thirteen research articles were included in the final analysis. The pooled prevalence of rheumatic heart disease in East African school children was 1.79% (17.9 cases per 1000 children (95% CI=11.6, 24.2; I<sup>2</sup>=95.1%; p&lt;0.001)). From the subgroup analysis conducted by publication year, a lower prevalence of RHD in school children was reported among studies published after 2015 (six studies; overall prevalence=1.17% (11.7 cases per 1000 school children); with 95% CI=0.60, 1.73%; I<sup>2</sup>=88.8%; p&lt;0.001). Additionally, the horn of Africa was found to have the lowest prevalence of RHD in school children among East African countries (six studies; overall prevalence=1.59% (15.9 cases per 1000 school children); with 95% CI=0.68, 2.51%; I<sup>2</sup>=94.2%; p&lt;0.001).</p> <p><strong>Conclusion:&nbsp;</strong>the prevalence of rheumatic heart disease (RHD) among school children in East Africa was considerably higher than the results from high-income countries. Therefore, community education on strep throat and its complications should be implemented through mass media. Rheumatic heart disease preventive strategies should be integrated with schools to reduce the prevalence of RHD among school children.</p> 2021-03-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237720 The impact of COVID-19 on the tuberculosis control activities in Addis Ababa 2022-12-06T09:00:49+00:00 Negussie Wodajo Beyene negussie.beyene@apopo.org Alemu Lakew Sitotaw negussie.beyene@apopo.org Ben Tegegn negussie.beyene@apopo.org Kidist Bobosha negussie.beyene@apopo.org <p>The first COVID-19 case was reported in Ethiopia on 13<sup>th</sup>&nbsp;March 2020 and series of announcements of set of measures, proclamation and directives have been enacted to fight the coronavirus pandemic. These have implications for the regular health services including the TB control program. This brief communication assesses the impact of the COVID-19 response on the TB control activities of Addis Ababa health centers based on research project data. We compared the patient flows in pre-COVID-19 period (quarter 1, Q1) and during COVID-19 (quarter 2, Q2 and quarter 3, Q3) of 2020 at 56 health centers in Addis Ababa from all 10 sub-cities per sub-city. The patient flow declined from 3,473 in Q1 to 1,062 in Q2 and 1,074 in Q3, which is a decrease by 62-76% and 52-80% in Q2 and Q3 respectively as compared to that of Q1. In Q2, Kolfe keranio and Kirkos sub-cities recorded the biggest decline (76 and 75% respectively) whereas Yeka sub-city had the least decline (62%). In Q3, Kirkos sub-city had the biggest decline (80%) and Addis ketema sub-city had the lowest (52%). We conclude that the series of measures, state of emergency proclamation and government directives issued to counter the spread of COVID-19 and the public response to these significantly affected the TB control activities in Addis Ababa city as attested by the decrease in the patient flow at the clinics. Health authorities may inform the public that essential health services are still available and open to everyone in need of these services.</p> 2021-03-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237723 Sero-epidemiology of human coronaviruses in three rural communities in Ghana 2022-12-06T09:13:41+00:00 Michael Owusu michaelowusu80@gmail.com Augustina Angelina Sylverken michaelowusu80@gmail.com Philip El-Duah michaelowusu80@gmail.com Godfred Acheampong michaelowusu80@gmail.com Mohammed Mutocheluh michaelowusu80@gmail.com Yaw Adu-Sarkodie michaelowusu80@gmail.com <p><strong>Introduction:&nbsp;</strong>acute respiratory tract infections (ARIs) are responsible for significant proportions of illnesses and deaths annually. Most of ARIs are of viral etiology, with human coronaviruses (HCoVs) playing a key role. This study was conducted prior to the outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to provide evidence about the sero-epidemiology of HCoVs in rural areas of Ghana.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional study conducted as part of a large epidemiological study investigating the occurrence of respiratory viruses in 3 rural areas of Ghana; Buoyem, Kwamang and Forikrom. Serum samples were collected and tested for the presence of IgG-antibodies to three HCoVs; HCoV-229E, HCoV-OC43 and HCoV-NL63 using immunofluorescence assay.</p> <p><strong>Results:&nbsp;</strong>of 201 subjects enrolled into the study, 97 (48.3%) were positive for all three viruses. The most prevalent virus was HCoV-229E (23%; 95% CI: 17.2 - 29.3), followed by HCoV-OC43 (17%; 95% CI: 12.4 - 23.4), then HCoV-NL63 (8%, 95% CI: 4.6 - 12.6). Subjects in Kwamang had the highest sero-prevalence for HCoV-NL63 (68.8%). human coronaviruses-229E (41.3%) and HCoV-OC43 (45.7%) were much higher in Forikrom compared to the other study areas. There was however no statistical difference between place of origin and HCoVs positivity. Although blood group O+ and B+ were most common among the recruited subjects, there was no significant association (p = 0.163) between blood group and HCoV infection.</p> <p><strong>Conclusion:&nbsp;</strong>this study reports a 48.3% sero-prevalence of HCoVs (OC43, NL63 and 229E) among rural communities in Ghana. The findings provide useful baseline data that could inform further sero-epidemiological studies on SARS-CoV-2 in Africa.</p> 2021-03-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237742 Pulmonary sarcoidosis masquerading as metastatic breast cancer: a case report 2022-12-06T10:07:05+00:00 Amol Dongre amolpgi@yahoo.co.in Trupti Dongre amolpgi@yahoo.co.in Mahesh Deshmukh amolpgi@yahoo.co.in Suraj Agrawal amolpgi@yahoo.co.in Niraj Kanchankar amolpgi@yahoo.co.in <p>Pulmonary lesions on imaging are presumed to be metastatic lesions in patients with breast cancer. Here, we report an interesting case of a 63-year-old lady with breast carcinoma showing pulmonary lesions on imaging suggestive of pulmonary metastases. Detailed evaluation of pulmonary lesions confirmed the presence of co-existing pulmonary sarcoidosis. Modern diagnostic methods like 18-flurodeoxyglucose positron emission tomography (18-FDG PET) are unable to clearly differentiate metastatic disease from granulomatous diseases like sarcoidosis. Thus, histological confirmation is needed for accurate staging and determining response to treatment and rarely, in non-responders, detecting any co-existing disease. This case emphasizes the need for detailed histopathological examination of lymph nodes in patients with non-responsive disease or recurrent disease despite adequate chemotherapy.</p> 2021-03-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237743 Clinical and epidemiological characteristics and outcomes of patients hospitalized for COVID-19 in Douala, Cameroon 2022-12-06T10:20:51+00:00 David Mekolo francois_boks@yahoo.fr Francois Adrien Bokalli francois_boks@yahoo.fr Fru McWright Chi francois_boks@yahoo.fr Steve Beukou Fonkou francois_boks@yahoo.fr Mbachan Maseoli Takere francois_boks@yahoo.fr Conrald Metuge Ekukole francois_boks@yahoo.fr Jean Moise Bikoy Balomoth francois_boks@yahoo.fr Dickson Shey Nsagha francois_boks@yahoo.fr Noel Emmanuel Essomba francois_boks@yahoo.fr Louis Richard Njock francois_boks@yahoo.fr Marcellin Ngowe Ngowe francois_boks@yahoo.fr <p><strong>Introduction:&nbsp;</strong>the coronavirus disease (COVID-19) is a disease that originated from Wuhan in December 2019. It rapidly spread across the globe causing high mortality especially among the elderly. Africa though not spared has limited studies regarding its effects on its population. We therefore sought to describe the epidemiological and clinical characteristics of COVID-19 in Douala, Cameroon.</p> <p><strong>Methods:&nbsp;</strong>we conducted a single-centre, retrospective, and observational study by reviewing records of patients managed for COVID-19 between the 8<sup>th</sup>&nbsp;March 2020 and 31<sup>st</sup>, May 2020. Cases were confirmed by real-time reverse transcriptase - polymerase chain reaction and were analysed for epidemiological, demographic, clinical, and radiological features. Outcomes were either clinical improvement by Day-28 or in-hospital mortality.</p> <p><strong>Results:&nbsp;</strong>we analyzed 282 case files, 192 were males (M: F=3:1). The mean age was 52 (+/- 15) years. Hypertension and diabetes accounted for 75% of the chronic medical conditions identified. Main presenting complaints were dyspnea, cough, asthenia, and fever (55-60%). Radiographic analysis showed a ground-glass appearance in 85% of cases. Chloroquine/Hydroxychloroquine was the most (91.8%) frequently used drug in management protocols, 35% needed oxygen supplementation while 6 patients were intubated. Severe pneumonia (11.3%) was the commonest complication. They were 91 admissions in the intensive care unit. The average length of hospital stay was 10 (+/- 5) days. The mortality rate was 32%.</p> <p><strong>Conclusion:&nbsp;</strong>our findings are concordant with universally reported data of COVID-19 hospitalised patients. These parameters are essential in designing effective prevention and control programs aimed at reducing the impact of the COVID-19 pandemic particularly in countries with limited resources.</p> 2021-03-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237748 Antenatal care and determinants of obstetric danger signs awareness of immediate postpartum women at Buea Regional Hospital, Cameroon 2022-12-06T10:39:06+00:00 Agbor Nathan Emeh emehnathan@yahoo.com Atem Njabnjem Atem emehnathan@yahoo.com Atongno Ashu Humphrey emehnathan@yahoo.com Tambetakaw Njang Gilbert emehnathan@yahoo.com Fongang Che Landis emehnathan@yahoo.com <p><strong>Introduction:&nbsp;</strong>a significant proportion of pregnancy related deaths result from delay in decision to seek care and this often stems from failure to identify obstetric danger signs earlier. Early identification of these danger signs will therefore reduce maternal mortality. However, studies on obstetric danger signs awareness are lacking in Cameroon. The objective of this study was to assess the determinants of obstetric danger signs awareness of women at immediate postpartum period. This will inform ANC providers´ practice.</p> <p><strong>Methods:&nbsp;</strong>between June and September 2019, women who delivered at the Buea Regional Hospital were interviewed within 24 hours following their delivery using a researcher-administered questionnaire that covered socio-demographic and obstetric variables. Data were entered into EpiData and analysis done using SPSS 16 and OpenEpi. Statistical significance was set at p-value &lt; 0.05.</p> <p><strong>Results:&nbsp;</strong>of the 532 participants, majority (230/532: 43.2%) were those aged 26-35; danger signs awareness rate was 73.3%. There was a statistically significant relation between age and awareness of obstetric danger signs which showed that older women were more aware than their younger counterparts (p=0.00). Other statistically significant determinants of danger sign awareness included occupation, level of education, parity, trimester of onset of antenatal visits and the number of visits before delivery (p&lt;0.05). Multiparity (370/490: 75.5%) and grand multiparity (14/22: 63.6%) were more likely to be aware of obstetric danger signs than primiparous women (6/20:30%). Similarly, those who started antenatal visits earlier (first or second trimester) and those who attended more visits were more likely to be aware of obstetric danger signs than their counterparts who started later or had lesser antenatal visits before delivery. The most reported danger signs were severe vaginal bleed (71.4%), fever (62.0%) and reduced fetal movement.</p> <p><strong>Conclusion:&nbsp;</strong>conclusively, more focus should be placed on the sensitisation about obstetric danger signs when in contact with primiparous and younger parturient during ANC visits.</p> 2021-03-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237751 Recrudescence de la fièvre jaune au Tchad: à propos du dernier cas confirmé dans le district sanitaire de Lai-Tchad 2022-12-06T10:55:09+00:00 Oumaima Mahamat Djarma oumidj@hotmail.com Djoissenanbaye Elisee oumidj@hotmail.com Mahamat Ali Bolti oumidj@hotmail.com Djiddi Ali Sougoudi oumidj@hotmail.com A Blondin Diop oumidj@hotmail.com Fatime Ahmat Haggar oumidj@hotmail.com Abdelsadick Hidjab oumidj@hotmail.com Adawaye Chatté oumidj@hotmail.com Joseph Mad-Toingue oumidj@hotmail.com Henri Fissou oumidj@hotmail.com Mekonyo Kolmian oumidj@hotmail.com Ali Mahamat Moussa oumidj@hotmail.com <p>La fièvre jaune (FJ) est une fièvre hémorragique virale, causée par le virus de la fièvre jaune, transmise par les moustiques du genre Aedes. Au Tchad depuis 2013, 04 cas de fièvre jaune ont été identifiés et confirmés dans le cadre du programme national de surveillance de la fièvre. Nous rapportons ici l'observation clinique du dernier cas confirmé dans le district sanitaire de Lai. Il s'agit d'un homme de 57 ans sans antécédents médicaux et chirurgicaux significatifs et un statut vaccinal inconnu. Il a consulté le 21 avril 2020 pour fièvre, ictère d'épistaxis d'abondance modérée à faible et hépatomégalie douloureuse. Dont les explorations para-cliniques ont permis de mettre en évidence le virus de la fièvre jaune en post mortem par RT-PCR. Ainsi la confirmation de la fièvre jaune dans ce district, le faible niveau de couverture vaccinale, la réalité de la circulation du virus et la présence du vecteur dans le pays devraient avertir d'une réelle menace de ré-émergence de la fièvre jaune au Tchad.</p> 2021-03-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237755 Knowledge and attitude towards blood donation among college students in Southwest Ethiopia 2022-12-06T11:04:42+00:00 Tewodros Yosef tewodrosyosef47@mtu.edu.et Wondimagegn Wondimu tewodrosyosef47@mtu.edu.et Melkamsew Tesfaye tewodrosyosef47@mtu.edu.et Aragaw Tesfaw tewodrosyosef47@mtu.edu.et <p><strong>Introduction:&nbsp;</strong>blood donation (BD) is affected by several factors, among which people's knowledge and attitude are the key determinants. However, the level of knowledge and attitude towards BD in Ethiopia is not yet well studied. Therefore, this study aimed to assess the level and factors associated with knowledge and attitude towards blood donation among health science college students in Southwest Ethiopia.</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional study was conducted among 394 health science students from June 1<sup>st</sup>&nbsp;to 15<sup>th</sup>&nbsp;2019. The data were collected using a structured self-administered questionnaire. The data were entered using EPI-data version 4.2.0.0 and analyzed using SPSS version 20. The correlation analysis was done to determine the association between the knowledge sum score and the attitude sum score. A binary logistic regression analysis was done to determine the association between the dependent and independent variables.</p> <p><strong>Results:&nbsp;</strong>the proportions of good knowledge and positive attitude towards BD were 69.3%, 95% CI (64.8%-73.4%) and 58.1%, 95% CI (52.3%-63.0%) respectively. The study also found that age ≥23 years (adjusted odds ratio (AOR)=1.67, 95% CI (1.04-2.67)), having a father with primary and secondary school and above (AOR=2.24, 95% CI (1.20-4.17) and AOR=2.26, 95% CI (1.26-4.06) respectively) and ever donated blood (AOR=3.64, 95%CI (2.26-5.85)) were factors associated with good knowledge of blood donation. Being a rural resident (AOR=1.59, 95% CI (1.01-2.40)) and graduating class student (AOR=0.56, 95% CI (0.34-0.96)) were factors associated with a positive attitude towards blood donation. The knowledge-related questions´ sum score value was positively correlated with the attitude-related questions´ sum score value (r=0.30, P&lt;0.001).</p> <p><strong>Conclusion:&nbsp;</strong>the knowledge and attitude towards BD among the study population are a substantial deficiency. Therefore, more effort is needed to increase the level of knowledge and attitude towards BD by inculcating short training courses for these groups of population in the existing curriculum.</p> 2021-03-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237756 Sociodemographic determinants of glycaemic control among children with type 1 diabetes in South Eastern Nigeria 2022-12-06T11:11:50+00:00 Chinwe Flora Ogugua ugochikani@yahoo.com Ugo Nnenna Chikani ugochikani@yahoo.com Chikosolu Yvonne Okiche ugochikani@yahoo.com Ugochi Maryann Ibekwe ugochikani@yahoo.com <p><strong>Introduction:&nbsp;</strong>diabetic complications have been identified as the major causes of morbidity and mortality in persons with type 1 diabetes mellitus (T1DM). Lack of appropriate glycaemic control is a significant risk factor for the onset and progression of long term complications of diabetes. Identifying the determinants of good glycaemic control is therefore imperative.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional, hospital-based study of children aged 3-18 years with T1DM. Subjects were consecutively enrolled after obtaining consent from their parents and assent from children aged ≥7 years. A questionnaire was completed recording their clinical history and sociodemographic variables. Their HbA1c was estimated and values ≤7.5% was defined as the cut-off for optimal glycaemic control.</p> <p><strong>Results:&nbsp;</strong>seventy-one children with T1DM were enrolled for the study. Thirty-eight (53.5%) of them were males. Mean age (years) was 13.7±4. Mean age at onset of diabetes was 11.6 years (range: 3-16 years), mean duration of diabetes was 24.4 months (range: 4-84 months), mean HbA1c value was 10.5% (range: 6.4%-14%); a multivariate logistic regression analysis was performed to identify determinants of optimal glycaemic control. Only caregivers' involvement in diabetes management P&lt;0.016, odd ratio 13.03 (95% CI:1.60-105.95) was identified as determinant of good glycaemic control.</p> <p><strong>Conclusion:&nbsp;</strong>our data suggest that of all the sociodemographic factors studied, caregivers' involvement in diabetes management was the only strong determinant for optimal glycaemic control.</p> 2021-03-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237787 COVID-19 pandemic: impacts on the achievements of sustainable development goals in Africa 2022-12-07T04:32:32+00:00 Goodness Ogeyi Odey ogeyi28odey@gmail.com Abrar Gamal Abdallah Alawad ogeyi28odey@gmail.com Ouma Sarah Atieno ogeyi28odey@gmail.com Elsa Olubunmi Carew-Bayoh ogeyi28odey@gmail.com Esther Fatuma ogeyi28odey@gmail.com Isaac Olushola Ogunkola ogeyi28odey@gmail.com Don Eliseo Lucero-Prisno III ogeyi28odey@gmail.com <p>Since the launch of the Sustainable Development Goals (SDGs) in 2015, Africa has made some progress towards its achievements, particularly in the area of gender equality- SDG 5, climate change -SDG 13 and preserving life on land- SDG 15. Although, some African countries have made tangible impact on the other goals such as health, food production and economic growth; these efforts experienced some setbacks with attention shifting to curbing the spread of the novel coronavirus. As much as mitigating the spread of the spread of COVID-19 is important, so is ensuring efforts made on other goals are not lost, as the SDGs are much interconnected, and failure in one impacts others. For the African continent to achieve sustainable development beyond COVID-19, strategic actions which will involve innovations, evaluations and strong political will towards implementations must be taken by relevant stakeholders, so the continent is not left behind in the global goals achievement by 2030.</p> 2021-03-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237788 Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement 2022-12-07T04:51:50+00:00 Godfrey Rwambuka Mugyenyi adeline_boatin@mgh.harvard.edu Joseph Ngonzi adeline_boatin@mgh.harvard.edu Blair Johnson Wylie adeline_boatin@mgh.harvard.edu Jessica Elizabeth Haberer adeline_boatin@mgh.harvard.edu Adeline Adwoa Boatin adeline_boatin@mgh.harvard.edu <p><strong>Introduction:&nbsp;</strong>vital sign monitoring is a key component of safe facility-based obstetric care. We aimed to assess quality of care around vital sign monitoring during obstetric hospitalizations in a tertiary-care facility in a resource-limited setting.</p> <p><strong>Methods:&nbsp;</strong>retrospective review of obstetric records at a tertiary care facility. We assessed documentation of vital signs including fetal and maternal heart rate, and maternal blood pressure, temperature, oxygen saturation and urine output. The primary outcome was the quality of vital sign monitoring (high- versus low-quality based on frequency of monitoring). We compared quality of monitoring with timing of admission, presence of complication, and delivery mode using chi-squared tests.</p> <p><strong>Results:&nbsp;</strong>among 360 records of obstetric admissions (94% of a planned random sample), 96% documented a delivery. Of these, 8% of pregnant women and 11% of postpartum women had high-quality vital sign monitoring documented on initial evaluation at admission. For women delivering during the hospitalization, 0.8% of women delivering had high-quality monitoring in the first four hours postpartum, with higher rates of high-quality monitoring in women delivering vaginally compared to those delivered by cesarean (1.4% versus 0%, p&lt;0.001). There were no differences in rates of quality monitoring by time of admission, or obstetric complication.</p> <p><strong>Conclusion:&nbsp;</strong>very few obstetric hospitalizations had high-quality vital sign monitoring. Attention towards improving vital sign monitoring is a critical need.</p> 2021-03-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237789 Service years of health professionals are associated with tuberculosis infection control practice in Ethiopian Teaching Hospital 2022-12-07T05:07:23+00:00 Wondimagegn Wondimu wonde1983.ww@gmail.com Tewodros Yosef wonde1983.ww@gmail.com Tadesse Gebremedhin wonde1983.ww@gmail.com Mohammed Muze wonde1983.ww@gmail.com <p><strong>Introduction:&nbsp;</strong>proper tuberculosis (TB) infection control (TBIC) practice of health professionals is one of the effective TB prevention approaches. Despite this reality, the TBIC practice of health care workers was not been well studied. This study assessed the TBIC practice of health professionals and associated factors in Mizan Tepi University Teaching Hospital, southwest Ethiopia.</p> <p><strong>Methods:&nbsp;</strong>an institution based quantitative cross-sectional study was conducted from September 1 to 30, 2019, by including all health professionals in the hospital. Participants who answered at least 50% of TBIC practice questions correctly were categorized as having good TBIC practice. Binary logistic regression was used to identify factors associated with the practice of the participants. The odds ratio with a 95% confidence interval and p-value was used to measure the strength of association; the significant association was declared at a p-value less than 0.05.</p> <p><strong>Results:&nbsp;</strong>the study found that 64.1% (95% CI: 56.6%, 70.7%) of the participants had good TBIC practice. More than half, 102(51.5 %) of study participants have service years of greater than or equal to five years. Only the service year of health professionals was significantly associated [95%CI (AOR= 2.43; 95%CI: 1.28, 4.6)] with the respondents´ TBIC practice.</p> <p><strong>Conclusion:&nbsp;</strong>only less than two-third of health professionals had good TBIC practice which is inadequate. And also experienced staff had significantly better TBIC practice. As a result, health professionals in MTUTH should be supported to practice TBIC as routine activity and opportunities should be made for senior staffs to share their TBIC experiences with others.</p> 2021-03-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237790 Challenges for malaria surveillance during the COVID-19 emergency response in Nampula, Mozambique, January - May 2020 2022-12-07T05:18:46+00:00 Gerson Afai Gt.afai88@gmail.com Auria Ribeiro Banze Gt.afai88@gmail.com Baltazar Candrinho Gt.afai88@gmail.com Cynthia Sema Baltazar Gt.afai88@gmail.com Erika Valeska Rossetto Gt.afai88@gmail.com <p>Since the announcement of the coronavirus disease (COVID-19) pandemic in January 30<sup>th</sup>&nbsp;2020, 68 countries reported to the World Health Organization that they were experiencing disruptions in malaria diagnosis and treatment. This situation had the potential to lead to delays in diagnosis and treatment, which could result in an increase in severe cases and deaths. This analysis was based on findings from a field visit, carried out between June 30<sup>th</sup>&nbsp;and July 1<sup>st</sup>, 2020, to a warehouse, to two health facilities, and a meeting with a community health worker, and an descriptive epidemiologic data analysis of health information system (HIS) to evaluate trends of the number of people tested for malaria and number of malaria cases reported, by comparing data from 2018, 2019 and 2020 for the period between January and May. The two health facilities and the warehouse had about two months of stock of antimalarial drugs, and patients with malaria symptoms were being tested for malaria at the COVID-19 screening site. The HIS data showed that the number of reported malaria cases decreased by 3.0% (177.646/172.246) in April, and 7.0% (173.188/161.812) in May, when comparing 2019 and 2020 data. People tested for malaria in community increased by 39.0% (190.370/264.730), between 2019 and 2020. The COVID-19 may have had a negative impact on the diagnosis and treatment of malaria in health facility (HF). The decrease in people tested for malaria in the health facilities may have overwhelmed the activities of the community.</p> 2021-03-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237791 Chimiothérapie du cancer du sein au cours de la grossesse: à propos d´un cas 2022-12-07T05:28:11+00:00 Henintsoa Murielle Rakotomalala tsoamurielle@yahoo.fr Andriatsihoarana Voahary Nasandratriniavo Ramahandrisoa tsoamurielle@yahoo.fr Malala Razakanaivo tsoamurielle@yahoo.fr Ny Ony Andrianandrasana tsoamurielle@yahoo.fr Florine Rafaramino tsoamurielle@yahoo.fr <p>La prise en charge d´un cancer du sein associé à une grossesse constitue un défi pour les médecins qui vient souvent du désir de la mère de mener à terme la grossesse malgré la nécessité d´une chimiothérapie. Une femme de 37 ans, multipare, enceinte à 20 semaines d´aménorrhée (SA) et 4 jours a été hospitalisée pour dyspnée NYHA IV. La patiente présentait un syndrome d´épanchement pleural liquidien gauche de grande abondance et une mastite bilatérale. Le diagnostic de cancer du sein métastatique était retenu par un examen cytologique du liquide pleural et une cytoponction mammaire révélant un carcinome galactophorique. La patiente a bénéficié d´un drainage pleural avec amélioration de la dyspnée mais le liquide pleural restait intarissable. Après discussion en réunion de concertation pluridisciplinaire (RCP), un traitement spécifique du cancer était impératif. Cinq cycles de chimiothérapie du protocole associant le 5-Fluoro-uracile, Epirubicine et Cyclophosphamide avaient été réalisés après le consentement du couple. L´épanchement pleural avait fortement diminué après la deuxième cure. En concertation avec l´obstétricien, la chimiothérapie avait été arrêtée un mois avant la 37<sup>e</sup>&nbsp;semaine d´aménorrhée. L´évolution de la grossesse était favorable, l´accouchement est dirigé après rupture des membranes avec issu par voie basse d´un bébé né à terme avec une bonne adaptation néonatale. A un an du suivi, la mère est toujours en cours de chimiothérapie et le bébé est en bonne santé. Plusieurs paramètres sont à considérer lors de l´administration des antinéoplasiques d´où l'intérêt d'une surveillance fœtale et obstétricale rapprochée. Une approche multidisciplinaire est recommandée pour la décision thérapeutique et le suivi.</p> 2021-03-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237792 Transformation sarcomateuse de la maladie de Recklinghausen 2022-12-07T05:35:52+00:00 Younes Barbach dr.younes2011@gmail.com Fatima Zahra Mernissi dr.younes2011@gmail.com <p><em>Neurofibromatosis type I is a common genetic disease. Affected patients are 4 times more likely to develop a tumor. Most tumors are benign (neurofibromas). Although these rarely result in malignant tumors, they represent the leading cause of death in patients, thus making neurofibromatosis type I a severe disease. It mainly develops to melanoma, pheochromocytoma, astrocytoma, optic glioma, Wilms tumor of and leukemia. Sarcomatous transformation is exceptional. Early diagnosis is essential. It arises from isolated nodular or plexiform neurofibromas. During the monitoring of patients with NF1 and with plexiform neurofibromas, clinicians should consider the possibility of its transformation into neurofibrosarcoma. This is also the case for rapid increase in tumor size, its hardening, its extremely painful nature or the occurrence of neurological signs. We report the case of a 42-year-old female patient, with childhood history of Von Recklinghausen disease, presenting with pain, bleeding and an increase in plexiform neurofibroma size in the right lower limb (A, B, C). Clinical examination showed coffee-with-milk colored spots, cutaneous neurofibromas and large size ulcerated and painful mass involving all the right lower limb. Computed tomography (CT) scan of the limb objectified a tumoral process at the level of the posterior region of the lower limb. Biopsy of the mass showed malignant peripheral nerve sheath tumor.</em></p> 2021-03-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237794 Fente mandibulaire médiane chez l´adulte: à propos d´un cas et revue de la littérature 2022-12-07T05:42:28+00:00 Bouchra Dani bouchradani89@gmail.com Zahra Sayad bouchradani89@gmail.com Malik Boulaadas bouchradani89@gmail.com <p>Les fentes oro-faciales sont des malformations congénitales fréquentes. La classification la plus utilisée est celle de Tessier qui comprend 30 variantes. Dont les fentes mandibulaires médianes (fente n°30 de Tessier) isolées ou accompagnées d´une fente de la lèvre inférieure, de la langue ou rarement du sternum. Elles sont très rares, moins de 70 cas (toutes formes confondues) ont été décrits dans la littérature. Nous rapportons un cas exceptionnel d´une fente mandibulo-sternale et nous faisons une revue de la littérature.</p> 2021-03-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237795 The magnitude and determinants of antepartum depression among women attending antenatal clinic at a tertiary hospital, in Mwanza Tanzania: a cross-sectional study 2022-12-07T05:59:37+00:00 Matiko Mwita wambula2016@gmail.com Doreen Kasongi wambula2016@gmail.com Eliya Bernard wambula2016@gmail.com Daniel Gunda wambula2016@gmail.com Blandina Mmbaga wambula2016@gmail.com <p><strong>Introduction:&nbsp;</strong>there is an increased vulnerability for the development of common mental disorders during the peripartum period as evidenced in depressive disorder.</p> <p><strong>Methods:&nbsp;</strong>a cross sectional study was used to determine the prevalence and risk factors associated with depression among pregnant women attending antenatal clinic (ANC) at Bugando Medical Centre (BMC), a tertiary level hospital in Mwanza Tanzania. A total of 380 pregnant women were recruited and interviewed by using Edinburg Postnatal Depression Scale. The sample size was randomly selected from the clinic.</p> <p><strong>Results:&nbsp;</strong>the mean age of the participants was 30.35 years, with minimum and maximum age of 20 years and 47 years respectively with 89.74% of the participants being married. Almost half of the participants, 53.68% were on the third trimester, with about two-third of the participants, 76.84% reports to have planned for their current pregnancies. The overall prevalence of depression was 15% with middle age of the partner (31-40 years), been married, high level of education, partner and family support were found to be statistically protective for depression while polygamy and partner violence were statistically risk factor for depression.</p> <p><strong>Conclusion:&nbsp;</strong>the results showed high prevalence of antepartum depression which emphasizes the importance of earlier screening, detection and intervention to reduce the burden of morbidity and disability.</p> 2021-03-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237797 Pathogens associated with acute diarrhea, and comorbidity with malaria among children under five years old in rural Burkina Faso 2022-12-07T06:14:46+00:00 Palpouguini Lompo palponet@yahoo.fr Marc Christian Tahita palponet@yahoo.fr Hermann Sorgho palponet@yahoo.fr William Kaboré palponet@yahoo.fr Adama Kazienga palponet@yahoo.fr Ashmed Cheick Bachirou Nana palponet@yahoo.fr Hamtandi Magloire Natama palponet@yahoo.fr Isidore Juste Ouindgueta Bonkoungou palponet@yahoo.fr Nicolas Barro palponet@yahoo.fr Halidou Tinto palponet@yahoo.fr <p><strong>Introduction:&nbsp;</strong>acute diarrhea in children under five years is a public health problem in developing countries and particularly in malaria-endemic areas where both diseases co-exist. The present study examined the etiology of childhood diarrhea and its comorbidity with malaria in a rural area of Burkina Faso.</p> <p><strong>Methods:&nbsp;</strong>conventional culture techniques, direct stools examination, and viruses´ detection by rapid tests were performed on the fresh stools and microscopy was used to diagnose malaria. Some risk factors were also assessed.</p> <p><strong>Results:&nbsp;</strong>on a total of 191 samples collected, at least one pathogen was identified in 89 cases (46.6%). The proportions of pathogens found on the 89 positive stool samples were parasites 51.69% (46 cases), viruses 39.33% (35 cases), and bacteria 14.61% (13 cases), respectively. The relationship between malaria and infectious diarrhea was significant in viral and parasites causes (p=0.005 and 0.043 respectively). Fever, vomiting and abdominal pain were the major symptoms associated with diarrhea, with 71.51%, 31.72% and 23.66% respectively. The highest viral diarrhea prevalence was reported during the dry season (OR=5.29, 95% CI: 1.74 - 16.07, p=0.001) while parasite diarrhea was more encountered during the rainy season (OR=0.41, 95% CI:0.33 - 0.87, p=0.011).</p> <p><strong>Conclusion:&nbsp;</strong><em>Giardia spp</em>&nbsp;and rotavirus were the leading cause of acute diarrhea in Nanoro, Burkina Faso with a predominance of rotavirus in children less than 2 years. Parasite and viral diarrhea were the most pathogens associated with malaria. However, the high rate of negative stool samples suggests the need to determine other enteric microorganisms.</p> 2021-03-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237799 Aneurysm of right sinus of valsalva revealed by COVID-19 infection 2022-12-07T06:20:07+00:00 Hammam Rasras h.rasras@hotmail.com Zalaria Bazid h.rasras@hotmail.com <p>A 68-year-old man with history of diabetes mellitus, presented to the emergency department for dyspnea with chest pain. On clinical examination, the patient was hypothermic (35.1°), blood pressure at 185/105 mmHg, heart beats at 135n with SpO<sub>2</sub>&nbsp;at 55%. In the para clinical work up, an inflammatory syndrome (white blood cells: 19,000/mm<sup>3</sup>, C-reactive protein (CRP): 268 mg/l, procalcitonin: 2.9 mg/l, fibrinogen: 8.7 g/l, lactate dehydrogenase: 1352 g/mol with ferretinemia: 2350 mg/l) was found, and because of the pandemic context, a thoracic computed tomography (CT) scan was performed; showing diffuse patchy ground-glass like opacities suggesting COVID-19 pneumonia with severe involvement (75%), a COVID-19 polymerase chain reaction (PCR) test was positive, with D-dimers: 8.40 ùg/l. Transthoracic echocardiogram (TTE) showed: an aneurysm of right sinus of valsalva with diameter at 56 mm, without regurgitation, systolic pulmonary artery pressure at 52 mmHg. Thoracic angio-CT scan showed bilateral pulmonary embolism and dilated aortic sinus at 56 mm. Due to the respiratory instability, the patient was intubated and ventilated. 24 hours later, he presented with an unrecovered cardiac arrest. Sinus of valsalva aneurysms (SOVAs) can be either acquired or congenital. Although there is debate regarding whether congenital or acquired subtypes are more frequent, Sova is a consequence of weakness of the elastic lamina at the junction of the aortic media and the annulus fibrosis. Many studies have reported vascular diseases during COVID-19 infection. This complication can be correlated with two main processes. The first is an endotheliitis, then in later stages of the disease, there is peri/panarteritis.</p> 2021-03-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237801 Impact of pregnancy on papillary thyroid carcinoma prognosis 2022-12-07T06:38:37+00:00 Yasmine Driouich drachadli@gmail.com Nassim Essabah Haraj drachadli@gmail.com Siham El Aziz drachadli@gmail.com Asma Chadli drachadli@gmail.com <p><strong>Introduction:&nbsp;</strong>thyroid carcinoma is more frequent in women of reproductive age. It can affect both fertility and the course of pregnancy. The aim of the study was to investigate the influence of pregnancy as a factor of recurrence or progression, on the prognosis of thyroid carcinoma.</p> <p><strong>Methods:&nbsp;</strong>we conducted a retrospective cohort study of 117 young female patients followed up for papillary thyroid carcinoma (PTC) at the Department of Endocrinology, Diabetology and Metabolic Diseases of Ibn Rochd University Hospital of Casablanca, from January 2010 to December 2018, divided into 2 groups: group 1 composed of pregnant patients (n=42) and group 2 being the control group (n=75). Statistical analysis was made using SPSS software version 22.0.0.</p> <p><strong>Results:&nbsp;</strong>average age of pregnant patients was 35 ± 6.5 years old. Mean duration between first pregnancy and treatment completion was 4.4 ± 3.1 years. Over an average treatment duration of 14.4 months in postpartum, 30 patients were in remission (thyroglobulin (Tg) &lt;1μg/l, negative thyroglobulin antibody and no morphological abnormality), while 12 had persistent symptoms (detectable Tg/thyroglobulin antibody and/or morphological abnormality). Thyroid stimulating hormone (TSH) during pregnancy was on average 0.83 mIU/l. Cancer progression was correlated with persistence of thyroid cancer to treatment before pregnancy (p = 0.01), pre-existing distant or locoregional metastases (p = 0.02) and delayed administration of radio-iodine therapy (p = 0.01). Interval between diagnosis and pregnancy, TSH level during pregnancy or the pre-conception thyroglobulin level did not have a statistically significant impact. Pregnancy was not associated with progression or recurrence of thyroid cancer (adjusted risk ratio 1.04, 95% confidence interval 0.91-1.32).</p> <p><strong>Conclusion:&nbsp;</strong>this study shows that pregnancy has no impact on recurrence or progression of thyroid cancer in patients declared in remission prior to conception.</p> 2021-03-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237802 The rare entity of cholocystocolonic fistula: a case report 2022-12-07T06:51:27+00:00 Nikolaos Garmpis nikosg22@hotmail.com Christos Damaskos nikosg22@hotmail.com Anna Garmpi nikosg22@hotmail.com Anna Garmpi nikosg22@hotmail.com Georgia Sypsa nikosg22@hotmail.com Dimitrios Mantas nikosg22@hotmail.com <p>Cholocystocolonic fistulas (CCFs) represent a rare medical entity. Previous inflammatory processes in the abdomen, especially in the gallbladder and surgeries are all related to their appearance. There are not typical findings concerning the clinical image and the therapeutic approach varies between patients. Herein, we present a case of a 46-year-old patient, with a history of perforated duodenal ulcer, suffering from abdominal pain and diarrheas. A computed tomography (CT) demonstrated air inside the biliary system. A laparotomy was conducted to the patient and no complications had occurred. In addition, a review of literature regarding the clinical presentation and the therapeutic options for this disease are discussed in this manuscript in relation to our patient.</p> 2021-03-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237988 Acute spontaneous hematoma of the corpus callosum in a COVID-19 patient: a case report 2022-12-09T04:33:48+00:00 Boubaker Charra idrissa4231@gmail.com Ayman Ellouadghiri idrissa4231@gmail.com Touda Kebbou idrissa4231@gmail.com Omar Ettouki idrissa4231@gmail.com Naima El Benna idrissa4231@gmail.com Moulay Hicham Afif idrissa4231@gmail.com Mohamed Benghanem Gharbi idrissa4231@gmail.com <p>Neurovascular involvement is a frequent occurring reported in COVID-19 patients. However, spontaneous hematomas of the corpus callosum are exceptionally seen. The authors of this article aim to report an unusual case of corpus callosum hematoma in a COVID-19 patient and discuss potential etiologies and mechanisms responsible for intracranial hemorrhage.</p> 2021-03-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237994 Aspects épidémio-cliniques des cancers du sein au Service d´Oncologie de Fianarantsoa, Madagascar de 2011 à 2018 2022-12-09T05:15:07+00:00 Mampionona Ranaivomanana ranaivo88@gmail.com Nomeharisoa Rodrigue Emile Hasiniatsy ranaivo88@gmail.com Hajanirina Rakotomahenina ranaivo88@gmail.com Florine Rafaramino ranaivo88@gmail.com <p><strong>Introduction:&nbsp;</strong>à notre connaissance, il s´agit d´une première étude épidémiologique des cancers du sein à Fianarantsoa. Notre objectif était de décrire les caractéristiques épidémio-cliniques de ces cancers au Service d´Oncologie de Fianarantsoa.</p> <p><strong>Méthodes:&nbsp;</strong>il s´agissait d´une étude rétrospective descriptive au Service d´Oncologie du Centre Hospitalier Universitaire de Tambohobe pendant 8 ans (2011 à 2018). Nous avons inclus toutes les patientes atteintes de cancer du sein avec une confirmation cytologique et/ou histologique. Les paramètres étudiés étaient l´âge, la profession, les antécédents familiaux de cancer du sein, la ménarche, la ménopause, la parité, la prise de contraception orale, le tabagisme, les circonstances de découverte, les symptômes mammaires, les signes d´extension, la localisation tumorale et le stade de la maladie.</p> <p><strong>Résultats:&nbsp;</strong>nous avons inclus 62 patientes d´âge moyen de 52,83 ± 10,47 ans. Les femmes au foyer constituaient 39% (n = 24) des cas. Aucune patiente n´avait une ménarche précoce. La ménopause tardive était survenue chez 6,45% (n = 4) et des antécédents familiaux de cancer du sein étaient retrouvés chez 8,06% (n = 5). La prise de tabac à chiquer a été retrouvée chez 17,74% (n = 11) des cas. Les symptômes mammaires étaient observés dans 95,2% (n = 59) des cas. Le quadrant supéro-externe était touché dans 53,23% (n = 33) des cas. Le stade III s´observait dans 55% (n = 34) des cas et le stade IV dans 32% (n = 20).</p> <p><strong>Conclusion:&nbsp;</strong>diagnostiqués à un stade avancé, les facteurs de risque de cancer du sein étaient peu observés.</p> 2021-03-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/242197 Obstructive lower urinary tract symptoms (LUTS) as the initial presentation of penile paraffinoma: a case report and literature review 2023-02-23T08:48:38+00:00 Asterios Symeonidis symeaste@gmail.com Evangelos N. Symeonidis symeaste@gmail.com Chrysovalantis Toutziaris symeaste@gmail.com Georgios Dimitriadis symeaste@gmail.com <p>Penile paraffinoma is a rare condition after penile injection of liquid paraffin or other mineral oils, with well-documented debilitating complications. Nevertheless, such injections are still performed by people of Eastern European and Asian descent for cosmetic penile augmentation. We report a case of penile paraffinoma in an otherwise healthy, 30-year-old male, with obstructive lower urinary tract symptoms (LUTS) as the sole complaint at presentation in the emergency department and a conservative approach. This case report describes an unusual presentation of penile paraffinoma in a young man and aims to raise public and physician awareness regarding disease manifestation to prevent high morbidity from delayed diagnosis and treatment.</p> 2021-03-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237998 La stéatose hépatique métabolique liée à l´obésité chez l´adulte Burkinabè 2022-12-09T05:22:35+00:00 Nômawendé Inès Compaoré noomadoc@gmail.com Aboubacar Coulibaly noomadoc@gmail.com Mali Koura noomadoc@gmail.com Kounpiélimé Sosthène Somda noomadoc@gmail.com Couna Christiane Somé noomadoc@gmail.com Nadine Marie Stella Zombré noomadoc@gmail.com Alain Bougouma noomadoc@gmail.com <p><strong>Introduction:&nbsp;</strong>la stéatopathie métabolique est-elle une priorité de santé en Afrique? Le but était d´étudier les facteurs épidémiologiques et les manifestations hépatiques (anomalies biologiques et la stéatose échographique) associés au syndrome métabolique (SM) chez les adultes suivis en ambulatoire.</p> <p><strong>Méthodes:&nbsp;</strong>étude multicentrique transversale avec un suivi longitudinal des patients. Elle a été menée de mars 2015 à août 2019 dans la ville de Ouagadougou. Etaient inclus les malades présentant un SM selon les critères harmonisés pour les africains subsahariens.</p> <p><strong>Résultats:&nbsp;</strong>la fréquence du SM était à 15,74%. Il y a eu un recrutement 3,8 fois plus rapide de patients la dernière année. Les femmes (57,04) étaient majoritaires; l´âge moyen de 44,69 ans. Le surpoids et l´obésité concernaient 87,32%. Les composantes du SM retrouvées étaient: la dyslipidémie (64,79%), l´hyperglycémie (49,30%), l´HTA (45,07%), le tour de taille moyen de 98,68 cm chez les hommes et de 101,13 cm chez les femmes. L´infection virale B était associée chez 19,01% et celle au HIV chez 1,40%. Une patiente présentait un syndrome de polykystose ovarienne. Une tradithérapie était en cours chez 14,08%. Les transaminases étaient normales chez 73,94%. Une stéatose hépatique échographique était retrouvée chez 71,13%. Le Fibroscan® avait été effectué par 40,42%. Le résultat de la stéatose était discordant de celui échographique chez 56,14%.</p> <p><strong>Conclusion:&nbsp;</strong>pour réduire le SM et ses composantes, il est nécessaire de lutter contre l´obésité (surtout féminine). Une meilleure accessibilité au Fibroscan® permettra d´améliorer sa prise en charge au Burkina Faso.</p> 2021-03-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/237999 Inflammatory myofibroblastic tumor of hard palate: a lesion of extreme rarity 2022-12-09T05:22:53+00:00 Naman Kirit Pandya pandyanaman21@gmail.com Utsav Umang Bhatt pandyanaman21@gmail.com <p>A 19-year young female patient presented with the chief complaint of palatal perforation since 15 days. No significant medical or familial history. No h/o of trauma. On clinical examination (A) a single round perforation was present on hard palate extending antero-posteriorly from distal surface of upper left 1<sup>st</sup>&nbsp;premolar to mesial surface of upper left 2<sup>nd</sup>&nbsp;premolar and medio-laterally extending 1 mm medially from marginal mucosa of 1<sup>st</sup>&nbsp;premolar to 1 cm laterally from mid palatine raphe. Clinically the extension was approx 5×5 mm with normal surrounding mucosa. No tooth mobility was noted. No signs of fluid discharge or nasal regurgitation was found. On palpation all inspectory findings were confirmed. No tenderness on palpation was present. Depth of the lesion was through and through from palatal to buccal cortex. On further radiological examination CBCT (B) showed a single round shape hypodense area between left maxillary premolars, approximately 1×1 cm in diameter. Aggressive destruction of buccal and lingual cortical plate with perforation in floor of maxillary sinus in left premolar region was noted (C and D). External root resorption was seen with both left premolars associated with the lesion. Differential diagnosis considering aggressive maxillary lesion was made as lateral periodontal cyst, traumatic injury and malignant tumor. Patient was planned for excisional biopsy with extraction of involved premolars under local anaesthesia. Histopathological examination revealed plump spindal cells arranged in fascicles and myofibroblastic cells with occasional mitosis. Immuno Histochemistry (IHC) further confirms the morphological findings, which were in consistent with the findings of IMT. Thus IMT of oral cavity should be included as a differential diagnosis of any aggressive lesions or for any localised palatal perforations.</p> 2021-03-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238001 Successful conservative management of a spontaneous intraperitoneal urinary bladder rupture secondary to benign prostatic hyperplasia: a case report 2022-12-09T05:29:19+00:00 Ahmed Ibrahimi ahmed.ibrahimi@um5s.net.ma Hamza Dergamoun ahmed.ibrahimi@um5s.net.ma Idriss Ziani ahmed.ibrahimi@um5s.net.ma Zayd El Boukili El Makhoukhi ahmed.ibrahimi@um5s.net.ma Hachem El Sayegh ahmed.ibrahimi@um5s.net.ma Lounis Benslimane ahmed.ibrahimi@um5s.net.ma Yassine Nouini ahmed.ibrahimi@um5s.net.ma <p>A spontaneous intraperitoneal bladder rupture is a rare, serious and life-threatening surgical emergency of various etiologies, with unspecific clinical presentation, and difficult diagnosis. Surgical treatment is the standard therapy for intraperitoneal bladder rupture; however, there is an increasing tendency toward conservative management in selected patients with favorable characteristics. Herein, we report a rare case of a 65-year-old male patient presented to the emergency department with intraperitoneal bladder rupture following an episode of acute urinary retention due to benign prostatic hyperplasia, and which was successfully managed conservatively with urinary bladder catheterization and antibiotic therapy, without any complication.</p> 2021-03-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238002 What led to upsurge of COVID-19 cases in Malawi? Public health perspective 2022-12-09T05:29:30+00:00 Chancy Skenard Chimatiro cchimatiro@gmail.com Precious Luwidzyi Hajison cchimatiro@gmail.com <p>The health system in Malawi has been overwhelmed with the growing number of COVID-19 cases during second wave of attack. The number of confirmed cases and case fatality rate has significantly increased as compared to the first episode between the months of January to June 2020. Majority of cases reported are through internal transmission, with no history of international travelling. Those in urban areas are most affected as compared to rural areas. Strict preventive measures with multi-sectoral collaboration are urgently required to curb the further spread of the disease. This paper discusses some of the factors that have led to upsurge of COVID-19 cases in Malawi from public health perspective.</p> 2021-03-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238004 Management of critically ill COVID-19 patients: challenges and affordable solutions 2022-12-09T05:33:22+00:00 Carlo Emanuele Caresia carlau90@gmail.com <p>I read with great interest the paper of Metogo and colleagues about the critically ill COVID-19 patients in Africa [<a href="https://www.panafrican-med-journal.com/content/article/38/270/full/#ref1">1</a>]. The authors stressed some persistent challenges of the anaesthesiologist-intensivist physicians due to lack or insufficient Intensive Care Units (ICU) beds and mechanical ventilators and paucity of ICU physicians and nurses. As Italian intensivist, with some experiences in Africa (the last ones in South Sudan and Angola, with the Italian NGO Doctors with Africa CUAMM) and with experience with critically ill COVID-19 patients, I would like to suggest some affordable solutions that could be adopted in many African hospitals.</p> 2021-03-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238005 Descending necrotising fasciitis of head and neck secondary to insect bite: report of a rare case 2022-12-09T05:33:56+00:00 Naman Kirit Pandya pandyanaman21@gmail.com Anendd Arroon Jadhav pandyanaman21@gmail.com <p class="ArticleParagraph">A 30-year-old diabetic male reported with continuous fever, dyspnoea and rapidly progressive painful swelling over left side of face, ear, neck extending to involve skin of the chest following an unspecified insect bite over left ear since 2 days. The lesion extended to involve left face, ear, submental, bilateral submandibular region and descended progressively to involve cervicofacial and anterior chest wall with erythema at the advancing front (A, B). Further systemic evaluation revealed 320 mg/dl random blood sugar, 102.6° fever, HR 106 beats/min, blood pressure 74/50 mmHg with 22 respiratory cycles/min with 92% O<sub>2</sub>&nbsp;saturation at atmospheric air. Further haematological evaluation demonstrated gross leukocytosis with presence of toxic granules and pencil cells in the peripheral smear indicative of sever sepsis/septic shock. The treatment was immediately instituted like supportive ventilation, insulin therapy, appropriate fluid, ionotropic support with empirical antibiotic therapy. Following initial optimization of the physical condition, the patient was scheduled for surgical debridement. However, the patient did not present with any clinical signs of improvement and within 6 hours after reporting, he succumbed to death following two episodes of cardiac arrest. Optimization of general condition of the patient, surgical debridement (i.e. fasciotomy and debridement) under appropriate empirical antibiotic coverage remains the critical tenet of management. The present report attempts to envisage the head and neck surgeon regarding unusual presentation with underlying comorbidities may rapidly transgress following a trivial injury to a life-threatening fatal event.</p> 2020-06-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238006 Availability, utilization and quality of emergency obstetric care services in Sousse, Tunisia 2022-12-09T05:42:46+00:00 Manel Limam manel.limam@yahoo.fr Faten Hachani manel.limam@yahoo.fr Mariem El Ghardallou manel.limam@yahoo.fr Mouadh Bachraoui manel.limam@yahoo.fr Manel Mellouli manel.limam@yahoo.fr Ali Mtiraoui manel.limam@yahoo.fr Hedi Khairi manel.limam@yahoo.fr Thouraya Ajmi manel.limam@yahoo.fr Chekib Zedini manel.limam@yahoo.fr <p><strong>Introduction:&nbsp;</strong>emergency obstetric care (EmOC) is a high-impact priority intervention strongly recommended for improving maternal health outcomes. The objectives of this study were to assess the availability, utilization, and quality of emergency obstetric care services in the Governorate of Sousse (Tunisia).</p> <p><strong>Methods:&nbsp;</strong>a cross-sectional study was conducted among public health facilities which performed deliveries in Sousse in 2017. Data were collected by consulting clinical records and registers and interviewing staff using WHO EmOC tools. Emergency obstetric care (EmOC) indicators were calculated.</p> <p><strong>Results:&nbsp;</strong>only the University maternity Unit functioned as full comprehensive EmOC facility. No other public facility provided all the 7 Basic EmOC signal functions 3 months prior to the survey. The unperformed signal functions were: administration of parenteral antibiotics, manual removal of placenta and assisted vaginal delivery. The number of EmOC facilities was 0.72 per 500,000 inhabitants. The met need for EmOC was 89.5%. The proportion of caesarean section was 24.2%. The direct obstetric case fatality rate was 0.159% and intrapartum and very early neonatal death rate was 0.65%.</p> <p><strong>Conclusion:&nbsp;</strong>raising maternity facilities to a minimum level of basic EmOC status would be a major contributing step towards maternal mortality reduction.</p> 2021-03-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238007 Successful pulsed methylprednisolone and convalescent plasma treatment in a case of a renal transplant recipient with COVID-19 positive pneumonia: a case report 2022-12-09T05:43:01+00:00 Muharrem Bayrak muhabayrak@hotmail.com Kenan Çadirci muhabayrak@hotmail.com <p>Coronavirus 2019 disease (COVID-19) is a deadly disease that was first seen in Wuhan, China, and primarily affects the respiratory system, but also has different systemic involvements. It has caused 89 million cases and 1.9 million deaths worldwide. COVID-19 positive renal transplant recipients have a higher mortality rate than COVID-19 patients in the normal population. There is no specific treatment and follow-up protocol for COVID-19 infection in transplant recipients. COVID-19 treatment and immunosuppressive therapy choices are controversial. Recently, pulse steroid therapies have been used in cases with severe COVID-19 pneumonia. Convalescent plasma therapy is used limitedly in COVID-19 patients. Our 49-year-old male patient has been a recipient of a renal transplant from a cadaver for 6 years. We aimed to make an additional contribution by presenting our patient to the literature whose COVID-19 PCR-RT test performed in the emergency department due to the complaints of fever, shortness of breath, and cough for five days was positive and had moderate COVID-19 pneumonia in thorax tomography and had serious clinical and radiological improvement after pulsed methylprednisolone and convalescent plasma therapy in the early period.</p> 2021-03-16T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238009 Unusual case of spontaneous hemopneumothorax in a Tunisian pulmonology department: a case report 2022-12-09T05:50:29+00:00 Rahma Ben Jazia rahmarr757@yahoo.fr Jihene Ayachi rahmarr757@yahoo.fr Farouk Chatbouri rahmarr757@yahoo.fr Ameni Kacem rahmarr757@yahoo.fr Amira Faidi rahmarr757@yahoo.fr Dhouha Ben Braiek rahmarr757@yahoo.fr Anis Maatallah rahmarr757@yahoo.fr <p>Spontaneous hemopneumothorax is a rare encountered entity in clinical practice. It can be life threatening, so a prompt diagnosis and therapeutic intervention are required. We report a case of a right spontaneous hemopneumothorax in a 31-year-old man, complicated with hemorrhagic shock. Conservative therapy with only thoracic drainage with close monitoring of outflow and hemodynamic parameters was performed. In front of hemodynamic instability, an emergency video-assisted thoracoscopic surgery was performed. An apical bulla adhering to the parietal pleura has been identified as the source of the bleeding. The resection of the bullae and electrocauterization of the bleeding adhesion were effectuated. The hemostasis was easily achieved. The actual experience suggests that video-assisted thoracoscopic surgery should be performed as soon as possible after the diagnosis of spontaneous hemopneumothorax. Indeed, conservative therapy with chest drainage should only be performed as bridge to recovery for the stabilization before the video-assisted thoracoscopic surgery.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238010 Concomitant acute limb ischemia and multiple acute ischemic strokes complicating COVID-19: a case report 2022-12-09T05:52:03+00:00 Falmata Laouan Brem miloubb1993@gmail.com Taha Abu-Al-Tayef miloubb1993@gmail.com Hammam Rasras miloubb1993@gmail.com Zainab El Mir miloubb1993@gmail.com Omar El Mahi miloubb1993@gmail.com Noha El Ouafi miloubb1993@gmail.com <p>Since the spread of the coronavirus disease 2019 (COVID-19) pandemic, cardiovascular complications are interestingly increasing, particularly thrombotic events, especially in those requiring intensive care. Venous thromboembolism is well known to occur in patients infected by the SARS-CoV-2, but only a few arterial thromboembolism cases have been previously reported. Herein, we report the case of a COVID-19 complicated by a concomitant acute right limb ischemia and multiple acute ischemic strokes. This rare case emphasizes the hypercoagulable state described in COVID-19 patients and the need for anticoagulation therapy to prevent these severe complications.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238011 La place de la chirurgie à ciel ouvert dans la reprise de la sténose urétérale étendue, ancienne et post infectieuse: à propos d´un cas 2022-12-09T05:58:19+00:00 Tresor Kibangula Kasanga kibangulakasanga@gmail.com Eric Mbuya Musapoudi kibangulakasanga@gmail.com Augustin Kibonge Mukakala kibangulakasanga@gmail.com Serges Ngoy Yumba kibangulakasanga@gmail.com François Katshitsthi Mwamba kibangulakasanga@gmail.com Patrick Ciza Zihairwa kibangulakasanga@gmail.com Nathalie Dinganga Kapessa kibangulakasanga@gmail.com Mbey Mukaz kibangulakasanga@gmail.com <p>Notre travail vise à rapporter, la place de la chirurgie à ciel ouvert dans la reprise d´une sténose urétérale étendue, ancienne et post infectieuse d´une part, et d´autre part, d´apporter notre expérience thérapeutique, cela à travers l´observation d´un patient âgé de 38 ans qui nous avait consulté dans notre service d´urologie des cliniques universitaires de Lubumbashi, pour douleur lombaire gauche, brûlures mictionnelles, fièvre sans horaire, Le bilan clinique et paraclinique, mettaient en évidence la sténose urétérale étendue. Une dérivation urinaire temporaire (urétérostomie gauche) était réalisée. Il a été repris, pour une urétérectomie suivie d´une réimplantation urétéro-vésicale gauche. Les suites postopératoires ont été simples, le patient a été revu 3 mois après l´intervention, il n´avait aucune plainte, la créatinine contrôle était normale, l´échographie et l´uroscan étaient dans les normes.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238012 Eosinophilia in school-going children with Plasmodium falciparum and helminth infections in the Volta region of Ghana 2022-12-09T06:01:43+00:00 Verner Ndudiri Orish pagordoh@uhas.edu.gh Jones Ofori-Amoah pagordoh@uhas.edu.gh Kokou Hefoume Amegan-Aho pagordoh@uhas.edu.gh Emmanuel Udochukwu Osisiogu pagordoh@uhas.edu.gh James Osei-Yeboah pagordoh@uhas.edu.gh Sylvester Yao Lokpo pagordoh@uhas.edu.gh Emmanuel Alote Allotey pagordoh@uhas.edu.gh Joseph Adu-Amankwaah pagordoh@uhas.edu.gh Daniel Edem Azuma pagordoh@uhas.edu.gh Percival Delali Agordoh pagordoh@uhas.edu.gh <p><strong>Introduction:&nbsp;</strong>eosinophilia is seen in children infected with parasitic organisms. This study aimed at evaluating eosinophilia in children infected with&nbsp;<em>Plasmodium falciparum</em>, Schistosoma haematobium and intestinal helminths in the Volta Region of Ghana. <strong>Methods:&nbsp;</strong>five hundred and fifty primary school children were selected for this study from 5 primary schools in 2 districts and a municipal area of the Volta Region of Ghana. Blood, stool and urine samples were obtained and screened for P. falciparum, intestinal helminths and S. haematobium respectively. Socio-demographic information were obtained using a standardized questionnaire administration. Pearson chi square analysis was used to evaluate the association between eosinophilia and parasitic infections, and multivariate logistics regression analysis was used to identify factors independently associated with increased risk of eosinophilia. <strong>Results:&nbsp;</strong>a total of 145(26.36%) children had eosinophilia of which 107(73.79%) were infected with P. falciparum infection, (p=0.016); 18(12.41%) with S. haematobium infection, (p=0.016); and 3(2.07%) children were infected with intestinal helminth, (p=0.36). Children infected with P. falciparum had 2 times increased risk of eosinophilia (AOR=2.01, 95% CI, [1.29-3.2], p=0.02); while children from Davanu primary school had 4 times increased risk of eosinophilia (AOR=4.3, 95% [2.41-10.10], p&lt;0.001). <strong>Conclusion:&nbsp;</strong>there was significantly high prevalence of eosinophilia among children infected with P. falciparum infection. A longitudinal study is needed to further understand the immune response of these children to parasitic infections.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238014 Depression and associated risk factors among hypertensive patients in Primary Health Care Centers in Dammam, Kingdom of Saudi Arabia 2022-12-09T06:06:42+00:00 Sumood Abdulbaqi Albasara researchmubshir@outlook.com Mohammad Shafee Haneef researchmubshir@outlook.com Mubashir Zafar researchmubshir@outlook.com Khawaja Ghulam Moinuddin researchmubshir@outlook.com <p><strong>Introduction:&nbsp;</strong>depression is a common mental illness and Hypertension is a chronic disease and due to the negligence depression is co-morbidity with hypertension. The aim of this study was to determine the prevalence of depression and its associated factor among hypertensive patients in Dammam.</p> <p><strong>Methods:&nbsp;</strong>it was a cross-sectional study and 342 hypertensive patients were selected from primary health care centers in Dammam, KSA. Beck Depression Inventory scale was used to determine the depression. The logistic regression analysis was used to assess the correlation between depression (dependent) and other variables. The P-value of less than 0.05 has been set to be statistically significant.</p> <p><strong>Results:&nbsp;</strong>the proportion of depression with various degrees of severity among study participants was 19.6%. After Adjustment of covariates, older age [aOR 3.33, 95% CI 1.22-9.10; p= 0.019,low income [a OR 3.19, 95% CI 1.02-9.11; p= 0.003, illiterate [aOR 3.41, 95% CI 1.09-7.65; p= 0.005], physical inactivity [aOR 2.65, 95% CI 1.21-9.65; p= 0.051], ever smoker [aOR 2.99, 95% CI 1.09-3.77; p= 0.002], long standing hypertension &gt; 3 years [aOR 3.765, 95% CI 1.01-7.10; p= 0.049] were more likely significantly associated with depression among hypertensive patients.</p> <p><strong>Conclusion:&nbsp;</strong>depression is common among hypertensive patients in our setting. The associated multiple risk factors are older age, low income (&lt; 3000 SR), physical inactivity, long standing hypertension.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238016 Malnutrition prevalence and associated biochemical factors among drug-resistance tuberculosis (DR-TB) patients at key treatment sites in Conakry City, Republic of Guinea 2022-12-09T06:16:03+00:00 Aboubacar Sidiki Magassouba almamy@maferinyah.org Almamy Amara Touré almamy@maferinyah.org Boubacar Djelo Diallo almamy@maferinyah.org Lansana Mady Camara almamy@maferinyah.org Demba Touré almamy@maferinyah.org Nfanly Conté almamy@maferinyah.org Macka Diaby almamy@maferinyah.org Soriba Naby Camara almamy@maferinyah.org Gnoume Camara almamy@maferinyah.org Adama Marie Bangoura almamy@maferinyah.org Tamba Alima Kamano almamy@maferinyah.org Adrien Fapeingou Tounkara almamy@maferinyah.org <p><strong>Introduction:&nbsp;</strong>drug-resistant tuberculosis is a major global health problem and a threat to health security given the increase in the number of cases and the challenges associated with care. Besides, the relationship between poor nutritional status and tuberculosis is clearly established. For relevant and evidence-based public health decision-making regarding the management of malnutrition in patients with drug-resistant tuberculosis in the initial phase, it is essential to estimate the prevalence of malnutrition and understand the risk factors associated with it. <strong>Methods:&nbsp;</strong>we performed a retrospective cohort study in drug-resistant tuberculosis patients aged 18 years and older, among which the nutritional status was assessed through BMI. All predictors were included in a prediction model using the multivariate logistic model according to the lowest Akaike criterion. Discrimination and model calibration was evaluated using receiver performance analysis, and the Hosmer and Lemeshow test. <strong>Results:&nbsp;</strong>this study revealed a prevalence of malnutrition of 64.7% in drug-resistant tuberculosis patients in our 218-patient series. The factors associated with malnutrition were: unsuccessful treatment, the active presence of mycobacterium tuberculosis, increased bacteriological conversion time, increased serum creatinine, increased transaminase SGPT of the liver, and anaemia. Some of the factors not associated with malnutrition included the history of anti-tuberculosis treatment, vomiting, hepatic SGPT, initial AFB count, smear and culture conversion time, depression, and chest x-ray. <strong>Conclusion:&nbsp;</strong>malnutrition remains a concern among drug-resistant tuberculosis patients in Guinea as it affects more than half of them with a negative impact on the outcome of treatment. Implementing specific interventions for these high-risk patients, including nutritional supplementation, psychosocial support, and treatment for tuberculosis, can improve management for better treatment outcomes.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238017 Evaluation of cellular changes in blood stored for transfusion at Bungoma County Referral Hospital, Kenya 2022-12-09T06:16:13+00:00 Phidelis Maruti Marabi phidelismaruti@yahoo.com Stanslaus Kiilu Musyoki phidelismaruti@yahoo.com Angela Amayo phidelismaruti@yahoo.com <p><strong>Introduction:&nbsp;</strong>during the storage of transfusion blood, it may undergo a series of cellular changes that in speculation could be the reason behind the risk of using prolonged stored blood. It's important therefore to monitor the cellular changes that may reduce its survival and function. The objective was to assess the cellular changes in whole blood stored for transfusion at Bungoma county referral hospital.</p> <p><strong>Methods:&nbsp;</strong>a single center, prospective and observational study design involving 20 randomly selected donor blood units in citrate phosphate dextrose adenine (CPDA-1) anticoagulant was employed, cellular changes were evaluated for 35 days. The changes were tested using the Celtac F Haematology analyzer. Statistical Analysis of variance was employed in the descriptive statistics. All the investigation was executed using statistical package for social sciences (SPSS V.23). Results were regarded as significant at P&lt;0.05. Results were presented in tables and charts.</p> <p><strong>Results:&nbsp;</strong>at the end of the 35 days blood storage at blood bank conditions, WBC, RBC, platelets counts and MCHC decreased significantly (P&lt;0.0001, =0.0182, &lt;0.0001, =0.0035). The MCV, HCT and MCH increased significantly (P &lt;0.0001, =0.0003, =0.0115) while HGB had insignificant variance (P =0.4185).</p> <p><strong>Conclusion:&nbsp;</strong>platelets, WBC, RBC counts, and indices are significantly altered in stored blood especially when stored over two weeks based on most of the cellular components analyzed in this study. The study, therefore, recommends the utilization of fresh blood to avoid the adverse outcome of cellular changes of reserved blood.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238020 Low level of community readiness prevails in rural northwest Ethiopia for the promotion of institutional delivery 2022-12-09T06:21:44+00:00 Adane Nigusie adane_n@yahoo.com Telake Azale adane_n@yahoo.com Mezgebu Yitayal adane_n@yahoo.com Lemma Derseh adane_n@yahoo.com <p><strong>Introduction:&nbsp;</strong>the health benefits of institutional delivery with the support of skilled professional are one of the indicators of maternal health status which have an impact on the health of women and new coming generation. Despite these benefits, many pregnant women in Ethiopia are not actively bringing delivery at health facility. This study was aimed at determining the readiness level of community for promoting child birth at health facility. <strong>Methods:&nbsp;</strong>a population-based cross-sectional study was conducted. We interviewed 96 key informants using a semi-structured questionnaire adapted from the community readiness assessment model and translated to Amharic language. The key informants were purposively selected in consultation with the district health office to represent the community. The interviews were transcribed verbatim and survey scores were matched with the readiness stage of 1 of the 9 for the five dimensions using the assessment guidelines. <strong>Results:&nbsp;</strong>this study placed nine kebeles at stage 3 (vague awareness), which indicates the need for more institutional delivery service strategy programming; efforts of the community were not focused and low leadership concern and one kebele was in stage 2 (denial/resistance). Six kebeles were placed at high level of readiness i.e. in stage 7 (stabilization), indicating actions are sustained by the local managers or opinion leaders. <strong>Conclusion:&nbsp;</strong>evidence derived from the present study can be used to match intervention tactics for promoting health facility child birth service utilization to communities based on their level of readiness.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238019 Public opinion regarding government response to COVID-19: case study of a large commercial city in Nigeria 2022-12-09T06:25:47+00:00 Ismaeel Yunusa ismaeelrx@gmail.com Sorochi Iloanusi ismaeelrx@gmail.com Osaro Mgbere ismaeelrx@gmail.com Nchebe-Jah Raymond Iloanusi ismaeelrx@gmail.com Anthony Idowu Ajayi ismaeelrx@gmail.com Ekere James Essien ismaeelrx@gmail.com <p><strong>Introduction:&nbsp;</strong>government measures to contain the COVID-19 pandemic cannot be effective without widespread compliance by the public. A greater understanding of citizens' perceptions of these measures can help government agencies adapt their strategies to boost compliance. We examined citizens' perceptions of government's measures to contain the COVID-19 pandemic and its implications on compliance using data from Onitsha city, Anambra State Nigeria.</p> <p><strong>Methods:&nbsp;</strong>data was obtained through in-person interviews of 140 consenting adults in March 2020. Descriptive and inferential statistics were used to summarize the data.</p> <p><strong>Results:&nbsp;</strong>most participants (84.7%) doubted government's ability to manage the COVID-19 outbreak, raising concerns about ineffective governance (25.7%) and inadequate health facilities (20.7%). However, participants expressed a favorable perception of school closures (92.3%) and a ban on large gatherings (83.9%), driven mostly by the need to contain the COVID-19 and avoid its spread. But, they were generally indifferent about the closure of the markets and workplaces due to concerns for food insecurity and lack of government's relief programs. Participants who had a positive perception of the ban on large gatherings were more likely to have high knowledge and to adopt good COVID-19 preventive practices.</p> <p><strong>Conclusion:&nbsp;</strong>the study showed a lack of public's confidence in the government's ability to manage the pandemic. This provides an opportunity for the city government and the public to reflect on the existing relationships, build mutual trust, and devise collaborative engagement that will boost compliance and help contain the devastating impact of COVID-19 pandemic.</p> 2021-03-17T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238024 Toxidermie médicamenteuse sous hydroxychloroquine pour traitement systémique d´un syndrome de Goujerot Sjögren primaire: à propos d´un cas 2022-12-09T06:30:13+00:00 Ansumana Mohammed Keita keitaansumanamohammed@yahoo.com Mouna Zahlane keitaansumanamohammed@yahoo.com Laila Benjilali keitaansumanamohammed@yahoo.com Lamiaa Essaadouni keitaansumanamohammed@yahoo.com <p>Nous rapportons un cas d´exanthème maculo-papuleux apparu après une semaine de prise de l´hydroxychloroquine 400mg prescrite pour une atteinte articulaire d´un syndrome de Gougerot-Sjögren primaire chez une patiente de 41 ans. Cette dernière était suivie pour une lésion glomérulaire minime idiopathique depuis plus d´un an, traitée efficacement avec la corticothérapie. Les exanthèmes maculo-papuleux ont régressé après avoir reçu l´hydrocortisone, la desloratadine et l´arrêt immédiat de l´hydroxychloroquine. Notre cas reflète l´importance d´insister sur la prescription à faible dose de l´hydroxychloroquine chez les sujets avec des pathologies préexistantes rénales et aussi l´intérêt de sensibiliser et d´éduquer les patients des effets secondaires de l´hydroxychloroquine.</p> 2021-03-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238025 Le syndrome de la poche à urines violette: à propos de deux cas au Centre Hospitalier Universitaire Régional (CHUR) de Ouahigouya 2022-12-09T06:33:05+00:00 Siébou Hien siebou2013@gmail.com Yérémadé Juste Bonzi siebou2013@gmail.com Amidou Sawadogo siebou2013@gmail.com Moussa Yanogo siebou2013@gmail.com Abibata Rachel Mande siebou2013@gmail.com Gérard Coulibaly siebou2013@gmail.com <p>Phénomène rare survenant le plus souvent chez des patients âgés constipés, porteurs de sonde urinaire chronique et en alitement prolongé, le syndrome de la poche à urine violette traduit généralement une infection du tractus urinaire. Plusieurs bactéries appartenant à deux groupes à la fois (groupe transformant l'indoxyl sulfate urinaire en indoxyl et groupe susceptible d'alcaliniser les urines par la production d'uréase) seraient en cause. Nous décrivons 2 cas au Burkina Faso chez des patientes jeunes de 30 et 16 ans en encéphalopathie urémique avec syndrome infectieux sévère ayant présenté des urines troubles avec une coloration violette de la poche collectrice. Contrairement aux séries rapportées dans la littérature, nos cas sont survenus après les deuxième et quatrième jours de sondage vésical et sur des patientes jeunes sans notion de constipation. Et malgré une antibiothérapie précoce, l´évolution a été défavorable chez une patiente.</p> 2021-03-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238026 Adolescent with severe granulomatosis with polyangiitis: a case report 2022-12-09T06:37:05+00:00 Hajar Arfaoui hamzaelkihal75@gmail.com Hamza Elkihal hamzaelkihal75@gmail.com Hasna Jabri hamzaelkihal75@gmail.com Wiam Elkhattabi hamzaelkihal75@gmail.com Hicham Afif hamzaelkihal75@gmail.com <p>Granulomatosis with polyangiitis (GPA) is a rare vasculitis among adolescents. Its pulmonary manifestations may mimic tuberculosis. We report the case of a 16-year-old female patient with multiple excavated lung nodules revealed by a chronic cough, hemoptysis, epistaxis and weight loss. The diagnosis of GPA was achieved due to systemic pulmonary, ENT and renal involvement, the positivity of anti-neutrophil cytoplasmic antibody directed against proteinase 3 (C-ANCA) and bronchial and nasal biopsies showing granulomatous inflammation with a dense perivascular infiltrate destroying the vessel wall. Bolus of glucocorticoids and immunosuppressants reversed her symptoms. Although GPA is a rare disease in teenagers, it should be considered as one of the differential diagnosis in adolescents presenting with excavated pulmonary nodules.</p> 2021-03-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238028 État des lieux des échographies obstétricales au service d´imagerie du Centre Hospitalier Universitaire de Bogodogo du 1er janvier 2016 au 31 décembre 2018 2022-12-09T06:41:23+00:00 Bénilde Marie Ange Tiemtoré-Kambou kbenildema@yahoo.fr Aischa Madina Napon kbenildema@yahoo.fr Tounougma Kaboré kbenildema@yahoo.fr Nina Astrid Ndé Ouédraogo kbenildema@yahoo.fr Lisa Kéré Nidjergou kbenildema@yahoo.fr Mohammed Tall kbenildema@yahoo.fr Issouf Franck N´dama Sieba kbenildema@yahoo.fr Abel Bamouni kbenildema@yahoo.fr Ousséini Diallo kbenildema@yahoo.fr Rabiou Cissé kbenildema@yahoo.fr <p>L´échographie obstétricale réalisée selon les normes depuis sa prescription jusqu´au compte rendu est un gage de qualité. Le but de notre étude était de faire le point des échographies obstétricales en vue de rendre rationnelle les échographies de suivi de la grossesse. Il s´est agi d´une étude transversale descriptive avec collecte rétrospective des données à travers les comptes rendus d´échographies obstétricales réalisées du 1<sup>er</sup>&nbsp;janvier 2016 au 31 décembre 2018. Sur les 13487 échographies de la période d´étude, 2355 étaient des échographies obstétricales, constituant 17,46% de l´activité échographique. L´âge moyen des gestantes était de 27,54 ans (±6,19). Le CHU de Bogodogo était la structure demandeuse pour 86,88%. Les paramédicaux étaient prescripteurs dans 66,47%. Les échographies du troisième trimestre constituaient 57,06%. L´âge gestationnel dans 12,99% était supérieur à 37 semaines tandis que dans 66,37% l´âge gestationnel était supérieur à 24 semaines d´aménorrhées (SA). Le suivi prénatal était indiqué dans 54,48%. Les grossesses étaient évolutives dans 97,49%. Les grossesses gémellaires représentent 2,72% et les grossesses pathologiques échographiques 11,80%. Le Doppler obstétrical a été réalisé dans 2,12% avec la pré-éclampsie comme indication principale (52%). Il y avait 1,18% de malformation avec atteinte du système nerveux dans 60,71%. À travers cet état des lieux, la formation des prescripteurs de l´échographie obstétricale apparait primordiale. La mise en place d´un observatoire des pratiques en échographie obstétricale serait d´un atout pour la qualité de ces examens médicaux.</p> 2021-03-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238029 Association du polymorphisme de la méthylènetétrahydrofolate réductase C677T avec le risque de cancer colorectal sporadique 2022-12-09T06:44:22+00:00 Imane Baghad b.imane06@yahoo.fr Driss Erreguibi b.imane06@yahoo.fr Rachid Boufettal b.imane06@yahoo.fr Saad Rifki Eljai b.imane06@yahoo.fr Farid Chihab b.imane06@yahoo.fr <p>Le cancer colorectal (CCR) est un problème majeur de santé publique dans le monde. Le métabolisme des folates est impliqué dans la synthèse, la réparation et la méthylation de de l´ADN. La méthylènetétrahydrofolate réductase (MTHFR) est une enzyme clé dans le métabolisme folique. Un polymorphisme commun de la MTHFR, le C677T, a été corrélé aux CCR. Cette étude cas témoins a été menée pour analyser l´association entre ce polymorphisme et le risque de CCR sporadique dans une population marocaine. Soixante-seize (76) patients atteints de cancer colorectal sporadique confirmé histologiquement et 182 témoins sans antécédents de cancer ont été recrutés pour cette étude. L´ADN a été isolé à partir de sang périphériques et les génotypes ont été déterminés par PCR-RFLP. Le risque d´association a été estimé par le calcul de l´odds ratio (OR) avec un intervalle de confiance à 95%. La fréquence des génotypes MTHFR chez les patients et les témoins a été de 34.1%CC; 56.6%CT; 9.21%TT et 51,6%CC; 42,8% CT; 6% TT respectivement. Le génotype CT et sa combinaison avec le génotype TT et l´allèle T sont associés à un risque accru de CRC avec un OR de 2.02 (avec un intervalle de confiance (IC) de 95%: 1.14-3.58, p = 0,01), de 2.05 (IC 95%: 1.18-3.58, p = 0.01) et de 1.61 (IC 95%: 1,07-2.40, p = 0,02). Les homozygotes TT n´ont pas été un facteur de protection dans notre étude avec un OR de 2,30 (IC 95%: 0.81-6.52, p = 0,11). Il existe une association statistiquement significative entre le variant MTHFR C677T et le risque de survenue de cancer colorectal sporadique dans la population étudiée.</p> 2021-03-18T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238030 Syndrome de Casse-Noisette: cause rare de douleurs abdominales chez l´adulte, à ne pas méconnaître (à propos d´un cas) 2022-12-09T06:50:49+00:00 Mohamed Reda Haboussi dr.mohamedredahaboussi@gmail.com Houria Tabakh dr.mohamedredahaboussi@gmail.com Amina Mouffak dr.mohamedredahaboussi@gmail.com Amine Fahl dr.mohamedredahaboussi@gmail.com Touda Kebbou dr.mohamedredahaboussi@gmail.com Najwa Touil dr.mohamedredahaboussi@gmail.com Abdellatif Siwane dr.mohamedredahaboussi@gmail.com Omar Kacimi dr.mohamedredahaboussi@gmail.com Nabil Chikhaoui dr.mohamedredahaboussi@gmail.com <p>De nos jours, la connaissance des anomalies vasculaires est primordiale pour tous les spécialistes en pratique clinique et peut prévenir de graves complications suite à des interventions précoces. Le syndrome de Casse-Noisette ou Nutcraker syndrome résulte d´une compression de la veine rénale gauche (VRG), généralement dans la fourchette formée par l´aorte abdominale et l'artère mésentérique supérieure (AMS), conduisant à la sténose de la partie aorto-mésentérique de la veine rénale gauche et dilatation de sa partie distale. La symptomatologie reste dominée par des douleurs lombaires, abdominales, pelviennes et hématurie. Son diagnostic est basé essentiellement sur les moyens d´imagerie moderne (tomodensitométrie, échographie-Doppler, phlébographie) et son traitement est controversé. Nous rapportons le cas d´une femme âgée de 43 ans, admise dans le cadre d´un bilan radiologique devant des douleurs épigastriques avec pesanteur pelvienne suite à un syndrome de Casse-Noisette.</p> 2021-03-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238031 Determinants, reasons for choice and willingness to recommend birthing facility among mothers in public and private health facilities in Ebonyi, Nigeria 2022-12-09T06:53:59+00:00 Ijeoma Nkem Okedo-Alex ijeomaninadr@gmail.com Ifeyinwa Chizoba Akamike ijeomaninadr@gmail.com Johnbosco Ifunanya Nwafor ijeomaninadr@gmail.com Chika Nwakanma Onwasigwe ijeomaninadr@gmail.com <p><strong>Introduction:&nbsp;</strong>facility-based births remain low in Nigeria despite the enormous benefits on maternal and neonatal health. We compared the determinants, reasons for choice and willingness to recommend public and private birthing facilities among mothers in Ebonyi, Nigeria. <strong>Methods:&nbsp;</strong>this was a cross-sectional survey among 620 women whose childbirth occurred in public (teaching) and private-for-profit mission hospitals in Ebonyi, Nigeria. Semi-structured, interviewer-administered questionnaires were used for data collection. <strong>Results:&nbsp;</strong>the mean age of the respondents was 29.86±4.4. Most had post-secondary education (71.0%), more than 4 antenatal visits (83.4%) and vaginal births (77.7%). Respondents with high economic status [adjusted odds ratio (aOR) 2.88; Confidence Interval (CI) 1.98-4.18], post-secondary education (aOR 1.73; CI 1.13-2.64) and urban residence (aOR 3.51; CI 2.19-5.61) were more likely to utilize public birthing facilities. In the private hospital, religion (78.4%) was the commonest reason for utilization while poor quality of services (61.9%) was the major cause of dissatisfaction. In the public hospital, the main reason for patronage was insurance enrolment (73.2%) while negative provider attitude (66.7%) led to dissatisfaction. In both facilities, majority (92%) were willing to recommend their birth facility to others. <strong>Conclusion:&nbsp;</strong>regardless of facility type, respondents were willing to recommend or reuse the health facility for subsequent obstetric care. Religion and insurance enrolment were the major reasons for choosing the private and public hospital respectively. Residence, educational and income status influenced birthing facility type used. We recommend improved quality of services in private hospitals and provision of insurance with improved provider attitude in public health facilities.</p> 2021-03-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238032 Challenges that may impact achieving and maintaining accreditation in clinical laboratories in Zambia during the COVID-19 pandemic 2022-12-09T07:03:22+00:00 Victor Daka dakavictorm@gmail.com Mutale Mubanga dakavictorm@gmail.com Bright Mukanga dakavictorm@gmail.com Ruth Lindizyani Mfune dakavictorm@gmail.com Misheck Chileshe dakavictorm@gmail.com Alfred Machiko dakavictorm@gmail.com Steward Mudenda dakavictorm@gmail.com Ephraim Chikwanda dakavictorm@gmail.com Tobela Mudenda dakavictorm@gmail.com Paul Simusika dakavictorm@gmail.com Samson Mwale dakavictorm@gmail.com Sinkala Musalula dakavictorm@gmail.com <p>The coronavirus disease 2019 (COVID-19) which was first reported in Wuhan City, China, has spread to many countries worldwide. It was declared a global pandemic by the World Health Organisation (WHO) on 11<sup>th</sup>&nbsp;March, 2020 [<a href="https://www.panafrican-med-journal.com/content/article/38/290/full/#ref1">1</a>]. As of 12<sup>th</sup>&nbsp;January, 2021, a total of 89,707,115 cases and 1,940,352 deaths had been reported globally, while 28,596 cases and 471 deaths had been reported in Zambia [<a href="https://www.panafrican-med-journal.com/content/article/38/290/full/#ref2">2</a>].</p> 2021-03-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238033 Les raisons du refus et abandon de soins aux urgences chirurgicales du Centre Hospitalier et Universitaire de Bouaké, Côte d´Ivoire 2022-12-09T07:07:13+00:00 Loukou Blaise Yao loukou09@gmail.com Achié Jean Régis Akobe loukou09@gmail.com Kouamé Innocent M´Bra loukou09@gmail.com Bada Justin Léopold Niaoré Sery loukou09@gmail.com Kouamé Jean-Eric Kouassi loukou09@gmail.com Aya Adelaïde Natacha Kouassi loukou09@gmail.com Yao Aboh Ganin Robert Arnaud Assere loukou09@gmail.com Koffi Léoplod Krah loukou09@gmail.com Michel Kodo loukou09@gmail.com <p>Le refus et l´abandon de soins est un comportement fréquemment observé dans notre pratique quotidienne. L´objectif de cette étude était de décrire l´épidémiologie et d´identifier les raisons de ces refus et abandons de soins. Une étude prospective a été réalisée du 1<sup>er</sup>&nbsp;janvier 2018 au 31 décembre 2018 aux urgences chirurgicales du Centre Hospitalier et Universitaire de Bouaké. Elle a concerné tous les patients admis pour des lésions traumatiques et ayant refusé ou abandonné les soins médicaux. Il a été colligé 106 cas de refus et abandon de soins sur 662 patients admis pour des pathologies traumatiques des membres pendant cette période donc une fréquence de 16%. L´âge moyen était de 37 ans. Il y avait 77 hommes (72,6%). Les patients exerçaient dans le secteur tertiaire dans 56,6% (n= 60). Les lésions observées étaient dominées par les fractures fermées 82,1% (n= 87) et les membres pelviens étaient les plus atteints 78,3% (n=83). Le traitement proposé était chirurgical (n=85; 80,2%) et orthopédique (n=21; 19,8%). Le coût du traitement orthopédique était estimé à 26 500 FCFA (40 euros) et à 250 000 FCFA (380 euros) pour le traitement chirurgical. Ces coûts variaient en fonction de l´implant prescrit et de la localisation. Le refus des soins était demandé par le patient lui-même (n=30; 28,3%), et par les parents (n=76; 71,7%). Les motifs retrouvés étaient dominés par le problème financier (n=62; 58,5%), la confiance en la médecine traditionnelle (n=42; 39,6%), la croyance religieuse (n=2;1,9%). Le délai moyen de refus de soins était de 22 heures. Il a été noté 88,7% (n=94) de décharge signées et 11,3% (n=12) d´évasion. Le refus des soins est récurrent dans notre contexte et est lié à l´insuffisance du système de santé en termes de prise en charge des patients à ressource financière limitée.</p> 2021-03-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238035 Clinical and biochemical correlates of hypogonadism in men with type 2 diabetes mellitus 2022-12-09T07:08:48+00:00 Ezekiel Musa ezemusa2000@gmail.com Jibril Mohammed El-Bashir ezemusa2000@gmail.com Fatima Sani-Bello ezemusa2000@gmail.com Adamu Girei Bakari ezemusa2000@gmail.com <p><strong>Introduction:&nbsp;</strong>there is an association between hypogonadism and obesity, chronic hyperglycaemia, and ageing in men with type 2 diabetes mellitus (T2DM). T2DM is known to be associated with low testosterone. There is a paucity of data on the risk factors of hypogonadism in Nigerian men with T2DM. The objective of this study was to determine the clinical and biochemical correlates of hypogonadism and clinical predictors of low total testosterone levels in men with T2DM.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional study consisting of 358 men with T2DM and 179 non-diabetic men (controls). Structured Androgen Deficiency in the Ageing Male questionnaire was administered. Clinical and biochemical parameters were measured. Free testosterone was calculated from albumin, SHBG and total testosterone using Vermeulen´s method. Hypogonadism was defined as fasting TT as &lt; 8 nmol/L with or without symptoms or TT of 8-12 nmol/L with symptoms of androgen deficiency. Low testosterone was defined as serum total testosterone levels ≤ 12 nmol/L.</p> <p><strong>Results:&nbsp;</strong>the mean (±SD) total testosterone of men with T2DM and controls were 8.79±3.35 nmol/L and 15.41±3.79 nmol/L respectively (p &lt; 0.001). The risk of hypogonadism was associated with central obesity (Odds ratio [OR] 2.24, 95% confidence interval [CI] 0.38-13.07), systolic hypertension (OR 3.93, 95% CI 0.67-23.10), hyperglycaemia (OR 2.48, 95% CI 0.37-16.46) and hypercholesterolaemia (OR 2.50, 95% CI 0.43-14.61). In a multivariable regression analysis, there was a significant negative correlation between total testosterone and triglycerides (r -1.85, 95% CI -3.58 - 0.12, P = 0.04) and HDL cholesterol (r -1.25, 95% CI -5.95-3.45, P = 0.02).</p> <p><strong>Conclusion:&nbsp;</strong>this study shows that in men with T2DM, triglycerides and HDL cholesterol are independent correlates of hypogonadism but not central adiposity, systolic blood pressure and glycaemia. Further large prospective studies are recommended.</p> 2021-03-19T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238039 Assessment of adherence to public health measures and their impact on the COVID-19 outbreak in Benin Republic, West Africa 2022-12-09T07:19:23+00:00 Philippe Sessou philippe.sessou@uac.bj Joseph Nelson Siewe Fodjo philippe.sessou@uac.bj Charles Sossa Jérôme philippe.sessou@uac.bj Souaïbou Farougou philippe.sessou@uac.bj Robert Colebunders philippe.sessou@uac.bj <p><strong>Introduction:&nbsp;</strong>following the global COVID-19 outbreak, the government of Benin implemented preventive measures to stall viral transmission. We sought to evaluate adherence of the Beninese people to these preventive measures, in order to identify predictors of poor adherence and adapt the national response to COVID-19. <strong>Methods:&nbsp;</strong>two consecutive online surveys were conducted between May and August 2020. Four hundred and sixty two and 507 adult participants aged 18 years and above responded to the first and second survey respectively, with &gt;70% being males. <strong>Results:&nbsp;</strong>more than 98% of respondents reported wearing face masks. A five-point adherence score was constituted by scoring observance to key preventive measures (mask use, physical distancing, hand hygiene, coughing hygiene and avoiding to touch one´s face). We observed that the mean adherence scores were fairly stable over time, respectively 4.08 and 4.03 during the first and second survey (p=0.439). Increasing age (aOR=1.043, 95% CI: 1.026 - 1.061; p&lt;0.001) and obtaining COVID-19 information from official sources (aOR=1.628, 95% CI: 1.275 - 2.081; p&lt;0.001) were significantly associated with higher adherence scores in a multivariable model. <strong>Conclusion:&nbsp;</strong>these findings suggest that a wide dissemination of adequate information about COVID-19 would increase adherence, and that targeted efforts should be directed towards increasing the compliance to preventive measures among the younger age groups.</p> 2021-03-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238038 Comparison of Amplix® hepatitis B virus and Roche COBAS AmpliPrep/COBAS Taqman hepatitis B virus assay in quantifying HBV DNA in plasma of chronic hepatitis B in Senegal 2022-12-09T07:22:01+00:00 Gora Lô goralo808@yahoo.fr Anna Julienne Selbé Ndiaye goralo808@yahoo.fr Amina Sow goralo808@yahoo.fr Amina Fall goralo808@yahoo.fr Aissatou Sow goralo808@yahoo.fr Oumar Barry goralo808@yahoo.fr Ndèye Marième Diop goralo808@yahoo.fr Halimatou Diop Ndiaye goralo808@yahoo.fr Ndèye Coumba Touré Kâne goralo808@yahoo.fr Souleymane Mboup goralo808@yahoo.fr <p><strong>Introduction:&nbsp;</strong>quantification of hepatitis B virus DNA, a key element in the management of chronic hepatitis B, allows a more direct and reliable measurement of viral replication and monitoring of the virological response to therapy. Polymerase chain reaction (PCR) platforms performing this quantification and adaptable to intermediate laboratories have been developed. Thus, this study was conducted to evaluate the on-site performance of the AMPLIX® hepatitis B virus (HBV) real-time PCR technique in comparison with the COBAS AmpliPrep™ technique.</p> <p><strong>Methods:&nbsp;</strong>performance of the AMPLIX® HBV real-time PCR technique was evaluated with repeatability and intermediate precision (reproducibility) determined. The comparison with COBAS Taqman was performed by testing, in parallel, 42 plasma samples. The statistical analysis using Meth Val® software was focused on correlation and concordance determination.</p> <p><strong>Results:&nbsp;</strong>AMPLIX® real-time PCR assay showed good reproducibility for the low (CV=6.65%) and high (CV=3.15%) control levels but also good repeatability for both the low (CV=2.12%) and high (CV=1.60%) concentration levels. Accuracy obtained in our study were less than acceptability limit fixed to 5%. Viral load measurements between Amplix and COBAS Taqman correlated strongly with a correlation coefficient of 0.97%. Concordance analysis gave an average of the differences of 0.54 log IU/L between the viral load measurements of the 2 techniques.</p> <p><strong>Conclusion:&nbsp;</strong>based on these results, the Amplix real-time PCR platform for the quantification of HBV DNA can be considered as a reliable system for the monitoring of chronic hepatitis B and also a system adapted to intermediate laboratories.</p> 2021-03-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238048 Registered nurses´ perspectives on barriers of cervical cancer screening in Swaziland: a qualitative study 2022-12-09T07:27:07+00:00 Siphiwesihle Sibonisiwe Mkhonta joyce.shirinde@up.ac.za Joyce Shirinde joyce.shirinde@up.ac.za <p><strong>Introduction:&nbsp;</strong>cervical cancer is highly preventable and curable if diagnosed and treated early, however, it is still the leading cause of death among women. Despite efforts to increase cervical cancer screening, its uptake is still low. The purpose of the study was to investigate the perspectives of registered nurses on barriers of cervical cancer screening in Swaziland. <strong>Methods:&nbsp;</strong>an exploratory qualitative design was used for the study. Face to face in depth interviews were conducted with 15 registered nurses using an interview guide. The study was conducted in four clinics from both the private and public sectors, which were purposively sampled. Interviews were captured using an audio recording device, they were transcribed verbatim and then analysed using thematic analysis. <strong>Results:&nbsp;</strong>four themes emerged which were deterrents to cervical cancer screening. These were perceived client barriers, health care system related barriers, nurse related barriers and the nature of the procedure. <strong>Conclusion:&nbsp;</strong>these barriers to service provision need to be addressed by extensive health education to women as well as the cervical cancer screening programme to provide all resources required to increase the uptake of screening.</p> 2021-03-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238052 Evaluation de la pratique de l´échocardiographie transœsophagienne (ETO): cas du Centre Hospitalier de Dax 2022-12-09T07:32:36+00:00 Jean Timnou Bekouti bekouti2002@yahoo.fr Manitra Rambolarimanana bekouti2002@yahoo.fr Akuvi Claude Adossou bekouti2002@yahoo.fr Mialy Ravakiniaina Ranaivosoa bekouti2002@yahoo.fr Roberto Prudencio bekouti2002@yahoo.fr Pierre Bolarin Lawani bekouti2002@yahoo.fr Alain Ranjatson bekouti2002@yahoo.fr Alpha Diawara bekouti2002@yahoo.fr Jean Louis Roynard bekouti2002@yahoo.fr <p>Le but de ce travail est d´évaluer la pratique de l´échocardiographie trans-sophagienne au Centre Hospitalier (CH) de DAX, selon les indications, le profil patient, les résultats retrouvés, la rentabilité de l´examen et la concordance avec l´attente des prescripteurs. Il s´agit d´une étude rétrospective transversale, descriptive à visée analytique menée de Janvier 2016 à Décembre 2018 au laboratoire d´explorations cardiovasculaires du CH de Dax. Sur les 460 examens demandés nous en avons retenu 434 pour l´étude. Les variables étudiées étaient le profil démographique des patients, les indications, les résultats, la rentabilité de l´examen et la concordance avec l´attente des prescripteurs. Sur les 434 examens réalisés, l´âge moyen de la population était de 64,37 ans, avec 64,29% de patients de sexe masculin et un sexe-ratio de 1,8. Le bilan d´accident vasculaire cérébral (AVC) (63,59%), la recherche d´endocardite infectieuse (16,12%) et l´évaluation thérapeutique de la prise en charge des thrombus intracavitaires (11,75%) étaient les indications majoritaires. Les prescripteurs étaient majoritairement les neurologues (60,83%). L´examen était normal dans 58,99% des cas. Les résultats pathologiques (40,78%) étaient dominés par les thrombi intra auriculaires (27,65%), les vidanges auriculaires altérées (9,45%), la présence de foramen oval perméable (5,07%), les anévrysmes du septum inter atrial (2,53%) et les endocardites infectieuses (2,76%). L´examen était rentable dans 40,78% des cas et les résultats étaient concordants à l´attente des prescripteurs dans 39,86%. Notre étude sur l´échocardiographie transœsophagienne a permis de montrer que les indications sont dominées par le bilan d´accident vasculaire cérébral. C´est un examen à faible taux de complications, rentable et avec des résultants concordant avec l´attente des praticiens.</p> 2021-03-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238057 Occlusion haute révélant une pneumatose kystique diffuse du grêle 2022-12-09T07:33:12+00:00 Mohammed Najih najih_m@hotmail.com Aziz Zentar najih_m@hotmail.com <p>La pneumatose kystique intestinale est une affection rare caractérisée par la présence de kystes gazeux dans la paroi intestinale, pouvant atteindre l'ensemble du tube digestif, avec une prédilection pour l'intestin grêle et le côlon. Le diagnostic est évoqué sur le scanner, l'intervention chirurgicale est indiquée en cas de complications. Nous rapportons une observation rare de pneumatose kystique étendue du grêle, source de manifestations occlusives imposant l'intervention chirurgicale qui consistait en une résection de 120cm du grêle proximal suivie d´une anastomose termino-terminale à 5cm de l´angle duodéno-jéjunal.</p> 2021-03-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238058 Flexible bronchoscopy in Ghana: initial experience in a tertiary hospital 2022-12-09T07:40:03+00:00 Adamu Issaka aissaka@yahoo.com Theophilus Adjeso aissaka@yahoo.com Iddrisu Baba Yabasin aissaka@yahoo.com <p><strong>Introduction:&nbsp;</strong>the use of flexible bronchoscopy in developing countries is limited. We report our initial experience and outcome with the use of flexible bronchoscopy at the Tamale Teaching Hospital in Ghana. This is the first reported case series of flexible bronchoscopy in Ghana.</p> <p><strong>Methods:&nbsp;</strong>a retrospective review of patients who had flexible bronchoscopy from 2017-2019 was analyzed. Patient demographics and outcomes were summarized using frequency distribution and percentages.</p> <p><strong>Results:&nbsp;</strong>we performed flexible bronchoscopies in 33 patients with mean age of 43 years. All patients were symptomatic at the time of presentation with the most common symptoms being chest pain (63.6%), dyspnea (57.6%) and cough (48.5%). The indication for bronchoscopy in most of the cases were suspected malignancy in 16 (48.5%) followed by infection 9 (27.3%), trauma 4 (12.1%) and others 4 (12.1%). We observed abnormal bronchoscopic findings in 25 (75.8%) of the cases with most of the pathologies in the right main bronchus. Twelve patients had toilet bronchoscopy, 6 had biopsy, 5 had no intervention and 4 patients had bronchoalveolar lavage (BAL). Culture and sensitivity results were available for 11 patients, of which 7 patients had negative results. Thirteen (13) malignancies and 11 inflammatory/infectious diseases were diagnosed in this case series. The mean procedure time was 32 minutes with mean hospital stay of 7 days. There was no complication or mortality in our series.</p> <p><strong>Conclusion:&nbsp;</strong>flexible bronchoscopy is a safe procedure and indispensable in Ghana where there is an increasing incidence of lung diseases.</p> 2021-03-22T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238061 Biodiversité de la flore fongique isolée au service de réanimation du Centre Hospitalo-Universitaire Souro Sanou de Bobo-Dioulasso, Burkina Faso 2022-12-09T07:44:28+00:00 Hadry Roger Sibi Matotou sibiroger617@gmail.com Ibrahim Sangare sibiroger617@gmail.com Cyrille Bisseye sibiroger617@gmail.com Marielle Karine Bouyou Akotet sibiroger617@gmail.com Sanata Bamba sibiroger617@gmail.com <p><strong>Introduction:&nbsp;</strong>les maladies nosocomiales demeurent un problème majeur de santé publique en Afrique subsaharienne notamment au Burkina Faso. Cette étude avait pour but de déterminer la biodiversité de la flore fongique identifiée au service de réanimation du Centre Hospitalier Universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso. <strong>Méthodes:&nbsp;</strong>l´étude transversale descriptive s´est déroulée d´août 2016 à janvier 2017. La flore fongique a été recherchée dans l´air ambiant et les espaces de réanimation. Les prélèvements ont été ensemencés et incubés pendant 3 à 4 jours à 37°C à l´étuve. L´identification des colonies fongiques était macroscopique et microscopique pour les champignons filamenteux. Le test de blastèse, les milieux chromogéniques et le test d´agglutination au latex ont servi à l´identification d´espèces de&nbsp;<em>Candida. </em><strong>Résultats:&nbsp;</strong>sur les 200 prélèvements collectés au total, 176 ont poussé sur la gélose Sabouraud-Chloramphénicol. La prévalence globale de la flore fongique était de 88% (176/200). Les moisissures étaient les agents fongiques majoritairement retrouvés (66,9%). Parmi les huit genres de moisissures identifiés,&nbsp;<em>Aspergillus</em>&nbsp;était le genre le plus représenté (48,9%) tandis qu´<em>Aspergillus fumigatus</em> était l´espèce la plus fréquemment rencontrée (32,9%).&nbsp;<strong>Conclusion:&nbsp;</strong>la décontamination régulière des niches fongiques devraient être systématiques dans le service de réanimation du CHUSS de Bobo-Dioulasso.</p> 2021-03-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238064 Évaluation des pratiques et connaissances en radioprotection des cardiologues en Tunisie 2022-12-09T07:52:43+00:00 Rania Hammami raniahammami@yahoo.fr Abdelhamid Ben Jmaa raniahammami@yahoo.fr Amine Bahloul raniahammami@yahoo.fr Selma Charfeddine raniahammami@yahoo.fr Tarek Ellouze raniahammami@yahoo.fr Souad Mallek raniahammami@yahoo.fr Imtinene Ben Mrad raniahammami@yahoo.fr Leila Abid raniahammami@yahoo.fr Samir Kammoun raniahammami@yahoo.fr Jihen Jdidi raniahammami@yahoo.fr <p><strong>Introduction:&nbsp;</strong>les procédures de cardiologie interventionnelle sont devenues complexes et chronophages avec un sur-risque d´exposition aux rayonnements ionisants. L´objectif de notre étude était d´évaluer le niveau des connaissances et des pratiques en radioprotection des cardiologues Tunisiens exposés au rayon X.</p> <p><strong>Méthodes:&nbsp;</strong>notre étude est descriptive analytique réalisée en octobre 2019, organisée sous forme de questionnaire anonyme des connaissances et pratiques en radioprotection et envoyé à tous les Cardiologues Tunisiens exposés aux rayons X.</p> <p><strong>Résultats:&nbsp;</strong>parmi 126 cardiologues exposés aux rayons X et ayant reçu le questionnaire, 58 médecins ont répondu au questionnaire (48%), avec une prédominance masculine (72%, n=42). Trente-huit médecins (65%) exerçaient dans le secteur public. L´expérience professionnelle était en moyenne de 12,02 ans (ET 6,88 ans). La moitié des médecins avaient un score de connaissances inférieur à 50%. La moyenne du score des pratiques était de 43,83 (ET 13,95%). Le port du tablier en plomb, de la cache thyroïde, du dosimètre, des lunettes en plomb, du calot en plomb était respectivement de 100% (n=58), 86,2% (n=50), 30,7% (n=18), 12,1% (n=7) et 1,7% (n=1). Il n´y avait pas de corrélation entre les scores et l´âge du médecin ainsi que la durée de l´expérience professionnelle. Les scores de connaissances ne différaient pas statistiquement entre les 2 sexes (p=0,06) ni entre le secteur public et le secteur privé (p=0,9). Le score de pratique était significativement plus élevé chez les hommes (0.007) et les cardiologues interventionnels comparés aux rythmologues et cardiopédiatres (p&lt;0.001).</p> <p><strong>Conclusion:&nbsp;</strong>le niveau des connaissances et des pratiques des cardiologues Tunisiens en radioprotection est globalement insuffisant. Ce qui interpelle les autorités sanitaires à organiser un plan de formation régulier pour cette population.</p> 2021-03-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238342 Radiological features of ankle synovial cell sarcoma 2022-12-13T07:33:00+00:00 Jihane Habi habijihane@gmail.com Nadia Moussali habijihane@gmail.com <p>A 23-years-old man was referred to our institution to investigate a painless right ankle mass. The clinical examination found a painful mass, fixed on the superficial and deep plane with vascular turgor. It measured 15x10cm (A). The X-ray of the ankle was done first and revealed opacity centred on the soft external malleolar tissues (arrow B). Then a magnetic resonance imaging (MRI) was performed. It showed multi lobulated mass with heterogeneous enhancement after injection of gadolinium (C) and a specific triple signal in T2 weighted images (D), made by a hyper signal (liquid), intermediate signal (tumor tissue) and hypo signal (septa). This radiological finding reminds a "bowl of grapes". The extension to the carpal bones was diagnosed as a hyper signal area on T2 (arrow D). The diagnosis of synovial sarcoma was suggested and then confirmed by pathological analysis after performing a surgical biopsy. The patient has developed a metastatic location in the right thigh. Synovial sarcoma is a malignant mesenchymal tumor. It presents 10% of all ankle soft tumors, and affects young adults with a sex ratio of 1. The lesion is often slow growing. On MRI, the synovial sarcoma diagnosis strongly suggestive by the classic "triple sign"; and "bowl of grapes sign" in T2 sequences. Its treatment is based on surgical excision adjunctive with chemotherapy or radiotherapy.</p> 2021-03-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238343 Case report of an acute myocardial infarction complicated by coronary spasm in a patient with chronic systemic lupus erythematosus 2022-12-13T07:42:01+00:00 Jeanne Lolita Pek sun_jian@jlu.edu.cn Zhang Jin sun_jian@jlu.edu.cn Sun Jian sun_jian@jlu.edu.cn <p>Acute myocardial infarction (AMI) is a major cause of death in a patient with systemic lupus erythematosus (SLE). Due to their chronic inflammatory state, patient with SLE has an increased risk of developing coronary artery disease. We report a case of a middle-aged woman with an acute myocardial infarction (AMI) caused by a right coronary artery (RCA) stenosis complicated with severe coronary artery spasm. Our patient has a history of long-standing SLE. Clinical expression of coronary artery disease (CAD) in SLE is the result of different pathophysiologic mechanism. From this case, we raise the importance of the clinician to be aware of the diverse pathophysiologic pathways involving a coronary artery in a patient with SLE.</p> 2021-03-23T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238345 A proposed framework to limit post-lockdown community transmission of COVID-19 in Africa 2022-12-13T08:02:11+00:00 Eric Nzirakaindi Ikoona klagoro@gmail.com David Lagoro Kitara klagoro@gmail.com <p>As of March 11, 2021, 3,992,044 coronavirus disease 2019 (COVID-19) cases and 106,615 deaths (case fatality rate 2.67%) have been reported on the African continent. In March 2020, even before the first case of COVID-19 was registered, some African countries implemented total lockdown measures, which limited movement of people, banned mass gatherings, and closed schools and borders. However, these control measures, which affect individuals and society's well-being, cannot be implemented for a long time. There is an urgent need for a robust framework to guide African countries to make evidence-based decisions on easing these restrictive measures and reapply them when the infection rates increase significantly. This article presents a proposed framework to guide lockdown easing while limiting the community spread of COVID-19 in Africa. Due to lack of information on the impact of relaxing restrictions on peoples' movement on the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the causative agent for COVID-19) and how businesses will respond, it is almost clear that there is no single grand lockdown exit strategy. African governments should develop flexible, iterative lockdown exit plans based on epidemiological disease data, economic indicators, and peoples' views to inform decisions, all of which are paramount for success. A phased approach of changes and willingness to adapt methods will allow governments to minimize the pandemic's adverse impact and respond accordingly as new control tools become available.</p> 2021-03-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238352 Allo-immunisation anti-érythrocytaire chez les polytransfusés au Centre National Hospitalier Universitaire de Cotonou: à propos de 51 cas 2022-12-13T08:17:14+00:00 Tatiana Baglo tatianabag@yahoo.fr Alban Zohoun tatianabag@yahoo.fr Bruno Léopold Agboton tatianabag@yahoo.fr Jacques Vigan tatianabag@yahoo.fr Paolo Ayaka tatianabag@yahoo.fr Ludovic Anani tatianabag@yahoo.fr Awa Omar Touré Fall tatianabag@yahoo.fr Dorothée Kindé Gazard tatianabag@yahoo.fr <p>La transfusion sanguine est un acte médical qui consiste à soigner un patient avec un produit sanguin labile. Chaque transfusion de concentré globulaire expose les receveurs à un risque d´allo-immunisation anti-érythrocytaire. La recherche d´anticorps anti-érythrocytaire (RAI) permet d´assurer la sécurité immuno-hématologique des patients transfusés. Au Bénin, ce test n´est pas systématique ni lors du bilan pré-transfusionnel, ni en post-transfusionnel. L'objectif de notre étude était de déterminer les allo-anticorps anti-érythrocytaires chez les polytransfusés. Pour ce, la RAI a été réalisée par le test indirect à l´antiglobuline en gel-filtration chez 51 polytransfusées dont 26 sélectionnés dans le service d´Hématologie et 25 dans le service de Néphrologie du CNHU-HKM. Après avoir phénotypé les patients allo-immunisés, la recherche des signes d´hémolyse a été effectuée chez eux. Les données cliniques et transfusionnelles des patients ont été collectées à partir des registres de transfusion et de leurs dossiers médicaux. Au terme de l'étude, la prévalence de l´allo-immunisation au sein de notre population était de 13,73%. Les anticorps identifiés avaient les spécificités suivantes: une association anti-RH1 + anti RH3, un anti LE1, puis une association anti-RH3 + anti-FY1. Les allo-anticorps étaient plus fréquents chez les patients ayant reçu plus de 15 poches de concentrés de globules rouges. Un des patients allo-immunisés présentait des signes biologiques d´hémolyse. Il n´existait pas de lien entre l´âge, le sexe, le diagnostic clinique et la survenue d´allo-immunisation anti-érythrocytaire. En conclusion, la réalisation systématique de la RAI chez les polytransfusés permettra de leur assurer une meilleure sécurité transfusionnelle au Bénin.</p> 2021-03-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238358 Hypertension artérielle maligne en milieu néphrologique à Abidjan: à propos de 168 cas colligés au Service de Néphrologie-Médecine Interne du CHU de Treichville 2022-12-13T08:28:31+00:00 Jean Astrid Aka cyrguei@yahoo.fr Cyr Monlet Guei cyrguei@yahoo.fr Serge Didier Konan cyrguei@yahoo.fr Patrick Sery Diopoh cyrguei@yahoo.fr Syndou Sanogo cyrguei@yahoo.fr Hubert Kouamé Yao cyrguei@yahoo.fr <p>L´hypertension artérielle maligne (HTAM) est une entité nosologique peu décrite en milieu néphrologique. L´objectif était de décrire le profil des patients présentant une HTA maligne en milieu néphrologique et identifier les facteurs pronostiques. Étude rétrospective, descriptive et analytique réalisée de janvier 2013 à décembre 2018 dans le service de néphrologie du CHU de Treichville. Le diagnostic d´HTA maligne était retenu devant une pression artérielle diastolique (PAD) ≥ 130 mmHg, une rétinopathie hypertensive au stade III ou IV selon Keith Wegener, avec une ou plusieurs autres atteintes viscérales cardiaques et/ou cérébrales et/ou rénales. Nous avons colligé 168 patients. L´âge moyen était de 41,10 ± 14,86 ans avec une prédominance masculine (sex-ratio de 1,54). Les facteurs de risque cardiovasculaire étaient l´HTA (79,20%), l´alcool (32,10%), le tabac (19,60%), la maladie rénale chronique (15,30%) et le diabète (11,30%). Ils étaient admis pour dyspnée (39,29%), poussée hypertensive (26,16%), troubles de la conscience (10 ,12%). L´examen clinique notait une anémie (82,10%), des œdèmes des membres inférieurs (63,10%), un œdème aigu du poumon (37,50%). Pour le retentissement de l´HTA, nous avons observé une insuffisance rénale (95,9%), une hypertrophie ventriculaire gauche (92,81%), un accident vasculaire cérébral (16,67%), un double retentissement cardiaque et rénal (85%). L´insuffisance rénale était chronique dans 78%. Les étiologies de l´HTAM étaient l´HTA essentielle (56,8%), la glomérulonéphrite chronique (29,8%) et le diabète (6%). L´évolution a été favorable dans 66,7% des cas et le décès constaté dans 25,6% des cas. En analyse multivariée, le taux d´urémie ≥ 2g/l [OR=5,07; IC95% = (2,39-10,75); p = 0,0001], l´hyperkaliémie [OR = 3,50; IC95% = (1,70-7,19); p = 0,001], l´hyponatrémie [OR = 2,90;IC95% = (1,40-6,03); p = 0,004], le taux d´hémoglobine &lt; 12g/dl [OR = 5,91; IC 95% = (1,34-26,00); p = 0,019] et l´IR terminale [OR =6,06; IC95% = (2,04-18,18); p = 0,001] étaient les facteurs associés à la survenue de décès. L´HTA maligne est consécutive à une HTA mal ou non traitée. Elle touche l´adulte jeune avec des complications multiviscérales dominées dans notre contexte par l´insuffisance rénale chronique terminale (IRCT). D´où l´intérêt d´un diagnostic précoce et d´une prise en charge adéquate de toute HTA.</p> 2021-03-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238519 Predictors of intestinal parasite infection among HIV patients on antiretroviral therapy in Jos, Plateau State, Nigeria, 2016: a cross-sectional survey 2022-12-16T06:26:38+00:00 Olawunmi Toyin Ajayi wunmsi@yahoo.com Olufunmilola Bamidele Makanjuola wunmsi@yahoo.com Adebola Temitope Olayinka wunmsi@yahoo.com Abdulhakeem Olorukooba wunmsi@yahoo.com Josephine Ene Olofu wunmsi@yahoo.com Patrick Nguku wunmsi@yahoo.com Olufunmilayo Ibitola Fawole wunmsi@yahoo.com <p><strong>Introduction:&nbsp;</strong>intestinal parasitic infection has been reported as a cause of morbidity and mortality among HIV patients on antiretroviral therapy (ART) due to interruption in treatment of the defaulting HIV patients. This study aimed to determine the prevalence and possible causes of intestinal parasites among HIV patients on ART. <strong>Methods:&nbsp;</strong>a survey involving 375 adult HIV/AIDS patients selected using a systematic random sampling technique was conducted in a Jos University Teaching hospital, Plateau State, Nigeria. Socio-demographic and clinical data was collected using semi- structured interviewer administered questionnaire and electronic dataset review. Fresh stool samples were collected from all participants for laboratory identification of intestinal parasites using formol-ether sedimentation and modified Ziehl-Neelsen techniques. Descriptive statistics, odds ratio and logistic regression model were computed at P ≤ 0.05. <strong>Results:&nbsp;</strong>the mean age of the study participants was 41.6±9.3years. Majority 294 (78.4%) were females, 141 (37.6%) lived in the rural area, 50 (13.3%) respondents did not have toilets in their homes. Most 275 (73.3%) had ART adherence level of 95% and above. Prevalence of intestinal parasites was 28.5%. Females (aOR = 2.14, 95% CI=1.12 – 3.89) and participants with no toilet facilities (aOR = 2.0, 95% CI=1.03 – 3.94) were significantly more likely to have intestinal parasites. <strong>Conclusion:&nbsp;</strong>The prevalence of intestinal parasites was high among HIV patients. Gender and unavailability of toilet in homes were found to be predictors of having parasites. We recommend that HIV patients should be periodically screened for IPs during the follow-up clinic visits.</p> 2021-03-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238522 Malformation artério veineuse utérine: à propos de deux cas au Centre Hospitalier Universitaire de la Guadeloupe 2022-12-16T06:47:09+00:00 Mègnissè Sèna Lokossou slokossou@yahoo.fr Gelly Akouala slokossou@yahoo.fr Allyriane Aganahi slokossou@yahoo.fr Mahoublo Vodouhe slokossou@yahoo.fr Andrea Larissa Lokossou slokossou@yahoo.fr Ambre Tramier slokossou@yahoo.fr Gülen Ayhan slokossou@yahoo.fr Eustache Janky slokossou@yahoo.fr <p>Les malformations artério-veineuses utérines sont une étiologie possible de métrorragies persistantes notamment en cas d´antécédent de fausses couches, de maladies trophoblastiques. Les auteurs rapportent les aspects diagnostiques et thérapeutiques de deux observations de malformations artério-veineuses utérines compliquant les suites du post-abortum à la maternité du Centre Hospitalier Universitaire de Pointe à Pitre en Guadeloupe. Les patientes ont présenté des métrorragies dans les suites d´un avortement traité par curetage. L´échographie couplée au Doppler a suspecté une malformation artério-veineuse. L´artériographie confirme le diagnostic et permet dans le même temps la réalisation d´un traitement conservateur par embolisation artérielle. Aucune complication n´est enregistrée. La méconnaissance des malformations artério-veineuse utérine peut avoir des conséquences délétères allant d´une hystérectomie d´hémostase par hémorragie cataclysmique au décès.</p> 2021-03-24T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238524 The effectiveness of tenofovir-based pre-exposure prophylaxis for prevention of HIV acquisition among sub-Saharan African women at high risk: a systematic review 2022-12-16T06:57:00+00:00 Grant Murewanhema gmurewanhema@yahoo.com Moffat Malisheni gmurewanhema@yahoo.com Noah Fongwen Takah gmurewanhema@yahoo.com <p><strong>Introduction:&nbsp;</strong>women in sub-Saharan Africa (SSA) are disproportionately affected by the HIV epidemic. In 2019, they constituted 59% of new infections; thus, they remain a key population for control. Public health interventions to prevent acquisition of HIV in this high-risk population are urgently needed. Tenofovir-based pre-exposure prophylaxis (TFV-PrEP) has been shown to reduce HIV infections in other key populations. However, comprehensive evidence regarding TFV-PrEP effectiveness in women living in SSA has not been determined. Therefore, we undertook a systematic review to determine the effectiveness of tenofovir-1% (TFV-1%) vaginal gel, oral tenofovir (TFV) and tenofovir-emtricitabine (TDF-FTC) pre-exposure prophylaxis for primary acquisition of HIV in at-risk women living in SSA. <strong>Methods:&nbsp;</strong>OVID Medline, Embase, CENTRAL, Web of Science and Clinical Trials.gov were searched for eligible studies from 1<sup>st</sup>&nbsp;January 2020 to 31<sup>st</sup> July 2020. Only randomised controlled trials (RCTs) conducted in women living in SSA were included. Measures of effectiveness (hazard ratios (HR), incidence rate ratios (IRR)) were extracted from individual studies to determine the effectiveness of TFV-PrEP in preventing HIV infection among at-risk women living in SSA.&nbsp;<strong>Results:&nbsp;</strong>from 2002 non-duplicate articles, four RCTs evaluating the effectiveness of one or more of the interventions against placebos were included. TFV-1% vaginal gel, oral TDF or TDF-FTC were not effective in preventing the acquisition of HIV infection in women living in SSA. However, poor adherence by study participants could have confounded the true effectiveness of TFV-PrEP in this high risk population. Meta-analysis was not conducted given the limited number of eligible studies identified from the search. <strong>Conclusion:&nbsp;</strong>the current evidence does not support the effectiveness of TFV-PrEP for HIV in SSA women. More studies aimed at addressing factors driving low adherence to HIV interventions in this high risk population are urgently needed in order to improve the design of future RCTs leading to the determination of more reliable estimates of TFV-1% vaginal gel or oral TDF or TDF-FTC effectiveness. Protocol registration: this systematic review was not registered in PROSPERO.</p> 2021-03-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238525 Paralysie obstétricale du plexus brachial (POPB): aspects épidémiologiques, thérapeutiques et évolutifs au Centre Hospitalier Universitaire de Bouaké, Côte d´Ivoire 2022-12-16T07:08:09+00:00 Célestin Adoubs Bénié tinodeben@yahoo.fr Jean Régis Achié Akobé tinodeben@yahoo.fr Franck Grah Lohourou tinodeben@yahoo.fr Ibrahim Traoré tinodeben@yahoo.fr Jean Bertrand Ahua Kpangni tinodeben@yahoo.fr Natacha Adelaïde Aya Kouassi tinodeben@yahoo.fr Inza Bamba tinodeben@yahoo.fr <p><strong>Introduction:&nbsp;</strong>la paralysie obstétricale du plexus brachial est une affection relativement rare mais qui n´a pas disparu malgré les importants progrès en obstétrique. L´objectif de cette étude était de décrire les aspects épidémiologiques, thérapeutiques et évolutifs de cette affection dans notre contexte. <strong>Méthodes:&nbsp;</strong>analyse rétrospective sur deux ans des dossiers de nouveau-nés ayant présenté une paralysie obstétricale du plexus brachial et pris en charge au Centre Hospitalier Universitaire de Bouaké. Les enfants reçus après l´âge de 3 mois n´ont pas été inclus. Les variables étudiées étaient d´ordre épidémiologique, thérapeutique et évolutif. <strong>Résultats:&nbsp;</strong>soixante patients ont été colligés, soit une fréquence de 28,5%. Il y avait 31 (52%) filles. L´âge moyen était de 8 jours [J0 et J35]. Les mères étaient multipares dans 94% des cas. L´accouchement a eu lieu dans un centre de santé dans 97% des cas. Tous les enfants étaient nés à terme avec 57 (95%) présentations céphaliques. L´accouchement était eutocique dans 74% des cas. Le poids moyen de naissance était de 3604g [2150g et 4500g]. Il y avait 47 cas (78%) de paralysie C5-C6. L´immobilisation coude au corps associée à la rééducation a été réalisée chez 51 enfants (85%). La rééducation a été réalisée immédiatement chez 9 enfants (15%). La récupération fonctionnelle du membre lésé a été complète chez 50 enfants (83%) après un recul de 6 mois. <strong>Conclusion:&nbsp;</strong>la paralysie obstétricale du plexus brachial demeure une affection obstétricale d´actualité. Son traitement conservateur, seule alternative dans notre contexte donne de bons résultats.</p> 2021-03-26T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238527 Correlates of knowledge of genetic diseases and congenital anomalies among pregnant women attending antenatal clinics in Lagos, South-West Nigeria 2022-12-16T07:17:21+00:00 Chibuzor Franklin Ogamba uzorogamba@gmail.com Alero Ann Roberts uzorogamba@gmail.com Ochuwa Adiketu Babah uzorogamba@gmail.com Chibuikem Anthony Ikwuegbuenyi uzorogamba@gmail.com Oluwaseun Joseph Ologunja uzorogamba@gmail.com Oluyinka Kehinde Amodeni uzorogamba@gmail.com <p><strong>Introduction:&nbsp;</strong>genetic diseases and congenital anomalies place a significant burden on the health of new-borns and their mothers. Despite the availability of a variety of prenatal screening tests, mothers' knowledge has been documented to determine uptake. This study aims to assess the knowledge of pregnant women about birth defects and the associated correlates with regard to willingness to do prenatal screening. <strong>Methods:&nbsp;</strong>a cross-sectional descriptive study was conducted among 422 antenatal mothers recruited sequentially as they attended antenatal clinics at the Lagos University Teaching Hospital. An interviewer-administered questionnaire was used to determine their knowledge of birth defects and willingness to do prenatal testing. <strong>Results:&nbsp;</strong>majority of the participants (92.2%) had at least secondary education. The mean total knowledge score of the respondents was 63%. Age and knowledge scores were not significantly correlated (r=-0.071, p=0.14). Being employed predicted higher knowledge scores (95% CI: 0.09, 2.09, p=0.03). Respondents who had primary school education and those who replied "I don't know" to willingness to test had significantly lower knowledge scores (95% CI:-15.01, -1.19, p=0.02 and 95% CI:-4.52, -0.68, p=0.01 respectively). Majority (79.1%) of the respondents were willing to undergo testing. Respondents' level of education was significantly associated with willingness to test (p=0.03). <strong>Conclusion:&nbsp;</strong>the observed knowledge gaps were considerable. There is need for improvement in education, the empowerment of women and access to quality healthcare including prenatal screening.</p> 2020-03-28T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238528 Magnitude and associated factors of contrast induced nephropathy among patients undergoing coronary angiography and interventions at a cardiac referral hospital in Tanzania - a cross-sectional study 2022-12-16T07:25:50+00:00 Pilly Chillo pchillo2000@gmail.com Ng'wigulu Malaja pchillo2000@gmail.com Peter Kisenge pchillo2000@gmail.com <p><strong>Introduction:&nbsp;</strong>contrast media are increasingly used in diagnostic and interventional procedures but are also known causes of acute kidney injury - a condition known as contrast induced nephropathy (CIN). We aimed to determine the magnitude and associated factors of CIN among patients undergoing coronary angiography and percutaneous coronary intervention at a cardiac referral hospital in Tanzania. <strong>Methods:&nbsp;</strong>all adult patients undergoing elective coronary angiography and percutaneous coronary intervention at Jakaya Kikwete Cardiac Institute were consecutively enrolled between August 2017 and January 2018, if they fulfilled the inclusion criteria. Pre-procedure, 24- and 72-hours' post procedure serum creatinine was measured. CIN was defined as increase of ≥25% or absolute increase of ≥44μmol/L of serum creatinine within 72 hours following exposure to contrast media. Data analysis were done using SPSS Version 20. P-value of &lt;0.05 was considered statistically significant. <strong>Results:&nbsp;</strong>in total, 210 (94.6%) out of 222 patients seen during the study period fulfilled the inclusion criteria and were enrolled. Their mean (SD) age was 61.3 (10.9) years and 64.3% were men. Hypertension, diabetes, smoking and alcohol consumption was present in 86.7%, 37.7%, 12.4% and 37.6% respectively. The incidence of CIN was 19% within 72 hours post procedure. On multivariate logistic regression analysis, independent factors for developing CIN were history of heart failure (aOR=7.34), central obesity (aOR=3.12), triple vessel disease (aOR=10.14) and post procedure stay of ≥3 days (aOR=4.1), all p&lt;0.05. <strong>Conclusion:&nbsp;</strong>the incidence of CIN found in this population is high (19%) and is associated with heart failure, obesity, multi-vessel disease and longer post-procedure hospital stay.</p> 2021-03-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238584 Tendinopathie achilléenne compliquée d´une rupture du tendon d´Achille consécutives à une automédication par la ciprofloxacine chez une hémodialysée: à propos d´un cas 2022-12-19T06:47:21+00:00 Gaël Clovis Gassongo Koumou gassgael@yahoo.fr Kevin Parfait Bienvenu Bouhelo Pam gassgael@yahoo.fr Mohamed Arrayhani gassgael@yahoo.fr Tarik Sqalli Houssaini gassgael@yahoo.fr Abdelmajid El Mrini gassgael@yahoo.fr <p>L´objectif de ce travail était de rappeler aux praticiens cette complication des fluoroquinolones, la tendinopathie. Il s´agit d´un effet secondaire rare mais, qui peut être source de handicap fonctionnel. Une femme de 79 ans, hémodialysée depuis 11 années avait présenté une douleur soudaine de la cheville gauche et une impotence fonctionnelle relative du membre homolatéral au 5<sup>e</sup>&nbsp;jour d´une automédication par la ciprofloxacine. Elle avait comme comorbidités, une gonarthrose chronique, une hyperparathyroïdie secondaire et une cardiopathie ischémique. Le diagnostic de tendinopathie achilléenne bilatérale et d´une rupture achilléenne gauche étaient retenus sur la base des arguments cliniques, confortés par l´échographie achilléenne. La responsabilité de la ciprofloxacine était évaluée à l´aide de la méthode française d´imputabilité des effets inattendus ou toxiques des médicaments. La prise en charge était chirurgicale suivie d´une rééducation fonctionnelle avec une évolution satisfaisante. La fréquence des tendinopathies liées aux fluoroquinolones varie de 15 à 20 accidents pour 100 000 sujets traités dont un tiers de cas sont compliqués de rupture tendineuse. L´incidence est liée à l´âge, avec un âge de prédilection &gt; 60 ans impliquant le vieillissement tissulaire. La péfloxacine et la ciprofloxacine sont les molécules les plus incriminées. Le délai d´apparition des symptômes noté à cinq jours dans cette observation corrobore avec la littérature. Nous avons retrouvé certains facteurs favorisants connus à savoir: insuffisance rénale chronique, dialyse, corticothérapie, hypolipémiant (statine). La présentation clinique est classique, suffisante pour poser le diagnostic. La localisation est majoritairement achilléenne. Elle est bilatérale dans 40 à 66%. La rupture tendineuse est la principale complication. La prise en charge est chirurgicale. Elle permet de rétablir l´anatomie et de prévenir le handicap fonctionnel préjudiciable. Nous rapportons un effet secondaire rare mais, potentiellement grave, lié aux fluoroquinolones et, qui expose à un handicap fonctionnel. L´âge avancé, l´insuffisance rénale chronique, l´hémodialyse chronique, la prise concomitante de statine et de corticoïde sont des facteurs traditionnels favorisants retrouvés ici. Les hémodialysés constituent une population à risque pour qui une surveillance même à distance d´un traitement à base de ces molécules revêt un intérêt non négligeable.</p> 2021-03-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238588 Developing vaccinology expertise for Africa: fifteen years and counting 2022-12-19T07:14:51+00:00 Edina Amponsah-Dacosta edina.amponsah-dacosta@uct.ac.za Rudzani Muloiwa edina.amponsah-dacosta@uct.ac.za Charles Shey Wiysonge edina.amponsah-dacosta@uct.ac.za Michael Gold edina.amponsah-dacosta@uct.ac.za Gregory Hussey edina.amponsah-dacosta@uct.ac.za Benjamin Mugo Kagina edina.amponsah-dacosta@uct.ac.za <p>For 15 years, the Annual African Vaccinology Course (AAVC) hosted by the Vaccines for Africa Initiative, has been at the forefront of vaccinology training in Africa. The AAVC was developed in 2005 in response to the growing demand for vaccinology training in Africa. To date, 958 policy makers, immunization managers, public and private health practitioners, scientists, postgraduate and postdoctoral students have been trained. These participants are from 44 of the 54 African countries. The course content covers diverse topics such as considerations for new vaccine introduction, mathematical modelling, and emerging and re-emerging vaccine preventable diseases. As the landscape of vaccinology continues to evolve, the AAVC aims to expand the reach of vaccinology training using blended learning approaches which will incorporate online and face-to-face formats, while expanding access to this popular course. Ultimately, the AAVC endeavours to develop a big pool of vaccinology expertise in Africa and to strengthen regional ownership for immunization programmes.</p> 2021-03-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238591 Diagnosis of Evans syndrome 2023-02-23T09:14:41+00:00 Andreas Angelopoulos evipapanikolaou215@gmail.com George Kirkilesis evipapanikolaou215@gmail.com Kiriaki Kakavia evipapanikolaou215@gmail.com Paraskevi Papanikolaou evipapanikolaou215@gmail.com <p>This manuscript concerns the case of a patient hospitalized and diagnosed with Evans syndrome. She was hospitalized with signs of thrombocytopenia induced purpura, petechiae, ecchymosis and anemia. She was successfully treated with corticoids and blood transfusions. Our purpose is to explain her clinical presentation and the exams, we used in order to make the diagnosis of Evans syndrome, which requires great suspicion. Moreover, other diseases causing hemolytic anemia and thrombocytopenia must be excluded. We used laboratory tests (blood samples, Coombs examination and virologic test). Bone marrow examination took place twice. Evans syndrome is an autoimmune disease which is characterized by the coexistence of hemolytic anemia and immune-mediated thrombocytopenia. There is no typical clinical presentation. Its etiology is unknown and its therapy is generally poor. Diagnosis of Evans syndrome is very difficult and requires the exclusion of other diseases causing anemia and thrombocytopenia.</p> 2021-03-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/242208 Knowledge, attitudes and practices towards menopause among Congolese middle-aged and postmenopausal women 2023-02-23T09:29:47+00:00 Sifa Marie Joelle Muchanga muchanga.sifa@unikin.ac.cd Anyeke Louise Lumumba muchanga.sifa@unikin.ac.cd Bebele Jean Patrice Kamba muchanga.sifa@unikin.ac.cd Etongola Papy Mbelambela muchanga.sifa@unikin.ac.cd Antonio Fredelindo Villanueva muchanga.sifa@unikin.ac.cd Marlinang Diarta Siburian muchanga.sifa@unikin.ac.cd Rahma Rashid Tozin muchanga.sifa@unikin.ac.cd <p><strong>Introduction:&nbsp;</strong>with the increase in life expectancy, women will live longer during their postmenopausal period. To improve their quality of life, they should be aware of what challenges they will be facing. This study aimed to evaluate the knowledge, attitudes and practices of middle-aged women towards menopause.</p> <p><strong>Methods:&nbsp;</strong>in this cross-sectional study, data collected using a multistage clustered random sampling from 54 health centres in the Democratic Republic of Congo were used. Participants filled a questionnaire derived from the menopause rating scale and from local beliefs. The knowledge, attitudes and practices towards menopause were evaluated among pre- and postmenopausal women.</p> <p><strong>Results:&nbsp;</strong>of the 353 women, both pre- and postmenopausal women knew the definition of menopause but for the symptoms, postmenopausal women were more informed than premenopausal. For the attitudes and practices towards menopause, while both had equally positive attitudes, the premenopausal women did not know which practices to adopt.</p> <p><strong>Conclusion:&nbsp;</strong>Congolese women had limited knowledge, positive attitudes and unconventional practices towards menopause. Health-care providers, therefore, need to dispense appropriate advice to middle-aged women before the advent of menopause.</p> 2021-03-30T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238594 Determinants of fertility differentials in Burundi: evidence from the 2016-17 Burundi demographic and health survey 2022-12-19T08:28:02+00:00 Jean Claude Nibaruta nibajclaude@gmail.com Noureddine Elkhoudri nibajclaude@gmail.com Mohamed Chahboune nibajclaude@gmail.com Milouda Chebabe nibajclaude@gmail.com Saad Elmadani nibajclaude@gmail.com Abdellatif Baali nibajclaude@gmail.com Hakima Amor nibajclaude@gmail.com <p><strong>Introduction:&nbsp;</strong>although fertility control remains a major priority for the Burundian government and most of its partners, few studies on Burundi´s fertility determinants are available to guide interventions. To address this gap, our study aims to examine the most factors influencing fertility differentials in Burundi by using the latest Burundi demographic and health survey data. <strong>Methods:&nbsp;</strong>using data from the 2016-17 Burundi demographic and health survey, one-way analysis of variance was performed to describe variations in mean number of children ever born across categories of correlate variables. Then univariable and multivariable poisson regression analyses were carried out to identify the most factors influencing fertility differentials in Burundi. <strong>Results:&nbsp;</strong>in our sample, the total number of children ever born ranged from 0 to 15 children by women with a mean number of 2.7 children (±2.8 SD). Factors such as urban residence (aIRR 0.769, 95% CI: 0.739 - 0.782, p = 0.008), increase in the level of education of both women and husbands (aIRRs of 0.718, 95% CI: 0.643 - 0.802, P&lt;0.001 and 0.729, 95% CI: 0.711 - 0.763, p&lt;0.001 respectively), no history of infant mortality experience (aIRR 0.722, 95% IC: 0.710 - 0.734, p&lt;0.001) and increase in age at first marriage or first birth (aIRRs of 0.864, 95% CI: 0.837 - 0.891, P&lt;0.001 and 0.812, 95% CI: 0.781 - 0.845, p&lt;0.001 respectively) are associated with a low fertility rate while factors such as residence especially in Southern region (aIRR 1.129, 95% IC: 1.077 - 1.184, p&lt;0.001), women and husband´s agricultural profession (aIRRs of 1.521, 95% CI: 1.429 - 1.568, P&lt;0.001 and 1.294, 95% CI: 1.211 - 1.316, p&lt;0.001 respectively), household poverty (aIRR 1.117, 95% IC: 1.080 - 1.155, p&lt;0.001), lack of knowledge of any contraceptive method (aIRR 1.502, 95% IC: 1.494 - 1.564, p&lt;0.001) and non-use of modern contraceptive methods (aIRR 1.583, 95% IC: 1.562 - 1.607, p&lt;0.001) are associated with a high fertility rate. <strong>Conclusion:&nbsp;</strong>the results of this study suggest that actions aimed at promoting education in general especially female education, improving child survival, women´s socio-economic status, agriculture mechanization and increasing number and scope of family planning services, could help reduce Burundi fertility rate.</p> 2021-03-30T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238645 Cardiovascular risk factors among patients with human immunodeficiency viral infection at a tertiary hospital in Ghana: a cross-sectional study 2022-12-20T06:50:07+00:00 Olutobi Adekunle Sanuade oluwatobisanuade@gmail.com Leonard Baatiema oluwatobisanuade@gmail.com Aaron Kobina Christian oluwatobisanuade@gmail.com Peter Puplampu oluwatobisanuade@gmail.com <p><strong>Introduction:&nbsp;</strong>the provision of antiretroviral treatment (ART) to people living with HIV/AIDS (PLHIV) has improved their life expectancy significantly. Conversely, this has been associated with an elevated risk of cardiovascular diseases. Yet, research to improve understanding of cardiovascular risk factors among PLHIV remains limited. This study examines the prevalence and correlates of cardiovascular risk factors among PLHIV at the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana. <strong>Methods:&nbsp;</strong>a cross-sectional study was conducted at the KBTH, Accra, Ghana. Patients were recruited from the adult HIV outpatient clinic at the infectious disease unit, KBTH. The sample comprised 525 PLHIV, aged 18 years and above. Data were analysed using descriptive statistics and a multivariable binary logistic regression. <strong>Results:&nbsp;</strong>among the patients, 9.7% (n=51) had hypertension and 15.6% (n=82) were reportedly patients with diabetes. With respect to the serum lipid profile, 24.8% (n=130) had hypertriglyceridemia, 49.1% (n=258) had hypercholesterolemia, 26.3% (138) had low high-density lipoprotein, and high low-density lipoprotein was found in 27.2% (n=143) of the cohort. The multivariable binary logistic regression results showed that being unemployed, underweight, being on ART, being male, having a higher level of education, and not having health insurance subscription significantly increased the odds of cardiovascular risk factors among the patients. <strong>Conclusion:&nbsp;</strong>current findings buttress concern for elevated risk of cardiovascular diseases among PLHIV and calls for increased attention for comprehensive care that includes the prevention and management of cardiovascular diseases and its risk factors among this vulnerable group.</p> 2021-03-30T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238648 New-onset restless leg syndrome in a COVID-19 patient: a case report with literature review 2022-12-20T06:59:32+00:00 Osama Mohiuddin anosh.9412@gmail.com Anosh Aslam Khan anosh.9412@gmail.com Syed Muhammad Ismail Shah anosh.9412@gmail.com Mohammad Daniyal Zafar Malick anosh.9412@gmail.com Shehzeen Fatima Memon anosh.9412@gmail.com Sumeen Jalees anosh.9412@gmail.com Farah Yasmin anosh.9412@gmail.com <p>Restless leg syndrome (RLS) is a sleep disorder characterized by the sudden urge to move the lower limbs during periods of rest accompanied by an unpleasant sensation like tingling or burning in the legs. Often, this urge is partially relieved by the movement of legs. However, it causes disturbance of sleep leading to daytime fatigue. Herein, we present an unusual case of new-onset of restless leg syndrome in a COVID-19 infected patient who presented three weeks after an uncomplicated delivery via caesarean section. The patient was managed with sleep hygiene measures, oral iron and vitamin C tablets apart from general COVID-19 management medications, subsequently leading to significant improvements. Here we have discussed possible associated factors, pathophysiological mechanisms and management of RLS in the case of COVID infected individuals.</p> 2020-03-30T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238649 Foreign bodies logded in the hypopharynx 2022-12-20T07:04:55+00:00 Miguel Carvalho miguelcarv75@gmail.com Rui Vieira miguelcarv75@gmail.com <p>We present the case of a 21-year-old female, with a history of bipolar disease, observed at the emergency department of our institution for voluntary ingestion of two foreign bodies. She complained of localized neck pain, dysphagia and odynophagia that started 2 hours before observation. Initial evaluation identified two thumbtacks lodged in the left pyriform sinus and valeculae. Despite swift preparation for removal of the foreign bodies under sedation, progression on the digestive tube occurred. One thumbtack was removed by endoscopic techniques from the gastric fundus. The other was expelled naturally in an uncomplicated fashion at day 8.</p> 2021-03-30T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238650 Assessment of maternal health services: a comparative study of urban and rural primary health facilities in Kano State, Northwest Nigeria 2022-12-20T07:13:26+00:00 Badia Maje Sayyadi usmanmi2000@gmail.com Awwal Umar Gajida usmanmi2000@gmail.com Rahila Garba usmanmi2000@gmail.com Usman Muhammad Ibrahim usmanmi2000@gmail.com <p><strong>Introduction:&nbsp;</strong>all pregnant women are at potential risk of obstetric complications; majority of which can be treated if appropriate care is accessed promptly. A shift in focus to quality of care has the potential to unlock significant returns for every mother and newborn to end preventable maternal and infant deaths. The study aimed to assess the quality of maternal health services in primary health facilities in urban and rural communities of Kano State. <strong>Methods:&nbsp;</strong>using a comparative cross-sectional study design that utilized mixed method of data collection, interviewer administered questionnaire were used to collect information from 438 women (219) each attending health facilities for maternal health services in rural and urban areas of Kano using multistage sampling technique from June to November, 2019. Six Key Informant Interviews with the heads of units/ facilities were purposively conducted. Quality of care was assessed using perspectives and system models based on the components of antenatal care received, postnatal care and perception of care received. A statistical significance was set at p-value &lt; 0.05. Thematic framework analysis was used to analyze verbatim transcript from qualitative interviews. <strong>Results:&nbsp;</strong>the age of the respondents ranged from 18-48 years with majority having secondary education in both communities. In both urban and rural communities´, majority of the respondents had only 1-3 antenatal care visits making up 63.5% and 70.3% respectively. Almost similar proportions of the urban (58.4%) and rural (50.2%) respondents were delivered by a skilled birth attendant. About two-third of the respondents, 67.6% and 65.3% in the urban and rural communities respectively were completely satisfied with the quality of care received. Qualitative interviews pointed ignorance as the major factor that prevent mothers from accessing quality care and reported that satisfactory services were provided in all facilities. <strong>Conclusion:&nbsp;</strong>considerable disparity exists between urban and rural communities in quality of maternal health services with better provision of most services in the urban communities. There is need for improvement in the desirable and minimum acceptable quality of maternal health services in Kano State.</p> 2021-03-30T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238652 Une hydrocèle du canal de Nuck découverte au cours d´un bilan d´infertilité: à propos d´un cas atypique 2022-12-20T07:22:34+00:00 Jihane Habi habijihane@gmail.com Amal Rami habijihane@gmail.com Hind Guerroum habijihane@gmail.com Mariam Kassimi habijihane@gmail.com Nabil Chikhaoui habijihane@gmail.com Mohamed Mahi habijihane@gmail.com <p>L´hydrocèle du canal de Nuck est une pathologie rare de la femme, souvent découverte durant l´enfance. Cette présentation rapporte un cas rare d´hydrocèle découverte à l´âge adulte au cours d´un bilan d´infertilité. A l´admission au service, la patiente a rapporté une tuméfaction inguinale droite chronique non douloureuse. L´imagerie a été typique d´une hydrocèle du canal de Nuck. L´échographie a retrouvé une formation kystique avec quelques fin septas et l´'imagerie par résonance magnétique (IRM) n´a pas retrouvé de communication avec le péritoine. Avec les mêmes moyens d´imagerie, un utérus bicorne non cloisonné a été découvert pouvant rentrer dans le cadre de son bilan d´infertilité. Le but principal de ce travail est de faire connaitre l´imagerie typique de l´hydrocèle du canal de Nuck un diagnostic peu connu et de le faire intégrer parmi les diagnostics différentiels des tuméfactions inguinales chez la femme.</p> 2021-04-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238653 Orf (ecthyma contagiosum) 2022-12-20T07:26:36+00:00 Konstantina Mavridou maria.bkl@gmail.com Maria Bakola maria.bkl@gmail.com <p>Orf, also known as ecthyma contagiosum, is a parapox virus infection endemic among sheep and goats that can be transmitted to humans, particularly to farmers, sheepherders, butchers and veterinarians. Although it’s a self-limiting infection, complications may be seen such as ocular involvement, erythema multiforme, extensive lesions in patients with atopic dermatitis and secondary bacterial infection. A 29-year-old man with no past medical history, presented to his primary care physician with a well-circumscribed, non-pulsating growth at the proximal phalanx of his right thumb. A carefully taken history revealed that this lesion had appeared three days ago as a red nonhealing papule. The patient reported no history of fever, pain or itching at the site. He mentioned exposure to sheep and goats since he was a shepherd. On examination, the lesion size was approximately 1.5cm in diameter and appeared as a nodule with a red centre surrounded successively with a white ring and then a red halo resembling as a target lesion. No other lesions and no lymphadenopathy were noted. Blood samples were normal and showed no signs of infection. The clinical observations and medical history were compatible with the virus infection Orf. The patient was seen at weekly intervals. The lesion was managed conservatively and no specific therapy was undertaken, other than topical disinfectants. After four weeks the lesion had completely healed without a scar.</p> 2021-04-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238654 Improving work and employment opportunities for women with psychosocial disabilities: an action research protocol 2022-12-20T07:43:55+00:00 Isaiah Gitonga gitongaisaiah0@gmail.com Elena Vladimirovna Syurina gitongaisaiah0@gmail.com Albert Tele gitongaisaiah0@gmail.com Ikenna Desmond Ebuenyi gitongaisaiah0@gmail.com <div class="BoxAbstract"> <p>In Kenya, employment rates for persons with disabilities are very low and those with psychosocial disabilities have even more dismal rates of employment. This situation has negative impact on the individual’s recovery, quality of life, mental and physical health. The systemic exclusion of persons with psychosocial disabilities in work and employment disproportionately affects women. The aim of this study is to test the feasibility of disability inclusion training to improve work and employment opportunities for women with psychosocial disabilities in Tana River County, Kenya. The study will adopt a mixed methods research design using action research approach. A sample of women with psychosocial disabilities will be trained using a researcher designed disability inclusion training manual, while employers and other stakeholders will be trained on inclusive employment. Trainings will be tailored to suit different employers and for different types of psychosocial disabilities. Interactive learning and linking sessions involving the two groups and process evaluations will be conducted at different time points to measure the impact of the intervention. Findings from this pilot study will inform future research on work and employability programs for rural women with psychosocial disabilities. The study protocol was approved by Maseno University Ethics Review Committee (MUERC/00851/20). Findings from this study will be disseminated through conference presentations and scientific publications in peer reviewed journals.</p> </div> <p class="ParagraphSeparator">&nbsp;</p> 2021-04-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238656 Spontaneous massive pectoral hematoma induced by vitamin K antagonist therapy: a case report 2022-12-20T07:56:59+00:00 Karima Benbouchta Karimabenbouchta397@gmail.com Asmae Mrabet Karimabenbouchta397@gmail.com Ossema Kallel Karimabenbouchta397@gmail.com Noha El Ouafi Karimabenbouchta397@gmail.com Zakaria Bazid Karimabenbouchta397@gmail.com <p>Vitamin K antagonists (VKA) based oral anticoagulation, is widely used for the prevention and treatment of thromboembolic disease. The major complication of this therapy is bleeding, and sometimes it can occur in unsuspected areas. Spontaneous pectoral hematoma is one of the rare complications due to over anticoagulation by VKA therapy, with only a few cases reported in the literature. Concomitant use of this therapy with commonly used antibiotic, especially in the elderly with multiple comorbidities, can increase the risk of bleeding. Herein, we report a case of a 72-year-old woman under VKA for the treatment of atrial fibrillation, who presented with a spontaneous massive pectoral hematoma, while using antibiotic to treat a respiratory tract infection, who was successfully managed.</p> 2021-04-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238660 Disseminated intravascular coagulation type of amniotic fluid embolism: a challenging case report with favorable outcome 2022-12-20T08:05:22+00:00 Mouna Gara ahmedbensaad28@yahoo.fr Arij Draouil ahmedbensaad28@yahoo.fr Ahmed Ben Saad ahmedbensaad28@yahoo.fr Manel Njima ahmedbensaad28@yahoo.fr Asma Ladib ahmedbensaad28@yahoo.fr Ons Cherif ahmedbensaad28@yahoo.fr Ali Jlali ahmedbensaad28@yahoo.fr Lotfi Grati ahmedbensaad28@yahoo.fr <p>Amniotic fluid embolism (AFE) is an unforeseeable, life-threatening complication of pregnancy and child birth. Although rare in an absolute sense, most contemporary series of maternal deaths from developed countries report AFE as a leading cause of mortality in the pregnant population. It has a heterogeneous presentation. This clinical heterogeneity makes the diagnosis of AFE difficult based on a beam of clinical and para-clinical arguments. Rapid diagnosis and immediate interdisciplinary treatment are essential for a good outcome. The present is a case of AFE with a disseminated intravascular coagulation (DIC) and a cardiorespiratory collapse following a vaginal delivery.</p> 2021-04-01T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238664 Neurological manifestations in patients with symptomatic COVID-19 admitted to the Bafoussam Regional Hospital, Cameroon 2022-12-20T08:13:08+00:00 Yannick Fogoum Fogang yanfogang@yahoo.fr Michel Noubom yanfogang@yahoo.fr Pierre-Yves Bassong yanfogang@yahoo.fr Paul Chimi Mbonda yanfogang@yahoo.fr Iliassou Njoudap Mfopou yanfogang@yahoo.fr Daniel Massi Gams yanfogang@yahoo.fr Callixte Tegueu Kuate yanfogang@yahoo.fr Joseph Kamtchum-Tatuene yanfogang@yahoo.fr <p><strong>Introduction:&nbsp;</strong>although the main manifestations of COVID-19 are respiratory, several neurological symptoms and complications have also been reported. The pandemic seems to have some epidemiological specificities in sub-Saharan Africa, and this may be reflected in the type and frequency of neurological symptoms. This study aimed to report neurological manifestations associated with symptomatic COVID-19 in a sub-Saharan African setting. <strong>Methods:&nbsp;</strong>we conducted a retrospective review of symptomatic PCR-confirmed COVID-19 cases admitted to the Bafoussam Regional Hospital between March and September 2020. Patients’ files were reviewed at discharge by a consultant neurologist. Socio-demographic characteristics, co-morbidities, symptoms on admission, neurological symptoms during hospitalization, management, and in-hospital outcome were recorded. Comparisons between patients with and without neurological symptoms were performed using Fisher’s exact and Mann-Whitney U test. <strong>Results:&nbsp;</strong>we enrolled 177 symptomatic patients (68% men). Mean age was 54.6 ± 17.8 years (range 2-99 years). Co-morbidities were present in 57.6% of patients, including hypertension (27.1%) and diabetes mellitus (25.4%). Neurological symptoms were found in 113 (63.8%) patients. The most frequent were headache (39.0%), myalgia (35.6%), anosmia (11.9%), impaired consciousness (10.7%) and delirium (5.6%). Regarding the presenting symptoms, fever was more frequent in patients with neurological symptoms than in those without (81.4% versus 50.0%, p&lt; 0.001), while digestive symptoms were less frequent in patients with neurological symptoms (0.9% versus 9.4%, p= 0.004). <strong>Conclusion:&nbsp;</strong>neurological manifestations are frequent and heterogeneous in patients with symptomatic COVID-19. Further studies are needed to clarify the pathophysiology of neurological symptoms in COVID-19 and their impact on patients’ long-term outcome.</p> 2021-04-05T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238683 Anomalous origin of right coronary artery with interarterial course revealed by effort angina: case report 2023-02-23T09:40:26+00:00 Hind Regragui re.hind19@gmail.com Badre El Boussaadani re.hind19@gmail.com Chakib Benajiba re.hind19@gmail.com Hanae Bouhdadi re.hind19@gmail.com Hicham Wazaren re.hind19@gmail.com Mohammed Cherti re.hind19@gmail.com <p>Anomalous origin of coronary artery with interarterial course is recognized as a rare congenital heart disease. Its main manifestation is myocardial ischemia related to systolic compression of coronary arteries positioned between the great arteries. We report a case of a middle-aged man admitted in our department for an effort angina during nordic walking. A coronary angiography was performed showing an anomalous coronary artery with a birth defect giving a right common trunk of the circumflex artery and the right coronary artery. We proceeded to a multidetector computed tomography coronary angiography (MDCTCA) to describe this variant of an anomalous coronary arteries which revealed a birth defect in the left anterior sinus of the right coronary and the circumflex artery from a right common trunk passing between the aorta and the trunk of the pulmonary arteries. Magnetic resonance imaging (MRI), exercise stress test and myocardial perfusion scintigraphy were performed in order to objectify an ischemia. Despite the positivity of myocardial scintigraphy, we recommended to our patient to limit exercise with a regular follow-up since he is only symptomatic during a major effort. There are many types of anomalous coronary arteries and the anatomic variant of a right coronary artery that course between the great vessels represents a risk of adverse event and sudden death in young athletes. The choice of therapy is controversial and depends especially on the variant of anomalous coronary artery and the symptoms.</p> 2021-04-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238684 Cold agglutinins revealed by abnormalities to the cell blood count: a case report 2022-12-20T11:19:37+00:00 Hafid Zahid h-zahid@hotmail.com Rachid Hadef h-zahid@hotmail.com Faycal Labrini h-zahid@hotmail.com Anass Yahyaoui h-zahid@hotmail.com Nezha Messaoudi h-zahid@hotmail.com <p>Cold agglutinin are erythrocyte antibodies which possess the property of agglutinating red blood cells at temperatures of below 37°C, this phenomenon is reversible after heating. This is usually immunoglobulin M (IgM) class. Their pathogenicity is much more related to their temperature range of activity than their title. As we report in this observation, cold hemagglutination makes it difficult to interpret certain immunological tests such as ABO Rh blood grouping or searching for irregular antibodies (SAI). The discovery of cold agglutinins can be fortuitous revealing itself by disturbances and aberrations in the results of blood count or as part of a suggestive clinical or laboratory table cold hemagglutinin disease. The search for a lymphoid hematological at their diagnosis should be systematic.</p> 2021-04-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238690 Recurrence of thyroglossal cyst: on the tongue! 2022-12-20T12:25:56+00:00 Vanesa Villamil vanesa_villamil@yahoo.com.ar Nery Alfredo Méndez Aguirre vanesa_villamil@yahoo.com.ar <p>Thyroglossal duct cysts (TDC) are the most common congenital cervical abnormality. On the other hand, lingual TDC are rare, comprising between 0.6% -3% of all TDC. We present the case of a patient with recurrence of the TDC, at the base of the tongue. Five-year-old patient with TDC was admitted on a scheduled basis to excise it. Exeresis of the cyst was performed using the Sistrunk technique. Postoperative elapsed without incidents, being discharge on the 3<sup>rd</sup>&nbsp;postoperative day. Three years after surgery, the patient returned for dysphagia and the appearance of a tumour on the base of the tongue (A). Cervical ultrasound was performed, showing a suprahyoid cystic structure, adjacent to the posterior third of the tongue, dependent on the blind foramen, compatible with lingual TDC (B). The patient underwent an intraoral approach, allowing complete removal of the cyst. Pathological anatomy confirmed the suspicion of TDC. TDC form anywhere from the blind foramen of the tongue to the base of the neck. Sixty one percent of the cysts are located between the thyroid gland and the hyoid bone and 1-2% are intralingual. Cases of transoral exeresis and using the Sistrunk technique are reported. We performed the first one, since the patient had already undergone cervical surgery. The exploration of the oral cavity in these patients is essential, since, as we have seen and learned in this case, there may be a recurrence or extension of the cyst to the blind foramen of the tongue.</p> 2021-04-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238693 A primary mediastinal germ cell tumor of yolk sac type: case report 2022-12-20T12:42:33+00:00 Khadija Darif khadija_sky@hotmail.fr Zineb Benbrahim khadija_sky@hotmail.fr Nisrine Acharfi khadija_sky@hotmail.fr Anass Khacha khadija_sky@hotmail.fr Mustapha Maaroufi khadija_sky@hotmail.fr Lamiae Amaadour khadija_sky@hotmail.fr Karima Oualla khadija_sky@hotmail.fr Samia Arifi khadija_sky@hotmail.fr Nawfel Mellas khadija_sky@hotmail.fr <p>The mediastinal malignant germ cells tumor represents less than 0.5% of thoracic tumors, although the mediastinum is one of the main extragonadic locations of these tumors. In the majority of cases, young people are those most affected. The prognosis of mediastinal malignant germ cells tumors is poor, especially non-seminomatous germ tumors. In this article, we report a rare case of a young 19-years-old patient treated for a mediastinal germ cell tumor of yolk sac. The patient presented a chest pain; the chest computed tomography (CT) showed a right paramedian mediastinal mass with a pleural effusion associated with supraclavicular and cervical lymph nodes. Biopsy revealed a non-seminomatousgerm cell tumor of yolk sac. The exams showed elevated alpha-fetoprotein (AFP), without any meaningful elevation of other serictumor markers. The patient received 4 cycles of chemotherapy based on etoposide, ifosfamide and platinum salts then a complete excision of the mass.</p> 2021-04-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238695 Social behaviors and HIV risk factors among men in Chad and Cameroon 2022-12-20T12:57:36+00:00 Bonheur Dounebaine dounebaine@gmail.com Kate Winskell khadija_sky@hotmail.fr <p><strong>Introduction:&nbsp;</strong>the neighboring Republics of Chad and Cameroon have respectively one of the lowest and highest HIV prevalence rates in central Africa at 1.3% and 4.5%, respectively. We conducted a comparative description of social behaviors and HIV risk factors among heterosexual men and explored the baseline of the first UNAIDS target (by 2020, 90% of people living with HIV will know their status) in the two countries. <strong>Methods:&nbsp;</strong>this was a retrospective cross-sectional study using Demographic and Health Survey data. We fitted a separate multilevel logistic model for each country. In total, 5248 men were interviewed in Chad and 7191 men in Cameroon. <strong>Results:&nbsp;</strong>Cameroonian men have a higher level of education, higher HIV testing rate, and are more knowledgeable about HIV than Chadian men. However, Chadian men have a lower number of lifetime sexual partners (2 interquartile range (IQR), 1-4) compared to Cameroonian men (6 IQR 3-15) and 86.96% of Chadian versus 57.30% of Cameroonian men reported fidelity to their domestic partners in the last twelve months. <strong>Conclusion:&nbsp;</strong>there is a crucial need to encourage HIV screening and testing among Chadian men, especially in rural areas. Testing also needs to be increased in Cameroon to meet the first UNAIDS target. Government and partners in Cameroon could support more research and campaigns that aim at reducing multiple sexual partnerships among the communities in Cameroon.</p> 2021-04-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238793 Multimorbidity of chronic diseases of lifestyle among South African adults 2022-12-22T06:00:36+00:00 Mukadas Oyeniran Akindele mukaakin@gmail.com Ushotanefe Useh mukaakin@gmail.com <p><strong>Introduction:&nbsp;</strong>the prevalence of non-communicable and chronic diseases has been on the increase globally and has been a major factor responsible for high morbidity and mortality. Multimorbidity of the chronic diseases in low/medium income countries should be a major concern for public health practitioners because of the communicable diseases they also battle with. This study was carried out to determine the prevalence of multi-morbidity of chronic diseases of lifestyle (CDL) among adult South Africans. <strong>Methods:&nbsp;</strong>we employed General House Survey (GHS) data released by Statistics South Africa (Stats SA) in December 2015 with a response rate was 90.5%. Data on diabetes mellitus, high cholesterol, stroke, heart attack/myocardial infarction, hypertension were analysed using descriptive and inferential statistics. <strong>Results:&nbsp;</strong>the outcome of this secondary data analysis showed that about 16.3% of South Africans respondents aged 18 years and above had a single/or multiple CDL. The majority of the respondents with CDL were females (10.9%), older adults (9.4%), married (8.5%), of the black racial extract (11.9%), and reside in urban areas (3.4%). Also, high blood pressure (13.7%) was the most reported prevalent chronic disease while heart attack (1.1%) was the least reported chronic disease. The outcome of regression analysis after adjustment showed that gender (OR=0.56, CI=0.53-0.60, p&lt;0.001), age [middle-aged adult(R=0.003, CI=0.003-0.004, p=0.001), older adult (R=0.25, CI=0.23-0.26, p=0.001)] and marital status[divorced (OR=1.55, CI=1.44-1.67, p&lt;0.001), separated (OR=1.71, CI=1.46-2.00, p=0.001), single (R=1.88, CI=1.71-2.07, p=0.001)] were among the correlates of chronic diseases of lifestyle for the 1st step of the adjustment. However, White population group (OR=1.17, CI=0.96-1.41, p=0.113), residing in farm settlement (OR=0.99, CI=0.84-1.16, p=0.910) and all the sub-scales of educational status were not correlates of the CDLs for the 2nd adjustment of regression analysis. <strong>Conclusion:&nbsp;</strong>the findings of the study suggest that CDL is endemic among the South African population and that the most susceptible groups are the older adults, females, the married, the uneducated and the coloured individuals.</p> 2021-04-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238794 Anaphylaxis following rivaroxaban ingestion: report of an extremely rare case 2022-12-22T06:07:50+00:00 Fahmi Yousef Khan fakhanqal@yahoo.co.uk Theeb Osama Sulaiman fakhanqal@yahoo.co.uk <p>We reported an anaphylactic reaction following ingestion of rivaroxaban in a 48-years-old male, who was recently discharged from the hospital as a case of deep vein thrombosis. At home, the patient developed a diffuse itchy skin rash, shortness of breath, and vomiting 30 minutes after rivaroxaban ingestion. Emergency Medical Service found that the patient had severe dyspnea, low blood pressure, and decreased blood oxygen saturation. The patient was given oxygen, intramuscular epinephrine, intravenous hydrocortisone, diphenhydramine, salbutamol nebulizer, and was immediately transferred to the emergency department of Hamad General Hospital. Subcutaneous enoxaparin was initiated, while hydrocortisone and salbutamol nebulizer continued. On the next day, his vital signs had stabilized, and intravenous hydrocortisone was switched to prednisolone tablets, and salbutamol nebulizer was switched to budesonide/salmeterol inhaler, whereas enoxaparin was overlapped with warfarin. After achieving the target international normalized ratio (INR), enoxaparin was discontinued and the patient was discharged with significant clinical and laboratory improvement.</p> 2021-04-06T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238908 Rudy and Borden technique for penile self-mutilation in Klingsor syndrome: a case report 2022-12-23T11:02:20+00:00 Imad Boualaoui imadboualaoui@gmail.com Hicham El Bote imadboualaoui@gmail.com Omar Bellouki imadboualaoui@gmail.com Ahmed Ibrahimi imadboualaoui@gmail.com Hachem El Sayegh imadboualaoui@gmail.com Yassine Nouini imadboualaoui@gmail.com <p>Penile self-mutilation is a challenging situation that often jeopardizes sexual and voiding functions. Surgical treatment is currently based on penile replantation, nevertheless its requirements of time, conservation, and quality of amputated phallus and microsurgical expertise are not constantly available. Here, we present a case of penile self-inflicted amputation in a 28-years-old patient suffering from a psychotic disorder, who did not preserve the amputated phallus. In the first clinical examination, we have attested a hemorrhagic total penile section, 6cm from the penoscrotal angle. We performed immediate surgical management. Rudy and Borden technique is a reconstructive surgery procedure with interesting functional results, by performing a dorsal vascularized split-thickness skin flap to cover the penile shaft. The aim of this technique is to avoid perineostomy which compounds significantly the quality of life.</p> 2021-04-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/238912 Human immunodeficiency virus (HIV) type 1 genetic diversity in HIV positive individuals on antiretroviral therapy in a cross-sectional study conducted in Teso, Western Kenya 2022-12-23T11:11:53+00:00 Maureen Adhiambo adhysmaureen2@yahoo.com Olipher Makwaga adhysmaureen2@yahoo.com Ferdinard Adungo adhysmaureen2@yahoo.com Humphrey Kimani adhysmaureen2@yahoo.com David Hughes Mulama adhysmaureen2@yahoo.com Jackson Cheruiyot Korir adhysmaureen2@yahoo.com Matilu Mwau adhysmaureen2@yahoo.com <p><strong>Introduction:&nbsp;</strong>high HIV-1 infection rates and genetic diversity especially in African population pose significant challenges in HIV-1 clinical management and drug design and development. HIV-1 is a major health challenge in Kenya and causes mortality and morbidity in the country as well as straining the healthcare system and the economy. This study sought to identify HIV-1 genetic subtypes circulating in Teso, Western Kenya which borders the Republic of Uganda. <strong>Methods:&nbsp;</strong>a cross-sectional study was conducted in January 2019 to December 2019. Sequencing of the partial pol gene was carried out on 80 HIV positive individuals on antiretroviral therapy. Subtypes and recombinant forms were generated using the jumping profile hidden Markov model. Alignment of the sequences was done using ClustalW program and phylogenetic tree constructed using MEGA7 neighbor-joining method. <strong>Results:&nbsp;</strong>sixty three samples were successful sequenced. In the analysis of these sequences, it was observed that HIV-1 subtype A1 was predominant 43 (68.3%) followed by D 8 (12.7%) and 1 (1.6%) each of C, G and B and inter-subtype recombinants A1-D 3 (4.8%), A1-B 2 (3.2%) and 1 (1.6%) each of A1-A2, A1-C, BC and BD. Phylogenetic analysis of these sequences showed close clustering of closely related and unrelated sequences with reference sequences. <strong>Conclusion:&nbsp;</strong>there was observed increased genetic diversity of HIV-1 subtypes which not only pose a challenge in disease control and management but also drug design and development. Therefore, there is need for continued surveillance to enhance future understanding of the geographical distribution and transmission patterns of the HIV epidemic.</p> 2021-04-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239047 Vaccination hesitancy among women of reproductive age in resource-challenged settings: a cause for public health concern 2022-12-28T09:04:14+00:00 Grant Murewanhema gmurewanhema@yahoo.com <p>Women of reproductive age are a key population for the control of COVID-19 owing to their levels of socio-economic activities and central role in the upkeep of stable families. Therefore, adequate vaccination uptake in this population is critical. However, this may be negatively affected by circulating rumours regarding SARS-CoV-2 vaccines and subfertility and pregnancy and breastfeeding concerns that have circulated widely on diverse social media. Urgent public health interventions are required to deal with vaccination hesitancy and promote uptake in this key population. This calls for concerted, multidisciplinary and multistakeholder consultative public health forums, public health research and action in the shortest possible period.</p> 2021-04-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239048 Canalicular adenoma of the tongue: report of a unique case 2022-12-28T09:11:00+00:00 Neetu Yadav laneetuy@gmail.com Manisha Khorate laneetuy@gmail.com Nigel Figueiredo laneetuy@gmail.com <p>Canalicular adenoma (CA) is a rare, unique benign salivary gland neoplasm, which usually involves the minor salivary glands of the upper lip, buccal mucosa and palate. It is usually seen in middle-aged or older individuals, has a female predilection, and commonly presents as a painless, slow-growing, non-ulcerated nodule or swelling. Its treatment involves surgical excision or enucleation. This case report describes a case of CA of the ventrum of the tongue diagnosed in a 41-year-old male patient, which could possibly be the first reported case of this lesion involving the tongue.</p> 2021-04-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239049 Giant umbilical hernia: “Lazy M-Omega” flap, a case report 2022-12-28T09:26:40+00:00 Vanesa Villamil vanesa_villamil@yahoo.com.ar Oscar Girón Vallejo vanesa_villamil@yahoo.com.ar Juana María Sánchez Morote vanesa_villamil@yahoo.com.ar Juan Pedro Hernández Bermejo vanesa_villamil@yahoo.com.ar <p>Umbilical hernia, one of the most frequent pathologies in pediatric surgical practice, is usually corrected with a relatively simple intervention, except in cases where there is a major defect, also called proboscoid hernia. We present a case report of a 20-month male patient that underwent surgical intervention of a giant umbilical hernia with the “Lazy-M and Omega” flap novel surgical technique. This technique has to be taken into account in surgical planning, since it is simple and easily reproducible.</p> 2020-10-29T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239051 Abdominal unicentric Castleman´s disease: a case report 2022-12-28T09:46:50+00:00 Samir Bradai bradaisamir78@gmail.com Amal Khsiba bradaisamir78@gmail.com Abdelwaheb Nakhli bradaisamir78@gmail.com Moufida Mahmoudi bradaisamir78@gmail.com Asma Ben Mohamed bradaisamir78@gmail.com Abir Chaabane bradaisamir78@gmail.com Emna Chelbi bradaisamir78@gmail.com Medhioub Mona bradaisamir78@gmail.com Lamine Hamzaoui bradaisamir78@gmail.com Mousadek Azouz bradaisamir78@gmail.com <p>Castleman's disease is a rare disease characterized by benign lymphoepithelial proliferation. There are two forms: unicentric and multicentric Castleman's disease. Mediastinal location is the most frequent. Intra-abdominal Castleman's disease is a rare presentation. We report a case of 65-year-old female who presented with epigastric pain. Investigations revealed a retroperitoneal mass which was surgically resected. Histopathological examination showed hyaline-vascular type Castleman's disease. In conclusion, Castelman´s disease is a diagnostic challenge and it must be included in the differential diagnosis of retroperitoneal tumors.</p> 2021-04-07T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239052 Chronic kidney diseases among homeless and slum dwellers in Accra, Ghana 2022-12-28T10:10:43+00:00 Ahmed Tijani Bawah ysquare2001@gmail.com Foster Edufia ysquare2001@gmail.com Fatima Nasara Yussif ysquare2001@gmail.com Anastasia Adu ysquare2001@gmail.com Yakubu Ayalsuma Yakubu ysquare2001@gmail.com <p><strong>Introduction:&nbsp;</strong>chronic kidney disease is an important risk factor for cardiovascular-related morbidity and death. In Ghana, relatively little is known about the prevalence of chronic kidney disease (CKD) in homeless and slum dwellers in the major cities of the country. This study aimed at determining the prevalence of CKD among homeless people in Nima and Agbogbloshie, Accra, Ghana, and to evaluate the association between socio demographic characteristics and CKD. <strong>Methods:&nbsp;</strong>we recorded information on individuals' socio-demographic characteristics and anthropometric indices, and took blood samples from a total of 512 homeless participants for serum creatinine measurement. Renal function was estimated according to the 4-variable Modification of Diet in Renal Disease (MDRD) and Cockcroft–Gault (C-G) equations. <strong>Results:&nbsp;</strong>participants with normal serum creatinine (SCr), made up of 232 males and 280 females totaling 512 took part in the study. Those with normal glomerular filtration rate (GFR) were 86% and 84.6% by means of the C-G and MDRD equations respectively. According to the C-G formula, kidney damage and mild to severe renal insufficiency was found in 13.2% of the participants and 4 participants (0.8%) had renal failure. On the other hand, 15.4% of the participants were found to have some kidney damage and mild to severe renal insufficiency according to the MDRD formula with no participant suffering from kidney failure. <strong>Conclusion:&nbsp;</strong>the prevalence of CKD among the homeless Ghanaians was significant, especially among those with hypertension, diabetes and human immunodeficiency syndrome virus (HIV) infection.</p> 2021-04-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239055 Coexistence and management of COVID-19 pandemic with other epidemics in West Africa: lessons learnt and policy implications 2022-12-28T10:18:20+00:00 Virgil Kuassi Lokossou vlokossou@wahooas.org Denis Bunyoga vlokossou@wahooas.org Issiaka Sombie vlokossou@wahooas.org Stanley Okolo vlokossou@wahooas.org <p>Since the beginning of the COVID-19 pandemic in West Africa, the region has faced a coexistence of epidemics raising questions about the management of the coexistence between COVID-19 and other epidemic prone diseases. We undertook a cross-sectional study covering the period from February to August 2020 in which an extensive desk review was completed and questionnaire was submitted to National Public Health Institutes. In addition, we conducted online interviews with 10 West African countries to discuss in-depth the strategies and challenges in managing the coexistence of epidemics. Eight epidemics coexisted with COVID-19 in West Africa. These epidemics were yellow fever and measles in five countries; meningitis in 4 countries; vaccine derived poliomyelitis and dengue fever in two countries; Lassa fever, Crimean Congo Hemorrhagic fever and hepatitis E virus in one country. COVID-19 pandemic has brought both positive and negative effects to the management of other epidemics. The management of coexistence was similar in most ECOWAS countries with different incident management systems set up to manage separate outbreaks. The experience in managing the coexistence of epidemics led ECOWAS Regional Center for Surveillance and Disease Control to recommend to member states that they should reinforce regular disease surveillance for seasonal outbreaks and country specific epidemiological diseases profile while not forgetting other emerging and remerging infectious diseases.</p> 2021-04-08T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239057 Giant duodenal lipoma: an unusual cause of gastrointestinal bleeding (a case report) 2022-12-28T10:31:45+00:00 Marouane Baiss rahali.anwar87@gmail.com Anwar Rahali rahali.anwar87@gmail.com Hicham Elmajdoubi rahali.anwar87@gmail.com Jalil Mdaghri rahali.anwar87@gmail.com Khalid Lahlou rahali.anwar87@gmail.com Rahal Mssrouri rahali.anwar87@gmail.com Said Benamr rahali.anwar87@gmail.com Abdellatif Settaf rahali.anwar87@gmail.com <p>Duodenal lipoma is a rare location of visceral lipomas, most are found incidentally via endoscopy or surgery and usually are asymptomatic. We report the case of a 58-year-old patient with an active bleeding duodenal lipoma. Although endoscopic treatment was scheduled initially, surgical intervention ultimately was indicated due to large size of tumor.</p> 2021-04-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239062 Hollow vaginal stent for a case of Mayer-Rokitansky-Kuster-Hauser syndrome: a case report 2022-12-28T10:38:17+00:00 Vikram Murlidhar Belkhode snimonkar@gmail.com Sharayu Vinod Nimonkar snimonkar@gmail.com <p>Congenital vaginal agenesis is a common condition with an instance of 1 in 5000 females. It is usually associated with Mayer-Rokitansky-Kuster Hauser syndrome. Such anomalies have a high impact on the physiology and psychology of patients. A simple approach for the hollowing of the customized vaginal stent prosthesis has been described for the case of Mayer-Rokitansky-Kuster-Hauser syndrome.</p> 2021-04-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239065 Social media and management of COVID-19 in a developing country: the case of Cameroon 2022-12-28T10:48:40+00:00 Valirie Ndip Agbor nvagbor@gmail.com Larissa Pone Simo nvagbor@gmail.com Terrence Beteck Epie nvagbor@gmail.com <p>Since the first reported case of the coronavirus disease 2019 (COVID-19) in Wuhan China, the virus has spread to every continent, including sub-Saharan Africa. There exist no cure or vaccine for COVID-19. Classic public health approaches such as hygiene and sanitation, and social distancing are the recommended measures to contain the spread of the causative virus. While it is possible to combine strict lockdown measures in some western countries, this is not practical in almost every country in sub-Saharan Africa. In Cameroon, those without symptoms are encouraged to respect measures of hygiene and sanitation, physical distancing, and to wear a mask in public places. Those who develop symptoms are isolated in accredited COVID-19 management centres until they recover. However, the latter strategy is ineffective in containing the local spread of the virus because testing is not robust. Intuitively, the control of the virus in Cameroon depends largely on how engaged the public is in fighting against the virus. Social media can complement the use of community health workers for community or public engagement. In this Viewpoint, we discuss how to optimize public engagement, to combat misinformation and to develop a culture for preparedness amidst the COVID-19 pandemic when time and resources are of the essence.</p> 2021-04-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239125 Urétérocèle sur uretère simplex chez l´enfant: aspects cliniques et thérapeutiques 2022-12-30T06:13:16+00:00 Samia Belhassen samia.belhassen@yahoo.fr Aziza Elezzi samia.belhassen@yahoo.fr Saida Hidouri samia.belhassen@yahoo.fr Rachida Laamiri samia.belhassen@yahoo.fr Sana Mosbahi samia.belhassen@yahoo.fr Amine Ksiaa samia.belhassen@yahoo.fr Lassad Sahnoun samia.belhassen@yahoo.fr Mongi Mekki samia.belhassen@yahoo.fr Mohsen Belguith samia.belhassen@yahoo.fr <p>L´urétérocèle est une dilatation pseudo-kystique de l´uretère terminal sous muqueux. C´est une uropathie malformative rare surtout si elle survient sur un uretère simplex. Il s´agit d´une étude rétrospective menée sur dix ans, de 12 dossiers de malades colligés au Service de Chirurgie Pédiatrique de l´Hôpital Fattouma Bourguiba de Monastir entre 2006 et 2016. L´âge moyen de nos malades est de 2,7 ans avec des limites allant de 7 jours à 11 ans, le sex ratio est de 1. Le tableau clinique a été dominé par la fièvre en rapport avec une infection urinaire haute. Le diagnostic a été posé essentiellement par l´échographie rénale et vésicale, l´urographie intraveineuse (UIV) et l´uréthro-cystographie rétrograde (UCR). L´urétérocèle était unilatéral dans 10 cas et bilatérale dans 2 cas soit un total de 14 cas d´urétérocèles. Tous ont été sur uretère simplex et ont été opérées par voie endoscopique. Aucun incident peropératoire n´a été noté. Les suites opératoires étaient simples. Une amélioration clinique et radiologique a été obtenue dans tous les cas. L´urétérocèle sur uretère simplex est une malformation urinaire très rare. Non diagnostiquée à temps, elle peut retentir sur le haut appareil. Le traitement endoscopique est une alternative séduisante avec des résultats satisfaisants.</p> 2021-04-09T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239126 Neuropsychological and behavioral disorders, functional outcomes and quality of life in traumatic brain injury victims 2022-12-30T06:23:43+00:00 Ghroubi Sameh habib.eleuch@ymail.com Feki Islem habib.eleuch@ymail.com Alila Samar habib.eleuch@ymail.com Chelly Hedi habib.eleuch@ymail.com Bouaziz Mounir habib.eleuch@ymail.com Elleuch Mohamed Habib habib.eleuch@ymail.com <p><strong>Introduction:&nbsp;</strong>the assessment of neuropsychological and behavioral disorders outcomes, functional outcomes and quality of life in traumatic brain injury victims. It was also to evaluate initial means of care provided to these patients. Finally, to study correlations between neuropsychological and behavioral disorders with demographic characteristics, injury severity, functional status and quality of life. <strong>Methods:&nbsp;</strong>it was a cross-sectional study including 50 patients with traumatic brain injury conducted in the physical medicine and rehabilitation department of Sfax. Memory disorders were tested by the mini mental state and the Glaveston orientation and amnesia tests. Executive functions were evaluated by the dysexecutive function scale. The psychological profile was evaluated using the hospital anxiety and depression scale and behavioral disorders were tested by the agitated behavior scale. Glasgow outcome scale has allowed the assessment of traumatic brain injury severity in terms of disability. Otherwise, functional capacity was measured by functional independence measure scale. Finally, health-related quality of life was measured using a generic measure (short-form-36) and the QOLIBRI scales. <strong>Results:&nbsp;</strong>abnormal executive functions were noted in 41 patients (82%) with a dysexcutive function average score of 33.20 ± 22.74. About psychological profile, depressive symptoms were found in 32 patients (64%). Moreover anxiety was noted in 20 patients (40%). Behavioral disorders such as aggressiveness and agitation were noted respectively in 32 (64%) and 8 patients (16%). The global social functional evolution was considered as unfavorable in 42% of the patients and favorable in 58%. Regarding to functional independence measure scale, 92% of the victims showed impairment. Memory impairment and abnormal executive functions were statistically correlated with traumatic brain injury severity. Elementary brain injury lesions shown on computed tomography were correlated with memory disorders especially for temporal, cortical brain contusion and diffuse axonal injury. Our study showed that patients with severe memory impairment, abnormal executive functions and depressive mood had significant functional. <strong>Conclusion:&nbsp;</strong>the executive function disorders, depressed mood and the memory disorders seemed to be the most frequent among neuropsychological disorders in traumatic brain injury. We noted that it is so important to evaluate neuropsychological disorders in traumatic brain injury because they were underestimated. We have already started this experience despite the lack of means in our department. The evaluation of the executive function in addition to the classic neuropsychological assessment is essential to propose efficient means of rehabilitation.</p> 2020-04-11T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239127 Pectus excavatum with brugada phenocopy electrocardiogram 2022-12-30T06:28:06+00:00 Ng Kian Seng sars2509@gmail.com Sarvesh Seger sars2509@gmail.com <p>A 17-year-old male consulted us because he had a "bizarre ECG". The patient was asymptomatic and the electrocardiogram (ECG) was part of a medical examination. Patient had no history of nonvasovagal syncope. There was no history of sudden cardiac death or Brugada syndrome in family members. Examination revealed a prominent pectus excavatum and there was no other skeletal or connective tissue abnormality. The chest radiograph was consistent with the diagnosis of pectus excavatum. The ECG showed deep negative P-wave in lead V1. The rSR' pattern (a partial right bundle branch block) in leads V1, V2 is followed by a rectilinear ST segment which slopes down into an inverted T-wave. Leads V 1-2 are reminiscent of the rectilinear type of Brugada syndrome. V3 does not have a partial right bundle branch block (RBBB) morphology; the coved ST terminates in a T-wave inversion (TWI). Brugada phenocopies are clinical entities characterized by an ECG pattern that is very similar to true Brugada syndrome but are elicited by other conditions. Such entities include electrolyte abnormalities, myocardial ischemia, pericarditis, myocarditis and pulmonary embolism. The Brugada phenocopy ECG pattern resolves after correction or amelioration of the underlying condition. It is believed that mechanical mediastinal compression from pectus excavatum onto the right ventricle causes changes in the right ventricular outflow tract (RVOT) resulting in the ECG abnormalities that mimic a Brugada syndrome.</p> 2021-04-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239128 Le Dieu des pauvres: socio-anthropologie de la résistance des villes Camerounaises à la COVID-19 2022-12-30T06:40:54+00:00 Amada Talikoa talikoajunior@gmail.com Rose-Danielle Ngoumou talikoajunior@gmail.com <p><strong>Introduction:&nbsp;</strong>la COVID-19, depuis son apparition a épuisé les systèmes sanitaires mondiaux. Il était prévisible que les pays avec un système sanitaire peu solide se verront gravement anéantis par la pandémie. Les pays d´Europe ont connu des pertes humaines importantes et on prévoyait que l´Afrique connaitrai un drame encore plus pire. Seulement depuis l´évolution de cette pandémie, on assiste à une remarquable résistance des pays d´Afrique et du Cameroun face à ce virus, comme s´ils vivaient en marge du monde. <strong>Méthodes:&nbsp;</strong>l´étude a été phénoménographique. Les données ont été collectées, de façon successive, des observations de médias (notamment les sites de l´OMS, télévisions Crtv (l´émission Parlons COVID), des réseaux sociaux (Facebook et Whatsapp) et des observations directes de quelques quartiers de Garoua (Roumdé-Adjia, Foulbéré, Kakataré) et Mora pour l´Extême-Nord, et la zone Sud de Yaoundé (Ngoa-Ekelé, Nkolondom, Mokolo). Ces observations ont été associées aux entretiens individuels, recensions et prises de notes aux abords des lieux de circulation publique (lieux de culte, marchés et les espaces de causerie; les Faada). Le cadre théorique mobilisé est la théorie du fonctionnalisme. <strong>Résultats:&nbsp;</strong>les résultats montrent que les Camerounais perçoivent la pandémie comme un phénomène éminemment métasocial ce qui explique leur tendance à utiliser la prière, « la nature » pour contrer cette attaque. <strong>Conclusion:&nbsp;</strong>une approche multidimensionnelle est capable d´offrir des voies de « libération ». Aussi, l´étude soulève une fois de plus la place de la médecine traditionnelle dans les systèmes sanitaires et montre le lien étroit qui existe entre la médecine traditionnelle et la spiritualité.</p> 2021-04-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239129 Cerebral nocardiosis with osteomyelitis of skull vault complicating a primary neck lesion in an immunocompetent patient: a case report 2022-12-30T06:51:13+00:00 Wafa Marrakchi marrakchiwafa02@gmail.com Abir Aouam marrakchiwafa02@gmail.com Ikbel Kooli marrakchiwafa02@gmail.com Hajer Ben Brahim marrakchiwafa02@gmail.com Adnene Toumi marrakchiwafa02@gmail.com <p>Nocardia infection is an uncommon and rare condition in immunocompetent patient. A case of cutaneous nocardiosis complicated with osteomyelitis of the vault scalp in a 64-year-old man, with no remarkable past medical history, is reported. Treatment with trimethoprime-sulfamethoxazole than doxycycline for 12 months led to complete resolution and no evidence of recurrence was noted. Nocardia infection should be considered even in immunocomptent patients and doxycycline is a good alternative for treatment.</p> 2021-04-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239131 Knowledge, attitude and control practices of sickle cell diseases among senior secondary students in Osun State, Nigeria 2022-12-30T07:13:56+00:00 Adeyemo Deborah Oluwadamilola akinrenitemidayo@gmail.com Temidayo Ifeoluwa Akinreni akinrenitemidayo@gmail.com Moshood Adekunle Adefisan akinrenitemidayo@gmail.com Seun Deborah Olayiwola akinrenitemidayo@gmail.com <p><strong>Introduction:&nbsp;</strong>sickle cell disease is one of the greatest public health problems of this age. This study was conducted to assess the knowledge, attitude and control practices on sickle cell disease (SCD) among selected secondary school students in Osun State, Nigeria. <strong>Methods:&nbsp;</strong>a descriptive cross sectional study involved 420 secondary school students within Osogbo Metropolis selected by a multistage stratified sampling technique, using self-administered structured questionnaire. Data were collected using pre-tested self-administered semi structured questionnaire. Data were analyzed using SPSS version 20. <strong>Results:&nbsp;</strong>a total of 420 students were interviewed, modal age range 15-20 years. There were more females (55%) than males (45%). Majority of them were Christians (57.1%). A larger percentage of the respondents were aware of SCD (58.5%). However, comprehensive knowledge as regards the various genotypes related to SCD, tests to be done for genotype screening among the respondents is low. One third of the respondents had positive attitude towards SCD (65%) and nearly one half (48%) of the respondents had bad control practices. <strong>Conclusion:&nbsp;</strong>findings in this study shows a high level of general awareness on SCD, even though comprehensive knowledge as regards the various genotype related to SCD, tests to be done for genotype screening among others is low. The need to improve on their attitude and practice towards the disease is highly recommended because having a good knowledge is not as important as applying the knowledge in a way to stop the spread of the disease.</p> 2021-04-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239132 Predictors of death in severe COVID-19 patients at millennium COVID-19 care center in Ethiopia: a case-control study 2022-12-30T07:25:26+00:00 Tigist Workneh Leulseged tigdolly@gmail.com Endalkachew Hailu Maru tigdolly@gmail.com Ishmael Shemsedin Hassen tigdolly@gmail.com Wuletaw Chane Zewde tigdolly@gmail.com Negat Woldehawariat Chamiso tigdolly@gmail.com Daniel Simeneh Abebe tigdolly@gmail.com Tariku Bahiru Jagema tigdolly@gmail.com Abdi Bekele Bayisa tigdolly@gmail.com Mesfin Abebe Gezahegn tigdolly@gmail.com Oli Seyoum Tefera tigdolly@gmail.com Wondmagegn Genaneh Shiferaw tigdolly@gmail.com Teketel Tilahun Admasu tigdolly@gmail.com <p><strong>Introduction:&nbsp;</strong>as the number of new cases and death due to COVID-19 is increasing, understanding the characteristics of severe COVID-19 patients and identifying characteristics that lead to death is a key to make an informed decision. In Ethiopia, as of September 27<sup>th</sup> 2020, a total of 72,700 cases and 1165 deaths were reported. Therefore, the study aimed to assess the determinants of death in severe COVID-19 patients admitted to millennium COVID-19 care center in Ethiopia.&nbsp;<strong>Methods:&nbsp;</strong>a case-control study of 147 severe COVID-19 patients (49 deaths and 98 discharged alive cases) was conducted from August to September 2020. A comparison of underlying characteristics between cases (death) and controls (alive) was assessed using a chi-square test and an independent t-test with a p-value of &lt;0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to identify predictors of severe COVID-19 outcome (alive vs death) where adjusted odds ratio (AOR), 95% confidence interval (CIs) for AOR, and P-values were used for testing significance and interpretation of results. <strong>Results:&nbsp;</strong>having diabetes mellitus (AOR= 3.257, 95%CI=1.348,7.867, p-value &lt;0.001), fever (AOR=0.328, 95%CI= 0.123,0.878, p-value=0.027) and shortness of breath (AOR=4.034, 95%CI=1.481,10.988, p-value=0.006) were found to be significant predictors of death in severe COVID-19 patients. <strong>Conclusion:&nbsp;</strong>the outcome of death in severe COVID-19 patients is found to be associated with exposures to being diabetic and having shortness of breath at admission. On the other hand, having a fever at admission was associated with a favorable outcome of being discharged alive.</p> 2021-04-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239135 Undernutrition among under-five indigenous Mbororo children in the Foumban and Galim health districts of Cameroon: a cross-sectional study 2022-12-30T07:31:57+00:00 Florence Titu Manjong nsaghads@hotmail.com Vincent Siysi Verla nsaghads@hotmail.com Thomas Obinchemti Egbe nsaghads@hotmail.com Dickson Shey Nsagha nsaghads@hotmail.com <p><strong>Introduction:&nbsp;</strong>despite increasing research interest on Indigenous peoples´ health worldwide, the nutritional status of Indigenous children in Cameroon remains unknown. This study was conducted to assess the prevalence of stunting, wasting, and underweight among under-five Indigenous Mbororo children in the Foumban and Galim health districts of the West Region. <strong>Methods:&nbsp;</strong>a cross-sectional study was conducted involving 472 child-caregiver pairs from 16 Mbororo Communities in the Foumban and Galim health districts. Interviewer-administered questionnaires were used for data collection. Anthropometric measurements were collected using standard procedures. Socio-demographic data were analyzed using descriptive statistics. Anthropometric indices: height-for-age, weight-for-height, and weight-for-age - z-scores were analyzed using z-score 06 Stata version 11 and compared with World Health Organization growth reference standards. Ethical approval was obtained from the Faculty of Health Sciences Institutional Review Board of the University of Buea. <strong>Results:&nbsp;</strong>overall prevalence of stunting, wasting and underweight were 55.08% (95% CI: 50.5-59.58), 13.77% (95% CI: 10.65-16.89), and 31.99% (95% CI: 27.76-36.21), respectively. Severe stunting, wasting and underweight were 34.53% (95% CI: 30.22-38.83), 3.18% (95% CI: 1.58-4.76), and 10.59% (95% CI: 7.80-13.37), respectively. Rates of stunting, wasting and underweight for female and male were: 56.88% and 52.71%; 12.38% and 14.72%; and 30.73% and 32.55%, respectively. Stunting, wasting and underweight rates varied with child age. <strong>Conclusion:&nbsp;</strong>the prevalence of undernutrition was high, indicating a serious public health problem and the necessity for strategies to ensure the optimal health of the target population.</p> 2021-04-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239136 Duplication digestive: à propos d´un cas néonatal 2022-12-30T07:43:58+00:00 Cyrine Belghith cyrinebelghith2812@gmail.com Sawssam Armi cyrinebelghith2812@gmail.com Souhir Najar cyrinebelghith2812@gmail.com Nahla Ben Saada cyrinebelghith2812@gmail.com Tahar Makhlouf cyrinebelghith2812@gmail.com Nabil Mathlouthi cyrinebelghith2812@gmail.com Olfa Slimani cyrinebelghith2812@gmail.com Leila Attia cyrinebelghith2812@gmail.com <p>Les duplications digestives sont définies comme des malformations tubulaires ou kystiques, siégeant sur un segment du tube digestif, de la cavité buccale à l´anus. Elles représentent une entité rare. Le diagnostic anténatal est possible quand il s´agit d´une forme kystique volumineuse. Nous rapportons le cas d´une patiente de 33 ans, primipare sans antécédents médicaux ou chirurgicaux dont la grossesse était mal suivie. Une seule échographie faite à 8 semaines d´aménorrhée (SA). Au cours du troisième trimestre l'examen échographique a montré une image kystique anéchogène de 3cm, à paroi propre, hautement situé dans le pelvis, non vascularisée. Cette image paraît de localisation antérieure, indépendante des reins et de la vessie. Afin de mieux explorer cette image et ses caractéristiques, une imagerie par résonance magnétique (IRM) fœtale a été réalisée montrant une image kystique à paroi propre, bien limitée, venant au contact des anses grêliques sur le versant mésentérique. Le diagnostic d´une duplication digestive a été fortement consolidé. L´accouchement s´est déroulé sans incidents par voie haute à 39 SA pour infertilité primaire de 7 ans. L´échographie post-natale a renforcé cette hypothèse, en montrant une formation kystique au niveau de l´hypochondre gauche, de 45 mm x 19 mm, multi cloisonnée, pouvant cadrer avec une duplication digestive. Le nouveau-né a été adressé à la consultation externe de chirurgie pédiatrique pour meilleure prise en charge et programmation d´un acte chirurgical dans les premiers 6 mois. La découverte d´une image fœtale kystique anéchogène pose le problème du diagnostic étiologique d´une part et du suivi et prise en charge post-natale d´autre part.</p> 2021-04-12T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/239137 Giant hepatic hemangioma: a challenging diagnosis 2022-12-30T07:53:27+00:00 Sana Landolsi sanalandolsi9@gmail.com Imène Ridène sanalandolsi9@gmail.com <p>A 50-year-old man without medical history, complained about effort dyspnea with enlargement of the abdomen. Physical examination showed an enlarged liver reaching the right and the left iliac fossa with a collateral venous circulation. Biological exams were within normal ranges. Hepatitis B and C serologies were negative. Abdominal computed tomography and magnetic resonance imaging demonstrated an enlarged liver of 36 cm in diameter. Multiple heterogenous bilateral liver masses with enhancement after contrast intravenous injection were shown.The largest one with 26 cm in diameter was located in the left liver. A dense collateral venous circulation existed. A diagnostic percutaneous biopsy was made. Histopathological exam concluded to giant cavernous cavernoma. Since the surgery was risky especially hemorrhage, a percutaneous embolization for the largest mass was indicated.</p> 2021-04-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241198 Seroprevalence of hepatitis B and associated factors among inmates: a cross sectional study in the Douala New Bell Prison, Cameroon 2023-02-09T07:23:11+00:00 Mathurin Pierre Kowo kowomathurinp@yahoo.fr Firmin Ankouane Andoulo kowomathurinp@yahoo.fr Daniel Tchamdeu Sizimboue kowomathurinp@yahoo.fr Antonin Wilson Ndjitoyap Ndam kowomathurinp@yahoo.fr Larry Tangie Ngek kowomathurinp@yahoo.fr Charles Kouanfack kowomathurinp@yahoo.fr Hubert Leundji kowomathurinp@yahoo.fr Rocard Djanteng kowomathurinp@yahoo.fr Bruno Ela Ondo kowomathurinp@yahoo.fr Judith Ndongo Torimiro kowomathurinp@yahoo.fr Elie-Claude Ndjitoyap Ndam kowomathurinp@yahoo.fr Oudou Njoya kowomathurinp@yahoo.fr <p><strong>Introduction:&nbsp;</strong>in Cameroon, data on viral hepatitis B infection in prison environments is limited. We determined the prevalence of hepatitis B infection (HBV) and correlates among prisoners incarcerated at the Douala New Bell Central Prison in Cameroon.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional study carried out in July 2018 and included 940 randomly selected prisoners. Data were collected using pre-tested questionnaire while blood screening for HBV surface antigen (HBs Ag) used rapid test, with confirmation via Elisa test. Sociodemographic characteristics and risk factors were compared among the three age groups with respect to the prison's partitioning. Factors associated with positive HBs Ag were identified using logistic regression adjusted to age and gender. Confounders were then excluded by logistic multivariate analysis. All p values less than 0.05 were considered statistically significant.</p> <p><strong>Results:&nbsp;</strong>of the 940 prisoners selected, 94% were male. The mean age of the study population was 33.81 ± 10.35 years. The median duration of incarceration and median number of incarcerations were 12 months (IQR:5-36) and 1 (IQR:1-2) respectively. HBV prevalence was 12.9% (95% CI: 10.7-15%). The use of non-injectable illicit drugs (OR:3.5; 95% CI:1.9-6.2; P&lt;0.001), sharing of needle or razors (aOR:24.1; 95% CI: 12.9-45.0; P&lt;0.001), sharing of tooth brushes(aOR:2.7; 95% CI:0.9-7.4) (P=0.053), having tattoos or piercings (aOR:1.9; 95% CI:1.1-3.1; P=0.01) were significantly associated with HBs Ag seropositivity.</p> <p><strong>Conclusion:&nbsp;</strong>prisoners in this setting had a high prevalence of HBV and related risk factors. These findings highlight an urgent need to implement control strategies and programs that reach people in detention centers in Cameroon.</p> 2021-04-13T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241199 Pharyngeal-cervical-brachial variant of Guillain-Barré syndrome: a case report of a rare complication following Dengue-Chikungunya co-infection 2023-02-09T07:24:57+00:00 Osama Mohiuddin anosh.9412@gmail.com Anosh Aslam Khan anosh.9412@gmail.com Syed Hamza Bin Waqar anosh.9412@gmail.com Ali Tariq Shaikh anosh.9412@gmail.com Momina Mariam Marufi anosh.9412@gmail.com Sumeen Jalees anosh.9412@gmail.com Farah Yasmin anosh.9412@gmail.com <p>Pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré Syndrome (GBS) is characterized by weakness in cervicobrachial and oropharyngeal region, together with areflexia of upper limbs. Being an uncommon variant, it is often misdiagnosed as other neurological conditions resembling GBS. Although most of the cases occur as a post-infectious complication, no reports describing its development following dengue-chikungunya co-infection have been documented. A young female presented with a progressive history of swallowing difficulty, bilateral arm weakness and neck weakness. Three weeks earlier, she was presented with clinical features corresponding to dengue and was symptomatically treated. Currently, hypotonia and decreased muscle strength were observed in both upper limbs and neck. Detailed investigation revealed the presence of Immunoglobulin M (IgM) antibodies against dengue antigen (NS 1) and Chikungunya virus (CHIKV), confirming the possibility of previous dengue-chikungunya co-infection. Nerve conduction studies and electromyography of upper limbs pointed towards findings consistent with the early stages of acute motor demyelinating and possible axonal neuropathy. The detection of antiganglioside antibodies (anti-GT1a antibodies), confirmed the diagnosis of the pharyngeal-cervical-brachial variant of GBS. A five days treatment of intravenous immunoglobulin (IVIG) along with physical rehabilitation was started which led to significant improvement and the patient was discharged after 15 days. PCB is an unfamiliar variant of GBS for many clinicians. Diagnosis can be made by a thorough history, clinical examination and investigations that can rule out other potential causes of cervicobrachial and oropharyngeal weakness. It also necessitates careful monitoring and followups after mono- and co-arboviral infections to prevent any debilitating neurological complications.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241200 Disparities in knowledge, attitude, and practices of infection prevention and control of Lassa fever among health care workers at The Federal Medical Centre, Owo, Ondo State, Nigeria 2023-02-09T07:29:53+00:00 Victor Okoliko Ukwenya voukwenya@futa.edu.ng Temiloluwa Adeola Fuwape voukwenya@futa.edu.ng Tokunbo Ibukun Fadahunsi voukwenya@futa.edu.ng Olayinka Stephen Ilesanmi voukwenya@futa.edu.ng <p><strong>Introduction:&nbsp;</strong>the knowledge and practices on Lassa fever (LF) infection prevention and control (IPC) remains poor among health workers in Nigeria despite LF endemicity. This study aimed to evaluate the knowledge, attitude, and practices of healthcare workers at the Federal Medical Centre, Owo towards LF.</p> <p><strong>Methods:&nbsp;</strong>this was a cross-sectional study among 451 healthcare workers who were enrolled using a simple random sampling technique. Data were collected using a semi-structured interviewer-administered questionnaire and analyzed with SPSS version 23. Adequate knowledge, positive attitude, and good practice of LF infection, prevention, and control were determined by the proportion of respondents who scored &gt;80% in each category. Descriptive statistics were done. Associations were explored using Chi-square tests.</p> <p><strong>Results:&nbsp;</strong>the mean age of respondents was 37.95±8.43 years, and 169 (37.5%) were doctors. The mean overall knowledge score was 18.33±2.14, and 236 (52.3%) had appropriate knowledge, 109 (24.2%) had a positive attitude, while 351 (77.8%) demonstrated adequate preventive practices towards LFIPC. Laboratory scientists had five times the odds of appropriate knowledge of LF IPC (OR=4.886; 95%CI: 1.580-15.107). Pharmacists had ten times odds of positive attitude towards LF IPC (OR=10.093; 95%CI= 1.055-95.516). Pharmacists had nine times odds of good LF IPC practices (OR=8.755; 95%CI=1.028-74.531).</p> <p><strong>Conclusion:&nbsp;</strong>disparities in knowledge, attitude, and practices of LF IPC exist among healthcare workers. To strengthen IPC, intervention strategies like training to address such gaps are needed.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241201 Gonorrhea vaginitis in a pediatric patient: a case report 2023-02-09T07:33:11+00:00 Ayu Wulansari Bambang ayuwulansaribambang21@gmail.com Idrianti Idrus ayuwulansaribambang21@gmail.com Safruddin Amin ayuwulansaribambang21@gmail.com Muji Iswanty ayuwulansaribambang21@gmail.com <p>Gonorrhea is all diseases caused by&nbsp;<em>Neisseria gonorrhoeae</em>. Prepubertal child is more susceptible to&nbsp;<em>N. gonorrhoeae</em>&nbsp;infection because the vagina is alkaline and contains no estrogen. Gonorrhea vaginitis is the most common form of gonorrhoea in prepubertal children beyond neonatal period. Transmission in child can be through sexual contact (abuse) or non-sexual contact. Gonorrhea vaginitis in children more often asymptomatic, with clinical manifestation such as mucopurulent discharge, vaginal pruritus and vulval erythema. Supporting examination comprise of gram staining from vaginal discharge, culture and nucleic acid amplification testing (NAAT). Ceftriaxone is drug of choice gonorrhea without complication in children. We report a case of 4 year and 9-month female girl that was diagnosed by history taking and supporting examination from gram staining and polymerase chain reaction (PCR) from vaginal discharge, and then treated with single dose ceftriaxone 125 mg intramuscular that gave clinical improvement.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241203 Predictive echocardiographic factors of severe obstructive sleep apnea 2023-02-09T07:40:14+00:00 Imen Touil hassenibnhadjamor@yahoo.fr Hassen Ibn Hadj Amor hassenibnhadjamor@yahoo.fr Melek Kechida hassenibnhadjamor@yahoo.fr Nadia Keskes Boudawara hassenibnhadjamor@yahoo.fr Yosra Brahem hassenibnhadjamor@yahoo.fr Soumaya Bouchareb hassenibnhadjamor@yahoo.fr Mohamed Taha Hasnaoui hassenibnhadjamor@yahoo.fr Leila Boussoffara hassenibnhadjamor@yahoo.fr Jalel Knani hassenibnhadjamor@yahoo.fr <p><strong>Introduction:&nbsp;</strong>obstructive sleep apnea (OSA) is a common chronic pulmonary disease, characterized by repetitive collapse of the upper respiratory airways, leading to oxygen desaturation. This condition is recognized to be associated with cardiovascular disease. Several studies have shown the effects of OSA on both geometry and cardiac function, with conflicting results. We aimed to investigate the relationship between echocardiographic abnormalities and the severity of OSA.</p> <p><strong>Methods:&nbsp;</strong>this is a cross-sectional single center study including patients, without any cardiovascular or pulmonary comorbidities, with polygraphy proven OSA. All participants underwent a detailed transthoracic echocardiography (TTE).</p> <p><strong>Results:&nbsp;</strong>a total of 93 patients were included in the study, with 62.2% (n=56) females. According to the apnea hypopnea index (AHI), patients were divided into two groups: mild to moderate OSA (5≤ AHI&lt; 30/H) and severe OSA (AHI≥ 30/H). There were no differences in baseline characteristics between the two groups. The assessment of echocardiographic parameters demonstrated that severe OSA have a higher left ventricular end-systolic (LVES) (47.6±7.2 VS 46.2±4.7), left ventricular end-diastolic (LVED) (31.3±6.2 VS 28.9±4.5) diameters and interventricular septum (IVS) thickness (12.7±2.4 VS11.7±2.5) diameters rather than mild to moderate OSA without a significant difference between the two groups. Furthermore, severe OSA patients had lower mean value of left ventricular ejection fraction (LVEF) and fractional shortening (FS) equal to 62.1±9.7 and 32.5±6.3 respectively. The difference between the two groups was not statistically significant. However, a significant association was shown between severity of OSA and left ventricular (LV) diastolic dysfunction, right ventricular internal diameter (RVID) and systolic pulmonary artery pressure (sPAP), with p=0.05, p=0.05 and p= 0.03 respectively. The RVID was also independently associated to the severity of the OSA (aOR 1.33, 95%CI:0.99-1.79; p=0.05).</p> <p><strong>Conclusion:&nbsp;</strong>using bidimensional echocardiography showed a relationship between severe OSA and right ventricular parameters (diastolic dysfunction and RVID) and sPAP.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241204 Comments on “Ileosigmoid knot in a patient with Down syndrome: a unique surgical emergency” by Boussaidane S et al. (Pan Afr Med J. 2021;38: 8) 2023-02-09T07:40:38+00:00 Sabri Selcuk Atamanalp ssa@atauni.edu.tr <p>Ileosigmoid knotting (ISK) is the wrapping of ileum or sigmoid colon around the other structure causing a double-loop intestinal obstruction. Both ISK and ISK complicating mental retardation are very rare clinical entities. In this commentary, I would like to discuss some details of ISK complicating mental retardation regarding to a published paper in The Pan African Medical Journal.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241205 Prevalence and factors associated with anaemia in pregnant women in Cascades Region of Burkina Faso in 2012 2023-02-09T07:48:16+00:00 Bernard Ilboudo bernardilboudo@gmail.com Isidore Traoré bernardilboudo@gmail.com Clément Zemlé Méda bernardilboudo@gmail.com Alain Hien bernardilboudo@gmail.com Maurice Kinda bernardilboudo@gmail.com Michèle Dramaix-Wilmet bernardilboudo@gmail.com Léon Gueswendé Blaise Savadogo bernardilboudo@gmail.com Philippe Donnen bernardilboudo@gmail.com <p><strong>Introduction:&nbsp;</strong>anaemia in pregnancy is a public health concern in Burkina Faso. This study aims at identifying the factors associated with the prevalence of anaemia in pregnant women at a regional level in Burkina Faso.</p> <p><strong>Methods:&nbsp;</strong>we conducted a cross-sectional study in the region called “Cascades”, located at the Western part of Burkina Faso. The study population included all pregnant women who attended antenatal care clinics in all public peripheral health facilities (districts) between May and June 2012 and agreed to participate in the study. They provided blood sample from which we measured the haemoglobin concentration using the Hemocue® system. The factors associated with anaemia in the study population were identified through multiple logistic regressions.</p> <p><strong>Results:&nbsp;</strong>the prevalence (95% CI) of anaemia in pregnancy in the Cascades region was 58.9% (56.6% - 61.2%). Anaemia in pregnancy was more common in district of Banfora (OR = 1.40; 95% CI: 1.07-1.83), among housewives (OR = 2.96; 95% CI: 1.10-8.0), in the Mossi ethnic group (OR = 1.39; 95% CI: 1.04-1.85) and among the wives of farmers and artisans (OR = 2.55; 95% CI: 1.59-4.07). Anaemia in pregnancy was less frequent among women who drank local beer (OR = 0.68; 95% CI: 0.49-0.94).</p> <p><strong>Conclusion:&nbsp;</strong>the prevalence of anaemia in pregnancy is high in Burkina Faso. Improving women's income level may contribute to reduce it. Further studies are needed to elucidate the link between the consumption of local beer, the local diet practices and anaemia in pregnant women.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241206 Association between latent tuberculosis and ischemic heart disease: a hospital-based cross-sectional study from Saudi Arabia 2023-02-09T07:48:22+00:00 Emad Ali Al Khoufi emadco2@yahoo.com <p><strong>Introduction:&nbsp;</strong>atherosclerosis could be a sequela of long-term activation of cell-mediated immunity as the case of latent tuberculosis infection. Atherosclerosis is the main pathological event in ischemic heart disease. The present study aimed to assess the prevalence of Latent tuberculosis infection (LTBI) among patients with ischemic heart disease (IHD) and to detect the association between both diseases. <strong>Methods:&nbsp;</strong>this cross-sectional study included 98 patients with a history of previously diagnosed ischemic heart disease who did a multi-detector computed tomography coronary angiogram (MDCTCA). Detailed clinical examination and investigations as chest X-ray and sputum examination were done for those with positive QuantiFERON-TB Gold test (QFT) to exclude active tuberculosis (TB). Participants having positive QFT results but with no evidence of active TB were considered as LTBI positive. <strong>Results:&nbsp;</strong>the prevalence of LTBI in patients with IHD was 19.3% as only nineteen of the ninety-eight patients were diagnosed with latent tuberculosis infection using the QuantiFERON serum test. Eighty-four percent (84.2%) of patients with LTBI had coronary artery atherosclerosis (CAA) compared to only 55.6% in patients without LTBI with a statistically significant difference. In multivariable analysis, Diabetes Mellitus (DM) (AOR 0.179, 95% C.I.:0.03-0.967), and LTBI (AOR 1.024, 95% C.I.:1.002-1.736) were significantly associated with coronary artery atherosclerosis (p=0.0001, and p= 0.003 respectively). <strong>Conclusion:&nbsp;</strong>the prevalence of latent tuberculosis infection among patients with ischemic heart diseases is high. Among different factors that are already well known to precipitate ischemic heart disease, latent tuberculosis should be considered.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241207 Outcomes of distal femoral fractures treated with dynamic condylar screw (DCS) plate system: a single centre experience spanning 15 years 2023-02-09T07:53:02+00:00 Meryem Lemsanni lemsani.meryam@hotmail.com Youssef Najeb lemsani.meryam@hotmail.com <p><strong>Introduction:&nbsp;</strong>the dynamic condylar screw (DCS) plate is an angular stable fixation (95°) system for distal femur fractures that allows for the ability to apply compression across the femoral condyles. The aim of this study was to evaluate our experience treating distal femur fractures with this device and give the long-term outcome.</p> <p><strong>Methods:&nbsp;</strong>a retrospective study was undertaken in our institution during the period from January 2002 to December 2016. A total number of 240 patients with distal femur fractures were managed using DCS plate system and included in the study. The mean follow-up period was 33 months (26 - 62 months). Clinico-radiological progression of fracture union as well as the functional outcome was studied.</p> <p><strong>Results:&nbsp;</strong>most of the fractures were closed injuries in young male patients resulting from traffic accidents. The average time to union was 12.6 weeks (range 11 - 23). Eight patients (3.3%) suffered superficial infection. Five patients (2.1%) developed deep venous thrombosis. Delayed union was observed in nine cases (3.7%) and non union in six cases (2.5%). At final follow-up, the mean range of motion (ROM) of knee was 115.7° (100°-148°). The mean Knee Society Score (KSS) was 84.5 (59 - 94) and the mean Lysholm score was 88.6 (range, 61 - 96), translating to good clinical results.</p> <p><strong>Conclusion:&nbsp;</strong>our study conclusively establishes that excellent functional outcome can be achieved with DCS plate inserted with skilled surgical technique in distal femur fractures including the ones that are communited or occurring in osteoporotic bone with a negligible complication rates.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241208 Knowledge, attitude and practice of kangaroo mother care among mothers in the neonatal wards of a tertiary care center 2023-02-09T07:57:00+00:00 Olubukola Olawuyi beatriceezenwa@yahoo.com Beatrice Nkolika Ezenwa beatriceezenwa@yahoo.com Iretiola Bamikeolu Fajolu beatriceezenwa@yahoo.com Mercy Onwuama beatriceezenwa@yahoo.com Chinyere Veronica Ezeaka beatriceezenwa@yahoo.com <p><strong>Introduction:&nbsp;</strong>approximately 1 million children die each year due to complications of preterm birth, with the major contributor to mortality being hypothermia. Kangaroo mother care (KMC) is an effective and low-cost technique which prevents the neonate from hypothermia. The mother uses her body temperature to keep the infant warm, thereby preventing demise from cold injury. Not much is known about the perception and practice of this simple and easy method of caring for preterm infants among post-natal mothers in Nigeria. This study aimed to determine the knowledge, attitude and practice of kangaroo mother care among mothers in the neonatal wards of a tertiary care center in Nigeria. <strong>Methods:&nbsp;</strong>this study was a hospital-based descriptive cross-sectional survey of sixty mothers selected from the Neonatal ward of the Lagos University Teaching Hospital (LUTH), Idi-Araba using convenient sampling technique. Data was collected with the use of a questionnaire and analyzed using descriptive statistics. Frequency and percentages were presented in tables and chi-square was used to test associations between categorical variables; p-value &lt;0.05 was considered significant. <strong>Results:&nbsp;</strong>the findings revealed that 80% of respondents had heard of kangaroo mother care with 66.6% having good knowledge. Two-thirds (65%) of the respondents had a good attitude towards the use of KMC with 71.7% feeling happy when their baby is in kangaroo position. The knowledge of mothers significantly influenced their attitude and practice of KMC, p &lt;0.05. <strong>Conclusion:&nbsp;</strong>the knowledge of KMC among mothers whose babies were admitted into the newborn wards of LUTH was high and they believe that KMC is helpful to their babies and were happy practicing it.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241209 Localisation abdominale d´un dermatofibrosarcome de Darrier et Ferrand: à propos d´un cas 2023-02-09T07:57:53+00:00 Issam Loukil issamloukilyoussef@gmail.com Amine Zouari issamloukilyoussef@gmail.com Bassem Abid issamloukilyoussef@gmail.com <p>Le dermatofibrosarcome est une tumeur cutanée rare d´aspect morphologique trompeur et inconnu pour la plupart des médecins. Le retard diagnostique peut conditionner la prise en charge et affecter le pronostic. Nous rapportons le cas d´un jeune patient qui a présenté des lésions protubérantes de la paroi abdominale pris à tort pour des kystes bénins. L´exploration radiologique a révélé une masse tissulaire du plan graisseux sous cutané suspecté d´être un fibrosarcome. Cette masse a été réséquée avec une marge de sécurité macroscopique. L´étude anatomopathologique a confirmé le diagnostic de dermatofibrosarcome. Le contrôle clinique et radiologique à distance n´a pas objectivé de récidive. Ce cas; à côté d´une tumeur rare qui nécessite une prise en charge spéciale.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241210 Improper disposal of face masks during COVID-19: unheeded public health threat 2023-02-09T08:00:31+00:00 Fisseha Shiferie fshiferie21@gmail.com <p>Ethiopia confirmed its first case of the novel coronavirus (COVID-19) pandemic in March 2020. As a means to tackle the spread of the virus, the government opened a campaign for the public to exercise hygiene measures such as washing hands frequently and physical distancing. A few weeks later, a five-month State of Emergency (SOE) was declared, and several businesses, schools and theatre halls were closed. People were advised to work from home, including permitting telecommuting for many government officials. However, mainly due to fear of economic crisis, the government was forced to release the lockdown and mass wearing of face masks has become a requirement. As health professionals and the government insist that people make use of facemasks, it is also equally important to give guidance on how to dispose of them safely because face masks that are disposed improperly have the potential in spreading SARS-CoV-2. The urgency of this comes in people's violations of rules when it comes to disposing of masks they used. Providing awareness creation programs about the negative impact of contaminated face masks on the health of individuals and introducing laws that can prohibit improper disposal of used personal protective equipment (PPEs) are among the solutions discussed in this manuscript that could help reduce the problem.</p> 2021-04-14T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241211 Adrenocorticotropic hormone (ACTH) independent Cushing's syndrome due to unilateral adrenocortical hyperplasia: two case reports 2023-02-09T08:04:00+00:00 Yousra Aouinati drachadli@gmail.com Amal Mjabber drachadli@gmail.com Nassim Essabah Haraj drachadli@gmail.com Siham El Aziz drachadli@gmail.com Asmaa Chadli drachadli@gmail.com <p>Adrenal unilateral macronodular hyperplasia is a rare cause of Cushing's syndrome. We discuss the case of two patients who present Cushing syndrome due to unilateral adrenal hyperplasia. They presented the signs of clinical hypercorticism as well as metabolic, cardiovascular and osteoporotic complications. Both patients presented clinical and laboratory signs of adrenocorticotropic hormone (ACTH)-independent Cushing syndrome with elevated urinary free cortisol (UFC) levels, adrenal computed tomography (CT) scan revealed the appearance of unilateral adrenal adenoma and normal contralateral adrenal gland. Adrenalectomy was performed under laparoscopic surgery; the resected mass was pathologically diagnosed as unilateral nodular adrenal hyperplasia. Unilateral adrenal hyperplasia is a very rare etiology of ACTH-independent Cushing syndrome, often mistaken for adenoma on CT and only pathological examination can confirm the diagnosis.</p> 2021-04-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241212 Cleidocranial dysostosis: a case report with clinical illustration 2023-02-09T08:06:57+00:00 Vanesa Villamil vanesa_villamil@yahoo.com.ar Ramón Ruiz Pruneda vanesa_villamil@yahoo.com.ar María Fernández Ibieta vanesa_villamil@yahoo.com.ar César Salcedo Cánovas vanesa_villamil@yahoo.com.ar <p>Cleidocranial Dysostosis or Dysplasia (CCD) is an infrequent clinical condition, with an autosomal dominant hereditary mode of inheritance. Triad lesions: multiple supernumerary teeth, partial or complete absence of the clavicles and open sagittal sutures and fontanelles. Nine-year-old female patient comes to our service for outpatient consultation with the main complaint of upper limbs mobility restriction with shoulders hypermotility. The chest X-ray showed partial absence of the clavicles and a cone-shaped thorax. The diagnosis of CCD was performed. Treatment of these patients requires a multidisciplinary approach which includes orthopaedic and dental corrections. The premature diagnosis allows a proper orientation for the treatment, offering a better life quality for the patient.</p> 2021-04-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241214 Osteomalacia: a forgotten diagnosis of multiple bone fractures 2023-02-09T08:07:17+00:00 Karim Khezami khezamikarim@gmail.com Mohamed Amine Bennour khezamikarim@gmail.com <p>We present a case of a 53-year-old female patient with chronic anemia, with no other significant medical history and on no regular medications. The patient was brought to the accident and emergency department following found on the floor of her home after having tripped over a mat and henceforth being unable to mobilize and complaining of pain in her bilateral hip and her right leg. X-rays confirmed bilateral neck of femur fractures and fracture of the distal end of the tibia and fibula. The bones were extremely gracile and osteoporotic. Investigations demonstrated raised parathyroid hormone levels (199 pg/mL, normal range (nr) 15-72), with low vitamin D (7 ng/mL, nr 50-100) and adjusted calcium (1.87 mmol/L, nr 2.2-2.6) levels. We have eliminated the diagnosis of myeloma. Calcium and vitamin D were replaced prior to the insertion of bilateral femoral nails.</p> 2021-04-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241216 Orofacial lesions associated with long-term highly active antiretroviral therapy among HIV-seropositive adults in Ibadan, Nigeria 2023-02-09T08:14:28+00:00 Oluwatoyin Elizabeth Abe ffagbule@gmail.com Omotayo Francis Fagbule ffagbule@gmail.com luwatobi Olubusi Olaniyi ffagbule@gmail.com Akinyele Olumuyiwa Adisa ffagbule@gmail.com Olalere Omoyosola Gbolahan ffagbule@gmail.com <p><strong>Introduction:&nbsp;</strong>highly active antiretroviral therapy (HAART) has contributed to a reduction in HIV-related oral lesions and improved quality of life among HIV seropositive patients. However, the therapy is not without its side effects. This study was aimed at assessing the self- reported orofacial manifestations due to long term use of HAART, as well as the pattern of oral lesions on examination. <strong>Methods:&nbsp;</strong>this was a cross-sectional study conducted among HIV seropositive adult patients in Ibadan, who had been on HAART for at least two years. Data were collected using an interviewer-administered questionnaire. Clinical diagnosis of HIV-related oral lesions was made according to the EC-Clearinghouse criteria. Data analysis was done using SPSS version 25. <strong>Results:&nbsp;</strong>the study participants comprised of 227 HIV seropositive patients who were HAART experienced, with 54 (24%) males and 173 (76%) females. Their mean age (±SD) was 44.7 (±9.4) years. The participants CD4 count ranged from 13-1338cells/mm³, with a median count of 341 cells/mm³. About half (45%) of the participants noted one or more orofacial changes since they commenced HAART. These oral changes included dryness of mouth, burning sensation, abnormal taste, melanotic hyperpigmentation, oral thrush, ulcers, and parotid swelling. Most of those who reported oral changes had been on HAART over 10 years (p=0.03), and the changes were more reported among those on the first-line regimen. <strong>Conclusion:&nbsp;</strong>melanotic hyperpigmentation was the most common oral lesion found and burning mouth syndrome was the most commonly reported complain among HIV-seropositive adults who are on long-term HAART.</p> 2021-04-15T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/pamj/article/view/241215 Prise en charge des instabilités patellaires objectives au Centre Hospitalier Universitaire Sylvanus Olympio de Lomé, Togo 2023-02-09T08:14:48+00:00 Tchaa Hodabalo Towoezim antoinetowezim@yahoo.com Kolima Ehlissou Komlavi Akloa