Impact of COVID-19 on Biological Diagnosis of Malaria: Case of the Thierno Mouhamadoul Mansour Barro Hospital in Mbour, Senegal

Background: In Africa, malaria-endemic regions have not been spared from COVID-19 outbreak which emerged in the first quarter of 2020. This pandemic has shown clinical and therapeutic similarities with malaria. This following study sought to determine the impact of COVID-19 on the malaria diagnosis. Method: A review of laboratory registers and an exploitation of the District Health Information Software 2 (DHIS2) to collect information on the diagnosis of malaria by microscopy and by rapid diagnostic test (RDT), but also that of COVID-19 was done from 2017 to 2021 at the Thierno Mouhamadoul Mansour Hospital in Mbour, Senegal. Results: In 2017, 199 Thick drops (TDs) and 1852 RDTs were performed for malaria diagnosis. In 2018, it was 2352 malaria tests with 2138 RDTs and 214 TDs, before reaching a peak of 3943 tests in 2019 including 3742 RDTs and 201 TDs. By 2020, 2263 tests were performed with 2097 malaria RDTs, 158 TDs and 8 COVID RDTs. The latter increased significantly in 2021, reaching 444 COVID RDTs, while TDs and malaria RDT kept decreasing to 147 and 1036 respectively. Positive TDs were higher in 2020 (11.4%) compared to 2017 (3.5%), 2018 (1.4%), 2019 (6.5%) and 2021 (6.8%). For malaria RDTs, a decrease in the number of positive tests was noted between 2017 (4.5%) and 2021 (1.3%). The COVID RDTs were all negative in 2020, 29.5% were positive and 4.1% were undetermined in 2021. Conclusion: COVID-19 has led to changes in efforts to diagnose malaria as well as an increase in malaria prevalence directed towards children under 5 years of age.

Prevalence and Risk Factors of Vaginal Trichomoniasis in Women: Study at the University Hospital of Pikine in the Suburbs of Dakar, Senegal

Introduction: This study aimed to investigate the epidemiology of genital trichomoniasis in Senegal. It sought to determine the prevalence and risk factors associated with this condition in Senegal. Methodology: The study took place at the university hospital of Pikine in the suburbs of Dakar. For each of the women recruited, socio-demographic data, clinical examination data and the results of direct examination of the vaginal sample were collected in a questionnaire designed for this purpose. Results: A total of 312 women with a mean age of 31.13 (±8.41) years were recruited in this study. The majority of these women (59.94%;95% CI = 54.25 - 65.38), were seen for an infectious diseases assessment. Leucorrhea (58.33%;95% CI = 52.63 - 63.83) and genital discharge on vaginal touch (99.36%;95% CI = 97.45 - 99.89) were the predominant signs on clinical examination. The overall prevalence of vaginal trichomoniasis after direct examination of the specimens was 1.28% (95% CI = 0.41 - 3.47). Only the distribution of this prevalence by occupation was statistically significant (p = 0.0004). Conclusion: The low prevalence of genital trichomoniasis in women and the risk factors associated with it found in this study, which took place about ten years ago, should prompt an update of the data to better define the problem in Senegal.

Study of the Frequency of Superficial Candidiasis at the Fann National Hospital: Search for Candida auris

Background: Superficial candidiasis is a very frequent opportunistic disease caused by yeasts of the genus Candida. Among Candida types, some, such as Candida auris, have developed resistance to several antifungal agents. The objective of this study was to determine the hospital frequency of superficial candidiasis diagnosed at the CHU Fann and to investigate the presence of C. auris among the identified Candida strains. Methods: A cross-sectional study was conducted from February to June 2019. It involved all patients received at the Parasitology-Mycology laboratory of the CHU of Fann for suspected superficial candidiasis. Nails, skin, and vaginal specimens were subjected to direct examination and culture to identify yeasts of the genus Candida. The Candida strains were then tested by molecular biology targeting the specific C. auris ITS2 region. Results: A total of 1196 patients were examined. One thousand two hundred and five specimens (1205) were collected, including 1042 vaginal specimens, 92 nail specimens, and 71 skin specimens. Superficial candidiasis was diagnosed in 408 patients (37%). Women (34.52%) and patients under 30 years of age (39.60%) were the most affected. Yeasts of the genus Candida were found in 411 specimens (349 vaginal swabs, 36 nail fragments, and 26 skin flakes) by routine mycological techniques. The Candida albicans complex (C. albicans, C. dubliniensis, and C. africana) represented 75.91% of the Candida strains isolated. Molecular biology did not identify C. auris. Conclusion: Superficial candidiasis remains very common in hospitals in Senegal. Candida auris was not found in our study. Due to its rapid spread, surveillance is necessary to prevent epidemics in our hospitals.

Malaria Characteristics in Children with Sickle Cell Disease

Background: The relationship between sickle cell disease and malaria is the subject of much controversy. However, there is a lack of data in our services. Our objective was to study the epidemiological, diagnostic and evolutionary characteristics of malaria in children with sickle cell disease followed in a specialized setting. Patients and Methods: We conducted a retrospective, descriptive, and analytical study of children with sickle cell disease (SCD) who presented with malaria and were followed at the Ambulatory Care Unit for Sickle Cell Children and Adolescents (USAD) at the Albert Royer National Children’s Hospital in Dakar, from January 1st, 2017, to December 31th, 2019. We included all the followed pediatric patients, less than 16 years, with sickle cell disease who presented at least one episode of malaria, confirmed by a positive thick drop, during this 3 years. We did not include patients with incomplete records or those older than 16 years. The clinical and biological signs, the follow up was collected and analyzed with Excel package 2019. Results: Of 3773 patients followed for sickle cell disease, 21 had presented malaria. The frequency was 0.5% or 7 cases/year. However, we exploited the data of 14 of them. The sex ratio was 6 boys for a girl and the mean age at admission was 7.3 years. The highest number of malaria cases was observed in 2018 and the peak frequency was observed in November with 8 cases (57.1%). Fever was the most frequent symptom, observed in 10 patients (71.4%). All patients were SS homozygous, with a mean baseline hemoglobin level of 7.5g/dl. All patients had a positive thick blood smear and Plasmodium falciparum was the only species found in the blood smear, with a mean parasite density of 1693 parasites/ml of blood. All patients had anemia, with a mean hemoglobin level of 7.74 g/dl. Twelve patients (85.7%) were hospitalized and had all received injectable artesunate followed by oral Artemisinin Combination Therapy (ACT). Long-lasting insecticidal nets were used in 9 patients (69.2%). The evolution was favorable in all patients, any death was reported. NO REPRESENTATION OF YOUR DATA IN TABLES OR FIGURES: it was a little serial. Conclusion: The patients who presented the association of malaria and sickle cell disease were all SS homozygotes. However, malaria must be considered as serious in this chronic anemic setting. That’s why it is important to improve prophylaxis.

Epidemiological Study of Intestinal Parasitosis at the Albert Royer National Children’s Hospital

Intestinal parasites are very common and represent a public health problem worldwide. Despite all the mass drug distribution strategies, these diseases still pose a public health problem in Senegal. It is in this context that we conducted this study, the aim of which was to reassess the epidemiology of intestinal parasitosis in children aged 0 to 15 years over one year in the parasitology-mycology laboratory of the Albert Royer Children’s Hospital. The study involved 1426 children aged between 2 months and 15 years, with an average age of 5.15 years. Children under 5 years of age represented 52.59% of the study population, and those over 5 years of age were 47.41%, with a sex ratio of 1.5. There were 176 subjects carrying at least one parasitic species, giving an overall prevalence of 12.34%. Of the children with parasites, 76.14% had intestinal protozoosis and 23.86% had helminthiasis. The parasitic species isolated were represented by Entamoeba coli (51.70%), followed by Giardia lamblia (17.05%), Entamoeba histolytica (5.11%), Trichomonas intestinalis (1.14%) and Entamoeba histolytica (0.57%). The main helminths found were eggs of Ascaris lumbricoides (21.02%) followed by Ankylostoma duodenale (1.14%), Trichuris trichiura (1.14%) and Taenia sp. (0.57%). The results of our study show once again the endemic nature of the disease.