Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, whic...Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert<sup>?</sup> MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.展开更多
Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiolo...Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiology and treatment, tetanus remains a real public health problem, particularly in developing countries. Tetanus in children and adults is still a frequent cause of hospitalization in the Infectious and Tropical Diseases Department (SMIT) of the Fann National University Hospital (CHNU). We conducted this study with the main objective of carrying out a situational analysis of tetanus at SMIT from 2010 to 2017. We recorded 706 cases of tetanus in a total of 8123 hospitalized patients. The median age of the patients was 23 years [1 - 90 years]. The sex ratio (M/F) was 4/1. More than half (58.78%) came from suburban areas. The population was most frequently made up of students (24%) or manual workers (22.1%). At least one comorbidity was present in 107 patients (15.15%). The absence of a vaccination record was found in 99.56%. The main portal of entry was integumentary (83.3%), post-circumcision (5.7%) and otogenous (4%). Tetanus was generalized in 93.9% of cases. The main signs of tetanus found were trismus and dysphagia. Patients were most frequently classified as stage II (78.7%). Antibiotic therapy was based on metronidazole (51.41%). Anti-tetanus serotherapy was carried out by sub-occipital administration in 97.6%. Tracheostomy was performed in 48 patients. Complications occurred in 226 patients (32.01%). The main complications were respiratory (53.98%), infectious (45.13%) and cardiovascular (41.59%). The average delay in hospitalization was 3.6 ± 3.4 days. The mean length of hospital stay was 11.9 ± 8.2 days. The hospital case-lethality rate was 18.98%. Despite the decline in cases over the years in our country, tetanus remains a public health problem because of its prevalence, severity, and lethality.展开更多
Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for ...Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16 - 77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%). Meningeal signs were present in 94.55% of patients, and consciousness disorders and intracranial hypertension were present in 63.64% and 56.36% respectively. Nerve palsy was found in 38.18%. CSF was clear in 81.64%. GeneXpert MTB/RIF in CSF was performed in 33 patients and was positive in 4 patients. Brain CT was abnormal in 72.09% of cases. Tuberculoma, hydrocephalus and meningeal contrast enhancement were the main lesions. The neuro-meningeal localization was associated with a pulmonary form in 32.7%. The lethality rate was 21.8%;higher in women (46.2% vs 14.3%;p = 0.01), in patients with a delay in consultation > 1 month (p = 0.03), and in patients who presented with consciousness disorders (p = 0.007). Conclusion: Despite the availability of the GeneXpert MTB/RIF, diagnosis of NMT remains difficult. Because of its variable clinical expression and the low sensitivity of the GeneXpert MTB/rif in the CSF, it exposes patients to serious complications. Among the factors associated with death, we found consciousness disorders, a long delay in diagnosis.展开更多
Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives:...Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.001]. Conclusion: In our series, infection with SARS-CoV-2 was associated with low lethality. Several risk factors were identified that need to be considered for successful management of patients.展开更多
文摘Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert<sup>?</sup> MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.
文摘Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiology and treatment, tetanus remains a real public health problem, particularly in developing countries. Tetanus in children and adults is still a frequent cause of hospitalization in the Infectious and Tropical Diseases Department (SMIT) of the Fann National University Hospital (CHNU). We conducted this study with the main objective of carrying out a situational analysis of tetanus at SMIT from 2010 to 2017. We recorded 706 cases of tetanus in a total of 8123 hospitalized patients. The median age of the patients was 23 years [1 - 90 years]. The sex ratio (M/F) was 4/1. More than half (58.78%) came from suburban areas. The population was most frequently made up of students (24%) or manual workers (22.1%). At least one comorbidity was present in 107 patients (15.15%). The absence of a vaccination record was found in 99.56%. The main portal of entry was integumentary (83.3%), post-circumcision (5.7%) and otogenous (4%). Tetanus was generalized in 93.9% of cases. The main signs of tetanus found were trismus and dysphagia. Patients were most frequently classified as stage II (78.7%). Antibiotic therapy was based on metronidazole (51.41%). Anti-tetanus serotherapy was carried out by sub-occipital administration in 97.6%. Tracheostomy was performed in 48 patients. Complications occurred in 226 patients (32.01%). The main complications were respiratory (53.98%), infectious (45.13%) and cardiovascular (41.59%). The average delay in hospitalization was 3.6 ± 3.4 days. The mean length of hospital stay was 11.9 ± 8.2 days. The hospital case-lethality rate was 18.98%. Despite the decline in cases over the years in our country, tetanus remains a public health problem because of its prevalence, severity, and lethality.
文摘Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16 - 77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%). Meningeal signs were present in 94.55% of patients, and consciousness disorders and intracranial hypertension were present in 63.64% and 56.36% respectively. Nerve palsy was found in 38.18%. CSF was clear in 81.64%. GeneXpert MTB/RIF in CSF was performed in 33 patients and was positive in 4 patients. Brain CT was abnormal in 72.09% of cases. Tuberculoma, hydrocephalus and meningeal contrast enhancement were the main lesions. The neuro-meningeal localization was associated with a pulmonary form in 32.7%. The lethality rate was 21.8%;higher in women (46.2% vs 14.3%;p = 0.01), in patients with a delay in consultation > 1 month (p = 0.03), and in patients who presented with consciousness disorders (p = 0.007). Conclusion: Despite the availability of the GeneXpert MTB/RIF, diagnosis of NMT remains difficult. Because of its variable clinical expression and the low sensitivity of the GeneXpert MTB/rif in the CSF, it exposes patients to serious complications. Among the factors associated with death, we found consciousness disorders, a long delay in diagnosis.
文摘Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.001]. Conclusion: In our series, infection with SARS-CoV-2 was associated with low lethality. Several risk factors were identified that need to be considered for successful management of patients.
