Cardiac Echography in Pediatrics at the Regional Hospital of Diourbel: Indication and Result

Childhood heart disease is a real public health problem. In our contexts, care remains a major challenge. Doppler echocardiography remains the essential examination for diagnosis. The objective of our study was to describe the different clinical indications for cardiac ultrasound in children and the main pediatric heart diseases at the Diourbel Heinrich Lübke Regional Hospital. This was a descriptive and analytical retrospective study spanning from 2020 to 2022;covering a series of 140 cases. The study was carried out using patient clinical observation sheets and consultation sheets. We identified 140 ultrasounds. The average age of patients was 35.96 months with extremes of 0.03 months and 192 months. The female sex was predominant, with an M/F sex ratio of 0.72. Ultrasound was systematically requested in 67.14% of the study population. The indications found were mainly: heart murmur, polymalformative syndrome, respiratory failure, bronchiolitis, cardiomegaly, suspicion of heart disease, cardiomegaly, pre-therapeutic and pre-operative assessment. A total of 71 cardiac abnormalities were found in 65 patients, i.e. a prevalence of 46.42%. Congenital heart disease was more frequent (found in 49 patients, a prevalence of 35%) and was dominated by the CIA. There was a female predominance in almost all heart diseases except in the case of endocarditis where codominance is found. Our study has made it possible, through echocardiography, to evaluate the indications for echocardiography in children, to determine the prevalence of heart disease in children and also to assess the relevance of requests for echocardiography.

Violence on Health Professionals: Experience of the Obstetrics &Gynecology and Pediatrics Departments at the University Teaching Hospital of Bouake;, Cote d’Ivoire

Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of this violence for the purpose to prevent them. Materials and Methods: This is a cross-sectional, descriptive study conducted in the Obstetrics & Gynecology and Pediatrics departments at the University Teaching Hospital of Bouaké from 26 January 2016 to 24 February 2016. It included 129 health workers who gave their consent. The data collection was done through individual interviews followed by a focus group according to the socio-professional category. Results: Out of 129 health professionals included, 100 were a victim of violence i.e. a frequency of 77.5%. Most of the violence occurred during “on-call hours” (55.8%) in the emergency units (34.8%). The violence was verbal (52.5%), physical (28.6%), moral and psychological (11.6%), theft (7.3%). The aggression was mainly related to patient’s care (32.1%), visiting hours (26%) and the low level of understanding of the person (16.5%). The victim’s immediate feelings were dominated by frustration (26.7%), discouragement (21.3%) and insecurity (18.3%). The victims received a medical assistance in 9% of cases. To prevent this violence, the staff mainly offered to raise awareness about violence (27.6%) and the respect for hospital staff (25%). Conclusion: Violence against health professionals is common and has negative impacts on staff and hospital activity. Its prevention requires a holistic approach centered on awareness. Keywords: Violence, Hospital, Pediatrics, Staff, Cote d’Ivoire.

Medication Error (ME) in the Pediatrics Service of the University Teaching Hospital (CHU) of Bouaké(Côte d’Ivoire)

Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To evaluate ME in pediatrics for the improvement of professional practice. Materials and Methods: This was a cross-sectional, descriptive and analytical study conducted in the service of pediatrics at the University Teaching Hospital (CHU) of Bouaké from January 11 to February 25, 2016. It involved 204 children hospitalized and treated with drugs. The variables studied were the prescription, dispensing and administration of the drugs. Results: A total of 483 prescriptions notes were recorded for 733 therapeutic lines, i.e. 2.3 prescriptions notes and 3.6 lines per child. The overall prevalence of ME was 31% (prescription 83%, dispensing 0%, administration 11%). The prescription error concerned the illegible writing (20%), the omission of the stamp & signature (47%), the omission of the date (33%), weight (66%), age (25%) and name of the child (9%).The drug name and the dosage were incorrect in 99% and 1% respectively. Regarding the administration error, care was provided by a person without a nursing qualification in 65.5% of cases. On the patient’s care record, the care giver’s name was omitted in 100%, the child’s name in 57% and the date in 47%. The route of administration and the administered dose were each incorrect in 5%. The student nurses and assistant nurse caregivers committed more prescription errors than doctors and nurses and midwives (p= 0,000 X2 = 44.91). Administration error was not significantly related to the service, the socio-professional category, the gender and the age of the patient. Conclusion: EM is common in pediatrics at the University Teaching Hospital (CHU) of Bouaké. To prevent it, it is necessary to strengthen the staff’s capacity to prescribe and administer the drug in children.

Reducing Extended Hospital Lengths of Stay

In the United States, the costs of health care have become a major burden for the health care system. In order to address this problem, the hospitals of Syracuse, New York, developed programs to provide subacute and complex care. The Subacute programs provided patient transportation services for dialysis and other types of care outside hospitals. They also developed programs for services such as intravenous therapy in nursing homes. The Complex Care Programs, such as intravenous therapy and mental health services, have provided alternatives to extended care in hospitals. During the past five years, utilization of these programs has varied, declining between 2019 and 2022, and then increasing between 2022 and 2024. The programs have avoided the need for 1530 - 2974 patient days in hospitals. The programs saved the Syracuse hospitals approximately $600 per inpatient day. This amounted to savings of $918,000 - $1,784,400 per year. These programs demonstrated how relatively small mechanisms can save large amounts of health care resources.

Evaluation of Entrance Skin Radiation Exposure Dose for Pediatrics Examined by Digital Radiography at Asser Central Hospital-KSA

Assessment of entrance skin doses for patients in Digital radiography examinations should be made as a means for the optimization of the radiation protection of the patients. We measured the entrance skin dose (ESD) received by 50 pediatrics undergoing 12 types of diagnostic X-ray examination at Radiology Department of Asser Central Hospital-KSA. The entrance skin dose ESD was determined via measurements parameters: focus to skin distance (FSD), tube current (mAs) and tube voltage (kV) in arithmetical equation. The mean ± SD for ESDs were found to be 0.16 ± 0.03, 0.21 ± 0.01, 0.63 ± 0.26, 0.55 ± 0.09, 0.15 ± 0.05, 0.27 ± 0.06, 0.41 ± 0.19, 0.46 ± 0.18, 0.46 ± 0.12, 0.20 ± 0.02, 0.39 ± 0.01, 0.29 ± 0.03, for PA chest, foot, AP pelvis, PA skull, PA hand, AP arm, ankle, AP shoulder, abdomen, forearm, AP femur, AP elbow consequently. Our study is considered as an attempt to evaluate the ESDs received by digital radiographic x-ray machine for children aged between 2 - 15 years old, taking in our considerations number of other variables. The mean ESD values obtained are found to be within the standard reference. The data obtained may add to the available information in national records for general use. It may provide guidance on where efforts on dose reduction will need to be directed to fulfill the requirements of the optimization process and serve as a reference for future researches.

Frequency of Group A Beta-Hemolytic Streptococcal Angina in Children in the Department of Pediatrics of Donka National Hospital

Background: Angina is a common paediatric condition. It has certain peculiarities in children, particularly with regard to the frequency of bacterial germs and the use of diagnostic tests. The aim of this study was to determine the place of the rapid diagnostic test in the management of group A beta-hemolytic streptococcal angina in children in the paediatric ward at Donka National Hospital. Methods: This was a prospective descriptive study lasting 6 months from 1st February to 31st July 2019 concerning children aged between 3 and 15 years old who were diagnosed with angina. Epidemiological, clinical, para-clinical and therapeutic variables were studied. Results: Out of 1494 registered children, we collected 116 cases of angina (7.76%). Out of 52 patients who benefited from the rapid diagnostic test, we recorded 13 cases of angina due to group A beta-hemolytic strptococcus. The male sex was the most dominant with 31 cases (59.69%) and a G/F sex ratio of 1.47. The age group most affected was between 3 and 5 years old (50%). The average age of our patients was 4.8 years with extremes of 3 and 14 years. Clinical manifestations were dominated by fever and dysphagia (100%) followed by odynophagia (11.79%). We recorded 13 cases of streptococcal angina (25%). Conclusion: The factors that influence it are multiple, dominated by community life, passive smoking and allergies. The use of RDTs in these young children would help in the diagnosis of acute group A beta hemolytic streptococcal angina and rational antibiotic prescription.

Monitoring Changes in Hospital Utilization

This study focused on recent issues concerning health care utilization at the community level. The study focused on developments in hospital inpatient lengths of stay and discharges. The analysis in the study demonstrated that hospital lengths of stay in the metropolitan area of Syracuse, New York increased by 25.0 percent between 2019 and 2023. This has been a notable increase in the movement of patients with this indicator. The analysis also demonstrated that numbers of inpatient discharges for these hospital services declined substantially during the same periods. Review of the data suggested that this information has been related. The increase in hospital lengths of stay has been related to a rise in numbers of patients at high severity of illness. They have also been associated with a decline in numbers of patients at low severity.

Acute Thoracic Syndrome in Sickle Cell Children at the Pediatrics Department of Donka National Hospital

Introduction: Acute thoracic syndrome is the appearance of a new pulmonary infiltrate on radiology associated with fever, desaturation or respiratory signs. It is the second leading cause of hospitalization and the first cause of death in sickle cell patients. It is an acute pulmonary complication whose pathophysiological mechanisms are still poorly understood. This study aims to study the epidemiological, clinical, therapeutic and evolutionary aspects of Acute Chest Syndrome in children at the Pediatrics Department of Donka National Hospital. Method: This is a prospective study of descriptive type for a period of 6 months from February 19 to August 19, 2019 on patients with sickle cell disease who developed an ATS in the pediatrics department of Donka National Hospital. Epidemiological, clinical, therapeutic and evolutionary data were studied and proportionate data were calculated. Results: The frequency of ATS was 39%. The mean age of our patients was 9.83 years with the extremes of 4 and 16 years. The age group from 6 to 10 years with a frequency of 66.7% was the most affected. Fever was the main clinical manifestation, followed by hepatomegaly. All our patients were homozygous SS and undergoing folic acid prophylaxis. 96% of our patients did not receive any specific vaccine. Antibiotic therapy, hyperhydration and analgesics were administered to all our patients. 96% of our patients were transfused with red blood cell concentrate. 96% of our patients were transfused with packed red blood cells. 96% of our patients were transfused with packed red blood cells and 96% of them had a favorable outcome. Conclusion: ATS is an acute complication of sickle cell disease responsible for significant mortality and morbidity in the pediatric population. Its treatment is symptomatic and must be started early. Emphasis must be placed on prevention to prevent or limit its occurrence.

Analysis of Hospital Budget Management Control Based on Smart Hospital

Hospitals are crucial healthcare facilities where patients seek treatment,and effective budget management within hospitals significantly impacts their operational efficiency and financial performance.In the age of information technology and advanced healthcare solutions,the emergence of smart hospitals represents a new trend in the medical industry’s evolution.Leveraging modern information technology can enhance the development of hospital IT systems and drive budget management toward greater intelligence.This paper begins by analyzing the influence of smart hospitals on hospital budget control.It then examines the current state of budget management control within smart hospitals.Finally,it proposes several strategies for budget management control in smart hospitals,aiming to provide guidance for relevant stakeholders.

Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a compre-hensive database search. To organise, categorise and synthesise the ex-isting literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured;2) use and immediate outcomes of HIT functionalities;3) different perfor-mance indicators and how HIT functionalities affect them;and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly meas-uring the use rate of HIT. We identified five dimensions of hospital per-formance indicators. Every dimension showed mixed results;however, in general, HIT has a positive impact on mortality and patient readmis-sions. We found several hospital characteristics that may affect the rela-tionship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regard-ing the functionalities, use and effects of HIT implementation in hospi-tals. Given our research outcomes, we suggest future research opportuni-ties to improve understanding of how HIT affects hospital performance. .

Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.

Micropenis Associated or Not with Cryptorchidism in the Endocrinology Department of Yopougon University Hospital in Ivory Coast: Epidemiological, Clinical, Paraclinical and Therapeutic Aspects

Background: Congenital malformations such as micropenis and cryptorchidism do not have immediate dramatic consequences. However, the diagnosis is often unknown at birth, and therefore late. In Ivory Coast, there are few studies on cryptorchidism and micropenis. We conducted this study to identify the epidemiological, clinical, etiological and therapeutic characteristics of the micropenis associated or not with cryptorchidism at Yopougon University Hospital. Methods: We conducted a retrospective descriptive study in the Department of Endocrinology-Diabetology of the Yopougon University Hospital carried out over 13 years from January 2005 to December 2018. All patients were included regardless of the presence of a micropenis associated or not with cryptorchidism in the clinical or paraclinical examination. Results: A total of 14 micropenis were reported associated in 6 cases with cryptorchidism. It was unilateral cryptorchidism in 4 patients or 66.66% of cases. The average age of affected patients was 21.32 years with extremes ranging from 10 months to 48 years. The reason for consultation was micropenis in 12 out of 14 cases or 85.75%. The associated signs apart from cryptorchidism were obesity in 42.86% of cases, gynecomastia in 35.71% of cases. The aetiology was dominated by idiopathic causes. Treatment with testosterone enanthate was more effective in pre-pubertal children than in adults. Conclusion: The diagnosis of micropenis associated or not with cryptorchidism is late because of the frustrations, taboos and psycho-social states that it causes. However, drug treatment is effective when treatment is started early.

Epidemiological and Clinical Aspects of Male Infertility in Patients Consulting at the Urology Department of the Yaounde Central Hospital

Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1st, 2016 to April 30th, 2021) at the Urology Department of the Yaounde Central Hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky social habits and comorbidities. An early start of health promotion activities, comorbidities prevention and early detection of spermogram abnormalities would make it possible to reduce the frequency of male infertility.

Prevalence and Factors Associated with Anemia among People Living with Human Immunodeficiency Virus Followed at the Outpatient Treatment Centre of Panzi General Referral Hospital in Eastern Democratic Republic of Congo

Introduction: Anemia in people living with human immunodeficiency virus (PLHIV) is a major health problem. Although anemia often responds to combination antiretroviral therapy, many patients remain anemic despite treatment, and such persistent anemia continues to adversely affect prognosis, regardless of drug response. Scientists have identified some of the factors involved. However, the mechanisms put in place have not been effective in overcoming them. Examples include the withdrawal of zidovudine from antiretroviral treatment lines, iron and folate supplementation, etc. Anemia is still a major concern in HIV-positive patients. The aim of this study is to assess the prevalence of anemia and its associated factors among PLHIV followed up at the outpatient treatment centre (CTA) of the Panzi General Reference Hospital (HGR) in South Kivu, Democratic Republic of Congo (DRC). Method: We conducted a cross-sectional, comparative study of 276 HIV-infected adults on antiretroviral therapy (ART) followed up at the CTA of Panzi HGR. Socio-demographic and nutritional parameters were collected using a survey questionnaire, and clinical assessment and nutritional status were performed at the centre. Hemoglobin, seric albumin and viral load determinations were performed at the HGRP laboratory. We constructed univariate and multivariate logistic regression models to assess factors associated with anemia in people living with HIV/AIDS. Results: We found a prevalence of anemia of 39.4%, including 4.1% severe anemia, 17.7% moderate anemia and 17.5% mild anemia. After multivariate adjustment, the factors associated with anemia in our PLHIV were: moderate undernutrition (aOR = 1.26;95% CI: 1.50 - 4.20;p = 0.001), severe undernutrition (aOR = 115.4;95% CI: 2.04 - 164.52;p = 0.021), hypoalbuminemia (aOR = 2.11;95% CI: 1.87 - 5.10;p = 0.004) and the lower degree of dietary diversity (aOR = 1.56;95% CI: 1.10 - 4.32;p = 0.034). Conclusion: The prevalence of anemia in PLHIV on ART is high. This greatly affects quality of life and increases the need for care. Early detection tools and management algorithms are essential in the follow-up of PLWHIV.

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Chronic End-Stage Renal Failure in the Nephrology Department of the University Hospital of Brazzaville in 2023

Objective: Chronic end-stage renal failure is a major public health problem in developing countries and is poorly documented. The objective of this study was to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of patients admitted for end-stage renal failure to the Department of Nephrology at the University Hospital of Brazzaville. Patients and Methods: This was a descriptive cross-sectional study collecting prospective data that took place over 10 months. We included 128 patients who were exhaustively identified. Sociodemographic, clinical, therapeutic and developmental data were collected using a standardized and pretested pre-established survey form. The EPI info software enabled the analysis and processing of the data. Results: We reported a male predominance with a sex ratio of 2.5. The median age was 50 years. The first cause found was diabetes (55%) followed by hypertension (46%). The majority of patients had a dialysis emergency and half could not be dialyzed for financial reasons. Conclusion: Our results highlighted that certain epidemiological parameters of end-stage renal failure are constantly changing, such as frequency, while others remain static, including the main etiologies, gender, and age. However, mortality continues to increase and deserves more attention.