Pronostic Factors of Cerebral Toxoplasmosis in Department of Infectious and Tropical Diseases at Donka National Hospital

Objectives: To identify predictive factors for poor prognosis during cerebral toxoplasmosis at Donka Hospital. Methods: It was a retrospective study of descriptive and analytic type lasting one year six months (18 months) from January 1st, 2016 to June 30th, 2017 which involved patients admitted and hospitalized for cerebral toxoplasmosis in HIV field. Data enter was performed by Epi data 3.1 software and SPSS 21 software for statistical analysis. The threshold of significance was p Results: We observed 87 cases of cerebral toxoplasmosis (CT). The mean age was 38.53 ± 12.16. The clinical signs were mainly infectious syndrome (100%), headache (69.0%), confusion (46.0%) and meningeal syndrome (41.4%). The lethality was 37.9%. Living with a partner (p = 0.007), CD4 at initiation of antiretroviral therapy 3 (p = 0.009), and coma (p = 0.02) were the factors associated with death. Conclusion: This study showed that cerebral toxoplasmosis is associated with very high morbidity and mortality in the Infectious Diseases Department of Donka National Hospital. Living in a relationship, CD4 counts at baseline 3 and coma were independently associated with death. Special attention to these factors associated with infectious resuscitation and primary prevention in patients with a CD4 T lymphocyte count below 200 cells/mm may improve the prognosis of this pathology.

Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké University Hospital Center, 2017-2021

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

Real-world effectiveness and safety of direct-acting antivirals in hepatitis C virus patients with mental disorders

BACKGROUND It is estimated that 58 million people worldwide are infected with the hepatitis C virus(HCV).Patients with severe psychiatric disorders could not be treated with previously available interferon-based therapies due to their unfavorable side effect profile.This has changed with the introduction of direct-acting antivirals(DAA),although their real-life tolerance and effectiveness in patients with different psychiatric disorders remain to be demonstrated.AIM To evaluate the effectiveness and safety of DAA in patients with various mental illnesses.METHODS This was a retrospective observational study encompassing 14272 patients treated with DAA for chronic hepatitis C in 22 Polish hepatology centers,including 942 individuals diagnosed with a mental disorder(anxiety disorder,bipolar affective disorder,depression,anxiety-depressive disorder,personality disorder,schizophrenia,sleep disorder,substance abuse disorder,and mental illness without a specific diagnosis).The safety and effectiveness of DAA in this group were compared to those in a group without psychiatric illness(n=13330).Antiviral therapy was considered successful if serum ribonucleic acid(RNA)of HCV was undetectable 12 wk after its completion[sustained virologic response(SVR)].Safety data,including the incidence of adverse events(AEs),serious AEs(SAEs),and deaths,and the frequency of treatment modification and discontinuation,were collected during therapy and up to 12 wk after treatment completion.The entire study population was included in the intent-to-treat(ITT)analysis.Per-protocol(PP)analysis concerned patients who underwent HCV RNA evaluation 12 wk after completing treatment.RESULTS Among patients with mental illness,there was a significantly higher percentage of men,treatmentnaive patients,obese,human immunodeficiency virus and hepatitis B virus-coinfected,patients with cirrhosis,and those infected with genotype 3(GT3)while infection with GT1b was more frequent in the population without psychiatric disorders.The cure rate calculated PP was not significantly different in the two groups analyzed,with a SVR of 96.9% and 97.7%,respectively.Although patients with bipolar disorder achieved a significantly lower SVR,the multivariate analysis excluded it as an independent predictor of treatment non-response.Male sex,GT3 infection,cirrhosis,and failure of previous therapy were identified as independent negative predictors.The percentage of patients who completed the planned therapy did not differ between groups with and without mental disorders.In six patients,symptoms of mental illness(depression,schizophrenia)worsened,of which two discontinued treatments for this reason.New episodes of sleep disorders occurred significantly more often in patients with mental disorders.Patients with mental illness were more frequently lost to follow-up(4.2%vs 2.5%).CONCLUSION DAA treatment is safe and effective in HCV-infected patients with mental disorders.No specific psychiatric diagnosis lowered the chance of successful antiviral treatment.

Characteristics, Management, and Outcomes of Tetanus Cases in a Referral Center in Senegal, between 2010 and 2017

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.

Detection of ARV-Resistant Mutants in HIV-1-Infected Individuals in a Context of Systematic Switching to an Association Based on Dolutegravir in Abidjan, Côte d’Ivoire

The emergence of antiretroviral resistance mutations represents a major threat to the achievement of national and global goals for the elimination of HIV-1 infection. The global strategy in 2019 in Cte d'Ivoire is a new national policy for the management of people living with HIV with the administration of dolutegravir (DTG)-based fixed-dose combination. The aim of our study was to evaluate HIV-1 resistance to antiretrovirals (ARVs) in infected adult subjects in Cte d’Ivoire in the context of a systematic switch to a DTG-based combination. Between February 2022 and October 2023, a cross-sectional survey with random sampling was conducted in 06 services caring for people living with HIV. A total of 139 participants were included in the study. Adults with a viral load ≥ 1000 copies/mL were tested for HIV-1 ARV resistance mutations. Molecular analyses were performed using protocol of ANRS-MIE (National Agency for Research on AIDS and emerging infectious diseases). The interpretation is performed by HIVGRAD (https://www.hiv-grade.de/cms/grade/). The frequencies of HIV-1 resistance to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (IINTs) and protease inhibitors (PIs) were 82%, 73%, 19% and 11% respectively. The main mutations observed in the different classes were K103N (45%), M184V (64%), E157Q (19%) and L10V/M46I/A71V/I54V (6%) respectively. This study reveals the emergence of resistance to DTG-based fixed-dose combinations, favored by high rates of resistance to NRTIs and NNRTIs. This finding underlines the need for enhanced viral load monitoring and HIV-1 genotyping tests to guide the choice of NRTIs for combination therapy. In addition, monitoring for mutations to second-generation NRTIs is essential, given the scale-up of DTG-based regimens currently underway in Cte d’Ivoire.

Profile of SARS-CoV-2 Infected Patients Hospitalized at the Epidemic Treatment Center (ETC) in Saint-Louis, Senegal during the First Two Waves

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.

Compliance with Hand Hygiene among Health Professionals in the Medical-Surgical Emergency Department of the Donka National Hospital

Introduction: The transmission of infectious agents through the hands of nursing staff during care is the main cause of nosocomial infections. Hand hygiene has been recognized for over a century as an effective measure to prevent healthcare associated infections in healthcare settings, the objective of this study was to appreciate the practice of hand hygiene during care by health professionals in the medical-surgical emergency department of the Donka National Hospital. Methods: It was a cross-sectional, analytical study. Data collection took place from March 1 to April 30, 2021. The study covered all health professionals, namely doctors, nurses, laboratory technicians, radiography technicians, pharmacists, students, stretcher bearers, surfactants who were present at the time of the study period. Results: During the study period, out of a total of 104 registered health professionals, we surveyed 99, which is a rate of 95%. The most represented age group was [30 - 39 years] with an average of 37.17 ± 10.34 years, and extremes of 22 years to 65 years. The male sex was the most dominant or 59.60% compared to the female sex or 40.40% with a sex ratio of 1.47. The hand hygiene compliance rate was low at 21%. The practice of hand hygiene during care for 100% of health professionals was very low, at 8.08%. No factors influence the observance of the practice of hand hygiene and the socio-professional characteristics of the conditions of provision of care activities. Conclusion: Hand hygiene during care is an essential aspect that must be considered as an essential measure in the prevention of infections in this period of the COVID-19 pandemic.

Impact of Plastic Waste on the Human Health in Low-Income Countries: A Systematic Review

Background: Plastic pollution is the accumulation of waste composed of plastic and its derivatives all over the environment. Whether in the form of visible garbage or microparticles, as it slowly degrades, plastic pollution poses significant threats to terrestrial and aquatic habitats and the wildlife that call them home, whether through ingestion, entanglement or exposure to the chemicals contained in the material. Unfortunately, there is a lack of documentation on the impact of plastic waste on human health in low- and middle-income countries (LMICs). Methods: We searched five electronic databases (PubMed, Embase, Global Health, CINAHL and Web of Science) and gray literature, following the preferred reporting elements for systematic reviews and meta-analyses (PRISMA), for the impact of plastic waste on human health in developing countries. We included quantitative and qualitative studies written in English and French. We assessed the quality of the included articles using the Mixed Methods Appraisal tool (MMAT). Results: A total of 3779 articles were initially identified by searching electronic databases. After eliminating duplicates, 3167 articles were reviewed based on title and abstract, and 26 were selected for full-text review. Only three articles were retained. The three articles dealt with practices likely to lead to oral exposure to plastic chemicals in human health, as well as the level of awareness of participants concerning the possible impact of plastic on human health, namely, the use of plastic baby bottles, the use of microwaves to cook food and reheat precooked food, the use of plastic bottles to store water in the refrigerator, water purifier containers with plastic bodies and plastic lunch boxes, the reuse of plastic bags and the inadequacy of treatment facilities. Conclusion: Plastic waste poses different risks to human health at every stage of its life cycle. Hence, strategies must be adopted to raise public awareness of the dangers of plastic waste to their health. Trial registration: The review protocol is registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42023409087).

Prevalence and virological profiles of hepatitis B infection in human immunodeficiency virus patients

AIM: To determine the prevalence of hepatitis B virus (HBV) in adult human immunodeficiency virus (HIV) patients with CD4+ T-cell count less than 500/mm 3 and without antiretroviral therapy; to describe different HBV-HIV coinfection virological profiles; and to search for factors associated with HBs antigen (HBsAg) presence in these HIV positive patients.METHODS: During four months (June through September 2006), 491 patients were received in four HIV positive monitoring clinical centers in Abidjan. Inclusion criteria: HIV-1 or HIV-1 and 2 positive patients, age ≥ 18 years, CD4+ T-cell count < 500/mL and formal and signed consent of the patient. Realized blood tests included HIV serology, CD4+ T-cell count, quantitative HIV RNA load and HBV serological markers, such as HBsAg and HBc antibody (anti-HBcAb). We performed HBeAg, anti-HBe antibody (anti-HBeAb), anti-HBc IgM and quantitative HBV DNA load in HBsAg positive patients. Anti-HBsAb had been tested in HIV patients with HBsAg negative and anti-HBcAb-positive. HBV DNA was also tested in 188 anti-HBcAb positive patients with HBsAg negative status and without anti-HBsAb. Univariate analysis (Pearsonχ 2 test or Fischer exact test) and multivariate analysis (backward step-wise selection logistic regression) were performed as statistical analysis. RESULTS: Mean age of 491 patients was 36 ± 8.68 years and 73.3% were female. Type-1 HIV was found in 97% and dual-type HIV (type 1 plus type 2) in 3%. World Health Organization (WHO) clinical stage was 1, 2, 3 and 4 respectively in 61 (12.4%), 233 (47.5%), 172 (35%) and 25 patients (5.1%). Median CD4+ T-cell count was 341/mm 3 (interquartile range: 221-470). One hundred and twelve patients had less than 200 CD4+ T-cell/mm 3 . Plasma HIV-1 RNA load was elevated (≥ 5 log 10 copies/mL) in 221 patients (45%). HBsAg and anti-HBcAb prevalence was respectively 13.4% and 72.9%. Of the 66 HBsAg positive patients, 22 were inactive HBV carriers (33.3%), 21 had HBeAg positive hepatitis (31.8%) and 20 had HBeAg negative hepatitis (30.3%). HBeAg and anti-HBeAb were indeterminate in 3 of them. Occult B infection prevalence (HBsAg negative, anti-HBcAb positive, anti-HBsAb negative and detectable HBV DNA) was 21.3%. Three parameters were significantly associated with the presence of HBsAg: male [odds ratio (OR): 2.2;P = 0.005; 95% confidence interval (CI): 1.3-3.8]; WHO stage 4 (OR: 3.2;P = 0.01;95% CI: 1.3-7.9); and aspartate aminotransferase (AST) level higher than the standard (OR: 1.9;P = 0.04; 95% CI: 1.02-3.8). CONCLUSION: HBV infection prevalence is high in HIV-positive patients. HBeAg positive chronic hepatitis and occult HBV infection are more frequent in HIVpositive patients than in HIV negative ones. Parameters associated with HBsAg positivity were male gender, AIDS status and increased AST level.

Unusual presentation of Brucellosis:Afebrile,culture positive Brucellosis and culture positive,seronegative Brucellosis

Objective:To investigate the unusual presentation of brucellosis.Methods:This prospective study was carried out on 46 patients suspected to brucellosis.The diagnosis was made with isolation of brucella species by Bone Marrow culture.Results:Among 40 culture positive patients,there were two unusual presentations of brucellosis: Afebrile culture positive and culture positive seronegative brucellosis.Conclusion:Some brucellosis patients would not match with criteria for diagnosis of brucellosis.Although it is needed to have positive serology or culture for diagnosis of brucellosis but sometimes,it is the clinical experiences,which help to diagnose and treat these kinds of patients.

Cryptotanshinone induces apoptosis of activated hepatic stellate cells via modulating endoplasmic reticulum stress

BACKGROUND Cryptotanshinone(CPT)has wide biological functions,including anti-oxidative,antifibrosis,and anti-inflammatory properties.However,the effect of CPT on hepatic fibrosis is unknown.AIM To investigate the effects of CPT treatment on hepatic fibrosis and its underlying mechanism of action.METHODS Hepatic stellate cells(HSCs)and normal hepatocytes were treated with different concentrations of CPT and salubrinal.The CCK-8 assay was used to determine cell viability.Flow cytometry was used to measure apoptosis and cell cycle arrest.Reverse transcription polymerase chain reaction(RT-PCR)and Western blot analyses were used to measure mRNA levels and protein expression of endoplasmic reticulum stress(ERS)signaling pathway related molecules,respectively.Carbon tetrachloride(CCL4)was used to induce in vivo hepatic fibrosis in mice.Mice were treated with CPT and salubrinal,and blood and liver samples were collected for histopathological examination.RESULTS We found that CPT treatment significantly reduced fibrogenesis by modulating the synthesis and degradation of the extracellular matrix in vitro.CPT inhibited cell proliferation and induced cell cycle arrest at the G2/M phase in cultured HSCs.Furthermore,we found that CPT promoted apoptosis of activated HSCs by upregulating expression of ERS markers(CHOP and GRP78)and activating ERS pathway molecules(PERK,IRE1α,and ATF4),which were inhibited by salubrinal.Inhibition of ERS by salubrinal partially eliminated the therapeutic effect of CPT in our CCL4-induced hepatic fibrosis mouse model.CONCLUSION CPT can promote apoptosis of HSCs and alleviate hepatic fibrosis through modulating the ERS pathway,which represents a promising strategy for treating hepatic fibrosis.

Antiretroviral Therapeutic Profile in Patients Living with HIV with Chronic Kidney Disease

Chronic Kidney disease (CKD) is one of the important complications during HIV infection. The advent of Highly Active Antiretroviral Therapy (HAART) has significantly improved the prognosis of these patients. This was a descriptive and analytical cross-sectional study of people living with HIV received at the Ambulatory Treatment Center (ATC) of the Department of Infectious Diseases of Sylvanus Olympio University Hospital (CHU-SO). The study period was 6 months from January 1, 2018 to June 30, 2018. A total of 234 patients were enrolled during the study period. The mean age of patients at initiation of treatment was 42.07 ± 9.49 years with an average duration of follow-up under antiretroviral treatment of 5.61 ± 3.22 years. The female sex was predominant (70.09%) and a sex ratio (M/F) of 0.43. Most people living with HIV were mostly classified at clinical stage 2 (30.77) and 3 (31.62%) of WHO at initiation of HAART. The mean CD4 rate was 223.30 ± 143.764 at initiation of HAART and 462.58 ± 202.723 at the time of study. The frequency of CKD was 11.11%. The majority of patients were placed in a fixed combination of Tenofovir/Lamivudine/Efavirenz in a proportion of 81.20% of cases. In univariate analysis shows that age greater than 45 years (p = 0.017). Pathological proteinuria (p = 0.021) were associated with CKD. In multivariate analysis, only age (p = 0.045) and pathological proteinuria (p = 0.035) were significantly associated with CKD.

Acute Renal Failure in Hospitals in Togo: Comparative Analysis of HIV Positive Patients and HIV Negative Patients

Introduction: Human Immunodeficiency (HIV) is a risk factor often associated with the occurrence of Acute Renal Failure (ARF). Objectives: To describe the profile of Acute Renal Failure (ARF) in HIV-infected patients and compare them to non-infected patients. Patients and Methods: It was a prospective study from January 2018 to February 2019 that took place in the nephrology, infectious diseases and internal medicine departments of the Sylvanus Olympio University Hospital Center in Lomé (Togo). Results: The prevalence of ARF in HIV-infected patients was 48.07%. HIV-infected patients had an average age of 46.9 ± 11.6 years (p = 0.36) compared to 44.0 ± 20.4 years for non-HIV infected patients. Female sex was predominant in the HIV-infected population with a sex ratio H/F of 0.6 (p 3) in 50% of cases. HIV infected patients had more anemia (52.0% versus 22.2%) with p = 0.002. Conclusion: No deaths were recorded in the HIV-infected group.

Epidemiological, Clinical, Therapeutic, Evolutionary and Prognostic Aspects of Children with COVID-19 in Bouaké(Côte d’Ivoire)

Context: Compared to adults, there are relatively few studies on pediatric COVID-19 due to the high rate of asymptomatic or paucisymptomatic forms. The aim of this study is to determine the epidemiological, clinical, therapeutic, evolutionary and prognostic aspects of COVID-19 infection in children. Patients and Methods: This was a prospective analytical study carried out from February 27, 2021 to January 27, 2022 at the COVID-19 Care Center of the Infectious and Tropical Diseases Department of the Bouaké University Teaching Hospital. The study population consisted of all children under the age of 16, seen in consultation and/or hospitalized with a positive COVID-19 RT-PCR. Data analysis was performed with Epi Info 7 software. The statistical tests used were the chi-square test and Fisher’s exact test depending on the conditions of validity with a significance threshold of p Results: Out of 955 patients received at the COVID-19 Care Center in Bouaké, there were 56 children (26 boys/30 girls), or, a prevalence of 5.86%. The mean age was 9.18 years ± 4.48 [extremes 3 months and 15 years]. Children over the age of 11 accounted for 48.21% of cases. They were contact cases in 35.71% and the contact person was the mother in 75% of cases. The main reasons for screening were cough (67.86%), fever (25%) and sneezing (21.43%). The pathological histories were asthma (83.33%), heart disease (33.33%) and sickle cell disease (16.67%). The medical examination revealed 6 cases of children in vital distress. The care consisted of home confinement for simple cases (89.29%) and hospitalization for cases presenting with vital distress (10.71%). The duration of confinement or hospitalization was between 10 and 15 days in 83.93% of cases. No cases of death were noted. The factors associated with the occurrence of symptomatic forms were age (p = 0.028), pathological history (p Conclusion: The proportion of pediatric cases of COVID-19 is low with a predominance during the season of harmattan. Pediatric infection with COVID-19 is benign and has a favorable evolution, with an almost intra-family transmission wich symptomatology is different from that of adults. Age and pathological history were the factors associated with the occurrence of symptomatic forms.

COVID-19 in Bouake (Côte D’Ivoire): Comparative Study of the Epidemiological, Clinical, Therapeutic, Evolutionary and Prognostic Aspects in Younger and Elderly Patients

Introduction: The clinical manifestations of many diseases vary with age, and older people often do not show typical symptoms of the disease. The present study aims to compare the epidemiological, clinical, therapeutic and evolutionary aspects of elderly patients with COVID-19 compared to young adult patients and to identify risk factors for mortality. Patients and Methods: This was a retrospective single-center analytical study conducted from January 27, 2021 to January 27, 2022 at the COVID-19 Care Center of the Infectious and Tropical Diseases Department of the Bouaké University Teaching Hospital. The study population consisted of all patients aged at least 18 years seen in consultation and/or hospitalized with a positive COVID-19 RT-PCR. The patients were divided into two groups: younger patients (Results: Of a total of 779 patients, 644 (82.7%) were young. The median age of all patients was 41 years (IQR 32 - 54, extreme 18 and 96). Of all the patients 38.5% had a comorbidity. Compared to younger patients, chronic heart disease (61.7% vs 21.5%;p Conclusion: Elderly people with COVID-19 have a different clinical presentation from younger, characterized by more atypical symptoms. Mortality risk factors are age, dyspnoea, impaired consciousness and fever. It is therefore necessary to act on its various factors to improve the prognosis of COVID-19 in this age group.

Deep Vein Thrombosis in HIV and Tuberculosis Treatment in a Case of a 19-Year-Old Guinean Student

The objective of this study was to describe Thrombotic manifestations and therapeutic management during HIV infection and tuberculosis in a 19-year-old male student. The objective of this study was to describe Thrombotic manifestations and therapeutic management during HIV infection and tuberculosis in a 19-year-old student. Observation: It is Mr. S. C., aged 19, admitted for pain and swelling of the right lower limb, physical asthenia and notion of fever. Evolution 5 days, with no particular history of cardiovascular disease, anti-retroviral treatment for 1 year and anti-tuberculosis treatment for 3 months. On clinical examination heart sounds are irregular with a heart rate at 115 bpm, blood pressure at 110/70 mmhg. A febrile red painful swelling at right lower limb with positive Homans sign. 0°C (Temperature 37.7°C), Weight at 58 Kg. The rest of the clinical examination is without particularity. Venous Doppler echo of the lower limbs: shows the presence of acute deep vein thrombosis of the right lateral vein. Mr. S. C. to benefit the following Medical Treatment: lovenox 0.6 UI subcutaneously morning and evening, Sintrom 4 mg 1 comprimed at night, Tramadol 50 mg morning and evening;with a good clinical evolution. CONCLUSION: TB and HIV are chronic infections that result in widespread inflammation predisposing patients to a MTVE (Venous thromboembolic disease) table as well as rifampicin and anti-proteases.

Contribution of ARV Treatment in the Correction of Anemia in People Living with HIV during the First Semester in the Hematology Department of Conakry University Hospital

Introduction: Anemia is frequently associated with the natural course of people living with HIV (PLWHIV). The objective was to describe the evolution of anemia in PLWHIV during the first 6 months of ART and to identify the associated factors in the hematology service of the Ignace Deen national hospital of the Conakry University Hospital. Methods: This was a prospective, observational descriptive and analytical study lasting one year from August 1, 2019 to July 31, 2020. It focused on PLWHIV who were newly included in ART during the period of study in the Hematology Department of Ignace Deen Hospital. Results: Of 45 PLWHIV, 40 presented with anemia of 88.89%. The mean age was 40.16 years ± 12.29 years and extremes of 22 and 71 years. The female sex represented 65% of cases with a sex ratio of 0.54. Prolonged fever was the main reason for consultation, 97.5%. The HIV-1 serotype was represented in all anemic patients. At least one OI was found in 24 patients, 60%. MO anemia was severe (28.9%), moderate (44.4%) and mild (26.7%). At M6 it was moderate (5.9%) and light (94.1%). It was normochromic normocytic in 55%. At M0, statistical analysis was significant between anemia and OIs, WHO stage and CD4 count, but the link was not established at M6. Conclusion: Anemia is frequently associated with HIV infection linked to delayed treatment. Its development would be better with the establishment of good support. Specific actions should be taken to better identify the factors involved.

COVID-19 vaccine related hypermetabolic lymph nodes on PET/CT:Implications of inflammatory findings in cancer imaging

We observed several patients presenting 2-[^(18)F]FDG uptake in the reactive axillary lymph node at PET/CT imaging,ipsilateral to the site of the COVID-19 vaccine injection.Analog finding was documented at[^(18)F]Choline PET/CT.The aim of our study was to describe this source of false positive cases.All patients examined by PET/CT were included in the study.Data concerning patient anamnesis,laterality,and time interval from recent COVID-19 vaccination were recorded.SUVmax was measured in all lymph nodes expressing tracer uptake after vaccination.Among 712 PET/CT scans with 2-[^(18)F]FDG,104 were submitted to vaccination;89/104 patients(85%)presented axillary and/or deltoid tracer uptake,related to recent COVID-19 vaccine administration(median from injection:11 days).The mean SUVmax of these findings was 2.1(range 1.6–3.3).Among 89 patients with false positive axillary uptake,36 subjects had received chemotherapy due to lymph node metastases from somatic cancer or lymphomas,prior to the scan:6/36 patients with lymph node metastases showed no response to therapy or progression disease.The mean SUVmax value of lymph nodal localizations of somatic cancers/lymphomas after chemotherapy was 7.8.Only 1/31 prostate cancer patients examined by[^(18)F]Choline PET/CT showed post-vaccine axillary lymph node uptake.These findings were not recorded at PET/CT scans with[^(18)F]-6-FDOPA,[^(68)Ga]Ga-DOTATOC,and[^(18)F]-fluoride.Following COVID-19 mass vaccination,a significant percentage of patients examined by 2-[^(18)F]FDG PET/CT presents axillary,reactive lymph node uptake.Anamnesis,low-dose CT,and ultrasonography facilitated correct diagnosis.Semi-quantitative assessment supported the visual analysis of PET/CT data;SUVmax values of metastatic lymph nodes were considerably higher than post-vaccine lymph nodes.[^(18)F]Choline uptake in reactive lymph node after vaccination was confirmed.After the COVID-19 pandemic,nuclear physicians need to take these potential false positive cases into account in daily clinical practice.

Avascular osteonecrosis of the femoral head during HIV infection and antiretroviral therapy: a case report

Avascular osteonecrosis of the femoral head is increasingly affecting HIV-infected patients. Several factors may contribute to its occurrence, including antiretroviral therapy and its complications. We report a case of avascular necrosis of the femoral head in a black woman infected with HIV and treated with antiretroviral drugs in Lomé, Togo, for about 13 years at the time of consultation and with therapeutic success. The antiretroviral treatment included a protease inhibitor initiated 3 years before the onset of the symptomatology which was marked by bilateral hip pain. Biochemical tests showed hypercholesterolemia (total and LDL-cholesterol) and a slight increase in triglycerides. Antiretroviral treatment with a protease inhibitor was changed to an integrase inhibitor. The surgical treatment that was indicated could not be performed because of the patient’s lack of financial means.

Changes in characteristics of patients with hepatitis C virus-related cirrhosis from the beginning of the interferon-free era

BACKGROUND Nearly 290000 patients with chronic hepatitis C die annually from the most severe complications of the disease.One of them is liver cirrhosis,which occurs in about 20%of patients chronically infected with the hepatitis C virus(HCV).Direct-acting antivirals(DAAs),which replaced interferon(IFN)-based regimens,significantly improved the prognosis of this group of patients,increasing HCV eradication rates and tolerability of therapy.Our study is the first to assess changes in patient profile,effectiveness,and safety in the HCV-infected cirrhotic population in the IFN-free era.AIM To document changes in patient characteristics and treatment regimens along with their effectiveness and safety profile over the years.METHODS The studied patients were selected from 14801 chronically HCV-infected individuals who started IFN-free therapy between July 2015 and December 2021 in 22 Polish hepatology centers.The retrospective analysis was conducted in real-world clinical practice based on the EpiTer-2 multicenter database.The measure of treatment effectiveness was the percentage of sustained virologic response(SVR)calculated after excluding patients lost to follow-up.Safety data collected during therapy and the 12-wk post-treatment period included information on adverse events,including serious ones,deaths,and treatment course.RESULTS The studied population(n=3577)was balanced in terms of gender in 2015-2017,while the following years showed the dominance of men.The decline in the median age from 63 in 2015-2016 to 61 years in 2021 was accompanied by a decrease in the percentage of patients with comorbidities and comedications.Treatment-experienced patients dominated in 2015-2016,while treatment-naive individuals gained an advantage in 2017 and reached 93.2%in 2021.Genotype(GT)-specific options were more prevalent in treatment in 2015-2018 and were supplanted by pangenotypic combinations in subsequent years.The effectiveness of the therapy was comparable regardless of the period analyzed,and patients achieved an overall response rate of 95%,with an SVR range of 72.9%-100%for the different therapeutic regimens.Male gender,GT3 infection,and prior treatment failure were identified as independent negative predictors of therapeutic success.CONCLUSION We have documented changes in the profile of HCV-infected cirrhotic patients over the years of accessibility to changing DAA regimens,confirming the high effectiveness of IFN-free therapy in all analyzed periods.