Managing a Hemodialysis Unit in Times of Pandemic to COVID-19. Experience of Edith Lucie Bongo Ondimba General Hospital

This is the description of the prevention and the development of the sessions of hemodialysis in our center hemodialysis to not be contaminated coronavirus. Actions taking are: respect of the measures decreed by the state for prevention. Although these measures are difficult socio-cultural for Africans, they became normal after two weeks. The hemodialysis is made free during this period in our public center. Indeed, the session of hemodialysis was 10,000 francs Africans financial community (CFA in french) or 16.72 American dollar, from the declaration of the state of emergency it has become free. We do hemodialysis free and explanation of covid19 signs in hemodialysis patients systematically. Each patient had the explanation of the pathology and above all we did everything to de-stress the patients, because there is a global psychosis. Cleaning hand before entering the hemodialysis room, we have positioned front of the hospital and before the service and the front of room hemodialysis, seals for washing hands. We monitor the temperature before hemodialysis with a thermoflash or a mercury thermometer for each patient. We made a mandatory to wear masks for all patients during hemodialysis sessions. We shared the masks in loincloth with liners to all the patients a local manufacture.

Pulmonary Hypoplasia: A Rare Cause of Chronic Cough in TB Endemic Area

Pulmonary hypoplasia is a rare disease characterized by a defect of lung development more often unilateral. The diagnosis requires several exams to eliminate other causes of pulmonary retraction. We report two cases at the department of pneumophtisiology of the University Teaching Hospital of Point G. The first case is a young adult who was complaining of a chronic cough. Etiological investigation required several exams including spirometry and Computed tomographic scan (CT scan). After elimination of all suspected causes of pulmonary opacity, the diagnosis of pulmonary hypoplasia was retained. The second case is a 2-year-old girl who was born with congenital cardiopathy whose respiratory complications were increasing during her childhood and respiratory explorations discovered pulmonary agenesis. Pulmonary hypoplasia is rare in our medical practice, but attention must be drawn to a retractile pulmonary opacity in young age after elimination of all infectious causes in TB endemic area.

Screening of Foot at Risk in Diabetic Patients

Introduction: The term “diabetic foot” refers to all conditions that affect the foot and are directly related to the impact of diabetes. Objective: Screen the foot at risk in diabetic patients at the hospital of Mali. Methods: It was a cross-sectional study from January 1st, 2016 to June 30, 2016, at the Department of Internal Medicine and endocrinology of the Hospital of Mali. It was focused on all hospitalized diabetic patients. Results: Thirty-two (32) patients had a foot at risk among 76 diabetic patients during the study period representing 42.10%. The sex ratio was 0.52. Type 2 diabetes accounted for 82%. A glycemic imbalance (HBA1C > 7%) was observed in 88.15%. Eighteen percent (18%) of patients had a history of ulceration or amputation;33% were walking barefoot;78.9% had tingles in the foot;31.6% had intermittent claudication;64.5% had foot cleanliness;8% claw toes;42% had abolition or reduction of superficial tenderness to monofilament and 21% had mixed foot (neuropathy + arteriopathy). In our study, 58.9% of patients had no risk of podiatry. Conclusion: Screening of foot at risk is essential in the management of diabetes because it determines the podiatric risk enabling to minimize future functional disabilities.

Prevalence and Clinical Relevance of Schistosoma mansoni Co-Infection with Mycobacterium tuberculosis: A Systematic Literature Review

Tuberculosis disease stands for the second leading cause of death worldwide after COVID-19, most active tuberculosis cases result from the reactivation of latent TB infection through impairment of immune response. Several factors are known to sustain that process.Schistosoma mansoni, a parasite of the helminth genus that possesses switching power from an immune profile type Th1 to Th2 that favors reactivation of latent TB bacteria. The aim of the study was to assess the prevalence of the co-infection between the two endemic infections. Systematic literature was contacted at the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. Original articles were included, and full texts were reviewed to assess the prevalence and better understand the immunological changes that occur during the co-infection. In total, 3530 original articles were retrieved through database search, 53 were included in the qualitative analysis, and data from 10 were included in the meta-analysis. Prevalence of the co-infection ranged from 4% to 34% in the literature. Most of the articles reported that immunity against infection with helminth parasite and more specifically Schistosoma mansoni infection enhances latent TB reactivation through Th1/Th2. In sum, the impact of Schistosoma mansoni co-infection with Mycobacterium tuberculosis is under-investigated. Understanding the role of this endemic tropical parasite as a contributing factor to TB epidemiology and burden could help integrate its elimination as one of the strategies to achieve the END-TB objectives by the year 2035.