Morbidite Et Mortalite Dans Un Service D’hepato- Gastroenterologie En Milieu Tropical

Aims: This study aims at studying the key parameters of our patients such as morbidity and mortality. Knowing these parameters will enable to objectively assess the epidemiological profile of the patients, the terms of their care taking as well as the efficiency and the profitability of our service. Method: This is a descriptive retrospective study over a year (from January 1st to December 31st, 2015). We included in the study patients of both sexes hospitalized and examined in the unit. Results: The hospitalization rate was 33.5 %. It was about 564 men (57.3 %) and 420 women (42.7 %) accounting for a sex ratio of 1.3. The patients’ average age was 48.1 years old (extremes: 22-80 years old). Chronic liver diseases were the first main cause of hospitalization with 43 % of cases. We noticed 26% of cirrhosis and 17% of hepatocellular carcinoma. The average hospital stay was 6.48 ± 5.45 days with some extremes of 1 and 57 days. The Co-morbidities found were mostly hypertension (10.8 %), HIV (6.1 %), and diabetes (1.3 %). The overall mortality rate was 14.8 % and was higher in men (p = 0.006). The specific mortality was higher in cirrhotic patients (6.6 %) and those with HCC (4.7 %). The highest lethally rates were those of colon cancers (100%) and pancreas (42.8 %). Conclusion: This study has enabled us to inventory the major causes of morbidity and mortality in our department. Mortality is influenced by gender, co-morbidities and tobacco. Digestive cancers are the most lethal diseases in our department

La Pathologie Anorectale Au Chu Campus De Lome (Togo)

Objective: To describe the clinical and endoscopic presentation of anorectal pathologies in the gastroenterology department of the CHU campus of Lomé. Patients and methods: Retrospective study based on reports of low digestive endoscopy carried out at the university teaching hospital Campus of Lome. We collected the age of the patients, their sex, the indications of the examination and the different anorectal lesions encountered. Results: The mean age was 41.8 ± 14.3 years. There was a predominance of 30-40 years (38.8%). There was also a male predominance with a sex ratio of 1.6. The most frequent indication was rectal bleeding (64.1%). Anal pain was found in 40.8% of cases. The most frequent lesions were hemorrhoids (69.9%) and anal fistula in 8.7% of cases. Cancer of the anus was rarely observed (1.9%) as was the rectal polyp (0.1%). Conclusion: Anorectal pathologies are relatively frequent in our department, especially in young patients and are dominated by hemorrhoidal disease

Drivers for Rift Valley fever emergence in Mayotte: A Bayesian modelling approach

Rift Valley fever (RVF) is a major zoonotic and arboviral hemorrhagic fever. The conditions leading to RVF epidemics are still unclear, and the relative role of climatic and anthropogenic factors may vary between ecosystems. Here, we estimate the most likely scenario that led to RVF emergence on the island of Mayotte, following the 2006–2007 African epidemic. We developed the first mathematical model for RVF that accounts for climate, animal imports and livestock susceptibility, which is fitted to a 12-years dataset. RVF emergence was found to be triggered by the import of infectious animals, whilst transmissibility was approximated as a linear or exponential function of vegetation density. Model forecasts indicated a very low probability of virus endemicity in 2017, and therefore of re-emergence in a closed system (i.e. without import of infected animals). However, the very high proportion of naive animals reached in 2016 implies that the island remains vulnerable to the import of infectious animals. We recommend reinforcing surveillance in livestock, should RVF be reported is neighbouring territories. Our model should be tested elsewhere, with ecosystem-specific data

Why are anopheline mosquitoes not present in the Seychelles?

<p>Abstract</p> <p>Background</p> <p>Species of anopheline mosquitoes are largely distributed over emerged lands around the world and, within the tropics, few areas are without these insects, which are vectors of malaria parasites. Among the exceptions is the Seychelles archipelago in the western Indian Ocean. However, in the Aldabra island group, located in the extreme western portion of the archipelago, <it>Anopheles gambiae s.l. </it>was introduced, leading to massive proliferation and then elimination, with the most recent autochthonous malaria cases recorded in 1931.</p> <p>Methods</p> <p>In order to re-examine the absence of anopheline mosquitoes in the Seychelles, an entomological field survey was conducted in December 2008 at 17 sites on four granitic islands, including Mahé and Praslin, and ten sites on coralline atolls in the extreme west, including Aldabra.</p> <p>Results</p> <p>No evidence of larval or adult anophelines was found at the surveyed sites, which supports their absence in the Seychelles.</p> <p>Conclusions</p> <p>In the granitic islands of the Seychelles, the climate is favourable for anophelines. However, these islands are protected by their remoteness and prevailing seasonal winds. In addition, stagnant freshwater, required in anopheline larval development, is relatively uncommon on the granitic islands because of the steep slopes. In the southwestern atolls (Aldabra and Providence-Farquhar groups), the presence of a long dry season of up to nine months and the total absence of permanent natural freshwater prevents the breeding of anophelines and their successful colonization. The Seychelles does not have any native land mammals and like in other parts of the world (Antarctica, Iceland, New Caledonia, Central Pacific islands) their absence is associated with the lack of anophelines. This suggests an obligatory relationship for anophelines to feed on terrestrial mammals, without alternative for blood-feeding sources, such as bats, birds and reptiles.</p

Evaluation of the Human IgG Antibody Response to Aedes albopictus Saliva as a New Specific Biomarker of Exposure to Vector Bites

Aedes-borne viruses like dengue and chikungunya are a major problem in Reunion Island. Assessing exposure to Aedes bites is crucial to estimating the risk of pathogen transmission. Currently, the exposure of populations to Aedes albopictus bites is mainly evaluated by entomological methods which are indirect and difficult to apply on a large scale. Recent findings suggest that evaluation of human antibody responses against arthropod salivary proteins could be useful in assessing exposure to mosquito bites. The results indicate that 88% of the studied population produce IgG to Ae. albopictus saliva antigens in Reunion Island and show that this biomarker can detect different levels of individual exposure. In addition, little cross-reactivity is observed with Aedes aegypti saliva, suggesting that this could be a specific marker for exposure to Aedes albopictus bites. Taken together, these results suggest that antibody responses to saliva could constitute a powerful immuno-epidemiological tool for evaluating exposure to Aedes albopictus and therefore the risk of arbovirus infection

Agroforesterie et services écosystémiques en zone tropicale

Respectueux de l’environnement et garantissant une sécurité alimentaire soutenue par la diversification des productions et des revenus qu’ils procurent, les systèmes agroforestiers apparaissent comme un modèle prometteur d’agriculture durable dans les pays du Sud les plus vulnérables aux changements globaux. Cependant, ces systèmes agroforestiers ne peuvent être optimisés qu’à condition de mieux comprendre et de mieux maîtriser les facteurs de leurs productions. L’ouvrage présente un ensemble de connaissances récentes sur les mécanismes biophysiques et socio-économiques qui sous-tendent le fonctionnement et la dynamique des systèmes agroforestiers. Il concerne, d’une part les systèmes agroforestiers à base de cultures pérennes, telles que cacaoyers et caféiers, de régions tropicales humides en Amérique du Sud, en Afrique de l’Est et du Centre, d’autre part les parcs arborés et arbustifs à base de cultures vivrières, principalement de céréales, de la région semi-aride subsaharienne d’Afrique de l’Ouest. Il synthétise les dernières avancées acquises grâce à plusieurs projets associant le Cirad, l’IRD et leurs partenaires du Sud qui ont été conduits entre 2012 et 2016 dans ces régions. L’ensemble de ces projets s’articulent autour des dynamiques des systèmes agroforestiers et des compromis entre les services de production et les autres services socio-écosystémiques que ces systèmes fournissent

Parasitoses Digestives : Aspects Epidemiologique Et Etiologique Dans Le Service D’hepato-Gastro-Enterologie Du Chu-Campus De Lome

Buts : L’étude a consisté d’une part en la description des aspects épidémiologiques et de relever les différentes manifestations cliniques révélatrices de ces parasites intestinaux, de l’autre, en la description du profil étiologique des parasitoses intestinales en milieu hospitalier Méthodologie : Il s’agit d’une étude rétrospective menée du 1er Janvier 1997 au 31 Décembre 2007, à partir des dossiers des malades des deux sexes, âgés d’au moins 15 ans et hospitalisés dans le service d’hépato-gastro-entérologie du CHU Campus de Lomé. Les données épidémiologiques, cliniques et paracliniques notamment l’examen parasitologique de chaque dossier étaient relevées et étudiées. Résultats : Durant notre période d’étude, 3585 patients ont été hospitalisés dans le service. Une parasitose intestinale était révélée dans 196 dossiers (5,47%). 223 parasites étaient identifiés dont 194 protozoaires (87%) et 29 helminthes (13%). L’âge moyen de nos patients était de 39,34 ans ± 15,92 (extrêmes : 15 et 93 ans), et une sex-ratio à 1,04. Les motifs d’hospitalisation étaient dominés par la gastroentérite aigüe (34,18%), suivie de la douleur abdominale isolée (26,53%). La numération, formule sanguine réalisée chez 180 (91,84%). L’hyper éosinophilie était constatée dans 14 cas (6,39%) dont 9 étaient associés aux helminthes (Ankylostome) et 5, aux protozoaires. Une anémie normocytaire normochrome et microcytaire hypochrome étaient observées dans respectivement 46cas et 15 cas. Cette anémie était associée aux protozoaires dans tous les cas (61 cas) et aux helminthes dans 9 cas. Cinquante (50) des patients ayant une parasitose intestinale avaient bénéficié d’une sérologie à VIH dont 15 étaient séropositifs au VIH. Chez ces patients, les protozoaires (pathogènes et non pathogènes) étaient retrouvés dans 14 cas et les helminthes dans 01 seul cas. Conclusion : Les parasitoses digestives occupent une place non négligeable dans le service d’hépatogastro-entérologie du CHU-Campus de Lomé. La prédominance des protozoaires est un témoin direct du péril fécal donc, du bas niveau d’hygiène individuelle et collective. L’émergence de parasite avec une symptomatologie considérée jusque là comme non pathogène (Isospora belli) est en rapport avec la pandémie du VIH-SIDA.Mots clés : Parasitoses digestives, CHU, Lomé.Goals: The survey consisted on the one hand in the epidemiological aspect description and to raise the different demonstrations revealing clinics of these intestinal interferences, of the other, in the description of the profile étiologique of the intestinal parasitoses in hospitable environment.Methodology: It is about a retrospective survey led from January 1st, 1997 to December 31, 2007, from the files of the patients of the two sexes, aged of at least 15 years and hospitalized in the service of hépato-gastro-entérologie of him FALLEN Campus of Lomé. The epidemiological data, clinics and paracliniques notably the exam parasitologique of every file was raised and studied. Results: During our period of survey, 3585 patients have been hospitalized in the service. An intestinal parasitose was revealed in 196 files (5.47%). 223 interferences were identified of which 194 protozoa (87%) and 29 helminthes (13%). The middle age of our patients was of 39.34 years ± 15.92 (extreme: 15 and 93 years), and one sex - ratio to 1.04. The motives of hospitalization were dominated by the gastro-enteritis aigüe (34,18%), consistent of the isolated abdominal pain (26.53%). The numeration, formula red chalk achieved at 180 (91,84%). The hyper éosinophilie was noted in 14 cases (6,39%) of which 9 were associated to the helminthes (Ankylostome) and 5, to the protozoa. An anemia normocytaire normochrome and microcytaire hypochrome were observed in respectively 46cas and 15 cases. This anemia was associated to the protozoa in any case (61 cases) and to the helminthes in 9 cases. Fifty (50) the patients having an intestinal parasitose had benefitted from a serology in VIH of which 15 were seropositive in the VIH. At these patients, the protozoa (pathogenic and non pathogenic) were recovered in 14 cases and the helminthes in 01 only case. Conclusion: The digestive parasitoses occupies a non negligible place in the service of hépato-gastroentérologie of the Chu - Campus of Lomé. The predominance of the protozoa is therefore a direct witness of the fecal peril, of the low level of individual and collective hygiene. The emergence of parasite with a symptomatologie considered until there as non pathogenic (Isospora belli) is in relation with the pandemic of the VIH - AIDS.Key words: Digestive Parasitoseses, FALLEN, Lomé.Article text in Frenc

Aspects étiologiques des rectorragies chez l’adulte en milieu africain : à propos de 85 cas colligés en 12 ans au CHU-Campus de Lomé

But : recenser les étiologies des rectorragies au CHU Campus de Lomé. Méthodologie : Il s’agit d’une étude rétrospectivr sur 12 ans (1er janvier 1990 - 31 décembre 2001), réalisée à partir des comptes-rendus de coloscopie. Elle a inclus les dossiers des malades des deux sexes, âgés de plus de 15 ans, ayant présenté une rectorragie explorée par une ano-rectoscopie et une coloscopie totale. Résultats : les rectorragies représentent 38,72 % des indications de la coloscopie. Les malades âgés de 24 à 45 ans ont été les plus atteints (52,94 %). Une prédominance masculine a été retrouvée (sex-ratio : 2,4). Parmi les étiologies retrouvées, les hémorroïdes ont été plus fréquentes (23,53 %) suivies par les colites non spécifiques (16,47 %), la recto-colite ulcéro-hémorragique (15,29 %), la diverticulose colique (10,58 %), les colites amibiennes (9,4 %) et le cancer colorectal (5,88%). Les hémorroïdes étaient associées à une colite non spécifique (1 cas), à une recto-colite ulcéro-hémorragique (1 cas), à une colite amibienne (1 cas) et à une diverticulose colique (1 cas). Dans 12 cas (14,12 %), aucune étiologie n’a été retrouvée. Conclusion : Les hémorroïdes représentent l’étiologie la plus fréquente des rectorragies à Lomé; cependant leur découverte à l’ano-rectoscopie ne doit pas dispenser de la réalisation d’une coloscopie complète à la recherche de lésions associées.Mots clés : Rectorragie, étiologie, ano-rectoscopie, coloscopie.Purpose: To count the aetiology of proctorrhagia in Lomé. Methods: It is a retrospective study, over 12 years (1st January 1990-31 December 2001), realised from the reports of the coloscopy. It included the patients of the two sexes, old of more than 15 years, having presented a proctorrhagia explored by ano-rectoscopy and coloscopy. Results: The proctorrhagia represent 38.72 % of the indications of the coloscopy. The patients from 24 to 45 years were reached (52.94 %). A male prevalence was found (sex-ratio: 2.4). Among the aetiology found, the haemorrhoids more frequent (23.53 %) were followed by the non specific colitis (16.47 %), the ulcero-haemorrhage rectocolitis (15.29 %), the colon diverticulosis (10.58 %), the amoebic colitis (9.4%) and colorectal cancer (5.88 %). The haemorrhoids were associated with a non specific colitis (1 case), an ulcero-hemorrhagic rectocolitis (1 case), an amoebic colitis (1 case) and diverticulose colic (1 case). In 12 cases (14.12 %), no aetiology was found. Conclusion: The haemorrhoids represent the most frequent aetiology of the proctorrhagia in Lomé; however their discovery in ano-rectoscopy should not exempt realisation of a complete coloscopy in the search of other causes.Key words: Proctorrhagia, aetiology, ano-rectoscopy, coloscopy