La Prévalence des Pathologies Thyroïdiennes chez le Sujet Âgé au Service de Médecine Interne de l’Hôpital National Donka

Introduction : Le vieillissement est associé à des modifications complexes de la fonction thyroïdienne qui interviennent à plusieurs niveaux de régulation. La sécrétion des hormones thyroïdiennes est en général dans les limites inférieures des valeurs usuelles. Méthodes : Il s’agissait d’une étude rétrospective à visée descriptive et analytique menée du 1er janvier 2013 au 31 décembre 2022 (soit 10 ans). L’étude était réalisée au service de médecine interne de l’hôpital national Donka (Guinée). Elle a porté sur les sujets âgés de 60 ans et plus suivis pour une pathologie thyroïdienne. Résultats : Durand la période d’étude nous avons colligé 88 cas de dysthyroïdies soit une prévalence de 17,95 %. Il y avait une prédominance féminine (56 cas) avec un sex ratio H/F de 0,57. L’âge moyen était de 64,5 ans (extrêmes de 60 et 85 ans). Les circonstances de diagnostic de la maladie thyroïdienne étaient principalement un goitre (59,1%), une exophtalmie (9,1%), une compression cervicale (25%), une cardiothyréose (5,7 %). Les principales manifestations de la thyrotoxicose étaient l’amaigrissement (17%), les palpitations (29,5%) et la fatigabilité (34,1%). Les signes d’hypothyroïdie prédominants étaient la constipation (17%) et le syndrome myxœdémateux (3,4%). L’hyperthyroïdie a été rencontrée chez 13,64% des patients, contre 29,54% de cas d’hypothyroïdie. L’échographie cervicale thyroïdienne avait retrouvé 36 cas de goitre diffus (40,9%), 18 cas de goitre multinodulaire (20,45%), 17 cas de nodule unique (19,31%). Les principales étiologies étaient la maladie de Basedow (11,4%), le goitre multinodulaire (46,6%), la thyroïdite de Hashimoto (17%), un goitre simple (5,7%). La thyroïdectomie avait concerné 33 patients (37,5%). Deux cas de décès étaient enregistrés en rapport avec une cardiothyréose. Conclusion : Les dysthyroïdies sont fréquentes chez le sujet âgé au CHU de Conakry et un dosage hormonal au moindre doute afin d’instaurer le traitement adéquat à temps serait requis afin de prévenir les complications.   Introduction: The aging is associated with complex changes in thyroid function that occur at several levels of regulation. Thyroid hormone secretion is generally within the lower limits of usual values. Methods: This was a retrospective study with descriptive and analytical aims carried out from January 1, 2013 to December 31, 2022 (i.e. 10 years). The study was carried out in the internal medicine department of the Donka national hospital (Guinea). It focused on subjects aged 60 and over followed for thyroid pathology. Results: During the study period we collected 88 cases of dysthyroidism, representing a prevalence of 17.95%. There was a female predominance (56 cases) with a M/F sex ratio of 0.57. The average age was 64.5 years (range 60 and 85 years). The circumstances of diagnosis of thyroid disease were mainly goiter (59.1%), exophthalmos (9.1%), cervical compression (25%), cardiothyreosis (5.7%). The main manifestations of thyrotoxicosis were weight loss (17%), palpitations (29.5%), and fatigability (34.1%). The predominant signs of hypothyroidism were constipation (17%) and myxedematous syndrome (3.4%). Hyperthyroidism was encountered in 13.64% of patients, compared to 29.54% cases of hypothyroidism. Cervical thyroid ultrasound found 36 cases of diffuse goiter (40.9%), 18 cases of multinodular goiter (20.45%), 17 cases of single nodule (19.31%). The main etiologies were Graves' disease (11.4%), multinodular goiter (46.6%), Hashimoto's thyroiditis (17%), simple goiter (5.7%). Thyroidectomy involved 33 patients (37.5%). Two cases of death were recorded in connection with cardiothyreosis. Conclusion: Dysthyroidism is common in the elderly at the Conakry University Hospital and a hormonal dosage if there is the slightest doubt in order to initiate the appropriate treatment in time would be required in order to prevent complications

La Prévalence des Pathologies Thyroïdiennes chez le Sujet Âgé au Service de Médecine Interne de l’Hôpital National Donka

Introduction : Le vieillissement est associé à des modifications complexes de la fonction thyroïdienne qui interviennent à plusieurs niveaux de régulation. La sécrétion des hormones thyroïdiennes est en général dans les limites inférieures des valeurs usuelles. Méthodes : Il s’agissait d’une étude rétrospective à visée descriptive et analytique menée du 1er janvier 2013 au 31 décembre 2022 (soit 10 ans). L’étude était réalisée au service de médecine interne de l’hôpital national Donka (Guinée). Elle a porté sur les sujets âgés de 60 ans et plus suivis pour une pathologie thyroïdienne. Résultats : Durand la période d’étude nous avons colligé 88 cas de dysthyroïdies soit une prévalence de 17,95 %. Il y avait une prédominance féminine (56 cas) avec un sex ratio H/F de 0,57. L’âge moyen était de 64,5 ans (extrêmes de 60 et 85 ans). Les circonstances de diagnostic de la maladie thyroïdienne étaient principalement un goitre (59,1%), une exophtalmie (9,1%), une compression cervicale (25%), une cardiothyréose (5,7 %). Les principales manifestations de la thyrotoxicose étaient l’amaigrissement (17%), les palpitations (29,5%) et la fatigabilité (34,1%). Les signes d’hypothyroïdie prédominants étaient la constipation (17%) et le syndrome myxœdémateux (3,4%). L’hyperthyroïdie a été rencontrée chez 13,64% des patients, contre 29,54% de cas d’hypothyroïdie. L’échographie cervicale thyroïdienne avait retrouvé 36 cas de goitre diffus (40,9%), 18 cas de goitre multinodulaire (20,45%), 17 cas de nodule unique (19,31%). Les principales étiologies étaient la maladie de Basedow (11,4%), le goitre multinodulaire (46,6%), la thyroïdite de Hashimoto (17%), un goitre simple (5,7%). La thyroïdectomie avait concerné 33 patients (37,5%). Deux cas de décès étaient enregistrés en rapport avec une cardiothyréose. Conclusion : Les dysthyroïdies sont fréquentes chez le sujet âgé au CHU de Conakry et un dosage hormonal au moindre doute afin d’instaurer le traitement adéquat à temps serait requis afin de prévenir les complications.   Introduction: The aging is associated with complex changes in thyroid function that occur at several levels of regulation. Thyroid hormone secretion is generally within the lower limits of usual values. Methods: This was a retrospective study with descriptive and analytical aims carried out from January 1, 2013 to December 31, 2022 (i.e. 10 years). The study was carried out in the internal medicine department of the Donka national hospital (Guinea). It focused on subjects aged 60 and over followed for thyroid pathology. Results: During the study period we collected 88 cases of dysthyroidism, representing a prevalence of 17.95%. There was a female predominance (56 cases) with a M/F sex ratio of 0.57. The average age was 64.5 years (range 60 and 85 years). The circumstances of diagnosis of thyroid disease were mainly goiter (59.1%), exophthalmos (9.1%), cervical compression (25%), cardiothyreosis (5.7%). The main manifestations of thyrotoxicosis were weight loss (17%), palpitations (29.5%), and fatigability (34.1%). The predominant signs of hypothyroidism were constipation (17%) and myxedematous syndrome (3.4%). Hyperthyroidism was encountered in 13.64% of patients, compared to 29.54% cases of hypothyroidism. Cervical thyroid ultrasound found 36 cases of diffuse goiter (40.9%), 18 cases of multinodular goiter (20.45%), 17 cases of single nodule (19.31%). The main etiologies were Graves' disease (11.4%), multinodular goiter (46.6%), Hashimoto's thyroiditis (17%), simple goiter (5.7%). Thyroidectomy involved 33 patients (37.5%). Two cases of death were recorded in connection with cardiothyreosis. Conclusion: Dysthyroidism is common in the elderly at the Conakry University Hospital and a hormonal dosage if there is the slightest doubt in order to initiate the appropriate treatment in time would be required in order to prevent complications

Upscaling cassava processing machines and products in Liberia

Open Access JournalCassava is produced by more than 80% of farming households and is an important contributor to gross domestic product (GDP) in Liberia. It is therefore important to assess the status of cassava processing into food and other products. A total of one hundred and sixty (160) well-structured questionnaires were used for the collection of information from eight counties, with twenty respondents from each county. It was found out that all the counties lack adequate modern cassava processing machines, with almost all cassava processing operations being done with rudimentary equipment. Gari and wet fufu are common products in Liberian markets, with no high-quality cassava flour (HQCF) or derivatives. Consequently, user and gender friendly processing machines were installed in six established modern cassava processing centres, and new cassava products, such as fufu powder, tapioca, and HQCF with its value-added products (10% bread and pastries), were introduced. This upscaling will enhance the cassava value chain in Liberia with improvement in livelihoods, especially for vulnerable women and unemployed youth

Development of an improved steamer for optimum retention of carotenoids in Attieke produced from biofortified cassava (Manihot esculenta Crantz) roots

Open Access ArticleAttiéké, made from biofortified (yellow) cassava genotypes, requires a new cooking method to minimize carotenoid degradation during processing. Thus, this research is aimed at designing and building a more efficient steamer to produce high-quality attiéké from biofortified cassava roots. Using three improved biofortified cassava genotypes (IBA141092, IBA070593, and IBA011368) obtained from IITA research farms, attiéké samples were produced using traditional and developed steamers. The results show that the developed steamer outperformed the traditional steamer; it was 1.5 times faster, used less fuel (2.6 times less), and had higher true carotenoid retention. The developed steamer genotype IBA070593 had the highest true retention of 90.4 percent, while the traditional steamer genotype IBA0141092 had the lowest carotenoid retention of 61.9 percent and the highest in the developed steamer (62.4 percent). When compared to the traditional steamer, the developed steamer had better cooking performance and a more extraordinary ability to retain carotenoids. Thus, the developed steamer is recommended for attiéké processors due to its improved cooking performance, and using this steamer to produce attiéké from biofortified cassava will help to alleviate vitamin A deficiency among attiéké consumers

Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980�2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1�4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980�2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age�sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5·8 million (95 uncertainty interval UI 5·7�6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7�53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3�43·6) to 2·6 million (2·6�2·7) neonatal deaths and 47·0% (35·1�57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6�3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license

Comparative evaluation of four different cassava peeling devices

Manual method predominates in the cassava peeling industry in Nigeria as more than 70% of the processed cassava in the market passed through manual process. Mechanical option has come to the forefront since other processing methods are discouraged based on their deficiencies. This work investigates improvements recorded with mechanical method over the manual method, and the inherent challenges of stakeholders in the industry. Three cassava peeling machines namely, BASICON, FATAROY and WAMABCO, were selected under the mechanical method. Manual method was also evaluated under similar test conditions. Performance evaluation was carried out on each cassava peeler to assess their fuel and power utilization, cost and ease of operation. Manual peeling process recorded an average peeling efficiency of 100% and average percentage tuber flesh loss of 5.5%. The BASICON cassava peeler had an average peeling efficiency of 96% and average percentage tuber flesh loss of 75%. The FATAROY cassava peeler had an average peeling efficiency of 72% with 23% average percentage tuber flesh loss. The WAMABCO cassava peeler had an average peeling efficiency of 64% and average percentage tuber flesh loss of 14%. The energy consumption rate obtained for the FATAROY cassava peeler was the best of all. The three cassava peelers evaluated performed 10 times faster than the manual method adopted for cassava peeling operation. The capacity of each of the machines was less than 800 kg/h, which is too small for industrial application. Manual method was the slowest and the most expensive, but offered a superior quality output. Small-scale processors therefore require suitable cassava peelers to aid the peeling operation of cassava in Nigeria’s cassava processing industry

Understanding long-term evolution and predictors of sequelae of Ebola virus disease survivors in Guinea : a 48-month prospective, longitudinal cohort study (PostEboGui)

Background : Longitudinal analyses are needed to better understand long-term Ebola virus disease (EVD) sequelae. We aimed to estimate the prevalence, incidence, and duration of sequelae and to identify risk factors associated with symptom occurrence among EVD survivors in Guinea.Methods : We followed 802 EVD survivors over 48 months and recorded clinical symptoms with their start/end dates. Prevalence, incidence, and duration of sequelae were calculated. Risk factors associated with symptom occurrence were assessed using an extended Cox model for recurrent events.Results : Overall, the prevalence and incidence of all symptoms decreased significantly over time, but sequelae remained present 48 months after Ebola treatment center discharge with a prevalence of 30.68% (95% confidence interval [CI] 21.40-39.96) for abdominal, 30.55% (95% CI 20.68-40.41) for neurologic, 5.80% (95% CI 1.96-9.65) for musculoskeletal, and 4.24% (95% CI 2.26-6.23) for ocular sequelae. Half of all patients (50.70%; 95% CI 47.26-54.14) complained of general symptoms 2 years' postdischarge and 25.35% (95% CI 23.63-27.07) 4 years' post-discharge. Hemorrhage (hazard ratio [HR], 2.70; P = .007), neurologic (HR 2.63; P = .021), and general symptoms (HR 0.34; P = .003) in the EVD acute phase were significantly associated with the further occurrence of ocular sequelae, whereas hemorrhage (HR 1.91; P = .046) and abdominal (HR 2.21; P = .033) symptoms were significantly associated with musculoskeletal sequelae.Conclusions : Our findings provide new insight into the long-term clinical complications of EVD and their significant association with symptoms in the acute phase, thus reinforcing the importance of regular, long-term follow-up for EVD survivors