Evaluation De La Prematurite Superieure Ou Egale A 32 Semaine D’amenorhée A L’hopital Regional De Ziguinchor Au Sud Du Senegal (Afrique De L’ouest)

Introduction: Prematurity is one of the leading causes of neonatal death in Africa. The objective of this work was to assess the preterm birth at the pediatric service of the regional hospital of Ziguinchor. Material and methods: This was a prospective, descriptive and analytical study of the case of hospitalized newborns whose age was between 32 SA to 36SA + 6 days. The study was conducted from May 21, 2013 to May 21, 2014. We included all premature infants at age ≥ 32SA.Those presenting a malformation were not included. We studied maternal socio-demographic, obstetric and neonatal parameters. Results: We have identified 140 newborns out of a total of 342 Preterm births and 2292 maternity births, a prevalence of 40.9% compared to preterm infants and 6.10% in relation to all births. 51.4 percent of mothers came from urban areas, 63.5 percent were between 20 and 34 years of age, not attending school in 45.7 percent, married in 72.9 percent and without work in 94.3 percent. The average gestures represented 3.09 . Arterial hypertension was the most common medical condition (67.7%). The followup was done by a midwife (82.1%) and 23.5% had received at least 4 NPC. Eclampsia and pre-eclampsia (48.9%) and RPM (42.8%) were common obstetric pathologies. The delivery was by caesarian (51.4%), hospital (92.1%), cephalic presentation (80%), with an average weight of 1816.79 g. An RCIU (16.4%), an RPM (61.9%). At birth, a DR (16.4%) was noted due to MMH (43.7%) and transitory tachypnea (50%). Asphyxia was reported in 3.5%. During hospitalization (6.7 days on average), 6.4% had RD caused by infection (77.7%). Other complications were infection (64.4%), hypoglycemia (28.5%), digestive hemorrhage (7.01%). The fatality rate was 7.9% due to infection (63.3%), DR (18%), haemorrhage (9%). The anthropometric measurements at the exit: P 1887.9g, T: 38.3cm, PC: 30.9cm; at 1 month P: 2387.1g, T: 46.6cm, PC: 32.8cm; at 30 months P: 12.1kg, T: 89.5cm, PC: 48.4cm. Conclusion: Moderate preterm birth accounts for almost half of the cases of prematurity in our series. Their optimal management would go through a better obstetric-neonatal collaboration but above all by the installation of kangaroo mother unit

Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study.

HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region.Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3).This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population