Depistage Des Lesions Du Col Uterin Au Chu Tokoin De Lome : Resultats D’une Serie De 512 Cas.

Purpose: Cervical cancer remains a real public health problem in Togo. This study was undertaken to sensitize women and to determine the prevalence of precancerous and canrous lesions of the cervix in the Togolese woman. Material and methods: This is a retrospective descriptive study of the results of a consecutive series of Pap smears performed in the Laboratory of Pathological Anatomy and Cytology CHU Tokoin Lome 2011-2013. Results: Epidemiological, 512 FCV were interpretable. The average age of women was 37.6 years, extreme 19 and 87 years. By occupation, we noted a predominance of unemployed women (351cas, 68,6%), followed by women traders (103 cases, 20,1%) . The distribution by marital status was possible to observe a predominance of married women (234 cases, 45, 7 %). In terms of reproductive history, we found a mean gravidity and parity respectively 3, 5 and 2. We noted 22 women living with HIV, 77.2% were infected with HIV1. Cytopathological, 512 smears selected, we observed 44 abnormal smears (8,6%). It was indeterminate lesions ASCUS / ASCUS (8 cases), endocervical hyperplasia (3 cases), low-grade lesions (17 cases), high-grade lesions (10 cases) and invasive carcinoma (6 cases). Conclusion: The detection rate of cervical cancer is low among the Togolese woman. The health professionals should take the habit of asking the FCV any woman having a consultation

DEGENERESCENCE KYSTIQUE DE MYOMES UTERINS SIMULANT UN CANCER DE L’OVAIRE : ETUDE D’UN CAS AU CHU DE KARA, AU NORD DU TOGO

Objective : We repport a case of cystic degeneration of two uterine myomas mimicking ovarian cancer. Observation : It concerned a fourty yaers old patient with uterine polymyoma, receeved at jully 15th, 2014 for progressive abdominal tumefaction and recurrent menemetrorrhagia. Huge and renitent mass distended her abdomen. Hemoglogin concentration was 5,78 g/dl and renal assessment was normal. Abdominal ultrasound revealed a huge mixte tumor with ascendancy of the cystic component and uterine polymyoma. Abdominopelvic scanner noted the mixte character of the tumor and suspected his ovarian origin and his malignancy. Tumor was 38 cms of main line. Ther was neither vegetation, nor ascite and nor abdominopelvic lymphatic nods. Xyphopubian laparotomy was practised after correction of the anemia and after prevention of thromboembolic desaese. In the openning, ovaries were normal ; there was left hydrosalpinx ; uterus was polymyomatous with two pediculed cystic degenerescence sub serous myoma measuring 40 cms and 15 cms. Conclusion : Cystic degenerescence of uterus myoma, whatever is rare, can be huge and mimic ovarian cancer instead of médical imaging contribution. It’s necessary to think of behind renitent adnexial masse in clinical context of uterus myoma

Viol Des Mineurs De 10 A 15 Ans Recus Au Chu-So De Lome

Minors of both sexs ages 10 to 15 are most at risk of sexual assault Objective: To determine the prevalence of sexual assault by rape among children aged 10 to 15 years and describe their management at the gynecology and obstetrics clinic of the CHU SO .Patients and methods: 134 files of rape victims were collected from September 1, 2010 to March 31, 2017 at the gynecology and obstetrics clinic of the CHU SO Results: Rape of minors aged 10 to 15 accounted for 26.6% of sexual assaults. There were 91% of girls. Most of our patients (54.5%) were raped between 7pm and 6am. Sixty eight (68) patients (40.3%) were referred for consultation between the 2nd day and the 8th day after the rape. Fifty-five point two percent of the victims had never had sexual intercourse before the rape. The perpetrator was known to the victim in 92.5% of cases. The tear of the hymen was old in 79.5% of the victims. HIV serology was positive in 1.6%. The rate of β HCG was positive in a 15-year-old patient. All our patients had psychological care. Conclusion: The rape of minors of both sexes is a reality in our developing society. The taboo of the sex must be raised for the fast denunciation of the rape and of an adequate care

Feasibility and acceptability of rapid HIV screening in a labour ward in Togo

Background: HIV screening in a labour ward is the last opportunity to initiate an antiretroviral prophylaxis among pregnant women living with HIV to prevent mother-to-child HIV transmission. Little is known about the feasibility and acceptability of HIV screening during labour in West Africa. Findings: A cross-sectional survey was conducted in the labour ward at the Tokoin Teaching Hospital in Lomé (Togo) between May and August 2010. Pregnant women admitted for labour were randomly selected to enter the study and were interviewed on the knowledge of their HIV status. Clinical and biological data were collected from the individual maternal health chart. HIV testing or re-testing was systematically proposed to all pregnant women. Among 1530 pregnant women admitted for labour, 508 (32.2%) were included in the study. Information on HIV screening was available in the charts of 359 women (71%). Overall, 467 women accepted HIV testing in the labour ward (92%). The HIV prevalence was 8.8% (95% confidence interval: 6.4 to 11.7%). Among the 41 women diagnosed as living with HIV during labour, 34% had not been tested for HIV during pregnancy and were missed opportunities. Antiretroviral prophylaxis had been initiated antenatally for 24 women living with HIV and 17 in the labour room. Conclusions: This study is the first to show in West Africa that HIV testing in a labour room is feasible and well accepted by pregnant women. HIV screening in labour rooms needs to be routinely implemented to reduce missed opportunities for intervention aimed at HIV care and prevention, especially PMTCT

Connaissance et attitude pratique des sages femmes sur la prevention de la transmission mere-enfant du virus de l’hepatite b a Lome (Togo)

Introduction : La prévention de la transmission mère enfant (PTME) du virus de l’hépatite B (VHB) implique une bonne connaissance du VHB et l’adoption de bonnes pratiques par les sages femmes (SF). L’objectif de cette étude était d’évaluer les connaissances et les pratiques des SF sur la PTME du VHB.Méthodes : Il s’agit d’une étude prospective, descriptive et analytique ; étaient incluses dans l’étude, les SF travaillant dans la ville de Lomé.Résultats : 87 SF avaient répondu aux questionnaires sur 134 SF (64,9%). Leur âge moyen était de 32,9±5ans. La plupart étaient recrutées en périphérie (41,4%) et travaillaient en salle d’accouchement (79,3%). La moitié ignorait que le VHB  se transmet au cours de la grossesse (65,5%) ou que le VHB ne se transmet par lors de l’allaitement (60,9%). La plupart des SF (90%) ne savait pas que le risque de transmission du VHB est corrélé à la présence de l’AgHBe. Plus de la moitié des  SF (65,5%) ne connaissait pas l’existence de l’immunoglobuline anti VHB. Les SF de moins de 5ans d’ancienneté professionnelle avaient la meilleure connaissance (p=0,0382) du vaccin anti VHB et de son intégration dans le PEV. Toutes les SF (97,7%) pratiquaient systématiquement le dosage de l’AgHBs, cependant 13,8% ne vaccinaient pas les nouveau-nés de mères AgHBs positif à la naissance. Presque la moitié (41,1%) des SF ne referaient pas les mères AgHBs positif vers un spécialiste. Les SF recrutées dans les CHU avaient la meilleure pratique de la vaccination du nouveauné à la naissance (p=0,007). Les SF ayant moins de 5ans d’ancienneté professionnelle avaient la meilleurs pratique du dosage de l’AgHBs (p=0,037).Conclusion : Les connaissances des SF sur la PTME sont moyennement bonnes. La pratique de la PTME par les SF serait influencée par la charge de travail. Très peu de mères Ag HBs positif étaient suivies en milieu spécialisé après accouchement.Mots clés : Connaissance, Attitude, Prevention de la transmission mère-enfant, hépatite B, Sage-femm

Carcinome hepatocellulaire au cours de la grossesse : a propos d’un cas au chu campus de Lome (Togo)

Introduction: Le carcinome hépatocellulaire (CHC) est une entité rare au cours de la grossesse. Le pronostic maternel et foetal est généralement mauvais. Objectif: rapporter notre expérience dans la prise en charge d’une jeune femme enceinte porteuse d’un carcinome hépatocellulaire. Observation: Nous rapportons le cas d’une patiente de 37 ans admise au CHU Campus de Lomé à un stade tardif avec insuffisance hépatocellulaire. Nous avons analysé l’âge de la patiente, l’origine virale du cancer, l’existence d’une cirrhose sous jacente, l’âge gestationnel. Conclusion: Le dépistage des virus de l’hépatite B et C devrait être systématique chez toutes les femmes enceintes. Toutes les femmes enceintes porteuses du VHB ou VHC devraient êtres l’objet d’une surveillance et une prise en charge particulière afin de faciliter le diagnostic précoce du carcinome hépatocellulaire sur grossesse.Mots clés: carcinome hépatocellulaire, grossesse, Togo.English Title: Hepatocellular carcinoma in pregnancy: A case report a the university teaching hospital campus of Lome (Togo)English AbstractIntroduction: Hepatocellular carcinoma (HCC) is a rare entity during pregnancy. The maternal and fetal prognosis is generally bad.Aim: To report our experience in the case of a pregnant woman carrying hepatocellular carcinoma.Case report: We report the case of a 37 year old patient admitted to the University Teaching Hospital Campus of Lomé at a late stage with liver failure. We analyze the age of the patient, the viral origin of cancer, the existence of underlying cirrhosis, gestational age.Conclusion: Screening for hepatitis B and C should be routine for all pregnant women. All pregnant women with HBV or HCV beings should be monitored and special support to facilitate the early diagnosis of hepatocellular carcinoma in pregnancy.Keywords: hepatocellular carcinoma, pregnancy, Tog