Troponine Ultra-sensible: Quelles Indications et Comment Interpréter les Résultats en Gériatrie Un cas d'Élévation de la Troponine chez une Octogénaire

La troponine T ultra-sensible (us), marqueur biologique spécifique du cœur, peut être élevée dans des conditions pathologiques autres que le syndrome coronarien aigu. Ces autres causes peuvent ou non être directement liées aux maladies cardiaques. Nous rapportons le cas d'une patiente de 85 ans présentant de multiples événements cardiovasculaires qui présentait une élévation de la troponine T us à 1088 pg/ml, probablement due à de multiples étiologies.   The ultra-sensitive troponin T (us), a specific biological marker of the heart, may be elevated in pathological conditions other than acute coronary syndrome. These other causes may or may not be directly related to heart disease. We report the case of an 85-year-old female patient with multiple cardiovascular events who presented an elevation of us troponin T to 1088 pg / ml, probably due to multiple etiologies

Facteurs Associés à L’inobservance Thérapeutique chez les Patients Admis pour Acidocétose Diabétique à l’Hôpital National de Niamey

Introduction : L’acidocétose diabétique est une complication aigue métabolique fréquente du diabète. L’inobservance thérapeutique, un des facteurs décompensant du diabète, peut être associé à plusieurs facteurs. Cette étude vise à identifier les facteurs associés à l’inobservance thérapeutique Patients et méthode : il s’agit d’une étude rétrospective réalisée au service de médecine interne de l’hôpital national de Niamey ayant inclus tous les diabétiques d’un ou plus, hospitalisé dans le service pour prise en charge d’une acidocétose. Résultats : Au total 197 dossiers ont été retenus dont 58,89% de sexe féminin contre 41,11% de sexe masculin. L’âge moyen de nos patients était de 46,80 +/- 14,31 ans avec des extrêmes de 15ans et de 80 ans. Le diabète de type 2 était le plus représenté avec 80,71%. La majorité de nos patients (63,45%) avaient une durée d’évolution de 5ans au plus. Les facteurs associés à l’inobservance thérapeutique sont : le genre, la durée d’évolution du diabète, le suivi régulier, et l’association ou non à l’Hypertension artérielle. Conclusion : Cette étude fait un premier état des lieux sur les facteurs associés l’inobservance thérapeutique des diabétiques admis pour acidocétose. Une étude prospective à plus grande échelle est nécessaire pour une meilleure maitrise de la question afin de mieux prévenir cette inobservance.   Introduction: Diabetic ketoacidosis is a common acute metabolic complication of diabetes. Therapeutic non-compliance, one of the decompensating factors for diabetes, can be associated with several factors. This study aims to identify factors associated with therapeutic non-compliance. Patients and method: this is a retrospective study carried out in the internal medicine department of the National Hospital of Niamey that included all diabetics of one or more, hospitalized in the department for the management of ketoacidosis. Results: A total of 197 applications were retained, of which 58.89% were female and 41.11% were male. The average age of our patients was 46.80 +/- 14.31 years with extremes of 15 years and 80 years. Type 2 diabetes was the most represented with 80.71%. The majority of our patients (63.45%) had a duration of evolution of up to 5 years. Factors associated with therapeutic non-compliance are : the gender, the duration of evolution of diabetes, regular follow-up, and the association or not with High Blood Pressure. Conclusion: This study makes a first inventory of the factors associated with the therapeutic non-compliance of diabetics admitted for ketoacidosis. A prospective study on a larger scale is necessary for a better control of the issue in order to better prevent this non-compliance

Facteurs Associés à l’Inobservance Thérapeutique chez les Patients Admis Pour Acidocétose Diabétique à l’Hôpital National de Niamey

Introduction: L’acidocétose diabétique est une complication aigue métabolique fréquente du diabète. L’inobservance thérapeutique, un des facteurs décompensant du diabète, peut être associé à plusieurs facteurs. Cette étude vise à identifier les facteurs associés à l’inobservance thérapeutique Patients et méthode : il s’agit d’une étude rétrospective réalisée dans le service de médecine interne de l’hôpital national de Niamey ayant inclus tous les diabétiques (type 1 et type 2) hospitalisés dans le service pour prise en charge d’une acidocétose. La liaison entre les variables qualitatives a été estimée à l’aide du test de Chi2 de Pearson et le test exact de ficher. Le test est significative si P<0,05. La quantification du risque a été calculée par l’estimation de l’Odds Ratio et de l’intervalle de confiance à 95%. Résultats : Au total 197 dossiers ont été retenus dont 58,89% de sexe féminin contre 41,11% de sexe masculin. L’âge moyen de nos patients était de 46,80 +/- 14,31 ans avec des extrêmes de 15ans et de 80 ans. Le diabète de type 2 était le plus représenté avec 80,71%. La majorité des patients (63,45%) avaient une durée d’évolution du diabète de cinq ans au plus. Les facteurs associés à l’inobservance thérapeutique sont : le genre, la durée d’évolution du diabète et la régularité ou non dans le suivi.  Conclusion : Cette étude fait un premier état des lieux sur les facteurs associés à l’inobservance thérapeutique des diabétiques admis pour acidocétose à Niamey. Une étude prospective à plus grande échelle est nécessaire pour une meilleure maitrise de la question afin de mieux prévenir cette inobservance.   Introduction: Diabetic ketoacidosis is a common acute metabolic complication of diabetes. Therapeutic non-compliance, one of the decompensating factors for diabetes, can be associated with several factors. This study aims to identify factors associated with therapeutic non-compliance. Patients and method: this is a retrospective study carried out in the internal medicine department of the National Hospital of Niamey that included all diabetics of one or more, hospitalized in the department for the management of ketoacidosis. The association between qualitative variables was estimated using Pearson's Chi2 test and the exact file test. The test is significant if P<0.05. The quantification of the risk was calculated by estimating the odds ratio and the 95% confidence interval. Results: A total of 197 applications were retained, of which 58.89% were female and 41.11% were male. The average age of our patients was 46.80 +/- 14.31 years with extremes of 15 years and 80 years. Type 2 diabetes was the most represented with 80.71%. The majority of our patients (63.45%) had a duration of evolution of up to 5 years. The factors associated with non-compliance with treatment are: gender, duration of development of diabetes and regularity or not in follow-up. Conclusion : This study makes a first inventory of the factors associated with the therapeutic non-compliance of diabetics admitted for ketoacidosis. A prospective study on a larger scale is necessary for a better control of the issue in order to better prevent this non-compliance

Facteurs Associés à L’inobservance Thérapeutique chez les Patients Admis pour Acidocétose Diabétique à l’Hôpital National de Niamey

Introduction : L’acidocétose diabétique est une complication aigue métabolique fréquente du diabète. L’inobservance thérapeutique, un des facteurs décompensant du diabète, peut être associé à plusieurs facteurs. Cette étude vise à identifier les facteurs associés à l’inobservance thérapeutique Patients et méthode : il s’agit d’une étude rétrospective réalisée au service de médecine interne de l’hôpital national de Niamey ayant inclus tous les diabétiques d’un ou plus, hospitalisé dans le service pour prise en charge d’une acidocétose. Résultats : Au total 197 dossiers ont été retenus dont 58,89% de sexe féminin contre 41,11% de sexe masculin. L’âge moyen de nos patients était de 46,80 +/- 14,31 ans avec des extrêmes de 15ans et de 80 ans. Le diabète de type 2 était le plus représenté avec 80,71%. La majorité de nos patients (63,45%) avaient une durée d’évolution de 5ans au plus. Les facteurs associés à l’inobservance thérapeutique sont : le genre, la durée d’évolution du diabète, le suivi régulier, et l’association ou non à l’Hypertension artérielle. Conclusion : Cette étude fait un premier état des lieux sur les facteurs associés l’inobservance thérapeutique des diabétiques admis pour acidocétose. Une étude prospective à plus grande échelle est nécessaire pour une meilleure maitrise de la question afin de mieux prévenir cette inobservance.   Introduction: Diabetic ketoacidosis is a common acute metabolic complication of diabetes. Therapeutic non-compliance, one of the decompensating factors for diabetes, can be associated with several factors. This study aims to identify factors associated with therapeutic non-compliance. Patients and method: this is a retrospective study carried out in the internal medicine department of the National Hospital of Niamey that included all diabetics of one or more, hospitalized in the department for the management of ketoacidosis. Results: A total of 197 applications were retained, of which 58.89% were female and 41.11% were male. The average age of our patients was 46.80 +/- 14.31 years with extremes of 15 years and 80 years. Type 2 diabetes was the most represented with 80.71%. The majority of our patients (63.45%) had a duration of evolution of up to 5 years. Factors associated with therapeutic non-compliance are : the gender, the duration of evolution of diabetes, regular follow-up, and the association or not with High Blood Pressure. Conclusion: This study makes a first inventory of the factors associated with the therapeutic non-compliance of diabetics admitted for ketoacidosis. A prospective study on a larger scale is necessary for a better control of the issue in order to better prevent this non-compliance

Troponine Ultra-sensible: Quelles Indications et Comment Interpréter les Résultats en Gériatrie Un cas d'Élévation de la Troponine chez une Octogénaire

La troponine T ultra-sensible (us), marqueur biologique spécifique du cœur, peut être élevée dans des conditions pathologiques autres que le syndrome coronarien aigu. Ces autres causes peuvent ou non être directement liées aux maladies cardiaques. Nous rapportons le cas d'une patiente de 85 ans présentant de multiples événements cardiovasculaires qui présentait une élévation de la troponine T us à 1088 pg/ml, probablement due à de multiples étiologies.   The ultra-sensitive troponin T (us), a specific biological marker of the heart, may be elevated in pathological conditions other than acute coronary syndrome. These other causes may or may not be directly related to heart disease. We report the case of an 85-year-old female patient with multiple cardiovascular events who presented an elevation of us troponin T to 1088 pg / ml, probably due to multiple etiologies

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Evaluation of the Behavior of the Sealing Grout of the Mining Holes and Verification of the Conformity of Mixing Water and Izegouandane and Tarat Aquifers: Case of Mining Company of AKOUTA (COMINAK)

The aims of this study is to identify the behavior of the sealing grout in the Izegouandane and Tarât aquifers, which are the main water supply sources in the northern region of Niger, in order to prevent contamination and reduce the impact of uranium mining activities on the groundwater. This study also made it possible to evaluate the conformity of the mixing water as well as the bearing capacity of the grout in the aquifers crossed in order to verify its conformity. The study area is located in a desert zone in the northern band of Niger, in Arlit city. The measured compressive strengths are 60 bars for cylinder A, 52.5 for cylinder B and 62.5 for cylinder C with an average value of 58.33 bars. The deduced base stress value is 2.24 MPa. The sampled mixing water has a pH of 8.7 with a suspended solids content of 0.02g/l, a Cl- concentration of 93 mg/l and nitrate and nitrite concentration values that are 5 mg/l and 12 mg/l respectively. These waters comply with the general specifications of the standards relating to the quality of mixing water and can therefore be used to fill in boreholes. The analysis of groundwater shows that for Izegouandane and Tarat aquifers the values of concentration of suspended solids are respectively 0.04 g / L to 0.001 g / L. The values of Ph of these waters are 8.7 and 8.1 respectively for the water table of Izegouandane and Tarat. The analysis of Izegouandane aquifer showed that the concentrations of chloride, nitrates and sulfates are respectively 32 mg/L, 9 mg/L and 36 mg/L. Those of magnesium, ammonium and carbon dioxide, they are respectively 1.5 mg/L, 0.8 mg/L and 0.5 mg/L. For the Tarat aquifer, the concentrations of chloride, nitrates and sulphates are respectively 47 mg/L, 29.5 mg/L and 47 mg/L. As for magnesium, ammonium and carbon dioxide, they are respectively 10.02 mg/L, 1.6 mg/L and 1.6 mg/L

Monitoring of Blasting Operations Techniques and Assessment of their Impacts on Groundwater in the Context of Underground Mining: Case of ROXGOLD SANU, Burkina Faso

This study focused to study the blasting operations and to evaluate their impacts on Groundwater at the ROXGOLD SANU underground mine in Burkina Faso. ROXGOLD SANU is a mining and exploration company, under Burkinabe law and the State is a non-contributing shareholder up to 10%. The seismic vibration values measured on the ground are between 0.075 and 8.45 mm/s. These values are therefore all below the limit value of 10 mm/s defined by the Burkinabe law for mining operations carried out in quarries and mines and in compliance with the IFC standard. The values of acoustic overpressure were also all below 122 dB, i.e. below the limit value of 125 dB allowed for blasting in quarries and solid rock mines. The analysis of groundwater levels recorded since 2014 showed that the different water tables on the site do not communicate with each other. The impact of mining activities on groundwater levels is limited mainly to one piezometer. ROXGOLD SANU has therefore implemented good blasting practices, as the average values of the data collected during blasting are well below the recommended thresholds. Nitrate values measured in mine water in 2016 ranged from 7.1 mg/l to 1054 mg/l. However, in 2018 an average concentration of 484 mg/l was measured. Nitrite values ranged from 0.015 mg/l to 51.5 mg/l in 2016. In 2018, a concentration of 1.9 mg/l of nitrite was observed in the study area. As for ammonium, its concentrations measured in the field in 2016 vary from 0.08 to 145 mg/l. Thus, it emerges that the concentration values of Nitrites, Ammoniums and Nitrates measured in the field are higher than the limit of the regulations in force. These high values of Nitrites (NO3-), Ammoniums (NH4+) and Nitrates (NO2-) observed in mine water of the study area could be directly linked to the blasting operations which release nitrogen into the environment. The mine water of the study area is not dumped on the ground. It is carefully managed and controlled, in case of flooding it is sent to the TSF and does not flow into nature. Nevertheless, It is therefore important to set up a mechanism for complaints and requests from the local population to study the effects of blasting in depth

Transfusional Malaria and Associated Factors at the National Blood Transfusion Center of Niamey-Niger

Summary. Problem. Transfusional malaria is an accidental transmission of Plasmodium via a blood transfusion. Its magnitude is underestimated and very little data on the assessment of this risk are available in Niger. Objective. This study aimed to determine the prevalence of plasmodial infection of blood bags at the National Blood Transfusion Center of Niamey (NBTC). Methodology. A cross-sectional study to diagnose Plasmodium infection by microscopy and Rapid Diagnostic Test (RDT) was carried out during the rainy season (September to November 2015). Blood grouping was performed by the BETH-VINCENT technique. Results. One thousand three hundred and fifty-seven (1357) blood bags were collected. One hundred and fifty-seven (11.6%) of the donors were infected with Plasmodium by microscopy and 2.4% (9/369) by rapid diagnostic test. All infections were with P. falciparum (100%). The mean parasite density was 197 parasites/μL (SD=281; [80: 2000]). There were no significant differences in infection prevalence between the ABO blood groups (p=0.3) or the rhesus positivity (p=08). There is also no significant difference in temporal (p=0.1) and spatial (p=0.6) distribution. Conclusion. The transmission of transfusional malaria during the rainy season is a fact in Niger. Such risks were independent of the ABO blood type and positivity for the rhesus antigen. Pretransfusion diagnosis or posttransfusion therapy should be instituted to prevent it

Traitement de la leishmaniose cutanee par le metronidazole : A propos de 78 cas au Niger

La leishmaniose cutanée sévit de façon endémique au Niger. Le premier cas a été rapporté en 1911. L’atteinte de la population rurale est prédominante. Les formes cliniques classiques à type de lésions ulcérocrouteuses, ulcéreuses et nodulaires sont  observées en nombre important et aux localisations diverses. Leishmania major est pratiquement l’agent pathogène retrouvé au Niger, pays situé dans une bande comprise entre les 8° et 20° latitudes nord allant de l’Atlantique à la frontière tchadienne. La  prise en charge avec le métronidazole est spectaculaire même dans des formes ayant résisté à l’antimoniate de méglumine.  Soixante-dix-huit patients ont été traités pendant huit (8) semaines et suivis pendant 1 an. Nous avons obtenu 100% de  guérison. Le métronidazole à l’état actuel est la meilleure indication dans le traitement de la leishmaniose cutanée au Niger.Mots clés : Leishmaniose cutanée, métronidazole, Niamey, Niger