Profil épidémiologique, clinique et radiologique de la tuberculose pulmonaire A microscopie positive (TPM+) au centre hospitalier régional universitaire de Saint-Louis (CHRU SL)

Introduction : la tuberculose pulmonaire demeure encore un fléau mondial en progression surtout dans les pays en voie de développement, malgré les actions de lutte mises en place depuis des décennies. Le but de ce travail était de décrire les aspects épidémiologiques, cliniques radiologiques et évolutifs de la TPM (+) au centre hospitalier régional de Saint-Louis. Il s'agissait d'étude descriptive rétrospective portant sur 191 dossiers deTPM+,hospitalisés au service de médecine du 1er Janvier 2016 au 31 Décembre 2017. Étaient inclus dans l'étude, tous les cas de TPM+ prouvée par la présence de BAAR à l'examen direct des crachats. Étaient exclus de l'étude les patients de moins de 14 ans, les cas de TPM(-) Résultats : Sur 1417 hospitalisations, 191 patients avaient une TPM+. L'âge moyen était de 36,5 ans avec des extrêmes de 14 à 81 ans. Sex-ratio de 2,2. Les pêcheurs étaient les plus touchés avec 34 % des cas. Un contage tuberculeux familial était noté chez 61 malades. Cent quarante six nouveaux cas de TPM(+) ont été notés. Conclusion : la TPM(+) demeure un problème de Santé Publique au Sénégal. Beaucoup d'efforts restent à faire dans la région de Saint-Louis à forte charge de tuberculose

Profil clinique et immunologique des patients infectés par le VIH à l'initiation du traitement antirétroviral au centre hospitalier régional de Sokodé (Togo), une décennie après la gratuité de la trithérapie

Introduction : L'initiation tardive du Traitement Anti-Rétroviral (TAR) est fréquente dans les pays à ressources limitées, où la plupart des individus ne connaissent pas leur statut sérologique jusqu'à ce qu'ils soient symptomatiques.Matériel et méthodes : Il s'est agi d'une étude transversale et analytique, qui s'est déroulée du 1er janvier 2016 au 31 décembre 2016 dans le service de médecine générale du Centre Hospitalier Régional (CHR) de Sokodé, le service de référence dans la prise en charge de l'infection à VIH dans la région centrale du Togo.Résultats : Cent-neuf patients dont 15 enfants (13,8%) ont été inclus dans la file active du service de médecine générale du CHR de Sokodé par l'initiation du TAR. La moyenne d'âge des patients était de 32,38 ans [1-59 ans] avec une prédominance féminine (67,9%). La majorité des patients était classée aux stades III (60 cas ; 55%) et au stade IV (11 cas ; 10,1%). Les manifestations cliniques ou affections opportunistes étaient dominées par la diarrhée chronique (15 cas), la fièvre prolongée inexpliquée (12 cas) et la candidose oropharyngée (12 cas). Le taux moyen des CD4 des patients était de 328,54 cellules/mm3 [0-2216 cellules/mm3] et la co-infection VIH-VHB a été retrouvée dans 13,8% (n = 15). L'association Ténofovir (TDF) - Lamivudine (3TC) - Efavirenz (EFV) (87,2% ; n = 95) a été la plus prescrite pour l'initiation du TAR.Conclusion : Le profil des patients infectés par le VIH à l'initiation du TAR à Sokodé est caractérisé par un stade avancé de l'infection à VIH

Character Strengths of Adolescent Survivors of Childhood Cancer

There is increased interest in possible positive outcomes for survivors of childhood cancer. This study investigated the manifestation of character strengths in adolescents who have survived cancer compared to that seen in healthy adolescents. The aim was to establish whether specific character strengths may be more prominent in adolescents who have survived cancer than in healthy adolescents. Two groups of participants; consisting of adolescents who have survived childhood cancer (n = 21) and a group of healthy adolescents (n = 21); were obtained through convenience sampling. They completed the Values in Action Inventory for Youth (VIA-Youth) (Park et Peterson 2006) as a measure of character strengths. No significant differences were found between the character strengths of adolescents who have survived cancer and their healthy peers; unlike the findings of a similar earlier study with adults (Peterson; Park et Seligman 2006). It is concluded that the experience of serious illness such as cancer neither hindered nor enhanced the development of character strengths in this group of adolescent survivors. More research is needed to understand positive psychological functioning in the aftermath of childhood cancer

We also have Cases of the Disease that you are researching about. Small-scale Enterprises and the Challenges of HIV/AIDS-Related Stigma and Discrimination in Kabale; Uganda

At the workplace; the HIV epidemic has brought about loss of productivity; staff turnover and increased labour costs among others. HIV stigma presents barriers to HIV prevention in different settings including the workplace. Unlike large scale enterprises; small-scale enterprises have received less attention in the fight against HIV/AIDS. This study employed a qualitative case study design. Data were collected from eighteen participants in three small-scale enterprises in Kabale; Uganda. Findings indicate that although there are effectively no workplace policies in small-scale enterprises; employees in the visited workplaces do not fear HIV/AIDS testing and disclosing their HIV/AIDS status as main sources of HIV-stigma although their perceptions remain hypothetical. Integrating clear anti-discriminatory HIV/AIDS policies may empower some small-scale enterprises with related HIV knowledge and skills in an effort to overcome the challenges of HIV-related stigma and discrimination

Injuries in Children and Adolescents Seen during 2006 at the Emergency Department of the National District Hospital; Bloemfontein

Background: Most children and adolescents recover fully from injuries. However; permanent disabilities may occur. The objective of the study was to investigate the prevalence and profile of injuries in children and adolescents five to 19 years of age seen at the emergency department of the National District Hospital in Bloemfontein. Methods: A retrospective descriptive study was conducted. Demographic and injury-specific information obtained from hospital records of 2006 was entered into a data-capturing form. Data were analysed by using descriptive statistics. Results: The prevalence of injuries in this age group was 20.3. Two hundred and nine records were investigated. The majority of cases were male (68.3). The median age was 15 years; and 43.5of injuries occurred in the age group 15 to 19 years. Approximately half (51.7) were Afrikaans-speaking and resided in suburban areas (50). Most injuries occurred at home (40.2) between 12h00 and 17h00 (38.7). Falls (33.7) were the most common cause of injury. Soft tissue injuries (35.9) occurred most commonly; fol lowed by lacerations (33.0) and fractures (16.7). Upper limb injuries (42.1) were seen more than lower limb injuries (27.8). Facial injuries occurred in 12of cases. X-rays were performed in 57.9of cases. Most patients (93.3) received medication; while 22were referred for specialist treatment. All cases except one were discharged from the emergency department. Parents accompanied patients in 65.6of cases. Conclusions: Optimal treatment should be given to the injured child or adolescent to avoid possible long-term injuryrelated sequelae. Preventive strategies should be formulated; enforced and evaluated

Psychosocial Impacts of Mentally Retarded Children on Parents in Sudan

This study was conducted on a community sample from Khartoum state; Sudan to explore the psychological and social impacts of the mentally retarded child on his/her parents. The study hypothesized that these effects are directly related to the age; number of handicapped children in the family as well as the degree of mental retardation Methods and population: Seven centers for teaching and training of handicapped children were recruited in Khartoum State. Ninety-one children aged 5-16 years were randomly selected and their intelligence quotient (I.Q) was etermined. Interviews for 82 mothers and 64 fathers of these children were held using a standardized anonymous questionnaire including socio-demographic data and information about the psychological and social impacts of the disability of children on their parents. The parents also completed the Hospital Anxiety and Depression Scale (HADS) to assess the presence of anxiety and depression. Results and discussion: The parents reported different psychological effects when they realized the children's disability. However; they tend to overcome their problem and become adapted to the situation. Sometimes; problems arise in the marital life and in social participation. The research showed that most parents suffered from degrees of anxiety and depression ranging mainly from severe to moderate. The number; age or degree of retardation of the children did not affect the social and psychological impacts on the parents significantly. The study recommends preventative measures to reduce the factors that lead to mental retardation. It also recommends the provision of rehabilitation services and training of children in schools and special institutes; besides supporting their families psychologically and socially to reduce their burden

Profile and Outcome of Non-Traumatic Paraplegia in Kano; Northwestern Nigeria

Aim: This study was aimed to identify the clinical and radiological profile of non-traumatic paraplegia and the various etiologies associated with the condition. Materials and Methods: A review of the clinical and radiological presentations of adult patients presenting with non-traumatic paraplegia managed at the Aminu Kano Teaching Hospital (AKTH) and Murtala Specialist Hospital (MMSH); Kano; from June 2006 to November 2009 was carried out. Patients underwent a detailed clinical evaluation followed by laboratory investigation and neuroimaging studies and were followed up for 9 months to asses outcome and complications. Results: 98 patients with non-traumatic paraplegia consisting of 71 males and 27 females (M:F: 5:2) were seen. The age range of the patients was between 16 and 76 years; with a mean age of 40 years (SD = 15.3) years; 54 (55) of the patients presented after 2 months of the onset of paraplegia. The commonest symptoms were weakness of the lower limbs (100); loss of sensation (55); sphincteric disturbance (50) radicular pain and paresthesia (38.4); back pain (21.4) and erectile dysfunction (40). All the patients had X-ray of the spine; 26.3had Magnetic Resonance Imaging (MRI) spine. The commonest etiological factors were tuberculosis (TB) (44.4); transverse myelitis (13.1); Guillain-Barre syndrome (9.1); metastatic spinal disease (4); and HIV myelopathy (4). However; the cause could not be identified in 14 (14) of the patients. The commonest site of affectation in those with TB spine was lower thoracic (53.8) and upper lumbar (23.1) vertebrae. Conclusion: Clinical profile of non-traumatic paraplegia in Kano; northwestern Nigeria; is similar to that reported elsewhere in Africa; with spinal tuberculosis and transverse myelitis accounting for over half the cases

Socio-Demographic Characteristics of Alcohol Abusers in a Rural Ijaw Community in Bayelsa State; South-South Nigeria

Background: Causal relationship has been established between alcohol and more than 60 types of disease and injury. Despite this, alcohol is still widely consumed in several communities in Nigeria, and sometimes considered a health tonic. This study described the pattern, prevalence, and factors associated with alcohol abuse in a typical Ijaw community, where alcohol is produced and consumed in large quantities. Materials and Methods: The study was carried out in Okoloba, a rural community in Bayelsa State, South-South Nigeria using an analytical cross-sectional study design. The data were collected from members of the community aged 16 to 65 years, using the Alcohol Use Disorders Identification Test questionnaire and clinical examination for hepatomegaly, tongue tremor, and hand tremor. Results: A total of 322 subjects, comprising 166 men and 156 women were studied. They had an average age of 41.4 ± 2.5 years, were mostly farmers (43.17%), married (66.15%), and had at most primary school education (62.42%). More than 90% of the subjects took alcohol in the preceding year, with more of them (43%) preferring the locally produced drinks. About 33% of the subjects had harmful drinking, while 12.73% had alcohol dependence problem. There is no significant age difference between the alcohol abusers and abstainers/social drinkers (P > 0.05), but alcohol abusers were significantly more likely to be males (P < 0.001), in polygamous marriages (P < 0.00001), had lower educational status (P < 0.0001), likely to be practitioners of the traditional religion (P < 0.0001), and more likely to be engaged in palm wine tapping. Conclusion: Alcohol is widely consumed in the community, but the prevalence of abuse was moderate, mainly due to cultural restrictions. Sales restrictions might be needed as the drinking habits of members of the community change with urbanization

Social and Economic Consequences of HIV and AIDS on Children: Case Study of a High-Density Community in Harare; Zimbabwe

We present results from a household-based survey that was conducted in Mabvuku; a high-density community in Zimbabwe. The objective of the study was to improve understanding of social and economic consequences of HIV and AIDS on children. Children affected by HIV and AIDS (CABA) formed the treatment group while those not affected by HIV and AIDS (non-CABA) were the control group. We found that many of the differences in the socio-economic indicators that we studied between CABA and non-CABA were not significant. Therefore our results indicate a gloomy scenario for all the children. These results are consistent with existing literature which indicates that the impact of HIV and AIDS is exacerbated by poverty. Based on evidence from this paper; we conclude that programmes and interventions targeted at children should encompass both CABA and non-CABA within a framework of sustained commitment to improving the lives of these children. We hope that our findings will be used in the formulation of interventions and strategies to improve the situation of children affected by HIV and AIDS and/or living in impoverished communities

Impact of Income on the Profile of Cardiovascular Risk Factors among Hypertensives in a Nigerian Tertiary Health Centre: a Cross-Sectional Study : Cardiovascular Topics

Background: In most developed countries; risk factors for cardiovascular diseases (CVD) are more prevalent in low socioeconomic classes. However; the pattern in developing countries appears to be different. This study sought to evaluate and compare risk factors for CVD as well as absolute CVD risk in hypertensive subjects grouped by income in Kano; Nigeria. Methods: The study was cross-sectional in design and carried out in Aminu Kano Teaching Hospital; Kano; Nigeria. Seventy treatment-naIve hypertensives and an equal number of hypertensives on treatment were recruited by balloting from the outpatient clinics; and then regrouped into low- and high-income earners. These two groups were then compared in terms of their profile of CVD risk factors and absolute CVD risk. All the assessed CVD risk factors are recognised in standard guidelines for the management of persons with systemic hypertension. Results: The low-income group comprised 45 patients (32.1) while the remaining 95 (67.9) had a high income. The most prevalent CVD risk factor was dyslipidaemia; found in 77.8 and 71.6of low- and high-income earners; spectively (p = 0.437). The prevalence of proteinuria was significantly higher among low-income earners (42.2) compared with high-income earners (15.8) (p = 0.001). Mean serum creatinine was also higher among low-income earners but the difference did not reach statistical significance (p = 0.154). Very high CVD risk was found in 75.6 and 70.5of low- and high-income earners; respectively (p = 0.535). Conclusion: Dyslipidaemia and very high CVD risk were found in over 71of the patients regardless of their level of income. Low-income earners had a higher prevalence of indices of renal damage. These findings pose a great challenge to the present and future management of all subjects; particularly those in the low-income group; given that in Nigeria; healthcare is largely paid for directly out of their pockets