ABSTRACT
UNLABELLED: The authors report a case of tetanus diagnosed in the aftermath of tooth extraction, in the absence of any other front door. OBSERVATION: A patient showed a persistent trismus several days after the extraction of tooth 38 performed at the dental office. The diffusion of tension and the appearance of paroxysms allowed the diagnosis of tetanus. DISCUSSION: The possibility of occurrence of tetanus after a tooth extraction should be kept in mind before a persistent trismus with rapid expansion in the neck and limbs. The dentist should be aware of the symptoms of tetanus to refer the patient to a specialized department.
Subject(s)
Tetanus/etiology , Tooth Extraction/adverse effects , Adult , Humans , Male , Molar, Third/surgery , Trismus/etiologyABSTRACT
OBJECTIVES: To determine the proportion of infectious diseases and their lethality at the Abidjan Military Hospital. PATIENTS AND METHODS: This cross-sectional study examined the medical files of patients hospitalized in the internal medicine unit of the hospital during 2004. RESULTS: The study included 668 patients with 855 diseases, 579 of them infectious (67.7%). The prevalence of HIV in this population was 41.3%. The main diseases observed were pneumonia (150 cases; 17.5%), malaria (82 cases; 9.6%), oropharyngeal candidiasis (83 cases; 9.7%), and tuberculosis (54 cases; 6.3%). The immediate causes of death were cerebral toxoplasmosis (27 cases; 39%), pneumopathy (25 cases; 36%), severe malaria (7 cases; 10%), tuberculosis (6 cases; 9%), and bacterial meningitis (5 cases; 7%). The prevalence of HIV infection prevalence among those who died of an infectious disease was 74.3%. CONCLUSION: Infectious diseases are the main pathologies seen in the internal medicine department of the in Abidjan Military Hospital. They were mainly opportunistic infections linked to AIDS. The creation of a laboratory of infectious microbiology and of a medical intensive care unit appears necessary to optimize management of these infectious diseases.
Subject(s)
Infections/complications , Infections/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Cote d'Ivoire , Cross-Sectional Studies , Female , Hospitals, Military , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
The purpose of this study was to determine the prevalence of HBsAg carriage in Ivorian gendarmerie recruits in 2008. This prevalence was 15.6%. It was highest in recruits aged 18 years (24%), in those who were married (33.3%) and in those who had had more than three sexual partners in the 6 months before the survey (19.4%). It was also higher in recruits who had never used condoms (20.6%) and in those who had undergone blood transfusions (27%). A policy of vaccination against HBV in the army, in teenagers and adults must be implemented to reduce HBsAg carriage in the army and in the Ivorian population.
Subject(s)
Hepatitis B Surface Antigens/blood , Hepatitis B/blood , Hepatitis B/epidemiology , Military Personnel , Adolescent , Adult , Cote d'Ivoire/epidemiology , Humans , Male , Seroepidemiologic Studies , Young AdultABSTRACT
A cross-sectional descriptive study was conducted from medical data of inpatients with tetanus in the Department of Infectious and Tropical Diseases of the University Hospital of Treichville in Abidjan from January 2003 to December 2007. In five years, 221 cases of tetanus have been hospitalized. The tetanus gateway was found in 188 patients (85%). Tetanus gateway linked to care was found in 22 patients (11.7%). Acts of care in question were intramuscular injections (10 cases) and operative procedures (12 cases). Concerning medical care by intramuscular injection, quinine (four cases), sulfadoxine-pyrimethamine (one case), and long-acting penicillin (one case) were the identified drugs. The operative procedures mainly involved were skin sutures (nine cases), cures of hernia (two cases), and flattening of Fournier's gangrene (one case). The average incubation period was 9.5 days. The invasion lasted for an average of 1.8 days. On admission, tetanus was immediately generalized for all patients with the presence of paroxysms in 20 patients (90.9%). The lethality of tetanus related care was 54.5%. The death rate in the first 48 hours of hospitalization was estimated at 83.3%. The average length of hospital stay was 14.6 days. Health workers should be involved in the prevention of tetanus in improving the quality of care and especially in reducing intramuscular injections. Also, any patient not immunized against tetanus should receive anti-tetanus serum and an update of its tetanus vaccine before any invasive procedures.
Subject(s)
Hospitals, University/statistics & numerical data , Injections, Intramuscular/adverse effects , Tetanus/etiology , Wound Infection/etiology , Adolescent , Adult , Aged , Child , Cote d'Ivoire/epidemiology , Cross Infection/epidemiology , Cross Infection/etiology , Cross Infection/prevention & control , Cross-Sectional Studies , Equipment Contamination , Female , Humans , Iatrogenic Disease , Inpatients , Length of Stay , Male , Middle Aged , Quality Assurance, Health Care , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Surgical Wound Infection/prevention & control , Sutures/adverse effects , Tetanus/epidemiology , Tetanus/prevention & control , Tetanus Toxoid , Vaccination , Wound Infection/epidemiology , Wound Infection/prevention & control , Young AdultABSTRACT
OBJECTIVE: The aim of this study was to assess the tolerability and adherence to all non-occupational post-exposure prophylaxis (PEP) for cases of HIV exposure in Abidjan. METHOD: We retrospectively studied all post-exposure prophylaxis for non-occupational exposures to HIV prescribed from January 1st, 2000 to December 31st, 2007 in the Abidjan infectious diseases department. We analyzed the types of exposure, socio-demographic characteristics of patients, antiretroviral therapy regimens, adherence and tolerability, duration of the treatment, and post-exposure follow-up. RESULTS: Over these eight years, we managed 128 consultations for non-professional exposures to HIV (50 male [39%], 78 female patients [61%]), average age 24.8 years (four-54 years). The most frequent exposures were due to rape (n=74), condom rupture (n=29), and occasional unprotected sex (n=21). The average delay before consultation was 20.8 hours. The antiretroviral chemoprophylaxis included a protease inhibitor in 93% of the cases; 80.5% of patients completed 28 days of chemoprophylaxis, while 8.6% interrupted the treatment, and 10.9% were lost to follow-up. The most frequent adverse effects were gastrointestinal, reported by 79 patients (61.7%). Only 34 patients (26.6%) returned for clinical and biological post-exposure follow-up with HIV control at third month, without documented seroconversion. CONCLUSION: Cases of sexual exposure to HIV are the main indication for post-exposure prophylaxis in Abidjan, except for occupational exposure to blood. However, post-exposure prophylaxis should be available in the units of primary care, such as emergencies departments.
Subject(s)
Anti-HIV Agents/therapeutic use , HIV Infections/prevention & control , Post-Exposure Prophylaxis , Adolescent , Adult , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/adverse effects , Bites, Human , Child , Child, Preschool , Condoms , Cote d'Ivoire , Equipment Failure , Female , Gastrointestinal Diseases/chemically induced , HIV Infections/transmission , HIV Protease Inhibitors/administration & dosage , HIV Protease Inhibitors/adverse effects , HIV Protease Inhibitors/therapeutic use , HIV Seropositivity , Humans , Male , Middle Aged , Needlestick Injuries , Patient Compliance , Post-Exposure Prophylaxis/statistics & numerical data , Rape , Retrospective Studies , Treatment Outcome , Unsafe Sex , Young AdultABSTRACT
The purpose of this retrospective study was to document morbi-mortality in soldiers at the Abidjan Military Hospital (AMH). The medical files of soldiers treated at Abidjan Military Hospital from January 1 to December 31, 2004 were reviewed. During the study period, a total of 155 soldiers were treated for 259 pathologies including 208 infectious diseases (80.5%). The most common diseases were HIV infection (85 cases; 42%), pneumopathy (40 cases; 19%), cerebral toxoplasmosis (22 cases; 10.5%), malaria (18 cases; 9%) and tuberculosis (11 cases; 5%). Direct causes of death were cerebral toxoplasmosis (32%), pneumopathy (28%), tuberculosis (16%) and severe malaria (12%). The prevalence of HIV infection in soldiers who died was 76%. Morbi-mortality in military personnel at the AMH is due mainly to HIV infection and related complications. Specific prevention measures should be implemented for an effective control of this epidemic.
Subject(s)
Hospital Mortality , Military Personnel , Adult , Cote d'Ivoire/epidemiology , Female , HIV Infections/epidemiology , Hospitals, Military , Humans , Lung Diseases/epidemiology , Malaria/epidemiology , Male , Middle Aged , Retrospective Studies , Toxoplasmosis, Cerebral/epidemiology , Tuberculosis/epidemiologyABSTRACT
L'objectif etait de preciser la morbi-mortalite des militaires a l'HMA. Il s'agit d'une retrospective realisee sur dossiers des patients hospitalises au service de medecine interne de l'Hopital Militaire d'Abidjan (HMA) du 1er janvier au 31 decembre 2004. Les 155 militaires inclus dans l'etude ont developpe 259 pathologies dont 208 pathologies medicales infectieuses (80;5); 48 medicales non infectieuses (18;5) et 3 pathologies chirurgicales (1). Les principales pathologies observees etaient l'infection a VIH (85 cas ; 42); la pneumopathie (40 cas ; 19); la toxoplasmose cerebrale (22 cas ; 10;5); le paludisme (18 cas ; 9) et la tuberculose (11 cas ; 5). Les causes directes de deces etaient la toxoplasmose cerebrale (32); une pneumopathie (28); la tuberculose (16) et le paludisme grave (12). La prevalence de l'infection a VIH chez les decedes etait de 76. La morbi-mortalite de militaires a l'HMA est essentiellement du fait de l'infection a VIH et ses complications. Des mesures de prevention specifiques devraient etre mises en oeuvre pour un controle efficace de cette epidemie
