[Acute Flaccid Paralysis Secondary to Poliomyelitis: 11 Years of Monitoring in Guinea (2005-2015)]. / Paralysies flasques aiguës dues à des poliovirus : bilan de 11 années de surveillance en Guinée (2005-2015).

The sustained worldwide use of the two available types of polio vaccines has significantly reduced the incidence of this disease. Our main objective is to report a 11-year monitoring period for acute flaccid paralysis secondary to poliovirus in Guinea. It was a retrospective descriptive study for all cases of acute flaccid paralysis (AFP) in which poliovirus was isolated by stool examination. During 11 years, 768 cases of AFP, including 8 cases of acute anterior poliomyelitis were collected at a frequency of 1%. The average age was 3.5 years with extremes of 1 year and 6 years, the most represented age group was 0-4 years with 7 cases. Six mothers were housewives doing gold panning as a revenue generating activity. The vaccine virus (serotype 2) was the most isolated with 6 cases.

L'utilisation soutenue à l'échelle mondiale des deux types de vaccins antipoliomyélitiques disponibles a considérablement diminué l'incidence de cette affection. Il s'agit ici d'une étude rétrospective de type descriptive, portant sur tous les cas de paralysie flasque aiguë (PFA) due aux poliovirus en Guinée chez lesquels le poliovirus a été isolé des selles, faisant l'état des lieux de 11 années de surveillance de la PFA. En 11 ans, 768 cas de PFA, dont huit cas de poliomyélite antérieure aiguë ont été enregistrés, soit une fréquence de 1 %. L'âge moyen était de 3,5 ans [1­6 ans]. La tranche d'âge de 0­4 ans était la plus représentée avec 7 cas. La majeure partie (6 cas) des mères des enfants étaient des agricultrices exerçant l'orpaillage. Les souches majoritairement isolées étaient dérivées du vaccin VDPV2.

Anxiety and depression among HIV patients of the infectious disease department of Conakry University Hospital in 2018.

Anxiety and depression continue to be significant comorbidities for people with human immunodeficiency virus (HIV) infection. The aim of this study was to determine the prevalence of anxiety and depression disorder among HIV patients at Conakry, Guinea. In this cross-sectional study, we described socio-demographic, clinical and psychosocial data related to anxiety and depression in 160 HIV patients of the University Teaching Hospital, Conakry, Guinea. The Hospital Anxiety and Depression Scale (HADS) was used for measuring depression and anxiety in the prior month. The HADS score of ⩾8 was used to identify possible cases of depression and anxiety. Multivariate logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of comorbid depression and anxiety among HIV patients was 8.1% and the prevalence of anxiety and depressive symptoms among HIV-infected patients was 13.8% and 16.9%, respectively. Multivariate analysis showed that individuals having BMI ⩽ 18 (AOR = 3.62, 95% confidence interval (CI) 1.37-9.57) and who did not receive antiretroviral treatment (AOR = 18.93, 95% CI 1.88-188.81) were significantly more likely to have depressive symptoms. Similarly, having age <40 years (AOR = 2.81, 95% CI 1.04-7.58) was also significantly associated with anxiety. Prevalence of symptoms of anxiety and depression was high in these HIV patients. This suggests a need for training on the screening and management of anxiety and depression among HIV patients.

Tetanus: epidemiology and Factors Associated with Death in the Departement of Tropical and infectious diseases of Donka National Hospital, Guinea.

In developing countries, tetanus remains a public health problem because of its frequency, severity, and still high mortality. The objective of this study was to describe the epidemiological profile of patients hospitalized for tetanus and to identify the factors associated with dying from it. This retrospective, descriptive, and analytical study reviewed hospital records of all patients, of all ages and genders who were treated for tetanus in our department over a 5-year period. Among 3549 patients during the study period, 75 had tetanus (2.11%), and 71 of them were included in our study. The median age of patients was 35 years (range: 11-70 years) with a male prevalence of 80%. The most frequently affected socio-professional categories were students (21.1%), farmers (18.3%), workers (15.5%), and shopkeepers and tradespeople (15.5%). The main entry points were post-traumatic (40.9%), cutaneous (33.8%), and post-surgical (16.90%). Paroxysm (95.8%), trismus (93.0%), generalized contracture (67.6%), and dysphagia (46.5%) were the most frequent signs. Among these cases, 40.9% were severe (40.85%), 49.3% moderate (49.30%), and 9.6% benign. We recorded 34 deaths (48%). Factors associated with death were age> 60 years (P = 0.01), fever (P = 0.01), hypertension (P = 0.02), and HIV infection (P = 0.01). Tetanus remains a frequent disease with high lethality. Death is associated with specific factors that should be taken into account in the criteria for assessing its prognosis.

[Tetanus Observation Over a 12-Month Period in Conakry, Guinea]. / Observation du tétanos sur une période de 12 mois à Conakry, Guinée.

The objective of this study was to determine the factors associated with death in patients hospitalized for tetanus. This study collected prospectively over a twelve (12) month period, the epidemiological, clinical and evolutionary data, and proceeded to an analysis of the factors associated with the death of hospitalized patients. We collected 32 patients with tetanus, or 5% of the total number of hospitalized patients. The average age was 36 ± 14 years. The sex ratio was 15 (30/2). The iatrogenic entrance door was found in 5 (15%) patients. Respiratory complications were the most frequent, ie 9 cases (28%). The most commonly used treatment regimen (28 cases, 88%) was the combination of metronidazole, diazepam, and anti-tetanus serum with an average hospital stay of 23 days. A Dakar prognostic score greater than or equal to 3, the presence of complications and a hospital stay of less than or equal to 7 days were the main factors associated with the death. Tetanus remains common in Guinea with a high lethality rate. Improving immunization coverage is imperative.

L'objectif de cette étude est d'analyser les facteurs associés au décès chez les patients hospitalisés pour tétanos. Cette étude a recueilli de façon prospective, sur une période de 12 mois, les données épidémiologiques, cliniques et évolutives, puis procédé à une analyse des facteurs associés au décès des patients hospitalisés. Nous avons colligé 32 patients atteints de tétanos, soit 5 % du total des patients hospitalisés. L'âge moyen était de 36 ± 14 ans. Le sex-ratio était de 15 (30/2). La porte d'entrée iatrogène a été retrouvée chez 5 (15 %) patients. Les complications respiratoires étaient les plus fréquentes, soit 9 cas (28 %). Le schéma de traitement le plus utilisé (28 cas, 88 %) a été l'association de métronidazole, de diazépam et de sérum anti-tétanique avec une durée moyenne d'hospitalisation de 23 jours. Un score pronostique de Dakar supérieur ou égal à 3, la présence de complications et une durée d'hospitalisation inférieure ou égale à 7 jours ont été les principaux facteurs associés au décès. Le tétanos reste fréquent en Guinée avec un taux de létalité élevé. L'amélioration de la couverture vaccinale est impérative.

Depression and HIV: Epidemiological and clinical aspects at the Bamako University Hospital (Mali).

Depression plays an important role in clinical worsening, morbidity and mortality related to HIV/AIDS. To describe the epidemiological and clinical aspects of depressive disorders in people with HIV in Mali. This prospective study took place in the department of psychiatry and infectious diseases at the Bamako University Hospital from July 2004 through October, 2005 and included all HIV-positive antiretroviral-naive patients with depression, diagnosed according to ICD-10 criteria. The study included 84 HIV-positive patients with a depressive disorder; our total population of HIV-positive patients was 316 during the study period, for a prevalence rate of 26.7 % in this population. The mean age of these depressed patients was 36.7 ± 8.5 years (range: 20-57); 63.1% were women, 47.7% had not attended or at least not completed primary school; 66.6% were married, and 92.9% lived in urban areas. Sad mood, anxiety, and refusal to eat were reported by 27.7%, 10.9%, and 9.1%, respectively, as a reason for consultation. Depression was associated with an anxiety disorder in 33 (39.3%) and a delusional disorder in 14 (16.7%). Severe depression was associated with low BMI and at a CD4 count <200 cells/mm3. Depression was found at a high frequency in our study. Its detection, operational research about it, and improved management are recommended to improve the health of people living with HIV.

Manifestations cliniques des patients vivant avec le VIH à l'ère de la trithérapie hautement active au service des maladies infectieuses du CHU Yalgado Ouedraogo (Burkina Faso)

Dans le but d'améliorer la prise en charge des patients vivant avec le VIH, nous avons mené cette étude avec pour objectif de décrire les manifestations cliniques des PVVIH hospitalisées dans le service des Maladies Infectieuses du CHU Yalgado Ouédraogo.Patients et méthode : Il s'agit d'une étude prospective qui s'est déroulée du 1er janvier 2013 au 28 février 2014. Ont été inclus tous les patients VIH positifs connus ou dépistés dans le service, sous traitement ARV ou non, admis dans le service. Le traitement et l'analyse des données collectées ont été faits à l'aide du logiciel Epi info version 3.5.1.Résultats : La prévalence hospitalière de l'infection à VIH était de 22%. Soixante-cinq pour cent des malades étaient de sexe féminin (sex ratio = 1,9). L'âge moyen des patients était de 40 ans ± 11. Quatre-vingt-onze pour cent (91%) des patients étaient positifs au VIH1 ; Le taux de CD4 médian était de 78 cellules/ml avec des extrêmes de 8 à 718 cellules/mm3. Soixante-sept pour cent (67%) des patients dépistés dans le service étaient au stade IV de la classification de l'OMS. Trente-six pour cent (36%) des patients avaient au moins une double comorbidité associée au VIH. Un état général altéré et une gastro-entérite étaient les signes cliniques présentés par la plupart des malades. La tuberculose, le paludisme grave, les mycoses digestives et les co-infections VIH/VHB étaient les plus fréquemment diagnostiqués. Trente pour cent (30%) des patients sous ARV étaient en échec thérapeutique. La létalité était de 23,6%, plus importante chez les patients sévèrement immunodéprimés (P = 0,01). Conclusion : Les manifestations cliniques sont caractérisées par un polymorphisme clinique. Le dépistage et la prise en charge précoce des pathologies fréquemment diagnostiquées chez les patients vivant avec le VIH contribueront à réduire leur mortalité

Tetanus in women of childbearing age in the infectious disease department in the national hospital of Conakry (Guinea).

OBJECTIVES: This study aimed to determine the hospital prevalence rate of tetanus in women of childbearing age in the infectious disease department of Donka CHU in Conakry and to describe their sociodemographic characteristics and outcomes. METHODOLOGY: This descriptive retrospective study examined the records of all patients aged 15 to 495 years hospitalized for tetanus over a 10-year period. RESULTS: During the study period, 74555 patients were hospitalized - 239 for tetanus. In all, 22 woman of childbearing age had tetanus, that is, 9.2%. Their mean age was 325 years. Most of the women were married (13/22) and lived in Conakry (18/22); 165 were housewives, and 65 patients had begun but not completed the required vaccinations. The incubation period was >75 days for 165 patients. Tetanus infection resulted from medical procedures for 9 women and trauma for 6. We recorded 125 deaths. The average duration of hospitalization was 215 days. CONCLUSION: Preventing tetanus requires a reinforcement of vaccination drives and especially the implementation of policies for booster reminders.

[Epidemic meningitis in 2013 in Republic of Guinea: Nesseria meningitidis W135 emergence]. / Epidémie de méningite en République de Guinée en 2013 : émergence de Nesseria meningitidis W135.

A prospective study conducted from 1 January to 31 December 2013 described a meningitis epidemic in Republic of Guinea. The identification of the germs was based on Gram stain, latex agglutination and culture. During the study period, 480 suspected cases of meningitis were reported by 21 health districts. The average age was 18±8 years and 62.5% were men. The vaccination status was unknown in all patients. The largest attack rates were found in Siguiri (3.2 per 10,000), Kankan (2.6 per 10,000) and Dabola (3.9 per 10,000). The locality of Kintinian in Siguiri was the only one to cross the epidemic threshold. The identified microorganisms were Haemophilus influenzae (1 time), Pneumococcus (2 times), Neisseria meningitidis A (4 times) and W135 (10 times) with a total of 17 positive samples. All of these germs were sensitive to chloramphenicol, ceftriaxone and ciprofloxacin. The average hospital stay was 6.5±2 days. The lethality was 13.8%. This meningitis epidemic was characterized by the emergence of Neisseria meningitidis W135. The monitoring of this serogroup should be increased and future vaccination strategies must include it presence.

Cholera in pregnant women: the 2012 epidemic at the reference center at the Donka National Hospital in Conakry.

Cholera is an epidemic diarrheal disease transmitted through the digestive tract; it can cause obstetric complications in pregnant women. The objective of this study was to describe the epidemiological, clinical, and therapeutic aspects of cholera in pregnant women, as well as its course, during the 2012 epidemic in Conakry. This retrospective, descriptive studied examined the records of this epidemic over a 7-month period (from May 15 to December 15, 2012). Of 2,808 cholera patients at our hospital, 80 were pregnant, that is, 2.85%. Their mean age was 30 years [range: 15-45 years], 94% were from Conakry (94%), and 69% were in the third trimester of pregnancy. Choleriform diarrhea and vomiting were the main signs, found respectively in 100% and 95% of the women; dehydration was mild for 16%, moderate for 45%, and severe for 39%. Support consisted of rehydration, by plans A (16%), B (45%) or C (39%) and antibiotic treatment based on erythromycin (85%), doxycycline (14%), or azithromycin (1%). Other drugs that were used included phloroglucinol-trimethylphloroglucinol (Spasfon(®)) for 45%, acetaminophen for 65%, and iron/folic acid for 1% of cases. The major obstetric complications were 4 intrauterine deaths (5%), 2 cases of threatened abortion (2%), 1 preterm delivery (1%), and 1 maternal death. The cholera outbreak in 2012 affected a large number of pregnant women in Conakry, most during their third trimester. The classic clinical manifestations were associated with obstetric complications and maternal-fetal risks.

2014 Anthrax epidemic in Koubia prefecture, Guinea-Conakry.

Anthrax disease is an anthropozoonosis caused by a Gram-positive bacterium, Bacillus anthracis. Our objective was to describe the epidemiological, clinical and therapeutic features of the 2014 epidemic in Koubia prefecture. This retrospective study examined all of the anthrax cases reported in Fafaya, Koubia Prefecture. In March and April 2014, there were 39 cases of human anthrax reported, for an incidence of 1.135%. The mean age was 20.9 (± 18.3) with a sex ratio of 2.54 (28/11) in favor of men. Seventy-six percent (23/39) were single. More than one half were students (53.8%). The main clinical signs were fever in 71, 8% (n = 28 /), papules 59% (n = 23), vesicles of 59% (n = 23) Digestive and cutaneous signs represented 35.9 % and 64.1% respectively; 35% had ingested contaminated meat and 17.95% were in direct contact with a sick animal. We didn't find any correlation between the mode of infection and onset of signs. The fatality rate was 28.21%. The 2014 epidemic of anthrax disease in the Koubia prefecture was marked by a high incidence and lethality. Clinical manifestations were cutaneaous and digestive. These results may serve further interventions to fight against anthrax disease. They should mainly focus on an awareness of peasants, surveillance and vaccination of cattle. Other studies seem to be necessary.

Tolérance et observance aux ARVs chez les personnes vivant avec le VIH suivis au service des maladies infectieuses de l'hôpital national Donka de Conakry, Guinée

Introduction : L'initiative Guinéenne d'accès aux ARV promulguée en 2003, a apporté un véritable élan de prise de conscience sur la nécessité que toutes les Personnes Vivant avec le VIH (PVVIH) du pays accèdent à un traitement. Les objectifs de ce travail étaient de déterminer la fréquence des effets indésirables (EI) survenus chez les PVVIH en fonction des régimes thérapeutiques, d'évaluer le niveau d'observance ainsi que d'identifier les facteurs associés à l'inobservance aux ARV.Matériels et méthodes : Il s'agissait d'une étude transversale qui s'est déroulée du 1er juillet au 30 septembre 2014 dans le service des maladies infectieuses de l'hôpital National Donka de Conakry. Pour une file active de 2341 PVVIH, 2118 étaient sous ARV (90,47%). Seuls 1325 (56,6%) répondaient à nos critères d'inclusion.Résultats : La moyenne d'âge était de 37,8 ± 11,1 ans et 67,3% était des femmes. L'AZT+3TC+NVP (59,9%) suivi de TDF+3TC+EFV (28,2%) étaient les principaux schémas thérapeutiques prescrits. La durée du traitement était inférieure à un an chez 30,7%, comprise entre 1 et 5 ans chez 62,4%. Les effets indésirables du traitement ont été retrouvés chez 13,4% des patients. L'anémie, le rash cutané, la fièvre étaient les principaux effets indésirables retrouvés chez les patients sous AZT+3TC+NVP. Ceux soumis à l'AZT+3TC+EFV présentaient essentiellement une anémie. L'inobservance globale au traitement a été rapportée chez 15,8% des patients. Les principaux facteurs associés à cette inobservance étaient la durée du traitement (p = 0,009) et l'altération de l'état général (p = 0,000001). Conclusion : Le maintien voire l'amélioration de ces résultats nécessite une surveillance régulière des effets indésirables ainsi que de l'observance

[Evaluation of antiretroviral treatment in HIV infected adult in the department of dermatology venereology of the Donka national hospital]. / Evaluation du traitement antiretroviral chez l'adulte infecte par le VIH au service de dermatologie venereologie de l'hopital national Donka.

If the use of highly active antiretroviral therapies (HAART) have largely improved survival, morbidity and the quality of life of the people living with HIV in Northern countries as well as Southern countries and particularly in Africa, many obstacles have slowed down their use. Thus the follow-up of the patients under HAART in certain developing countries is still limited even non-existent. OBJECTIVE: The objective of this work was to bring the therapeutic outcomes obtained after a minimal six months period of follow-up among HIV+ patients admitted in external consultations or following hospitalizations. MATERIAL AND METHODS: We carried out a retrospective and descriptive study concerning patients followed from January 1st, 2004 to December 31st, 2008 (5 years). RESULTS: Our study concerned 275 patients including 61.41% women with a sex-ratio (M/W) of 0.62. The average age of our patients was of 36.83 [rage: 18-70]. The initial average weight of our patients was 59.88 kg [range: 30-107] with the majority (66.91%) at the stage III of the WHO clinical classification. The serologic profile was dominated by HIV1 (97.09%) with a number of average CD4 of 210.99 cells/mm3 at the initiation of the ARV treatment. The evolution under treatment was marked clinically by an average ponderal gain of 7,45kg, with weight increasing from 59.88 kg to 67.33 kg between M0 and M54. Biologically, the number of average CD4 increased from 210.99 to 643 between M0 and M48 with an average gain of 432.01 cells/mm3. On the virological level, the plasmatic viral load was carried out for 64 patients out of 275. It was undetectable in 31 patients, be it 48.44%. CONCLUSION: In conclusion, the therapeutic outcomes of the patients under HAART was good at the end of this study with a satisfactory clinical issue, marked by an increase in the average weight which corroborates a good immunological and virological response.

Si l'utilisation des multithérapies antirétro-virales (ARV) a grandement amélioré la survie, la morbidité et la qualité de vie des PVVIH dans les pays du Nord, dans les pays du Sud, et notamment en Afrique, de nombreux obstacles ont freiné leur utilisation. C'est ainsi que le suivi des patients sous ARV dans certains pays en voie de développement est encore timide voir inexistant. OBJECTIF: L'objectif de ce travail était de rapporter les réponses thérapeutiques obtenues après une période minimale de six mois de suivi chez des patients VIH+ admis en consultations externes ou à la suite d'hospitalisations. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude rétrospective de type descriptif concernant les patients suivis dans la période du 1er janvier 2004 au 31 décembre 2008, soit 5 ans. RÉSULTATS: Notre étude a concernée 275 patients dont 61,41% de femmes avec un sex-ratio (H/F) de 0,62. L'âge moyen de nos patients était de 36,83 [18 70]. Le poids moyen initial de nos patients était de 59,88 kg [30 ­107] avec la majorité (66,91%) au stade III de la classification clinique de l'OMS. Le profil sérologique était dominé par le VIH1 (97,09%) avec un nombre de CD4 moyen à 210,99 cellules/mm3à l'initiation du traitement ARV. L'évolution sous traitement a été marquée cliniquement par un gain pondéral moyen de 7,45kg, le poids moyen passant de 59,88 kg à 67,33 kg entre M0 et M54. Biologiquement, le nombre de CD4 moyen est passé de 210,99 à 643 entre M0 et M48 soit un gain moyen de 432,01 cellules/mm3. Sur le plan virologique, la charge virale plasmatique réalisée chez 64 patients sur 275 était indétectable chez 31 patients soit 48,44%. CONCLUSION: Globalement, la réponse thérapeutique était bonne au terme de cette étude avec une réponse clinique satisfaisante, marquée par une augmentation du poids moyen qui corrobore une bonne réponse immunologique et virologique.

[Causes of lymphocytic meningitis in people with HIV admitted to the Infectious Disease department of Conakry]. / Étiologies des méningites lymphocytaires chez les personnes vivant avec le VIH suivies dans le service des maladies infectieuses de Conakry.

OBJECTIVES: The advent of HIV infection has significantly changed the distribution of the causes of lymphocytic meningitis. The objective of this study was to identify these causes among persons with HIV hospitalized in the infectious disease department of the CHU of Conakry. MATERIALS AND METHODS: This retrospective study examined hospital records of patients with HIV infection admitted for lymphocytic meningitis over a 10-year period. RESULTS: Of the 8649 hospitalizations in the department during the study period, 3167 patients had HIV infection, and 85 of the latter were diagnosed with lymphocytic meningitis. Slightly more than half were male (sex ratio M/F = 1.1). Their mean age was 32 years. Of these 85 patients, 73 were positive for HIV-1 only and 12 for HIV1+2. A CD4 count was performed only in 13/85 patients and averaged 140 cells/mm3. The main causes associated with lymphocytic meningitis were cryptococcosis (58%), toxoplasmosis (5%), and tuberculosis (2%). Streptococcus pneumoniae, Neisseria meningitidis, and Hæmophilus influenzae were also identified in 16% of cases. In 18% of cases no microbe was identified. The overall lethality rate was 68%; it reached 100% for tuberculous meningitis and for the cases without any identified cause and was 75%-76% for the patients with toxoplasmosis and cryptococcosis. The survival rate was 100% for all bacterial causes. CONCLUSION: A cause for lymphocytic meningitis was identified in more than 81% of the patients in our series, and the most common microbe was Cryptococcus neoformans. A better microbiological technical platform and improved accessibility to treatment would enable us to provide more relevant results and treatment.

Ebola outbreak in Conakry, Guinea: epidemiological, clinical, and outcome features.

OBJECTIVES: The authors studied the epidemiological, clinical, and outcome features of the Ebola virus disease in patients hospitalized at the Ebola treatment center (ETC) in Conakry to identify clinical factors associated with death. MATERIALS AND METHODS: A prospective study was conducted from March 25 to August 20, 2014. The diagnosis of Ebola virus infection was made on real-time PCR. RESULTS: Ninety patients, with a positive test result, were hospitalized. Their mean age was 34.12±14.29 years and 63% were male patients. Most worked in the informal sector (38%) and in the medical and paramedical staff (physicians 12%, nurses 6%, and laboratory technicians 1%). Most patients lived in the Conakry suburbs (74%) and in Boffa (11%). The main clinical signs were physical asthenia (80%) and fever (72%). Hemorrhagic signs were observed in 26% of patients. The comparison of clinical manifestations showed that hiccups (P=0.04), respiratory distress (P=0.04), and hemorrhagic symptoms (P=0.01) were more frequent among patients who died. Malaria (72%) and diabetes (2%) were the most frequent co-morbidities. The crude case fatality rate was 44% [95% confidence interval (33-54%)]. The average hospital stay was 7.96±5.81 days. CONCLUSION: The first Ebola outbreak in Conakry was characterized by the young age of patients, discrete hemorrhagic signs related to lethality. Its control relies on a strict use of preventive measures.

[Epidemiology of bacillary pulmonary tuberculosis according to HIV status of patients followed in the department of infectious diseases Conakry (Guinea)]. / Épidémiologie de la tuberculose pulmonaire bacillifère selon le statut VIH des patients suivis dans le service des maladies infectieuses de Conakry (Guinée).

Despite many efforts of prevention and the availability of free treatment, TB/HIV co-infection is still rampant in Guinea. The objective of this study was to describe the epidemiology of smear positive pulmonary tuberculosis according to HIV status among patients hospitalized in the infectious diseases department of Conakry University Hospital. This was a descriptive and analytical retrospective study of patient records admitted for pulmonary tuberculosis from January 2003 to December 2012. During this period, 1953 cases of tuberculosis were collected of which 346 (17.7%) were smear positive. There was a marked male predominance (59.7%). The average age was 38 ± 11 years. The majority of patients originated from the suburbs of Conakry and its surrounding prefectures (76.7%). People without profession were most represented (40.7%). A level of primary education was the most frequently reported (39.7%). Out of 325 patients tested for HIV, the serology was positive in 185 patients (56.9%). A contact with a TB patient was reported in 21.4% of HIV negative patients, and in 6.5% of the HIV-positive group (p = 0.0006). There was no difference between the two groups regarding clinical signs and symptoms. The mean CD4 count was comparable in both groups (p = 0.05). Lethality was higher among co-infected patients (30.4% against 15.56%; p = 0.00037). Strengthening the prevention of TB among PLWHA by the administration of isoniazide seems necessary and warrants further study on this subject in Guinea.

[Scorpion envenomation treated in the Infectious and Tropical Diseases at the Donka National Hospital, Guinea]. / Les envenimations scorpioniques traitées dans le service des maladies infectieuses et tropicales de l'hôpital national Donka, Guinée.

A retrospective descriptive study was conducted from 1(st) October 2010 to 30 November 2012 on the records of patients admitted for scorpion envenomation in the Department of Infectious and Tropical Diseases at the Donka National Hospital. The objective of this study is to describe the epidemiological profile and clinical characteristics of scorpion envenomation in Maritime Guinea, from scorpion stings recently covered in this service. We collected 75 cases of scorpion envenomation. The median age was 21.5 with interquartile 8 and 20 and sex ratio was 1.29. The upper limbs were involved in 55% of cases, followed by the lower limbs (35%), trunk (6%), head and neck (4%). We observed 63% of patients with local signs, 30% mild and general clinical signs of 7% severe systemic symptoms. All patients received an analgesic and a heterologous antitoxin, associated with an antibiotic (87% of patients), a corticosteroid (72%), diazepam (13%) and furosemide (34.6%). The incidence of scorpion envenomation is not negligible despite underreporting of cases, most often treated in traditional medicine.

[Canine and human rabies in Conakry: epidemiology and preventive aspects]. / La rage canine et humaine à Conakry : aspects épidémiologique et prophylactique.

In Guinea, stray dogs are present in large numbers in public places and around landfills. The objectives of this study were to determine the frequency of human exposure to rabies risk, the cases of human and canine rabies and to describe the epidemiological profile of the cases. This retrospective and descriptive study was conducted in health and veterinarian facilities within the city of Conakry. All records of patients admitted in these facilities because of animal bites and veterinary records for aggression by domestic animals from 2002 to 2012, so, during an 11-year period, were collected. During the study period, 7 994 people were concerned by domestic animal bites. Males were the most affected with 60.4% of all cases. Students represented the higher class with 36.0%, followed by workers (18%). The majority of injuries were to the lower limbs (54.4%). The dog has been implicated in the attacks in 98.8% of cases. Among the 2 916 biting dogs which were placed under observation, 14 developed clinical rabies. Among those assaulted, 11 cases of rabies were reported. From 7 994 victims of domestic animal bites, 2 634 received post-exposure prophylaxis and the dropout rate was 51%. Rabies is a real risk in Conakry. Provisions in terms of public health strategy must be taken to minimize it.

[The hospital-borne tetanus in the reference service of the Donka National Hospital in Conakry (2001-2011)]. / Le tétanos nosocomial dans le service de référence de l'hôpital National Donka à Conakry (2001-2011).

Become almost non-existent in the developed countries, the hospital-borne tetanus always stays of current events in our country in spite of the forensic problem which it puts. The objectives of this study were to determine prevalence of this affection, to describe its clinical picture and to determine its lethality. It is about a retrospective study of a duration of 11 years realized in the service of the infectious diseases of Conakry. Among 8649 hospitalizations from 2001 till 2012 we brought together 239 cases of tetanus (2.7%) among which 60 hospital-borne tetanus (0.7%). Men represented 73% of these cases, with a sex-ratio M/F of 2.7. The age bracket of 20-40 years was the most affected with 32 cases (53.3%). A single patient had begun his vaccinal calendar which had remained incomplete. Both national hospitals of the CHU of Conakry and private hospitals were the biggest suppliers of this hospital-borne tetanus with respectively 22 and 27 cases (36.6 and 45%). Tetanus related to IM of quinine represented 26 cases (43.3%) whereas the hernial cure was found in 16 cases (26.6%). The average duration of invasion and incubation was respectively 1.5 days and 6 days for the dead (n = 45.7%) and 2 days and 10.5 days for the survivors. Three-quarters of 60 patients died. The fight against this type of tetanus passes inevitably by an improvement of the working conditions, a strict application of the rules of asepsis and the in-service training of the medical and paramedical staff.

[Evaluation of antiretroviral treatment in HIV infected adult in the department of dermatological venereology of the Donka National Hospital]. / Evaluation du traitement antiretroviral chez l'adulte infecte par le VIH au service de dermatologie venereologie de l'Hopital National Donka.

If the use of highly active antiretroviral therapies (HAART) have largely improved survival, morbidity and quality of life of the people living with HIV in Northern and Southern countries, and particularly in Africa, many obstacles have slowed down their use. Thus the monitoring of patients under HAART in certain developing countries is still very low, if not non-existent. OBJECTIVE: The objective of this study was to bring the therapeutic outcomes obtained after a minimal six months period of monitoring among HIV positive patients admitted in external consultations or following hospitalizations. MATERIAL AND METHODS: We carried out a retrospective descriptive study concerning patients monitored from January 1st, 2004 to December 31st, 2008, that is to say 5 years. RESULTS: Our study consisted of 275 patients including 61.41% women with a man:woman sex-ratio of 0.62. The average age of our patients was of 36.83 [ranging from 18 to 70]. The initial average weight of our patients was 59.88 kg [range: 30-107] with the majority (66.91%) at stage III of the WHO clinical classification. The serologic profile was dominated by the HIV1 (97.09%) with a CD4 average of 210.99 cellules/mm3, the the start of the HAART. The evolution under treatment was marked clinically by an average ponderal gain of 7,45kg, with average weight going from 59.88 kg to 67.33 kg between M0 and M54. Biologically, the CD4 average went from 210.99 to 643 between M0 and M48 or an average gain of 432.01 cells/mm3. On the virological level, the plasmatic viral load carried out on 64 patients out of 275, was undetectable in 31 patients or 48.44% of cases. CONCLUSION: Our findings show that the therapeutic outcomes for patients under HAART was good and with a satisfactory clinical response, marked by an increase in the average weight which indicates a good immunological and virological response.

Si l'utilisation des multithérapies antirétrovirales (ARV) a grandement amélioré la survie, la morbidité et la qualité de vie des PVVIH dans les pays du Nord, dans les pays du Sud, et notamment en Afrique, de nombreux obstacles ont freiné leur utilisation. C'est ainsi que le suivi des patients sous ARV dans certains pays en voie de développement est encore timide voir inexistant. OBJECTIF: L'objectif de ce travail était de rapporter les réponses thérapeutiques obtenues après une période minimale de six mois de suivi chez des patients VIH+ admis en consultations externes ou à la suite d'hospitalisations. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude rétrospective de type descriptif concernant les patients suivis dans la période du 1er janvier 2004 au 31 décembre 2008, soit 5 ans. RÉSULTATS: Notre étude a concernée 275 patients dont 61,41% de femmes avec un sex-ratio (H/F) de 0,62. L'âge moyen de nos patients était de 36,83 [18 70]. Le poids moyen initial de nos patients était de 59,88 kg [30 ­107] avec la majorité (66,91%) au stade III de la classification clinique de l'OMS. Le profil sérologique était dominé par le VIH1 (97,09%) avec un nombre de CD4 moyen à 210,99 cellules/mm3à l'initiation du traitement ARV. L'évolution sous traitement a été marquée cliniquement par un gain pondéral moyen de 7,45kg, le poids moyen passant de 59,88 kg à 67,33 kg entre M0 et M54. Biologiquement, le nombre de CD4 moyen est passé de 210,99 à 643 entre M0 et M48 soit un gain moyen de 432,01 cellules/mm3. Sur le plan virologique, la charge virale plasmatique réalisée chez 64 patients sur 275 était indétectable chez 31 patients soit 48,44%. CONCLUSION: Globalement, la réponse thérapeutique était bonne au terme de cette étude avec une réponse clinique satisfaisante, marquée par une augmentation du poids moyen qui corrobore une bonne réponse immunologique et virologique.