Contribution of COVID Antigenic RDT to the Management Strategy of COVID-19 Pandemic in a Senegalese Company.

OBJECTIVE: To describe the contribution of the rapid antigen diagnostic testing (RDT) to the management strategy of the COVID-19 pandemic. METHODOLOGIES: The protein chain reaction (PCR) and the RDT have been performed on each COVID-19 suspected workers from December 2020 to September 2021. RESULTS: A total of 286 people tested. A positivity rate of 38.1% was recorded. The average time to obtain PCR results was 8.3 days. 54.8% (n = 142) of the RDT were followed by a PCR for confirmation or invalidation and 100% of positive cases with Ag-RDT were confirmed by the PCR. We have noticed a 58.3% reduction of lost work days due to COVID-19, since the use of the Ag-RDT. CONCLUSION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid diagnostic tests are efficient. They have enabled early treatment of COVID-19 patients, helped hold back the spread of the disease in a high-risk professional environment, and reduced the impact of the pandemic on a vital sector in developing countries.

Apport de la TDM thoracique pour le dépistage de la COVID-19 et impact médico-économique de la pandémie à COVID-19 au service de radiologie de Fann (Dakar-Sénégal) / Contribution of thoracic CT for COVID-19 screening and medico-economic impact of the COVID-19 pandemic in the radiology department of Fann (Dakar-Senegal)

Objectifs :Évaluer l'apport de la TDM thoracique dans le diagnostic des patients suspects de COVID-19en comparaison avec la technique de référence (RT-PCR) et déterminer l'impact médico-économique de la COVID-19 au service de radiologie du CHU de Fann. Matériels et méthodes: Il s'agissait d'une étude rétrospective, descriptive sur une période de 4 mois allant du 1er avril au 31 Juillet 2020, au service de radiologie du CHU de Fann.Ont été inclus les patients reçus pour suspicion clinique de COVID-19, qui avaient eu une TDM thoracique et un prélèvement naso-pharyngé par écouvillonnage pour RT-PCR, soit au total 314 patients. Nous avons étudié les données épidémiologiques, cliniques, les images évocatrices de COVID-19 (opacités en verre dépoli, condensation, topographie lésionnelle), existence ou non d'une embolie, les anomalies en faveur de surinfection, les lésions associées, l'impact sur la fréquentation des différentes modalités etl'impact sur les recettes. Résultats:L'âge médian était de 62 ans et le sex-ratio 1,61. La fièvre a été présente chez 7 patients (2,23%); la toux chez 17 patients (5,41%); la dyspnée chez 30 patients (9,55%) et un syndrome de détresse respiratoire chez 63 patients (20,07%). La clinique n'a pas été précisée chez 163 patients (51,91%). La TDM thoracique était normale chez 20 patients (6,37%), évocatrice de COVID-19 chez 274 patients (87,26%) et non évocatrice de COVID-19 chez 20 patients (6,37%). La RT-PCR était positive chez 125 patients soit 39,80%. La sensibilité et la spécificité de la TDM étaient respectivement de 91,2% et 15,34%. La valeur prédictive positive, la valeur prédictive négative et le taux de précision étaient respectivement de 42%, 72,5% et 45,5%. La baisse du taux de fréquentation était de 59% en radiographie standard, 55% en échographie, 24% au scanner et 87% en mammographie. Dans notre étude on a noté une baisse de 40% des recettes au second trimestre de 2020 comparativement au premier trimestre. Conclusion: La TDM thoracique a une bonne sensibilité pour le diagnostic de la COVID-19. De ce fait, elle peut être considérée comme un outil principal pour la détection des lésions pulmonaires évocatrices de pneumonie COVID-19. Les impacts médico-économiques de la COVID-19 ont été considérables.

False ground-glass opacity and suspicion of COVID-19, beware of the technique for performing the CT.

Ground-glass opacity is a CT sign that is currently experiencing renewed interest since it is very common in patients with COVID-19. However, this sign is not specific to any disease. Besides, the possibility of false positive ground-glass opacity related to insufficient inspiration during the acquisition of the chest CT should be known. We report the case of a 36-year-old patient suspected of COVID-19 and in whom a second acquisition of chest CT was necessary to remove false ground-glass opacities that erroneously supported the diagnosis of COVID-19.

Risk of Ipsilateral Deep Vein Thrombosis After Use of AngioSeal Closure Device in Aneurysmal Subarachnoid Hemorrhage Patients.

BACKGROUND: Deep vein thrombosis (DVT) is a known complication in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study investigated the association between use of the AngioSeal (St. Jude Medical, Minnetonka, MN) vascular closure device and the risk of ipsilateral and any DVT event after angiography in patients with aSAH. METHODS: We conducted a review of our institutional cerebral angiography database for the years 2005-2018 to identify all adult patients who underwent angiography for aSAH. We compared the incidence of DVT (occurring within 14 days) between aSAH patients who underwent manual compression versus the AngioSeal closure device. RESULTS: A total of 459 aSAH patients underwent angiography; 262 underwent manual compression (57.1%) and 197 received AngioSeal (42.9%). There was a 3.4% rate of ipsilateral DVT in the manual compression group and 7.6% in the AngioSeal closure device group (χ2 test, P = 0.04). Similarly, the rate of any DVT was 8.8% for manual compression and 16.8% for patients who received AngioSeal (χ2 test, P = 0.01). On multivariate analysis, AngioSeal remained a significant independent predictor of ipsilateral DVT (odds ratio 2.4, P = 0.04) and any DVT (odds ratio 2.3, P = 0.01). CONCLUSIONS: In aSAH patients undergoing cerebral angiographic procedures with access through the femoral artery, the use of AngioSeal closure device was found to be associated with a significantly increased risk of ipsilateral DVT within 14 days.

Aspects tomodensitométriques des anomalies lombaires dans l'exploration des lombalgies au centre hospitalier régional de Kaolack : à propos de 67 cas

Objectifs : rechercher les étiologies des lombalgies à la tomodensitométrie.Matériels et méthode : il s'agissait d'une étude transversale, prospective sur une période de 04 mois (07 Avril au 07 Aout 2018) incluant 67 patients (43 hommes et 24 femmes). L'âge moyen était de 49,58 ans. Les paramètres étudiés étaient les anomalies osseuses, discales et des parties molles non discales, analysées avec les logiciels SPSS 22.0 et CS-ENTRY 7.0 avec une p-value significative de 0,02.Résultats : les examens TDM étaient anormaux dans 97% des cas. on notait une étroitesse canalaire était notée chez 26,9% des patients, une arthrose corporéale chez 43,3%, une arthrose des articulaires postérieures chez 44,8% et une lyse isthmique chez 4,5% des patients. Une anomalie discale était trouvée chez 94% des patients, dominée par la hernie discale (61,9%) suivie du vide discal (23,8%) et du bombement global (14,3%). Ces anomalies discales siégeaient à l'étage L4-L5 dans 41,2 % et un conflit disco-radiculaire était noté chez 46 patients soit 69,7 %, le siège de ce conflit était canalaire dans 73,9%. Une hypertrophie des ligaments jaunes et une raréfaction de la graisse épidurale étaient notées chez 7 patients soit 10,4% des cas.Conclusion : la tomodensitométrie avait permis de diagnostiquer les différentes pathologies responsables de lombalgie chez 97% des patients, dominées par les anomalies discales

False ground-glass opacity and suspicion of COVID-19, beware of the technique for performing the CT

Ground-glass opacity is a CT sign that is currently experiencing renewed interest since it is very common in patients with COVID-19. However, this sign is not specific to any disease. Besides, the possibility of false positive ground-glass opacity related to insufficient inspiration during the acquisition of the chest CT should be known. We report the case of a 36-year-old patient suspected of COVID-19 and in whom a second acquisition of chest CT was necessary to remove false ground-glass opacities that erroneously supported the diagnosis of COVID-19

Bayesian Nonparametrics and Biostatistics: The Case of PET Imaging.

Biostatistic applications often require to collect and analyze a massive amount of data. Hence, it has become necessary to consider new statistical paradigms that perform well in characterizing complex data. Nonparametric Bayesian methods provide a widely used framework that offers the key advantages of a fully model-based probabilistic framework, while being highly flexible and adaptable. The goal of this paper is to provide a motivation of Bayesian nonparametrics (BNP) through a particular biomedical application, namely Positron Emission Tomography (PET) imaging reconstruction.

[Characteristics of work-related injuries and the fate of the victims: about 133 cases reported to the Social Security Fund in Dakar, Senegal]. / Caractéristiques des accidents du travail et devenir des victimes: à propos de 133 cas déclarés auprès de la Caisse de Sécurité Sociale de Dakar (Sénégal).

INTRODUCTION: Work-related injuries have an impact on social security system of the country, on the victims as well as on their relatives. The objective is the aim of our study was to describe the different characteristics of work-related injuries reported to the Social Security Fund (CSS) in Dakar as well as the socioprofessional course of the victims. METHODS: We conducted a retrospective cross-sectional study over a period of 5 years, from 2002 to 2006. Data were collected from 133 cases out of 9 308 reported to the CSS. Various parameters were studied: the socioprofessional characteristics of victims and the lesional features of the injuries. The victims were interviewed to gather informations about their socioprofessional history and their professional situation. RESULTS: The average age of patients was 37,55 years, with a male predominance (99,22 %). BPW (22.6%) and fishing (15%) sectors were most affected. Almost two thirds of injuries happened in the workplace (77.4%). These injuries resulted in fractures in 51.7% of cases and affected the hand in 30.1% of cases. Nearly two thirds of injured subjects (60.9%) had resumed their profession. Thirty one subjects were fired and 12 were redeployed. The average period of temporary total incapacity was 236.7 days. The median annual pension was 1 640 329 CFA Francs (2 504,31 Euros). CONCLUSION: In Senegal, work-related injuries don't have specific characteristics, as described elsewhere. The low resources allocated to the victims and the lack of supporting social-policy measures explain the different types of suffering of the victims and their families.

"Same difference": comprehensive evaluation of four DNA methylation measurement platforms.

BACKGROUND: DNA methylation in CpG context is fundamental to the epigenetic regulation of gene expression in higher eukaryotes. Changes in methylation patterns are implicated in many diseases, cellular differentiation, imprinting, and other biological processes. Techniques that enrich for biologically relevant genomic regions with high CpG content are desired, since, depending on the size of an organism's methylome, the depth of sequencing required to cover all CpGs can be prohibitively expensive. Currently, restriction enzyme-based reduced representation bisulfite sequencing and its modified protocols are widely used to study methylation differences. Recently, Agilent Technologies, Roche NimbleGen, and Illumina have ventured to both reduce sequencing costs and capture CpGs of known biological relevance by marketing in-solution custom-capture hybridization platforms. We aimed to evaluate the similarities and differences of these four methods considering each platform targets approximately 10-13% of the human methylome. RESULTS: Overall, the regions covered per platform were as expected: targeted capture-based methods covered > 95% of their designed regions, whereas the restriction enzyme-based method covered > 70% of the expected fragments. While the total number of CpG loci shared by all methods was low, ~ 24% of any platform, the methylation levels of CpGs covered by all platforms were concordant. Annotation of CpG loci with genomic features revealed roughly the same proportions of feature annotations across the four platforms. Targeted capture methods comprise similar types and coverage of annotations and, relative to the targeted methods, the restriction enzyme method covers fewer promoters (~ 9%), CpG shores (~ 8%) and unannotated loci (~ 11%). CONCLUSIONS: Although all methods are largely consistent in terms of covered CpG loci, the commercially available capture methods result in covering nearly all CpG sites in their target regions with few off-target loci and covering similar proportions of annotated CpG loci, the restriction-based enrichment results in more off-target and unannotated CpG loci. Quality of DNA is very important for restriction-based enrichment and starting material can be low. Conversely, quality of the starting material is less important for capture methods, and at least twice the amount of starting material is required. Pricing is marginally less for restriction-based enrichment, and the number of samples that can be prepared is not restricted to the number of capture reactions a kit supports. However, the advantage of capture libraries is the ability to custom design areas of interest. The choice of the technique would be decided by the number of samples, the quality and quantity of DNA available and the biological areas of interest since comparable data are obtained from all platforms.

Évaluation du stress chez le personnel au service des refugiés et demandeurs d'asile à Dakar

Introduction. Dans les pays émergents, les conséquences du stress demeurent sous-évaluées. Le stress cumulatif est associé au travail humanitaire. Une lourde charge de travail est souvent associée à un manque de reconnaissance du travail accompli et à des difficultés de communication. S'ajoutent la nécessité de faire face à des situations devant lesquelles on se sent désarmé (souffrance des bénéficiaires, guerre) ou au contraire des situations d'attente avec impossibilité d'agir pour des raisons de sécurité. L'objectif de notre travail était d'évaluer la prévalence du stress chez le personnel de l'UNHCR et de l'OFADEC à Dakar au Sénégal et de déterminer les facteurs caractéristiques du stress. Patients et méthodes. Nous avons mené une étude transversale descriptive et analytique du 30 mai au 30 décembre 2012. Soixante individus ont été sélectionnés grâce à un échantillonnage aléatoire. A l'aide d'un questionnaire auto-administré, nous avons enregistré les caractéristiques sociodémographiques, l'hygiène de vie, les conditions de travail, le plan de carrière et les propositions d'amélioration, l'appréciation du stress et les problèmes relationnels. La saisie et exploitation des données ont été effectuées par les logiciels Epi-Info 3.5.4 et Microsoft Excel 2010. Résultats. Cinquante-deux salariés ont participé à l'étude, 30 exerçant à l'OFADEC et 22 à l'UNHCR avec une prédominance masculine (sexe ratio = 1,73). Il s'agissait d'une population jeune, entre 20 et 39 ans dans 53,84 % des cas, tabagique dans 11,53 % des cas et présentant des troubles du sommeil dans 15,38 % des cas. 78.8% des enquêtés avaient un contrat à durée déterminé. La prévalence du stress était de 40,38 % (n = 21) avec une prédominance masculine (sexe ratio = 2). La quasi-totalité des stressés (92,9 %) travaillait en équipe et 66,7 % avaient travaillé sans arrêt durant les 12 derniers mois. 25 agents (42,9 %) se sentaient épuisés, 12 (23,8 %) inquiets ; 10 (19 %) avaient un mal être et 7(14,3 %) avaient plusieurs sentiments à la fois. 37 (71,4 %) stressés adoptaient une attitude agressive face au stress et 29(56,7 %) des agents déclaraient être victimes d'agression verbale. Conclusion. Une bonne gestion du stress au travail passe par la mise en place de modes d'organisation favorables à la santé physique et mentale des travailleurs

Epigenetic Identity in AML Depends on Disruption of Nonpromoter Regulatory Elements and Is Affected by Antagonistic Effects of Mutations in Epigenetic Modifiers.

We performed cytosine methylation sequencing on genetically diverse patients with acute myeloid leukemia (AML) and found leukemic DNA methylation patterning is primarily driven by nonpromoter regulatory elements and CpG shores. Enhancers displayed stronger differential methylation than promoters, consisting predominantly of hypomethylation. AMLs with dominant hypermethylation featured greater epigenetic disruption of promoters, whereas those with dominant hypomethylation displayed greater disruption of distal and intronic regions. Mutations in IDH and DNMT3A had opposing and mutually exclusive effects on the epigenome. Notably, co-occurrence of both mutations resulted in epigenetic antagonism, with most CpGs affected by either mutation alone no longer affected in double-mutant AMLs. Importantly, this epigenetic antagonism precedes malignant transformation and can be observed in preleukemic LSK cells from Idh2R140Q or Dnmt3aR882H single-mutant and Idh2R140Q/Dnmt3aR882H double-mutant mice. Notably, IDH/DNMT3A double-mutant AMLs manifested upregulation of a RAS signaling signature and displayed unique sensitivity to MEK inhibition ex vivo as compared with AMLs with either single mutation.Significance: AML is biologically heterogeneous with subtypes characterized by specific genetic and epigenetic abnormalities. Comprehensive DNA methylation profiling revealed that differential methylation of nonpromoter regulatory elements is a driver of epigenetic identity, that gene mutations can be context-dependent, and that co-occurrence of mutations in epigenetic modifiers can result in epigenetic antagonism. Cancer Discov; 7(8); 868-83. ©2017 AACR.This article is highlighted in the In This Issue feature, p. 783.

[Diagnosis and treatment of the epithelial ovarian cancer at the West African Cancer Center of Dakar]. / Prise en charge diagnostique et thérapeutique des tumeurs épithéliales malignes de l'ovaire dans le Centre Ouest-Africain de lutte Contre le Cancer de Dakar.

INTRODUCTION: Epithelial ovarian cancer are the most frequent of ovarian cancer, their prognosis is very bad. The aim of this study is to describe the diagnosis, the treatment and to assess the survival rate of the patients. METHODS: It was a retrospective study realized at the Cancer Institute of Dakar from December 2000 to January 2007. We have collected 117 patients with epithelial ovarian cancer. The mean age was 49 years. Patients were comprised: 22 stage I, 32 stage II, 35 stage III and 26 stage IV. Primary surgery was performed to 34 patients and the other patients were treated with chemotherapy and surgery. The survival rate was assessed by Kaplan-Meier method and the Logrank test had allowed to compare the survival among age and optimal surgery. RESULTS: Optimal surgery R0 was done in 20 cases and surgical resection R2 was performed in 45 cases. Pathological exam had found 65 serous cystadenocarcinoma, 28 mucinous cystadenocarcinoma and 21 endometrioid cystadenocarcinoma, one malignant tumor of Brenner. Overall survival at five years was 13.3%. The survival among optimal surgery was 16.3 and 2.3% for suboptimal surgery. There was no significant difference of the survival among patients who were less than 40 years old (P = 0.334). CONCLUSION: Prognosis of epithelial ovarian cancer is worse in Senegal as like as in the world. To improve the survival of our patients, we must detect the early diagnosis of these tumors and to introduce the neoadjuvant chemotherapy before optimal surgery.

Revisiting long-term adherence to highly active antiretroviral therapy in Senegal using latent class analysis.

BACKGROUND: Adherence is one of the main predictors of antiretroviral treatment success. A governmental initiative was launched in 1998 for HIV-infected patients in Senegal to provide access to highly active antiretroviral therapy. METHODS: Between August 1998 and April 2002, 404 adult patients were enrolled. Adherence measurements, defined as pills taken/pills prescribed, were assessed between November 1999 and April 2009 using a pill count along with a questionnaire for 330 patients. Predictors of adherence were explored through a random-intercept Tobit model and a latent class analysis (LCA) was performed to identify adherence trajectories. We also performed a survival analysis taking into account gender and latent adherence classes. RESULTS: Median treatment duration was 91 months (interquartile range, 84-101). On average, adherence declined by 7% every year, was 30% lower for patients taking indinavir, and 12% higher for those receiving cotrimoxazole prophylaxis. Based on the predicted probability of having an adherence ≥ 95%, LCA revealed 3 adherence behaviors and a better adherence for women. A quarter of patients had a high adherence trajectory over time and half had an intermediate one. Male gender and low adherence behavior over time were independently associated with a higher mortality rate. CONCLUSIONS: This study shows that an overall good adherence can be obtained in the long term in Senegal. LCA suggests a better adherence for women and points out a large subsample of patients with intermediate level of adherence behavior who are at risk for developing resistance to antiretroviral drugs. This study warrants further research into gender issues.

A 84-month follow up of adherence to HAART in a cohort of adult Senegalese patients.

OBJECTIVES: To assess long-term adherence of the first HIV-1 patients receiving highly active antiretroviral therapy (HAART) in Senegal, and to identify the main determinants of adherence. METHODS: The first 180 patients enrolled in the Senegalese HAART initiative between August 1998 and April 2001 followed up for at least 30 days were eligible. Adherence was assessed monthly at each drug dispensation between November 1999 and November 2006 by a pharmacist using a pill count completed by a questionnaire. Adherence was expressed as the proportion of tablets taken to prescribed tablets. An adherence of 95% was considered to be good. A random-intercept logit model was fitted to identify the main determinants of adherence. RESULTS: Adherence data were available for 158 of 167 eligible patients. Twenty-nine patients died during the study period and 10 were lost to follow-up. Median treatment duration was 78 months, accruing to 6657 person-months of observation. Overall, mean adherence reached 91% [median: 100%, interquartile range (IQR) 96-100%] and adherence exceeded 95% in 78% [95% CI 77-79%] of observations. After 4 years of treatment mean adherence stabilized around 90% and adherence > or =95% stabilized around 70%. Treatment duration and protease inhibitor (PI)-based regimen (indinavir) had a negative effect on adherence, but adherence tended to improve with time for patients receiving a PI. Patient-level variance was highly significant and accounted for a third of total variance. CONCLUSIONS: This work demonstrates that good long-term adherence can be achieved in the sub-Saharan context given close monitoring and adherence support measures, confirms the worse adherence for indinavir and underlines the importance of patient heterogeneity.

[Occupational allergic contact dermatitis in Dakar]. / Les eczemas de contact professionnels a Dakar.

Occupational dermatitis, mainly allergic contact dermatitis and skin irritations are increasing because of new allergens and diversity of the industrial procedures. In Senegal occupational contact dermatitis are currently observed and they are not declared at our social security institution. The aim of our trial was to determinate the frequency of occupational allergic contact dermatitis, the allergens responsible and the exposed occupations. We included in a one year lasting prospective trial, all patients with occupational contact dermatitis confirmed by positive cutaneous allergological tests. Among 201 cases of contact dermatitis, 27 (12,91%) were included and predominant occupational sectors were building, mechanics, health, cleaning and trade. Main responsible allergens were dichromate of potassium (7), N-isopropyl N-phenylparaphenylenediamine (3), fragrance mix (3), thiuram mix (3), colophane (3), formaldehyde (2), nickel sulphate (2), Chalk (2). Building sector was the most frequent source because of high use of dichromate of potassium in cement and formaldehyde in painting-glue. In mechanics, N-isopropyl N-phenylparaphenylenediamine is present in rubbers and fragrance mix in oils. Occupational dermatitis in health workers are due to presence of thiuram mix in the gloves, and dichromate of potassium found in antiseptics. To decrease the incidence of occupational contact dermatitis in our country, we have to promote prevention among workers by using individual protective outfits and increasing workers medical survey and information about risks and means of prevention.