[Sexuality assessment of homozygous adult sickle cell patients with a history of priapism in Senegal]. / Évaluation de la sexualité des drépanocytaires adultes homozygotes ayant des antécédents de priapisme au Sénégal.

OBJECTIVES: The objective of this study was to evaluate the sexuality of SS sickle cell patients with a history of priapism. METHODS: This was a case-control study of adult SS sickle cell patients. The occurrence of priapism as well as the nature of the priapism had been investigated. The patients were subdivided into three groups: Group 1 (no priapism), Group 2 (intermittent priapism) and Group 3 (acute priapism). The patients' sexuality was studied using the IIEF-15 questionnaire. RESULTS: We interviewed 191 SS sickle cell patients. The mean age was 27.1±7.1 years. Priapism was observed in 43.5 %. Only 77 patients were eligible for the IIEF15 questionnaire. Groups 1 and 2 performed significantly better than group 3 on erectile function (EF) and orgasmic function (OF) scores. There was no significant difference in the EF and OF scores between groups 1 and 2. No significant difference was observed between the three groups for the scores of sexual desire (SD), intercourse satisfaction (IS), and overall satisfaction (OS). The impairment of erectile function in group 2 was related to the age of the first episode of priapism and the last episode. The impairment of erectile function in group 3 was related to the duration of evolution (P<0.05). CONCLUSION: This study shows that priapism is responsible for impaired erectile function in SS adult sickle cell patients. A program to prevent intermittent episodes of priapism should be put in place.

Management of gestational trophoblastic diseases in a low resource country: establishment of a national center and its results.

To describe the process of establishing a reference center for gestational trophoblastic diseases (GTD) in Senegal and to report its main results so far. We describe the history and establishment of the center, which is based on the experience of the main international centers. The adaptations made to patient follow-up are detailed, while we follow FIGO and WHO diagnostic and management criteria. Finally, we report our main results. Between 2011 and 2017, 878 files were registered at the Center. More than half of the women had no histological confirmation of GTD (60.8 %). The diagnosis was then based on ultrasound images or macroscopic examination of molar vesicles. Spontaneous remission occurred in 64.5 % of the cases, while gestational trophoblastic neoplasia developed in 23.5 %. The FIGO criteria were slightly adapted for hCG monitoring. Methotrexate was the drug of choice in the low-risk group (97.8 %), while the EMACO protocol was financially difficult for nearly half of the high-risk group. The overall remission rate was 83 % and the specific lethality 11.6 %. Our center has demonstrated the efficiency of centralizing the management of GTDs. Difficulty in access to hCG and antimitotic drugs makes management difficult. However, we have introduced alternative solutions that we are working to improve.

Simulation training for emergency obstetric and neonatal care in Senegal preliminary results.

To describe a new training approach for emergency obstetric and neonatal care (EmONC) introduced in Senegal to strengthen the skills of healthcare providers. The approach was based on skills training according to the so-called "humanist" method and on "lifesaving skills". Simulated practice took place in the classroom through 13 clinical stations summarizing the clinical skills needed for EmONC. Evaluation took place in all phases, and the results were recorded in a database to document the progress of each learner. This approach was used to train 432 providers in 10 months and to document the increase in each participants' technical achievements. The combination of training with the "learning by doing" model ensured that providers learned and mastered all EmONC skills and reduced the missed learning opportunities observed in former EmONC training sessions. Assessing the impact of training on EmONC indicators and introducing this learning modality in basic training are the two major challenges we currently face.

Profile of black woman in Senegal with breast cancer.

To describe the profile of Senegalese black women with breast cancer. This is a retrospective and prospective study of patients receiving care for breast cancer in the breast diseases department of the Aristide Le Dantec Teaching Hospital in Dakar from 2010 through June 2014. 188 women patients met the inclusion criteria. Their mean age at diagnosis was 43.3 years. The age of onset of the first menses was early (<12 years) in 7 patients (4.9%). More than two thirds of the women (71.6%) were premenopausal at diagnosis. At least one pregnancy was reported by 161 women (86.1%) and 96.3 had given birth. Mean age at first pregnancy was 19.47 years, and 85.9% had had their first pregnancy before the age of 30. Similarly, 133 (87.3%) had breastfed, for a mean duration of 18.36 months. In our country, breast cancer occurs in young women, who had their first menses after 12 years, are premenopausal, had their first pregnancy before the age of 30, and breastfed for several months. These data suggest that further study of this profile is needed but that the testing policy must change drastically, to start much earlier than 50 years.

Breast cancer in women younger than 35 years : features and outcomes in the breast unit at Aristide le Dantec Teaching Hospital, Dakar.

The aim of this study was to determine the clinical features and outcomes of women younger than 35 years with breast cancer. This study was performed at Gynecologic and Obstetric Clinic of Dakar Teaching Hospital and retrospectively reviewed the records of all women younger than 35 years seen in our department for histologically proven breast cancer. Data were analyzed with SPSS software (Statistical Package for Social Science) Version 23. Between 2007 and 2015, 62 women with breast cancer met the inclusion criteria and were included. The incidence of women in this age group treated in our department was 22.6%. The median age at diagnosis was 29.7 years. The mean time to consultation was 12.5 months, and the disease was locally advanced at diagnosis in 79% of cases. Histological study found 85.5% of cancers were invasive ductal carcinoma. The immunohistochemical study found positive hormone receptors in 12 women (19.4%) and overexpression of HER-2 in 8 (12.9%). Chemotherapy was performed in 54 patients (87.1%), and surgery in 47 (62.9%). Recurrence occurred in 12. In all, 22 women died (35.5%) by the end of the study period. Mean survival was 36.7 months (CI 29.5 to 43.9) and median survival 39.7 months (CI 22.1 to 57.5). This high incidence rate in our study is consistent with that found in young African-American women and is worrisome. These results seem to point towards a genetic origin and call for a thorough search of the profile. They also call also for the involvement of pathologists and collaboration with other research teams.

Survival and persistence of Bacillus clausii in the human gastrointestinal tract following oral administration as spore-based probiotic formulation.

AIMS: This study aimed to investigate the fate of Bacillus clausii spores orally administered as lyophilized or liquid formulation to healthy volunteers. METHODS AND RESULTS: The study was a randomized, open-label, cross-over trial in which two commercial probiotic formulations containing spores of four antibiotic-resistant B. clausii strains (OC, NR, SIN, T) were given as a single dose administration. Faecal B. clausii units of each strain were counted on selective media and extrapolated for the total weight of evacuated faeces. RAPD-PCR typing was used to confirm B. clausii identification. Bacillus clausii was found alive in faeces for up to 12 days. In some volunteers, the recovered amount of OC, NR or SIN was higher than the number of administered spores. Bioequivalence among the two formulations was demonstrated. CONCLUSIONS: Bacillus clausii spores survive transit through the human gastrointestinal tract. They can undergo germination, outgrowth and multiplication as vegetative forms. Bacillus clausii strains can have different ability to survive in the intestinal environment. Bacillus clausii spores administered as liquid suspension or lyophilized form behave similarly in vivo. SIGNIFICANCE AND IMPACT OF THE STUDY: This work contributes towards a better understanding of the behaviour of B. clausii spores as probiotics.

Gestational trophoblastic neoplasia after achieving a nondetectable serum human chorionic gonadotrophin level.

OBJECTIVE: To determine the risk of recurrent trophoblastic disease after normalisation of human chorionic gonadotrophin (hCG) levels in women with hydatidiform mole. DESIGN: A retrospective review of data from a national gestational trophoblastic disease centre. SETTING: The Trophoblastic Disease Unit, Dakar, Senegal. SAMPLE: Women with pregnancies affected by hydatidiform mole registered between 2006 and 2012. METHODS: The women were followed up in accordance with the hospital protocol 'Score de Dakar'. For women who progressed to gestational trophoblastic neoplasia (GTN) the time to onset of GTN, treatment and evolution were evaluated. The rate of evolution to GTN after normalisation of hCG was determined. MAIN OUTCOME MEASURES: Rate of occurrence of GTN after chemotherapy for hydatidiform mole. RESULTS: Five hundred and thirty-one women were diagnosed to have molar pregnancies. According to the hospital's protocol, 107 (20.2%) of these had chemotherapy and 224 (42.2%) had prophylactic chemotherapy. Five hundred and thirteen women (96.4%; 95% confidence interval [95% CI] 95.05-98.14%) achieved remission. Eighteen women (3.4%; 95% CI 1.86-4.94%) developed GTN (11 before remission and seven after remission). Seven women out of the 18 developed GTN after hCG normalisation (1.3%). Five of these seven were diagnosed beyond the recommended period of follow up. The mean interval to diagnosis of GTN was 18.7 months. These seven women underwent combination chemotherapy: five achieved complete remission whereas two died from GTN. CONCLUSIONS: Cytotoxic therapy for hydatidiform mole does not prevent GTN, it delays its diagnosis and promotes GTN after normalisation of hCG.

[Advanced prostate cancer in Senegal. Clinical aspects at the General Hospital of Grand Yoff]. / Cancer avancé de la prostate au Sénégal. Aspects diagnostiques à l'hôpital de Grand Yoff.

UNLABELLED: Prostate cancer is a common disease, which continues to be discovered at advanced stages in Africa, despite improved diagnostic tools. AIM: The authors report the experience of the Department of Urology, General Hospital of Grand Yoff Dakar in the diagnostic of advanced prostate cancer. MATERIAL: This was a retrospective descriptive study on patients followed for advanced prostate cancer during the period from January 1st, 2004 to May 31st, 2010. RESULTS: There were 102 people aged from 51 to 96 years with an average of 71 ± 9 years. A comorbid condition was associated in 24.5 % of cases. The circumstances of discovery were pain (32 cases), neurological signs (17 cases), and urinary disorders. DRE had objectified an abnormality in all patients. The serum levels of prostate specific antigen ranged from 5.88 ng/mL to 21,660 ng/mL, with an average of 1447.57 ± 812 ng/mL. A prostate biopsy was performed in 44 patients and prostatic adenocarcinoma was found in 97.7 % of cases with Gleason scores greater than 7 (33 cases). We found different metastatic sites at vertebral column (23 cases), at lung (14 cases), and on pelvic bones (11 cases). CONCLUSION: The prostate cancer is a serious condition with high morbidity and mortality. The diagnosis is not made early in developing countries. We need a strategic plan to improve the early screening and we should develop supportive care too because of the high number of advanced cases diagnosed in our context.

[Surgical options in the treatment of noma]. / Options chirurgicales dans la prise en charge du noma.

In the acute phase of noma, the role of surgery is minor and the treatment consists in the realisation of local or regional flaps and sometimes the management of haemorragia. For reasons social and economic reconstruction of the loss of substance should be conducted on site. The treatment consists of surgical excision of fibrous tissue, the removal of the ankylosis and the closure of the PDS by local flaps, or free pediculated. Because of the extreme variety of loss of substance (PDS) and the multiple surgical options, a systematic and eventually, the standardization of the surgical approach in the treatment of sequelae of noma is essential.

A la phase aigue du noma, le rôle de la chirurgie est mineur et consiste en des soins locaux et occasionnellement au traitement de l'hémorragie.Pour des raisons socioculturelles et économiques, la reconstruction des pertes de substance doit se dérouler sur place. Le traitement chirurgical consiste en l'excision des tissus fibreux, la levée de l'ankylose et la fermeture des PDS par des lambeaux locaux, pédiculés ou libres.A cause de l'extrême variété des pertes de substance (PDS) et des multiples options chirurgicales, une systématisation et éventuellement, une standardisation de l'approche chirurgicale dans le traitement des séquelles de noma est indispensable.

[Isolated mandibular fractures study's in the CHU-OS of Bamako: 55 cases]. / Etude des fractures isolees de la mandibule au CHU d'odontostomatologie de Bamako: a propos de 55 cas.

AIMS: The aim of this study was to determine sociodemographics, clinical and therapeutic aspects in patients with isolated mandibular fractures in the Bamako dentistry teaching hospital (CHU-OS). MATERIALS AND METHODS: We carried out restrospective study over a period of four months involving isolated mandibular fracture cases, confirmed by a clinical and radiological examination in 2006. The data were collected from medical records, entered and analyzed using Epiinfo.fr 6.0 software. RESULTS: The lesions involved 42 men and 13 women with a sex ratio of 3.23. The age group of 21-30 was the most affected. The main cause was found to be road traffic accidents with 72.72 % of the total cases. The fractures of the mandible at the level of horizontal branch were the most frequent with 34.54 %. The orthopedic treatment was used in 72.72 % of the cases, with a good and very good results. CONCLUSION: This study shows the high frequency of isolated fractures of the mandible mainly from road traffic accidents, as well as their occurrence among young adults.

OBJECTIF: L'objectif de cette étude était, de déterminer les aspects sociodémographiques, cliniques et thérapeutiques, des patients présentant des fractures mandibulaires isolées, au Centre Hospitalier Universitaire d'Odonto Stomatologie (CHU OS) de Bamako. MATÉRIELS ET MÉTHODE: Nous avons réalisé une étude rétrospective sur une période de quatre mois, des cas successifs de fractures mandibulaires isolées, confirmés par un examen clinique et radiologique en 2006. Les données ont été recueillies à partir des dossiers médicaux, saisies et analysées avec le logiciel Epiinfo.fr 6.0. RÉSULTATS: Les lésions ont concerné 42 hommes et 13 femmes, avec un sex ratio de 3,23. La classe d'âge la plus atteinte a été celle de 21 ­ 30 ans. Les accidents de la voie publique ont été la principale cause, avec 72,72% des cas. Les fractures de la mandibule au niveau de la branche horizontale, ont été les plus fréquentes (34,54%). Le traitement orthopédique a été utilisé dans 72,72% des cas, avec de bons à très bons résultats. CONCLUSION: Cette étude montre la fréquence élevée des fractures de la mandibule isolée lors des accidents de la voie publique, et aussi leur survenue chez l'adulte jeune.

Encapsulating peritoneal sclerosis.

Encapsulating peritoneal sclerosis (EPS) is a rare but potentially lethal complication of peritoneal dialysis (PD). Peritoneal tuberculosis is considered an etiologic factor. We report a case of EPS in a 40-year-old man who was switched to hemodialysis because of peritoneal tuberculosis after 2 years of PD. Because of the persistence of gastrointestinal symptoms and cachexia, laparoscopic exploration was performed, which revealed an important thickening of the peritoneal membrane sheathing the intestinal loops. Accordingly, a diagnosis of EPS was made. Anti-tuberculosis treatment associated with a low dose of corticosteroids stabilized the disease.

[Trancesarean intra-uterine device. Pilot study performed at Dakar teaching hospital]. / Dispositif intra-utérin mis en place en cours de césarienne. Étude pilote réalisée au centre hospitalier universitaire de Dakar.

OBJECTIVES: To demonstrate the feasibility of copper IUD insertion following cesarean deliveries and assess its safety. PATIENTS AND METHODS: This is a prospective pilot study at Pikine national hospital from February 15 to November 15, 2012. Were evaluated the efficacy, incidence and spectrum of complications and continuation rates. RESULTS: Fifty-nine subjects were enrolled and 46 received an IUD. The average age of patients was 28 years. No patient had previously used IUDs. Forty-four patients (97.5%) were returned to the first follow-up visit at the first month, 41 patients (89.1%) at the second visit and 39 patients (86.9%) at the third visit. The rate of lost sight was 8.7%. Pain and bleeding were reported rarely: 2.3% at the first month, 4.9% at the third month and 7.7% at the sixth month for the bleeding and 6.8% at the first month, 2.4% at the third month and 2% at the sixth month for pain. The rate of expulsion was 2.2%. CONCLUSION: The insertion of the IUD following cesarean delivery has an acceptable rate of expulsion and no increased rate of adverse effects. This technique should be popularized.

[Management of prostate cancer in Senegal: what is being done?]. / Cancer de la prostate : quelle prise en charge au Sénégal ?

OBJECTIVE: To evaluate the management of patients with prostate cancer in Senegal. MATERIALS AND METHODS: We performed a retrospective descriptive study, based on the medical records of patients managed for prostate cancer during a period of six years and a half from January 1, 2004, to June 30, 2010. All records of inpatients and outpatients managed for prostate cancer were collected. Data collection was performed through a standardized survey form, and included the following parameters: age, presence or absence of known history of prostate cancer in siblings, circumstances of discovery, clinical and paraclinical examination, histology and therapeutic modalities. RESULTS: We studied the records of 164 patients with prostate cancer. The mean age of our patients was 65years, ranging from 43 to 96years. The circumstances of diagnosis were mostly due to lower urinary tract symptoms. Digital rectal examination was suggestive in 87% of cases, and PSA levels were high in 100% of cases, ranging from 5.88ng/ml to 21,660ng/ml, with a mean of 1447.57ng/ml. Half of the patients had PSA levels greater than or equal to 100ng/ml. The most common histological type was adenocarcinoma. During the study period, 49 radical prostatectomies were performed. The mean PSA levels of patients who underwent a prostatectomy were 23.4ng/ml. Radical retropubic prostatectomy was performed in 35 patients, and radical perineal prostatectomy was performed in 10 cases. Pulpectomy was the method most commonly used in metastatic prostate cancer; it was performed in 48 patients. After resistance to castration, antiandrogens were reintroduced in 13 patients, and diethylstilbestrol in four patients. Only two patients underwent a taxane-based chemotherapy regimen. CONCLUSION: The diagnosis of prostate cancer was usually tardive in Senegal. Treatment often involves surgical castration. Prostatectomy was only very seldom indicated.

[Quality of life in hemodialysis patients in Dakar: differences for the tropics?]. / Qualité de vie des patients en hémodialyse à Dakar (Sénégal): quelles particularités pour les personnes vivant en milieu tropical ?

UNLABELLED: In recent years, measuring quality of life (QoL) to quantify the impact of disease on patients' lives has become widespread. We conducted a study to evaluate the QoL of hemodialysis patients in Dakar and to identify factors that influence it. PATIENTS AND METHODS: This cross-sectional study took place from May through July 2008 in two hemodialysis centers in the city of Dakar. It included all patients who had been undergoing dialysis for more than 3 months, were in stable clinical condition with no hospitalization in the previous month and consented to participate. QoL was assessed with the Kidney Disease Quality Of Life Short-Form version 1.2 (KDQoL-SF), which comprises 43 items specific to kidney disease as well as the 36 items of the SF-36. RESULTS: Our study included 60 patients. Their mean age was 50.5 years, and the male/female sex ratio was 0.9. The global mean score (for the SF-36 was 45.7 ± 25.5, 41 ± 24.4 for the physical dimension and 53.6 ± 27.3 for the mental health dimension. The mean global KDQoL score was 55.2 ± 24.0, 44.8 ± 26.1 for the physical dimension, and 54.8 ± 24.4 for the mental health dimension, 60.8 ± 21.3 for the specific dimension of dialysis and 78.4 ± 22.3 for patient satisfaction. The study shows that the QoL of 90% of our patients was impaired by their kidney disease. CONCLUSION: Studies that focus on QoL of dialysis patients are rare in Africa. This one showed an impaired QoL, especially for physical health, among our hemodialysis patients.

RNA versus DNA (NucliSENS EasyQ HIV-1 v1.2 versus Amplicor HIV-1 DNA test v1.5) for early diagnosis of HIV-1 infection in infants in Senegal.

The objective of this study was to compare the performance of the NucliSENS EasyQ HIV-1 v1.2 platform (bioMérieux, France) to the Amplicor HIV-1 DNA test v1.5 (Roche Molecular Systems, Switzerland) in detecting HIV-1 infection in infants using venipuncture-derived whole blood in tubes and dried blood spots. A total of 149 dried blood spots and 43 EDTA-anticoagulated peripheral blood samples were collected throughout Dakar and other areas in Senegal from infants and children aged 3 weeks to 24 months who were born to HIV-1-infected mothers. Samples were tested using the NucliSENS and Amplicor technologies. The NucliSENS and Amplicor results were 100% concordant using either EDTA-anticoagulated peripheral blood or dried blood spots. Compared to Amplicor, the sensitivity and specificity of the NucliSENS test were 100%. The NucliSENS EasyQ HIV-1 RNA assay performed as well as the Amplicor HIV-1 DNA test in detecting HIV-1 infection in infants. In addition, this platform can give an indication of the viral load baseline. The NucliSENS EasyQ platform is a good alternative for early infant diagnosis of HIV-1 infection.

[Breast cancer on a scar of excision of ectopic breast tissue: a case report]. / Cancer du sein sur la cicatrice d'exérèse d'un tissu mammaire ectopique: à propos d'un cas.

The cancerization of supernumerary breast is uncommon. So when this situation occurs, the diagnosis is often late. Cancers of ectopic breast tissue have been reported in the international literature, but to our knowledge, no cancer after excision of accessory breast gland has been published. This article describes a case of ectopic breast tissue cancer in axillary situation occurring several years after excision and details its specific diagnostic, therapeutic and prognosis.

[Total cystectomies for cancers locally advanced of bladder about 12 cases in the service of urology of the general hospital of Grand-Yoff]. / Cystectomies totales pour cancers localement avancés de vessie au service d'urologie de l'hôpital général de Grand-Yoff.

OBJECTIVE: The goals of the study is to evaluate the feasability of the total cystectomy for cancer infiltrating locally advanced of bladder and to evaluate perioperatitive morbidity and short-term results. PATIENTS AND METHODS: We made a retrospective study concerning 12 first patients having profited from a total cystectomy for cancer infiltrating of the bladder in our hospital over one period of 1 year. The parameters of study were: the age at the time of the diagnosis, circumstances of the diagnosis, antecedents of the patient, the histological type and stage TNM before and after intervention, the type of derivation associated, duration of the intervention, the anesthesia, complications and morbidity per- and postoperational. We carried out calculations of average and frequency for the data analysis. RESULTS: The mean age was 51 years (extreme: 32; 83). They were nine men and three women. The circumstances of diagnosis were dominated by the total hematuria and in less frequency by the bladder irritative symptoms. The antecedents of the patients were dominated by the schistosomia (five cases) and the tobacco addiction (two cases). The histological type obtained in preoperative after biopsy or trans urethral resection of bladder found, seven cases of squamous cell carcinoma, four cases of transitional cell carcinoma and one case of adenocarcinoma. Into preoperative, three patients were at the stage pT2, eight patients pT3, one pT4. Four patients had a replacement of bladder: three by a bladder in Z and a patient had Camey II. They were the three patients pT2 preoperative and a patient pT3. Two patients had a standard ureterosigmoidostomy type coffey: the patient pT4 and a patient pT3. The six other patients had Bricker. All the patients profited from a blood transfusion peroperational (two units on average). We did not record any operational mortality. The complications and morbidity are represented by the suppurations of wall (three cases), the vesicocutaneous fistula (one case), the infections urinary and the anemia which was constant. CONCLUSION: The management of bladder cancer poses a real problem in our countries because of the diagnosis at advanced stage.

Paraneoplastic polymyositis associated with breast cancer: a therapeutic emergency.

The association of polymyositis and cancer was first described in 1916, the most frequent cancers being mammary and gynecological for women, bronchopulmonary for men and digestive for both. This article reports a severe paraneoplastic polymyositis associated with breast cancer. The authors discuss its clinical, pathological and therapeutic particularities.

Capacity building for the modified filarial hydrocelectomy technique in West Africa.

To harmonise the technique of filarial hydrocelectomy throughout the West African subregion, training workshops were organized in 10 endemic West African countries involving surgeries on Filarial hydrocele patients (Filariceles). Countries included Ghana, Nigeria, Niger, Burkina Faso, Senegal, Mali, Liberia, Gambia, Sierra Leone and Togo. Patients were recruited by the Filariasis programme managers in all these countries and workshops were done to train surgeons from teaching, government and district hospitals with funding mainly from the West African Filariasis Project. A total of 16 workshops were held in 10 West African Countries, and a total of 500 filarial hydrocele/chylocele cases were operated using the technique of total tunical resection without drainage with excellent postoperative results. The average operating time for a unilateral hydrocele was 45 min to 1h and for bilateral hydrocele was 1½ h to 2h depending on the size of the hydrocele .All patients were admitted for a minimum of 5 days postoperative. Training workshops were successfully organized in 10 out of the envisaged 12 west African Countries with 214 surgeons trained. Since 2004 till date the trained surgeons have also operated 2500 filaricele cases bringing it to a total of 3000 cases operated so far. Evaluation studies revealed that the infection rates in one country was initially 60% and then it later dropped to 20% and this was actually attributed to poor follow up by the selected National Coordinator. However complication rates in all the Countries where workshops were done ranged between 5% and 7% made up of infection, haematoma and or delayed wound healing. Recurrence rates have been very low about 3-5% per Country.

[Peritoneal dialysis in a tropical area, a reality]. / Dialyse péritonéale en milieu tropical, une réalité.

INTRODUCTION: Chronic kidney disease is now regarded as amajor public health concern. This is especially true in developing countries where it accounts for significant morbidity, mortality and decreased life expectancy. The main problem for developing countries is the cost of dialysis. Indeed, the availability of peritoneal dialysis for renal replacement therapy is low in sub-Saharan Africa. Since March 2004 peritoneal dialysis has been available to some patients with end-stage renal disease in Senegal. The purpose of this study was to assess epidemiologic, clinical, technical patterns and outcomes in patients who underwent peritoneal dialysis in the first three years of the program. MATERIALS AND METHODS: This three-year retropective study identified 26 patients who underwent peritoneal dialysis for end-stage renal disease for a period of at least 15 days. Patients not meeting these criteria were not included. All patients had a Baxter type transfer set. Lactate-bicarbonate solution was used for countinuous ambulatory peritoneal dialysis. In 3 cases, Icodextrin- and amino-acid based-solutions were employed. In automated peritoneal dialysis, the Home Choice machine was used for all patients. Epidemiological, clinical/paraclinical data and outcomes were noted for each patient. RESULTS: Twenty-six patients were included in the study. Median age was 48 +/- 6 years with a M/F sex ratio of 1.17. Most patients (84%) were literate. Diabetic nephropathy and nephroangiosclerosis were the main causes of end-stage renal disease. The mean Charlson score was 3 (range, 2 to 5). Mean residual diuresis was 435 mL/day. The peritonitis rate was 1 per 20 patient months. Staphylococcus aureus and Pseudomonas aeruginosa were the most common germs. Six patients presented catheter infection: exit-site in 4 and tunnel in 2. Catheter obstruction occurred in three cases. At the end of the study, 6 patients were still in automated peritoneal dialysis and 8 in countinuous ambulatory peritoneal dialysis. Six 6 patients died and 6 were switched to hemodialysis. CONCLUSION: Peritoneal dialysis is available as a renal replacement therapy in Senegal. It has allowed end-stage renal disease patients greater autonomy in their working place.