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Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tuberculosis is an endemic disease in Senegal. Cutaneous forms are rare and are characterized by their clinical polymorphism. They account for 2% of the extrapulmonary locations of tuberculosis [1, 2]. We report an observation of a tuberculous gumma of the buttock that led to the discovery of an active pulmonary localization in an immunocompetent adult. A 47-year-old man was admitted for a painful swelling of the right buttock that had been developing for four years. The physical examination noted an indurated, multinodular, and polyfistulized plaque, with confluent yellowish pus emission, on the inferomedial face of the right buttock, associated with bilateral inguinal lymphadenopathy. Cutaneous tuberculosis was found in the histology, which showed TB granuloma, and the gastric tube fluid was positive for acid-fast bacilli. Thoracoabdominopelvic CT showed multiple basal acinar micronodules in both lungs. Serology was negative for both HIV and HBV. All signs of tuberculosis disappeared after six months of treatment. In endemic zones, cutaneous tuberculosis is characterized by its clinical polymorphism. It must also be looked for in any perineal abscess. Early management greatly improves the prognosis.

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.

Sexual violence is widespread in the world and has a negative impact on women's mental, social, and physical well-being. The purpose of this study was to describe the epidemiological and clinical aspects of the occurrence of sexual violence among patients seen in the Gynecology-Obstetrics department at Ignace Deen National Hospital. This is a cross-sectional, descriptive, observational study of victims of sexual violence seen in the department, directly or on court orders, during the two-year period from May 1, 2016, to April 30, 2018. The data were analyzed with SPSS 16.0 software. Sexual violence accounted for 3.5% of all consultations in the department during the study period. They concerned adolescents (64.0%), females (97.1%), students (78.6%), and single individuals (95.7%). More than half of the sexual assaults were committed in the abuser's home (57.1%), by an assailant known to the victim (87.0%), at night (71.4%), by one person (85.7%), and during the weekend (60.0%). The lesions observed included vulvovaginitis (45.8%), vaginal tears (8.7%), facial bruises (8.7%), anal tears (4.4%), and ocular contusions (4.4%). The gynecological examination was normal in 21.4% of cases. Vaginal penetration was the sexual act practiced most often (88.4%) by aggressors, compared with acts of sodomy (4.3%). We noted 7.2% of fondling. Overall, 58.6% had previously had their hymen broken, and 34.3 very recently, while the hymen was intact in 7.1% of cases. The frequency of sexual violence is underestimated in our society. Its prevention involves its punishment, adequate medical care of victims, and improvement of the status of women.

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.

Polyradiculoneuropathies (PRNs) are inflammatory disorders of the peripheral nervous system. They are diffuse in general, sparing neither the proximal portions of the elements of this system, where they predominate, nor the cranial nerves. To describe the epidemiological and diagnostic profiles, as well as the course, of patients with PRN in the Cocody university hospital center (Abidjan) neurology department over the past six years. This retrospective single-center study describes PRN cases and their course during the 6-year period of 2009-2014 in this neurology department. Among 5319 cases seen in the neurology department over the study period, 58 patients met our criteria, i.e., 1.1%. More patients were men: 55.2% for a sex ratio of 1.23. They included 4 cases of ethanol poisoning, 2 cases of undecompensated diabetes, and one reaction to vaccination for yellow fever (AAV). The electroneuromyographic tracing supported a finding of demyelination in 55.1%, axonal loss in 25.9% and both in 19%. PRN is a relatively common pathology that is often overlooked. Etiological investigation was difficult in our setting. Early management can improve the prognosis of this disorder.

Introduction: Candida infections are most frequently encountered on the skin and nails. Their proportions vary according to geoclimatic and sociocultural conditions. The objective of this study was to determine the prevalence of skin and/or nail candidiasis diagnosed in the parasitology and mycology laboratory of Le Dantec University Hospital in Dakar, Senegal., Materials and Methods: This study included 994 patients with suspected skin and/or nail mycosis tested at the parasitology and mycology laboratory during the 8-year study period of 2008-2015. Each patient had both a direct examination and a mycological culture., Results: The patients' median age was 34 with an interquartile range of 25 years. Of these 994 patients, 613 had confirmed skins and/or nail fungal infections. In descending order, the fungi isolated and identified from these mycoses were Candida (n= 387, 63.1%), dermatophytes (28.4%), and mold (8.5%). Thus Candida accounted for nearly two thirds of the skin and/or nail mycoses and had a prevalence rate among the patients with suspected skin or nail candidiasis of 38.9%. These skin/nail sites was more common among women (72%) than men (28%), and slightly more than half of them (50,1%) were adults aged 31 to 60 years. The duration of candidiasis exceeded a full year for 76.3%. Onychomycoses were found more frequently (65.24%) than epidermomycoses, and both sites were infected in 5.17%. Candida albicans was the species isolated most frequently, accounting for 80% of Candida specimens., Conclusion: Our results reinforce the importance of mycological confirmation of the diagnosis. The mycology laboratory has a crucial role in making the differential diagnosis with other dermatoses of similar clinical appearance and thus in guiding the choice of treatment.

To identify the protozoa responsible for intestinal parasitosis diagnosed at Le Dantec University Hospital in Dakar, Senegal. The retrospective study included 2578 patients for whom stool samples were analyzed from 2011 to 2015. The sex ratio was 1.1. Patients' mean age was 28.5 years, with a range of 11 days to 91 years. Direct examination and the Ritchie technique were performed to search for parasites. In total, 317 patients had intestinal protozoa, for a prevalence of 12.3 %. Infections involved one (91%) or two parasites (9%). The most common species found alone were Entamoeba coli (51.5%), E. histolytica/E. dispar (17 %), and Giardia intestinalis (10.5%). The most common associations were E. coli with G. intestinalis (3.6 %) and with E. histolytica (2.4%). These infections affected significantly more outpatients than inpatients (65 %, p = 0.0049) and slightly more women (51.1%, p = 0.22) than men. Adults accounted for 67% of the confirmed intestinal protozoa: 39% aged 31-60 years, 28% aged 15-30, and only 7% older than 60 (p = 0.5). Most of the protozoa isolated were non-pathogenic. However, health education should be promoted in addition to the mass treatment program already begun to limit and even halt the spread of these neglected diseases.

Uterine rupture is an obstetric catastrophe that has become rare in developed countries. In developing countries, including Guinea, however, it remains a major concern of obstetricians. The objectives of this work were to calculate the frequency of uterine rupture in our département, describe the women's social and demographic characteristics, identify factors predisposing them to uterine rupture, describe its treatment, and assess maternal and fetal prognosis. Data for this descriptive study were collected in 2 phases, with a retrospective review of files covering the 3-year period from April 1, 2011, to March 31, 2014, followed by prospective data collection for the 6-month period from April 1 to September 30, 2014. This study of uterine rupture took place at the maternity unit of Donka National Hospital (CHU Conakry). We identified 98 cases of uterine rupture among 26 827 births, for a frequency of 0.36%. The women's mean age was 28.4 years (range: 16-43 years). The socio-demographic profile of the women admitted for uterine rupture was that of a housewife (50%), with two or three previous deliveries (41.84%), and who had no prenatal care (58.17%). Most of the ruptures took place in birthing centers, outlying maternity units, or during the journey to reach our reference department (87.16%). Most uterine ruptures were iatrogenic (69.38%) and occurred on an non cicatriciel uterus (62.24%). The rupture was most often complete. Most surgical treatment was conservative, by hysterorrhaphy (80.61%). Four women died, for a lethality rate of 4.80%. Almost all women were admitted without signs of fetal life. The role of uterine rupture in the obstetric activity in this service requires joint and urgent action by all stakeholders in the health system to combat this catastrophic complication that is evidence of a poor quality of obstetric care.

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.

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.

Objective: To report the experience of our unit with vaginal cesarean deliveries., Patients and Methods: This is a retrospective, descriptive study of seven vaginal cesarean deliveries performed in the maternity unit of the Centre Hospitalier Regional Universitaire de Saint-Louis in Senegal during the third quarter of 2012. The women's clinical characteristics were studied and indications for cesarean sections discussed., Results: The seven vaginal cesareans accounted for 3.2% of the cesarean deliveries performed during the study period (219) and 0.6% of all births (1428). The women's average age was 31 years. Gestational age ranged from 17 to 34 weeks of gestation. The principal indication for surgery was placental abruption, in 5 (72%) cases). The fetus was dead in 4 of the 7 cases. The mean 5-min Apgar score at birth for the liveborn infants was 5 (of an optimum score of 10). Mean fetal weight at birth was 1700 g. The mean operative time was 20.7 minutes. In one case, the incision extended to the uterine corpus. The postoperative course was uneventful in all cases., Conclusion: Vaginal cesarean is safe, fast, but not without complications. It requires perfect mastery of vaginal surgery.

The objectives of this study were to calculate the frequency of hysterectomies at the Conakry university hospitals (Donka Hospital and Ignace Deen Hospital), describe the women's social, demographic, and clinical characteristics, and identify the key indications, the surgical techniques used, and the prognosis. This was a 2-year descriptive study, retrospective for the first year (May 2011-April 2012) and prospective for the second (May 2012-April 2013), of 333 consecutive hysterectomies performed in the obstetrics and gynecology departments of these two hospitals. Hysterectomy is one of the surgical procedures most commonly performed in these departments (following cesarean deliveries), with frequency of 4.4% interventions. The profile of the women undergoing this surgery was that of a woman aged younger than 49 years (61%), married (75.7%), multiparous (33%), of childbearing age (61%), and with no history of abdominal or pelvic surgery (79.6%). Nearly all hysterectomies were total (95%, compared with 5% subtotal; the approach was abdominal in 82.25% of procedures and vaginal in 17.75%. The most common indication for surgery was uterine fibroids (39.6%), followed by genital prolapse (22.2%), and obstetric emergencies (17.8%). The average duration of surgery was 96 minutes for abdominal and 55 minutes for vaginal hysterectomies. The principal intraoperative complication was hemorrhage (12.31%), and the main postoperative complication parietal suppuration (21.02%). The average length of hospital stay was 10.3 days for abdominal hysterectomies and 7.15 days for vaginal procedures. We recorded 14 deaths for a lethality rate of 4.2%; most of these deaths were associated with hemorrhagic shock during or after an obstetric hysterectomy (93%). Hysterectomy remains a common intervention in developing countries. Its indications are common during the pregnancy and postpartum period, with high morbidity and mortality rates. Improving obstetric coverage could reduce its indications.

The objectives of this study were to calculate the frequency of ectopic pregnancy in the department, define its epidemiological, diagnostic, therapeutic, and prognostic aspects, and determine a clear therapeutic approach appropriate to our setting. In this prospective study, we compiled all cases of ectopic pregnancy seen in 2011 and 2012 in the obstetrics-gynecology department at Ignace Deen University Hospital in Conakry. Ectopic pregnancies represented 1.3% of all deliveries over this period. In the 111 cases in this population, women aged 30-34 years accounted for 31.5%, those pregnant for the first time 40.5%, nulliparous women 35.1%, married women 72.1%, those without schooling 43.2%), and those with a history of sexually transmitted infection 57.6% (these categories are not exclusive, and the same women may be included in several). Secondary amenorrhea with abdominopelvic pain and metrorrhagia was the reason for admission in 56.5% of cases. Ultrasound in early pregnancy is infrequent in Conakry. Almost all of our patients underwent emergency surgery (80.2%) More than half of the ectopic pregnancies were located in the ampulla of the uterine tubes (73.0%). There were three abdominal pregnancies and 2 ovarian. In all cases the treatment was surgical, most often salpingectomy. Postoperative complications occurred in 35.1% of cases, most often anemia (27.9% of all cases) requiring blood transfusion in 11.7% of all cases before, during, or after surgery. The maternal death rate was 1.8%. Ectopic pregnancy remains a major concern at Ignace Deen CHU. Reduction of its frequency requires increased population awareness of sexually transmitted infections and illegal abortions. Management should be prompt and appropriate.