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Introduction: With 11.7% new cases worldwide in 2020, female breast cancer is not only the first among gynaecological cancers, it is also the first cancer worldwide. Also, disease stage during diagnosis is an important cost predicting factor. Methods: It was a transversal descriptive study carried out in the Obstetrics and Gynaecology unit of the Sylvanus Olympio University Hospital (SO UH) and in the International Cancer Centre of Lome (ICCL) during July and august of the year 2022. Results: Only 146 patients were enrolled in our study, with a participation rate of 30.87%. The mean age of the patients was 48.9 ± 11.7 years with extremes of 25 and 77 years. Fifty one patients (39%) were resellers. Sixty four patients (43.8%) attended secondary education. The median cost of breast cancer diagnosis was 182080 FCFA ]55680; 487680] FCFA. The median cost of chemotherapy was 1640790 FCFA ]199820; 5208885] FCFA. The median cost of surgical treatment of breast cancer was 230 320 FCFA ]135240; 368060] FCFA. The median cost of hormonal treatment was 206200 FCFA ]36750; 494850] FCFA. The median cost of radiotherapy was 1 765 000 FCFA ]1715000; 2030 000] FCFA. Of the 146 patients, 46 had not undergone any other complementary tests apart from diagnostic tests. The median cost of the tests carried out as part of the pre-therapeutic assessment and follow-up was 21 500 FCFA (0; 824 760] FCFA. The direct medical cost of breast cancer management was 119200 FCFA [36616- 1604669] FCFA for patients with health insurance (17.1% of patients). Conclusion: The direct medical cost of breast cancer treatment is higher than the average household income in Togo. The question of what measures could be taken to increase adherence to treatment by patients living with this cancer and to reduce the large number of long-lost patients is still pending.

Introduction : Le but de cette étude est de déterminer les principales complications des suites de couches à la maternité du CHU-Kara. Patientes et Méthodes : il s’est agi d’une étude rétrospective et descriptive menée du 1er janvier 2017 au 31 décembre 2020 portant sur les complications des suites de couches au CHU Kara. Résultats : 300 cas de complications du post partum soit une fréquence de 3,13% ont été enregistrées dans le service de gynécologie-obstétrique du CHU Kara. La majorité des patientes était référée (59,33%) avec une tranche d’âge comprise entre 18 et 30 ans (49%). Les complications des suites de couches majoritaires étaient les complications hémorragiques 59,31%, l’anémie du post partum 17%, l’endométrite 9,33% et l’éclampsie du Post partum 6,30 %. Toutes ces complications ont nécessité une prise en charge médicale et obstétricale. L’hystérectomie et la triple ligature vasculaire ont été effectuées respectivement dans 1,69% et 3% des cas. Nous avons enregistré 17 décès maternels soit 6%. Conclusion : Il ressort de cette étude que les complications hémorragiques étaient les plus fréquentes en suites de couche au CHU Kara. La meilleure prise en charge de ces complications du post partum passerait par une meilleure réorganisation du système de prise en charge et un renforcement du plateau technique de toutes les structures sanitaires.

Objectives: Tuberculosis is a real public health problem in developing countries. The aim of our article was to study the epidemiological, clinical, diagnostic characteristics of female genital tuberculosis in Togo.Patients and methods: This was a descriptive and cross-sectional study on all cases concerning histologically diagnosed female genital tuberculosis in the department of pathological anatomy of Lomé in 1997-2018 (20years). Results: We collected 22 cases of women's GT, representing 2.2% (1008 cases) of extra-pulmonary tuberculosis. The mean age of the patients was 33.8 ± 0.2 years. Nine (9) patients had a history of treated GT. Depending on the location, the ovaries and fallopian tubes were the most affected (n=9 cases, 40.9%). Eighteen patients (81.8%) had at least one immunosuppression factor including HIV in 13 patients (72.2%). The reasons for consultation were metrorrhagia and pelvic pain with an associated mass in 7 women discovered on clinical examination and imaging. The macroscopic appearance of the specimens was suggestive of the diagnosis of genital tuberculosis in 12 cases (54.5%). Histology revealed caseous necrosis isolated in 3 patients (13.6%) and associated with gigantocellular epithelioid granulomas in 19 patients (86.4%). The patients received standard antibiotic treatment combining rifampicin, isoniazid, ethambutol and pyrazinamide. Conclusion: Genital tuberculosis is a rare extra-pulmonary location in Togo, often occurring in women with HIV, and the clinical polymorphism can lead to confusion with gynecological cancers.

Introduction : Le but de cette étude est de déterminer les principales complications des suites de couches à la maternité du CHU-Kara. Patientes et Méthodes : Il s’est agi d’une étude rétrospective et descriptive menée du 1er janvier 2017 au 31 décembre 2020 portant sur les complications des suites de couches. Résultats : Parmi les accouchées nous avons enregistré 300 cas de complications du post partum soit une fréquence de 3,13%. La majorité des patientes était référée (59,33% n=178) avec une tranche d’âge comprise entre 18 et 30 ans (49% n=147). Les complications hémorragiques représentaient 59,31%(n=178), l’anémie du post partum 17%(n=51), l’endométrite 9,33% (n=28) et l’éclampsie du post partum 6,30 % (n=20). Toutes ces complications ont nécessité une prise en charge médicale et chirurgical. L’hystérectomie et la triple ligature vasculaire ont été effectuées respectivement dans 1,69% (n=5) et 3%(n=9) des cas. Nous avons enregistré 17 décès maternels soit 6%. Conclusion : Il ressort de cette étude que les complications hémorragiques étaient les plus fréquentes en suites de couche au CHU Kara. La meilleure prise en charge de ces complications du post partum passerait par une meilleure réorganisation du système de prise en charge et un renforcement du plateau technique de toutes les structures sanitaires. Introduction: The aim of this study is to determine the main complications of the postpartum period at the maternity hospital of CHU-Kara. Patients and Methods: This was a retrospective and descriptive study conducted from January 1, 2017, to December 31, 2020, on the complications of postpartum. Results: Among the women who gave birth, we recorded 300 cases of postpartum complications, i.e. a frequency of 3.13%. The majority of patients were referred (59.33% n=178) with an age range between 18 and 30 years (49% n=147). Bleeding complications represented 59.31% (n=178), postpartum anemia 17% (n=51), endometritis 9.33% (n=28), and postpartum eclampsia 6.30% (n=20). All these complications required medical and surgical management. Hysterectomy and triple vascular ligation were performed in 1.69% (n=5) and 3% (n=9) of cases respectively. We recorded 17 maternal deaths (6%). Conclusion: This study shows that hemorrhagic complications were the most frequent complications of childbirth at Kara University Hospital. The best management of these post-partum complications would require a better reorganization of the management system and a strengthening of the technical platform of all health facilities.

Introduction: Obstetric Fistula (OF) is an abnormal communication between the bladder and the vagina or between the rectum and the vagina and or both. The objective was to describe the experience of OF by the victims. Methodology: The gynecology-obstetrics clinic of the CHU Sylvanus Olympio in Lome served as the framework for this study. This was a descriptive cross-sectional study, which took place from February 28 to March 19, 2011. Results: A total of 76 women with OF were interviewed. Mothers were more attentive to the problems of women with OF (38.2%). More than half of women with OF (53.9%) were rejected by non-family circle. The vast majority of them have experienced a change in their sex life (75%). Before the fistula, 77.6% had an income-generating activity. The fistula was associated with a vulvar rash (55.3%). Women with OF (93.4%) had a permanent need for cleanliness. Conclusion: The pursuit of cleanliness is an important characteristic of women with OF. The latter are often abandoned by their husbands. All this experience leads women with OF to a “social death”.

Background: Dysgerminoma is a germ cell tumor of the ovary usually found in young women. It represents 1% to 2% of all ovarian cancers. The preoperative diagnosis is generally difficult. The surgery and the pathology study are therefore essential for the diagnosis, and optimal management. The incidence of pregnancy with dysgerminoma is extremely low. The treatment and management during pregnancy often jeopardize the materno-fetal prognosis. We report a case of ovarian dysgerminoma in an 18-year-old pregnant woman. Observation: Patient was an 18-year-old, female with no known past medical history, who presented to the emergency room at 29 weeks + 3 days pregnancy with dyspnea and a voluminous uterus (height 42 cm). An ultrasound showed an active pregnancy, and a large vascularized, finely echogenic, multi-partitioned, thick-walled liquid ovarian tumor. Ca125 was 231.5 IU/ml. Ovarian dysgerminoma was suspected. The surgery and the pathology study of the surgical specimen confirmed the suspected diagnosis. Patient died on postoperative day 8. Conclusion: Ovarian dysgerminoma is a rare malignant tumor, which must be suspected in case of complex ovarian mass of young women. When diagnosed during pregnancy, its management jeopardizes the materno-foetal prognosis.

Introduction: OVT is rare, with an incidence of 0.05% to 0.18% and occurring preferentially in postpartum period. Any delay in management may compromise the patient’s vital prognosis. Observation: We report a case of a 34-year-old patient, G2P3, who delivered twins by cesarean section at 39 weeks of amenorrhea. She presented abdominal pain and fever on the 4th day of postpartum. Biological tests showed a biological inflammatory syndrome and a positive blood culture with gram-positive Staphylococcus. After 72 hours of antibiotics with no clinical or biological improvement, a CT scan revealed a 12 mm thrombus in the lumen of the right ovarian vein’s connection to the inferior vena cava. Antibiotic treatment was continued, associated with an anticoagulant. The evolution was been favorable. Conclusion: Rare and serious pathology, the diagnosis is made using medical imaging. The outcome is generally favorable with antibiotic therapy and anticoagulant therapy.

This was a cross-sectional and descriptive study conducted from January 2nd to march 30th 2019 in the township of Hiheatro in Togo. We included in the study, women who had given birth at least once at home and who accepted to undergo the survey. Data were collected, using a pre-planned and pre-tested survey sheet, by a team of four trained interviewers under the responsibility of a supervisor. Interviews were carried out in the homes of the respondents after obtaining their informed consent. The parameters studied were the number of births at home, socio-demographic characteristics, and reasons for births at home and maternal and fetal prognosis. 411 women gave birth at home in the township. The average number of births at home per woman was 2 with extremes of 1 and 7 births per woman. The average age of the women was 28.4 years with the extremes of 15 and 38 years. The 25 - 34 age group represented 67.1% of cases. The average parity of the patients was 2. Multiparas represented 59.8% of cases. The main reasons for giving births at home by the interviewees were insufficient financial means in 36% of cases and the lack of means of transport in 28% of cases. Maternal morbidity was marked by 14.1% perineal tear, 1.6% hysterectomy. Four hundred and eleven newborns were registered. Of these newborns, 4.4% were stillborn and 8.8% did not cry at birth. Free obstetric care and increased awareness on the importance of assisted deliveries will improve the maternal-fetal prognosis.

Introduction: Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. Objective: To assess the practice of AMTSL in four maternity in the commune of Kara (Kara University Hospital Center, Kara Tomde Regional Hospital Center, SOS Kara Mother-Child Hospital, and Adabawere Peripheral Care Unit). Method: This was a cross-sectional descriptive study over four months, from January 28 to May 28, 2019. Two questionnaires were used for data collection: an observation and evaluation grid AMTSL practice and a questionnaire for providers. The grid was designed and adapted to the RPC repository model for emergency obstetric and neonatal care in Africa 2018. The data was processed using the Epi Info 7 software. Results: During the study period, 528 parturients were identified and 30 providers surveyed. No provider had received ongoing training in AMTSL. The practice of AMTSL was systematic at each delivery. The practice was correct in 45.8%. Factors associated with incorrect practice were relationship between caregiver-patient (p = 0.0005), placental examination (p = 0.0003), postpartum monitoring (p = 0.0001). Conclusion and Suggestion: The practice of AMTSL is systematic, but it was incorrect regardless of the provider’s qualification. Continuing education on AMTSL is necessary to prevent postpartum hemorrhage.

Introduction: Cervico-isthmic pregnancy is rare, and serious because of its hemorrhagic complication. Its management varies according to the teams. Observation: We report a case of cervico-isthmic pregnancy on a cesarean scar. This is a 35-year-old, G2P2, who consulted for bleeding from the 1st trimester of pregnancy. The clinical examination found a minimal uterine bleeding. The diagnosis was made by a vaginal ultrasound which found a cervico-isthmic implantation of the pregnancy on the caesarean scar. A protocol of Mifepristone and Misoprostol followed by administration of a single dose of 1 mg/kg of Methotrexate was performed. Cure was obtained 1 month after treatment by negativation of plasma HCG. No bleeding complications were noted. A follow-up ultrasound performed 2 months later showed a uterine vacuity and the presence of an isthmocoele. It was in fact a pregnancy that had implanted in the isthmocoele. Conclusion: Cervico-isthmic pregnancy is rare. His treatment is not codified. Drug management was successful.

Introduction: Teenage pregnancies have serious consequences for the health of mothers and their children. The aim of this work was to study the circumstances of the onset of teenage pregnancy. Methodology: This was a cross-sectional and descriptive study, which took place from July 1st to 31st, 2019 at the Peripheral Care Unit (USP) of Gbodjome in Togo. Results: A total of 100 adolescent girls were interviewed (12.6%). The average age of adolescent girls was 17.2 years (12 - 19 years). Adolescent girls were predominantly in primary school (42.0%) and single status (58.0%). Forty-two decimal zero percent of adolescent girls (42.0%) were living with their partners. In 5.0% of cases, adolescent girls were victims of sexual harassment. The pregnancy was the result of rape in 10.0% of cases. Ten decimal zero percent of adolescent girls (10.0%) had more than one sexual partner. Nearly half of the respondents (49.0%) knew at least one method of contraception, but only 8.0% used it. Financial help from the partner (57.0%) was the leading cause of sex. Conclusion: Teenage pregnancies have a negative impact on both the young mother and the unborn child. The ideal would be to make schooling for girls free, from primary school to the A-level.

Introduction: L’evaluation de la satisfaction montre l’adequation entre les attentes des patients et la qualite des soins recus. Objectif: evaluer la satisfaction des accouchees hospitalisees en suites de couches a la maternite de l’hopital de Be. Patientes et methode: Il s’est agi d’une etude transversale a visee descriptive et analytique menee du 1er juillet au 31 aout 2018 soit une duree de 2 mois. Elle a eu pour cadre, le secteur des suites de couches de la maternite de l’hopital de Be. La collecte des donnees par interview directe a ete faite a l’aide d’une fiche d’enquete anonyme sur le modele Saphora-MCO questionnaires Project COMPAQH et adapte a nos realites. Le traitement et l’analyse des donnees ont ete realisees grâce aux logiciels Epi data et Epi info. Resultats: Au total 300 accouchees ont accepte participer a l’etude. L’âge moyen etait de 29 ± 6,2 ans. La satisfaction globale etait de 94%. Les principaux elements de satisfaction etaient : l’accueil (94,7%), le respect de l’intimite (96,7%), la prise en charge des soins (94%), le delai d’attente (86,7%). L’insatisfaction etait due a l’insuffisance de communication des soignants (65,7%) et de proprete des chambres et des sanitaires (57%). L’âge, le niveau d’instruction, la parite, le mode d’accouchement avaient influence significativement l’insatisfaction des patientes. Conclusion: Cette etude a permis de relever les elements d’insatisfaction des clientes. Il est opportun d’associer les clients dans le processus de la qualite des soins a l’hopital de Be. Introduction: Satisfaction assessment shows the match between patient expectations and the quality of care received. Objective: to assess the satisfaction of women hospitalized in the maternity ward of the obstetrics and gynecology department of the Be hospital in order to contribute to the improvement of the quality of care in the maternity ward. Patients and method: This was a cross-sectional study with descriptive and analytical aims conducted from July 1 to August 31, 2018, i.e., a duration of 2 months. It took place in the puerperium section at the maternity of the Be hospital. Data collection by direct interview was done using an anonymous survey form on the Saphora-MCO questionnaires Project COMPAQH model and adapted to our realities. Data processing and analysis were carried out using Epi data and Epi info software. Results: A total of 300 women agreed to participate in the study. The average age was 29 ± 6.2 years. Overall satisfaction was 94%. The main elements of satisfaction were: reception (94.7%), respect for privacy (96.7%), management of care (94%), waiting time (86.7%). Dissatisfaction was due to insufficient communication from caregivers (65.7%) and cleanliness of rooms and toilets (57%). Age, level of education, parity and mode of delivery had a significant influence on the respondent’s dissatisfaction. Conclusion: This study identified factors that led to patient’s dissatisfaction. It is appropriate to involve patients in the quality of care process at the Be hospital.

Background: Breast cancer is the most common cancer in women, and its incidence and mortality rates are expected to increase significantly over the next few years, particularly in developing countries. The aim of this study was to describe the epidemiological, clinical, radiological, histopathological, and prognostic aspects of breast cancer in Togo. Materials and methods: We retrospectively analyzed at our Department of Pathology of Lomé all cases of breast cancer in women confirmed by histology over a period of 20 years (2000-2019). Results: We collected 804 cases of breast cancer in women. The median age was 46.7 years (range, 12-86 years). Patients aged Conclusion: Breast cancer is a frequent pathology in Togolese women, predominant in young adults, often diagnosed at a late stage with limited possibilities of treatment. The establishment of early care programs is essential.

International audience; Background: Access to antiretroviral treatment has improved the life expectancy of HIV-positive patients, most often associated with a desire to limit childbearing. Women living with HIV (WLHIV) commonly have unmet need for contraception and could be at risk of unintended pregnancy. Preventing unintended pregnancies among women living with HIV are effective strategies to eliminate mother-to-child transmission of HIV. Objective: The aim of this study was to assess unmet need for limiting childbirth and its associated factors among women living with HIV in Togo. Methods: This facility based cross-sectional study was conducted, between June and August 2016, among WLHIV in their reproductive age (15–49 years) in HIV-care settings in Centrale and Kara regions Data was collected using a structured and pretested questionnaire. WLHIV who desired to limit childbirth but not using contraception were considered to have unmet need of birth limitations. Univariate and multivariate Poisson regression models with robust variance were performed to identify associated factors with unmet needs. A multi-model averaging approach was used to estimate the degree of the association between these factors and the unmet need of birth limitations. Results: A total of 443 WLHIV were enrolled, with mean age of 34.5 years (standard deviation [SD] = 7.0). Among them 244 (55.1%) were in couple and 200 (45.1%) had at least the secondary level of education. 39.1% were followed-up in a private healthcare facility. At the time of the survey, 40.0% did not desire childbearing but only 9.0% (95% CI [6.7–12.1]) of them expressed unmet needs for limiting childbirth. In multivariable analysis, associated factors with unmet needs of birth limitations were: being aged 35 years or more (adjusted prevalence ratio (aPR) = 3.11, 95% confidence intervals (95% CI) [1.52–6.38]), living in couple (aPR = 2.32 [1.15–4.65]), living in Kara region (aPR = 0.10 [0.01–0.76]), being followed in a private healthcare facility (aPR = 0.08[0.01–0.53]) and having severe HIV symptoms (aPR = 3.50 [1.31–9.37]). Conclusion: Even though the unmet need for births limitation was relatively low among WLHIV in Togo, interventions to improve more access to contraceptive methods, and targeting 35 to 49 years old women, those in couple or followed in the public healthcare facilities would contribute to the eradication of mother-to-child transmission of HIV.

Background Primary squamous cell carcinoma of the endometrium is an extremely rare tumor with poorly understood pathogenesis. Case presentation We report a case of a 28-year-old Togolese woman who had consulted for vaginal bleeding and pelvic pain. Ultrasound showed thickening of the lining of the endometrium, and biopsy curettage was done. Anatomopathological examination was noteworthy for a proliferation of squamous cells often connected by union bridges arranged in tumor lobules with dyskeratotic maturation. Immunohistochemistry showed epithelial membrane antigen positivity, anti-pancytokeratin 1 markers of tumor cells positivity, chromogranin A negativity, actin negativity, S100 negativity, estrogen receptor negativity, and progesterone receptor negativity. In situ hybridization had objectified human papillomavirus genotypes 16/18. The diagnosis of primary squamous cell carcinoma of the endometrium associated with human papilloma virus was retained. A hysterectomy was performed, and the tumor was classified pT1N0M0. Conclusion The pathogenesis of this endometrial cancer is complex, and its association with human papillomavirus does not explain its genesis.

Background: The elderly cancers are worldwide a major public health issue. Their exact incidence is unknown in Togo. The purpose of this study was to describe epidemiological and histological data of cancers in the elderly in Togo. Materials and Methods: This was a cross-sectional and descriptive study of cases of elderly cancers diagnosed at the laboratory of pathology of the university teaching hospital of Lome from 1995 to 2014 (20 years). Cases of examination on samples of the elderly (biopsy, excision, surgical specimens) were collected from the data records of that laboratory. Results: Overall, 792/5200 cases of elderly cancer were collected representing 15.2% of all cancers diagnosed in the laboratory. The annual incidence was 39.6 cases. Patient age ranged from 65 to 103 years old, with a mean of 68.5 ± 4 years old. The sex ratio (M/F) was 1.3. At pathological level, the study material included pieces (n=290 cases; 36.6%) and biopsies (n=502 cases; 63.4%). Cancers located preferably in prostate in men (38%), and in women the most frequent locations were cervix (16.2%) and breast (15.8%). We noticed four histological groups: carcinomas (n = 706 cases; 89.1%), sarcomas (n = 43 cases; 5.5%), lymphoma (n = 34 cases; 4.3%) and melanoma (n = 9 cases; 1.1%). Carcinomas were dominated by adenocarcinomas (50.1%) and squamous cell carcinomas (33.8%); Kaposi’s sarcoma (32.6%) was the most common histological type in sarcomas. Conclusion: Our results showed that the elderly cancers were frequent in Togo, locating mostly in uterus cervix and breast in female, and prostate in men. This study could help to advocate the establishment of a cancer registry in Togo.

Objectif : L’objectif de cette etude etait de documenter l’influence des images pornographiques sur les comportements sexuels des eleves dans la commune de Cocody a Abidjan, Cote d’Ivoire.Methode : Il s’agissait d’une etude transversale a visee descriptive et analytique realisee d’octobre a novembre 2013 aupres des eleves dans quatre etablissements scolaires de la commune de Cocody a Abidjan.Resultats : Au total, 398 eleves (224 garcons et 174 filles) ont participe a l’enquete. Parmi eux, 14,3 % avaient acces a des images pornographiques soit sur internet soit a la television. Sur les 398 eleves enquetes, 52,8 % (210) etaient sexuellement actifs au moment de l’enquete, parmi lesquels 41,9 % (88/210) avaient au moins deux partenaires sexuels. A l’analyse bivariee, l’acces a des images pornographiques etait statistiquement associe au fait d’etre sexuellement actif (OR = 2,61 ; 95 %IC [1,41 ; 4,83]), a la precocite des rapports sexuels (OR = 2,38 ; 95 %IC = [1,19 ; 4,76]) et au multipartenariat sexuel (OR = 6,09 ; 95 %IC = [2,79 ; 13,3])Conclusion : Les resultats de ce travail nous ont permis de noter que l’acces a des images pornographiques avait une influence negative sur les comportements sexuels des eleves a Abidjan (Cote d’Ivoire).

Justification and Objectives: The reasons for the choice of contraceptive methods in Lome were insufficiently documented. The current study aimed to identify preferential contraceptive methods in women in Lome and the reasons for the choices. Materials and Methods: Prospective study conducted on 734 clients recruited in five family planning centers in the municipality of Lome over a period of 3 months (30th September to 30th December 2005). Data were collected by direct interview and processed by Excel and Epi info 7 software. Results: Contraceptive methods preferred in descending order were: Medroxyprogesterone acetate injection (51.6%), Norethisterone enantate injection (17.3%), inert Intra Uterine Device (12.0%), Progestogen implants (11.0%), combined oral pills (8.03%) and spermicide jelly (0.1%). The main reasons for choices were the method’s reversibility (32.56%) and its long acting property; especially in illiterate women (p < 10-10). Friends and medical staff counted for the choice in 9.26%. In 76.87% of cases, the husbands were reported to agree with the chosen methods. Conclusion: The choice of contraceptive methods in Lome was mainly guided by the notion of reversibility and its long acting property. The focus should be put more on the quality of counselling towards women with low education level.

Objectives: To determine the prevalence of women who delivered in the two major sickle cell syndromes, “SS” and “SC”, and to identify maternal and early neonatal prognosis inherent to each form. Material and Methods: This is a comparative, descriptive and retrospective cross-sectional study of 226 files of women carrying major sickle cell syndrome (66 cases of “SS” form versus 160 cases of “SC” form), collected from May 2008 to May 2013 at the Gynecology and Obstetrics Clinic of the Sylvanus Olympio’s University Hospital of Lome. Data were processed by Epi Info 6 software. For comparison of variables, the Chi-2 test of Fisher with significance as p major sickle cell syndromes represent 0.8% of all the deliveries during the study period. Caesarean section, especially prophylactic one, was the dominant mode of delivery. The SS forms have been exposed to have more vaso-occlusive crises (22.7% vs. 13.1%; p = 0.04, OR = 0.31), more blood transfusion (57.6% vs. 29.4%; p = 7 × 10-5, OR = 3.2) and more puerperal infections (p gave exposure to greater maternal morbidity. Resuscitative measures in adults and newborns should be reinforced at the delivery time of these “at-risk-pregnancies”.

We report a case of poorly differentiated squamous cell carcinoma of the vulva induced by human papillomavirus in a 23-year-old woman, in whom we experienced diagnostic difficulties.

Objective of the study was to determine the association of cervical cancer association and schistosomiasis infection. We conducted a retrospective and descriptive study of cases of cervical cancer and identified cases associated with schistosomiasis. A total of 1027 cases of cervical cancer were collected, and 19 cases revealed an association with schistosomiasis. This association was mainly related to squamous carcinoma with 18/19 cases. All patients were from rural areas. Of the 19 cases of association, 17 cases showed signs of HPV infection. Our data show a high degree of HPV infection that causes cervical cancer and not schistosomiasis.

Background Ovarian sarcomas represent less than 1% of all ovary cancers and usually are frequent in adults. Primary angiosarcomas are exceptional in the ovaries within children. Case presentation We reported a case of primary ovarian angiosarcoma in a 12-year-old girl in a resource-constrained context. Immunohistochemistry study showed the positivity of CD34, CD31, factor VIII, while S100 was negative. The diagnosis of primary non-metastatic angiosarcoma was retained. She was unable to undergo the CWS-2002P chemotherapy since her parents could not afford it. Conclusion This case report described a rare type of a primary ovarian angiosarcoma within a child, diagnosed in a low-income country in a laboratory with limited resources.

Breast cancer in young female patients represents a public health problem in developing countries. The objectives of the study were to study the epidemiological and histological characteristics of breast cancer in female patients under 35 years of age. This was a retrospective analytical study of a series of 158 cases of breast cancer in female patients under 35 years of age, conducted at the University Teaching Hospital of Lome between 2000 and 2015. A total of 158 cases were collected, representing 36.2% (436) of all breast cancer cases. The average age of the patients was 30.9 years (range, 16-35 years). A family history of breast cancer at the 1st or 2nd degree was identified in 13.9% of cases. Genetic mutation studies were carried out for 7 patients, 5 of which revealed mutations (4 BRCA1 and 1 BRCA2). According to the locus, the cancer was located preferentially in the left breast in 88 cases (55.7%). Malignant mammary lesions were epithelial tumors (n=144 cases, 91.1%), infiltrating (n=125 cases, 79.1%) and non-infiltrating (n=19 cases, 12.0%). The other histological groups consisted of 8 cases of sarcomas (5 cases of angiosarcoma, 2 cases of fibrosarcoma and 1 case of Kaposi's sarcoma), 5 cases of lymphomas and one case of melanoma. Not otherwise specified infiltrating ductal carcinomas were SBR II and III in 43.2 and 35.2% of cases, respectively. The tumors classified as T4 were the most frequent (30.4%). Regarding the lymph node status, lymph node metastasis was noted in 22.8% of cases. Studies of hormone receptors were carried out in 23 patients and were positive for 11 patients: Estrogen receptor (ER)+plus progesterone receptor (PR)+(7 patients), ER+PR-(4 patients). Of the aforementioned 8 cases of sarcoma, 5 were angiosarcoma. The lymphomas were predominantly Burkitt's type for 4 cases. Mammary ultrasonography was performed in 45.6% of the patients and 54.4% underwent the combined ultrasonography and mammography. Ultrasound identified one or more sign of malignancy in 67 patients (42.4%), and combined ultrasonography and mammography classified 51.9% of lesions in BIRADS 4 and 5. The incidence of breast cancer in young Togolese patients is high. It is a disease distinguished by a delay in diagnosis, which contributes to the high number of cases that initially diagnosed at an advanced stage, particularly the high histo-prognosis grades of infiltrating ductal carcinoma. These results indicate a genetic origin; therefore, a thorough investigation into genetic mutations should be carried. In addition, further collaborative studies are required to verify these results.

The objective of this study was to document the influence of pornography on the sexual behaviour of school children in the Cocody district of Abidjan, Cote d'Ivoire.This cross-sectional, descriptive and analytical study was conducted from October to November 2013 with pupils from four schools in Cocody, Abidjan.A total of 398 pupils (224 boys and 174 girls) were interviewed: 14.3% of them had access to pornography on internet or television. 52.8% (210) of the 398 pupils interviewed were sexually active at the time of the survey, 41.9% (88/210) of whom had at least two sexual partners. On bivariate analysis,access to pornography was statistically associated with being sexually active (OR= 2.61; 95%CI [1.41; 4.83]), early onset of sexual intercourse (OR= 2.38; 95%CI = [1.19; 4.76]) and multiples exual partners (OR== 6.09; 95%CI= [2.79; 13.3])Conclusion: The results of this study demonstrate that access to pornography had a negative influence on the sexual behaviour of school children in Abidjan (Côte d'Ivoire].

Minors of both sexs ages 10 to 15 are most at risk of sexual assault Objective: To determine the prevalence of sexual assault by rape among children aged 10 to 15 years and describe their management at the gynecology and obstetrics clinic of the CHU SO .Patients and methods: 134 files of rape victims were collected from September 1, 2010 to March 31, 2017 at the gynecology and obstetrics clinic of the CHU SO Results: Rape of minors aged 10 to 15 accounted for 26.6% of sexual assaults. There were 91% of girls. Most of our patients (54.5%) were raped between 7pm and 6am. Sixty eight (68) patients (40.3%) were referred for consultation between the 2nd day and the 8th day after the rape. Fifty-five point two percent of the victims had never had sexual intercourse before the rape. The perpetrator was known to the victim in 92.5% of cases. The tear of the hymen was old in 79.5% of the victims. HIV serology was positive in 1.6%. The rate of β HCG was positive in a 15-year-old patient. All our patients had psychological care. Conclusion: The rape of minors of both sexes is a reality in our developing society. The taboo of the sex must be raised for the fast denunciation of the rape and of an adequate care.

Epidemiological and Clinical Aspects of Dysmenorrhea in Young Girls at School in Lome Objectives: To describe the epidemiological and clinical aspects of dysmenorrhea in young girls at school. Materials and Methods: This is a prospective cross-sectional descriptive study, conducted from 25th January to 10th April, 2012. The collection of data was made by indirect interview using a survey form completed by the girls, individually in confidence and anonymously. The data were analysed by computer processing with Epi info7 software, and comparison of some of the data was made by Chi-square Exact Test of Fischer with significance level at p

Background Adherence to antiretroviral therapy (ART) is beneficial in reducing the risk of emergence of HIV resistant strains. Adherence to ART among Persons Living with HIV/AIDS (PLWHA) is influenced by several factors related to the patient, the medication, and health facilities. In Togo, previous studies on adherence to ART have reported good adherence to ART during the first year of follow-up. However these may hide many disparities dues to cultural specificities which may differ across geographic areas of the country. We sought to determine the level of adherence to ART and document the associated factors among PLWHA at the regional hospital of Sokodé, Togo. Methods This was an analytical cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months before the study. Results A total of 291 PLWHA on ART were enrolled in the study. The mean age (±SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 195 (67.0%) were living with their partners and 210 (72.2%) had formal education. Two-thirds (194/291; 66.7%) of the PLWHA interviewed lived in urban areas. The global adherence to ART was 78.4%; the factors associated with ART adherence were: level of education (aOR = 3.54; p = 0.027), alcohol consumption (aOR = 0.43; p = 0.033), ART perception (aOR = 2.90; p = 0.026) and HIV status disclosure to sexual partner (aOR = 7.19; p ≤ 0.001). Conclusion Although the level of adherence to ART in this study was higher than those reported in some studies in Sub-Saharan Africa, it remains sub-optimal and needs improvement. This may therefore hinder the implementation of efficient interventions related to access to ART services.

This is a retrospective study whose objective is to describe the epidemiological and clinical aspects of the management of sexual violence in Black Africa. The study included 373 cases of alleged female victims of sexual assault registered in the Department of Obstetrics and Gynecology of the University Teaching Hospital, Tokoin, Lomé, from 2007 to 2009. Sexual assault accounted for 4.37% of reasons for consultation and vaginal penetration (62.2%) was the predominant mode. The victim was often a small girl of an average age of 12 years. The mean reporting delay which was about 13 days has considerably limited some aspects of the management. We found 14.5% signs of genital trauma, nine cases of HIV serological conversions (2.4%) and eight induced pregnancies. Sexual assault among female victims in Lomé affected the young and vulnerable population. Governments must further inform about this issue and create multidisciplinary free management centres.