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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.

Objectives: Study the prognostic, clinical and epidemiological profile of high blood pressure and pregnancy association at the Sylvanus Olympio Teaching Hospital (CHU Sylvanus Olympio) of Lome. Patients and Method: It is about a retrospective study that is carried out at the gynecology-obstetrics unit from January to December 2016. Pregnant women with High Blood Pressure after delivery were concerned. Results: In total, 767 pregnant women with High Blood Pressure out of 12107 were taken. The frequency of HBP-pregnancy association was 6.33%. The 21 to 30 bracket age was the most represented (53.71%). The most common risk factor was the overweight or over-obseness (41.98%). Other risk factors were the first delivery and maternal age superior to 30 years old. Common clinical cases described in the study are the same as a predominance of preeclampsia. Caesarean has been the common method of delivering with foetal complications of prematurity type, neonatal suffering and hypotrophy. Conclusion: HBP-pregnancy association is a public health concern with serious foetal maternal complications. The prevention of this association is of great importance.

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.

Introduction Strokes are the first cause of non-traumatic disability and the second cause of death worldwide. Data analysis is useful to improve their care. Our purpose was to describe the epidemiological profile of stroke cases admitted at the Sylvanus Olympio University Hospital (CHU-SO) from 2017 to 2018. Method We conducted a descriptive study that included all stroke cases admitted at Internal Medicine Department of CHU-SO from January 2017 to December 2018. Socio-demographic and clinical data were collected by medical records reviewing and patients' interview and thereafter compiled and analyzed with Epi Info 7.2.1.0. Results The overall prevalence was 7.6% (173/2, 270) and 11.4% in patients aged 50 and over. Median age was 58.5 years, Interquartile interval (IQ) [48-65] and M/F sex ratio was 1.16. The median delay for admission to CHU-SO was one day, IQ [0-2]. Among patients' medical history, high blood pressure, strokes, alcoholism and diabetes accounted for 68.2% (118/173), 16.8% (29/173), 15.0% (26/173) and 12.1% (21/173) respectively. Hemorrhagic stroke cases accounted for 80.6% (29/36) in patients aged less than 50, while ischemia's accounted for 64.2% (61/95) among those aged 50 and over. Recovery occurred in 30.1% (52/173) with 80.8% (42/52) of sequelae. Deaths occurred in 62.4% (108/173) and were associated with the absence of the head CT scan (OR=2.71; 95% CI [1.14-6.73]). Conclusion Strokes affected mainly active people with high mortality exacerbated by the absence of the head CT scan. Early availability of the head CT scan and implementation of other specific strategies carried out of an action plan could contribute to reduce the burden of stroke at CHU-SO.

International audience; ObjectiveThe objective of this study is to assess the quality of life and to identify factors associated with good global quality of life among people living with HIV/AIDS (PLWHA) in Togo.ResultsIn total, 880 PLWHA with mean age (standard deviation) of 39.6 (10.1) years, were interviewed. Most of them (78.4%) were female. The global score of quality of life was ranged from 42.6 to 112, with a mean (standard deviation) estimated at 86.3 ± (13.3). More than the three-quarters (76.2%) of the participants had a good global quality of life. In multivariate analysis, secondary education level or higher (adjusted odds ratio = 1.78, 95% confident interval (CI) [1.10–2.85]), living in Kara health region (adjusted odds ratio = 4.39, 95% CI [2.94–6.57]), being on antiretroviral therapy (adjusted odds ratio = 6.99, 95% CI [4.11–11.9]) and HIV sero-status disclosure (adjusted odds ratio = 1.83, 95% CI [1.28–2.61]) were associated with a better overall quality of life (score ≥ 77.3).Keywords: Quality of life, PLWHA, Togo

The purpose of this study was to describe the different circumstances in which diabetes mellitus was detected in the Department of Internal Medicine at the Sylvanus Olympio University Hospital in Lome. We conducted a retrospective and descriptive study in the Department of Internal Medicine, at the Sylvanus Olympio University Hospital in Lome from January 2015 to December 2017. During the study period, 307 patients with diabetes mellitus were admitted to our Department, of whom 104 did not know to have diabetes. The average age of patients was 51.27 years (ranging from 20 to 90 years), the sex ratio (M/F) was 0,5. Type 2 diabetes was diagnosed in 75% of cases, type 1 in 23% of cases and secondary in 2% of cases. The discovery of diabetes was fortuitous in 11.53% of cases (n=12). Some patients had symptoms (26.92%, n=28) while others had complications (61.53%, n=64). Complications included: ketoacidosis (n=34), hyperosmolar hyperglycemic syndrome (n=3), high blood pressure (n=8), ischemic stroke (n=4), diabetic foot (n=2), diabetic nephropathy (n=2), polyneuropathy (n=1), infections (n=18, 8 with metabolic complications). This study shows that in the Department of Internal Medicine, at the Sylvanus Olympio University Hospital in Lome, diabetes mellitus is most commonly diagnosed when patients have complications. It is essential to educate our populations about prevention and screening tests.

International audience; Introduction Contraceptive use among HIV-infected women in Togo is poorly documented. We aim at assessing the prevalence of modern contraceptive use and associated factors among HIV-infected women in Togo. Design Cross-sectional study. Setting The study was conducted in five HIV care centres in the Centrale and Kara regions in Togo. Participants We included 461 HIV-positive women aged between 15 and 49 years and who were sexually active. Main outcome measure The outcome variable was HIV-infected women who were using modern contraceptive methods. Results A total of 461 HIV-infected women were interviewed, with an average age of 34.3 (+/- 7.1). Among them, 332 (73.1%) women reported using contraceptive methods, mostly condom alone (74.7%) or in combination with hormonal contraceptive (16.9%). In multivariate analysis, education level (primary: adjusted OR (aOR)=1.99, 95% CI (1.05 to 3.76); secondary level and higher: aOR=3.95, 95% CI (2.03 to 7.67)), WHO clinical stage (stage II: aOR=0.7, 95% CI (0.37 to 1.33)), follow-up in private care facilities (aOR=2.54, 95% CI (1.22 to 5.29)) and having a child (aOR=2.51, 95% CI (1.41 to 4.5)) were associated with higher contraceptive use, while marital status (living in union: aOR=0.45, 95% CI (0.28 to 0.74)) and WHO stages III and IV (aOR=0.47, 95% CI (0.24 to 0.94)) were associated with lower contraceptive use. Conclusion About three-quarters of sexually active HIV-infected women in Togo were using contraceptive methods, and private health facilities favoured this contraceptive use. It is important to strengthen the implementation of interventions to increase the incentives for HIV-infected women to use contraception in Togo.