25 research outputs found
Criminal prosecution of a male partner for sexual transmission of infectious diseases: The views of educated people living in Togo
No full textObjectives: The acceptability by people in Togo of criminal prosecution for sexual transmission of infectious diseases was examined.
Methods: One hundred and ninety-nine persons in Togo judged acceptability of criminal prosecution for sexual transmission of infectious diseases in 45 scenarios composed of combinations of four factors: (a) the type of illness, (b) the awareness of the serological status (c) the partners’ marital status, and (d) the male partner’s attitude toward his sexual partner following transmission of the virus.
Results: Three qualitatively different views were identified. For 50% of the participants, a male partner (with HIV, Hepatitis B, or Gonorrhea) could be sued when he knew his serological status but did not inform his sexual partner or when he refuses to take care of his sexual partner whom he infected. When he did not know his serological status or when the female partner was also informed of this serological status, he should not be sued on condition that he accepts to take care of her. For 26%, when both partners were informed, the male partner should not be sued, irrespective of other circumstances. For 24%, when the male partner accepts to take care of the female partner whom he infected, he should not be sued.
Conclusions: Regarding criminal prosecution for sexual transmission of infectious diseases, most people in Togo disagreed with the provisions of the “Model Law for STI/HIV/AIDS for West and Central Africa”. Rather, they endorsed the position of the Joint United Nations Programme on HIV and AIDS
Fighting COVID-19 in the West Africa after experiencing the Ebola epidemic
No full textCoronavirus disease 2019 (COVID-19) dissemination occurred from December 2019 and quickly spread to all countries. Infected patients with COVID-19 have had a wide range of symptoms, ranging from mild to severe illness. The most mortality was observed in patients with underlying disease and over 45 years. World statistics have shown that the COVID-19 outbreak is most expanded in Middle Eastern, West Asian, European, North, and South American countries, and is least expanded in African countries. Therefore, the aim of the paper was the evaluation of six African countries including Mali, Mauritania, Niger, Guinea, Togo, and Djibouti to find why this disease is least expanded in African countries. Study was conducted by Questioner for countries health organizers to define their different aspect exposure and fight with COVID-19 including epidemiology, clinical aspects of the disease, case definitions, diagnosis laboratory confirmation, and referral of cases by the portal of entry, ease management, and disease prevention in these countries. According to this opinion review, due to the low international flights and low domestic travel, the spread, and prevalence of COVID-19 was low and the return of the immigrants of these countries has caused the spread of COVID-19 among these countries. Experience, preparation, and impact of previous infections epidemic such as the Ebola virus epidemic would have beneficial, which have promoted certain reflexes among people that cause low dissemination in these countries
Aspects epidemiologiques, cliniques et therapeutiques des otites externes: à propos de 801 cas
Get PDFL'objectif de ce travail etait de déterminer l'épidémiologie, la clinique et la thérapeutique des otites externes (OE). Il s'agissait d'une étude rétrospective d'une année menée du 1er janvier au 31 décembre 2006 dans le service ORL du CHU-Tokoin. Huit cent un cas d'otite externe (OE) soit 11,9% des consultations étaient recensés. Le sexe féminin représentait 476 cas (59,42%). Le sex ratio était de 0,68. L'âge moyen des patients était de 25,4 ans avec des extrêmes de 05 mois et 81 ans. La tranche d'âge de 0-15 ans était la plus fréquente avec 360 cas (45%). L'allergie dans 74 cas (60,66%), la lésion de grattage dans 24 cas (19,67%), les corps étrangers du conduit auditif externe dans 18 cas (14,75%) et la natation dans 6 cas (4,92%) étaient les facteurs favorisants. L'otalgie dans 638 cas (79,65%) était le symptôme le plus fréquent. Les différentes formes cliniques des otites externes se répartissaient comme suit: otite externe diffuse dans 612 cas (76,40%), furoncle du CAE 126 dans cas (15,73%), otomycose dans 58 cas (7,24%), zona du conduit auditif externe dans 3 cas (0,37%) et otite externe nécrosante dans 2 cas (0,25%). Les gouttes auriculaires étaient administrées à tous les patients. L'évolution avait noté 799 patients (99,75%) guéris sans complication, un cas de décès et un cas de guérison avec séquelle. Traitée correctement, l'otite externe guérit sans complication. Son éviction passe par une sensibilisation des populations sur l'entretien du conduit auditif externe.Key words: Otite externe, épidémiologie, complications, microbiologi
Alcohol use, viral hepatitis and liver fibrosis among HIV-positive persons in West Africa: a cross-sectional study
Get PDFINTRODUCTION
Liver fibrosis is often the first stage of liver disease in people living with HIV (PLWHIV) in industrialized countries. However, little is known about liver fibrosis and its correlates among PLWHIV in sub-Saharan Africa.
METHODS
The study was undertaken in three HIV referral clinics in Côte d'Ivoire, Senegal and Togo. Enrolled PLWHIV underwent a non-invasive assessment of liver fibrosis combining liver stiffness measure (LSM) with transient elastography and the aspartate aminotransferase-to-platelet ratio index (APRI). Significant liver fibrosis was defined as LSM ≥7.1 kPa. Patients were screened for alcohol use (alcohol use disorder identification test (AUDIT)-C questionnaire), hepatitis B virus (HBV) antigen, hepatitis Delta virus (HDV) antibody and anti-hepatitis C (HCV) antibody. A logistic regression model was used to identify the factors associated with significant liver fibrosis.
RESULTS
A total of 807 PLWHIV were screened at a median age of 43 years (interquartile range (IQR): 36-50). Their median CD4 count was 393 cells/mm(3) (IQR: 234-563) and 682 (84.5%) were on antiretroviral therapy (ART). The prevalence of significant fibrosis was 5.3% (3.8-6.7). Infections with HBV and HCV were identified in 74 (9.2%) and nine (1.1%) participants. Main factors associated with liver fibrosis were alcohol use (AUDIT-C >6): (odds ratio (OR) = 4.0, confidence interval (CI): 1.2-14.0), (Ref. AUDIT-C <4) and HBV infection (OR = 2.9, CI: 1.2-7.2). Of the 74 patients positively screened for HBV, 50.0% were on a tenofovir-based ART regimen. Overall, 10% of HIV/HBV coinfected patients were detected with a positive HDV antibody with a higher prevalence in patients with a significant liver fibrosis (43.0%) compared to others (6.3%) (p = 0.01).
CONCLUSION
Considering the WHO recommendations to screen for HBV infection and treat co-infected patients with tenofovir-based ART, screening of alcohol use and brief interventions to prevent alcohol abuse should be implemented in West Africa, especially in HBV/HIV co-infected patients
HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa.
Get PDFBACKGROUND
Prisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa.
METHODS
Screening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis.
RESULTS
Overall, 680 inmates were included with a median age of 30 years [interquartile range: 24-35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8-32.1), HBV infection (OR = 4.8; CI 1.8-12.8), HCV infection (OR = 52.6; CI 4.1-673.8), use of traditional medicines (OR = 3.7; CI 1.4-10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1-9.8) compared to Dakar.
CONCLUSIONS
HIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates
Peoples’ attitude toward COVID-19 vaccine, acceptance, and social trust among African and Middle East countries
Get PDFBackground: To end the COVID-19 pandemic, a large part of the world must be immune to the virus by vaccination. Therefore, this study aimed to gauge intent to be vaccinated against COVID-19 among ordinary people and to identify attitudes towards vaccines and barriers for vaccine acceptance. Methods: The study population comprises 1880 people residing in different countries that answer a prepared questionnaire. The questionnaire topics are demographics, historical issues, participants’ attitudes and beliefs regarding vaccines, concerns, and vaccine hesitancy. Results: Attitudes and beliefs relating to vaccines in general, and the COVID-19 vaccine, were ascertained. Overall, 66.81% of the contributors would like to be vaccinated against COVID-19, while %33.19 did not intend to be vaccinated. Reasons for COVID-19 vaccine hesitancy included concern regarding vaccine side effects, fear of getting sick from the uptake of the vaccine, and the absence of accurate vaccine promotion news. Individuals with higher education believe that India (68.6%) produces the best vaccine (P<0.001), while healthcare workers think the Chinese vaccine (44.2%) is the best (P=0.020). Individuals with higher education have not been vaccinated, not be healthcare workers, and females were the most contributors to effective of the vaccine in reducing mortality from COVID-19 disease. Conclusion: Given the degree of hesitancy against COVID-19 vaccination, a multifaceted approach to facilitate vaccine uptake that includes vaccine education, behavioral change strategies, and health promotion, is paramount
Trends in hepatitis B virus testing practices and management in HIV clinics across sub-Saharan Africa
Get PDFAbstract Background Approximately 8% of HIV-infected individuals are co-infected with hepatitis B virus (HBV) in sub-Saharan Africa (SSA). Knowledge of HBV status is important to guide optimal selection of antiretroviral therapy (ART) and monitor/prevent liver-related complications. We describe changes in testing practices and management of HBV infection over a 3-year period in HIV clinics across SSA. Methods A medical chart review was conducted in large urban HIV treatment centers in Côte d’Ivoire (3 sites), Benin, Burkina Faso, Cameroon, Kenya, Senegal, South Africa, Togo, Uganda and Zambia (1 site each). Of the patients who started ART between 2010 and 2012, 100 per year were randomly selected from each clinic. Demographic, clinical and laboratory information as well as individual treatment histories were collected using a standardized questionnaire. We examined changes over time in the proportion of patients screened for HBV infection (HBV surface antigen [HBsAg]-positivity), identified predictors of HBV testing using logistic regression, and assessed the proportion of patients initiating a tenofovir (TDF)-containing ART regimen. Results Overall, 3579 charts of patients initiating ART (64.4% female, median age 37 years) were reviewed in 12 clinics. The proportion of patients screened for HBsAg increased from 17.8% in 2010 to 24.4% in 2012 overall, and ranged from 0.7% in Kenya to 96% in South Africa. In multivariable analyses, age and region were associated with HBsAg screening. Among 759 individuals tested, 88 (11.6%; 95% confidence interval [CI] 9.4–14.1) were HBV-infected, of whom 71 (80.7%) received a TDF-containing ART regimen. HBsAg-positive individuals were twice as likely to receive a TDF-containing first-line ART regimen compared to HBsAg-negative patients (80.7% vs. 40.3%, p < 0.001). The proportion of patients on TDF-containing ART increased from 57.9% in 2010 to 90.2% in 2012 in HIV/HBV-co-infected patients (Chi-2 test for trend: p = 0.01). Only 114 (5.0%) patients were screened for anti-HCV antibodies and one of them (0.9%, 95% CI 0.02–4.79) had a confirmed HCV infection. Conclusions The systematic screening for HBV infection in HIV-positive patients before ART initiation was limited in most African countries and its uptake varied widely across clinics. Overall, the prescription of TDF increased over time, with 90% of HIV/HBV-coinfected patients receiving this drug in 2012
Facteurs etiologiques des pneumopathies communautaires bacteriennes chez les sujets ages au Centre Hospitalier Universitaire Tokoin (Togo)
No full textObjectif: Décrire les facteurs étiologiques des pneumopathies communautaires bactériennes non tuberculeuses chez les sujets âgés de 60 ans et plus au CHU-Tokoin au Togo.Patients et méthode: Il s’agissait d’une étude rétrospective réalisée dans le service de Maladies Infectieuses et de Pneumologie du CHU-Tokoin (Lomé) du 1er janvier 2003 au 31 décembre 2008. Les patients étaient retenus sur la base des arguments cliniques, radiographiques, bactériologiques et évolutifs. Ainsi tout dossier de patient âgé de 60 ans et plus pris en charge dans le service pour une infection pulmonaire à l’exception de la tuberculose a été considéré comme sujet d’étude. Les résultats bactériologiques étaient issus des examens cytobactériologiques (ECB) de la ponction pleurale, de l’expectoration et de l’hémoculture. Le test VIH pour la recherche de l’infection avait été réalisé chez les patients qui avaient donné leur accord.Résultats: Quatre vingt neuf (89) cas soit 11,1 % de pneumopathies bactériennes du sujet âgé ont été enregistrés. Quarante huit (54 %) avaient une mauvaise hygiène buccodentaire. Le sexe ratio homme/femme a été de 1,23. Vingt six soit 29,21 % ont été tabagiques .Vingt deux patients (25 %) ont bénéficié d’une antibiothérapie trois mois avant leur hospitalisation. Seize (35 %) des 46 patients qui ont accepté le test VIH avaient une infection par le VIH associée. Six patients étaient sous chimio prophylaxie au cotrimoxazole dans le cadre de la prise en charge de l’infection par le VIH. Le tableau clinique a été dominé par la toux (85,39 %), dyspnée 59,55 %, la douleur thoracique 57,30 %, fièvre 51,68 %, douleurs thoraciques 57,30 % et parfois l’altération de l’état général 28,09 %. Streptococcus pneumoniae, Klebsiella pneumoniae étaient les plus rencontrés. Toutes les souches de pneumocoque et Klebsiella étaient sensibles au ceftriaxone, amoxicilline-acide clavulanique, ciprofloxacine et à l’amoxicilline dans 50 % des cas pour le pneumocoque, Cinq souches de pneumocoque et trois de klebsiella étaient résistantes au cotrimoxazole. En première intention la bi antibiothérapie (Amoxicilline plus gentamicine) a été choisie dans 72 % des cas.Mots clés: Pneumopathies, sujet âgé, facteurs étiologiques, TogoEnglish AbstractObjective: Describe etiologic factors of bacterial community pneumonia among person old than 60 years and more in Infectious Diseases and Pneumology Service (CHU-Tokoin) of Togo.Material and methods: We retrospectively reviewed the records of hospitalized for community-acquired pneumonia among elderly persons in the service of Infectious Diseases and Pneumology (CHU-Tokoin, Togo). The patients were retained on the basis of clinical, radiographic, bacteriological and prognostic argument. Between January 1st 2002 and December 31st 2005 inpatient dossiers were identified. So all file of patient aged of 60 years and older admitted in the service for a pulmonary infection has been considered like topic of survey. The tuberculosis cases were excluded. The bacteriological results were descended of the exams cytobacteriological (ECB) of the pleural puncture, the expectoration and the haemoculture The HIV test had been achieved among the patients who had given their agreement.Results: Eighty nine (89) cases (11.1%) of elderly person with bacterial pneumopathies have been recorded in the service. Forty eight (54%) had bad mouth hygiene. The sex ratio (man / woman) was of 1.23. Twenty six, either 29.21% have smoked. Twenty two patients (25%) had used antibiotherapy three months before their hospitalization. Sixteen (35%) of 46 patients who accepted HIV test had an HIV infection. Six patients were under cotrimoxazole’s prophylaxis. The clinical picture has been dominated by the cough (85.39%), dyspnea 59.55%, the thoracic pain 57.30%, fever 51.68%, thoracic pains 57.30% and the general status alteration 28.09%. Streptococcus pneumoniae, Klebsiellas pneumoniae were the more accounted for pneumopathies. All pneumococcus and Klebsiella were sensitive to the ceftriaxone, amoxicillin-clavulanate, ciprofloxacine. Fifty percent (50%) of pneumococcus’s cases were also sensitive to amoxicillin.Five stumps of pneumococcus and three of klebsiella were resistant to the cotrimoxazole. In first intention the bi antibiothérapie (Amoxicilline plus gentamicine) has been chosen in 72% of the cases.Keywords: Pneumopathy, elderly persons, Tog
Seroprevalence and risk factors for Brucella species and Coxiella burnetii exposure in a cross-sectional serosurvey of occupationally exposed groups in peri-urban Lomé, Togo.
Get PDFBACKGROUND: Brucella species and Coxiella burnetii have been detected in livestock populations in Togo. Populations exposed to livestock ruminants through their occupation may be at increased risk of infection. METHODS/PRINCIPAL FINDINGS: A cross-sectional serosurvey was conducted in 108 abattoir and 81 dairy farm workers (from 52 dairy farms) in peri-urban Lomé, Togo in 2019-2020. Structured questionnaires were used to collect data on participant livestock contact and dairy product consumption. Sera were tested using the Rose Bengal plate agglutination test (RBT) and the indirect Brucella IgG Enzyme-Linked Immunosorbent Assay (ELISA) for Brucella, and the IgG ELISA for Coxiella burnetii in Phase 1 and in Phase 2. Fresh bulk milk samples from farms were tested using an indirect milk ELISA for Brucella IgG. The association between seropositivity and exposure variables was examined using logistic regression with robust standard errors to account for site-level clustering. Eighteen workers (9.5%, 95% CI 5.5-16.0) were Brucella seropositive. Twenty-eight percent (95% CI 22.5-34.3) of workers were seropositive for C. burnetii. Twenty of fifty-one farms which gave milk samples tested positive for Brucella antibodies (39.2%, 95% CI 26.6 - 53.4%). Farmworkers had nearly twice the crude odds of being Brucella seropositive compared to abattoir workers (OR 1.93, 95% CI: 0.94-3.93, p = 0.07). After adjusting for age, working on farms with animal ill health, a positive milk test, participating in small ruminant husbandry and assisting with cattle abortion were all associated with increased odds of seropositivity. Farm and abattoir workers who consumed raw milk at least every month were more likely to be seropositive for Brucella species (OR 3.79, 95% CI: 2.34-6.13, p < 0.001) while participants who consumed fermented milk and cheese had greater odds of being seropositive for C. burnetii (OR 1.59, 95% CI: 1.26-2.00, p < 0.001 and OR 1.70, 95% CI: 0.97-2.98, p = 0.07 respectively). CONCLUSIONS: Livestock workers in peri-urban Lomé have been exposed to both Brucella and Coxiella burnetii bacteria. The widespread consumption of raw dairy products and lack of personal protective equipment (PPE) use is of concern as both dairy consumption and participation in animal husbandry activities have been seen to increase odds of seropositivity for both pathogens. A One Health prioritization of zoonotic disease would help to bring together the relevant sectors to adequately resource prevention and control of zoonoses of public health concern in Togo, which may particularly impact workers in close contact with animals
High prevalence of HIV-1 drug resistance among patients on first-line antiretroviral treatment in Lomé, Togo
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