16 research outputs found
Vulnerability of groundwater to pollution at the Dabiss bauxite mining area, Boké Prefecture, Republic of Guinea
No full textBoké Prefecture has become a popular mining location, with various extractive corporations competing for bauxite extraction. Water samples were obtained from eighteen water wells across the Dabiss study area. All Physico-chemical parameters and major ions of groundwater were compared with World Health Organization (WHO) standard. Furthermore, using Excel and the Inverse Distance Weighted (IDW) interpolation technique in Arc GIS software, bi-plots of Physico-chemical parameters and spatial variations of water quality maps were generated respectively. A vulnerability study of groundwater pollution by mining activities was conducted by applying the standard DRASTIC method. It was found that the drinking water samples of the study areas were usually within the water quality standards of WHO. According to physicochemical analysis, most of the groundwater in the study area appears to be acidic. An equilibrium was set up in the aquifer between the chemical composition of the water and that of the rocks. The DRASTIC method enabled us to show a low vulnerability index to groundwater pollution. The results of this study could prevent diseases linked to the consumption of water contaminated and improve the quality of life of the population and will serve as a reference document in other mining areas
Microalbuminurie chez l'Enfant Diabétique Guinéen : Prévalence et Facteurs de Risque dans une Étude Multicentrique
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Introduction. Le diabète chez l'enfant entraîne des complications rénales précoces dont la microalbuminurie constitue un marqueur important, particulièrement sous-étudié en Afrique de l'Ouest. En Guinée, la prévalence et les déterminants de cette complication restent méconnus, limitant les stratégies de prévention. Cette étude visait à déterminer la prévalence de la microalbuminurie et identifier les facteurs associés chez les enfants et adolescents diabétiques suivis dans trois centres guinéens. Méthodologie. Nous avons mené une étude transversale descriptive en mai-juin 2024 aux services d'endocrinologie-diabétologie de Conakry, Labé et Boké. L'échantillon consécutif incluait tous les patients pédiatriques suivis pour diabète de type 1. La microalbuminurie était définie par un ratio albumine/créatinine urinaire entre 30-300 mg/g. Résultats. L'étude a inclus 160 patients d'âge moyen 16,9±5,0 ans, avec une légère prédominance féminine (51%). La prévalence globale de microalbuminurie était de 35,6%, variant significativement entre sites : 54% à Conakry, 33% à Boké et 20% à Labé. L'analyse multivariée a identifié l'IMC (p=0,018 à Conakry, p=0,01 à Labé, p=0,02 à Boké) et la durée du diabète (p=0,01 à Boké, p=0,005 à Labé) comme facteurs indépendamment associés à la microalbuminurie. Aucune corrélation significative n'a été observée avec l'HbA1c. Conclusion. Plus d'un tiers des enfants diabétiques guinéens présentent une microalbuminurie, avec des variations régionales importantes. L'IMC et la durée d'évolution émergent comme déterminants majeurs, soulignant l'importance du dépistage systématique et de interventions ciblées sur le contrôle pondéral.
ABSTRACT
Introduction. Diabetes in children leads to early renal complications where microalbuminuria represents an important marker, particularly understudied in West Africa. In Guinea, the prevalence and determinants of this complication remain unknown, limiting prevention strategies. This study aimed to determine microalbuminuria prevalence and identify associated factors in diabetic children and adolescents followed in three Guinean centers. Methodology. We conducted a cross-sectional descriptive study in May-June 2024 at endocrinology-diabetology services in Conakry, Labé and Boké. The consecutive sample included all pediatric patients followed for type 1 diabetes. Microalbuminuria was defined by urinary albumin/creatinine ratio between 30-300 mg/g. Results. The study included 160 patients with mean age 16.9±5.0 years, with slight female predominance (51%). Overall microalbuminuria prevalence was 35.6%, varying significantly between sites: 54% in Conakry, 33% in Boké and 20% in Labé. Multivariate analysis identified BMI (p=0.018 in Conakry, p=0.01 in Labé, p=0.02 in Boké) and diabetes duration (p=0.01 in Boké, p=0.005 in Labé) as independently associated with microalbuminuria. No significant correlation was observed with HbA1c. Conclusion. Over one-third of Guinean diabetic children present microalbuminuria, with significant regional variations. BMI and disease duration emerge as major determinants, highlighting the importance of systematic screening and targeted interventions on weight control
Importance of screening for urinary tract infection in African Black diabetics
Get PDFUrinary tract infections are common and often latent in diabetic patients. The objective of this study was to determinethe frequency of urinary tract infections and the organisms responsible.This is a descriptive type prospective study conducted in the Endocrinology and Diabetology ward of Donka UniversityHospital. All diabetic patients hospitalised from January 3rd to April 4th 2013 were included in the study.Two hundred and sixty-two diabetics had been screened, 64 (24.42%) had a urinary tract infection 41 women (64%)and 23 men (36%). The average age was 56.48 16.3 years with a range of 20-90 years. Urinary tract infections weremore frequent between the ages of 45 and 74 (67.20%). Sixty patients were married, four were single. Fifty-six patientswere type 2 diabetes against eight type I diabetes. Urine test strips showed 60 cases of pyuria, 36 cases of nitruria, 21cases of proteinuria and three cases of hematuria. Organisms identified were: Escherichia coli in 31 cases (48.43%): 25women and six men; Klebsiella pneumoniae in 14 cases (21.87%): nine women and five men; Staphylococcus aureusin 11 cases (17.18%): six women and five men; and Proteus mirabilis in eight cases (12.51%): two women and six men.The clinical manifestations were: asymptomatic bacteriuria in 57 cases (89.06%); acute cystitis in five cases (7.81%); andacute urethritis in two cases (3.13%).Urinary infection in African diabetics is very common. It requires a systematic screening with urine test strips becauseasymptomatic types are by far the most common. This would allow early treatment and avoid serious complications
Adhésion au Traitement Médicamenteux et Facteurs Associés chez les Diabétiques de Type 2 à Conakry
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Introduction. La détérioration de la qualité de vie des patients diabétiques de type 2 et la survenue des complications cardio-vasculaires et neurologiques sont les conséquences de la faible adhésion au traitement. En Guinée, aucune donnée publiée n’est disponible sur ce sujet. Le but de cette étude était d’évaluer la qualité de l’adhésion au traitement médicamenteux et de décrire les facteurs qui lui sont associés au cours du diabète de type 2. Méthode. Entre le 1er juin et le 31 août 2017 ; 600 sujets (510 ambulatoires et 90 hospitalisés) ont été interrogés après recueil de leur consentement. Tous les patients ont été soumis au questionnaire qui comportait les caractéristiques sociodémographiques, les caractéristiques médicales et l’Échelle de mesure d’adhésion aux médicaments de Morisky à 8 éléments. Résultats. Au total 69% des sujets participants étaient des femmes ; l’âge moyen était 55,79±11,58 ans ; 74,2% vivaient à Conakry et dans sa banlieue ; la durée d’évolution moyenne connue du diabète était 5,9 ± 5,6 ans. L’adhésion au traitement était faible (score < 6) 30,2%, moyenne (score de 6 à <8) 39,5% et haute (score = 8) 30,3%. La meilleure qualité de l’adhésion au traitement était significativement associée à la concomitance d’un traitement au long cours (p=0,049), à la fréquence des prises de médicaments par jour (p=0,038) et à la pratique d’une autosurveillance glycémique (p=0,026). La survenue d’une rupture du traitement était associée à une mauvaise qualité de l’adhésion (p<0.001). Les caractéristiques sociodémographiques n’étaient pas liées à l’adhésion. Conclusion. Cette étude a montré que le manque d’adhésion était associé à la rupture de traitement. Le manque de moyens financiers était l’une des causes de rupture de traitement. De ce fait, l’évaluation de l’adhésion devrait être instaurée dès le début du traitement et être suivi. Une éducation thérapeutique focalisée sur de meilleurs résultats thérapeutiques doit intégrer de manière plus systématique l’évaluation de l’adhésion.
ABSTRACT
Introduction. Deterioration in the quality of life of type 2 diabetic patients and the onset of cardiovascular and neurological complications are the consequences of poor adherence to treatment. In Guinea, no published data are available on this subject. The aim of this study was to assess the quality of medication adherence and to describe the factors associated with it in type 2 diabetes. Methods. Between June1 and August 31, 2017; 600 subjects (510 outpatients and 90 inpatients) were interviewed after obtaining their consent. All patients completed the questionnaire, which included sociodemographic characteristics, medical characteristics and the 8-item Morisky Medication Adherence Scale. Results. A total of 69% of participating subjects were women; mean age was 55.79±11.58 years; 74.2% lived in Conakry and its suburbs; mean known duration of diabetes was 5.9 ± 5.6 years. Adherence to treatment was low (score < 6) 30.2%, medium (score 6 to < 8) 39.5% and high (score = 8) 30.3%. Better adherence was significantly associated with concomitant long-term treatment (p=0.049), frequency of daily medication intake (p=0.038) and self-monitoring of blood glucose (p=0.026). The occurrence of treatment discontinuation was associated with poor quality of adherence (p<0.001). Socio-demographic characteristics were not related to adherence. Conclusion. This study showed that poor adherence was associated with treatment discontinuation. Lack of financial means was one of the causes of treatment discontinuation. Adherence assessment should therefore be introduced at the start of treatment and followed up. Therapeutic education focused on improving therapeutic outcomes must incorporate adherence assessment more systematically
Assessments of Ebola knowledge, attitudes and practices in Forécariah, Guinea and Kambia, Sierra Leone, July–August 2015
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The border region of Forécariah (Guinea) and Kambia (Sierra Leone) was of immense interest to the West Africa Ebola response. Cross-sectional household surveys with multi-stage cluster sampling procedure were used to collect random samples from Kambia (
n
= 635) in July 2015 and Forécariah (
n
= 502) in August 2015 to assess public knowledge, attitudes and practices related to Ebola. Knowledge of the disease was high in both places, and handwashing with soap and water was the most widespread prevention practice. Acceptance of safe alternatives to traditional burials was significantly lower in Forécariah compared with Kambia. In both locations, there was a minority who held discriminatory attitudes towards survivors. Radio was the predominant source of information in both locations, but those from Kambia were more likely to have received Ebola information from community sources (mosques/churches, community meetings or health workers) compared with those in Forécariah. These findings contextualize the utility of Ebola health messaging during the epidemic and suggest the importance of continued partnership with community leaders, including religious leaders, as a prominent part of future public health protection.
This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.</jats:p
Temporal evolution of the humoral antibody response after Ebola virus disease in Guinea: a 60-month observational prospective cohort study
No full textInternational audienceBackground: Insufficient long-term data are available on antibody kinetics in survivors of Ebola virus disease (EVD). Likewise, few studies, with very small sample sizes, have investigated cross-reactions between Ebolavirus spp. In this study, we aimed to assess the humoral antibody response and its determinants in survivors of EVD and assess cross-reactivity of antibodies between diverse Ebolavirus spp.Methods: In this observational, prospective cohort study, we collected blood samples from patients from three recruitment sites in Guinea included in the Postebogui study, and we assessed IgG antibody binding to recombinant glycoprotein, nucleoprotein, and 40-kDa viral protein (VP40) of Zaire (EBOV), Bundibugyo (BDBV), and Sudan (SUDV) Ebolaviruses. Participants from the PostEbogui study, from whom we had at least one blood sample that could be tested for the presence of antibodies, were eligible for this analysis. Patients in the PostEbogui study were assessed clinically at inclusion, 1 month and 3 months later, and subsequently every 6 months for up to 60 months after discharge from the Ebola treatment centre. We explored predictors of glycoprotein, nucleoprotein, and VP40 antibody concentrations through a linear mixed model. A logistic mixed model was done to estimate the probability of seropositivity and associated determinants. We assessed cross-reactivity by use of hierarchical cluster analysis.Findings: Of the 802 patients included in the Postebogui study, 687 were included in our analyses. 310 (45%) patients were men and 377 (55%) were women, with an overall median age at the time of the first blood sample of 27·3 years (IQR 19·5–38·2). We observed an overall significant decrease over time of EBOV antibodies, with antibodies against nucleoproteins decreasing more rapidly. At 60 months after discharge from the Ebola treatment centre, the probability of having antibodies against glycoproteins was 76·2% (95% CI 67·2–83·3), against nucleoproteins was 59·4% (46·3–71·3), and against VP40 was 60·9% (51·4–69·8). Persistence of EBOV RNA in semen was associated with higher concentrations of IgG antibodies against nucleoprotein EBOV antigens. Individually, we observed in some survivors an antibody wax-and-wane pattern. The proportion of cross-reactions was highest between glycoproteins from Kissidougou and Mayinga EBOV strains (94·5%, 95% CI 92·5–96·1), followed by EBOV VP40 and BDBV VP40 (88·3%, 85·7–90·6), and EBOV VP40 and SUDV VP40 (83·3%, 80·3–86·1).Interpretation: The probability for survivors of EVD to have antibodies against one or more EBOV antigens remained high, although approximately 25% of survivors had undetectable antibodies, which could have implications, such as a possible decreasing population immunity, for future Ebola outbreaks in the same region
Understanding long-term evolution and predictors of sequelae of Ebola virus disease survivors in Guinea : a 48-month prospective, longitudinal cohort study (PostEboGui)
No full textBackground : Longitudinal analyses are needed to better understand long-term Ebola virus disease (EVD) sequelae. We aimed to estimate the prevalence, incidence, and duration of sequelae and to identify risk factors associated with symptom occurrence among EVD survivors in Guinea.Methods : We followed 802 EVD survivors over 48 months and recorded clinical symptoms with their start/end dates. Prevalence, incidence, and duration of sequelae were calculated. Risk factors associated with symptom occurrence were assessed using an extended Cox model for recurrent events.Results : Overall, the prevalence and incidence of all symptoms decreased significantly over time, but sequelae remained present 48 months after Ebola treatment center discharge with a prevalence of 30.68% (95% confidence interval [CI] 21.40-39.96) for abdominal, 30.55% (95% CI 20.68-40.41) for neurologic, 5.80% (95% CI 1.96-9.65) for musculoskeletal, and 4.24% (95% CI 2.26-6.23) for ocular sequelae. Half of all patients (50.70%; 95% CI 47.26-54.14) complained of general symptoms 2 years' postdischarge and 25.35% (95% CI 23.63-27.07) 4 years' post-discharge. Hemorrhage (hazard ratio [HR], 2.70; P = .007), neurologic (HR 2.63; P = .021), and general symptoms (HR 0.34; P = .003) in the EVD acute phase were significantly associated with the further occurrence of ocular sequelae, whereas hemorrhage (HR 1.91; P = .046) and abdominal (HR 2.21; P = .033) symptoms were significantly associated with musculoskeletal sequelae.Conclusions : Our findings provide new insight into the long-term clinical complications of EVD and their significant association with symptoms in the acute phase, thus reinforcing the importance of regular, long-term follow-up for EVD survivors
Sequences used from GISAID and acknowledgments.
No full textSARS-CoV-2 has claimed several million lives since its emergence in late 2019. The ongoing evolution of the virus has resulted in the periodic emergence of new viral variants with distinct fitness advantages, including enhanced transmission and immune escape. While several SARS-CoV-2 variants of concern trace their origins back to the African continent—including Beta, Eta, and Omicron–most countries in Africa remain under-sampled in global genomic surveillance efforts. In an effort to begin filling these knowledge gaps, we conducted retrospective viral genomic surveillance in Guinea from October 2020 to August 2021. We found that SARS-CoV-2 clades 20A, 20B, and 20C dominated throughout 2020 until the coincident emergence of the Alpha and Eta variants of concern in January 2021. The Alpha variant remained dominant throughout early 2021 until the arrival of the Delta variant in July. Surprisingly, despite the small sample size of our study, we also found the persistence of the early SARS-CoV-2 clade 19B as late as April 2021. Together, these data help fill in our understanding of the SARS-CoV-2 population dynamics in West Africa early in the COVID-19 pandemic.</div
Maternal immunisation with trivalent inactivated influenza vaccine for prevention of influenza in infants in Mali: a prospective, active-controlled, observer-blind, randomised phase 4 trial
No full textSummaryBackgroundDespite the heightened risk of serious influenza during infancy, vaccination is not recommended in infants younger than 6 months. We aimed to assess the safety, immunogenicity, and efficacy of maternal immunisation with trivalent inactivated influenza vaccine for protection of infants against a first episode of laboratory-confirmed influenza.MethodsWe did this prospective, active-controlled, observer-blind, randomised phase 4 trial at six referral centres and community health centres in Bamako, Mali. Third-trimester pregnant women (≥28 weeks' gestation) were randomly assigned (1:1), via a computer-generated, centre-specific list with alternate block sizes of six or 12, to receive either trivalent inactivated influenza vaccine or quadrivalent meningococcal vaccine. Study personnel administering vaccines were not masked to treatment allocation, but allocation was concealed from clinicians, laboratory personnel, and participants. Infants were visited weekly until age 6 months to detect influenza-like illness; laboratory-confirmed influenza diagnosed with RT-PCR. We assessed two coprimary objectives: vaccine efficacy against laboratory-confirmed influenza in infants born to women immunised any time prepartum (intention-to-treat population), and vaccine efficacy in infants born to women immunised at least 14 days prepartum (per-protocol population). The primary outcome was the occurrence of a first case of laboratory-confirmed influenza by age 6 months. This trial is registered with ClinicalTrials.gov, number NCT01430689.FindingsWe did this trial from Sept 12, 2011, to Jan 28, 2014. Between Sept 12, 2011, and April 18, 2013, we randomly assigned 4193 women to receive trivalent inactivated influenza vaccine (n=2108) or quadrivalent meningococcal vaccine (n=2085). There were 4105 livebirths; 1797 (87%) of 2064 infants in the trivalent inactivated influenza vaccine group and 1793 (88%) of 2041 infants in the quadrivalent meningococcal vaccine group were followed up until age 6 months. We recorded 5279 influenza-like illness episodes in 2789 (68%) infants, of which 131 (2%) episodes were laboratory-confirmed influenza. 129 (98%) cases of laboratory-confirmed influenza were first episodes (n=77 in the quadrivalent meningococcal vaccine group vs n=52 in the trivalent inactivated influenza vaccine group). In the intention-to-treat population, overall infant vaccine efficacy was 33·1% (95% CI 3·7–53·9); in the per-protocol population, vaccine efficacy was 37·3% (7·6–57·8). Vaccine efficacy remained robust during the first 4 months of follow-up (67·9% [95% CI 35·1–85·3] by intention to treat and 70·2% [35·7–87·6] by per protocol), before diminishing during the fifth month (57·3% [30·6–74·4] and 60·7 [33·8–77·5], respectively). Adverse event rates in women and infants were similar among groups. Pain at the injection site was more common in women given quadrivalent meningococcal vaccine than in those given trivalent inactivated influenza vaccine (n=253 vs n=132; p<0·0001), although 354 [92%] reactions were mild. Obstetrical and non-obstetrical serious adverse events were reported in 60 (3%) women in the quadrivalent meningococcal vaccine group and 61 (3%) women in the trivalent inactivated influenza vaccine group. Presumed neonatal infection was more common in infants in the trivalent inactivated influenza vaccine group than in those in the quadrivalent meningococcal vaccine group (n=60 vs n=37; p=0·02). No serious adverse events were related to vaccination.InterpretationVaccination of pregnant women with trivalent inactivated influenza vaccine in Mali—a poorly resourced country with high infant mortality—was technically and logistically feasible and protected infants from laboratory-confirmed influenza for 4 months. With adequate financing to procure the vaccine, implementation will parallel the access to antenatal care and immunisation coverage of pregnant women with tetanus toxoid.FundingBill & Melinda Gates Foundation
All SPSS Tables and Outputs from Assessments of Ebola knowledge, attitudes and practices in Forécariah, Guinea and Kambia, Sierra Leone, July–August 2015
No full textThe border region of Forécariah (Guinea) and Kambia (Sierra Leone) was of immense interest to the West Africa Ebola response. Cross-sectional household surveys with multi-stage cluster sampling procedure were used to collect random samples from Kambia (n = 635) in July 2015 and Forécariah (n = 502) in August 2015 to assess public knowledge, attitudes and practices related to Ebola. Knowledge of the disease was high in both places, and handwashing with soap and water was the most widespread prevention practice. Acceptance of safe alternatives to traditional burials was significantly lower in Forécariah compared with Kambia. In both locations, there was a minority who held discriminatory attitudes towards survivors. Radio was the predominant source of information in both locations, but those from Kambia were more likely to have received Ebola information from community sources (mosques/churches, community meetings or health workers) compared with those in Forécariah. These findings contextualize the utility of Ebola health messaging during the epidemic and suggest the importance of continued partnership with community leaders, including religious leaders, as a prominent part of future public health protection.This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’
