6 research outputs found
Prevalence and Psychosocial Impact of Coronavirus Disease 2019 in Chronic Hemodialysis Patients in Dakar, Saint-Louis, and Ziguinchor: A Prospective Multicentric Study between February 2020 and June 2020
No full textChronic hemodialysis (HD) patients are particularly vulnerable to coronavirus disease 2019 (COVID-19). We assessed the prevalence and psychosocial impact of COVID-19 in these patients in Senegal. This multicenter prospective, descriptive, and analytical study included 345 patients who had been on chronic HD for at least 1 month (average age = 49.67 ± 14.58 years; sex ratio: 1.14). Eighty-one patients (23.48%) believed that COVID-19 negatively impacted their dialysis treatment. In total, 257 patients (74.49%) perceived themselves to be at risk, and 128 patients (37.1%) were worried about attending the dialysis center. Only 109 patients (31.59%) were tested by polymerase chain reaction; 13 (11.92%) were positive. In total, 322 patients (93.6%) were informed through television or radio, 338 (97.97%) were aware of the barrier measures, and 83 (24.06%) had difficulty applying the barrier measures, mainly on transport. Masks were the best-known measure, as reported by 331 patients (95.94%). In a bivariate analysis, knowledge of the barrier measures was associated with education level (P <0.001). Perceptions of the risk of COVID-19 were associated with knowledge of the barrier measures (P = 0.05), whereas transport difficulties were associated with socio-professional activity (P = 0.048) and education level (P = 0.007). Difficulties with exploration were associated with socio-professional activity (P <0.001) and educational level (P = 0.003). We found that COVID-19 was a problem among chronic HD patients in Senegal, most of whom had a good knowledge of the barrier measures. The pandemic created anxiety and difficulties in transport, drug supply, and access to specialized care among these patients
Usefulness of foot-to-foot bioimpedance analysis for assessing volume status in chronic hemodialysis patients at the Aristide Le Dantec University Hospital (Senegal)
No full textIntroduction: Determination of dry weight is one of the daily goals to achieve in hemodialysis. The aim of this study was to validate the use of bioelectrical impedance analysis (BIA) in estimation of dry weight in a population of Senegalese chronic hemodialysis patients.
Patients and methods: A 9-week cross-sectional study was carried out at the hemodialysis unit of Aristide Le Dantec University Hospital. Adult patients with no previous hospital history were included. The total body water (TBW) was measured with a single frequency bioelectric impedance foot-to-foot analyzer, before and after six successive hemodialysis sessions. These results were compared with those from clinical measurements with the Watson equation using a Student’s t-test and Bland-Altman analysis.
Results: 264 measurements were made in 22 patients (46.6 years, 54.5% men, 92.3 months on dialysis, 62.7 kg mean dry weight). A significant reduction in weight (ΔWeight = 2.0 ± 1.1 kg; p < 0.0001) and in TBW measured by the BIA (ΔTBWBIA = 3.3 ± 1.0 liters; p < 0.0001)) or calculated by Watson’s equation (ΔTBWWatson = 0.5 ± 0.2 liter; p = 0.0001) was observed. There was a strong linear correlation and agreement between the 2 TBW measurements in pre-dialysis. In post-dialysis the concordance diagram indicated a bias = –2.2 and wide agreement limits.
Conclusion: The BIA allows reproducible and reliable measurements and a fair estimate of the TBW in pre-dialysis
Evaluation de l’état hydrique chez les patients hémodialysés chroniques : une étude transversale monocentrique: Assessment of the hydration status in chronic hemodialysis patients: a single-center cross-sectional study
No full textContext and objective. For many practitioners, blood pressure is the main indicator of the hydration status of the chronic hemodialysis patient. The objective of this study was to assess the extent to which bioimpedance analysis (BIA) can assist in determining acute changes in fluid volume during the hemodialysis session. Methods. This was a 9-week longitudinal study. The total body water (TBW) was measured with a BIA analyzer, before and after 6 successive sessions. The ΔWeight was compared to the ΔTBW by calculating the P/V ratio (ΔWeight/ΔTBW) with the assumption that the dry weight is reached when P/V = 1. Results. The measurements made in 22 patients (46.6 years, 54.5% men, 92.3 months on dialysis) were reproducible. There was no statistically significant difference between ΔTBW and ΔWeight. However, at the individual level, significant differences had been observed. Using hypertension as a marker for a state of hyperhydration, a 31.8% agreement was noted between the P/V ratio and hypertension. Conclusion. Although the loss of water predicted by the BIA did not always correspond to the weight loss, BIA is a technique that can be used to assess the variations in TBW during the hemodialysis session in patients.
Contexte et objectif. La pression artérielle est pour de nombreux praticiens, l’indicateur principal du statut hydrique du patient hémodialysé chronique. L’objectif de la présente étude était d’évaluer dans quelle mesure l’analyse d’impédance bioélectrique (BIA) pourrait aider à la détermination des variations aigues du volume hydrique au cours de la séance d’hémodialyse. Méthodes. Il s’agissait d’une étude de suivi longitudinal sur 9 semaines. Le volume total d’eau (VTE) a été mesuré par BIA, avant et après 6 séances. Le ΔPoids a été comparé au ΔVTE par le calcul du ratio P/V (ΔPoids / ΔVTE) dans l’hypothèse que le poids sec est atteint lorsque P/V = 1. Résultats. Les mesures faites chez 22 patients (46,6 ans, 54,5% hommes, 92,3 mois en dialyse) étaient reproductibles. Il n’y avait pas de différence statistiquement significative entre le ΔVTE et le ΔPoids. Cependant à l’échelon individuel des différences importantes étaient observées. En utilisant l’hypertension artérielle (HTA) comme marqueur d’un état d’hyperhydratation, une concordance de 31,8% était notée entre le ratio P/V et l’HTA. Conclusion. Bien que la perte d’eau prédite par la BIA ne corresponde pas toujours à celle du poids, la BIA est une technique qui peut être utilisée pour évaluer les variations du VTE au cours de la séance d’hémodialys
Evaluation des complications cardiovasculaires au centre d’hémodialyse de l’hôpital régional de Ziguinchor au sud du Sénégal.
No full textIntroduction : Les complications cardiovasculaires sont très létales chez les patients hémodialysés chroniques. Elles constituent la première cause de mortalité dans cette population qui est 3 à 20 fois plus élevée par rapport á la population générale de même âge.L’objectif de ce travail était de déterminer la fréquence des complications cardiovasculaires chez les patients hémodialysés chroniques.Patients et méthodes : Il s’agissait d’une étude prospective descriptive et analytique de 2 mois au centre d’hémodialyse de l’hôpital régional de Ziguinchor.Le recueil des données était effectué grâce á un questionnaire renseignant sur les paramètres épidémiologiques, cliniques, paracliniques. Tous les patients avaient bénéficié d’un électrocardiogramme et d’une échographie cardiaque trans-thoracique faites en post dialyse.Résultats : L’âge moyen des patients était de 41,14 ans et 57,14% des patients étaient hypertendus. La dyspnée d’effort était la principale manifestation clinique soit 47,61% et 28,57% des patients avaient une hypertrophie ventriculaire gauche électrique. A l’échocoeur, l’hypertrophie ventriculaire gauche concentrique était le plus notée dans 47,61%.Conclusion : les patients hémodialysés chroniques sont exposés á des complications cardiovasculaires fréquentes et létales. La prise en charge correcte nécessite une surveillance avec des examens paracliniques périodique pour prévenir les complications
Particularities of COVID-19 infection in chronic hemodialysis patients in Sub-Saharan Africa: experience from Senegal (West Africa)
No full textThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in December 2019 in China and has rapidly become a major global health concern. Patients with end-stage renal disease receiving dialysis treatment are very exposed to the SARS-CoV-2 during their frequent visits to healthcare facilities and immune induced by uremia. The aim of our work was to describe the particularity of COVID-19 infection in hemodialysis patients in sub-Saharan Africa and in Ziguinchor, south of Senegal, particularly. To do this, we conducted a monocentric prospective study over a period of 16 months at the Ziguinchor hemodialysis center and compared our results to a study that focuses on the seroprevalence of SARS-CoV-2 in chronic hemodialysis patients. We found a low prevalence of COVID-19 infection while the majority of our patients were in contact with the virus
Transmission of malaria in relation to distribution and coverage of long-lasting insecticidal nets in central Côte d'Ivoire
No full textThe use of long-lasting insecticidal nets (LLINs) is an effective malaria control strategy. However, there are challenges to achieve high coverage, such as distribution sustainability, and coverage keep-up. This study assessed the effect of LLINs coverage and contextual factors on entomological indicators of malaria in rural Côte d'Ivoire.; The study was carried out between July 2009 and May 2012 in three villages (Bozi, N'Dakonankro and Yoho) of central Côte d'Ivoire. In Bozi and Yoho, LLINs were distributed free of charge by the national malaria control programme in 2008. In Bozi, an additional distribution was carried out in May 2011. No specific interventions were done in N'Dakonankro. Entomological surveys were conducted in July 2009 and July 2010 (baseline), and in August and November 2011 and in February 2012. Frequency of circumsporozoite protein was determined using an enzyme-linked immunosorbent assay. Regression models were employed to assess the impact of LLINs and changing patterns of irrigated rice farming on entomological parameters, and to determine associations with LLINs coverage and other contextual factors.; In Bozi, high proportion of LLIN usage was observed (95-100%). After six months, 95% of LLINs were washed at least once and 79% were washed up to three times within one year. Anopheles gambiae was the predominant malaria vector (66.6% of all mosquitoes caught). From 2009 to 2012, in N'Dakonankro, the mean annual entomological inoculation rate (EIR) increased significantly from 116.8 infectious bites/human/year (ib/h/y) to 408.8 ib/h/y, while in the intervention villages, the EIR decreased significantly from 514.6 ib/h/y to 62.0 ib/h/y (Bozi) and from 83.9 ib/h/y to 25.5 ib/h/y (Yoho). The risk of an infectious bite over the three-year period was significantly lower in the intervention villages compared to the control village (p >0.001).; High coverage and sensitization of households to use LLINs through regular visits (particularly in Bozi) and abandoning irrigated rice farming (in Yoho) resulted in highly significant reductions of EIR. The national malaria control programme should consider household sensitization and education campaigns and other contextual factors to maximize the benefit of LLINs
