History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use...History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the Bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to December 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the Bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.展开更多
Goals: The aim of this study was to determine the antibiotic resistance profile of serotypes of Streptococcus pneumoniae strains circulating in Bangui. Methodology: A prospective and analytical analysis was carried ou...Goals: The aim of this study was to determine the antibiotic resistance profile of serotypes of Streptococcus pneumoniae strains circulating in Bangui. Methodology: A prospective and analytical analysis was carried out at the National Laboratory of Clinical Biology and Public Health from 2017 to 2022. The strains came from our study on the contribution to the study of antibiotic sensitivity of Streptococcus pneumoniae strains. The multiplex PCR test was used for its cost-effectiveness in terms of amplifiers which can be purified in order to be sequenced. It also makes it possible to detect several germs as well as their serotypes. For a PCR reaction, several elements are involved in the reaction medium or Master Mix. These are the desoxyribonucleotides (dNTPs), the magnesium ions (MgCl2) and the primers. A set of 14 primers divided into 3 classes were used. Class 1 primers served as an internal control by targeting the cpsA gene. It is a highly conserved gene found in capsular loci characterized to date. The primers of the second class were used to target specific serotypes by specific reactions (out of six possibilities). The group reaction was carried out using the primers of the third class in order to carry out an initial screening of the samples and to classify the pneumococcal isolates. Related serotypes were grouped based on the amplification of common genes. Using the technique of electrophoresis on agarose gel and an ultraviolet radiation device, the migration bands are then visualized and analyzed. The data collected had been entered into Excel 2010 and analyzed with Epi info 7. The exact Fischer chi2 test at the 5% threshold, the relative risk and its 95% confidence interval were used to compare the proportions and determine the associations. Results: 187 antibiotic-resistant strains of Streptococcus pneumoniae were collected. The average frequency of serotypes 1, 9A, 4 and untypeable identified were 43.59%, 18.18%, 18.27% and 39.57% respectively. The frequency of serotype 1 was predominant for the age展开更多
Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way a...Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.展开更多
Introduction: In many societies, sexuality is still a taboo subject. In the Central African Republic, this topic is rarely discussed outside the context of gynecological consultations and infertility, whereas the sexu...Introduction: In many societies, sexuality is still a taboo subject. In the Central African Republic, this topic is rarely discussed outside the context of gynecological consultations and infertility, whereas the sexual life of couples is often disrupted by the arrival of a child, particularly by the ordeal of childbirth. The aim of the study is to analyze the sexual experience of Central African women after childbirth in order to contribute to improving the health of the population, in particular that of mother and child, and to facilitate harmony within the couple. Methodology: Descriptive and analytical cross-sectional study covering the period from July 1 to August 30, 2023, at the maternity ward of the Center University Hospitalier Communautaire. The study concerned only women who had given birth between the second week and the sixth month postpartum. The sampling was exhaustive. Results: A total of 303 women agreed to take part in our study, aged between 15 and 44, more than half of whom had completed secondary school. The eagerness of the women to take part in the study shows that they are ready to express themselves about their sexuality despite certain biases linked to the method of patient selection. Resumption of sexual relations was initiated by the partners within six weeks in the vast majority of cases. Conclusion: Resumption of sexual intercourse was delayed, often at the partner’s initiative. Further studies are needed to understand the cultural, religious and psychological dimensions of postpartum sexuality in the Central African context.展开更多
Background: In Central African Republic, a study carried out in 2019 highlighted the limits of conventional radiography in the diagnosis of non-traumatic lower back pain in adults. Objective: The objective of this stu...Background: In Central African Republic, a study carried out in 2019 highlighted the limits of conventional radiography in the diagnosis of non-traumatic lower back pain in adults. Objective: The objective of this study is to show the value of CT scanning in the exploration of non-traumatic pathologies of the lumbar spine in adults. Patients and Method: Retrospective and descriptive cross-sectional study covering the files of patients aged at least 18 years old, sent for lumbar scanning from March 1 to December 31, 2021 at the medical imaging center. Results: In total, 593 scan examinations were performed including 159 (26.8%) examinations of the lumbar spine. The average age of the patients was 49.84 years. The majority were male (66%). 127 (79.8%) were referred mainly to the neurology and rheumatology departments. Common low back pain (n = 97, 61%) was the main reason for requesting a CT scan. The lumbar scan was performed without contrast product in 88.7% of cases. In total, 148 (93.1%) examinations were pathological and dominated by overall disc overhang (62.2%) and somatic and interapophyseal osteoarthritis (16.9%). The other lesions were spondylodiscitis (7.4%), tumor-like lesions (3.4%) and narrow lumbar canal (1.4%).展开更多
Introduction: Cranioencephalic exploration has always played a major role in CT scans. In the Central Africa Republic (CAR), the lack of cross-sectional imaging before the year 2020 meant that no study had focused on ...Introduction: Cranioencephalic exploration has always played a major role in CT scans. In the Central Africa Republic (CAR), the lack of cross-sectional imaging before the year 2020 meant that no study had focused on cranioencephalic lesions. The aim of this study was to contribute to improving the management of cranioencephalic pathologies in CAR. Patients and Method: The study took place at the Bangui National Medical Imaging Centre (CNIMB). It was a retrospective study over a two-year period (March 1, 2021 to February 30, 2023). All patients referred for cranioencephalic CT scans were included, regardless of age or sex. Results: 1745 CT scans were performed, 575 of which were cranioencephalic CT scans. The majority of patients were male (53%). Most lived in the capital Bangui (90.9%). Patients aged 61 and over were the most representative. The distribution of patients by requesting department showed that the reception and emergency department was one of the least requesting departments. The main abnormalities observed were strokes, 82.1% of which were ischaemic strokes and 17.9% haemorrhagic strokes. Strokes were followed by degenerative lesions. Post-traumatic injuries included haemorrhagic contusions (38.3%), subdural haematomas in 20.5% of cases, and extradural haematomas (9.3%). Craniofacial lesions (fractures) were observed in 45.8% of cases. Conclusion: Cranioencephalic scans accounted for 1/3 of CT examinations performed during the study period. It revealed pathologies that could not be detected by conventional means. All in all, CT scans contributed to the diagnosis of cerebral pathologies.展开更多
The conflict between poverty and the resulting over-exploitation of natural resources on the one hand, and ecological restoration and sustainable development on the other hand, in the southwest China karst region was ...The conflict between poverty and the resulting over-exploitation of natural resources on the one hand, and ecological restoration and sustainable development on the other hand, in the southwest China karst region was studied. In this region, the karst forest (a mixed evergreen and deciduous broad-leaved forest) is rapidly degrading due to over-exploitation (sloping farming). We suggest that an Ecological Compensation (EC) model should be established with: financial institutions, local people, and a third part as an intermediate link. The process would continue for 20 years. As a case study we used Bangui town (3800 families) in the upper reaches of Pearl River. The per capita income of residents was used as the benchmark. The compensation would start with 80%, and decrease to 20% over a period of 20 years. Infrastructure investment would decrease from 20% of the total person’s compensation to 5% as the farmers increasingly use alternative income sources. The EC includes compensation for individual, infrastructure, and environmental investments. The total EC for Bangui would be 305,064 × 104 yuan during the 20 years.展开更多
Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries...Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1<sup>st</sup>, 2017 to December 31<sup>st</sup>, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi<sup>2</sup> = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi<sup>2</sup> = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi<sup>2</sup> = 108.73;p < 0.001), CD4 count 200/mm<sup>3</sup> (OR = 14.12 [4.03 - 57.20];Khi<sup>2</sup> = 21.68;p < 0.001), viral load > 1000 copies/mm<sup>3</sup> (OR = 8.85 [2.33 - 43.20];Khi<sup>2</sup> = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi<sup>2</sup> = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi<sup>2</sup> = 40.60;p <sup>2</sup> = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi<sup>2</su展开更多
Microscopy-positive and drug-resistant pulmonary tuberculosis (MPT+) is one of the most feared diseases due to the cost of its management and the associated mortality. The GeneXpert, a new molecular test, is in greate...Microscopy-positive and drug-resistant pulmonary tuberculosis (MPT+) is one of the most feared diseases due to the cost of its management and the associated mortality. The GeneXpert, a new molecular test, is in greater demand for the diagnosis of MPT+ resistance cases. The application of GeneXpert to new cases of MPT+ is not effective in the country’s TB screening centres. The objective of this study is to assess the contribution of GeneXpert to the determination of MPT+ resistance cases in Bangui. The study was cross-sectional and covered the period from February to July 2022. The diagnosis of tuberculosis was first performed by microscopy with Ziehl Neelsen hot stain. The GeneXpert was then used to test for resistance in the sputum of all patients with positive microscopy. The collected data was entered into Excel 2013 and analysed with Epi Info 3.3.7. We analysed data from 755 patients, 80 of whom had resistance. The 80 patients ranged in age from 6 to 68 years (mean age = 35 years). The prevalence of resistant TB was 10.60% (80/755). Primary resistance accounted for 73.75% and secondary resistance for 26.25%. The age group 20 - 39 years (57.50%), male (72.50%), 8th district (17.50%), people living in couples (53.75%), farmers (13.75%) were the socio-demographic characteristics most affected by resistance. Treatment failure (13.75%), relapses (13.75%), the notion of contagion (28.75%), a history of smoking (40%) and alcohol (61.25%) were the clinical antecedents reported by the patients. Treatment failure and relapse were the variables associated with the occurrence of resistant PMT+ (p 0.05). A considerable proportion of the overall Mycobacterium tuberculosis resistance to anti-tuberculosis drugs (10.60%) was identified by GeneXpert. Treatment failure and relapse were the factors associated with the risk of resistance.展开更多
Introduction: Hepatitis B virus (HBV) infection is a public health problem in sub-Saharan Africa, due to its frequency and progression to complications such as cirrhosis and/or hepatocellular carcinoma (HCC). Objectiv...Introduction: Hepatitis B virus (HBV) infection is a public health problem in sub-Saharan Africa, due to its frequency and progression to complications such as cirrhosis and/or hepatocellular carcinoma (HCC). Objective: To help improve the management of cirrhosis and hepatocellular carcinoma. Patients and Methods: This was a 34-month cross-sectional study conducted in the Hepato-Gastroenterology Department of the CHU de l’Amitié Sino-centra-fricaine in Bangui. It included patients of both sexes aged 18 years or older with a diagnosis of HBV-related cirrhosis and/or HCC. Results: During the study period, 1344 patients were admitted to hospital, 681 of them for chronic liver disease (51%). Among patients admitted for chronic liver disease, in particular cirrhosis and/or HCC, HBV was implicated in 288 cases (42.30%), of whom 170 (24.96%) met our inclusion criteria. These included 123 men (72.35%) and 47 women (27.65%). The sex ratio was 2.61. The mean age of our patients was 40 years (±11 years) with extremes of 18 and 76 years. Cirrhosis was observed in 101 cases (59.41%), HCC on cirrhosis in 59 cases (34.70%) and HCC in 10 cases (5.89%). Cirrhosis was classified as Child-Pugh B in 62 cases and C in 20 cases. HCC on cirrhosis was classified according to BCLC stage C in 7 cases and stage D in 52 cases. Conclusion: HBV is the leading cause of cirrhosis and HCC in the Central African Republic. Chronic liver disease is diagnosed at the advanced stage of the disease. Hence the importance of early detection, prevention through vaccination at birth, and management of infected patients.展开更多
Accidental acute upper airway obstruction (UAO) is a common situation in pediatric emergencies. It is a source of morbidity and even mortality, particularly in children under 3 years of age. We report a clinical case ...Accidental acute upper airway obstruction (UAO) is a common situation in pediatric emergencies. It is a source of morbidity and even mortality, particularly in children under 3 years of age. We report a clinical case of traumatic foreign body injury to the upper aerodigestive tract in a 7-year-old girl following a play accident.展开更多
Background: Bacterial meningitis is a major public health problem worldwide due to its severity. It is a vaccine-preventable disease. Methodology: It was a retrospective descriptive study conducted at the Pediatric Te...Background: Bacterial meningitis is a major public health problem worldwide due to its severity. It is a vaccine-preventable disease. Methodology: It was a retrospective descriptive study conducted at the Pediatric Teaching Hospital of Bangui from June 2019 to May 2021. Children aged 1 month to 15 years hospitalized for bacterial meningitis were included in the study. Data were entered and analyzed using Stata/IC version 16.1. Results: Of 2490 patients hospitalized during the study period, 122 (4.9%) had bacterial meningitis. The patients were male in 54.92% of cases with a sex ratio of 1.21. The mean age was 35.95 months ± 49.16. Most of the patients (84.42%) came directly from home. The average consultation delay was 3.4 days ± 2.6. The vaccination coverage was 56.55%. The CSF study isolated germs from 24 patients (19.67%), the main ones being S. pneumoniae (75%) and H. influenzae (16.67%). Ceftriaxone was prescribed alone or in combination in all cases as first-line treatment. The average duration of antibiotic therapy was 8.95 days. The mortality rate was 27.87% and 12.30 % of patients had sequelae. Conclusion: Bacterial meningitis is common in Bangui and still poses a public health problem despite the introduction of new vaccines in the EPI. Improving vaccination coverage and raising awareness for early consultation could improve the situation.展开更多
Background: The advent of antiretroviral treatment has considerably increased the life expectancy of people living with HIV in recent years. The Central African Republic, despite challenges related to the socio-politi...Background: The advent of antiretroviral treatment has considerably increased the life expectancy of people living with HIV in recent years. The Central African Republic, despite challenges related to the socio-political context, is committed to achieving the UNAIDS 90-90-90 targets and to the elimination of AIDS by 2030 advocated by the WHO. Objective: To analyze survival among HIV-positive adult patients on antiretroviral therapy from 2015 to 2020. Methods: This was a history-based cohort study of patients started on ART. The main variable was survival. The Kaplan-Meier method was used to describe the survival curve since inclusion in the cohort and a multivariate Cox model was used to investigate factors associated with mortality on ART. Results: A total of 145 naive patients started ART at the Outpatient Treatment Centre (OTC) in 2015. A female predominance was observed in our study with 78.08% of cases. The analysis of the patients’ fate at the time of point of treatment showed that 58.62% of them were still in active care and 13.10% died. The probability of survival at 5 years was 0.82 and mortality was significantly associated with very advanced disease (WHO stage IV) (p = 0.047) and anemia (p = 0.039). Conclusion: The majority of patients were still in care at the endpoint and mortality was significantly related to advanced disease and anemia. Early management of people living with HIV combined with better quality of care would improve their survival.展开更多
<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Hepatitis B Virus (HBV) and Human Immunodeficiency Virus </span>...<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Hepatitis B Virus (HBV) and Human Immunodeficiency Virus </span><span style="font-family:Verdana;">(HIV) infection is a public health problem worldwide, particularly in sub-Saharan </span><span style="font-family:""><span style="font-family:Verdana;">Africa. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> to compare the epidemiological, clinical and biological characteristic</span></span><span style="font-family:""><span style="font-family:Verdana;">s of chronic HBV and HIV infection in blood donors at the National Center for Blood Transfusion (NCBT) in Bangui. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> This was an 8-month analytical cross-sectional study from August 10, 2011 to April 9, 2012. During this study, we consecutively enrolled consenting blood donors of both sexes in which the search for HBsAg and HIV infection was </span><span><span style="font-family:Verdana;">carried out. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period, 850 blood donors were collected</span></span><span style="font-family:Verdana;">. H</span><span style="font-family:Verdana;">BsAg was found in 142 donors (16.7%), of whom 55 blood donors (6.5%</span><span style="font-family:Verdana;">) were coinfected with HIV. On the other hand, HIV serology was positive in 77 blood donors (9.1%) including 55 co-infected (6.5%) with HBV. In order to better compare the risk factors, we have not included HIV-HBV coinfected patients. Only 795 blood donors were selected for the risk factor study. There were 87 cases of HBsAg positive (10.9%) and 22 cases of HIV positive (2.8%). </span><span style="font-family:Verdana;">The average age of HIV and HBV infected patients was 25.7 and 26.2 years</span><span style="font-family:Verdana;">, </span><span style="font-fam展开更多
<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Despite the Maternal and Neonatal Tetanus (MNT) elimination initiative, neon...<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Despite the Maternal and Neonatal Tetanus (MNT) elimination initiative, neonatal tetanus still persists in some parts of the world. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To determine hospital prevalence and describe epidemiological, clinical, therapeutic and outcome aspects of neonatal tetanus at the Pediatric Teaching Hospital in Bangui. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">It was the review of hospitalized newborns’ files in the neonatal unit at Pediatric Teaching Hospital in Bangui between January 2016 and December 2019. Newborns discharged with tetanus diagnosis, and whose files were usable were included. The variables studied were: for the newborn: age, sex, birth weight, the reason for transfer, diagnosis, cause and time of death, place and method of delivery;for the mother: age, antenatal care, tetanus vaccine status, parity and geographical provenance. Epi Info 7 software, version 7.1.3.3 was used for data analysis. The chi2 test with the significance level set at p < 0.05 and the odds ratio were used. </span><b><span style="font-family:Verdana;">Résultats: </span></b><span style="font-family:Verdana;">Forty-eight (48) out of 5796 newborns had neonatal tetanus (0.8%).</span><span style="font-family:Verdana;"> They were newborns to mothers with an average age of 18.8 years of which 68.8% (n = 33) were primipara and 87.5% (n = 42) not vaccinated against tetanus. Childbirth happened at home in 91.7% (n = 44), and the blade was used for sectioning the umbilical cord in 39.6% (n = 19). Newborns were referred from rural area in 47.9% (n = 23). A single antenatal care contact was done in 68.7% (n = 33). Tetanus was classified as severe according to the Dakar prognosis score between 4 and 6 in 89.6% of cases (n = 43). The death occurred in 58.3% (n = 28). </span><b><span style="font-family:展开更多
<strong>Introduction:</strong><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">The majority...<strong>Introduction:</strong><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">The majority of pregnancies and births go off without incident even though they all present risks. Retro-placental hematoma (RPH) is an extreme obstetric emergency. The aim of our study was to assess the maternal-fetal prognosis of this pathology in our patients. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">This is a retrospective descriptive and analytical study over 5 years ranging from the period from January 1st, 2015 to December 31st, 2019. The study</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s population consisted of pregnant women, in the 3rd trimester, who </span><span style="font-family:Verdana;">were </span><span style="font-family:Verdana;">presented with the retro-placental</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">hematoma during the pregnancy or childbirth and taken care of in the maternity ward of the Centre Hospitalier Universitaire Communautaire. </span><b><span style="font-family:Verdana;">Results:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">During our study period, we recorded 87 cases of retro-placental hematoma</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">and 40</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;">763 deliveries. The frequency of retro-placental hematoma was</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.21% at delivery. The average maternal age was 26.4 years with extremes of 16 and 40 years. The parity</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s average was 3.8 with extremes of 1 and 13. The mean gestational age at the time of the ons展开更多
Introduction: Cirrhosis is the final stage in the development of any chronic liver disease. The objective of our study was to determine the therapeutic route of patients with cirrhosis. Patients and Methods: This was ...Introduction: Cirrhosis is the final stage in the development of any chronic liver disease. The objective of our study was to determine the therapeutic route of patients with cirrhosis. Patients and Methods: This was a one-year cross-sectional study of consenting patients of both sexes with cirrhosis who were hospitalized for the first time. The study took place from October 1, 2013 to September 30, 2014. The diagnosis of cirrhosis was based on clinical, biological and morphological arguments. Results: In total, 1028 patients were hospitalized, including 202 for cirrhosis (19.6%). One hundred and four patients (10.1%) met our inclusion criteria. These were 70 men (67.3%) and 34 women (32.7%). The sex ratio was 2.05. The average age was 43.74 ± 13.74 years. In 68 cases (65.4%), cirrhosis was considered a supernatural disease and in 36 cases (34.6%) was a natural disease. At the first signs, 88 patients (84.6%) had consulted (traditional healer in 34 cases, pastor in 25 cases, marabout in 16 cases and general practitioner in 13 cases). The pastor prayed to 25 patients (24%). The traditional healer made the patients ingest herbal preparations (n = 18), associated or not with scarification (n = 4) and/or enema (n = 28). The marabout recited Quranic verses written on a board, then washed and ingested in 16 cases (15.4%). The general practitioner prescribed treatment to the 13 patients (12.5%). The various treatments received had led to hepatic encephalopathy (21 cases), digestive hemorrhage (15 cases), abdominal pain (3 cases), jaundice (3 cases), increased abdominal bloating (21 cases). The patients had consulted the specialist within an average of 74 ± 15.3 days. The average time to hospital was 21 days ± 13. Conclusion: Cirrhosis is diagnosed at the complication stage due to inappropriate treatment by pastors, marabouts and the general practitioner. The population must be made aware of the early use of health care facilities.展开更多
Objective: To describe the epidemiological, clinical, biological and morphological aspects of primary liver cancer (PLC). Patients and Methods: We conducted a 38-month cross-sectional study in the Department of hepato...Objective: To describe the epidemiological, clinical, biological and morphological aspects of primary liver cancer (PLC). Patients and Methods: We conducted a 38-month cross-sectional study in the Department of hepatogas-troenterology and Internal Medicine “Amitié Sino-Centrafraine” University Hospital Center in Bangui. Included in the study were all patients with a diagnosis of PLC. The PLC’s diagnostic arguments were the large tumor liver associated or not with the elevation of alpha-fetoprotein, the heteronodular liver hypervascularized on abdominal ultrasound. Data analysis was done using Epi Info 3.5.1 software. Results: We collected 115 cases of CPF among 2410 hospitalized patients (4.7%). There were 86 men and 29 women (sex ratio: 2.9). The average age was 50 years old. The main risk factors were alcohol consumption (72.2%) and chronic hepatitis B infection (67.4%). Frequent clinical signs were pain in the right hypochondrium and/or epigastric (93.86%), large tumor liver under examination (91.3%), weight loss (74.78%). The serum alpha-fetoprotein concentration was ≥ 400 ng/ml in 73% of the cases. The abdominal ultrasound found a heteronodular liver in all patients. The nodules were multiple hyperechoic in 66.1% of the cases. According to the Child-Pugh classification, the patients were classified as B (49.5%) and C (33.9%). The Okuda Classification ranked patients at stage 1 in 16.5% cases, stage 2 in 52.1% cases and stage 3 in 31.3% cases. According to the BCLC classification, 5.2% of patients were in stage A, 12.2% in stage B, 52.2 in stage C and 30.4% in stage D. Death was recorded during hospitalization in 89 cases (77.4%). Conclusion: CPF is a frequent and serious pathology in Bangui. Its diagnosis is often late, preventing curative treatment. The main causes are alcohol consumption and the hepatitis B virus. The population should be educated to reduce the incidence of this disease.展开更多
Background: Rotavirus is the most common pathogen of severe acute diarrhea in children under five years of age worldwide. Objective: The objective of this study was to determine the morbidity and mortality of rot...Background: Rotavirus is the most common pathogen of severe acute diarrhea in children under five years of age worldwide. Objective: The objective of this study was to determine the morbidity and mortality of rotavirus diarrhea while describing the seasonal kinetics of the infection according to climatic parameters in Bangui. Methodology: This was a descriptive and analytical cross-sectional study conducted from January 1, 2011 to December 31, 2020 in the Central African Republic (CHUPB). The health data were recorded and processed with the Access 2019 software, then analyzed with the STATA version 14 software. The climatic trends in the study area and its seasonal variations were highlighted by the monthly rainfall coefficient of Alfred Angot: Cm = 12 Pm/P. Results: Morbidity was 45.99% of cases. The 1 to 12 months old represented 93.81% of cases. The mean age of the children was 6.8 months, the sex ratio was 1.20. The symptomatic triad was diarrhea (100%), vomiting (90.20%) and fever (87.5%). Moderate dehydration was reported in 81.05% of cases. The main genotype combinations found were P[8]G1 in 34.02% (n = 115/338), P[6]G1 in 21.59% (n = 73/338) and P[6]G2 in 16.86% (n = 57/338). Case fatality was 11.45%. The risk of death was influenced by rural origin, severe dehydration, hypovolemic cloc and duration of hospitalization > 5 days. Low rainfall correlated with the highest rates of rotavirus diarrhea. Likewise, high temperature correlated with the highest number of cases of rotavirus diarrhea. Conclusion: Acute rotavirus diarrhea is an important morbidity and mortality issue in children under 5 years old in Bangui.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Introduction:</strong> Stroke is a major public health problem even more dramatic in young peopl...<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Introduction:</strong> Stroke is a major public health problem even more dramatic in young people. <strong>Goal of the study:</strong> To make our contribution to the knowledge of strokes of the young subject. <strong>Methodology:</strong> It was a retrospective study conducted over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Department of Neurology of C between Hospitalier A Sino-Central African Friendship University (CHUSCA) from Bangui. <strong>Results:</strong> During the study, 225 cases of stroke were recorded, including 26 cases in young subjects, representing a hospital frequency of 11.5%. The average age was 42.5 years with extremes ranging from 24 to 49 years. The most represented age group was 45 and 49 with a sex ratio (M/F) of 1.36. The average age for men was 41.93 years compared to 39.27 years for women. Civil servants were in the majority in 50% of the cases. Alcohol was the main FDR (80.8%) followed by hypertension (61.5%) and tobacco (50%). The majority of patients (57.70%) were admitted to neurology after the first 24 hours. Ischemic stroke represented 73.08% compared to 26.92% of AVCH. The lethality was 20.08%. The sequelae were found in 69.20% of cases. Cardiac exploration had found 57.10% of LVH. <strong>Conclusion: </strong>This study confirms a high frequency of stroke in the young subject. The predominance of modifiable FRCVs requires the implementation of a specific strategy based on awareness, early detection and effective and adequate PEC.</span> </div>展开更多
文摘History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the Bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to December 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the Bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.
文摘Goals: The aim of this study was to determine the antibiotic resistance profile of serotypes of Streptococcus pneumoniae strains circulating in Bangui. Methodology: A prospective and analytical analysis was carried out at the National Laboratory of Clinical Biology and Public Health from 2017 to 2022. The strains came from our study on the contribution to the study of antibiotic sensitivity of Streptococcus pneumoniae strains. The multiplex PCR test was used for its cost-effectiveness in terms of amplifiers which can be purified in order to be sequenced. It also makes it possible to detect several germs as well as their serotypes. For a PCR reaction, several elements are involved in the reaction medium or Master Mix. These are the desoxyribonucleotides (dNTPs), the magnesium ions (MgCl2) and the primers. A set of 14 primers divided into 3 classes were used. Class 1 primers served as an internal control by targeting the cpsA gene. It is a highly conserved gene found in capsular loci characterized to date. The primers of the second class were used to target specific serotypes by specific reactions (out of six possibilities). The group reaction was carried out using the primers of the third class in order to carry out an initial screening of the samples and to classify the pneumococcal isolates. Related serotypes were grouped based on the amplification of common genes. Using the technique of electrophoresis on agarose gel and an ultraviolet radiation device, the migration bands are then visualized and analyzed. The data collected had been entered into Excel 2010 and analyzed with Epi info 7. The exact Fischer chi2 test at the 5% threshold, the relative risk and its 95% confidence interval were used to compare the proportions and determine the associations. Results: 187 antibiotic-resistant strains of Streptococcus pneumoniae were collected. The average frequency of serotypes 1, 9A, 4 and untypeable identified were 43.59%, 18.18%, 18.27% and 39.57% respectively. The frequency of serotype 1 was predominant for the age
文摘Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.
文摘Introduction: In many societies, sexuality is still a taboo subject. In the Central African Republic, this topic is rarely discussed outside the context of gynecological consultations and infertility, whereas the sexual life of couples is often disrupted by the arrival of a child, particularly by the ordeal of childbirth. The aim of the study is to analyze the sexual experience of Central African women after childbirth in order to contribute to improving the health of the population, in particular that of mother and child, and to facilitate harmony within the couple. Methodology: Descriptive and analytical cross-sectional study covering the period from July 1 to August 30, 2023, at the maternity ward of the Center University Hospitalier Communautaire. The study concerned only women who had given birth between the second week and the sixth month postpartum. The sampling was exhaustive. Results: A total of 303 women agreed to take part in our study, aged between 15 and 44, more than half of whom had completed secondary school. The eagerness of the women to take part in the study shows that they are ready to express themselves about their sexuality despite certain biases linked to the method of patient selection. Resumption of sexual relations was initiated by the partners within six weeks in the vast majority of cases. Conclusion: Resumption of sexual intercourse was delayed, often at the partner’s initiative. Further studies are needed to understand the cultural, religious and psychological dimensions of postpartum sexuality in the Central African context.
文摘Background: In Central African Republic, a study carried out in 2019 highlighted the limits of conventional radiography in the diagnosis of non-traumatic lower back pain in adults. Objective: The objective of this study is to show the value of CT scanning in the exploration of non-traumatic pathologies of the lumbar spine in adults. Patients and Method: Retrospective and descriptive cross-sectional study covering the files of patients aged at least 18 years old, sent for lumbar scanning from March 1 to December 31, 2021 at the medical imaging center. Results: In total, 593 scan examinations were performed including 159 (26.8%) examinations of the lumbar spine. The average age of the patients was 49.84 years. The majority were male (66%). 127 (79.8%) were referred mainly to the neurology and rheumatology departments. Common low back pain (n = 97, 61%) was the main reason for requesting a CT scan. The lumbar scan was performed without contrast product in 88.7% of cases. In total, 148 (93.1%) examinations were pathological and dominated by overall disc overhang (62.2%) and somatic and interapophyseal osteoarthritis (16.9%). The other lesions were spondylodiscitis (7.4%), tumor-like lesions (3.4%) and narrow lumbar canal (1.4%).
文摘Introduction: Cranioencephalic exploration has always played a major role in CT scans. In the Central Africa Republic (CAR), the lack of cross-sectional imaging before the year 2020 meant that no study had focused on cranioencephalic lesions. The aim of this study was to contribute to improving the management of cranioencephalic pathologies in CAR. Patients and Method: The study took place at the Bangui National Medical Imaging Centre (CNIMB). It was a retrospective study over a two-year period (March 1, 2021 to February 30, 2023). All patients referred for cranioencephalic CT scans were included, regardless of age or sex. Results: 1745 CT scans were performed, 575 of which were cranioencephalic CT scans. The majority of patients were male (53%). Most lived in the capital Bangui (90.9%). Patients aged 61 and over were the most representative. The distribution of patients by requesting department showed that the reception and emergency department was one of the least requesting departments. The main abnormalities observed were strokes, 82.1% of which were ischaemic strokes and 17.9% haemorrhagic strokes. Strokes were followed by degenerative lesions. Post-traumatic injuries included haemorrhagic contusions (38.3%), subdural haematomas in 20.5% of cases, and extradural haematomas (9.3%). Craniofacial lesions (fractures) were observed in 45.8% of cases. Conclusion: Cranioencephalic scans accounted for 1/3 of CT examinations performed during the study period. It revealed pathologies that could not be detected by conventional means. All in all, CT scans contributed to the diagnosis of cerebral pathologies.
文摘The conflict between poverty and the resulting over-exploitation of natural resources on the one hand, and ecological restoration and sustainable development on the other hand, in the southwest China karst region was studied. In this region, the karst forest (a mixed evergreen and deciduous broad-leaved forest) is rapidly degrading due to over-exploitation (sloping farming). We suggest that an Ecological Compensation (EC) model should be established with: financial institutions, local people, and a third part as an intermediate link. The process would continue for 20 years. As a case study we used Bangui town (3800 families) in the upper reaches of Pearl River. The per capita income of residents was used as the benchmark. The compensation would start with 80%, and decrease to 20% over a period of 20 years. Infrastructure investment would decrease from 20% of the total person’s compensation to 5% as the farmers increasingly use alternative income sources. The EC includes compensation for individual, infrastructure, and environmental investments. The total EC for Bangui would be 305,064 × 104 yuan during the 20 years.
文摘Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1<sup>st</sup>, 2017 to December 31<sup>st</sup>, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi<sup>2</sup> = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi<sup>2</sup> = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi<sup>2</sup> = 108.73;p < 0.001), CD4 count 200/mm<sup>3</sup> (OR = 14.12 [4.03 - 57.20];Khi<sup>2</sup> = 21.68;p < 0.001), viral load > 1000 copies/mm<sup>3</sup> (OR = 8.85 [2.33 - 43.20];Khi<sup>2</sup> = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi<sup>2</sup> = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi<sup>2</sup> = 40.60;p <sup>2</sup> = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi<sup>2</su
文摘Microscopy-positive and drug-resistant pulmonary tuberculosis (MPT+) is one of the most feared diseases due to the cost of its management and the associated mortality. The GeneXpert, a new molecular test, is in greater demand for the diagnosis of MPT+ resistance cases. The application of GeneXpert to new cases of MPT+ is not effective in the country’s TB screening centres. The objective of this study is to assess the contribution of GeneXpert to the determination of MPT+ resistance cases in Bangui. The study was cross-sectional and covered the period from February to July 2022. The diagnosis of tuberculosis was first performed by microscopy with Ziehl Neelsen hot stain. The GeneXpert was then used to test for resistance in the sputum of all patients with positive microscopy. The collected data was entered into Excel 2013 and analysed with Epi Info 3.3.7. We analysed data from 755 patients, 80 of whom had resistance. The 80 patients ranged in age from 6 to 68 years (mean age = 35 years). The prevalence of resistant TB was 10.60% (80/755). Primary resistance accounted for 73.75% and secondary resistance for 26.25%. The age group 20 - 39 years (57.50%), male (72.50%), 8th district (17.50%), people living in couples (53.75%), farmers (13.75%) were the socio-demographic characteristics most affected by resistance. Treatment failure (13.75%), relapses (13.75%), the notion of contagion (28.75%), a history of smoking (40%) and alcohol (61.25%) were the clinical antecedents reported by the patients. Treatment failure and relapse were the variables associated with the occurrence of resistant PMT+ (p 0.05). A considerable proportion of the overall Mycobacterium tuberculosis resistance to anti-tuberculosis drugs (10.60%) was identified by GeneXpert. Treatment failure and relapse were the factors associated with the risk of resistance.
文摘Introduction: Hepatitis B virus (HBV) infection is a public health problem in sub-Saharan Africa, due to its frequency and progression to complications such as cirrhosis and/or hepatocellular carcinoma (HCC). Objective: To help improve the management of cirrhosis and hepatocellular carcinoma. Patients and Methods: This was a 34-month cross-sectional study conducted in the Hepato-Gastroenterology Department of the CHU de l’Amitié Sino-centra-fricaine in Bangui. It included patients of both sexes aged 18 years or older with a diagnosis of HBV-related cirrhosis and/or HCC. Results: During the study period, 1344 patients were admitted to hospital, 681 of them for chronic liver disease (51%). Among patients admitted for chronic liver disease, in particular cirrhosis and/or HCC, HBV was implicated in 288 cases (42.30%), of whom 170 (24.96%) met our inclusion criteria. These included 123 men (72.35%) and 47 women (27.65%). The sex ratio was 2.61. The mean age of our patients was 40 years (±11 years) with extremes of 18 and 76 years. Cirrhosis was observed in 101 cases (59.41%), HCC on cirrhosis in 59 cases (34.70%) and HCC in 10 cases (5.89%). Cirrhosis was classified as Child-Pugh B in 62 cases and C in 20 cases. HCC on cirrhosis was classified according to BCLC stage C in 7 cases and stage D in 52 cases. Conclusion: HBV is the leading cause of cirrhosis and HCC in the Central African Republic. Chronic liver disease is diagnosed at the advanced stage of the disease. Hence the importance of early detection, prevention through vaccination at birth, and management of infected patients.
文摘Accidental acute upper airway obstruction (UAO) is a common situation in pediatric emergencies. It is a source of morbidity and even mortality, particularly in children under 3 years of age. We report a clinical case of traumatic foreign body injury to the upper aerodigestive tract in a 7-year-old girl following a play accident.
文摘Background: Bacterial meningitis is a major public health problem worldwide due to its severity. It is a vaccine-preventable disease. Methodology: It was a retrospective descriptive study conducted at the Pediatric Teaching Hospital of Bangui from June 2019 to May 2021. Children aged 1 month to 15 years hospitalized for bacterial meningitis were included in the study. Data were entered and analyzed using Stata/IC version 16.1. Results: Of 2490 patients hospitalized during the study period, 122 (4.9%) had bacterial meningitis. The patients were male in 54.92% of cases with a sex ratio of 1.21. The mean age was 35.95 months ± 49.16. Most of the patients (84.42%) came directly from home. The average consultation delay was 3.4 days ± 2.6. The vaccination coverage was 56.55%. The CSF study isolated germs from 24 patients (19.67%), the main ones being S. pneumoniae (75%) and H. influenzae (16.67%). Ceftriaxone was prescribed alone or in combination in all cases as first-line treatment. The average duration of antibiotic therapy was 8.95 days. The mortality rate was 27.87% and 12.30 % of patients had sequelae. Conclusion: Bacterial meningitis is common in Bangui and still poses a public health problem despite the introduction of new vaccines in the EPI. Improving vaccination coverage and raising awareness for early consultation could improve the situation.
文摘Background: The advent of antiretroviral treatment has considerably increased the life expectancy of people living with HIV in recent years. The Central African Republic, despite challenges related to the socio-political context, is committed to achieving the UNAIDS 90-90-90 targets and to the elimination of AIDS by 2030 advocated by the WHO. Objective: To analyze survival among HIV-positive adult patients on antiretroviral therapy from 2015 to 2020. Methods: This was a history-based cohort study of patients started on ART. The main variable was survival. The Kaplan-Meier method was used to describe the survival curve since inclusion in the cohort and a multivariate Cox model was used to investigate factors associated with mortality on ART. Results: A total of 145 naive patients started ART at the Outpatient Treatment Centre (OTC) in 2015. A female predominance was observed in our study with 78.08% of cases. The analysis of the patients’ fate at the time of point of treatment showed that 58.62% of them were still in active care and 13.10% died. The probability of survival at 5 years was 0.82 and mortality was significantly associated with very advanced disease (WHO stage IV) (p = 0.047) and anemia (p = 0.039). Conclusion: The majority of patients were still in care at the endpoint and mortality was significantly related to advanced disease and anemia. Early management of people living with HIV combined with better quality of care would improve their survival.
文摘<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Hepatitis B Virus (HBV) and Human Immunodeficiency Virus </span><span style="font-family:Verdana;">(HIV) infection is a public health problem worldwide, particularly in sub-Saharan </span><span style="font-family:""><span style="font-family:Verdana;">Africa. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> to compare the epidemiological, clinical and biological characteristic</span></span><span style="font-family:""><span style="font-family:Verdana;">s of chronic HBV and HIV infection in blood donors at the National Center for Blood Transfusion (NCBT) in Bangui. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> This was an 8-month analytical cross-sectional study from August 10, 2011 to April 9, 2012. During this study, we consecutively enrolled consenting blood donors of both sexes in which the search for HBsAg and HIV infection was </span><span><span style="font-family:Verdana;">carried out. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period, 850 blood donors were collected</span></span><span style="font-family:Verdana;">. H</span><span style="font-family:Verdana;">BsAg was found in 142 donors (16.7%), of whom 55 blood donors (6.5%</span><span style="font-family:Verdana;">) were coinfected with HIV. On the other hand, HIV serology was positive in 77 blood donors (9.1%) including 55 co-infected (6.5%) with HBV. In order to better compare the risk factors, we have not included HIV-HBV coinfected patients. Only 795 blood donors were selected for the risk factor study. There were 87 cases of HBsAg positive (10.9%) and 22 cases of HIV positive (2.8%). </span><span style="font-family:Verdana;">The average age of HIV and HBV infected patients was 25.7 and 26.2 years</span><span style="font-family:Verdana;">, </span><span style="font-fam
文摘<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Despite the Maternal and Neonatal Tetanus (MNT) elimination initiative, neonatal tetanus still persists in some parts of the world. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To determine hospital prevalence and describe epidemiological, clinical, therapeutic and outcome aspects of neonatal tetanus at the Pediatric Teaching Hospital in Bangui. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">It was the review of hospitalized newborns’ files in the neonatal unit at Pediatric Teaching Hospital in Bangui between January 2016 and December 2019. Newborns discharged with tetanus diagnosis, and whose files were usable were included. The variables studied were: for the newborn: age, sex, birth weight, the reason for transfer, diagnosis, cause and time of death, place and method of delivery;for the mother: age, antenatal care, tetanus vaccine status, parity and geographical provenance. Epi Info 7 software, version 7.1.3.3 was used for data analysis. The chi2 test with the significance level set at p < 0.05 and the odds ratio were used. </span><b><span style="font-family:Verdana;">Résultats: </span></b><span style="font-family:Verdana;">Forty-eight (48) out of 5796 newborns had neonatal tetanus (0.8%).</span><span style="font-family:Verdana;"> They were newborns to mothers with an average age of 18.8 years of which 68.8% (n = 33) were primipara and 87.5% (n = 42) not vaccinated against tetanus. Childbirth happened at home in 91.7% (n = 44), and the blade was used for sectioning the umbilical cord in 39.6% (n = 19). Newborns were referred from rural area in 47.9% (n = 23). A single antenatal care contact was done in 68.7% (n = 33). Tetanus was classified as severe according to the Dakar prognosis score between 4 and 6 in 89.6% of cases (n = 43). The death occurred in 58.3% (n = 28). </span><b><span style="font-family:
文摘<strong>Introduction:</strong><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">The majority of pregnancies and births go off without incident even though they all present risks. Retro-placental hematoma (RPH) is an extreme obstetric emergency. The aim of our study was to assess the maternal-fetal prognosis of this pathology in our patients. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">This is a retrospective descriptive and analytical study over 5 years ranging from the period from January 1st, 2015 to December 31st, 2019. The study</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s population consisted of pregnant women, in the 3rd trimester, who </span><span style="font-family:Verdana;">were </span><span style="font-family:Verdana;">presented with the retro-placental</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">hematoma during the pregnancy or childbirth and taken care of in the maternity ward of the Centre Hospitalier Universitaire Communautaire. </span><b><span style="font-family:Verdana;">Results:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">During our study period, we recorded 87 cases of retro-placental hematoma</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">and 40</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;">763 deliveries. The frequency of retro-placental hematoma was</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.21% at delivery. The average maternal age was 26.4 years with extremes of 16 and 40 years. The parity</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s average was 3.8 with extremes of 1 and 13. The mean gestational age at the time of the ons
文摘Introduction: Cirrhosis is the final stage in the development of any chronic liver disease. The objective of our study was to determine the therapeutic route of patients with cirrhosis. Patients and Methods: This was a one-year cross-sectional study of consenting patients of both sexes with cirrhosis who were hospitalized for the first time. The study took place from October 1, 2013 to September 30, 2014. The diagnosis of cirrhosis was based on clinical, biological and morphological arguments. Results: In total, 1028 patients were hospitalized, including 202 for cirrhosis (19.6%). One hundred and four patients (10.1%) met our inclusion criteria. These were 70 men (67.3%) and 34 women (32.7%). The sex ratio was 2.05. The average age was 43.74 ± 13.74 years. In 68 cases (65.4%), cirrhosis was considered a supernatural disease and in 36 cases (34.6%) was a natural disease. At the first signs, 88 patients (84.6%) had consulted (traditional healer in 34 cases, pastor in 25 cases, marabout in 16 cases and general practitioner in 13 cases). The pastor prayed to 25 patients (24%). The traditional healer made the patients ingest herbal preparations (n = 18), associated or not with scarification (n = 4) and/or enema (n = 28). The marabout recited Quranic verses written on a board, then washed and ingested in 16 cases (15.4%). The general practitioner prescribed treatment to the 13 patients (12.5%). The various treatments received had led to hepatic encephalopathy (21 cases), digestive hemorrhage (15 cases), abdominal pain (3 cases), jaundice (3 cases), increased abdominal bloating (21 cases). The patients had consulted the specialist within an average of 74 ± 15.3 days. The average time to hospital was 21 days ± 13. Conclusion: Cirrhosis is diagnosed at the complication stage due to inappropriate treatment by pastors, marabouts and the general practitioner. The population must be made aware of the early use of health care facilities.
文摘Objective: To describe the epidemiological, clinical, biological and morphological aspects of primary liver cancer (PLC). Patients and Methods: We conducted a 38-month cross-sectional study in the Department of hepatogas-troenterology and Internal Medicine “Amitié Sino-Centrafraine” University Hospital Center in Bangui. Included in the study were all patients with a diagnosis of PLC. The PLC’s diagnostic arguments were the large tumor liver associated or not with the elevation of alpha-fetoprotein, the heteronodular liver hypervascularized on abdominal ultrasound. Data analysis was done using Epi Info 3.5.1 software. Results: We collected 115 cases of CPF among 2410 hospitalized patients (4.7%). There were 86 men and 29 women (sex ratio: 2.9). The average age was 50 years old. The main risk factors were alcohol consumption (72.2%) and chronic hepatitis B infection (67.4%). Frequent clinical signs were pain in the right hypochondrium and/or epigastric (93.86%), large tumor liver under examination (91.3%), weight loss (74.78%). The serum alpha-fetoprotein concentration was ≥ 400 ng/ml in 73% of the cases. The abdominal ultrasound found a heteronodular liver in all patients. The nodules were multiple hyperechoic in 66.1% of the cases. According to the Child-Pugh classification, the patients were classified as B (49.5%) and C (33.9%). The Okuda Classification ranked patients at stage 1 in 16.5% cases, stage 2 in 52.1% cases and stage 3 in 31.3% cases. According to the BCLC classification, 5.2% of patients were in stage A, 12.2% in stage B, 52.2 in stage C and 30.4% in stage D. Death was recorded during hospitalization in 89 cases (77.4%). Conclusion: CPF is a frequent and serious pathology in Bangui. Its diagnosis is often late, preventing curative treatment. The main causes are alcohol consumption and the hepatitis B virus. The population should be educated to reduce the incidence of this disease.
文摘Background: Rotavirus is the most common pathogen of severe acute diarrhea in children under five years of age worldwide. Objective: The objective of this study was to determine the morbidity and mortality of rotavirus diarrhea while describing the seasonal kinetics of the infection according to climatic parameters in Bangui. Methodology: This was a descriptive and analytical cross-sectional study conducted from January 1, 2011 to December 31, 2020 in the Central African Republic (CHUPB). The health data were recorded and processed with the Access 2019 software, then analyzed with the STATA version 14 software. The climatic trends in the study area and its seasonal variations were highlighted by the monthly rainfall coefficient of Alfred Angot: Cm = 12 Pm/P. Results: Morbidity was 45.99% of cases. The 1 to 12 months old represented 93.81% of cases. The mean age of the children was 6.8 months, the sex ratio was 1.20. The symptomatic triad was diarrhea (100%), vomiting (90.20%) and fever (87.5%). Moderate dehydration was reported in 81.05% of cases. The main genotype combinations found were P[8]G1 in 34.02% (n = 115/338), P[6]G1 in 21.59% (n = 73/338) and P[6]G2 in 16.86% (n = 57/338). Case fatality was 11.45%. The risk of death was influenced by rural origin, severe dehydration, hypovolemic cloc and duration of hospitalization > 5 days. Low rainfall correlated with the highest rates of rotavirus diarrhea. Likewise, high temperature correlated with the highest number of cases of rotavirus diarrhea. Conclusion: Acute rotavirus diarrhea is an important morbidity and mortality issue in children under 5 years old in Bangui.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Introduction:</strong> Stroke is a major public health problem even more dramatic in young people. <strong>Goal of the study:</strong> To make our contribution to the knowledge of strokes of the young subject. <strong>Methodology:</strong> It was a retrospective study conducted over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Department of Neurology of C between Hospitalier A Sino-Central African Friendship University (CHUSCA) from Bangui. <strong>Results:</strong> During the study, 225 cases of stroke were recorded, including 26 cases in young subjects, representing a hospital frequency of 11.5%. The average age was 42.5 years with extremes ranging from 24 to 49 years. The most represented age group was 45 and 49 with a sex ratio (M/F) of 1.36. The average age for men was 41.93 years compared to 39.27 years for women. Civil servants were in the majority in 50% of the cases. Alcohol was the main FDR (80.8%) followed by hypertension (61.5%) and tobacco (50%). The majority of patients (57.70%) were admitted to neurology after the first 24 hours. Ischemic stroke represented 73.08% compared to 26.92% of AVCH. The lethality was 20.08%. The sequelae were found in 69.20% of cases. Cardiac exploration had found 57.10% of LVH. <strong>Conclusion: </strong>This study confirms a high frequency of stroke in the young subject. The predominance of modifiable FRCVs requires the implementation of a specific strategy based on awareness, early detection and effective and adequate PEC.</span> </div>
