Prevalence and awareness of diabetes in Guinea: findings from a WHO STEPS

Aims: The aim of the present study was to determine the prevalence of diabetes, and to assess its awareness and related risk factors among adult Guineans.Methods: A population-based cross-sectional survey was conducted on 1 100  adults (46.6% women) aged 35–64 years from Lower Guinea, during September to December 2009, using the WHO STEPwise approach of surveillance of chronic  disease risk factors. Data were collected in three steps: demographic and  behavioural risk factors, blood pressure and anthropometric measurements, and fasting blood cholesterol and glucose testing. A multi-stage cluster sample design was applied to generate nationwide representative data.Results: The mean age of all participants was 47.3 years (SD 8.8), similarly in  Conakry, rural Lower Guinea and urban Lower Guinea. The prevalence of diabetes was 5.7% (95% CI 4.0–8.1). Among participants with diabetes, only 44.0% were aware of their status. In multivariable logistic regression analysis, determinants of diabetes prevalence were urban residency, male sex, age group 45–64 years, increased waist circumference, hypertension and hypercholesterolemia. Male sex, rural residency, age group 45–54 years, no formal education, waist circumference, hypertension and hypercholesterolemia were independent predictors of screen-detected diabetes.Conclusion: The present study found a high prevalence and low awareness of  diabetes, suggesting the need for appropriate actions to strengthen primary  healthcare approaches towards non-communicable diseases in Guinea.Keywords: Diabetes, epidemiology, Guine

Obstetric emergencies in the maternity ward of the Ignace Deen national hospital CHU of Conakry: sociodemographic, therapeutic and maternal fetal prognosis aspects

Background: Despite government efforts to reduce maternal mortality, the risk of a woman dying from obstetric complications is about one in six in the poorest regions of the world compared to one in thirty thousand in North Europe. The objective was therefore to describe the clinical socio-demographic aspects and to establish the maternal and fetal prognosis of obstetric emergencies.Methods: This was a descriptive cross-sectional prospective study over a 6-month period from January 1 to June 30, 2020 carried out at the maternity ward of the Ignace Deen national hospital (Conakry university hospital) in Guinea. The study looked at a continuous series of 662 obstetric emergency cases.Results: The frequency of admission of obstetric emergencies was 22.62%. They concerned young women (29.5 years old) on average, first-time mothers (53.32%), with low income professional activities, evacuated from a peripheral maternity unit (63.14%), no schooling (44.9%), married (92.3%), using the more often a means of public transport (66.5%) and whose pregnancies were poorly monitored (63.9%). Fetal emergencies were dominated by acute fetal distress (91.3%) and maternal emergencies were dominated by hypertensive emergencies (pre-eclampsia and eclampsia 37.44%) followed by hemorrhagic emergencies (last trimester hemorrhage and postpartum hemorrhage 34.34%). Pregnant and parturient women were more frequently admitted to labor (62.7%) and gave birth more frequently by caesarean section (86.70%). the staff reacted promptly to make a treatment decision in 75.5% of cases within fifteen minutes. emergency procedures were performed in less than fifteen minutes in almost all cases (97.4%), specific treatment was carried out in less than an hour in the majority of cases (68.3%). The maternal case fatality rate was 4.1% with the main cause of death being hemorrhagic shock of 51.8%. The stillbirth rate was 17.4%.Conclusions: The anticipation of emergency obstetric care (SOU) and close collaboration between the obstetrician, the anesthesiologist-resuscitator are essential in the management of obstetric emergencies

Creating a National Specimen Referral System in Guinea: Lessons From Initial Development and Implementation

In the wake of the 2014–2016, West Africa Ebola virus disease (EVD) outbreak, the Government of Guinea recognized an opportunity to strengthen its national laboratory system, incorporating capacity and investments developed during the response. The Ministry of Health (MOH) identified creation of a holistic, safe, secure, and timely national specimen referral system as a priority for improved detection and confirmation of priority diseases, in line with national Integrated Disease Surveillance and Response guidelines. The project consisted of two parts, each led by different implementing partners working collaboratively together and with the Ministry of Health: the development and approval of a national specimen referral policy, and pilot implementation of a specimen referral system, modeled on the policy, in three prefectures. This paper describes the successful execution of the project, highlighting the opportunities and challenges of building sustainable health systems capacity during and after public health emergencies, and provides lessons learned for strengthening national capabilities for surveillance and disease diagnosis

Acute Arboviral Infections in Guinea, West Africa, 2006

Acute febrile illnesses comprise the majority of the human disease burden in sub-Saharan Africa. We hypothesized that arboviruses comprised a considerable proportion of undiagnosed febrile illnesses in Guinea and sought to determine the frequency of arboviral disease in two hospitals there. Using a standard case definition, 47 suspected cases were detected in approximately 4 months. Immunoglobulin M antibody capture enzyme-linked immunosorbent assays and plaque-reduction neutralization assays revealed that 63% (30/47) of patients were infected with arboviruses, including 11 West Nile, 2 yellow fever, 1 dengue, 8 chikungunya, and 5 Tahyna infections. Except for yellow fever, these are the first reported cases of human disease from these viruses in Guinea and the first reported cases of symptomatic Tahyna infection in Africa. These results strongly suggest that arboviruses circulate and are common causes of disease in Guinea. Improving surveillance and laboratory capacity for arbovirus diagnoses will be integral to understanding the burden posed by these agents in the region

Resurgence of Ebola virus in 2021 in Guinea suggests a new paradigm for outbreaks

These authors contributed equally: Alpha K. Keita, Fara R. Koundouno, Martin Faye, Ariane Düx, Julia Hinzmann.International audienc

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Diseño y aplicación de un procedimiento para la planificación energética según la NC-ISO 50001:2011

In this paper we designed and implemented a process for considering energy planning requirements of the NC-ISO 50001: 2011 ¨Energy Management¨. The premise was to design requirements of international standards related to energy management ISO 50001: 2011, UNE 216301: 2007, DIN EN 16001, ANSI / MSE 2000: 2008 and quality management ISO 9001: 2008. For application was selected as a case study Hydraulics Company Cienfuegos, using tools and techniques such as: working with experts, review of documents, tools Total Technology Management Energy Efficient and quality, obtaining as results the energy planning, through the determination of the structure of energy consumption, significant consumption areas, which led to establish base line and energy goal of the organization.En el presente trabajo se diseñó y aplicó un procedimiento para la planificación energética teniendo en cuenta los requerimientos de la NC-ISO 50001: 2011 ¨Gestión de la energía¨. El diseño tuvo como premisas requisitos de las normas internacionales relacionadas con la gestión de la energía ISO 50001: 2011, UNE 216301: 2007, DIN EN 16001, ANSI/MSE 2000: 2008 y de gestión de la calidad ISO 9001: 2008. Para la aplicación se seleccionó como caso de estudio la Empresa Oleohidráulica Cienfuegos, utilizándose herramientas y técnicas, tales como: trabajo con expertos, revisión de documentos, las herramientas de la Tecnología de Gestión Total Eficiente de la Energía y de calidad, obteniéndose como resultados la planificación energética, a través de la determinación de la estructura de consumo energético, las áreas de consumo significativo , lo que conllevó a establecer la línea base y meta energética de la organización

Obstetric emergencies in the maternity ward of the Ignace Deen national hospital CHU of Conakry: sociodemographic, therapeutic and maternal fetal prognosis aspects

Background: Despite government efforts to reduce maternal mortality, the risk of a woman dying from obstetric complications is about one in six in the poorest regions of the world compared to one in thirty thousand in North Europe. The objective was therefore to describe the clinical socio-demographic aspects and to establish the maternal and fetal prognosis of obstetric emergencies.Methods: This was a descriptive cross-sectional prospective study over a 6-month period from January 1 to June 30, 2020 carried out at the maternity ward of the Ignace Deen national hospital (Conakry university hospital) in Guinea. The study looked at a continuous series of 662 obstetric emergency cases.Results: The frequency of admission of obstetric emergencies was 22.62%. They concerned young women (29.5 years old) on average, first-time mothers (53.32%), with low income professional activities, evacuated from a peripheral maternity unit (63.14%), no schooling (44.9%), married (92.3%), using the more often a means of public transport (66.5%) and whose pregnancies were poorly monitored (63.9%). Fetal emergencies were dominated by acute fetal distress (91.3%) and maternal emergencies were dominated by hypertensive emergencies (pre-eclampsia and eclampsia 37.44%) followed by hemorrhagic emergencies (last trimester hemorrhage and postpartum hemorrhage 34.34%). Pregnant and parturient women were more frequently admitted to labor (62.7%) and gave birth more frequently by caesarean section (86.70%). the staff reacted promptly to make a treatment decision in 75.5% of cases within fifteen minutes. emergency procedures were performed in less than fifteen minutes in almost all cases (97.4%), specific treatment was carried out in less than an hour in the majority of cases (68.3%). The maternal case fatality rate was 4.1% with the main cause of death being hemorrhagic shock of 51.8%. The stillbirth rate was 17.4%.Conclusions: The anticipation of emergency obstetric care (SOU) and close collaboration between the obstetrician, the anesthesiologist-resuscitator are essential in the management of obstetric emergencies.</jats:p