Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa

OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 < 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged <40, 40-59 and ≥60 years, respectively. In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1; 3.6), people aged ≥60 years (aOR 2.9, 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension

Tuberculoses non confirmées bactériologiquement dans le service des maladies infectieuses du CHU Yalgado Ouédraogo de Ouagadougou, Burkina Faso

Introduction: la tuberculose demeure un problème majeur de santé publique au Burkina Faso. Son diagnostic bactériologique reste difficile dans notre contexte avec pour conséquence un retard de mise sous traitement préjudiciable aux patients. L’objectif de notre travail est d’étudier les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs de la tuberculose non confirmée bactériologiquement dans le service des maladies infectieuse du CHUYO. Patients et méthode: Nous avons effectué une étude transversale qui a consisté à examiner les dossiers médicaux au cours de la période du 01/01/2005 au 31/12/2019. La tuberculose non confirmée bactériologiquement est un cas de tuberculose qui ne remplit pas les critères de confirmation bactériologique, mais chez qui la forme évolutive a été diagnostiquée sur la base des signes cliniques et/ou radiologiques. Résultats: durant la période d’étude un total de 95 dossiers de patients tuberculeux a été retenu dont 74 cas de tuberculose non confirmées bactériologiquement soit une fréquence de 77,9% des patients tuberculeux. L’âge moyen des patients était de 40 ±13 ans. Quarante un pour cent des patients étaient sans profession et 67,2% vivaient en zone urbaine. L’état général à l’admission était altéré chez 93,1% de nos patients. Les signes les plus fréquents étaient la toux chronique, la dyspnée, l’anémie, la déshydratation, le syndrome infectieux et le syndrome de condensation pulmonaire. La radiographie pulmonaire a contribué au diagnostic chez 90% des patients. La tuberculose était multifocale chez 39% des cas. La sérologie VIH était positive chez 76,4% des patients. Le délai moyen de diagnostic était de 13,2±5 jours. Tous les patients ont bénéficié d’un traitement antituberculeux selon le protocole national. L’évolution a été marquée par une létalité de 30,6%. Conclusion: la tuberculose non confirmée bactériologiquement est fréquente au service des maladies infectieuses du CHUYO. Son diagnostic est tardif avec comme conséquence une lourde létalité. Mots clés: Tuberculose non confirmée, bactériologie, VIH, maladies infectieuses, CHUYO. English Title: Bacteriologically unconfirmed tuberculoses in the infectious diseases department of CHU Yalgado Ouédraogo in Ouagadougou, Burkina Faso English Abstract Introduction: Tuberculosis (TB) remains a major public health problem in Burkina Faso. Its bacteriological diagnosis remains difficult in our context, resulting in a delay of treatment harmful to patients. The objective of our work is to study the epidemiological, diagnostic, therapeutic and evolutionary aspects of bacteriologically unconfirmed tuberculosis in the infectious disease department of CHUYO. Patients and method: We conducted a cross-sectional which consisted to a review of medical records during the period of 01/01/2005 to 31/12/2019. Bacteriologically unconfirmed tuberculosis is defined as a case of tuberculosis that does not meet the criteria for bacteriological confirmation, but in which the progressive form has been diagnosed on the basis of clinical and/or radiological signs. Results: During the study period a total of 95 medical records of patients with tuberculosis were retained, including 74 cases of bacteriologically unconfirmed tuberculosis, representing a frequency of 77.9% of TB patients. The average age of patients was 40 years ±13. Forty-one percent of patients were without a profession and 67.2% lived The most common signs were chronic cough, dyspnea, anemia, dehydration, infectious syndrome and pulmonary condensation syndrome. Chest X-ray contributed to the diagnosis in 90% of patients. Tuberculosis was multifocal in 39% of cases. HIV serology was positive in 76.4% of patients. The average time to diagnosis was 13.2 ±5 days. All patients received anti-tuberculosis treatment according to the national protocol. The evolution was marked by a lethality of 30.6%. Conclusion: Bacteriologically unconfirmed tuberculosis is common in the infectious diseases department of CHUYO. the diagnosis is late with a heavy lethality. Key words: Tuberculosis not confirmed, bacteriology, HIV, infectious diseases, CHUYO

Infectious morbidity and mortality in the infectious diseases department of the CHU Yalgado Ouédraogo in Burkina Faso in 2019

Introduction: Infectious diseases remain a major public health problem in developing countries. The objective of this study was to determine the epidemiological and clinical profile of infectious pathology in the infectious diseases department of CHU Yalgado Ouédraogo in Ouagadougou. Patients and method: This was a cross-sectional and retrospective study that took place in the infectious diseases department of the Yalgado Ouédraogo University Hospital from January 1, 2019 to December 31, 2019. Were included all patients hospitalized in the said service during the study period. For each patient retained sociodemographic, clinical and diagnostic data were collected. Results: In one year, 159 patients had been hospitalized in the infectious diseases department of the YO UHC. The mean age of the patients was 42±9 years with extremes of 15 and 80 years. The female sex was the most represented (55.5%) with a sex ratio of 0.8. The majority of patients (64%) came from the province of Kadiogo. The most frequently diagnosed infectious diseases were HIV infection (24%), pulmonary infections (21.8%), malaria (14%), dengue fever (9%), urinary tract infections (7.5%), meningitis (3.8%), typhoid fever (3%), rabies (3%), chicken pox (3%), tetanus (3.8%), toxoplasmosis (3.8%), and cutaneous leishmaniosis (3%). The signs of severity presented by our patients were dominated by dyspnea, severe anemia, and severe dehydration. The delay of consultation was 13.5 days and the average duration of hospitalization was 9.8 days, with a hospital mortality of 24%. Conclusion: HIV infection, malaria and pulmonary infections were the most frequent reasons for hospitalization. It is therefore important to strengthen the technical facilities of hospitals for early diagnosis and appropriate management of infectious pathology</jats:p

Study of mycoses diagnosed in patients living with HIV hospitalized in the infectious diseases department of the CHU YO of Ouagadougou

Objective: To study the mycoses in HIV patients hospitalized in the infectious diseases department of the CHU YO (Yalgado Ouédraogo) Patients and method: This was a retrospective study carried out in the SMIT of the CHU-YO over a period of ten years from January 1, 2010 to December 31, 2019. Results: During the study period 145 cases of mycosis were diagnosed in patients living with HIV. The average age of the patients was 42±11 years. The sex ratio was 0.64. On admission, the majority of patients (71.54%) had an impaired general condition. All patients were severely immunocompromised (mean CD4 count=59 cells/mm3). Digestive candidiasis and neuromeningeal cryptococcosis were the most frequently diagnosed mycoses. Other comorbidities were dominated by digestive coccidiosis (Cryptosporidiosis, Isosporosis) and common germ pneumonia. All patients had received antifungal and antiretroviral treatment. The evolution was marked by a lethality of 25%. Conclusion: The mycoses are relatively frequent and potentially serious during HIV infection. Their prognosis was even worse when the TCD4 lymphocyte count was low and when there were other associated comorbidities.</jats:p

Rage furieuse de l'enfant transmise par un chat errant : à propos d'un cas et revue de la littérature

La rage est une zoonose grave qui sévit dans la plupart des pays en développement. Elle est transmise généralement par le chien enragé mais exceptionnellement le chat peut être source de contamination de la maladie. Nous rapportons un cas de rage furieuse transmise par un chat errant, survenu chez un enfant. Le tableau clinique s'est installé 45 jours après une morsure et griffure par un chat errant alors que l'enfant était parti tôt le matin pour ses besoins derrière une concession abandonnée. La symptomatologie se résumait à une agitation psychomotrice, des hallucinations, un délire, une photophobie, une hydrophobie, une hyperesthésie cutanée, une détresse respiratoire et une déshydratation modérée, le tout évoluant dans un contexte fébrile.  Sous traitement symptomatique, il décéda 48 heures après son admission.&#x0D; Il ressort la nécessité de sensibiliser les populations et le personnel de santé sur le risque rabique après une exposition à une morsure ou à une griffure par un chat</jats:p

Impact of alternative treatment approach for cerebral toxoplasmosis among HIV/AIDS patients from a resourcepoor setting in Burkina Faso

Cerebral toxoplasmosis is caused by the protozoan Toxoplasma gondii because of reactivation of latent tissue cysts in the Acquired Immunodeficiency Syndrome (AIDS) patients with severe immunosuppression. The objective of this study was to evaluate the benefit of co-trimoxazole in presumptive and prevention of cerebral toxoplasmosis in Human Immunodeficiency Virus (HIV)/AIDS patients at Bobo-Dioulasso Hospital in Burkina Faso from June 2012 to October 2014. ELISA and ELFA were performed on serum for the quantitative determination of IgG and IgM anti-T. gondii, respectively. The seroprevalence of toxoplasmosis was 29.3%. No IgM antibodies for T. gondii were found. Six patients with Toxoplasma-specific antibodies presented cerebral toxoplasmosis. All patients were infected by HIV-1 with the median of CD4+ T lymphocytes at 141 cells/μl. No patient was under antiretroviral therapy. No case of cerebral toxoplasmosis was noted in patients receiving co-trimoxazole in prevention. Presumptive treatment of cerebral toxoplasmosis with co-trimoxazole was effective in all patients with a significant clinical improvement in 83.3%. These results attest the benefit of cotrimoxazole in cerebral toxoplasmosis treatment in countries where drug resources are limited when sulfadiazine is not available. Ours finding highlight the importance of establishing toxoplasmosis chemoprophylaxis to HIV with severe immunosuppression patients and positive Toxoplasma serology

Characterization of the fungal flora of dolo, a traditional fermented beverage of Burkina Faso, using MALDI-TOF mass spectrometry

International audienc

Hemorrhagic stroke following snake bite in Burkina Faso (West Africa). A case series

Abstract Background Snake bites remain a major medical problem in West Africa, and hemorrhagic stroke following a snakebite has emerged as a rare secondary condition. The objective of this study was to determine the neurological complications following snake bite. Methods This study included all the cases of hemorrhagic stroke following snake bite admitted in the neurology Department of Yalgado Ouedraogo University Teaching Hospital during the period from January 1st, 2018 to December 31st 2019. Results Three cases of hemorrhagic stroke following snake bite were included in the study. The strokes occurred 4–15 days after the snakebite. Traditional treatment was applied in two cases. Complications were significant, including local manifestations and severe anemia in 2 patients who received blood transfusion. Snake anti-venom was applied. At admission, motor deficit, conscience disorders and fever were the most frequent complaints. Patients received repeated dose of snake anti-venom was applied, antitetanus prophylaxis and antibiotherapy during hospitalization. The majority of the patients had completely recovered. Conclusions Hemorrhagic stroke following snake bites are rare in Burkina Faso. Clinical outcome of stroke was favorable after treatment by antivenom, anti-tetanus serum and antibiotics. </jats:sec

Sacroillite tuberculeuse: à propos de deux cas

La sacroiliite tuberculeuse est rare et de diagnostic difficile. Les auteurs rapportent deux cas. Il s'agissait dans le premier cas d'une patiente de 40 ans ayant une infection à VIH ; le diagnostic a été histologique après une biopsie chirurgicale. Le second cas a concerné un patient de 25 ans vivant en milieu carcéral chez qui le diagnostic a été établi sur la base des arguments cliniques, biologiques, radiologiques et l'efficacité du traitement ; l'intradermoréaction à la tuberculine était phlycténulaire. Le scanner a été indispensable au diagnostic lésionnel en montrant une érosion des berges et des abcès des parties molles. Le traitement a été médical et a fait appel aux antituberculeux.The Pan African Medical Journal 2016;2