Disease In Senegal Research Articles

Pott's disease in Senegal

The purpose of this study is to report our experience on Pott's disease in Senegal, which belongs to the group of least-developed countries .In these countries, tuberculosis is still a public health issue. Regarding spine tuberculosis, we attempted to implement a diagnostic and therapeutic approach appropriate for our conditions of medical practice. The authors reported a retrospective epidemiological and clinical study of 255 patients suffering from tuberculosis of the spine. Theses patients were hospitalized at the University Hospital of Fann in Dakar from January 1986 to July 1998. Sixty percent came from the capital, the mean age was 34.9 years, there were 136 males for 119 females, and antituberculosis immunization were not done every time. Associated extra-spinal tuberculosis, predominantly tuberculosis of the lung, was observed in 28.2 patients (59%). Of 37 patients tested for human immunodeficiency virus (HIV) infection, only one was positive. Patients came late to the hospital, leading to a high percentage of neurological complications (79.2%). Our diagnostic strategy was based on epidemiological and clinical criteria already defined by Martini. Thoracic spine (53.8%) and lumbar sacral spine (21.7%) were the column vertebral segments most frequently involved. All patients received antituberculosis chemotherapy, and only 39 patients underwent surgery with laminectomy without posterior instrumentation. Functional outcome study was done for 89 paraplegic patients: 26 (29%) went to Frankel grade D or E and, among 27 operated patients, nine entered theses grades. Seventeen patients (11.5%) died. We developed the concept of "spinal-cord rescue," which focuses more on neurological rather than biomechanical issues.

Le paludisme grave de l’enfant en milieu hospitalier sénégalais

Objectives: The authors had for aim to establish the frequency of severe malaria in pediatric medical emergencies, the distribution of its various clinical forms, and its lethality in hospital settings. Method: A prospective study was carried out from July 1st, 1998 to December 31st, 1999 at the Dakar Albert Royer Children’s Hospital. All the children admitted in the ICU with a positive thick blood drop and at least one WHO criterion of malaria gravity was included. Results: Severe malaria accounted for 16% of the medical emergencies. Neurological manifestation were the most frequent (75% to 97%). Anemia was significantly higher in younger patients (24.5%) and lethality reached 14.5%. Comments: The incidence of severe malaria in Dakar has not changed in the last 30 years. However the disease occurs earlier during the transmission period. Thus, it is necessary to promote an early management of severe malaria and to improve the technical level of assistance in order to reduce the lethality of this disease in Senegal.

New results in clinical severity of homozygous sickle cell anemia, in Dakar, Senegal.

Despite the unicity of its genetic mutation, Sickle cell homozygosity presents different clinical features. Our objectives were to evaluate disease severity in Senegalese patients. Sixty (60) homozygous sickle cell patients were followed up monthly during one year and disease severity was assessed using the "severity index" (SI) which is resulting from epidemiologic, clinic and biological data. Mean age was 20.13, sex ratio was 0.87 and mean age of diagnosis was 9.8 years. 90% of patients presented vaso-occlusive crisis (2.53 per patient), 73.3% had infectious episodes (1.9 per patient), 69.3% had never been transfused and 25% of patients had presented chronic complications linked to anemia or ischemia. Mean hemoglobin value was 8.1 g/dl and mean Hb F was 8.2%. Low seric ferritin was found in 1.7% of patients. Benign form of homozygous sickle cell anemia (SI< or =6) was found in 48.3% of patients. Our data confirm the relative good tolerance of homozygous sickle cell disease in Senegal. The haplotype Senegal may play an important role but others host and environmental factors operate certainly because some severe cases were identified in our patients. The identification of all these factors might contribute to a better follow up of sickle cell disease.

Infection due to hepatitis delta virus in Africa: report from Senegal and review.

A review of the literature shows strong variations in the prevalence of hepatitis delta virus (HDV) among Africans seropositive for hepatitis B surface antigen (HBsAg). In Senegal, West Africa, prevalence of antibodies to HDV among asymptomatic HBsAg carriers appears to be linked to regional and/or socioeconomic factors. Antibodies to HDV were found in 22 (47%) of 47 HBsAg-seropositive patients with liver disease who were hospitalized in the main hospital of Dakar and in 4% to 44% of asymptomatic HBsAg carriers. Eight (36%) of 22 patients with liver disease were seropositive for IgM antibodies to HDV, whereas none of 18 asymptomatic subjects were seropositive (P less than .01). According to studies conducted in Europe and the United States, the presence of this marker may constitute support for the argument that HDV plays a role in the development of HBsAg-associated liver diseases in Senegal and, presumably, within the African continent.

Reaction of Locally Improved Pearl Millets to Three Insect Pests and Two Diseases in Senegal

Eight locally improved pearl millet ( Pennisetum americanum (L.) Leeke) cultivars were compared with the traditional cultivar ‘Souna’ during the 1982-1984 crop seasons for their reaction to the attack of three insect pests and two diseases in Senegal. In 1984, ‘H9-127’ harbored lower larval populations of Lema planifrons Weise (Coleoptera: Chrysomelidae) than seven cultivars tested. When the level of stalk infestation and number of larval Acigona ignefusalis Hampson (Lepidoptera: Pyralidae) were compared among the nine cultivars, none was resistant. Cultivar ‘IBV-8001’ showed the least susceptibility to Raghuva albipunctella De Joannis (Lepidoptera: Noctuidae), downy mildew (caused by Sclerospora graminicola (Sacc.) Schroet.), and head smut (caused by Tolyposporium penicillariae Bref.). Because ‘IBV-8001’ is more resistant to one insect pest and two diseases and its yields are higher than those of ‘Souna’, its general cultivation is recommended in major millet-growing zones of Senegal.

Hepatitis D (delta agent) in primary hepatocellular carcinoma and liver disease in Senegal.

A total of 308 individuals belonging to ten different ethnic groups in Senegal were investigated. They suffered from primary hepatocellular carcinoma (PHC), liver cirrhosis, chronic hepatitis and other liver diseases, or were healthy controls. Their sera were investigated for the presence of markers of infection with hepatitis B and D (delta agent) virus. Out of 130 clinically diagnosed patients with PHC, 88 had alpha-fetoprotein levels above 100 micrograms/l, supporting the diagnosis. After clinical examination, 133 subjects were considered to be healthy or to have a liver disease other than PHC. Among these, 83 (31 clinically healthy and 52 with liver disease) had alpha-foetoprotein less than 15 micrograms/l and were therefore considered not to have PHC. Out of the 88 patients with definite PHC, 74% were positive for HBsAg, whereas out of the 83 subjects without PHC, 50% of those with other liver disease and 26% of the healthy controls were positive. Anti-delta was present in 21% of the patients with or without PHC. It was found in nine different ethnic groups in the country. The present data confirm that HBV is related to the etiology of PHC. The present investigation showed a high prevalence of delta antibodies in patients with PHC, but against the role of hepatitis D infection in the evolution of malignancy is the fact that it was equally common in chronic liver disease without evidence of carcinoma.