Hospitals In Senegal Research Articles

Assessing use of the WHO surgical safety checklist for pediatric surgery in Senegal: A nationwide survey

Introduction The World Health Organization (WHO) introduced the surgical safety checklist (SSC) to reduce postoperative morbidity and mortality; however, its use in low- and middle-income countries is still low. Methods We conducted a survey from January 2 to 22, 2024, in public hospitals’ pediatric surgery departments and units in Senegal to assess the use of the WHO SSC or an adapted version. Results The participation rate was 100% (23 hospitals), with 11 second-level hospitals (47.8%) and 10 (43.5%) having at least two pediatric surgeons. All hospitals had an anesthetist nurse, and 18 hospitals (78.3%) had at least two scrub nurses. For the surgical workload, 14 hospitals (60.9%) had five to 10 surgical interventions weekly. Eleven hospitals (47.8%) had training on use of the SSC, and 8 of the 23 hospitals (34.8%) used the SSC. The WHO SSC nonutilization was mainly due to a lack of training in nine hospitals (60%) and SSC unavailability in five hospitals (33.3%). Members of 22 hospitals (95.6%) were available for training on use of the SSC. Conclusion The WHO SSC is poorly used in pediatric operating rooms of public hospitals in Senegal. The main reasons for nonutilization are remediable.

Burn-out among practitioners managing abdominal surgical emergencies in Senegal

IntroductionSurgery represents a distinct medical specialization that necessitates direct interaction with patients and the ability to manage complications. Burn-out is defined as a syndrome arising from persistent workplace stress that has not been effectively addressed. The objective of this work was to assess the prevalence and factors associated with burn-out among practitioners managing abdominal surgical emergencies in Senegal. A descriptive and analytical cross-sectional study was conducted; the study included healthcare professionals (general practitioners, general surgeons, anesthesiologists, nurses) involved in the management of surgical emergencies across all hospitals in Senegal. A standardized assessment of perceived stress was conducted using the Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion, depersonalization, and personal accomplishment. A multiple linear regression model was used to estimate the determinants of burn-out on the three subscales. A total of 186 observations were included in the study, for a response rate of 90.7%. The majority of participants were from the capital region of Dakar (44. 6%). There were 46 women (24. 7%) and 140 men (75. 3%). The mean age was 34 years 9 ±6.7 years, with a range of 24–59 years. The majority of participants were married (71%), followed by single individuals (26. 3%), divorced (2. 2%), and widowed (0. 5%). The majority of participants were physicians (80. 6%), followed by nurses (19. 4%). The most common medical specializations were general surgery (58.7%), anesthesia and resuscitation (22. 7%), and general medicine (18. 7%). Additionally, 46% of participants were in training (residency program). The predominant motivations included passion for the profession (75.3%), patient satisfaction (69. 9%), stimulating challenges (21%), and salary considerations (11. 8%). The overall prevalence of high burn-out (at least in one dimension) was 46.2%. A multiple linear regression model showed that the risk factors contributing to high burn-out were divorce status, being in training, and being motivated by stimulating challenges, salary considerations or passion for the profession. The protective factors were a positive perception of one's salary, a favorable physical work environment, and high-quality training. This study revealed an alarming prevalence of burn-out among surgical teams dealing with abdominal emergencies in Senegal. These findings call for immediate action to ensure the well-being of surgical teams and, by extension, the quality of healthcare delivery.

Urolithiasis: morphological and constitutional profile of stones at a university hospital in Senegal

Urolithiasis: morphological and constitutional profile of stones at a university hospital in Senegal

Application of the 2019 PRINTO Classification Criteria for Juvenile Idiopathic Arthritis at a Tertiary Hospital in Senegal, West Africa

Application of the 2019 PRINTO Classification Criteria for Juvenile Idiopathic Arthritis at a Tertiary Hospital in Senegal, West Africa

Assessment of Haptoglobin Gene Polymorphism in cryptogenic Ischemic Stroke in West African Patients

Introduction: For a long time, it was assumed that stroke only affected people aged over 60, but recent studies have shown that it can occur in younger people. In the latter group, molecular factors and inter-individual differences in susceptibility are being increasingly incriminated. The aim of our study was therefore to evaluate the haptoglobin gene polymorphism in subjects with cryptogenic ischemic stroke.
 Methodology: This was a prospective case-control study and included subjects with cryptogenic ischemic stroke followed at the neurology department of FANN hospital in Senegal. Healthy controls were recruited and matched with the cases according to sex and age ±2 years. The Hp gene polymorphism was determined using conventional PCR without enzymatic digestion and biochemical parameters were assayed using the Architect ci4100 system (Abott, USA).
 Results: Our study included 35 patients with cryptogenic stroke. The mean age of the patients was 45±11 years and the sex ratio was 1:1. Assessment of cardiovascular risk factors showed a high frequency of hypertension (46.57%) followed by dyslipidemia (21.42%) and diabetes (10.71%). Drug use was found in 7.14% of subjects. With regard to haptoglobin genotypes, Hp2-2 was much more prevalent in stroke patients (21.42%) than in control subjects (14.28%). In contrast, the Hp1-1 genotype was more prevalent in control subjects, with a rate of 57.14%, compared with 39.28% for cryptogenic strokes.
 Conclusion: Our results seem to show that the Hp2-2 genotype is involved in the occurrence of cryptogenic ischemic stroke. However, the impact of these parameters must be assessed in conjunction with other associated cardiovascular risk factors.

Childhood-onset rheumatoid arthritis at a tertiary hospital in Senegal, West Africa

BackgroundChildhood-onset rheumatoid arthritis (CORA), known as rheumatoid factor (RF)-positive juvenile idiopathic arthritis is a type of juvenile idiopathic arthritis that shares the same genetic factors and clinical features as adult-onset rheumatoid arthritis. In Africa, CORA hasn’t been the subject of a specific study.ObjectivesThe aim of this study is to describe the clinical features, disease activity, functional disability, and treatment of CORA at diagnosis in Senegal and compare the findings to other CORA populations.MethodsWe conducted a mixed cohort study by reviewing the medical records of patients diagnosed with CORA with an age of symptom onset < 18 years according to the 2019 PRINTO provisional criteria for RF-positive JIA from January 2020 to December 2022 at rheumatology department of Aristide Le Dantec Hospital in Dakar, Senegal. We collected demographic, clinical, paraclinical and therapeutic data. Disease activity score was assessed by DAS28-ESR and DAS28-CRP. Functional disability was assessed using Health Assessment Questionnaire (HAQ) or Childhood HAQ.ResultsA total of 21 patients were included. Eighteen (85.7%) were Females. The mean age at symptom onset was 13.0 ± 3.0 years, and at diagnosis was 16.4 ± 4.2 years. Morning stiffness, joint swelling, and joint deformities were found in 20, 18 and 13 patients respectively. Four patients had a family history of rheumatoid arthritis. Five patients had extra-articular involvement such as rheumatoid nodules. Two patients had interstitial lung disease. The biological inflammatory syndrome was found in 90% of cases. 16 of 21 (76.2%) patients had positive RF, and 18 of 20 (90%) patients had positive Anti-CCP. Seven of 12 (58.3%) patients had positive anti-nuclear antibodies. The mean DAS28-ESR was 5.7 ± 1.0. Fifteen (71.4%) patients had high disease activity (DAS28-ESR > 5.1). The mean DAS28-CRP was 5.4 ± 1.1. The median HAQ was 2.12 with a mean HAQ of 1.9. Nineteen (90.5%) patients were treated with methotrexate, while 17 (81%) had a combination of methotrexate and hydroxychloroquine. Oral prednisone was used in 17 (81%) cases. Non-steroidal anti-inflammatory drugs were used in 4 cases (19%). After 6 months of treatment, mean DAS28-CRP was 2.9.ConclusionIn our study, CORA mainly affects 13-year-old girls, characterised by high disease activity with joint deformity and significant functional impairment. Treatment is mainly based on methotrexate, prednisone and hydroxychloroquine. Further studies are needed to determine the exact clinical phenotype of this disease.

Epidemiological, etiological and evolutionary profile of vesico-vaginal fistulas in Senegal

To evaluate the epidemiological, etiological and evolutionary profile of vesico-vaginal fistulas (VVF) in university hospitals in Senegal. This is a retrospective, descriptive, single-center study, collecting the records of patients followed for VVF between January 2014 and December 2019 at the Urology and Andrology Department of the Centre hospitalier universitaire Aristide Le Dantec, Dakar, Senegal. The following parameters were studied: age, geographical origin, parity, and etiology of VVF. To assess the evolution of the epidemiological and etiological profile of VVF, we compared our results with those of series published by our structure. Forty-five (45) VVFs were identified over a period of 6years. This represents an annual average of 7.5 fistulas. The average age was 40±15.13years with extremes of 13years and 75years; 17 patients (37.8%) were older than 45years. The average parity was 3 with extremes from 0 to 12 children. Multiparous women represented 68.8% of the patients. Obstetric VVF (OVF) was more frequent (48.9%) followed by iatrogenic VVF (33.3%). The mean age was higher in the IVF group compared to the VVF group (32years) (P=0.0004). Thirty patients were from the Dakar region and its suburbs (66.6%). The etiology of VVF did not vary according to the geographical origin of the patients (P=NS). VVF was frequently associated with the management of cervical cancer in 42.2% of cases. Comparison of our current data with previous series shows a reduction in the annual incidence of VVF. VVFs, although they have decreased significantly, are still predominant. There is a constant increase in the number of IVF. There is an evolution of the epidemiological and etiological profile marked by a decrease in the frequency of VVFs and an increase in that of IVFs. It is also worth noting the frequent association between cervical cancer and VVF. Level 4: retrospective study.

ASSESSMENT OF OCCUPATIONAL EXPOSURE TO EXTERNAL RADIATION AMONG WORKERS OF THREE COMMUNITY HOSPITALS IN SENEGAL.

Occupational radiation doses of 602 medical workers from the departments of Radiology, Thoracic and cardiovascular surgery, Operating room, Nuclear medicine, Radiotherapy and cardiology were evaluated during 2017 to 2021 in three hospitals in Senegal. Each hospital was subdivided into various occupational groups. Whole-body doses Hp(10), local skin doses Hp(0.07) and annual collective dose Hp(10) were measured by OSL (optically stimulated luminescence) dosimetry. The occupational groups with the highest radiation exposures, ~0.185mSv in 1y, were in the field of nuclear medicine, radiology, cardiology, Thoracic and cardiovascular surgery and Operating room. All results of the measured annual effective dose were below the ICRP (International Commission on Radiological Protection) dose limits of 20 mSv/y, averaged over any 5-y period.

Bipolar Transurethral Resection of the Prostate: Short-Term Outcome Evaluation in Regional Hospital in Senegal

Introduction: Transurethral resection of the prostate is still the most popular procedure that use for the surgical treatment of lower urinary tract symptoms due to benign prostatic obstruction in developed countries. Bipolar transurethral resection of the prostate (B-TURP) is a recent technique in our urological practice. The aim of this study was to evaluate our preliminary results on the use of a B-TURP in Kolda (Senegal) in a benign prostatic hyperplasia (BPH). Materials and Methods: This was a 15-month, retrospective and descriptive study from June 2021 to August 31, 2022. It examined the records of patients who had BPH requiring surgical treatment and who received Bipolar transurethral resection of the prostate (B-TURP) during the study period at the Kolda Regional Hospital in Senegal. We used a Karl STORZ bipolar endoscopy column with a 26 sheath and 30˚ optics. The parameters studied were the civil status of the patients, the clinical and para-clinical data as well as the operative indications. The data were entered and analyzed using Epi-info 3.5.1.1. Results: A total of 31 patients underwent bipolar transurethral resection of the prostate during the study period. The mean age of patients was 68.5 ± 12.6 years (range, 56 - 77 years). The mean total PSA was 4 ± 2.3 ng/ml (range, 0.5 - 11 ng/ml). The mean prostate size assessed by ultrasound was 54 ± 12.3 ml (range, 30 - 90 ml). The operative indication was dominated by BPH with impact on the upper urinary tract. The mean of bladder irrigation time was 21.4 ± 3.9 hours (range, 12 - 26 hours). In the immediate post-operative period, blood transfusions were performed in 2 patients (6.5%). In the medium-term follow-up, we noted one 1 (3.2%) case of urine retention requiring bladder catheterization. Conclusion: Bipolar Transurethral resection of the prostate B-TURP in saline system is efficacious and safe. The results of this preliminary study of B-TURP are satisfactory with a low complication rate. B-TURP decreases the duration of the hospitalization and the port of the probe. Our perspectives are oriented towards endoscopy of the upper urinary tract.

Epidemiology of Digestive Surgical Emergencies in a Sub-Saharan African Country: A Multicentre Pilot Study Protocol.

Digestive surgical emergencies remains one of the main general surgery activities. Despite the associated mortality rate in low income countries, epidemiologic data about this subject is rare and multicenter studies are even more. We aimed to study an epidemiology of digestive surgical emergencies in Senegal by multicenter protocol. it will a prospective multicenter pilot study from May to July 2022. The patients were from General surgery departments of these teaching hospital in Senegal: Dakar Principal Hospital, Aristide le Dantec Hospital, Dalal Jamm hospital and Saint-Louis Regional Hospital. The Schwartz formula was used. We used a proportion of abdominal surgical emergency of 20%. We had a sample size of 246 patients. this research protocol will be submitted to Ethics committee of four hospital that included. The results of this study can help to get better the management of our digestives emergencies and at the same time improve mortality rate. Digestive surgical emergencies is a public health issueBecause of high mortality rate in poorest countries, epidemiological data in Senegal must be knownThese information can help to lower associated mortality.

Pathological Fractures in Chronic Hemodialysis Patients in a Teaching Hospital in Senegal: Prevalence and Associated Risk Factors

Pathological Fractures in Chronic Hemodialysis Patients in a Teaching Hospital in Senegal: Prevalence and Associated Risk Factors

Acute Renal Failure in the Elderly in the Nephrology Department of Aristide Le Dantec Hospital in Senegal: About 45 Cases

Acute Renal Failure in the Elderly in the Nephrology Department of Aristide Le Dantec Hospital in Senegal: About 45 Cases

Profiles of Major Cognitive Disorders in Elderly People Followed at the Geriatric Clinic of Fann National University Hospital in Senegal

Profiles of Major Cognitive Disorders in Elderly People Followed at the Geriatric Clinic of Fann National University Hospital in Senegal

Study of prognostic factors in gastric cancer: Application of a cox model and logistic regression

Introduction: Gastric cancer has a poor prognosis. It is the fifth most common cancer in terms of incidence and the fourth most common cancer in terms of mortality world wide. The aim of our study is to identify the clinical and pathological factors associated with survival and predictive of death. Method: Our study included 262 patients over a 13-year periodfrom 2007 to 2020 at Aristide Le Dantec Hospital in Senegal and Conakry Hospital in Guinea. The survival period was established from one month after treatment to the date of death or last news. We first used the Cox proportional hazard model to identify independent factors associated with survival. Then we applied logistic regression to these factors to develop the prognostic equation. Results: The overall survival at 6 months, 1 year and 5 years after treatment was respectively 74%, 57%, 38%. The probability of occurrence of death after 5 years can be estimated with 93\% accuracy, by: log (π_i / (1 - π_i)) = -19,983 + 2,119* Métastases + 1,268* Ulcère gastrique + 1,100* Tabac + 37,646* Epigastralgie + 37,563* Cardiopathie + 37,220*Mucineux. Conclusion: Our approach contributes to determine the impact of clinical and pathological factors on the survival of patients and the eventual occurrence of death related to stomach cancer.

Traumatic posterior dislocation of hip with ipsilateral fracture of shaft of the femur: external maneuvers reduction and osteosynthesis by screw plate about a case and review of literature at Tambacounda regional hospital in Senegal

&lt;p&gt;Traumatic hip dislocation associated with an ipsilateral femoral fracture is a rare injury. It occurs in a high-energy traumatic context. The classic mechanism consists of a fall with landing on the hip, which initially dislocates and the femur fracture occurs secondarily by adduction of the proximal fragment. The diagnosis is difficult in front of the fracture whose signs mask the vicious attitude of the dislocation. We reported the case of a passenger of a motorcycle who collided with a parked car. He was ejected from the motorcycle and landed on his right hip. We performed X-rays of hip and lower limb at his admission which revealed a dislocation of hip in its high posterior variety and a medio-diaphyseal fracture of femur on same side. Reduction of dislocation by external maneuvers was made and osteosynthesis of femur with screwed plate performed 48 h later. After 16 months of care, functional and radiological results sufficient.&lt;/p&gt;

Open Fractures of Limbs by the Bite of Domestic Donkeys: An Unusual Aetiology

Introduction: The aim of this study is to describe the epidemiological, lesional, therapeutic and evolutionary profile of open fractures of limbs by bites of domestic donkeys. Patients and Methods: This is a prospective descriptive study over 28 months made in the Orthopedics-Traumatology department of the Tambacounda Regional Hospital in Senegal, concerning patients bitten by donkeys, resulting in an open fracture of the thoracic and pelvic limbs. Results: Twelve male patients were included. The average age was 10.50 years ± 2.60. The most common circumstance was the bite when two donkeys were separated. The thoracic limbs were the most affected by the occurrence of the arm. Cauchoix-Duparc type II and AO A2 and B2 were predominant. The essential trimming/osteosynthesis was carried out within 24 hours of the bite. Serovaccination was systematic, but on the other hand, a single dose of anti-rabies serum was administered. Pinning was the most commonly used bone synthesis. Complications were mainly infectious, followed by a case of radial nerve palsy and non-union on pins. Conclusion: The typical profile of an open donkey bite fracture is a male child/adolescent who is bitten during the separation of two fighting donkeys. The lesions are most often found in the thoracic limbs with a predominance of Cauchoix-Duparc type II and type A2 and B2 fractures of the AO, whose treatment consisted of trimming and pinning. The infectious complications of the soft tissues marked the evolution.

Urological emergencies in a regional hospital in Senegal: a 20-month retrospective study

urological emergencies are diverse and varied, and are frequently encountered in urological practices. The purpose of this work was to study the epidemiological features and management of urological emergencies at the regional hospital of Kolda, Senegal. we conducted a retrospective and descriptive study collecting data from the medical records of all patients admitted as a urological emergency for 20 months (January 2020 and August 31, 2021). urological emergencies accounted for 3.6% of admissions to the Emergency Department and for 20.4% of urological consultations. The average age of patients was 51.9 ± 21.5 years, ranging from 1 to 98 years. Urinary retention was the most common urological emergency, observed in 249 cases (57.3%), followed by urogenital infections 89 (20.5%). Renal colic affected 48 (11%) of patients. Emergency management was based on urinary catheterization, which was performed in 193 patients (44.3%). The most common surgical procedures were suprapubic catheterization (42 patients; 51.9%) and emergency scrotal exploration (15 patients; 18.6%). in our context, urological emergencies are dominated by urinary retention due to prostatic disorders and urethral stenosis. Traumatic emergencies are uncommon.

Benign Stenosis of Oesophagus: About 101 Cases in the Digestive Endoscopy Department of the General Idrissa Pouye Hospital (Dakar, Senegal)

Introduction: Benign oesophageal strictures are defined as narrowing of the oesophageal lumen not related to neoplastic pathology. They are frequently encountered during endoscopic practice and are often responsible for a reduction in the quality of life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little data are available on these benign esophageal strictures. The objective of our study was to determine the sociodemographic, diagnostic and therapeutic aspects of benign oesophageal strictures in a digestive endoscopy centre in Senegal. Patients and Methods: This was a retrospective, descriptive study analysing reports of upper GI endoscopies performed between January 2015 and December 2017 in a hospital in Senegal. Reports that concluded to have non-neoplastic oesophageal stenosis were collated. Sociodemographic data, indications for and results of endoscopy, and therapeutic modalities were collected. These data were analysed using the Sphinx version 5 software. Results: We collected 101 cases of benign oesophageal stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean age of the patients was 34 years (range 2 and 83 years) with a median of 37.9 years. There was a female predominance with a sex ratio of 0.38 (73 females). Dysphagia, the main symptom, was present in 87 patients (86.1% of cases) with a Dysphagia score greater than or equal to 2 in 51 patients (50.5%). The average duration of this dysphagia, excluding caustic stenosis, was 4 years (extremes 1 and 15 years). Endoscopy revealed simple stenosis in 76 cases (75.2% of cases). A membranous ring of the cervical oesophagus, suggestive of the Plummer-Vinson syndrome ring, was found in 60 patients (59.4% of cases) and was the primary cause; other aetiologies were dominated by caustic stenosis (19 cases), Schatzki rings (8 cases) and peptic stenosis (4 cases). Endoscopic dilatation was performed in 90 patients (89.1% of cases) with Savary Gilliard bougies (87 cases) and hydrostatic balloons (3 cases). The average number of dilatation sessions was 1.69. In 10 patients (11.1%), refractory stenosis was observed. This stenosis could be resolved after further dilatation in 8 cases before the 8th session. In 2 patients, dilatation failed. Conclusion: Benign oesophageal strictures in our digestive endoscopy centre in Senegal mainly affect young adults, with a predominance of women. Diagnosis is often late. Cervical oesophageal rings in the context of Plummer-Vinson syndrome are the main cause. Oesophageal dilatation with bougies is of great therapeutic value.

Clinical and Paraclinical Aspects of Febrile Convulsions in Children at the Ziguinchor Peace Hospital: Documentary Study

Introduction: Febrile seizures are seizures associated with fever in children. They represent a frequent reason for consultation in pediatric emergencies. Febrile convulsions are often qualified as benign pathologies but they are a source of concern, explaining the number of tolls imposed on these children. The aim of the study was to report the practice to a hospital in Senegal.&#x0D; Materials and Methods: This is a retrospective study of children's records, from January 1, 2015 to January 31, 2020. Were included, patients aged less than or equal to 5 years, hospitalized in the pediatric department of the Ziguinchor Peace Hospital, for a febrile convulsion. Newborns and children with psychomotor development abnormalities were excluded. We have studied the clinical and etiological data.&#x0D; Results: We collected 85 (51 boys, 34 girls) cases of febrile convulsions, ie a hospital frequency of 10,6%. The mean age of the patients was 23,6 months, peaking in infants 12 to 18 months. The mean temperature was 38,8° C and the seizure was tonic-clonic in 64,7%. We noted 57 cases of simple febrile convulsions (67,1%) and 28 cases of complicated febrile convulsions (32,9%). The etiology of fever was dominated by otorhinolaryngologic infections (42,4%); malaria (18,8%) and bronchopulmonary infections (08,2%). The average length of hospital stay was 02,8 days. We deplored two deaths (02,4%).&#x0D; Conclusion: Febrile convulsions are common in children under 5 years old. They are secondary to respiratory tract infections and malaria.

E-Art: An Assisted Reproductive Technology Information System for Infertility Management in Low Resource Settings

Research Question: How an electronic medical record E-ART was designed and implemented for the monitoring and management of infertile couples in Dakar, Senegal? Design: The study was carried out in the scenario of a public hospital of a reference university maternity hospital in Senegal, a private clinic, anda lab practice. The compilation of data for the automatic calculation of performance indicators and its transcription to a standard in electronic form was carried out by specialists in Gynecology- Obstetrics, Biologists, and Computer Scientists. Results: E-ART software is structured around several hierarchical tables allowing users to register and store all relevant patients’ information. E-ART structures the patient’s data to provide a clear overview of their medical history and users’ activity performance. E-ART makes medical users’ life so much easier. Users can generate and send letters, prescriptions quickly and efficiently using the customized templates which they can modify or create. In addition to these capabilities, all of the features expected in an Assisted Reproductive technology EHR are handled by E-ART, such as ovarian stimulation monitoring, blood test measurements, egg retrieval, embryo culture, embryo transfer and so much more. E-ART makes it possible to manage all stages from ovarian stimulation to embryo transfer. The EART software also allows to generating reports and statistics according to customized templates and those of ANARA. Conclusion: The computerization of medical records has become a necessity today. An area as sensitive as the management of infertility and ART techniques cannot escape to it. Crossing the line to Electronic medical records could help assess practices in order to improve them.