Publications by authors named "Mouhamadou Ndiaye"

59 Publications

Humanitarian Maxillofacial Mission's Success Requires Experienced Surgeons, Careful Planning, and Meeting With the Local's Care Needs.

J Oral Maxillofac Surg 2021 May 18. Epub 2021 May 18.

Professor, Department Head, Department of Maxillo-Facial Surgery, Sorbonne Université, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France.

Purpose: Meeting with local needs of low- and middle-income countries during maxillofacial humanitarian mission is not easy. This article aimed to report on 5 years of experience in humanitarian maxillofacial surgery missions. In addition, several key points for best practices and meeting the medical needs of local populations are discussed.

Methods: In this retrospective case series, all medical charts of patients managed during humanitarian maxillofacial surgery missions organized within the department of maxillofacial surgery of Le Dantec Hospital (Senegal) were analyzed. Disease characteristics, treatments modality, and outcomes were reviewed. Moreover, missions planning and costs were studied.

Results: Between 2015 and 2018, 5 humanitarian missions were organized totalizing 177 patients, one-third of which were treated surgically. Tumors (35%) and sequelae from previous surgeries, cancrum oris or trauma (24%) were the most frequently treated disorders. Most patients were treated with free flap reconstructions (35%). Postoperative complications were observed for only 3 patients (5%). With a median follow-up of 13 months, no sequelae requiring specific treatment were observed. The estimated total cost for each mission was $39,000.

Conclusion: In order to benefit both the locals and the volunteers, humanitarian maxillofacial missions should be carefully planned and volunteers appropriately prepared. Other keys to the success of such missions are setting up training and support programs, reflecting upon ethical considerations, understanding local cultural customs and ensuring mutual respect with the locals. Frequent self-evaluation and long-term mission sustainability are critical. Finally, mission costs should be evaluated.
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http://dx.doi.org/10.1016/j.joms.2021.05.011DOI Listing
May 2021

Epidemiological aspects of superficial fungal infections in Koranic schools in two localities of Senegal (Thies and Touba).

Mycoses 2021 Jun 2. Epub 2021 Jun 2.

Cheikh Anta Diop University of Dakar, Dakar, Senegal.

Background: In developing countries, superficial fungal infections (SFI) are endemic and cause a therapeutic problem because of the duration and cost of treatment. Community living and promiscuity are key factors in the direct or indirect transmission and spread of these diseases.

Objectives: The objective was to study the epidemiological aspects of SFI, among koranic school children in two localities in Senegal.

Patients/methods: School koranic students were recruited in Thies and Touba. Diagnosis of fungal diseases was carried out using conventional techniques (microscopic examination and culture).

Results: Among 210 children, the overall prevalence of SFI was 25.71%, with 27.63% in Touba and 20.68% in Thiès. The clinical lesions were epidermophytosis (0.5%), intertrigo (0.9%), palmoplantar keratoderma (KPP) (0.9%), onychomycosis (7.7%) and tinea capitis (TC) (90%). The species responsible for the SFI were Trichophyton soudanense (85.18%), Microsporum audouinii langeronii (9.25%), Trichophyton rubrum (3.70%) and Chrysosporium keratinophilum (1.85%). The prevalence of infection was higher among boys (85.18%).

Conclusion: Superficial fungal infections are prevalent in koranic school children and attention should be given to non-dermatophytic species that could be responsible for SFI.
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http://dx.doi.org/10.1111/myc.13330DOI Listing
June 2021

Genomic investigation of a dengue virus outbreak in Thiès, Senegal, in 2018.

Sci Rep 2021 May 14;11(1):10321. Epub 2021 May 14.

Laboratoire de Parasitologie-Mycologie, Hôpital Aristide le Dantec, Université Cheikh Anta Diop de Dakar, BP 16477, Dakar, Senegal.

Dengue virus is a major and rapidly growing public health concern in tropic and subtropic regions across the globe. In late 2018, Senegal experienced its largest dengue virus outbreak to date, covering several regions. However, little is known about the genetic diversity of dengue virus (DENV) in Senegal. Here we report complete viral genomes from 17 previously undetected DENV cases from the city of Thiès. In total we identified 19 cases of DENV in a cohort of 198 individuals with fever collected in October and November 2018. We detected 3 co-circulating serotypes; DENV 3 was the most frequent accounting for 11/17 sequences (65%), 4 (23%) were DENV2 and 2 (12%) were DENV1. Sequences were most similar to recent sequences from West Africa, suggesting ongoing local circulation of viral populations; however, detailed inference is limited by the scarcity of available genomic data. We did not find clear associations with reported clinical signs or symptoms, highlighting the importance of testing for diagnosing febrile diseases. Overall, these findings expand the known range of DENV in Senegal, and underscore the need for better genomic characterization of DENV in West Africa.
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http://dx.doi.org/10.1038/s41598-021-89070-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121849PMC
May 2021

High prevalence of asymptomatic Plasmodium infection in Bandafassi, South-East Senegal.

Malar J 2021 May 12;20(1):218. Epub 2021 May 12.

Laboratory of Parasitology and Mycology, Cheikh Anta Diop University of Dakar, Dakar, Senegal.

Background: Malaria control and elimination strategies are based on levels of transmission that are usually determined by data collected from health facilities. In endemic areas, asymptomatic Plasmodium infection is thought to represent the majority of infections, though they are not diagnosed nor treated. Therefore, there might be an underestimation of the malaria reservoir, resulting in inadequate control strategies. In addition, these untreated asymptomatic Plasmodium infections maintain transmission, making it difficult or impossible to reach malaria elimination goals. Thus, the aim of this study was to determine the prevalence of asymptomatic Plasmodium infections in southeastern Senegal.

Methods: A cross sectional study was conducted among asymptomatic individuals (N = 122) living in the village of Andiel located in Bandafassi, Kédougou, which consisted of about 200 inhabitants during the malaria transmission season in late October 2019. For each individual without malaria-related symptoms and who consented to participate, a rapid diagnostic test (RDT) was performed in the field. Results were confirmed in the laboratory with photo-induced electron transfer (PET-PCR).

Results: Malaria prevalence was 70.3% by PET-PCR and 41.8% by RDT. During the same period, the health post of the area reported 49. 1% test positivity rate by RDT. The majority of the infected study population, 92.9%, was infected with a single species and 7.1% had two or three species of Plasmodium. Plasmodium falciparum was predominant and represented 90.2% of the infections, while 6.5% were due to Plasmodium ovale and 3.3% to Plasmodium malariae. 59.4% of children targeted for SMC (zero to ten years old) were infected.

Conclusion: In southeastern Senegal, where the transmission is the highest, malaria control strategies should address asymptomatic Plasmodium infections at the community level. The results suggest that this area could be eligible for mass drug administration. Moreover, non-falciparum species could be more common and its prevalence should be determined countrywide.
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http://dx.doi.org/10.1186/s12936-021-03746-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117620PMC
May 2021

Pulmonary Madurella mycetomatis mycetoma secondary to knee eumycetoma, Senegal.

PLoS Negl Trop Dis 2021 03 25;15(3):e0009238. Epub 2021 Mar 25.

Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Dakar, Senegal.

Mycetoma is a neglected tropical disease which is endemic in Senegal. Although this subcutaneous mycosis is most commonly found on the foot, extrapodal localisations have also been found, including on the leg, knee, thigh, hand, and arm. To our knowledge, no case of blood-spread eumycetoma has been reported in Senegal. Here, we report a case of pulmonary mycetoma secondary to a Madurella mycetomatis knee eumycetoma. The patient was a 41-year-old farmer living in Louga, Senegal, where the Sudano-Sahelian climate is characterised by a short and unstable rainy season and a steppe vegetation. He suffered a trauma to the right more than 20 years previously and had received treatment for more than 10 years with traditional medicine. He consulted at Le Dantec University Hospital in Dakar for treatment of a right knee mycetoma which had been diagnosed more than 10 years ago. He had experienced a chronic cough for more than a year; tuberculosis documentation was negative. Grains collected from the knee and the sputum isolated M. mycetomatis, confirmed by the rRNA gene ITS regions nucleotide sequence analysis. An amputation above the knee was performed, and antibacterial and antifungal therapy was started with amoxicillin-clavulanic acid and terbinafine. The patient died within a month of his discharge from hospital.
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http://dx.doi.org/10.1371/journal.pntd.0009238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993608PMC
March 2021

Efficacy and safety of artemisinin-based combination therapy and the implications of Pfkelch13 and Pfcoronin molecular markers in treatment failure in Senegal.

Sci Rep 2020 06 1;10(1):8907. Epub 2020 Jun 1.

Department of Parasitology and Mycology, Cheikh Anta Diop University, Avenue Cheikh Anta Diop, BP 5005 Fann, Dakar, Senegal.

In 2006, Senegal adopted artemisinin-based combination therapy (ACT) as first-line treatment in the management of uncomplicated malaria. This study aimed to update the status of antimalarial efficacy more than ten years after their first introduction. This was a randomized, three-arm, open-label study to evaluate the efficacy and safety of artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ) and dihydroartemisinin-piperaquine (DP) in Senegal. Malaria suspected patients were screened, enrolled, treated, and followed for 28 days for AL and ASAQ arms or 42 days for DP arm. Clinical and parasitological responses were assessed following antimalarial treatment. Genotyping (msp1, msp2 and 24 SNP-based barcode) were done to differentiate recrudescence from re-infection; in case of PCR-confirmed treatment failure, Pfk13 propeller and Pfcoronin genes were sequenced. Data was entered and analyzed using the WHO Excel-based application. A total of 496 patients were enrolled. In Diourbel, PCR non-corrected/corrected adequate clinical and parasitological responses (ACPR) was 100.0% in both the AL and ASAQ arms. In Kedougou, PCR corrected ACPR values were 98.8%, 100% and 97.6% in AL, ASAQ and DP arms respectively. No Pfk13 or Pfcoronin mutations associated with artemisinin resistance were found. This study showed that AL, ASAQ and DP remain efficacious and well-tolerated in the treatment of uncomplicated P. falciparum malaria in Senegal.
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http://dx.doi.org/10.1038/s41598-020-65553-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264303PMC
June 2020

A twenty-eight-year laboratory-based retrospective trend analysis of malaria in Dakar, Senegal.

PLoS One 2020 15;15(5):e0231587. Epub 2020 May 15.

Department of Parasitology, Cheikh Anta Diop University, Dakar, Senegal.

Introduction: Health facility-based records offer a rich source of information to understand trends and changes in malaria cases over time. This study is aimed at determining the changes in malaria occurrence over the last 28 years, from 1989 to 2016 in Dakar, Senegal.

Methods: Laboratory suspected and confirmed malaria records from 1989 to 2016 were reviewed from the laboratory registers of the Laboratory of Parasitology and Mycology of Aristide Le Dantec Hospital. Interrupted time series (ITS) analysis was used to estimate the changes by comparing malaria cases post-intervention (2006-2016) with that of the pre-intervention (1989-2005) period.

Results: A total of 5,876 laboratory confirmed malaria cases were reported out of 29,852 tested cases, with total slide positivity rate (SPR) of 19.7%. Malaria case counts exhibited a fluctuating trend with major peaks occurring in the years 1995 and 2003 with SPR of 42.3% and 42.5%, respectively. Overall, a remarkable decline in the total number of laboratory confirmed malaria cases was observed over the last 28 years. P. falciparum was almost the only reported species, accounting for 99.98% of cases. The highest SPR was observed in the age group of under five years during the pre-intervention period while this shifted to the age group of 6-15 years old for the subsequent years. Two major malaria peak seasons were observed: one in September during the pre-intervention period and the other in November for the post-intervention period. The ITS analysis showed a dramatic decline of 83.6% in SPR following the scale-up of interventions in 2006.

Conclusion: A remarkable decline in laboratory confirmed malaria cases in Dakar over 28 years was observed. The period of rapid decline in malaria SPR coincided with the scale-up in interventions beginning in 2006 with the introduction of ACTs, followed by the widespread introduction in 2008 of bed nets treated with insecticides. Robust surveillance data should be maintained in the context of malaria elimination efforts.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231587PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228107PMC
July 2020

Clustering of asymptomatic Plasmodium falciparum infection and the effectiveness of targeted malaria control measures.

Malar J 2020 Jan 21;19(1):33. Epub 2020 Jan 21.

School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA.

Background: Because clustering of Plasmodium falciparum infection had been noted previously, the clustering of infection was examined at four field sites in West Africa: Dangassa and Dioro in Mali, Gambissara in The Gambia and Madina Fall in Senegal.

Methods: Clustering of infection was defined by the percent of persons with positive slides for asexual P. falciparum sleeping in a house which had been geopositioned. Data from each site were then tested for spatial, temporal and spatio-temporal clustering in relation to the prevalence of infection from smear surveys.

Results: These studies suggest that clustering of P. falciparum infection also affects the effectiveness of control interventions. For example, the clustering of infection in Madina Fall disappeared in 2014-2016 after vector control eliminated the only breeding site in 2013. In contrast, the temporal clustering of infection in Dioro (rainy season of 2014, dry season of 2015) was consistent with the loss of funding for Dioro in the second quarter of 2014 and disappeared when funds again became available in late 2015. The clustering of infection in rural (western) areas of Gambissara was consistent with known rural-urban differences in the prevalence of infection and with the thatched roofs, open eaves and mud walls of houses in rural Gambissara. In contrast, the most intense transmission was in Dangassa, where the only encouraging observation was a lower prevalence of infection in the dry season. Taken together, these results suggest: (a) the transmission of infection was stopped in Madina Fall by eliminating the only known breeding site, (b) the prevalence of infection was reduced in Dioro after financial support became available again for malaria control in the second half of 2015, (c) improvements in housing should improve malaria control by reducing the number of vectors in rural communities such as western Gambissara, and (d) beginning malaria control during the dry season may reduce transmission in hyperendemic areas such as Dangassa.

Conclusions: From a conceptual perspective, testing for spatial, temporal and spatio-temporal clustering based on epidemiologic data permits the generation of hypotheses for the clustering observed and the testing of candidate interventions to confirm or refute those hypotheses.
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http://dx.doi.org/10.1186/s12936-019-3063-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6975028PMC
January 2020

A Comparative Study on Phenotypic versus ITS-Based Molecular Identification of Dermatophytes Isolated in Dakar, Senegal.

Int J Microbiol 2019 18;2019:6754058. Epub 2019 Dec 18.

Laboratoire de Parasitologie-Mycologie, CHU Aristide Le Dantec, BP 5005, Dakar, Senegal.

Classically, dermatophytes are identified by phenotypic methods even if these methods, sometimes, remain difficult or uncertain. On the other hand, nucleotide sequence analysis of internal transcribed spacers (ITS) of rDNA has proved to be a useful method for identification of dermatophytes. The objective of this study was to compare the phenotypic method with DNA sequencing of the ITS regions for identification of dermatophyte species isolated in Dakar, Senegal. A collection of thirty-two strains of dermatophytes were isolated from patients suffering from dermatophytosis. Mycological identification revealed ( = 13), ( = 10), ( = 5), and one strain for each of the following species: , , and and one unidentified strain. For comparison, ITS-based PCR and DNA sequencing were applied for identification of the isolated dermatophytes. ITS sequences showed, in BLAST search analysis, 99-100% of similarity. Identification of dermatophyte isolates by conventional methods was confirmed by DNA sequencing of the ITS regions in 84% of cases. Discrepancies concern mostly misidentified as . PCR sequencing provided an excellent tool for identifying dermatophyte strains that do not present typical morphological characteristics. It was also able to give correct identification of an atypical strain of responsible of mycetoma of the scalp.
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http://dx.doi.org/10.1155/2019/6754058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942864PMC
December 2019

Analysis of anti-Plasmodium IgG profiles among Fulani nomadic pastoralists in northern Senegal to assess malaria exposure.

Malar J 2020 Jan 13;19(1):15. Epub 2020 Jan 13.

Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal.

Background: Northern Senegal is a zone of very low malaria transmission, with an annual incidence of < 5/1000 inhabitants. This area, where the Senegal National Malaria Control Programme has initiated elimination activities, hosts Fulani, nomadic, pastoralists that spend the dry season in the south where malaria incidence is higher (150-450/1000 inhabitants) and return to the north with the first rains. Previous research demonstrated parasite prevalence of < 1% in this Fulani population upon return from the south, similar to that documented in the north in cross-sectional surveys.

Methods: A modified snowball sampling survey of nomadic pastoralists was conducted in five districts in northern Senegal during September and October 2014. Demographic information and dried blood spots were collected. Multiplex bead-based assays were used to assess antibody responses to merozoite surface protein (MSP-1) antigen of the four primary Plasmodium species, as well as circumsporozoite protein (CSP) and liver stage antigen (LSA-1) of Plasmodium falciparum.

Results: In the five study districts, 1472 individuals were enrolled, with a median age of 22 years (range 1 to 80 years). Thirty-two percent of subjects were under 14 years and 57% were male. The overall seroprevalence of P. falciparum MSP-1, CSP and LSA-1 antibodies were 45, 12 and 5%, respectively. Plasmodium falciparum MSP-1 antibody responses increased significantly with age in all study areas, and were significantly higher among males. The highest seroprevalence to P. falciparum antigens was observed in the Kanel district (63%) and the lowest observed in Podor (28%). Low seroprevalence was observed for non-falciparum species in all the study sites: 0.4, 0.7 and 1.8%, respectively, for Plasmodium ovale, Plasmodium vivax and Plasmodium malariae MSP-1. Antibody responses to P. vivax were observed in all study sites except Kanel.

Conclusion: Prevalence of P. falciparum MSP-1 antibodies and increases by study participant age provided data for low levels of exposure among this transient nomadic population. In addition, antibody responses to P. falciparum short half-life markers (CSP and LSA-1) and non-falciparum species were low. Further investigations are needed to understand the exposure of the Fulani population to P. vivax.
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http://dx.doi.org/10.1186/s12936-020-3114-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958760PMC
January 2020

Geographical distribution of mycetoma cases in senegal over a period of 18 years.

Mycoses 2020 Mar 14;63(3):250-256. Epub 2020 Jan 14.

Cheikh Anta Diop University of Dakar, Dakar, Senegal.

Background: Mycetoma is a pathological process in which fungal or actinomycotic agents of exogenous origin produce grains. In the absence of data on the global burden, it is important to map mycetoma cases, which are useful to implement control strategies.

Objective: The objective of this study was to map mycetoma cases diagnosed in Senegal over a period of eighteen years.

Methodology: The cases of mycetoma identified in the laboratory of Mycology at Aristide Le Dantec Hospital were extracted from the notebooks; information on the dates of collection, geographical origin and fungal agent identified was entered in Excel and analysed.

Results: Three hundred and thirty-seven cases of mycetoma were diagnosed from 1993 to 2016 at Aristide Le Dantec Hospital. Mapping shows that overall, the western zone presented the majority of cases 47% (120), followed, respectively, by the central zone 32% (80), the northern zone 18% (47) and the southern zone 2% (6). However, over the years, this distribution is different with a decrease in cases from the periods 1993-2000 and 2011-2016 of 19% in the western and a progressive increase of cases in northern and central zones of, respectively, 13% and 14%. In the 1990s, the cases were predominant in Dakar, Louga and Diourbel. During 2011-2016, Thies, Diourbel, Fouta and Louga presented more cases.

Conclusion: The spatial distribution of mycetoma in Senegal changed over the years, most frequent in the west of the country, and during 1993 to 2000, mycetoma is now more common in the north.
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http://dx.doi.org/10.1111/myc.13037DOI Listing
March 2020

Cardiac pacing challenge in Sub-Saharan Africa environnement: experience of the Cardiology Department of Teaching Hospital Aristide Le Dantec in Dakar.

BMC Cardiovasc Disord 2019 08 14;19(1):197. Epub 2019 Aug 14.

Cardiology departement of teaching Hospital Aristide Le Dantec, Dakar, Senegal.

Background: Cardiac pacing is a growing activity in Sub-Saharan Africa. There is little data on the characteristics of this interventional treatment in our regions. The goal was to evaluate the results of cardiac pacing in a referral service in sub-Saharan Africa.

Methods: We carried out a twelve-year retrospective study (from January 1st, 2004 to December 31st, 2015) in the Cardiology Department of Aristide Le Dantec University Hospital. This work included all patients who received definitive cardiac pacing during the study period and followed up in the service.

Results: In total we included 606 patients. There was a growing trend in activity with a peak in 2015 (17%). The average age was 70.6 ± 12.03 years. Some patients (15.4%) came from the subregion. The patients were mostly of medium socio-economic level (53%); 14% were of low socio-economic level. Patients were symptomatic in 85% of cases (37.4% syncope). The indications were dominated by complete atrioventricular block (81.5%); sinus dysfunction accounted for 1.9% of them. A temporary pacemaker was used in 60% of cases for an average duration of 5.1 ± 6.3 days. Antibiotics, local anesthesia and analgesics were used in all cases. Implanted pacemakers were single chamber in 56% of cases and double chamber in 44% of cases. In 39 patients (6.4%), the pacemaker was a « re-used » one. The atrial leads were most often placed in a lateral position (94.5%). The ventricular ones were predominantly tined (95.7%) and more often located at the apical level. Complications were noted in 24 patients (3.9%), dominated by devices externalizations and infections, which together accounted for 2.7% of cases. The number of people in the cathlab was significantly higher and the duration of the temporary pacemaker was longer for patients who had a complication. There was no significant difference depending on the type of pacemaker used (new or reused). Seven (7) in hospital death cases were reported.

Conclusion: Cardiac pacing is a growing activity in Dakar.
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http://dx.doi.org/10.1186/s12872-019-1176-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694489PMC
August 2019

[Indications and results of surgical resection of bubbles arising from pulmonary emphysema].

Pan Afr Med J 2018 20;31:48. Epub 2018 Sep 20.

Service de Chirurgie Thoracique et Cardio-vasculaire, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal.

Surgical resection of bubbles or bullectomy is the gold standard in the treatment of bubbles arising from pulmonary emphysema. It is usually indicated for patients with complicated bubbles or when they are the underlying cause of disabling dyspnea. This study aims to determine the indications for bullectomy and to evaluate surgical outcomes in our Department. We conducted a retrospective, descriptive study of 24 patients (23 men and 1 woman) whose average age was 49 years and who had undergone bullectomy between 2004 and 2013. Collected data were: factors favoring the occurrence of bullous emphysema, the circumstances in which bubble was detected, data from the radiological examinations, data from pulmonary and cardiovascular function testing, data from bullectomy, data from postoperative clinical and functional examination. Morbidity rate was 37.5 %. The main complication was persistent air leak (7 cases). One patient died two days after surgery due to acute respiratory failure. The average follow-up period was 26 months during which we observed improvement of dyspnea in all patients and no complications. Bullectomy is an effective, reliable and safe surgical technique that may improve patients' quality of life for a few years.
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http://dx.doi.org/10.11604/pamj.2018.31.48.16160DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430856PMC
April 2019

[Interauricular communications in children: diagnosis and treatment, about 49 cases at the Children?s University Hospital in Dakar].

Pan Afr Med J 2018 2;30:245. Epub 2018 Aug 2.

Service de Chirurgie Thoracique et Cardio-vasculaire, Hôpital de Fann, UCAD, Dakar, Sénégal.

Interauricular communication (IAC) is the second most important congenital heart disease in children. It accounts for 6-8% of congenital cardiac malformations in children. However, many questions are still open about this pathology. Thus, this study aims to report the prevalence rate of IAC in hospital but especially to describe its clinical, paraclinical and therapeutic aspects. For this purpose, we conducted a retrospective descriptive study. Data were collected by means of a questionnaire and then entered and analyzed in Sphinx (V5). The prevalence in Hospital was 2x1000. The average age of patients was 37 months, the sex-ratio was 0,75. No prenatal diagnosis was made. Parental consanguinity was detected in 30% of cases. Respiratory infections were found in 24% of cases. Cardiomegaly was found in 35 cases with hypervascularization in 63% of cases. Ultrasound showed a predominance of ostium secundum; wide IAC was found in 63% of cases. Pulmonary stenosis was the most important associated heart attack. Pulmonary arterial hypertension was found in 63% of the cases. Treatment was based on diuretics, which were largely used and only 7 children underwent surgery. Evolution was favorable in 39 patients reflecting a rate of 79%. Early diagnosis of IAC should be improved as well as surgical treatment of IAC affecting infants.
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http://dx.doi.org/10.11604/pamj.2018.30.245.14556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307921PMC
January 2019

Risk assessment of the occurrence of sudden death related to hypertrophic cardiomyopathy in Dakar.

Cardiovasc J Afr 2018 01 23;29(1):e1-e5. Epub 2018 Jan 23.

Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.

Aim: The aim of this study was to assess of the risk of sudden death in a population of hypertrophic cardiomyopathy patients in Dakar.

Methods: This was a transverse study at the cardiology clinic of Aristide Le Dantec Hospital from January 2014 to June 2015. We used the European Society of Cardiology risk score to calculate this risk.

Results: The average age of patients was 53 years. Unexplained syncope was found in two patients and two others had a family history of sudden death. The septal hypertrophy average was 20.9 mm. Seven patients had left intraventricular obstruction. One patient had a high risk of sudden death, three had intermediate risk and 13 had low risk. Competitive sport was not allowed, 13 patients were under medical treatment, one had an implantable cardioverter defibrillator and two had no treatment.

Conclusion: Our study highlighted a low and intermediate risk of the occurrence of sudden death at five years. One patient had a high risk of sudden death.
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http://dx.doi.org/10.5830/CVJA-2017-010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002797PMC
January 2018

Quality control of malaria microscopy reveals misdiagnosed non-falciparum species and other microscopically detectable pathogens in Senegal.

Ann Clin Microbiol Antimicrob 2018 Mar 15;17(1). Epub 2018 Mar 15.

Laboratory of Parasitology and Mycology, Cheikh Anta Diop University, Avenue Cheikh Anta Diop, BP 5005 Fann, Dakar, Senegal.

Background: In developing countries, malaria diagnosis relies on microscopy and rapid diagnostic tests. In Senegal, national malaria control program (NMCP) regularly conducts supervisory visits in health services where malaria microscopy is performed. In this study, expert microscopists assessed the performance of laboratory technicians in malaria microscopy.

Methods: The present external quality assessment (EQA) was conducted in three different areas of malaria transmission. Participants were laboratory technicians previously trained by NMCP on malaria microscopy. Stored read slides were randomly collected for blinded re-checking by expert microscopists. At the same time a set of 8 slides (3 positive P. falciparum and 5 negative slides) were submitted to participants for proficiency testing. Microscopists performance were evaluated on the basis of the errors rates on slide reading-high false positive (HFP), high false negative (HFN), low false positive (LFP) and low false negative (LFN)-and the calculation of their sensitivities and specificities relative to expert microscopy. Data were entered and analysed using Microsoft Excel software.

Results: A total of 450 stored slides were collected from 17 laboratories for re-checking. Eight laboratories scored 100% of correct reading. Only one major error was recorded (HFP). Six laboratories recorded LFN results: Borrelia, P. ovale, and low parasite densities (95 and 155 p/μl) were missed. Two P. falciparum slides were misidentified as P. malariae and one P. ovale slide as P. vivax. The overall sensitivities and specificities for all participants against expert microscopists were 97.8 and 98.2% respectively; Sensitivities and specificities of hospital microscopists (96.7 and 98.9%) were statistically similar to those of health centre microscopists (98.5 and 97.8% respectively) (p = 0.3993 and p = 0.9412 respectively). Overall, a very good agreement was noted with kappa value of 0.96 (CI 93.4-98.6%) relative to expert microscopy. Proficiency testing showed that among the 17 participants, 11 laboratories scored 100% of correct reading. Three LFN and four LFP results were recorded respectively. The P. falciparum slide with Maurer dots was misidentified as P. ovale in 1 centre and the same slide was misread as P. vivax in another centre; No major error (HFP or HFN) was noted.

Conclusion: EQA of malaria microscopy showed an overall good performance especially regarding P. falciparum detection. However, efforts need to be made addressing the ability to detect non-falciparum species and others endemic blood pathogens such as Borrelia. The further NMCP training sessions and evaluations should consider those aspects to expect high quality-assured capacity for malaria microscopy.
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http://dx.doi.org/10.1186/s12941-018-0261-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5853095PMC
March 2018

Onychomycosis Caused by spp. in Dakar, Senegal: Epidemiological, Clinical, and Mycological Study.

Dermatol Res Pract 2017 4;2017:1268130. Epub 2017 Dec 4.

Laboratoire de Parasitologie-Mycology, CHU Le Dantec, BP 5005, Dakar, Senegal.

spp. represent 9 to 44% of onychomycoses caused by other than dermatophytes. This retrospective study describes 17 cases of onychomycosis diagnosed at the Laboratory of Parasitology and Mycology of Le Dantec University Hospital in Dakar, Senegal, from 2014 to 2016. It included all patients received in the laboratory for suspicion of onychomycosis between January 1, 2014, and December 31, 2016. Diagnosis was based on mycological examination including direct examination and culture. Mycological analysis was considered positive when direct examination and culture were positive after at least one repeat. Seventeen onychomycosis cases representing 12.9% of all onychomycoses reported were diagnosed. There were 5 cases on the fingernails and 12 on the toenails in 6 males and 11 females, and the mean age was 44 years (range: 26-64). Onychomycoses were diagnosed in immunocompetent patients except in a diabetic patient. The mean duration of lesions was 4.9 years (range: 1-15), and distal subungual onychomycosis was predominant. Almost all patients were from suburban areas of Dakar region. The most frequent species isolated belong to complex. Because of the risk of disseminated infection in immunocompromised patients, realization of susceptibility tests is necessary to ensure better therapeutic management.
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http://dx.doi.org/10.1155/2017/1268130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733963PMC
December 2017

Metastatic Spinal Cord Compression Secondary to Liver Cancer.

Case Rep Neurol Med 2017 2;2017:1679523. Epub 2017 Nov 2.

Department of Neurosciences, Fann National Teaching Hospital-Cheikh Anta Diop University, 10700 Dakar, Senegal.

Metastatic spinal cord compression (MSCC) is a medical emergency that requires rapid diagnosis and treatment to reduce pain, to preserve neurological functioning, and to prolong survival. The diagnosis of liver cancer is often neglected in the differential diagnosis of MSCC. Treatment is usually palliative and evolution is often fatal. This is a case report of a 28-year-old patient living in Mauritania hospitalized in November 2014 at the neurology department of Fann national teaching hospital in Dakar, for the management of a chronic dorsal spinal cord compression. The radiological and laboratory investigations done revealed the metastatic compression originating from a liver cancer with elevated alpha-fetoprotein and aspartate transaminase, positive hepatitis B surface antigen, and multiple metastasis in the lungs, mediastinum, ribs, iliac, and peritoneum. The hip joint X-ray showed a spontaneous fracture of the right femoral neck. The multidisciplinary treatment was palliative and the evolution was fatal within the month of hospitalization. Earlier diagnosis and treatment of MSCC may not have saved the life of the patient but may have prevented much suffering and would likely have prolonged the life of a young man.
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http://dx.doi.org/10.1155/2017/1679523DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688373PMC
November 2017

[Epidemiological features of cardiorenal syndrome: a study of 36 cases in the Cardiology Department in Dakar].

Pan Afr Med J 2017 21;28:58. Epub 2017 Sep 21.

Service de Cardiologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.

Introduction: Cardiorenal syndrome (CRS) is a pathophysiologic disorder of the heart and the kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. In Africa, particularly in Senegal, the incidence of cardiorenal syndrome is not accurately known. This study aimed to assess the prevalence of CRS in the Cardiology Department.

Methods: We conducted a retrospective study including all patients with heart failure associated with alteration of renal function, hospitalized in the Cardiology Department between April 2010 and April 2011. Data were analyzed with the statistical software Epi-Info 3.5.3.

Results: 36 patients were included in the study. The prevalence rate was 3.7% with male predominance (sex-ratio 1.77) and an average age of 56.9 years [30-92]. Patients' medical history was dominated by high blood pressure (52.77%) and diabetes (19.4%). The main etiologies were hypertensive cardiomyopathy (39%) and coronary heart disease (19.44%). The symptomatology was dominated by dyspnoea (69.4%) and edema (50%). 17 patients had anemia. The mean measured clearance (MDRD) was 46 ml/min. Doppler echocardiography showed mainly kinetic disorders (89.3%) and left ventricular systolic dysfunction (71%). The three renal ultrasound examinations were normal. Six deaths (16.7%) were recorded.

Conclusion: Cardiorenal syndrome is a reality and marks a turning point in the evolution of heart and kidney diseases. In Senegal, its prevalence in the Cardiology Department is low. Prospective multicentric studies should be conducted in order to better evaluate this syndrome in Senegal.
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http://dx.doi.org/10.11604/pamj.2017.28.58.10257DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718758PMC
December 2017

Post-ivermectin encephalopathy in Senegal: a case report.

Pan Afr Med J 2017 18;27:202. Epub 2017 Jul 18.

Cheikh Anta Diop University, Neurosciences Department, Fann National Teaching Hospital, Dakar, Senegal.

Ivermectin is an ant parasitic drug used for combating onchocerciasis and lymphatic filariasis. It works by inhibiting the function of neurons and muscles, thus causing paralysis of microfilariae. Side effects of this drug have been reported including post-ivermectin encephalopathy requiring emergency care in hospital. We report the case of a 35 years old patient living in rural areas of Senegal who presented two days after a mistake in administration of a second dose of ivermectin, headaches, altered consciousness and bilateral blindness. The workup revealed brain white matter lesions, abnormal liver function tests and biological inflammation without evidence of Loa loa microfilariae in blood and cerebrospinal fluid. Corticosteroid treatment was administered in emergency and patient recovered despite the persistence of bilateral blindness. Inflammatory process seems to have an important role in the pathophysiology of this encephalopathy. We should therefore carefully control the administration of this drugs.
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http://dx.doi.org/10.11604/pamj.2017.27.202.12106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579453PMC
September 2017

Evaluation of CareStart™ Malaria HRP2/pLDH (Pf/pan) Combo Test in a malaria low transmission region of Senegal.

Malar J 2017 08 10;16(1):328. Epub 2017 Aug 10.

Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal.

Background: This study was initiated from the observation that prevalence of malaria obtained with rapid diagnostic test (RDT) (CareStart™Malaria HRP2/pLDH Combo Test) was higher than in microscopy in a malaria low transmission area of Senegal. PCR was then performed to evaluate the performance of the RDT compared to microscopy in clinical settings.

Methods: The study included 215 patients suspected of malaria in two peri-urban area of Dakar. Finger-pick blood samples were tested using RDT (CareStart™Malaria HRP2/pLDH Combo Test). Venous blood samples were collected for light microscopy and PCR (gold standard). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated as performance characteristics.

Results: Considering PCR as the gold standard, CareStart™RDT showed high sensitivity (97.3%) and specificity (94.1%) with PPV and NPV of 97.3 and 94.1%, respectively, while microscopy had a sensitivity and specificity of 93.2 and 100%, respectively, and PPV and NPV of 100 and 87.2%, respectively.

Conclusions: Malaria CareStart™RDT test demonstrated a superior sensitivity compared to microscopy, which is the gold standard for malaria diagnosis. CareStart™RDT could be a useful tool in individuals suspected of malaria even in areas where prevalence is low.
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http://dx.doi.org/10.1186/s12936-017-1980-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5553680PMC
August 2017

Distribution of Parasites Detected in Stool Samples of Patients in Le Dantec University Hospital of Dakar, Senegal, from 2011 to 2015.

J Trop Med 2017 15;2017:8296313. Epub 2017 May 15.

Service de Parasitologie et Mycologie, Faculté de Médicine, de Pharmacie et d'Odontologie, Université Cheikh Anta Diop, BP 16477, Dakar, Senegal.

To identify the parasites responsible for intestinal parasitic infections diagnosed at Le Dantec University Hospital of Dakar, distribution of parasites detected in stool samples of patients was studied. From 2011 to 2015, 2578 patients were included in the study. A direct examination and Ritchie technique were performed as parasite search techniques. In total, 408 samples were positive showing 440 intestinal parasites; this corresponds to prevalence of 15.8%. Parasites were detected in monoparasitism (85.7%) and multiparasitism (14.3%). The most common species found in monoparasitism were (38.9%), (12.7%), (8%), and (7.3%). The most common associations were (3.6%) and (2.7%). Nonhospitalized patients were significantly more affected with 65.4% compared to hospitalized counterparts; and also there were more men (50.7%) than women. With 67.4%, adults were the most affected age group, while the elderly were less affected with only 7% ( = 0.5). This study shows increasing prevalence of intestinal parasitic infections over the years. So health education should be promoted in addition to the already begun mass treatment program. This would help to limit or even halt the spread of these diseases.
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http://dx.doi.org/10.1155/2017/8296313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447258PMC
May 2017

High resolution melting: a useful field-deployable method to measure dhfr and dhps drug resistance in both highly and lowly endemic Plasmodium populations.

Malar J 2017 Apr 19;16(1):153. Epub 2017 Apr 19.

Laboratory of Parasitology Mycology, Aristide le Dantec Hospital, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, 5005, Dakar, Senegal.

Background: Emergence and spread of drug resistance to every anti-malarial used to date, creates an urgent need for development of sensitive, specific and field-deployable molecular tools for detection and surveillance of validated drug resistance markers. Such tools would allow early detection of mutations in resistance loci. The aim of this study was to compare common population signatures and drug resistance marker frequencies between two populations with different levels of malaria endemicity and history of anti-malarial drug use: Tanzania and Sénégal. This was accomplished by implementing a high resolution melting assay to study molecular markers of drug resistance as compared to polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP) methodology.

Methods: Fifty blood samples were collected each from a lowly malaria endemic site (Sénégal), and a highly malaria endemic site (Tanzania) from patients presenting with uncomplicated Plasmodium falciparum malaria at clinic. Data representing the DHFR were derived using both PCR-RFLP and HRM assay; while genotyping data representing the DHPS were evaluated in Senegal and Tanzania using HRM. Msp genotyping analysis was used to characterize the multiplicity of infection in both countries.

Results: A high prevalence of samples harbouring mutant DHFR alleles was observed in both population using both genotyping techniques. HRM was better able to detect mixed alleles compared to PCR/RFLP for DHFR codon 51 in Tanzania; and only HRM was able to detect mixed infections from Senegal. A high prevalence of mutant alleles in DHFR (codons 51, 59, 108) and DHPS (codon 437) were found among samples from Sénégal while no mutations were observed at DHPS codons 540 and 581, from both countries. Overall, the frequency of samples harbouring either a single DHFR mutation (S108N) or double mutation in DHFR (C59R/S108N) was greater in Sénégal compared to Tanzania.

Conclusion: Here the results demonstrate that HRM is a rapid, sensitive, and field-deployable alternative technique to PCR-RFLP genotyping that is useful in populations harbouring more than one parasite genome (polygenomic infections). In this study, a high levels of resistance polymorphisms was observed in both dhfr and dhps, among samples from Tanzania and Sénégal. A routine monitoring by molecular markers can be a way to detect emergence of resistance involving a change in the treatment policy.
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http://dx.doi.org/10.1186/s12936-017-1811-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395743PMC
April 2017

Obstructive Primary Cardiac T-Cell Lymphoma: A Case Report from Senegal.

Am J Case Rep 2017 Mar 20;18:281-285. Epub 2017 Mar 20.

Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.

BACKGROUND Cardiac lymphoma is a rare entity, defined by the non-extra cardiac location at diagnosis. CASE REPORT Our patient was a 32-year-old female with no particular medical history, who presented with right heart failure with recurrent ascites and pleural effusion. There was a progressive worsening exertional dyspnea. On admission, examination revealed an irregular tachycardia at 170 beats per minute (bpm) and congestive heart failure. The electrocardiogram scored full tachyarrhythmia by atrial fibrillation with an average ventricular rate of 179 cycles per minute. Doppler echocardiography showed dilatation and systolic dysfunction of the left ventricle. There were dilated atria. We noted a large mass in the right atrium, which was less mobile, heterogeneous, integral with the wall, and filling three quarters of the cavity. It clogged the tricuspid valve in diastole. CT scan showed a tissue process enhanced after contrast injection, occupying the predominant cavities in the right atrium and filling it. Its borders were irregular. The lesion was extended to the posterior mediastinum, in front of the vertebral axis. In addition, there was a thrombosis of the jugular vein and the inferior vena cava. There was no other tumor site noted. The patient died after presenting with cardiovascular shock associated with refractory right heart failure. Pathology examination confirmed T-cell lymphoma. CONCLUSIONS The primitive cardiac lymphoma is an entity of intra-cardiac masses. It is therefore to be considered even if the diagnosis is challenging.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5374889PMC
http://dx.doi.org/10.12659/ajcr.901455DOI Listing
March 2017

Superior Foville syndrome due to pontine hemorrhage: a case report.

Pan Afr Med J 2016 6;25:215. Epub 2016 Dec 6.

Fann National Teaching Hospital-Cheikh Anta Diop University.

The Superior Foville Syndrome is a rare clinical feature of stroke or brain hemorrhage. Few cases have been reported worldwide particularly in Africa. We report the case of a 20 years old patient resident in Senegal with no known medical history. He was admitted on August 2015 in the Neurology Department of Fann National Teaching Hospital for an abrupt onset of left body side weakness, acute headaches and rotatory vertigo five days before admission. The physical examination found a superior Foville Syndrome. And the brain CT scan shown hemorrhage at the right inferior part of the pons compressing the fourth ventricle. No cause of this hemorrhage stroke has been found. Superior Foville syndrome is a rare clinical presentation of stroke and presented a rich semiological feature of the posterior cerebral fossa.
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http://dx.doi.org/10.11604/pamj.2016.25.215.10648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326188PMC
March 2017

[Clinical, electrocardiographic and echocardiographic aspects in elderly hypertensive patients in Senegal].

Pan Afr Med J 2016 17;25:77. Epub 2016 Oct 17.

Service de Cardiologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar Etoile, Senegal.

Introduction: Arterial hypertension (HTA) in the elderly is an independent risk factor for cardiovascular disease. Our study aims to describe the clinical, electrocardiographic and echocardiographic aspects of Arterial hypertension in elderly patients.

Methods: We conducted a descriptive, cross-sectional study from January to September 2013. Hypertensive patients =60 years treated in Outpatient Cardiology Department at the Principal Hospital in Dakar were included in the study. Statistical data were analyzed using Epi Info 7 software and a p-value < 0.05 was taken as significant.

Results: A total of 208 patients were enrolled in the study. The average age was 69.9 years with a female predominance (sex ratio 0.85). Average blood pressure was 162/90 mm Hg. HTA was under control in 13% of cases. The ECG showed evidence of rhythm disturbance (17.78%), left atrial enlargement (45.19%), left ventricular hypertrophy (28.85%) and complete atrioventricular block in 2 cases. Holter ECG revealed non-sustained ventricular tachycardia (Lown class IVb) in 4 cases, paroxysmal atrial fibrillation in 6 cases and paroxysmal atrial flutter in 1 case. Echocardiography performed in 140 patients showed mainly concentric left ventricular hypertrophy in 25 patients, occuring more frequently in males (p=0,04) and dilated left atrium in 56,42% of cases, occuring more frequently in elderly patients (p= 0,01).

Conclusion: Electrocardiographic and echocardiographic aspects in elderly hypertensive population are characterized by concentric left ventricular hypertrophy and by the frequency of arrhythmias sometimes revealed by long-term continuous external electrocardiographic recording.
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http://dx.doi.org/10.11604/pamj.2016.25.77.10086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324146PMC
March 2017

Penetrating chest injuries caused by swordfish sword used as a weapon.

Asian Cardiovasc Thorac Ann 2017 Mar 10;25(3):229-232. Epub 2017 Feb 10.

1 Thoracic and Cardiovascular Surgery Clinic, Fann University Hospital Center, Dakar, Senegal.

We report 5 cases of penetrating chest wounds caused by weapons made from swordfish swords, involving breakage of the sword that later appeared as a thoracic foreign body. The patients had been assaulted 2 days to 17 years earlier. Three of them had a chronic infected wound, one had a penetrating thoracic wound with hemopneumothorax, and one had a foreign body. Computed tomography showed a foreign body in the lung in 4 cases, with aortic penetration in one. The foreign body was removed via thoracotomy in all 4 patients, with aorta repair in one who presented later with a pseudoaneurysm.
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http://dx.doi.org/10.1177/0218492317694521DOI Listing
March 2017

Plasmodium falciparum malaria co-infection with tick-borne relapsing fever in Dakar.

Malar J 2017 Jan 11;16(1):24. Epub 2017 Jan 11.

Laboratoire de Parasitologie-Mycologie, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal.

Background: West African tick-borne relapsing fever (TBRF) due to Borrelia crocidurae and malaria are co-endemics in Senegal. Although expected to be high, co-infections are rarely reported. A case of falciparum malaria and B. crocidurae co-infection in a patient from Velingara (South of Senegal) is discussed.

Case: A 28 year-old-male patient presented to Aristide Le Dantec Hospital for recurrent fever. He initially presented to a local post health of Pikine (sub-urban of Dakar) and was diagnosed for malaria on the basis of positive malaria rapid diagnostic test (RDT) specific to Plamodium falciparum. The patient was treated as uncomplicated falciparum malaria. Four days after admission the patient was referred to Le Dantec Hospital. He presented with fever (39 °C), soreness, headache and vomiting. The blood pressure was 120/80 mmHg. The rest of the examination was normal. A thick film from peripheral blood was performed and addressed to the parasitology laboratory of the hospital. Thick film was stained with 10% Giemsa. Trophozoite of P. falciparum was identified at parasite density of 47 parasites per microlitre. The presence of Borrelia was also observed, concluding to malaria co-infection with borreliosis.

Conclusions: Signs of malaria can overlap with signs of borreliosis leading to the misdiagnosis of the latter. Thick and thin smear or QBC test or molecular method may be helpful to detect both Plamodium species and Borrelia. In addition, there is a real need to consider co-infections with other endemics pathogens when diagnosing malaria.
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http://dx.doi.org/10.1186/s12936-017-1682-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225580PMC
January 2017

West Africa International Centers of Excellence for Malaria Research: Drug Resistance Patterns to Artemether-Lumefantrine in Senegal, Mali, and The Gambia.

Am J Trop Med Hyg 2016 Nov 22;95(5):1054-1060. Epub 2016 Aug 22.

Medical Research Council, The Gambia.

In 2006, artemether-lumefantrine (AL) became the first-line treatment of uncomplicated malaria in Senegal, Mali, and the Gambia. To monitor its efficacy, between August 2011 and November 2014, children with uncomplicated Plasmodium falciparum malaria were treated with AL and followed up for 42 days. A total of 463 subjects were enrolled in three sites (246 in Senegal, 97 in Mali, and 120 in Gambia). No early treatment failure was observed and malaria infection cleared in all patients by day 3. Polymerase chain reaction (PCR)-adjusted adequate clinical and parasitological response (ACPR) was 100% in Mali, and the Gambia, and 98.8% in Senegal. However, without PCR adjustment, ACPR was 89.4% overall; 91.5% in Mali, 98.8% in Senegal, and 64.3% in the Gambia (the lower value in the Gambia attributed to poor compliance of the full antimalarial course). However, pfmdr1 mutations were prevalent in Senegal and a decrease in parasite sensitivity to artesunate and lumefantrine (as measured by ex vivo drug assay) was observed at all sites. Recrudescent parasites did not show Kelch 13 (K13) mutations and AL remains highly efficacious in these west African sites.
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http://dx.doi.org/10.4269/ajtmh.16-0053DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094217PMC
November 2016

[Anatomical bases of external pudendal artery injuries during surgical treatment of pelvic limb varices].

Pan Afr Med J 2016 7;24:199. Epub 2016 Jul 7.

Laboratoire d'Anatomie et Organogenèse, Faculté de Médecine, de Pharmacie et d'Odontologie, Université Cheikh AntaDiop de Dakar, Sénégal.

Introduction: External pudendal artery is a collateral branch of the common femoral artery which is the primary blood supply to the penis or the clitoris. Its relationship with the venous arch of the great saphenous vein and its afferents in femoral triangle, are very narrow. This often entails injuries during crossectomy and great saphenous vein stripping. These lesions can cause sexual dysfunction.

Methods: This study reports the case of a dissection of 22 inguinal regions in 13 men and 9 women who underwent surgical treatment of the femoral triangle. The distribution and the relationship between the external pudendal artery and the venous arch of the great saphenous vein are studied.

Results: Single external pudendal artery is the most common. All external pudendal arteries originate from the common femoral artery. The most common type of relationship is between the sub-crossing of the venous arch of the great saphenous vein and a single external pudendal artery. Moreover, we recorded a pre-crossing, an alternate crossing and some relationship with the common femoral vein and the afferences of the venous arch of the great saphenous vein. Some surgical techniques expose more or less to external pudendal artery injury.

Conclusion: This study confirms previous data but shows some peculiarities about the relationship between the venous arch of the great saphenous vein and external pudendal artery.
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http://dx.doi.org/10.11604/pamj.2016.24.199.7874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072870PMC
February 2017
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