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D Thiam

Publications and source records attributed to D Thiam.

At least 19 recordsLinked to original sources
PubMed2006

[Seroprevalence of hepatitis C virus (HCV) in Senegalease blood donors].

INTRODUCTION: Hepatitis C virus (HCV) is an important problem of public health in the world according to its transmission mode and its pathogenesis. The risk of blood transmission has led to be the systematic screening of blood donors in the world. In Senegal no study about HCV prevalence on the general population and also has been done. The aim of our study was to determine HCV prevalence in blood donors and the rate of co-infection with hepatitis B (HCV/HBV) or with HIV infection (HCV/HIV). MATERIALS AND METHODS: This study had been done in the National Blood Transfusion Centre (CNTS) in Dakar. Two different techniques has been used for the assessment HCV: 1/ ELISA technique and 2/ Immunoblot RIBA as confirmation test. RESULTS: Our study relates to 1565 blood donors recruited in CNTS during 2002. 369 of them were new blood donors with 365 females and 1200 males. The mean average was 30.5 +/- 9.5 years, ranged from 18 to 59 years. HCV ELISA test were positive in 22 plasma samples and one of them were co-infected with hepatitis B (HCV/HBV). Four out of these 22 samples have been confirmed positive to RIBA test and three of them were not determined. HCV seroprevalence were 1.4% after ELISA and 0.25% after RIBA testing. This seroprevalence were similar in male and in female and higher in new blood donors than in regular blood donors. CONCLUSION: Our results reinforce the necessity to screen hepatitis C virus in all Senegalese blood transfusion centres.

Adolescent↗
PubMed2005

[Prevalence and morbidity of G6PD deficiency in sickle cell disease in the homozygote].

Sickle cell disease and G6PD deficiency have similar prevalence of 8 to 10% in Senegalese population. Our objectives were to determine the prevalence of G6PD deficiency in Hb S carriers and normal subjects, and to assess the interaction of G6PD deficiency on clinical severity of sickle cell disease. G6PD activity was measured in 319 sickle cell patients and in 318 subjects without HbS. Clinical severity was compared in male homozygous sickle cell patients (11 with G6PD deficiency and 19 without deficit). In homozygous sickle cell patients, the G6PD status was assessed after correction of reticulocyte count following the micro-centrifugation method of Herz. We found that prevalence of G6PD deficiency was higher in sickle cell disease patients (21.6 %) than in normal subjects (12.3 %) (p = 0.001). No difference was found in the two groups of male sickle cell disease patients concerning number of vaso-occlusive crisis, number of transfusion, frequency of infectious episodes, number of chronic complications, disturbances on patient's activity and total index severity.

Adolescent↗
PubMed2005

[Expression of proliferation marker Ki 67 in chronic lymphocytic leukemia].

Chronic lymphocytic leukemia (CLL) is characterized by a clonal expansion of low proliferating mature B and T lymphocytes in the bone marrow and peripheral blood. The nuclear antigen Ki 67 is a protein detected in G1, S, G2 and M phases of the cell cycle, but not in G0, and thus, is a widely accepted proliferation marker of Human tumors. The aim of this study was to evaluate Ki 67 monoclonal antibody in CLL. We studied 48 patients diagnosed as CLL on the presence of clinical signs, over 4.109/l circulating lymphoid cells and immunophenotyping by flow cytometry using CD19, CD5, CD22, CD23, FMC7 and immunoglobulin light chains monoclonal antibodies. Ki 67 immunostaining was determined by Avidin Biotin Complex method. Our results allows to characterize between CLL: one group which proliferation rate (percentage of Ki 67 positive cells) was equal or less than 2%, represented by 14 cases (29,2%) with morphological aspect of typical CLL, one group which proliferation rate was between 3% and 9% represented by 32 cases (66,6%) with morphological aspect of polymorph CLL or prolymphocytic leukemia, and a last group with proliferation rate equal or up to 10% and corresponding to two cases (4,2%) of transformation of CLL to high grade Non Hodgkin lymphoma. There were no correlation between Matutes immunological score and proliferation rate, as this rate was 2.9% in score < 3 and 2.7% in score > 3. This study confirm the Ki 67 usefulness in studying cellular proliferation, and underline that CLL with polymorphic cytology are more proliferate than typical CLL. These data reinforce the notion that CLL is a disease with heterogeneity in clinical behavior, immunophenotype, cytogenetic, molecular aspects, and thus, prognostic.

Adult↗
PubMed2004

[Non-Hodgkin's lymphoma in Dakar: study of 107 cases diagnosed between 1986 and 1998].

Non-Hodgkin's Lymphomas (NHL) are the most prevalent malignant hemopathies in Senegal. In this study we have investigated the epidemiological aspects considering the HIV infection pandemic, and evaluated the diagnosis means and evolutive features of this disease in Dakar. Between 1986 and 1998 (13 years), we collected 107 cases of NHL, all histologically confirmed. Average age of patients was 31.4 years (2-85 years) and sex ratio was 21. HIV infection was found in three out of 62 patients tested (4.8%). At moment of diagnosis, 72% of patients were in stage III or IV according to the Ann Arbor Staging System. Large cell lymphomas were predominant (67.2%), followed by small lymphocyte lymphomas (24.2%) and follicular lymphoma with 8.4% of cases. Localization of lymphomas was exclusively nodal (30.8%) or extra nodal (31.7%) or mixed (37.3%). In therapeutical field, 21.5% of patients were treated with only symptomatical means. Chemotherapy was used in 54 patients (78.2% of treated patients), surgery was performed in 6 patients (8.6%), association of radiotherapy and chemotherapy in 5 patients (7.2%) and 4 patients (5.7%) were treated with surgery + chemotherapy. The average survival time was 344 days. Four patients (3.7%) were alive 3 years after diagnosis and only 2 patients (1.8%) after 5 years.

Adolescent↗
PubMed2004

[Maternal anaemia: effect on the newborn].

Pregnancy increases considerably iron needs in mother and her foetus. The purpose of our study is to measure the effect of maternal anaemia on the foetus and the effect of iron supplementation on the maternal and foetal reserves. Therefore, we conducted a three-month cross sectional study at the gynaecological and obstetrics clinics of Aristide Le Dantec Hospital. Ninety-five women aged 16 to 43 years old and having an haemoglobin rate < 11 g/dl were recruited. Most of them were primipares. Among them 69 had a low ferritinemia (< 50 ng/ml), 36, a ferritinemia collapsed (< 30 ng/ml) and 13 virtually non-existent reserves (< 12 ng/ml). All newborns were born in terms with an apgar score >/= in 93 of them. Among them 24 had anemia (rate of haemoglobin < 14 g/dl) and 54.7% a low ferritinemia. There is no relationship between the maternal and foetal rates of haemoglobin; 74% of newborn had a normal rate of haemoglobin. Among 36 women with low ferritinemia only two gave birth to a newborn without iron reserves. In our study, among 68 women who received iron regularly, 41 had normal reserves and 43 gave birth to a newborn with high ferritinemia. There is significant difference between the women having received iron during their pregnancy and those not supplemented as regards the effect on newborn (p = 0.00001). The prevention of iron deficiency and anaemia can be done by the iron systematic and premat supplementation.

Adolescent↗
PubMed2004

[Bone marrow aspiration in diagnosis of hemopathies in Dakar, Senegal].

The cytological study of bone marrow aspirate, is a useful technique in diagnosis and epidemiological surveillance of hemopathies. Between January 1991 and February 1999, we realized 1000 bone marrow puncture in Dakar hospitals, this study aims to analyze the frequency of diagnosed hemopathies, and to appreciate justification of prescription. Mean age was 31.6 (1 to 88 years). Bone marrow puncture was safe because no incident was observed. Interpretation was possible in 937 cases while the 33 authors was diluted by blood. Bone marrow was normal in 550 cases (57.3%) whereas abnormality was detected in 417 cases (42.7%). The more frequent pathology were quantitative or qualitative defect of bone marrow production with respectively 25.8% and 20.1%, followed by chronic myeloid leukemia (16%), lymphoproliferative disorders (16%), acute leukemias (13.9%), bone marrow metastasis (5.9%), and storage diseases (1.9%). The best justification of the prescription was obtained when done on the basis of hemogram abnormalities or signs in hematopoietic organs with a pathology found in 90% of cases. Prescription on the basis of non hematological signs or to search for metastasis when primitive tumor was not identified were less efficient with respectively 20% and 42% of normal bone marrow. These results emphasize the interest of bone marrow aspiration in epidemiological surveillance of hemopathies, and the advantage to respect the rights indications, in consideration of pain and intolerability of the puncture by patients.

Adolescent↗
PubMed2003

[Homozygous sickle cell disease in patients above 20 years of age: follow-up of 108 patients in Dakar].

CONTEXT: The progress realized in the treatment of sickle cell anemia has resulted to a better and longer life for these patients in developed countries. Ongoing challenge are to manage complication and social living for these patients. The purpose of this study was to determine morbidity, mortality and socioprofessional insertion of homozygous sickle cell patients, followed up in Dakar university hospital. PATIENTS AND METHODS: We performed a longitudinal and prospective study including 108 homozygous sickle cell anemia patients, whose age were above 20 years, followed in a regular basis (at least 3 times per year), during 5 years on average (3 to 12 years). All patients had a quarterly hematological check-up and a annual statement to detect chronic complications. Clinic and paraclinical data, as information in socioprofessional insertion were noted in medical records for analysis. RESULTS: Mean age was 27 years (20-51 years). The age between 20-29 years was represented by 67.5%, 26.9% aged 30-39 years and 5.6% were above 40 years of age. Men were slightly predominant with a sex-ratio of 1.25. Concerning morbidity, 96.3% of patients had at least 1 vaso-occlusive crisis per year, 26.9% were transfused and 64.8% had been hospitalized during the follow-up. A chronic complication was found in 49% of patients (53/108). The more frequent of these complications were gall stone (10%), femoral head necrosis (9.2%), priapism (11.6% of men), chronic leg ulceration (4.6%), ophthalmic involvement (3.7%), renal and cardiac complications (2.7% for each one). The presence of complications was not significantly influenced by patient's sex. Five patients died during a mean follow-up of 5 years. Concerning school attendance, 13% reach university level whereas 47% stop their education on the secondary level and 40% on primary level. Professionally, 36.2% of patients had no exercise any activity. CONCLUSION: Our results emphasize that life expectancy can be prolonged in sickle cell anemia patients in Africa, when they have a benefit of a regular follow-up. We show also the respective frequency of chronic complications and then, the necessity of multidisciplinary teams to optimize the take care of sickle cell anemia patients in Africa.

Adult↗
PubMed2003

[Pattern of type A hemophilia in Senegal: prospective study in 54 patients].

Little is known about hemophilia in the developing countries because of the difficulties in the diagnosis and the therapeutical management of this disease. Here we present the results of the follow-up of 54 patients in Senegal. Diagnosis was always confirmed by measuring the biological activity of factors VIII and IX. Patients were treated at home or in the hematology service according to the gravity of hemorrhage events. The severe form represented 29.6%, moderate form was 55.6% and minor form 14.8%. Total number of hemorrhage events was 1078 per year: 449 hemarthrosis (41.7%), 373 exteriorized hemorrhage (34.7%) and 256 hematomas (23.7%). Mean frequency of hemarthrosis per patient per year was 12 in severe form, 8 in moderate form and 3 in minor form. Mean frequency of hematomas per patient per year was 5.2 in severe, 4.9 in moderate and 4.2 in minor form. For exteriorized hemorrhage, the mean frequency was 7.06 in severe, 7.4 in moderate and 6.5 in minor form. The severity of hemophilia significantly influenced the frequency of hemarthrosis (P = 0.02) but not the frequency of hematoma (P = 0.6) and exteriorized hemorrhage (P = 0.6). Treatment of these accidents was performed at home (88.5%), in day hospital (9.5%) or needed hospitalization (1.8%). Three patients have died during this three-year survey, one because of HIV infection and the two others from digestive hemorrhage. In conclusion, lesser morbidity and mortality were observed when compared with previously. The importance of a regular follow up and education of patients must be emphasized especially if factor concentrates are not available.

Adolescent↗
PubMed2003

[Epidemiologic aspects and medical-social impact of hemophilia at the University Hospital Center in Dakar].

The epidemiology and medico-social impact of hemophilia is poorly understood in Africa due to low incidence of the disease and lack of trained hematologists and adequate laboratory facilities. The purpose of this report is to describe our experience with the organization of regular follow-up for hemophilia patients at the University Hospital Center in Dakar, Senegal. A total of 54 patients with type A hemophilia were included in this three-year study. Moderate forms of hemophilia were the most common (55.6%) followed by severe (29.6%) and minor (14.8%) forms. There was no significant difference in mean patient age according to disease severity, i.e., 19.3 years for patients with severe forms, 13.4 years for patients with moderate forms and 15 years for patients with minor forms. Patients over 20 years of age accounted for 27.9% of the study population. The remaining patients were younger, i.e., between 10-19 years (33.3%) and between 1 and 9 years (38.8%). Eighty-seven percent of patients lived in Dakar and the remaining 13% were from various regions of the country. Among the 54 patients in this study, there were 38 (70.3%) with no hemophiliac brother in the family, 13 (24.1%) with one hemophiliac brother and three (5.6%) with two hemophiliac brothers. Osteoarticular damage was found in 28 patients (53.8%) involving the knee in 22, elbow in 18 and ankle in 9. Four patients were positive for HBs Ag (7.4%) and one patient for HIV. Professional or scholastic activity was possible in 69.2% of patients under 20 years old and 46.6% over 20 years old. Although results are still inadequate, a clear-cut improvement has been noted in the survival and quality of life of hemophiliacs in comparison with previous years. These findings show the value of regular surveillance for hemophilia patients in countries with limited resources.

Adolescent↗
PubMed2003

[Hairy cell leukemia revealed by an isolated neutropenia].

Hairy cell leukemia is a rare lymphoproliferative disorder which affect predominantly older males. Typical presentation includes pancytopenia, splenomegaly, presence of malignant cells with hairy projections, and some difficulty to perform a bone marrow aspiration. Reported is a 78 year - old female patient, who presented only neutropenia. There was no splenomegaly and the bone marrow aspiration was easy. Diagnosis was based on the presence of characteristic cells in a second bone marrow aspiration, whereas a treatment by recombinant human G-CSF was introduced for a suspicion of an idiopathic neutropenia. Confirmation was done with immunostaining by DBA 44 monoclonal antibody. This is the first case of hairy cell leukemia reported in Dakar, and with an uncommon clinical presentation making it difficult to be recognized.

Aged↗
PubMed2002

[Evaluation of thrombotic risk in type 2 diabetes: determination of platelet factor 4 and beta thromboglobulin].

We achieved the dosage of platelet factor 4 (PF 4) and beta thromboglobulin (B-TG), two proteins stored in platelet alpha granules and released from the platelets when activated. These proteins were studied by ELISA technics in patients with type 2 diabetes without any complications (n = 32), with thrombotic complication (n = 32) and in a healthy control group (n = 32). The diabetic patients with complications had significantly elevated plasma levels of PF4 and B-TG compared with diabetic patients without complications, whereas levels of these proteins where normal in control group. These high rates of PF4 and B-TG were significantly related to a disturbance of lipidic balance. Our data suggest that platelet hyperactivation may be a reliable element in the pathogenesis of thrombotic complications in type 2 diabetes.

Adult↗
PubMed2001

[Respiratory manifestations of malignant lymphomas: report of 5 cases].

In this study the authors report 5 cases of malignant lymphomas consisting in a Hodgkin's disease and 4 non Hodgkinian lymphomas. Patients aged from 16 to 55 years were 4 males and 1 female, consulting in Department of respiratory disorders of the University Hospital in Dakar, Senegal, West Africa, from 1986 thru 1992. Detoriation of the general status, cough, dyspnea and cervical adenopathy were remaked in all patients. Thoracic pain and syndrom of right pleurisy were diagnosed in one case of non Hodgkinian malignantlymphoma. X Ray exploration of the chest detected 4 cases of mediastinal adenopathies and 3 pleurisis in non Hodgkinian malignant lymphomas; and reticulonodular opacities of pulmonary basis in the Hodgkin's disease case. The diagnosis has been confirmed by pathologic anatomy studis of the biopsed ganglia. The endemic characteristic of tuberculosis in developing countries make necessary to evoke it in first of any adenopathy. When the clinical feature is atypical, a biopsy of ganglia must be performed to avoid diagnosis delay which could lead to agravate the prognosis of malignant lymphomas.

Adolescent↗
PubMed2000

[Fibrinolytic syndrome during surgery for benign prostatic hypertrophy (50 cases in the urology service at the Aristide le Dantec University Hospital Center)].

Prostate's surgery is an haemorrhagic one owing to difficulties of surgical haemostasis and anomalies of the blood coagulation. The aim of this study to assess haemostasis anomalies after protatectomy for benign prostatic hyperplasia (BPH). We have performed a prospective study including 50 men of more of 55 years old. All of them underwent suprapubic open prostatectomy. Significant pertubation of haemostasis, particularly fibrinolysis has been found. We have noticed fibrin degradation product in 88% of cases after intervention versus 62% before (p < 0.001) and a decrease of plasminogen rate in 94.4% of operated patients versus 82% before. The older the patient were, more important were the pertubations. Moreover, the anomalies were most important when the duration of surgery lasted more than one hour and when the BPH was voluminous. However, the disturbance of haemostasis was rarely associated to clinical symptoms. So, we do not recommend any therapeutic when clinical symptoms are absent. Biological screening the day of surgery, the day after and one week later are necessary to prevent haemorrhage.

Academic Medical Centers↗
PubMed2000

[Antiphospholipid antibodies and recurrent spontaneous abortions at the Aristide Le Dantec University Hospital Center].

Antiphospholipids including lupus anticoagulants (LA) and anticardiolipins (ACL) are known to be able to lead to many obstetricals complications like gravidic chorea, eclampsia and repeated spontaneous abortion. Our objective was to determine place of antiphospholipids among women presenting repeated spontaneous abortion in Senegal. We tested prospectively 96 women in a breeding age with a past history of at least 2 spontaneous abortion. 14.6% and 21.1% of tese women present present respectively LA and ACL. The prevalence of antiphospholipids in among women presenting repeated abortion is higher in Senegal and similar to those previously reported confirming its place in this pathology important. A strategy of diagnosis should be defined between obstetricians and biologists in order to improve the obstetrical prognosis.

Abortion, Habitual↗
PubMed1999

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.

Activities of Daily Living↗
PubMed1999

[Hematologic abnormalities and immunodepression in HIV/AIDS- related pulmonary tuberculosis].

Our objectives were to describe hemato-immunological abnormalities encountered in tuberculosis patients HIV seropositive (TBVIH+, n = 67) or not (TBVIH-, n = 39) and in HIV asymptomatic patients (aSVIH+, n = 40). We found: a great reduction of mean value of RBC and Hb in TBVIH+ and TBVIH-; a reduction of mean value of leucocytes, total lymphocytes and CD4+ lymphocytes in TBVIH+ and aSVIH+; an inversion of [formula: see text] ratio, more important in TBVIH+ than in aSVIH+. HIV and tuberculosis association, HIV1 serotype and CD4 < 200/mm3 were found to promote significantly hemato-immunological abnormalities.

Acquired Immunodeficiency Syndrome↗
PubMed1999

[Protein C, protein S and antithrombin III at normal delivery and during abruptio placentae].

Protein C, Protein S and Antithrombin III were screened in one hundred patients admitted for abruptio placentae and one hundred women who delivered normally in Dakar university hospital. We found a reduction of Protein S at normal delivery which is linked to hypercoagulation activity during this process. PC and PS were significantly decreased during abruptio placentae in relation with the disseminated intravascular coagulation which was found in our study. We recommend to include these tests to explore aetiologies of abruptio placentae and to confirm their congenital deficit two months after delivery.

Abruptio Placentae↗