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M Soumare

Publications and source records attributed to M Soumare.

At least 19 recordsLinked to original sources
PubMed2005

[Current aspects of Salmonella bacteremia cases in the Ibrahima Diop Mar Infectious Diseases clinic, Fann National Hospital Center (Senegal)].

OBJECTIVE: The aim of this study was to describe epidemiological, clinical and bacteriological aspects of Salmonella bacteremia in the Fann university hospital infectious diseases clinic. PATIENTS AND METHOD: This study was carried out on data recorded between January 1, 1996 and December 31, 2003. The strains were identified according to biochemical (API 20E, BioMérieux) and antigenic features. Their susceptibility to antibiotic drugs was tested by antibiogram. Research of strains secreting of an extended-spectrum betalactamase was performed. RESULTS: Fifty five cases of Salmonella bacteremia were recorded as follows: S.Typhi bacteremia (32 cases), S. Paratyphi C bacteremia (4 cases), S. typhimurium bacteremia (9 cases), S. enteritidis bacteremia (32 cases) and S. spp bacteremia (8 cases). All the strains were susceptible to ciprofloxacin, ceftriaxone, aztreonam, amoxicillin+clavulanic acid and 90 % of them were susceptible to cotrimoxazole. Bacteremia occurred in 50 HIV infected patients (49%). Salmonella other than Typhi bacteremia were more often present in patients with HIV (81% vs 36% in patients without HIV infection) (P = 0.00001). The lethality rate was 42%. This rate was higher in patients with HIV (56 vs 23% in patients without infection) (P = 0.002). CONCLUSION: The lethality rate of Salmonella bacteremia is high, especially in AIDS patients. Therefore, priority must be given to prevention and chemoprophylaxis with cotrimoxazole should be a good way to reduce the incidence of bacteremia in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed2005

[Clear-fluid meningitis in HIV-infected patients in Dakar].

This retrospective study was carried out to describe the epidemiological, clinical and aetiological aspects of clear-fluid meningitis among HIV-positive patients admitted at the Infectious Diseases Clinic in Fann Teaching Hospital in Dakar Data were collected for analysis from patients files recorded from January 1, 2001 to December 31, 2003. Forty-six cases of clear-fluid meningitis were found among HIV-infected patients, representing 51.7% of cerebro-meningeal diseases and 92% of meningitis encountered in those patients. Sex ratio MIF was 1.5 and the mean age of patients was 40.7 years [range 23-61 years]. Clinical presentations comprised headache (80%), fever (67%), meningeal syndrome (74%), coma (28%), convulsions (9%), focal neurological deficits (11%), cranial nerves dysfunction (9%). Aetiologies were represented by neuromeningeal cryptococcosis (29 cases) and tuberculous meningitis (5 cases). In 26% of cases no aetiology was found. The case fatality rate was 63% overall (29 deaths) and 83.3% among cases with unknown aetiology. It did not vary significantly according to epidemiological and clinical variables studied. Neurological sequelae were found in 4 patients who recovered. A better management of clear-fluid meningitis among HIV-positive patients should benefit from the reinforcement of our diagnostic capacities, the availability of effective systemic antifungal drugs and the prevention of opportunistic infections in the course of HIV/AIDS infection.

Adult↗
PubMed2005

[Prescription of morphinics in the management of pain in Dakar teaching hospitals].

The correct management of pain is one of the most frequent problems in a daily medical practice. To achieve this goal physicians have to use many drugs. Among these drugs morphinics represent a special category with specific rules of administration. To assess the use of morphinics in the management of pain in Dakar teaching hospitals and to determine the reasons of under or over prescription, we carried out this study A questionnaire was sent to 200 medical doctors in two teaching hospitals in Dakar between February and April 1999. The response rate was 89.5% (179). According to 73.2% of medical doctors who answered the questionnaire, pain frequently leads to consultation but surprisingly only 14 physicians (7.8%) recognize a regular use of morphinics while 70.1% of them prescribe morphinics exceptionally Morphinics are mainly used to control pain in cancerology (37.2%) and post-operative pain (21.3%). The main reasons to explain the under-use of morphinics were: the fear of respiratory side-effects of morphinics (35.3%), the ignorance of prescription rules (23.5%). The training regarding prescription of morphinics was provided during medical studies and only 10 out of the medical doctors had an adequate postgraduate training in this domain. As expected 51.4% of physicians thought that their training during medical studies was inadequate. To improve the management of pain in our country we recommend a better training of medical doctors during medical studies and the promotion of postgraduate seminars on the use of these molecules. The legislation and rules of administration must be cleared and these drugs should be more available in drugstores and hospital pharmacies. All of these modifications are necessary to help medical doctors to overcome the fear of morphinics for a better management of pain in our country.

Adult↗
PubMed2003

[Resistance of bacteria and antibiotic prescription in Fann University Teaching Hospital, Dakar].

The objective of this study conducted in Fann University Teaching Hospital in Dakar, is to establish correlation beetwen the prescription and consummation of antibiotics in the one hand, and the susceptibility of strains isolated in this hospital on the other hand. An interview of medical practitioners and pharmacists was realised to appreciate the antibiotics used in the clinics, the bacteria taken aim, the criteria of choice, the place of antibiogram, the place of antibiotics in orders of medicines and pharmacists, the consummest family of antibiotics. In the lab, all of pathogen bacteria were tested by disc diffusion test (antibiogram) to appreciate the susceptibility to antibiotics. The results show that Enterobacteria represented 60.8% of isolates and among them, Escherichia coli (30.6%) was the most representative specie in hospitalized and non hospitalized patients. 52% of the strains of E. coli were susceptible to aminopenicillins in external patients, versus less than 35% in hospitalized. In Neurosurgery, Pseudomonas aeruginosa was the most frequent bacteria and all of the strains were susceptible to imipenem, dibekacin and ciprofloxacin. Beta-lactams were the most used drugs in the first place (78.8%), related to habits of prescription of medical staff and to avaibility of antibiotics. The choice of antibiotics must take the susceptibility of strains into account.

Anti-Bacterial Agents↗
PubMed2002

[Clinical, bacteriological and therapeutic aspects of meningococcal meningitis in Dakar in 1999].

Two major outbreaks of meningitis due Neisseria meningitidis serogroup A occurred in Senegal in 1998 and 1999. The purpose of this report is to describe clinical, bacteriological and therapeutic findings in 70 patients admitted for cerebrospinal meningitis to the Infectious Disease Clinic at the Fann University Teaching Hospital in Dakar in 1999. Diagnosis was based on direct microscopic examination after Gram staining in 71% of the cases, culture in 76%, and detection of soluble antigens in cerebrospinal fluid in 24%. Median patient age was 20 years. The highest incidence, i.e. 66% of cases, was recorded during February, March and April. Meningitic syndrome and fever were observed with 86% of the cases. The average duration of antibiotic therapy was 8 days. Chloramphenicol was the most commonly used drug (84% of cases). All strains identified in cultures were sensitive to chloramphenicol, ceftriaxone and cefotaxime but resistant to cotrimoxazole. Outcome was favorable in 93% of the cases. Three patients (4%) died and two (3%) developed hearing loss. Despite the low death rate in this series of patients treated in a hospital setting, mass vaccination is still the most effective mean of controlling meningococcal meningitis.

Adolescent↗
PubMed2002

[Multifocal tuberculosis with epididymitis and orchitis in an HIV negative patient].

This case report try to point out the importance of early diagnosis, and an appropriate treatment in multifocal tuberculosis including a testicular localization. A 25 year-old male with a past history of tuberculosis contact and untreated chronic cough with haemoptysis is admitted in our in-patient clinic. Eighteen months earlier, he presented a long course fever, with lumbar pain. Thereafter, the patient condition worsened as he lost weight and developed an enlargement of the right testicle with an scrotal abscess fistulous and a meningo-encephalitis clinical presentation. The bacilloscopy performed on gastric specimen and scrotal caseous was negative. The cerebrospinal fluid was clear and showed a mixed formula with 370 cells including 50% of lymphocytes, an elevated albumin (0.70g/l) and low glucose (0.10g/l) . Sterile pus was detected in urine. The tuberculosis skin test was positive. In addition to the clinical and epidemiological context, the radiological findings (chest and spine X-ray, testicular ultrasonography, cerebral CT Scan) were consistent with multifocal tuberculosis infection with lung miliary, epididymal-orchitis, and brain tuberculomas. The patient was treated successfully using a two-step protocol: two-month treatment with isoniazid, rifampicin, ethambutol and pyrazinamid altogether; followed by a seven-month regimen with isoniazid and rifampicin. Nevertheless,the patient is likely to develop static trouble and infertility because of the spine sequela and testicle atrophy he presented.

Adult↗
PubMed2001

[Antifungal drug susceptibility of Candida causing oropharyngeal candidiasis in HIV infected patients].

Candidiasis are very usual infections of HIV infected patients. By medicine pressure, susceptibility to antifungal drugs decrease in some Candida strains. This study carded out in 1997 at hospital, aimed to identify the yeast species isolated from HIV infected patients with oropharyngeal candidiasis, test their susceptibility to antifungal drugs and a previous antifungal treatment impact. Thus, 60 patients yielded to questionnary were recruited. Isolated yeast colonies from buccal tract after culture on Sabouraud medium with chloramphenicol were identified with the API 20 C AUX (BioMérieux) system by assimilation of different sugars. Susceptibility was evaluated by ATB FUNGUS (BioMérieux) system. 55 from the 60 isolated yeasts were identified and among them C. albicans and C. tropicalis were the main species with 75% and 11,7% respectively rates. In HIV1 infected patients, all specieswere isolated and C. albicans predominated (80,4%) on the other hand, C. albicans and C. tropicalis were the only isolated yeasts from the HIV2 infected patients with 83,3% and 16,6% respectively rates. Susceptibility of C. albicans was 72,2% to nystatine, 58,3% to amphotericin B, 83,3% to flucytosin, 12,8% to miconazole, 8,5% to econazole and 10,6% to ketoconazole. Susceptibility of C. albicans to polyenes was modified by a previous antifungal treatment. This study indicated emergence of saprophytic yeasts of the buccal mucosa and seemed to be more fostered by HIV1 serotype than HIV2. So, C. albicans's susceptibility to polyenes decreased by untimely use of antifungal drugs and by controlling it one could improve the clinic conditions of HIV infected patients.

Adult↗
PubMed2000

[Tetanus: epidemiological aspects at the Infectious Disease Clinics at the Fann University Hospital Center in Dakar].

This retrospective study was carried out to assess the recent epidemiological aspects of tetanus in Senegal. Based on the records of tetanus cases admitted at the Infectious Diseases Clinic in Dakar over a 7-year periode (1990-1996), this study showed that tetanus is still a major public health concern in Senegal. A global prevalence rate of 18.8% was found. Portals of entry were noticed to be: dirty wounds (48%), the umbilical stumps (19%), non sterile intra-muscular injections (4.5%), surgery (3.3%) and traditional practices (4.2%). Nevertheless, in a high proportion of cases (13.3%), the portal of entry was not found. A 30.3% case fatality rate was observed, that varied significantly according to portals of entry, reaching 60.4% in umbilical tetanus. It is recommended here that the immunization programme against tetanus be reinforced and supported by I E C Strategies together with retraining of medical personnel.

Academic Medical Centers↗
PubMed2000

[Tetanus osteoarticular complications in Dakar].

To assess the epidemiological and clinical features of osteoarticular symptoms during tetanus infection, we carried out a retrospective study in infectious Diseases Ward of the University Teaching Hospital in Dakar (Senegal). Over a period of 7 years (1990-1996), 1, 199 cases of tetanus of more than 1 month of age were diagnosed. Among those who survived (n = 948), 18 cases of osteo-articular manifestations were observed (1.8%): 15 presented with vertebral fracture located within the thoracical part T4-T8 (83.3%) while 3 patients had para-articular osteoma in the elbows (16.7%). These complications occurred on stage II (89%) and stage III (11%) of Mollaret's classification of tetanus infection. Males were more represented than females (sex-ratio = 5) and the median age was 13 years (range = 6-45 years). The mean hospitalisation duration was significantly higher for patients with para-articular osteoma (6 weeks) than for those with vertebral fracture (3 weeks). No major functional impairment was noticed during hospitalisation and patients required only physiotherapy and clinical and radiological surveillance. Although not frequent and of some little functional consequence, osteoarticular complications of tetanus, should invite to improve the antitetanic immunization strategies in developing countries.

Adolescent↗
PubMed2000

[Urinary tract infections in Dakar: etiologies, therapeutic basis].

This prospective study, performed in Fann University Teaching Hospital from January 1st to December 31st 1998, concern 1446 samples of urine. Enterobacteria (87.56%) were the most frequent aetiology, and Escherichia coli (48.7%) was the leading species in this family. The strains of E. coli present more resistant profil to beta-lactams (70.27%). Fluoroquinolons are active on more than 80% of the strains responsible of urinary tract infection in Dakar.

Anti-Infective Agents, Urinary↗
PubMed2000

[Shigella bacteraemia: a report of two cases observed in Dakar].

Shigellosis is usually a self-limiting enteric disease, rarely accompanied by extra-intestinal manifestations. In Senegal, shigella bacteraemia is poorly documented. The authors report two retrospective cases of Shigella dysenteriae 1 bacteraemia in an infant aged 12 months and a 32 years-old adult admitted at the Infectious Diseases Clinic in Dakar. In both cases, a fatal outcome was observed, in relation to complications: endotoxic shock in the infant, severe intestinal haemorrhage in the adult.

Academic Medical Centers↗
PubMed1999

[Management of severe malaria in children in developing countries. A protocol for economic evaluation].

This prospective one-year study was conducted as a preliminary phase to setting up a protocol for economic appraisal of management of severe malaria at Albert Royer Children's Hospital in Dakar, Senegal. Data was routinely collected using a standardized checklist. The four key indicators chosen for this study were nurse workload, adequacy of care (number of patients receiving adequate care), direct cost, and mortality rate. The mean daily care workload was estimated to be 27.2 minutes. This indicator assesses the relationship between supply and demand. Based on 5 criteria, care was considered as adequate in 54.5 p. 100 of patients. This indicator is helpful in judging the effectiveness of the therapeutic modalities used. The direct cost of treating severe malaria was estimated to be 45963 CFA francs. This indicator will be useful in establishing controls to reduce costs. The mortality rate was 12.2 p. 100. Comparison of this rate with previous years suggests little improvement in the outcome of malaria management at the institution. This indicator must be taken into account in the ongoing quality control program. Overall these findings should enable institutional decision-making to improve management of severe malaria based on objective measurable data.

Child↗
PubMed1999

[Epidemiological, clinical and therapeutic aspects of severe malaria in adults in the infectious disease department of Central University Hospital of Dakar].

To assess epidemiological, clinical and therapeutic features of severe malaria among adults in Dakar (Senegal), we carried out a 5-year retrospective study in Infectious Diseases Ward (January 1992-December 1996). Over this period, 222 cases of severe malaria were included according to WHO definition criteria, 120 of them (54%) being adult patients. Monthly distribution of cases showed 2 peaks, on October and November. Most of the patients were males (sex-ratio = 2.1) and lived in urban area (91.7%). The mean age was 28.9 years (range = 16-73 years). Clinically, all of the cases presented with stage II coma. Association existed with convulsion (20%), severe anaemia (29.2%), renal failure (19.2%), hypoglycaemia (17.5%) and jaundice (34%). Patients were treated using quinine intravenously. Case fatality rate reached 26.7%, indicating life-threatening potential of malaria in adults living in urban area.

Adolescent↗
PubMed1999

[Sensitivity to cotrimoxazole of bacteria isolated at the Central University Hospital of Fann, Dakar].

This study concern a survey of bacterial resistance to cotrimoxazole; 510 strains of Enterobacteria (167), Vibrio cholerae(206) and Staphylococcus aureus(137) were tested by disc diffusion and agar dilution methods. An interview was conducted with 86 health personals to appreciate the influence of prescription. Staphylococcus aureus were the most susceptible bacteria (13% of resistance), and Vibrio cholerae the most resistant (95%). Related to the gender, Enterobacteria present 43 to 72% of resistance. The data of interview show a very frequent use of cotrimoxazole, related to the disponibility and the accessibility of this drug.

Anti-Bacterial Agents↗
PubMed1999

[Pneumocystosis in HIV infected patients presenting with acid-fast bacilli negative pneumopathy at the Central University Hospital at Dakar].

Pneumocystosis is an opportunist parasitic disease which occurs currently at Europe and United States in HIV infected patients. In Africa, the disease is not current. Pneumocystosis has been detected in the Fann medical universitary center at Dakar from HIV infected patients with acido alcoholo resistant bacilli negative pneumopathy. Analysis of broncho alveolar liquid(BAL) of 29 patients after Giemsa and Blue of Toluidin O staining allowed isolating of two cases of pneumocystosis. A man and a woman were the patients. They were HIV1 positive with at X ray bilateral interstitial syndrome. The CD4 lymphocytes count of the one was lower than 200/mm3 and for the other it was higher than 200/mm3.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Acute and long-term changes in T-lymphocyte subsets in response to clinical and subclinical measles. A community study from rural Senegal.

To investigate the possibility of long-term suppression of T-lymphocyte subsets, we examined children exposed to measles at home during an epidemic in rural Senegal, at time of exposure and 1 and 6 months later. The measles case fatality ratio was 1%. Subclinical measles was common among vaccinated children exposed to measles (45%). Both clinical and subclinical cases of measles showed a significant rise in absolute CD4 count in the incubation period. In the prodromal phase and the first week after the rash, the lymphocyte percentage, the white blood cell count and the absolute CD4 cell numbers were significantly reduced. There was no persistent decrease of absolute CD4 or CD8 numbers at 1 or 6 months after exposure. Measles infection was followed by significant changes in the subset composition, both CD4 and CD8 percentages being significantly higher in the second month after measles than among non-seroresponders. These changes were more marked among girls, since they had significantly higher CD4 percentages and CD4/CD8 ratios than boys in the convalescence phase. In conclusion, measles infection is not associated with a long-term suppression of CD4+ or CD8+ T-lymphocytes.

Adolescent↗
PubMed1998

[Methicillin-resistant Staphylococcus aureus in Dakar].

This study was carried out at the Fann University Hospital Center in Dakar, Senegal between 1994 and 1996. The purpose was to assess the prevalence of methicillin-resistant Staphylococcus aureus and to propose alternative treatments. A total of 149 stains of Staphylococcus aureus were isolated from a variety of clinical specimens. Sensitivity to various antibiotics was tested by the disc diffusion technique (anti-biogram). Resistance to methicillin was evaluated by the oxacillin disc diffusion technique on Mueller-Hinton agar containing 5% NaCl. The prevalence of methicillin resistance was 66.4%. All strains of Staphylococcus aureus were sensitive to vancomycin. Other highly effective antibiotics included fucidic acid (94%), aminoglycosides (91%), cotrimoxazol (89.6%), and norfloxacin (84.5%). Most strains (70.6%) presented a wide profile against macrolides and related groups. The LSa phenotype (resistance to lincosamines and streptogramines) was the predominant resistant phenotype. The results of this study indicate that the prevalence of methicillin-resistant Staphylococcus aureus is increasing in Senegal. Since these strains respond well to chloramphenicol and cotrimoxazole, clinicians are advised to use these drugs as an alternative first-line treatment.

Methicillin Resistance↗
PubMed1997

[Sensitivity profiles of enterobacteria isolated at th Fann University Hospital Center, Dakar].

This study concerns 180 strains of Enterobacteria isolated at Fann University Teaching Hospital (Dakar, Senegal). The susceptibility to antibiotics was tested by disc diffusion test (antibiogram) and by dilution method determining the minimum inhibitory concentration (MIC). All of the species present more resistant profile to beta-lactams (> 55%); however ceftriaxon and aztreonam present the lower MIC 50 (< 0.06 microgram/ml). Fluoroquinolon inhibits more than 90% of the strains of E. Coli and Proteus. Chloramphenicol is active on Salmonella, but ceftriaxon, aztreonam and the fluoroquinolon present good alternatives. Cotrimoxazole is active only on 54% of Shigella strains.

Anti-Bacterial Agents↗