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Introductionla COVID-19 s´est rapidement propagée depuis son apparition en Chine devenant actuellement un problème de santé internationale. Son diagnostic définitif se fait par réaction de polymérisation en chaîne (PCR) sur des prélèvements nasopharyngés. Ce moyen diagnostic est de faible sensibilité avec des résultats différés. Ce qui laisse place à la tomodensitométrie thoracique comme moyen diagnostic alternatif. Les objectifs de cette étude étaient d´évaluer la fréquence des lésions TDM évocatrices de COVID-19 et de confronter les résultats de la tomodensitométrie (TDM) à ceux du test PCR.Méthodesétude prospective réalisée sur une période de 15 jours ouvrables et qui a porté sur 47 patients. Ces patients étaient recrutés sur la présence d´au moins 2 signes cliniques du COVID-19. Une TDM thoracique sans injection selon le protocole « FAIBLE-DOSE » a été réalisé. Un test PCR sur prélèvements nasopharyngés a été fait chez les patients avec des signes évocateurs de COVID à la TDM. Un test sérologique été réalisé en cas de discordance entre les résultats TDM et PCR.Résultatsla TDM thoracique était anormale chez 38 patients et normale chez 9 patients. Des lésions évocatrices de COVID-19 ont été identifiées chez 32 patients. Deux patients ont eu des lésions de pneumopathie non spécifique. Des lésions de pneumopathie tuberculeuse ont étés visualisées chez 3 patients. Un patient a eu des lésions de pneumopathie interstitielle commune. La DLP (dose-length product) moyenne était de 59 mGy.cm avec des extrêmes de 25 et 95 mGy.cm. L´opacité en verre dépoli était présente chez 100% des suspects de COVID-19 à la TDM. Le résultat du test PCR a confirmé la TDM chez 12 patients soit une valeur prédictive positive de la TDM de 37,5%. Chez 20 patients avec lésions COVID à la TDM, le test PCR était négatif soit un taux de faux positif de 62,5%. Chez les patients avec test PCR négatif, 4 ont fait un test sérologique de COVID-19 et ce test était positif chez 3.Conclusionla TDM thoracique low-dose permet de réduire l´irradiation chez les patients COVID-19 qui sont à risque de dose cumulative par répétition des TDM. La TDM permet d´identifier les lésions évocatrices de COVID-19. Elle permet également le triage des patients en permettant d´identifier d´autres diagnostics.

ObjectivesPublic awareness and the dissemination of tailored information to lay populations are essential for highly endemic countries like Senegal to achieve hepatitis B elimination targets by 2030. In Senegal, despite its high prevalence, hepatitis B has not received sufficient attention in health communication campaigns compared with other health issues like HIV. We aimed to explore knowledge and perceptions surrounding hepatitis B virus (HBV), as well as the influence of digital media on the information accessed by individuals living with HBV in Senegal.DesignWe employed a mixed-methods approach combining qualitative semistructured interviews conducted with people living with HBV enrolled in the Senegalese hepatitis B cohort (SEN-B), with a quantitative content analysis of online news coverage focused on HBV within the online media of Senegal.SettingA referral University hospital in Dakar, Senegal.Participants29 individuals aged >18 years presenting with a positive hepatitis B surface antigen (HBsAg) with a median age of 40 years (IQR 27–54), of whom 51.7% were female.Outcomes and analysisQualitative interviews were conducted between December 2019 and October 2021, and we employed purposive sampling to select participants enrolled in SEN-B. Thematic analysis facilitated a systematic synthesis of respondents’ narratives. All data analyses were performed using Atlas.ti (V.22). For content analysis of online media news collected from September 2019 to May 2022, a structured data extraction form was developed to collect relevant information from the selected online news articles. Data on readers’ comments spaces were extracted using an inductive approach and were processed using thematic analyses. The quantitative data issued from content analysis were exported to Stata SE V.17.0 (StataCorp) for statistical analysis.ResultsWe observed a generalised lack of knowledge about HBV among participants, some of whom had never heard of the virus prior to their screening. Incomprehension regarding the disease contributed to feelings of fear and anxiety, leading participants to express various concerns about their personal health status, transmission, cure and treatment(s). The presence of rumours surrounding the disease further underscored the limited awareness of HBV revealing the marginal recognition of HBV as a significant societal concern. In many cases, the absence of effective health communication strategies at the national level resulted in individuals turning to traditional and online media for information, which often intensified their fears and concerns about HBV. An analysis of Senegalese media coverage about HBV included 157 articles published between 2009 and 2022. 55.4% (87/157) of these publications appeared in July, coinciding with World Hepatitis Day, while 65.0% (102/157) focused on general HBV epidemiology and activities led by the National Hepatitis Programme. Online media also served as informal spaces where unaccredited actors within the health sector promoted treatments lacking official verification. Additionally, the reactions’ spaces provided a venue for the exchange of information, though without any guarantee of its accuracy.ConclusionsFacilitating collaboration and engagement between health communication stakeholders and communities is crucial for effectively disseminating structured information and culturally appropriate messages, ultimately contributing to raising awareness of HBV.

Ground-glass opacity is a CT sign that is currently experiencing renewed interest since it is very common in patients with COVID-19. However, this sign is not specific to any disease. Besides, the possibility of false positive ground-glass opacity related to insufficient inspiration during the acquisition of the chest CT should be known. We report the case of a 36-year-old patient suspected of COVID-19 and in whom a second acquisition of chest CT was necessary to remove false ground-glass opacities that erroneously supported the diagnosis of COVID-19.

Although the foot remains the main localization of mycetomas, extrapodal attacks, which are rarely studied, are also possible and occur either initially or following an extension. The objectives were to describe the epidemiological, clinical and etiological features of extrapodal mycetomas in Senegal. Cross-sectional and retrospective study with multicentric enrollment in four reference department, two of which are in dermatology and two in orthopedics and traumatology. We included the files of patients with extrapodal mycetoma followed from January 2000 to December 2020. The data were analysed with SPSS software. Any p less than or equal to 0.05 was statistically significant. We collected 82 cases representing 39% of mycetoma cases (n = 210). The average age was 41.9. The sex ratio was 3.1. Professionally, most patients were active farmers in 51% of cases (n = 33), pastoralists and housewives in 9 % (n = 6) respectively. The mean duration of evolution was 7.5 years. Exclusively extrapodal topographies were noted in 84% of cases (n = 69). Foot and extrapodal locations were concomitant in 16% of cases (n = 13). Mycetoma foci were distributed as follows: 59 in the trunk, 47 in the lower limbs, 9 in the upper limbs, 1 in the scalp and 1 in the neck. The etiology was actinomycotic in 46% of cases (n = 38), fungal in 38% (n = 31). It was not specified in 16% of cases (n = 13). Bone involvement occurs after 5 years (p = 0.001) unrelated to the etiology (p = 0.6). Extrapodal mycetomas are secondary to direct inoculation. However, extension to bone is exclusively due to diagnostic delay. Periodic consultations in endemic areas combined with training of resident health personnel are necessary for early diagnosis in order to improve the prognosis.

COVID-19 has spread rapidly since its emergence in China and is currently a global health issue. Its definitive diagnosis is made by PCR on nasopharyngeal swabs. However, this diagnostic test has low sensitivity with delayed results. Hence, thoracic computed tomography represents an interesting alternative. The aims of this study were to assess the frequency of computed tomography (CT) lesions suggestive of COVID-19 and to compare the results of CT and PCR test. a prospective study carried out over15 working days and involved 47 patients. These patients were recruited based on the presence of at least 2 clinical signs of COVID-19. Chest CT without contrast according to the \"LOW-DOSE\" protocol was performed. A PCR test on nasopharyngeal swabs was done in patients with signs suggestive of COVID on CT. A serological test was performed in case of a discrepancy between the CT and PCR results. thoracic CT was abnormal in 38 patients and normal in 9 patients. Lesions suggestive of COVID-19 have been identified in 32 patients. Two patients had lesions of non-specific pneumonia. Tuberculosis lesions were visualized in 3 patients. One patient had lesions of interstitial pneumonia. The mean DLP was 59 mGy.cm with extremes of 25 and 95 mGy.cm. Ground-glass opacity was present in 100% of COVID-19 suspects on CT. The results of the PCR test were the same than CT in 12 patients. The positive predictive value for CT was 37.5%. In 20 patients with COVID lesions on CT, the PCR test was negative with a false positive rate of 62.5%. In the patients with negative PCR test, 4 had a serological test for COVID-19 and this test was positive in 3. low-dose chest CT can reduce radiation exposure in COVID-19 patients who are at risk of cumulative dose due to repetitive exam. CT can identify lesions suggestive of COVID-19. It also enables the triage of patients by identifying other diagnoses.

La maladie à coronavirus 2019 (COVID-19) déclarée en Chine en fin 2019 s´est rapidement généralisée aux autres continents. Son diagnostic se fait par test PCR (Polymerase Chain Reaction) sur des prélèvements naso-pharyngés. Ce test bien que spécifique est d´une sensibilité moindre comparé à la TDM thoracique. Nous rapportons le cas d´un patient testé négatif à deux reprises et chez qui la TDM retrouvait des signes typiques de COVID-19 et une embolie pulmonaire. Et ce n´est qu´après un troisième test PCR qu´il a été positif. Ce qui montre l´intérêt de répéter plusieurs fois les tests PCR mais également de considérer les signes scanographiques comme argument diagnostic devant induire une prise en charge adéquate.

Objectifs. Décrire les particularités épidémiologiques, cliniques et étiologiques des mycétomes extrapodaux au Sénégal.Méthodologie.Étude transversale et rétrospective avec recrutement multicentrique dans quatre services de référence dont deux en dermatologie et deux en orthopédie-traumatologie. Étaient inclus les dossiers de malades présentant un mycétome extrapodal suivis de janvier 2000 à décembre 2020. Les données étaient analysées avec le logiciel SPSS.Résultats.Nous avons colligé 82 cas représentant 39 % des cas de mycétomes (n = 210). L’âge moyen était de 41,9 ans. Le sexe-ratio était de 3,1. Les professions majoritaires étaient les cultivateurs en activité dans 51 % des cas (n = 33), les éleveurs et les ménagères dans 9 % (n = 6) des cas respectivement. La durée moyenne d’évolution était de 7,5 ans. Les topographies uniquement extrapodales étaient notées dans 84 % des cas (n = 69). Une localisation podale et extrapodale était concomitante dans 16 % des cas (n = 13). Les foyers de mycétomes se répartissaient comme suit : 59 au tronc, 47 aux membres inférieurs, 9 aux membres supérieurs, 1 au cuir chevelu et 1 au cou. L’étiologie était actinomycosique dans 46 % des cas (n = 38), fongique dans 38 % (n = 31). Elle n’a pas été précisée dans 16 % des cas (n = 13). L’atteinte osseuse survenait après 5 ans (p = 0,001) sans lien avec l’étiologie (p = 0,6).Conclusion. Les mycétomes extrapodaux sont en majorité secondaires à une inoculation directe et leur extension osseuse est exclusivement due au retard diagnostique. Des consultations périodiques en zone d’endémie associées à une formation du personnel de santé résident sont nécessaires pour un dépistage précoce afin d’en améliorer le pronostic.Extrapodal mycetomas in Senegal: epidemiological, clinical and etiological study of 82 cases diagnosed from 2000 to 2020Objectives. Although the foot remains the main localization of mycetomas, extrapodal attacks, which are rarely studied, are also possible and occur either initially or following an extension. The objectives were to describe the epidemiological, clinical and etiological features of extrapodal mycetomas in Senegal.Methodology. Cross-sectional and retrospective study with multicentric enrollment in four reference department, two of which are in dermatology and two in orthopedics and traumatology. We included the files of patients with extrapodal mycetoma followed from January 2000 to December 2020. The data were analysed with SPSS software. Any p less than or equal to 0.05 was statistically significant.Results. We collected 82 cases representing 39% of mycetoma cases (n = 210). The average age was 41.9. The sex ratio was 3.1. Professionally, most patients were active farmers in 51% of cases (n = 33), pastoralists and housewives in 9 % (n = 6) respectively. The mean duration of evolution was 7.5 years. Exclusively extrapodal topographies were noted in 84% of cases (n = 69). Foot and extrapodal locations were concomitant in 16% of cases (n = 13). Mycetoma foci were distributed as follows: 59 in the trunk, 47 in the lower limbs, 9 in the upper limbs, 1 in the scalp and 1 in the neck. The etiology was actinomycotic in 46% of cases (n = 38), fungal in 38% (n = 31). It was not specified in 16% of cases (n = 13). Bone involvement occurs after 5 years (p = 0.001) unrelated to the etiology (p = 0.6).Conclusion. Extrapodal mycetomas are secondary to direct inoculation. However, extension to bone is exclusively due to diagnostic delay. Periodic consultations in endemic areas combined with training of resident health personnel are necessary for early diagnosis in order to improve the prognosis.

Introduction Abdominal surgical emergencies have a high mortality rate. Effective management primarily relies on the early identification of patients at high risk of postoperative complications. The objective of our study was to determine the prognostic factors associated with poor outcomes from abdominal surgical emergencies in Senegal and to establish a predictive score for mortality for preoperative risk evaluation (NDAR (New Death Assessment Risk) score). Methodology This was a retrospective national cross-sectional study conducted over one year in 14 regions of Senegal. Adult patients (aged > 15 years) who presented with a traumatic or non-traumatic abdominal surgical emergency were included. The studied variables included clinical and paraclinical data. The variable of interest was death within 30 days of the surgery. Logistic regression was used to identify the factors independently associated with mortality. Risk factors identified after logistic regression analysis were weighted using odds ratio (OR) values rounded to the nearest whole number. The predictive capacity of the score was evaluated by analyzing the ROC (Receiver Operating Characteristic) curve based on the area under the curve (AUC). Results A total of 1114 patient records were included, with a mortality rate of 4.4%. Diagnoses were observed in patients included appendicitis in 39.8% of cases ( n  = 444), followed by peritonitis in 22.3% ( n  = 249), intestinal obstruction in 18.5% ( n  = 205), strangulated hernias in 10.5% ( n  = 117), and abdominal trauma in 6.1%. Logistic regression, established the following scores: age > 40 years (score 2), ASA status grade 2 or higher (score 1), presence of a positive QSIRS score (score 2), diagnosis of peritonitis (score 2), diagnosis of intestinal obstruction (score 1), and the presence of intestinal necrosis (score 3). The score is positive if the total is strictly greater than 5, indicating a 17.7% risk of mortality. This score had a high predictive capacity with an AUC of 0.7397. Conclusion This study enabled the establishment of a score that allows for the early identification of at-risk patients, even in constrained resource settings, facilitating appropriate perioperative management and timely surgical intervention to reduce the risk of complications. This approach, focused on early recognition of high-risk patients, is crucial for improving clinical outcomes in abdominal surgical emergencies.