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J K Assimadi

Publications and source records attributed to J K Assimadi.

25 records · Page 2Linked to original sources
PubMed1999

[Health care seeking behavior of children in Togo].

Epidemiological and anthropological studies were carried out in Togo on health seeking behavior for under 5 children to determine causes of dysfunctions in health services. This article reports on the main findings of the anthropological study. Anthropological literature on health seeking behavior has identified labeling and associated explanatory models of illness as important factors for making choices in the use of health services. This study, carried out among 100 families in Togo on health seeking behavior for under-five children, found little difference in the signs and symptoms of illness recalled and the health resources used. Different causal explanations similarly showed little variation in signs and symptoms of illness. The only causal explanation for illness which appeared to correspond to place of recourse was related to social causes, where traditional practitioners were more often consulted. Families explained choices more on the basis of the accessibility and quality of health services (geographical and financial accessibility, reception by health personnel, organization of services, drug availability) than on the basis of the particular signs and symptoms of the illness. Improving the organization and functioning of health services should contribute more to appropriate use of the modern health care sector than interventions targeting user populations, since the latter appear to be aware of the advantages of modern medicine, but find financial, social and organizational features of services unsatisfactory.

Adult↗
PubMed1998

[Severe malaria in children in Togo].

BACKGROUND: The definition of severe malaria is no longer limited to cerebral malaria, but is as well extended to other clinical forms of the disease. This work analyses epidemiological, clinical and evolutive aspects of severe malaria in Togo. PATIENTS AND METHODS: This study included 549 children, aged from 0 to 15 years, hospitalized in 1994-5 in the pediatric department of the Lome-Tokoin University Teaching Hospital for severe malaria as defined by World Health Organization (WHO) criteria. RESULTS: The hospitalization frequency was 7.44%; the maximum frequency was from 1 to 5 years of age, but 6.56% of patients were more than 10 years old. The most frequent clinical form was that of severe anemia, followed by cerebral complications, as seen in many African countries. The death rate was 18.94% and the proportional mortality was 8.21%; 2.73% of the patients had neurological sequelae (behaviour disturbances in five cases, aphasia in four, hemiplegia in three, mumbling in one, oculomotor paralysis in one, and cerebellar ataxia in one). Hypoglycemia was fairly frequent (11.6%) and was associated with a poor prognosis. CONCLUSION: It is possible to improve severe malaria prognosis in Africa by insisting not only on better equipment in intensive care wards, but also on improved and early management of hypoglycemia.

Adolescent↗
PubMed1995

[Gastrointestinal and urinary parasitic infection in children at a regional hospital center in Togo: some epidemiological aspects].

To determine the impact of parasitic infection of the digestive and urinary tract in children living in a rural area of Togo, a retrospective study was conducted in a Pediatric Department of Kara, Togo. Results revealed that 35% of the 1610 children between the ages of 0 and 16 years had positive tests for parasites in stools or urine and that 117 had more than one parasite. Trichomonas intestinalis, Entamoeba histolytica, Schistosoma mansoni and Necator americanus accounted for 86.5% of the parasitic infections observed. Parasitic infection was observed during the neonatal period and its incidence increased in males up to the age of 12 years and during the rainy months of the year. Study of associated diseases indicated that 56% of children with parasites also had malaria and that 47% were anemic. Parasitic infection of the digestive and/or urinary tract was noted in 31.8% of children under the age of 5 years with malnutrition.

Adolescent↗
PubMed1994

[Use of health facilities by children from 0 to 5 years in Togo. Results of an epidemiological study carried out at a RHC (Atakpamé)].

Through a prospective survey coordinated by the CIE of Paris, and carried at a semi-urban regional hospital (Atakpame), the authors studied the use of health structures by inpatient and outpatient consulting children. Questionnaires were filled for the 112 children of the study. Results were as follows: There is a maladjustment between recruitment at the regional hospital and its real mission (emergency cases and special health care). Thus only 13.3% of children were seen for an emergency, and 4.5% admitted for special health case. In the majority of cases (69.4%), the health state of patients was not alarming. Improper channelling of the patients is responsible for this condition. 79.4% of children consult directly at the hospital without prior consultation at the "peripheral" health centers. The regional health center thus finds itself overburdened, whereby long waiting periods before consultation (> 300 mn for certain patients), and delay in the management of referred patients.

Child, Preschool↗
PubMedDate not supplied

[Intracavernous injections of etilefrin: its efficacy in the treatment of priapism in sickle cell patients].

OBJECTIVE: To date, the treatment of priapism in sickle-cell patients has relied on measures aimed at lowering blood viscosity and acidosis and reducing the level of circulating hemoglobin S (hyperhydration, alkalinization, or exsanguinotransfusion...) Surgical cavernous-venous shunt may be proposed if conservative treatment fails. We examined the efficacy of intracavernous etilefrin injections. PATIENTS AND METHODS: From January 1996 through October 1997 (20 months) we performed 35 consecutive intracavernous injections of an alphastimulant, etilefrin in 7 sickle-cell patients (6 SS, 1 AS) who had experienced one or several episodes of low-flow priapism lasting 2 to 28 hours. RESULTS: Involution of the tumefaction was rapidly achieved in all cases. Tolerance was satisfactory, although some post-injection undesirable effects were reported by certain patients: moderate transient pain (2-5 min) in the retrosternal area, or intense pain in the penis (more intense than the priapism) which lasted 10 to 30 minutes. This work confirmed the earlier reported efficacy of intracavernous injections of etilefrin and suggests that the autonomous nervous system plays an important role in the genesis of this condition in sickle-cell patients. Patients should be informed about the observed undesirable effects which have not been reported previously in the literature. CONCLUSION: Etilefrin can be proposed as first line treatment for priapism in sickle-cell patients (at least in cases lasting less than 24 h). The pathogenic mechanism could involve neuromuscular dysfunction.

Administration, Topical↗
PubMedDate not supplied

[Idiopathic thrombopenic purpura in a child in black Africa: a case report in Togo].

UNLABELLED: Idiopathic thrombocytopenic purpurea (ITP) is an autoimmune disease that occurs frequently in Europe and the US, but has rarely been described in Africa. Case report. An 8-year-old girl was admitted for cutaneous and mucosal bleeding. She had a low platelet count (11 x 10(9)/l). ITP was suspected and the diagnosis was confirmed by bone marrow examination. Corticosteroid treatment was effective. DISCUSSION: This is the second case reported in Togo since 1982. The diagnosis of the disease is straightforward, so the lack of cases reported in central Africa suggests that the disease is rare in this region. The rarity of the disease may be due to genetic or environmental factors, or it may simply be that physicians overlook this disease when making their diagnosis. Corticosteroids are now the preferred treatment for ITP because of the risk of transmitting Creutzfeldt-Jacob's disease by intravenous administration of immunoglobulin. Splenectomy is the ultimate treatment for chronic forms. CONCLUSION: Unlike other diseases, the diagnosis and treatment of which require methods unavailable in parts of Africa, ITP treatment, as currently practiced in countries of the northern hemisphere, is within the reach of most African countries. Further studies are required to determine the true frequency of the disease in central Africa.

Anti-Inflammatory Agents↗