Pan African Medical Journal最新文献

{"title":"Risk factors for cervical cancer in Morocco: a case-control study.","authors":"Malika Allali, Khaoula Errafii, Rachid El Fermi, Nouha Messaoudi, Karima Fichtali, Hicham El Fazazi, Adil El Ghanmi, Sanaa El Majjaoui, Nabil Ismaili, Lahcen Wakrim, Najib Al Idrissi, Abdelaziz Wajih Rhalem, Bouchra Ghazi, Ahd Ouladlahsen, Youssef Bakri, Hassan Ghazal, Salsabil Hamdi","doi":"10.11604/pamj.2025.50.87.45024","DOIUrl":"10.11604/pamj.2025.50.87.45024","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer (CC) is one of the most common malignancies among women in Morocco. This study aims to evaluate the risk factors associated with CC in Moroccan women aged 18 to 62.</p><p><strong>Methods: </strong>this was a case-control study of 169 women who received radio-chemotherapy and 100 controls. Statistical analyses were performed using SPSS version 29.0.10 to determine associated factors at a significance level of ≤0.05.</p><p><strong>Results: </strong>significant associations were found between CC and the following factors: educational level (OR= 9.167), sexual activity during menstruation (OR= 2.351), previous occurrences of sexually transmitted infections (OR= 2.173), and history of multiple sexual partners by the husband (OR= 6.305). However, family history of cancer, consanguinity, number of sleeping hours, and stress did not show any significant association with CC. HPV infection was detected in 33.81% of cases and 8% of controls, with HPV16 being the most prevalent genotype (59.57%), followed by HPV53 (14.79%). Other genotypes were found at lower frequencies. The phylogenetic analysis of HPV isolates showed that the distribution of HPV sequences in Moroccan women with cervical cancer is mainly linked to European, Saudi Arabian and North African epidemiological conditions, suggesting recombinant HPV forms. Additionally, American isolates formed two distinct outgroups, likely due to geographical distance, indicating variations in HPV strains by region.</p><p><strong>Conclusion: </strong>Morocco faces a significant burden of CC, with HPV being the primary cause. Lifestyle risk factors like low education, male sexual behavior, multiple pregnancies, and sexual intercourse also contribute.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"87"},"PeriodicalIF":0.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade of acquired aplastic anemia: insights from a Central South African Center.","authors":"Debi Mmasabata Seriti Moagi, Jacques Le Roux Malherbe, Claire Louise Barrett","doi":"10.11604/pamj.2025.50.86.44404","DOIUrl":"10.11604/pamj.2025.50.86.44404","url":null,"abstract":"<p><strong>Introduction: </strong>aplastic anemia (AA) is a rare blood disorder with a considerable mortality rate, particularly if left untreated. Limited South African data on AA prompted this study to investigate the clinico-hematological features, management, and outcome of patients managed at our center.</p><p><strong>Methods: </strong>a ten-year retrospective observational study of all patients at the Universitas Academic Hospital with confirmed AA was conducted. Data on patient demographics, clinical and laboratory data, management, and outcomes were collected and analyzed.</p><p><strong>Results: </strong>twenty-seven patient files were included. Idiopathic AA was the most common (55.6%), while 12 patients (44.4%) had secondary causes. Most (70.4%) patients presented with severe AA. The majority (77.8%) received immunosuppressive therapy (IST) as first-line treatment, with most (80.9%) responding to treatment (complete, hematological and partial responses). Overall treatment response across available modalities was good (77.8%), with a few (22.2%) cases of refractory disease. Many patients were lost to follow-up (51.9%). Although access to hematopoietic stem cell transplantation (HSCT) in South Africa is limited, our center's treatment response rate to IST (80.9%) is comparable to international studies. The study found no association between HIV and AA, and no transfusion-related complications were observed.</p><p><strong>Conclusion: </strong>the study suggests that AA remains a disease of the young in South Africa. Most patients in this study presented with severe disease. The presence of paroxysmal nocturnal hemoglobinuria is in line with other studies. Addressing the high loss-to-follow-up rate is crucial for future studies.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"86"},"PeriodicalIF":0.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates on the polio surveillance action plan's key performance indicators: East and Southern African countries (January 2022 to December 2023).","authors":"Daudi Manyanga, Charles Byabamazima, Brine Masvikeni, Sarah Wanyoike","doi":"10.11604/pamj.2025.50.85.43108","DOIUrl":"10.11604/pamj.2025.50.85.43108","url":null,"abstract":"<p><p>The Global Polio Eradication Initiative (GPEI) partners are closely monitoring the progress of the implementation of key strategic activities of the polio eradication strategy for the years 2022-2026. This is being done using the Global Polio Surveillance Action Plan 2022-2024, which includes a set of indicators to track progress. All countries in the ESA sub-region have been informed about these key performance indicators, and the World Health Organization (WHO) is keeping a weekly eye on their implementation. We conducted a descriptive secondary analysis of field Acute Flaccid Paralysis (AFP) surveillance data compiled from 19 countries of East and Southern Africa for the period of January 2022 to December 2023. During the period, Seychelles did not report any AFP case, and therefore the country is excluded from the final analysis. A total of 18,078 AFP cases were detected, reported, and verified from nineteen countries in ESA and we found 8,049 females (44.5%) and 10,029 males (55.5%). This shows a male child was more likely to get AFP compared to a female child (11% difference, p < 0.0001). We noticed a significant increase in prompt AFP cases detection of 4% and an increased number of cases investigated within 11 days from the date of onset of paralysis from 7,790 (89%) in 2022 to 8,246 (91%) in 2023 (2% change, p < 0.0001). The two AFP surveillance quality indicators in the study period rose from 4.4 in 2022 to 4.7 in 2023 (0.3 increase, p < 0.0001). Of the 8,964 AFP stool samples assessed in 2023, 53% were delivered to the national polio laboratories within 72 hours compared to 52% of 8,666 AFP stool samples in 2022 (1% difference, p-value of 0.1838). There is an overall improvement in the Global Polio Surveillance Action Plan (GPSAP) indicators in the ESA subregion for the period of 1 January 2022 to 31 December 2023. We recommend utilizing innovative methods to improve case detections, providing tailored surveillance training to lower levels, and enhancing sample shipment and capacities to process samples timely.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"85"},"PeriodicalIF":0.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of acute flaccid paralysis surveillance system in Kebbi State, Nigeria between 2013-2018.","authors":"Abdulmumin Hashim Bala, Yahaya Mohammed, Olajide Adewale Owolodun, Lukman Surajudeen, Ismail Abdullateef Raji, Charles Rahab Amaza","doi":"10.11604/pamj.2025.50.84.46398","DOIUrl":"10.11604/pamj.2025.50.84.46398","url":null,"abstract":"<p><strong>Introduction: </strong>since 1988, polio incidence has declined by over 99% globally, from more than 350,000 annual cases in over 125 endemic countries to transmission now limited to Pakistan and Afghanistan. Africa has not reported wild poliovirus since 2016. An effective Acute Flaccid Paralysis (AFP) surveillance system is crucial for detecting and interrupting polio transmission. This evaluation assessed the Acute Flaccid Paralysis (AFP) surveillance system in Kebbi State, Nigeria, to identify operational gaps.</p><p><strong>Methods: </strong>using updated Center for Disease Control and Prevention (CDC) guidelines and the World Health Organization (WHO) performance standards, the study reviewed AFP surveillance data from 2013-2018, conducted stakeholder interviews using adapted questionnaires and key informant interviews, and analyzed data using means, frequencies, and proportions.</p><p><strong>Results: </strong>among the 49 respondents, 98% reported that case definitions and investigation forms were easy to use, while 97% found data tools adaptable to changes. All surveillance officers understood AFP case definitions and expressed willingness to sustain the system. Key performance indicators, including non-polio AFP rates (24.6-55.2), stool adequacy (95-99.7%), timeliness, and reporting completeness all consistently met WHO standards.</p><p><strong>Conclusion: </strong>the evaluation concluded that the AFP surveillance system in Kebbi State, Nigeria, is useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, although donor dependency remains a concern. A significant gap was the lack of data on 60-day follow-ups and laboratory feedback. Addressing these issues is important to further strengthen the system.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"84"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic cavernous hemangioma mimicking an epidural neurinoma in an hourglass shape: a case report and review of the literature.","authors":"Dahmane Elhairech, Mohamed Lmejatti","doi":"10.11604/pamj.2025.50.83.40589","DOIUrl":"10.11604/pamj.2025.50.83.40589","url":null,"abstract":"<p><p>Epidural cavernous hemangioma is a rare vascular malformation, accounting for 5-12% of all spinal cord vascular malformations. We report a case of low dorsal spinal cord compression at D5-D6 due to a cavernous hemangioma mimicking the clinical and radiological features of an epidural neuroma in an hourglass shape. The clinical presentation was progressive spastic paraplegia over six months in a 41-year-old patient with no significant medical history. Magnetic resonance imaging showed a compressive D5-D6 intradural lesion with T2 hyperintensity, displaying an hourglass appearance suggestive of an epidural neuroma, with a significant extracanal component filling the ipsilateral latero-vertebral space. Histological examination confirmed cavernous hemangioma by immunohistochemistry. The postoperative outcome was favorable following total surgical removal of the lesion.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"83"},"PeriodicalIF":0.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of propofol allergy (the innovative role of the basophil activation test in the identification of allergen): a case report.","authors":"Chaimaa Chahine, Zakaria Zidane, Karima Mohtadi, Sanaa Souat, Khadija El Azhary, Rachid Saïle, Abdallah Badou, Mohammed Ali Debbarh, Claude Lambert, Ibtihal Benhsaien, Hanane Salih Alj","doi":"10.11604/pamj.2025.50.82.46400","DOIUrl":"10.11604/pamj.2025.50.82.46400","url":null,"abstract":"<p><p>Drug allergies (DA), particularly to anesthetics, are underexplored in Morocco. Traditional diagnostic methods such as skin tests and specific IgE assays are costly, risky, and often inaccessible. The basophil activation test (BAT) is emerging as a safer and more effective alternative, especially for diagnosing propofol allergy, an under-researched area. This study examines the role of the basophils activation test in diagnosing perioperative anaphylaxis to propofol. A 32-year-old woman experienced two anaphylactic reactions during fibroscopy after propofol administration. The basophil activation test (BAT) was performed one week later using diluted propofol, measuring basophil activation via CD63 and CD203c markers by flow cytometry. Results showed 0% basophil activation in the negative control, 85.7% in the positive control, and 19.05% at 1 mg/ml of propofol, with a strong correlation (0.973) between concentration and activation. The basophil activation test (BAT) offers a reliable diagnostic method, particularly in Morocco, where traditional tests are limited, providing a cost-effective solution for diverse allergens in low-resource settings.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"82"},"PeriodicalIF":0.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Azygos lobe-a rare anatomical variant.","authors":"Aishwarya Kishor Kedar, Vivek Alone","doi":"10.11604/pamj.2025.50.81.44865","DOIUrl":"10.11604/pamj.2025.50.81.44865","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"81"},"PeriodicalIF":0.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influenza virus sentinel surveillance: results of system evaluation in Mozambique, 2016-2021.","authors":"Samanta Djaló, Almiro Tivane, Neuza Nguenha, Nilsa Nascimento, Áuria Banze, Érika Rossetto, Cynthia Semá","doi":"10.11604/pamj.2025.50.80.41994","DOIUrl":"10.11604/pamj.2025.50.80.41994","url":null,"abstract":"<p><p>The 2009 influenza pandemic has caused health challenges around the world. Mozambique has faced challenges in implementing surveillance systems, which are obstacles to the timely detection of outbreaks and epidemics. It is intended to evaluate the performance of the influenza sentinel surveillance system between 2016 and 2021. A descriptive-cross-sectional evaluation of the influenza sentinel surveillance system was conducted at the sentinel posts in Maputo. The sample was calculated, and a simple random sampling technique was used to select the 372 patient record forms. Microsoft Excel and Tableau were used for frequency calculations. Based on the Centers for Disease Control - 2001 script, data quality, stability, sensitivity, representativeness, timeliness, and positive predictive value were evaluated. 28.0% (1,305/4,660) of the analyzed samples had positive results, and 56.1% (2,617/4,660) were male. The system obtained data completeness and consistency of 69.9% (3,260/4,660) and 68% (355/372), respectively. It obtained a sensitivity of 77.5% (842/1,086) in 2017, a representative in 98.4% 1,285/1,305 of the neighborhoods, the opportunity of 50.4% (2,349/4,660), and a positive predictive value of 31.4% (410/1,305). The system proved to be useful, providing reliable data on influenza viral circulation. Continuous influenza monitoring would promote prevention interventions in the most vulnerable groups.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"80"},"PeriodicalIF":0.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Livedoid vasculopathy in protein S deficiency.","authors":"Hemant Juneja, Gaurang Aurangabadkar","doi":"10.11604/pamj.2025.50.77.46735","DOIUrl":"https://doi.org/10.11604/pamj.2025.50.77.46735","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"77"},"PeriodicalIF":0.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of lymphocyte infiltration on the survival of patients with gastric and colorectal cancers at the Yaoundé General Hospital (Cameroon).","authors":"Etienne Okobalemba Atenguena, Astryde Larissa Tchutchou Ndjeutcham, Vanelle Lotie Messah Kamdem, Estelle Alida Ngne Mbopda, Manuella Mayemi, Carole Marlise Menzy, Stéphane Zingue","doi":"10.11604/pamj.2025.50.79.43589","DOIUrl":"https://doi.org/10.11604/pamj.2025.50.79.43589","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;digestive cancers (DC) are a group of cancers affecting the gastrointestinal tract and are capable of triggering an immune response. The cells produced during this response are tumor effectors whose role is to rid the body of tumor cells. The functional role of these cells, particularly the tumor-infiltrating lymphocytes (TILs), in the prognosis of patients remains poorly understood in Cameroon. This study aimed to evaluate the impact of lymphocyte infiltration on the survival of patients with certain digestive cancers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;we conducted a retrospective cross-sectional study at the Oncology Department and the Anatomo-Cytopathology Laboratory of the Yaoundé General Hospital (YGH). Patients histologically diagnosed with colorectal and gastric cancers with available data from YGH between 2019 and 2023, who consented to participate and had a biopsy sample available at the YGH laboratory, were included in the study. Initially, we described patients' sociodemographic, clinical, and pathological characteristics. Then, we estimated the grade of lymphocyte infiltration in colorectal and gastric cancers using Hematoxylin-Eosin (HE) staining and analyzed the correlation between lymphocyte infiltration and patient survival through Cox regression. Data were analyzed with a significance level set at 5% for all comparisons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;the study enrolled 90 patients with colorectal cancer and 50 with gastric cancer. Overall survival was 64.8% at 49 months in the study population, with the median not reached for colorectal cancer, and 64% at 39 months for gastric cancer, also with a median not reached. The average age at diagnosis for colorectal and gastric cancers was 54 ± 14.53 years and 53.24 ± 11.41 years, respectively. Men predominated in both pathologies, with a sex ratio of approximately 1.11. Colonic location was predominant (53%; 46/90) for colorectal cancer, with stage III disease being most common, while the antropyloric location (46%; 23/50) was predominant for gastric cancer, with stage IV being most frequent according to the AJCC. Moreover, 86% of patients had TILs in their histological samples, with a predominance of high TILs in both colorectal (38%; 34/90) and gastric (42%; 21/50) cancers. The performance of chemotherapy was inversely proportional to TILs in colorectal cancer, while no significant difference was found between TILs and chemotherapy in gastric cancer. However, no association was found between TILs and patient survival in either colorectal or gastric cancers. Patients who had metastases had a risk of death of 14.07 (aHR: 14.07, 95% CI 1.66-119.24; p = 0.015) compared with those who did not. Similarly, patients who had not taken chemotherapy had a 21.32 greater risk of death (aHR: 21.32, 95% CI 5.35-84.96; p&lt;0.001) than those who had.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;there was no statistically significant difference in survival between patients suffer","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"50 ","pages":"79"},"PeriodicalIF":0.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}