Papers by Daniel Tony EYENI SINOMONO
HEALTH SCIENCES AND DISEASES, May 1, 2021
Introduction. Au Congo où l'hémodialyse est encore à ces débuts, il n'existe pas de données scien... more Introduction. Au Congo où l'hémodialyse est encore à ces débuts, il n'existe pas de données scientifiques nationales sur les hémodialysés chroniques. Les objectifs de l'étude étaient de déterminer la prévalence des patients en hémodialyse chronique au Congo-Brazzaville et décrire leurs caractéristiques socio démographiques, cliniques et évolutives. Patients et méthodes. Il s'est agi d'une étude multicentrique descriptive transversale s'étalant sur une période de 2 ans et 06 mois, du 1 er mars 2018 au 1 er septembre 2020. Ont été inclus les hémodialysés chroniques (HDC) de tout âge, en dialyse depuis au moins 3 mois. Nous avons étudié les caractéristiques sociodémographiques et les variables diagnostiques (étiologies, retentissement ; et terrain de survenue de l'insuffisance rénale chronique terminale. Résultats. Nous avons recensé 93 patients (17 HDC/pmh). L'âge moyen était de 52 ±13.16 ans avec une prédominance masculine de 67.8% et un niveau socioéconomique moyen élevé (93%). La principale néphropathie causale était hypertensive (43%). Quarante patients (43%) dialysaient avec une fistule artérioveineuse. L'HTA était également la principale comorbidité (89,2%). Les complications inter-dialytiques étaient dominées par l'anémie (78,4%), celles perdialytiques étaient dominées par l'hypertension intradialytique (dans plus de 2 séances/mois chez 63,7% des patients). Conclusion. La prévalence nationale des hémodialysés chroniques est faible au Congo, contrastant avec une fréquence élevée de l'insuffisance rénale chronique au stade terminal. Les hémodialysés congolais sont des jeunes hypertendus majoritairement de sexe masculin et de classe moyenne. L'anémie et l'hypertension intradialytique sont fréquentes traduisant une prise en charge inadéquate qui reste à évaluer.
Archives of Cardiovascular Diseases Supplements, 2022
Zenodo (CERN European Organization for Nuclear Research), Dec 18, 2022
Covid-19 Hemodialysis Patients Brazzaville Background: Due to their immunosuppression to varying ... more Covid-19 Hemodialysis Patients Brazzaville Background: Due to their immunosuppression to varying degrees and significant comorbidity, patients on chronic dialysis have an increased risk of developing severe acute respiratory syndrome 2 (SARS-CoV-2) at Covid 19. We wanted to describe the incidence, risk factors and outcomes of Covid 19 infection in these patients in Brazzaville. Patients and methods: The study was carried out in a private hemodialysis center in Brazzaville (Congo). The data was collected retrospectively. Included were chronic hemodialysis patients who tested positive for Covid-19 between April 1, 2020 and November 30, 2021. We assessed disease characteristics, mortality, risk factors for infection and mortality from multivariate logistic regression analyses. Results: During the study period, 14 out of 46 hemodialysis patients (30.4%) were diagnosed with Covid-19 infection. Their average age was 42.3 ± 8.7 years with a male predominance (sex-ratio = 2.5). Among them, 13 (92.8%) presented with respiratory distress requiring hospitalization and the mortality rate was 42.8%; only one was vaccinated against covid-19 (Vaccine from the Johnson Johnson laboratory). Significant predictors associated with infection included HIV (OR= 12.4; 95% CI 17.1-43.7) and diabetes mellitus (OR= 9.7; 95% CI 17.1-43.7), the main risk factor for death is the suspension of hemodialysis sessions (OR= 14; 95% CI 16.9-68.7). Conclusion: Patients on chronic hemodialysis are at increased risk of SRASCoV-2 infection and mortality from the Covid-19 coronavirus disease. It will be necessary to work to vaccinate these patients as a priority and to maintain the regularity of their weekly sessions by creating an intra-hospital emergency hemodialysis unit.
International Journal of Advanced Research
Background: Due to their immunosuppression to varying degrees and significant comorbidity, patien... more Background: Due to their immunosuppression to varying degrees and significant comorbidity, patients on chronic dialysis have an increased risk of developing severe acute respiratory syndrome 2 (SARS-CoV-2) at Covid 19. We wanted to describe the incidence, risk factors and outcomes of Covid 19 infection in these patients in Brazzaville. Patients and methods: The study was carried out in a private hemodialysis center in Brazzaville (Congo). The data was collected retrospectively. Included were chronic hemodialysis patients who tested positive for Covid-19 between April 1, 2020 and November 30, 2021. We assessed disease characteristics, mortality, risk factors for infection and mortality from multivariate logistic regression analyses. Results: During the study period, 14 out of 46 hemodialysis patients (30.4%) were diagnosed with Covid-19 infection. Their average age was 42.3 ± 8.7 years with a male predominance (sex-ratio = 2.5). Among them, 13 (92.8%) presented with respiratory dist...
Open Journal of Nephrology
Introduction: Chronic Kidney Disease (CKD) is a major global public health problem. In Congo, we ... more Introduction: Chronic Kidney Disease (CKD) is a major global public health problem. In Congo, we have very few studies on it. Patients and Methods: We carried out an analytical cross-sectional study with retrospective data collection including patients aged 18 to 49 years, hospitalized for CKD in the nephrology department of University Hospital of Brazzaville, during the period from January 1, 2016 to August 31, 2020. The variables considered were socio-demographic, clinical, paraclinical, therapeutic and evolutionary. The statistical test used was Pearson's chi-square test. Results: CKD in those under 50 represented 21.1% of admissions and 35.6% of CKD. The mean age was 35.9 ± 8.4 years. There was a male predominance with a sex ratio of 1.27. Hypertension was the most common comorbidity (49.2%), followed by HIV (13.6%) and diabetes mellitus (13.2%). Stage 5 CKD was most prevalent (82.7%). Indeterminate kidney disease was in the order of 55.9%. The low socioeconomic level (74.9% of cases) hampered the achievement of dialysis in 66.3% of patients for whom this treatment was indicated. Failure to perform dialysis significantly influenced the occurrence of death (p-value = 0.005). Conclusion: CKD is common among people under 50 and more affects males with a high mortality rate due to lack of access to dialysis. The main causes are hypertension and HIV.
HEALTH SCIENCES AND DISEASES, Mar 28, 2021
HEALTH SCIENCES AND DISEASES, Dec 26, 2020
The Pan African medical journal, Oct 11, 2019
Nous nous sommes permis d'étudier les aspects épidémiologiques, cliniques et évolutifs des amylos... more Nous nous sommes permis d'étudier les aspects épidémiologiques, cliniques et évolutifs des amyloses rénales, et d'identifier les facteurs de mauvais pronostic. Il s'est agi d'une étude rétrospective, ayant porté sur tous les patients hospitalisés entre janvier 2013 et décembre 2014, pour une amylose rénale. Le diagnostic était confirmé par la ponction-biopsie rénale ou par la biopsie des glandes salivaires accessoires. Vingt-cinq patients étaient colligés dont 17 hommes et huit femmes; âgés en moyenne de 47,2 ± 18 ans. La fréquence hospitalière et le taux d'incidence étaient respectivement de 2,4% et 12,5 cas/an. A l'admission le syndrome néphrotique était retrouvé dans 100% et l'insuffisance rénale dans 68%. La protéinurie était ≥6g/24h dans 60%. Les autres manifestations étaient digestives (n=14), cardiaques (n=10) et l'hypotension artérielle (n=11). Les maladies infectieuses et inflammatoires étaient les principales causes retrouvées (60%). La tuberculose représentait à elle seule 20%. Après un suivi moyen de 219,5 jours, l'insuffisance rénale chronique était notée dans 16 cas (64%) dont 11 cas au stade terminal (44%). Six patients étaient décédés. L'insuffisance rénale au diagnostic, l'aggravation de la fonction rénale et la réhospitalisation étaient corrélées au risque d'insuffisance rénale chronique terminale (p: 0,03-0,04). L'atteinte cardiaque, la réhospitalisation et un débit de protéinurie ≥6g/24h étaient les facteurs associés au risque de décès (p< 0,03). L'insuffisance rénale, l'atteinte cardiaque, le débit de protéinurie ≥6g/24h et la réhospitalisation constituent les principaux facteurs de mauvais pronostic retrouvés dans cette cohorte.
Open Journal of Nephrology, 2021
Introduction: Conjunctival-corneal or choroidal calcifications are frequent in SHPT, blindness is... more Introduction: Conjunctival-corneal or choroidal calcifications are frequent in SHPT, blindness is however exceptional. We report a case of blindness secondary to compressive ischemic optic neuropathy. Case Report: Mr. B.E.K., 49 years old, has a chronic renal failure secondary to unlabeled glomerular nephropathy for 17 years. He has been on chronic hemodialysis for 12 years and has had SHPT for nine years. He secondarily developed disabling segmental osteoarticular deformities associated with kyphoscoliosis, "drumstick" fingers and facial dysmorphism. Five months before admission he developed eye pain and reduced visual acuity progressing within one month to blindness. Biology noted: serum creatinine at 726 umol/l (60-120 umol/L), azotemia at 14.3 mmol/l (2.5-7.5 mmol/L), serum calcium at 2.25 (2.25-2.55 mmol/L), phosphatemia at 1.13 (0.8-1.35 mmol/L), alkaline phosphatases at 2196 (5-270 IU/L) and parathyroid hormone level at 2257 (10-60 pg/mL). Retinal angiography revealed lesions suggestive of ischemic neuropathy. The orbit CT scan with 3D coronal reconstruction revealed narrowing of the caliber of the optical channels with dystrophic thickening of the skull base and cranial vault. Cranioencephalic and orbital MRI revealed diffuse brown tumors and pre-chiasmatic optic atrophy. Discussion: The most frequent ocular complications of SHPT are conjunctival-corneal or sclero-choroidal calcifications, asymptomatic, associated with hypercalcemia. Compressive manifestations are rarer, represented mainly by an amputation of the visual field, diplopia, ptosis or blindness, as described in our patient. The main cause is osteodystrophy and brown tumors of the skull base (1%-2%
International Journal of Approximate Reasoning, 2021
Context: Acute kidney failure (AKI) is a sudden and reversible deterioration of kidney function. ... more Context: Acute kidney failure (AKI) is a sudden and reversible deterioration of kidney function. It is of various etiologies which are decisive for its management. Goals: Determine the frequency of AKI determine the types the different stages and aetiologies of AKI in the nephrology service of the university hospital of Brazzaville(UHB). Patients and Methods: This was a retrospective and descriptive study. We reviewed the files of patients hospitalized between January 1, 2016 and October 31, 2020 in the nephrology department of the UHB. Were included, patients aged at least 18 years with a discharge diagnosis of AKI. The study variables were socio-demographic data, stages the type of AKI and the aetiologies. Results: Out of 1,823 hospitalized patients, 244 were hospitalized for an AKI (13.38%), of which 164 had met the inclusion criteria. These were 60.2% boys and 39.8% women, with an average age of 47 ± 19 years. AKI was stage 3 in 69.5%. It was functional in 55.2% of cases with s...
European Heart Journal Supplements, 2021
Aims May Measurement Month is a global screening campaign to raise awareness regarding elevated b... more Aims May Measurement Month is a global screening campaign to raise awareness regarding elevated blood pressure (BP). With the growing burden of hypertension, it is imperative to regularly assess the disease’s prevalence, risk factors, and awareness levels in a country. The current prevalence of hypertension in India as per the National Family Health Survey Data stands at 25.3%. May Measurement Month mobilizes healthcare professionals and sensitizes them to regularly measure BP, and impart lifestyle modification advice to the community. It also complements the deficiency in screening programmes at a national and international level. Methods and results May Measurement Month was carried out in May 2019 as an opportunistic screening campaign for adults (≥18 years). It was carried out by over 5000 trained volunteers across approximately 1000 screening sites (hospitals, public places, pharmacies, villages, and malls) in India. A total of 362 708 (57% males and 42.7% females) people were ...
European Heart Journal Supplements, 2020
To determine the proportion with hypertension among opportunistic screenees in the Republic of th... more To determine the proportion with hypertension among opportunistic screenees in the Republic of the Congo. This cross-sectional study was conducted in Republic of the Congo in May 2018. This screening was done in urban and rural areas that included Brazzaville, Pointe-Noire, District of Ngoyo, and District of Nkayi. The study protocol was provided by the International Society of Hypertension, and local ethical clearance was obtained. The data were processed by the May Measurement Month global project team. In total, 6169 people were screened, 2418 of which were female (39.2%). Most of the people screened were from 18 to 29 years old (n = 4184, 67.8%). The proportion of hypertension found was 22.2% (n = 1371). Among the hypertensive patients, 40.2% were aware of their hypertension, but only 493 (36.0%) were on antihypertensive treatment, and only 16.0% were controlled. The frequency of diabetes was 2.2% (n = 135), 2.3% (n = 139) had a previous stroke, and overweight and obesity were p...
European Heart Journal Supplements, 2020
Hypertension (HTN) is highly prevalent and the leading cardiovascular risk factor for death globa... more Hypertension (HTN) is highly prevalent and the leading cardiovascular risk factor for death globally. A large proportion of individuals with high blood pressure (BP) are unaware leading to under treatment and poor control. To address this, the International Society of Hypertension (ISH) initiated a global mass screening campaign, the May Measurement Month 2017 (MMM17), in which Kenya participated. Following the success of the campaign, its successor MMM18 was launched. Here, we present the Kenyan results for MMM18. Opportunistic screening of consenting adults was done in various sites across Kenya in May 2018, by volunteers trained using ISH material, under the co-ordination of the Kenya Cardiac Society. Blood pressure, pulse rate, weight, and height were measured by standard methods. Definitions of HTN and statistical methods all adhered to the standard MMM protocol. We screened 49 548 subjects, mean age 39.95 (15.3) years. In total, 49.4% had never had a BP measurement taken. Afte...
International Journal of Advanced Research, 2020
Introduction: The arteriovenous fistula (AVF) is the vascular approach of choice recommended in h... more Introduction: The arteriovenous fistula (AVF) is the vascular approach of choice recommended in hemodialysis. The objective of our work is to assess the place of AVF in hemodialysis centers in Brazzaville, to determine the complications during the first AVF punctures and their risk factors. Patients and Method: We carried out a cross-sectional, descriptive study in two hemodialysis centers in Brazzaville. The study runs from January 15 to December 31, 2019. Prosthetic AVFs were excluded. The complications that occurred during the first AVF punctures were studied and analyzed with the Epi info software. Results: first AVF punctures were performed in 24 patients (57.14% of patients on chronic dialysis). In 17 patients (70.83%) it was a radioradial AVF and in seven patients (29.17%) a humero-cephalic AVF. The intensity of the puncture pain was 8/10 in nine patients (37.5%) and 7/10 in seven patients (29.17%). Eleven patients (45.83%) developed a complication that caused the hemodialysis session to be adjourned. The complications found are a large hematoma (25%), a hemorrhage in a jet with a pre-shock state (12.5%), a rupture of the AVF (4.17%), an arterial puncture with pulsatile hematoma (4.17 %). The risk factors for the complications found are the humerocephalic site (p <0.05), overweight (p <0.01), an AVF flow rate greater than 1000 ml / min (p <0.05). Conclusion: The use of AVF is still low in our dialysis centers. The first punctures are intensely painful; complications are frequent.
Pan African Medical Journal, 2019
Nous nous sommes permis d'étudier les aspects épidémiologiques, cliniques et évolutifs des amylos... more Nous nous sommes permis d'étudier les aspects épidémiologiques, cliniques et évolutifs des amyloses rénales, et d'identifier les facteurs de mauvais pronostic. Il s'est agi d'une étude rétrospective, ayant porté sur tous les patients hospitalisés entre janvier 2013 et décembre 2014, pour une amylose rénale. Le diagnostic était confirmé par la ponction-biopsie rénale ou par la biopsie des glandes salivaires accessoires. Vingt-cinq patients étaient colligés dont 17 hommes et huit femmes; âgés en moyenne de 47,2 ± 18 ans. La fréquence hospitalière et le taux d'incidence étaient respectivement de 2,4% et 12,5 cas/an. A l'admission le syndrome néphrotique était retrouvé dans 100% et l'insuffisance rénale dans 68%. La protéinurie était ≥6g/24h dans 60%. Les autres manifestations étaient digestives (n=14), cardiaques (n=10) et l'hypotension artérielle (n=11). Les maladies infectieuses et inflammatoires étaient les principales causes retrouvées (60%). La tuberculose représentait à elle seule 20%. Après un suivi moyen de 219,5 jours, l'insuffisance rénale chronique était notée dans 16 cas (64%) dont 11 cas au stade terminal (44%). Six patients étaient décédés. L'insuffisance rénale au diagnostic, l'aggravation de la fonction rénale et la réhospitalisation étaient corrélées au risque d'insuffisance rénale chronique terminale (p: 0,03-0,04). L'atteinte cardiaque, la réhospitalisation et un débit de protéinurie ≥6g/24h étaient les facteurs associés au risque de décès (p< 0,03). L'insuffisance rénale, l'atteinte cardiaque, le débit de protéinurie ≥6g/24h et la réhospitalisation constituent les principaux facteurs de mauvais pronostic retrouvés dans cette cohorte.
Open Journal of Pediatrics, 2019
Introduction: Acute renal failure (ARF) is a medical emergency that does not spare children. Its ... more Introduction: Acute renal failure (ARF) is a medical emergency that does not spare children. Its interest lies in the search for etiologies and management made difficult by the poor quality of hospital technical platform in Africa. Objectives: To improve the management of ARF in children, determine its prevalence, and identify the causes and factors associated with mortality. Patients and Methods: We reviewed the records of children from one month to 17 years hospitalized between January 2016 and December 2018 in every pediatric department at the University Hospital of Brazzaville and included those whose discharge diagnosis included the item "ARF". Study variables were age, sex, source, (para)clinical signs, stage and type of ARF, etiology and evolutionary profile. Results: Included were 18952 hospitalized children out of whose 253 had ARF 1.3%. There were 145 (57.3%) boys and 108 (42.7%) girls with an average age of 71.5 months. The mean time to consultation was 8.1 days. ARF was at failure stage in 147 cases (58.1%). It was functional in 210 cases (83.0%), out of which 95.1% resulted from severe dehydration. No extra-renal treatment was performed. Lethality was 34.4%. Hypovolemic shock (56.3%), severe sepsis (18.4%) and severe malaria (14.9%) were the main causes. Young age, provenance of the child, severe dehydration, deep coma, oligoanuria, stage of failure, hyperkalemia, absence of an extra-renal purification center were factors associated with mortality (p < 0.0002). Conclusion: The high prevalence of ARF and its lethality requires public health actions including proper management of dehydration and malaria but also the creation of an extra-renal purification center.
International Journal of Clinical Urology
Objective: To evaluate the management of erectile dysfunction (ED) in chronic kidney failure (CKF... more Objective: To evaluate the management of erectile dysfunction (ED) in chronic kidney failure (CKF) patients in Congo. Patients and method: This was a cross-sectional study with prospective data collection over a period of 9 months, carried out in the nephrology departments of three hospitals in Congo. The IIEF-5 score was used to assess erectile function. We included all CRD patients with ED over 18 years of age. Results: The mean age of the patients was 54.4±(range: 20 years and 81 years). Cardiovascular risk factors were dominated by high blood pressure which accounted for 86 patients (91.5%). BMI was normal in 76 patients (80%). Grade 2 hypertension was noted in 47 patients (49.47%). Two patients (2%) did not have secondary sexual characteristics. The average duration of CKF was 3 years. The onset of ED was preceded by CKF in 92 cases (96.8%). The onset of ED was gradual in 72 cases (78.2%). The circumstance of the occurrence of ED was found in five cases (5.2%). Penile stiffness was low in 86 cases (90.5%). Sixty-four patients (67.4%) did not have a nocturnal erection. Other associated sexual disorders were decreased libido in 46 cases (48.4%), anorgasmia in 53 cases (55.8%) and premature ejaculation in 47 cases (49.47%). The mean IIEF 5 score was 11.38±4.44. Erectile dysfunction was severe in 43 cases (45.2%). Examination of the penis was normal in all cases. Erectile dysfunction was difficult to bear in 51 cases (53.7%). The testosterone level was between 5.5-32 nmol / L in 44 patients (68.8%). FSH and LH levels were increased in 60% of cases. The prolactin level between 1.8-29.2 micrograms / l in 14 cases (70%). The medical treatment of erectile dysfunction concerned 36 patients (37.8%). Conclusion: ED has psychological consequences that accentuate the suffering of patients. Modification of these risk factors must be undertaken early. IPDE5 have improved the management of erectile dysfunction
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Papers by Daniel Tony EYENI SINOMONO