Centre Hospitalier Universitaire de Yopougon

In sub-Saharan African countries like Côte d'Ivoire, most individuals with Type 2 diabetes mellitus (T2DM) are undiagnosed, and therefore at risk of experiencing late T2DM diagnosis. Within this region, little is known about late T2DM diagnosis, which is defined as the onset of complications at, or around the time of, laboratory diagnosis. Our objective was to assess the prevalence of late T2DM diagnosis in Abidjan (Côte d'Ivoire) and identify biological and social factors associated with late T2DM diagnosis. A retrospective chart review was carried out between January and May 2022 using patient records in four diabetes centres of Abidjan. Late diagnosis was defined as the onset of at least one T2DM complication within two years following T2DM laboratory diagnosis. Descriptive and multiple correspondence analyses were conducted. Patients (n = 217) had a mean age of 49.0 ± 11.4 years at T2DM laboratory diagnosis, and about half were female (male-female ratio: 0.9). One quarter (25.3%) of patients with T2DM experienced late diagnosis. Most (72.7%) complications observed were chronic. Late diagnosis was associated with older age (≥ 50 years), residence in lower-income municipalities of Abidjan, hypertension, and no family history of T2DM. Age, living area, and family history were significantly associated with early and late T2DM diagnosis in the multiple correspondence analysis. To reduce late T2DM diagnosis and prevent its complications, screening strategies in Côte d'Ivoire could consider prioritizing older adults, adults living in lower-income municipalities of Abidjan, and those without family history of T2DM. The online version contains supplementary material available at 10.1007/s40200-026-01879-7.

Central nervous system tumors present significant diagnostic and therapeutic challenges, as WHO histomolecular prognostic criteria are not always optimal. Decision-making increasingly relies on multidisciplinary team meetings (MDTs), which require highly qualified specialists. We aimed to assess available human resources and propose a framework for subregional collaboration through a West African neuro-oncology MDT. A multicenter descriptive study was conducted via an online questionnaire from April 13 to June 15, 2025, involving 35 healthcare professionals from nine West African countries. Participants included 45.7% neurosurgeons, over 57% with <3 years' experience. Most managed <100 patients/year, and 90% performed <100 tumor excisions. Awake surgery and stereotactic biopsy were rare. Access to chemotherapy, pathology, immunohistochemistry, and molecular biology was reported by 83%, 80%, 51%, and 14% of respondents, respectively. Median turnaround time was about 3 weeks for histopathology and about 1 month for immunohistochemistry. Clinical trial access was available to 26%. Neurosurgeon density was <1 per million inhabitants, peaking in Senegal (1 per 700,000). Only 34% reported functional MDTs. Nearly all participants (95%) supported establishing a subregional network with regular online MDTs (monthly or bimonthly) and a specialized interuniversity degree. MDTs are essential in neuro-oncology, enabling individualized therapeutic planning. Given critical workforce shortages in West Africa, a subregional collaborative MDT network could optimize patient care, enhance resource sharing, and standardize management across the region.

Children are largely exposed to air pollution in low- and middle-income countries, yet data on exposure and respiratory effects of air pollution remain limited. This study aimed to assess the feasibility and outcomes of joint ambulatory monitoring of exposure to fine particulate matter (particles with a diameter of less than 2.5 µm (PM2.5)) and spirometry in children living in Abidjan, Côte d'Ivoire. We did a cross-sectional observational study among children aged 7-17 years. After a baseline spirometry, children were asked to wear portable PM2.5 sensors and to perform 2×3 daily flow-volume curves using a portable spirometer for 7 days. We described the proportion of acceptable measurements, per cent predicted forced expiratory volume (ppFEV1), and hourly geometric mean PM2.5 concentrations, and analysed the cumulative delayed effects of PM2.5 on ppFEV1 using distributed lag non-linear models. Of 29 children enrolled, 18 (62.1%) were female, median age 12 years, all performed spirometry with 1101 (90.4%) of 1218 expected flow-volume curves obtained. Of these, 625 (51.3%) acceptable curves were received and 313 valid, non-duplicate curves were analysed. The median ppFEV1 was 79.6% (71.5-87.4), with lower values in the morning than in the evening (p<0.001). Of 146 160 expected PM2.5 measurements, 93 689 (64.1%) were obtained; 6328 aberrant data were excluded. The median hourly PM2.5 concentrations were 164.2 (107.0-272.2) µg/m³. PM2.5 levels varied throughout the day, with pollution peaks observed in the morning. A significant decrease in ppFEV1 was observed between 0 and 2 hours post-exposure, after an IQR increase of 120.9 µg/m³ in PM2.5 exposure (β=-2.21; CI -3.74 to -0.69). Ambulatory spirometry and PM2.5 measurements are feasible with portable devices in African children. High PM2.5 exposure and individual variability in lung function highlight the need for further research on the respiratory effects of air pollution in children.

IntroductionTranssphenoidal endonasal endoscopic surgery has established itself as the preferred approach for the treatment of pituitary adenomas. Although this minimally invasive approach offers excellent results in terms of tumor resection and reduced morbidity, the quality of postoperative medical care remains a determining factor in functional prognosis.ObjectiveTo analyze the modalities of post-operative medical management and evaluation of the clinical, endocrine and radiological evolution of patients presenting with a pituitary adenoma by transsphenoidal endonasal endoscopic approach.MethodologyThis is a retrospective, single-center study involving 150 patients selected between 2015 and 2022. Functional adenomas represented 58% of cases, with a predominance of prolactinomas (33%), followed by corticotropes (17%) and somatotropes (5%). Nonfunctional adenomas constituted 42% of cases. The analysis focused on tumor characteristics, postoperative complications, hormonal replacement management and medium-term results.ResultsHormone replacement was initiated in 65% of patients. Transient diabetes insipidus occurred in 12% of cases, while cerebrospinal fluid (CSF) leak was observed in 6% of patients. A visual disturbance was noted in 82% of the cases concerned. Complete endocrine recovery was achieved in 22% of patients. The five-year radiological recurrence rate is 15%, mainly observed in invasive or partially resected adenomas.ConclusionPostoperative management of pituitary adenomas requires a multidisciplinary approach, with rigorous endocrine monitoring. Long-term evaluation shows an overall favorable evolution, although the need for hormone replacement therapy remains frequent. Earlier anticipation of post-operative endocrine disorders helps improve patients’ quality of life.

IntroductionMultimodal MRI coupling with morphological sequences, diffusion, perfusion and spectroscopy, represents an almost essential tool in the management of surgical pathology. Used well, it allows a diagnostic approach of choice, surgical planning and therapeutic monitoring.ObjectiveEstablish the rate of correct diagnosis with the histopathology of radiologists and neurosurgeons based on MRIMaterials and MethodsThis was a cross-sectional and analytical, multicenter retrospective study from February 2017 to October 2024 and prospective from November 2024 to June 2025. Included were all patients operated on for an intracranial expansive process of nature tumor, The first retrospective part consisted of comparing the imaging results with the anatomopathology data and secondly the neurosurgeon’s hypotheses with the conclusions of the anatomopathologyResultsDuring the study we had a study population of 257 patients. The average age was 33.5 +/- 17.5 years, the sex ratio was M/F : 1.78. The supratensorial topography of the lesions was the most common. Intracranial hypertension syndrome, pyramidal syndrome, comitial syndrome, and visual disturbances were the most common. The tumor lesions identified during the study period included 25 gliomas, 19 Astrocytomas, 11 hemangioblastomas, 17 medulloblastomas, 3 Craniopharyngiomas, 156 meningiomas, 13 metastases, and 13 rare tumors. The retrospective study reported an overall positive predictive value of 72.73%, a negative predictive value of 94.12%, a sensitivity of 94% and a specificity of 72%ConclusionMultimodal MRI is effective for brain tumors and should be requested as first intention in the face of any suspicion of an expansive tumor process.IntroductionL’IRM multimodale couplant aux séquences morphologiques, la diffusion, la perfusion et la spectroscopie, représente un outil presqu’incontournable dans la prise en charge de la pathologie chirurgicale. Bien utilisée, elle permet une approche diagnostique de choix, de planification chirurgicale et de suivi thérapeutique.ObjectifEtablir le taux de bon diagnostic avec l’histopathologie des radiologues et des neurochirurgiens sur la base de l’IRM.Materiels et MethodesIL s’agissait d’une étude transversale et analytique, multicentrique rétrospective de février 2017 à Octobre 2024 et prospective de Novembre 2024 à juin 2025. Y Etaient inclus tous les patients opérés d’un processus expansif intracrânien de nature tumorale, La première partie rétrospective ayant consisté à confronter les résultats de l’imagerie aux données de l’anatomopathologie et dans un second temps les hypothèses du neurochirurgien aux conclusions de l’anatomopathologie,ResultatsNous avons eu au cours de l’étude une population d’étude de 257 patients. L’âge moyen était de 33,5 +/- 17,5 ans, La sexe ratio était de H/F : 1,78. La topographie sus tensorielle des lésions était la plus fréquente. Le syndrome d’hypertension intracrânienne, le syndrome pyramidal, le syndrome comitial, et les troubles visuels étaient les plus fréquents. Les lésions tumorales recensées durant la période d’étude regroupaient 25 gliomes, 19 Astrocytomes, 11 hémangioblastomes, 17 médulloblastomes, 3 Craniopharyngiomes, 156 méningiomes, 13 métastases, et 13 tumeurs rares. L’étude rétrospective a rapporté une valeur prédictive positive globale de 72,73%, une valeur prédictive négative de 94,12%, une sensibilité de 94% et une spécificité de 72%ConclusionIRM multimodale est performant pour les tumeurs cérébrales et devrait être demandée en première intention devant toute suspicion de processus expansif tumoral

IntroductionWith an incidence of 9.12/100,000 per year increasing with age, intracranial meningiomas are the most common intracranial neoplasms. They represent 1/3 of CNS tumors with a female predominance. These are extra-axial tumors developed at the expense of arachnoid cells. In 35% of cases they are located at the convexity. Around 80% are considered benign and classified as WHO grade 1 ; slow progression with a good prognosis. The standard treatment is surgical excision, the extent of which is assessed by the Simpson grade. However, this excision can be difficult due to the location and thus influence the Simpson grade, thus favoring recurrences. The objective of this work is to study the correlation between location ; Simpson grade and occurrence of recurrence after surgical resection.MethodThis is a multicenter, retrospective, descriptive and analytical study carried out in three hospitals in Abidjan covering neuroimaging data, anatomo-pathological results and operative reports of patients operated on for meningiomas from 2014 to 2024. The data were analyzed with Excel software.ResultsWe collected 16 files of meningiomas. The average age was 45.81 years with extremes of 26 and 64 years. Located in 68.75% at the base of the skull and 43.75% of excisions were Simpson grade 2.ConclusionThe location of meningiomas influences the quality of excision and the risk of recurrence. The more complex shapes of the skull base require rigorous preoperative evaluation to optimize surgical and prognostic results.

Introduction: Transfusion of packed red blood cells (PRBCs) is a common practice in neonatology, particularly in premature newborns. This study’s objective was to assess the application and adequacy of departmental guidelines regarding RBC transfusion in newborns. Methods: This was a retrospective, cross-sectional, descriptive and analytical study of hospitalized newborns transfused between January 1, 2023, and December 31, 2024, in the neonatology department of the Yopougon University Hospital, relocated to Béago. The transfusion indication in effect in the department was pallor and anemia in premature infants, with a threshold of 10 g/dL. Results: We collected data on 239 patients who received transfusions out of a total of 5880 hospitalized newborns, representing a hospital frequency of 4.06%. In 63.1% of cases, patients were admitted before one week of age. Fifty-four percent of patients had low birth weight at admission. Respiratory distress and pallor on clinical examination were the most common signs, found in 57.7% and 33.89% of cases, respectively. Among them, 61.9% received at least two transfusions, with an average hemoglobin level of 10.13 g/dL before transfusion and 14.7 g/dL afterward. Among premature infants (27.7%), transfusions were also given between 11 - 13 g/dl in the presence of signs of decompensation. The average hemoglobin level after transfusion was 14 g/dl. The mortality rate was 30.5%; factors associated with death were low birth weight and low gestational age. Conclusion: Double transfusion significantly improved patients’ hemodynamic and respiratory status. We recommend that all newborns under 32 weeks of gestation weighing less than 2500 g with a hemoglobin level below 10 g/dL receive two blood transfusions, if necessary, with a target hemoglobin level of 13 g/dL.

Abstract Background. Very few studies have been set in Subsaharan Africa according to hydroxyurea effacy and safety. We aimed to evaluate Hydroxyurea efficacy and safety and its benefits in low-resource settings. Methods We conducted a prospective comparative study of SCA patients. 128 patients was enrolled and divided in two groups. 68 patients treated by hydroxyurea at doses 10-20mg/kg/day and 62 patients control groups without hydroxyurea. The end points assessed was feasibility, safety, and benefits (laboratory variables, sickle cell–related events, transfusions). Results : The patients assigned to hydroxyurea treatment had lower annual rate of crises than the control group (median, 2.9 vs. 5.3 crises per year, P=0.001), fewer annual rate of hospitalizations (median 2.2 vs. 4.7, P=0.002), and fewer annual rate of transfusion (median 1.3 vs.5.1, P=0.001). We observed a significant increase in Hb F level from 11.77% to 14.6% (p=0.001) in patient treated by hydroxyurea. We also observed a significant increase in the mean of Hb level from 7.3 g/dl to 9.2 g/dl for patients treated by hydroxyurea (p=0.004). Patients treated by hydroxyurea also have a beneficial effect on WBC and platelet levels by reduction in leukocytosis and thrombocytosis. the occurrence of annual number of infectious complications was significantly lower in the group of patients with hydroxyurea. Conclusion: Hydroxyurea has a key clinical benefits by reducing the incidence of vaso-occlusive events, infections, transfusions, which translates into fewer hospitalizations. The main problem is the fact that, it’s not accessible for most of our patients who live in poor socio-economical condition.