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Patassi A.A.,Service des Maladies Infectieuses et de Pneumologie | Saka B.,Service de Dermatologie | Landoh D.E.,British Petroleum | Kotosso A.,Service des Maladies Infectieuses et de Pneumologie | And 7 more authors.
BMC Research Notes | Year: 2013

Background: Infection with Penicillium marneffei is a common opportunistic infection in Southeast Asia where it is endemic. We report a case of Penicillium marneffei infection with fatal outcome in a Togolese woman infected with Human Immunodeficiency Virus (HIV). Case presentation. A 45-years-old patient, infected with Human Immunodeficiency Virus had consulted for ongoing febrile pneumonia since two weeks. Clinical examination revealed fever of 38.5°C, dyspnea, pulmonary syndrome condensation and papulo-nodular of "molluscum contagiosum" like lesions located on the face, arms, neck and trunk. Sputum smear was negative for tuberculosis. The chest radiograph showed reticulonodular opacities in the right upper and middle lobes and two caves in the right hilar region. The CD4 count was 6 cells/mm3 after a year of antiretroviral treatment (Zidovudine-Lamivudine-Efavirenz). She was treated as smear negative pulmonary tuberculosis after a lack of gentamicin and amoxicillin plus clavulanic acid response. Culture of skin samples and sputum had revealed the presence of P. marneffei. A treatment with ketoconazole 600 mg per day was initiated. After two weeks of treatment, there was a decrease in the size and number of papules and nodules, without any new lesions. We noted disappearance of cough and fever. The chest X-ray showed a decrease of pulmonary lesions. There was no reactivation of P. marneffei infection but the patient died from AIDS after two years of follow up. Conclusion: We report a case of P. marneffei infection in a HIV-infected patient in a non-endemic country. Clinicians should think of P. marneffei infection in all HIV-infected patients with "molluscum contagiosum" like lesions. © 2013 Patassi et al.; licensee BioMed Central Ltd.

Yaya I.,Aix - Marseille University | Landoh D.E.,Ministere de la Sante. S C INH Togo | Saka B.,University of Lomé | Patchali P.M.,Center Hospitalier Regional Chr Of Sokode | And 5 more authors.
BMC Public Health | Year: 2014

Background: Adherence to antiretroviral therapy (ART) is beneficial in reducing the risk of emergence of HIV resistant strains. Adherence to ART among Persons Living with HIV/AIDS (PLWHA) is influenced by several factors related to the patient, the medication, and health facilities. In Togo, previous studies on adherence to ART have reported good adherence to ART during the first year of follow-up. However these may hide many disparities dues to cultural specificities which may differ across geographic areas of the country. We sought to determine the level of adherence to ART and document the associated factors among PLWHA at the regional hospital of Sokodé, Togo. Methods: This was an analytical cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months before the study. Results: A total of 291 PLWHA on ART were enrolled in the study. The mean age (±SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 195 (67.0%) were living with their partners and 210 (72.2%) had formal education. Two-thirds (194/291; 66.7%) of the PLWHA interviewed lived in urban areas. The global adherence to ART was 78.4%; the factors associated with ART adherence were: level of education (aOR = 3.54; p = 0.027), alcohol consumption (aOR = 0.43; p = 0.033), ART perception (aOR = 2.90; p = 0.026) and HIV status disclosure to sexual partner (aOR = 7.19; p ≤ 0.001). Conclusion: Although the level of adherence to ART in this study was higher than those reported in some studies in Sub-Saharan Africa, it remains sub-optimal and needs improvement. This may therefore hinder the implementation of efficient interventions related to access to ART services. © 2014 Yaya et al.; licensee BioMed Central.

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