BackgroundChronic lymphocytic leukemia (CLL) is a mature B-cell neoplasm characterized by the expansion of CD5-positive lymphocytes in peripheral blood. While CLL is the most common type of leukemia in Western populations, the disease is rare in Africans. Hence, clinical and laboratory data and studies of CLL in Sub Saharan populations have been limited. The aims of this study were to analyze the characteristics of senegalese patients with CLL at the time of the diagnosis and to identify the correlation between clinical characteristics (Binet stage) with age, gender, laboratory parameters and chromosomal abnormalities.MethodsIn this study, we investigated the clinical and laboratory characteristics of CLL in Senegal. A total of 40 patients who had been diagnosed with CLL during the period from July 2011 to April 2015 in Senegal were evaluated. Cytology and immunophenotype were performed in all patients to confirm the diagnosis. The prognosis factors such as Binet staging, CD38 and cytogenetic abnormalities were studied. The statistical analysis was performed using STATA version 13 (Stata college station Texas). Each patient signed a free and informed consent form before participating in the study.ResultsThe mean age was 61 years ranged from 48 to 85. There were 31 males and only 9 females (sex ratio M : F = 3,44). At diagnosic, 82.5 % of the patients were classified as having advanced Binet stages B or C. The prognosis marker CD38 was positive in 28 patients. Cytogenetic abnormalities studied by FISH were performed in 25 patients, among them, 68 % (17 cases) had at least one cytogenetic abnormality and 28 % had 2 simultaneous cytogenetic abnormalities.ConclusionAfricans may present with CLL at a younger age and our data suggest that CLL in Senegal may be more aggressive than in Western populations.

For more than two years after the emergence of COVID-19 (Coronavirus Disease-2019), significant regional differences in morbidity persist. These differences clearly show lower incidence rates in several regions of the African and Asian continents. The work reported here aimed to test the hypothesis of a pre-pandemic natural immunity acquired by some human populations in central and western Africa, which would, therefore, pose the hypothesis of an original antigenic sin with a virus antigenically close to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). To identify such pre-existing immunity, sera samples collected before the emergence of COVID-19 were tested to detect the presence of IgG reacting antibodies against SARS-CoV-2 proteins of major significance. Sera samples from French blood donors collected before the pandemic served as a control. The results showed a statistically significant difference of antibodies prevalence between the collected samples in Africa and the control samples collected in France. Given the novelty of our results, our next step consists in highlighting neutralizing antibodies to evaluate their potential for pre-pandemic protective acquired immunity against SARS-CoV-2. In conclusion, our results suggest that, in the investigated African sub-regions, the tested populations could have been potentially and partially pre-exposed, before the COVID-19 pandemic, to the antigens of a yet non-identified Coronaviruses.

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Introduction: The resting electrocardiogram is generally called upon in the evaluation of cardio-vascular risk in diabetics. Thus we proposed in this work to evaluate electrocardiographic changes in patients with type 2 diabetes. Methods: This was a cross-sectional and descriptive observation that took place from 1 January 2014 to 1 October 2014 in the Internal Medicine/Endocrinology Departments of Pikine National Hospital and Cardiology National Hospital of Grand-Yoff. Results: One hundred (100) patients consisted of 43 male and 57 female diabetics. The sex ration male/female ratio was 0.7. The average age was 58.3 years. Men were twice as likely to be active as women. Rhythm disorders were noted in 20% of patients, 13% of whom were women. Right atrial hypertrophy was found in 11% of patients and left hypertrophy in both men and women (25%). Wolf-Parkinson White syndrome was present in 2% of patients. A complete right bundle block was present in 11% of patients. Primary repolarization disorders were noted in 17% of patients and secondary in 18% of patients, postero-diaphragmatic necrosis in 14% of patients, real posterior necrosis in 2% of patients, extensive anterior necrosis in 15% of patients. The QT interval was lengthened in 21% of patients including 14 women. Left ventricular hypertrophy was present in 33% of patients and right ventricular hypertrophy was found in 10% of patients. The bivariate analysis showed that electrocardiographic abnormalities were more correlated with the association of certain risk factors such as hypertension and dyslipidemia, the feminine gender, but also the poor glycemic balance. On the other hand, physical activity and treatment had a protective effect. Conclusion: The ECG is certainly insufficient for an exhaustive exploration of the heart of the diabetic patient, but still very useful in our conditions of exercise to improve the care of our patients.

IntroductionMorbidity and mortality from diabetes are compounded by associated cardiovascular risk factors. For this reason, taking care of these risk factors is a public health goal.In this study we evaluated the level of control of cardiovascular risk factors in black Africans with type 2 diabetes in Senegal.MethodsBetween March 2007 and July 2008, we recruited type 2 diabetes patients from outpatient care in a specialised hospital in Senegal. Data were collected on a survey form designed for this purpose. An electrocardiogram and laboratory examinations were also performed. The level of control of diabetes and associated cardiovascular risk factors were assessed, as recommended by the American Diabetes Association (ADA).ResultsA total of 318 type 2 diabetes subjects (237 women) were recruited. The average age was 58.2 ± 9.2 years (40–85). The mean duration of diabetes was 6.9 ± 5.9 years. The average glycaemic level was 1.4 ± 0.5 g/l and glycated haemoglobin was 7.6 ± 3.2%. The average length of patient follow up was 6.7 ± 6.1 years with a single annual consultation; 63.2% of the patients were on an insulin + biguanide combination, with good diabetes control (HbA1c < 7%) in 25% of cases. Antihypertensive drugs were prescribed in 28.1% of hypertensive patients. More than half (51.9%) of these hypertensive patients were treated with angiotensin converting enzyme inhibitors. Their blood pressure was well controlled (< 130/85 mmHg) in 5.4% of the hypertensive patients (10/185). The low-density lipoprotein (LDL) cholesterol goal was achieved in 18.5% of cases (5/27).ConclusionThis study shows that the prevalence of cardiovascular risk factors is higher among black Africans suffering from type 2 diabetes. The control of these factors was not optimal in our study.

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Introduction: Management of pheochromocytoma faces different challenges leading to misdiagnosis and therapeutic delay in developing countries. The aim of our study was to evaluate the diagnostic and therapeutic features as well as the evolution of our management strategies in hospital setting in recent years in Dakar. Patients and Method: We carried out a retrospective study over 12 years (January 2005 to June 2017), in 4 hospitals in Dakar. We only included patients with established diagnosis of pheochromocytoma upon clinical, biological, radiological and histological arguments. Results: During this period, 16 observations have been collected and were all about female patients. The mean age at the time of diagnosis was 36.81 years. The clinical signs were dominated by hypertension found for 14 patients. At biological examination, hypersecretion catecholamine was found in 13 patients, high urinary metanephrines in 7 patients, high plasmatic metanephrines in 2 patients and raised urinary Vanyl Mandelic Acid (VMA) in 4 patients. Dosage of chromogranin A showed high level for one patient. Abdominal CT scan allowed making the adrenal origin of tumors precise. One patient presented bilateral pheochromocytoma. Before being treated surgically, all patients had had medical preparation. The surgical treatment by median laparotomy consisted of an enucleation of the tumor in 2 patients, and adrenal resection in 11patients.The evolution after surgery was favorable in 12 patients out of 13. One patient died 2 days after surgery by hemodynamic instability. In 2 patients who presented metastases, multidrug therapy with cyclophosphamide, vincristine and dacarbazine was decided after a multidisciplinary meeting, but they died before treatment. Conclusion: Management of pheochromocytomas in developing countries is obviously improving, but the mortality rate remains high. Early diagnosis and perioperative care are to be targeted for better outcome and prognosis of this rare tumor in our areas.

Introduction: We assess the severity of the rheumatoid arthritis in a Senegalese African black population. Patients and methods: It is a retrospective study achieved in the service of Internal Medicine of Aristide Le Dantec teaching hospital of Dakar between January 2005 and December 2016 in patients suffering from rheumatoid arthritis. We specified for every patient the predictive data of severity of the rheumatoid arthritis. Results: Four hundred and three patients have been gathered (39 men and 364 women), with the mean age of 45.8 years. An active tobacco addiction was noticed in 10 patients. The diagnostic delay was on average of 72 months. Characteristic articular deformations were noticed in 215 patients (53.3%). They were correlated to male (p = 0.038), to age (p = 0.001) and to the activity of the rheumatoid arthritis (p = 0.0445). Systemic manifestations have been observed in 213 cases (52.9%), particularly anemia (50.8%). They were correlated to the anti-CCP antibodies (p = 0.047). The ESR was increased at the first hour in 84.4% of cases (median: 43 mm; extreme: 1and 160). CRP was elevated in 63.71% of cases (median of 12 mg/l; extreme: 1 and 384). The rheumatoid factor was positive in 57.6% of the cases. The anti-CCP antibodies were present in 89.2% of the cases. Articular erosions were objectified in all cases. A DAS 28 superior to 5