Background: Infectious diseases remain a major contributor to hospital morbidity and mortality in sub-Saharan Africa despite progress in HIV, tuberculosis and malaria control. Contemporary hospital-based data are needed to guide referral pathways, clinical governance, antimicrobial stewardship and resource allocation. Aim: This study aimed to describe the morbidity and mortality profile of patients admitted to the Department of Infectious and Tropical Diseases (SMIT) of Fann National University Hospital in Dakar, Senegal. Methods: We conducted a retrospective descriptive study that included patients hospitalised from 1 January 2023 to 31 December 2024. Sociodemographic, clinical, laboratory, microbiological, therapeutic and outcome data were extracted from standardised medical records. Data were analysed using descriptive statistics. Results: Among 1,018 admissions, 1,002 complete records were included, corresponding to approximately 42 admissions per month. The median age was 42 years (interquartile range: 27–57), and 594 patients (59.3%) were male. At least one comorbidity was recorded in 48.2% of patients, mainly HIV infection (20.5%), hypertension (10.1%) and diabetes mellitus (8.1%). Fever (73.2%) and altered general condition (70.0%) were the most frequent clinical features. Tuberculosis was the leading diagnosis (25.75%), followed by tetanus (10.88%), neuromeningeal infections (7.98%) and HIV-related opportunistic infections (7.39%). The main bacterial isolates were Escherichia coli (18.3%), Staphylococcus aureus (16.0%) and Klebsiella pneumoniae (15.3%). Antibiotics were administered to 70.1% of patients. Hypoxia, neurological failure and septic shock were the main complications. Overall, 209 deaths were recorded, corresponding to an in-hospital mortality rate of 20.9%. Conclusion: The burden of severe infectious diseases remains substantial in this tertiary referral department, with frequent comorbidity, bacterial infections, organ dysfunction and high mortality. Strengthening early referral, systematic admission assessment, microbiological diagnostics and antimicrobial stewardship should be priorities.

Background: Tuberculosis remains a major public health concern in Senegal, and evaluation of treatment outcomes is necessary to assess programme performance. This study evaluated first-line anti-tuberculosis treatment outcomes at the Infectious and Tropical Diseases Department of Fann University Hospital in Dakar. Methods: A retrospective descriptive study was conducted using records of patients registered for tuberculosis treatment between 1 January 2022 and 31 December 2023. Sociodemographic, clinical, bacteriological, and therapeutic data were extracted from medical records and treatment registers. Data were entered using Microsoft Excel 2016 and analysed using SPSS version 20.0. Results: Overall, 102 patients were included. The median age was 33 years, and 63.7% were male. Most patients (59.8%) were from Dakar. Pulmonary tuberculosis accounted for 51% of cases, and 38% of patients were HIV-positive. Tuberculosis was bacteriologically confirmed in 46.1% of patients; among confirmed cases, GeneXpert was used in 76.6%. The standard six-month regimen was administered to 86.3% of patients. Treatment was completed by 63.7%, and 12.7% were cured, giving a treatment success rate of 76.5%. Six deaths, one treatment failure, one loss to follow-up, and 16 unevaluated outcomes were recorded. Conclusion: Treatment success was achieved in approximately three-quarters of patients. Improved completeness of treatment registers, timely diagnostic confirmation, and strengthened follow-up are needed to reduce unevaluated outcomes and support continuity of tuberculosis care.

INTRODUCTION:Despite progress in prevention and treatment, infectious diseases remain a major cause of morbidity and mortality in West Africa. Hospital-level data are limited. This study aimed to assess the burden, clinical spectrum, and outcomes of infectious diseases at a referral hospital in Senegal. METHODOLOGY:A retrospective study of all non-coronavirus disease 2019 (COVID-19) infectious disease admissions at the Centre Hospitalier National Universitaire (CHNU) de Fann from January 2021 to December 2022 was conducted. Sociodemographic, clinical, diagnostic, and outcome variables were recorded. Logistic regression identified factors independently associated with in-hospital mortality. RESULTS:A total of 1,098 patients (median age 42, 57.2% male) were included. Tuberculosis (TB; 21.8%), malaria (13%), and community-acquired pneumonia (9.2%) were the leading diagnoses. Human immunodeficiency virus (HIV) infection was present in 28.1% of patients, with 58.4% having opportunistic infections. Overall mortality was 25.0%. Independent predictors of death included HIV-positive status (OR: 2.1; 95% CI: 1.4-3.2), neurological involvement (OR: 1.7; 95% CI: 1.2-2.5), age > 60 years (OR: 1.9; 95% CI: 1.1-3.1), and sepsis (OR: 2.3; 95% CI: 1.5-3.6). CONCLUSIONS:Infectious diseases remain a leading cause of hospitalization and death in Senegal. Improving early diagnostics, integrating TB/HIV services, and expanding access to fungal testing are crucial to improve outcomes in resource-limited hospital settings.

Tuberculous pyomyositis occurs mainly in immunocompromised patients, either through hematogenous spread (secondary form) or following direct trauma. However, it may also occur in immunocompetent patients without an initial focus and without clinical or radiological evidence of infection. The report presents a case of primary tuberculous pyomyositis presenting as an abscess of the left thigh. Initial treatment with broad-spectrum antibiotics for presumed tropical pyomyositis caused by common bacteria proved ineffective, with persistence of clinical signs. Microbiological examination of the pus using the Xpert test identified Mycobacterium tuberculosis. Clinical evolution was favourable under antituberculosis therapy combined with abscess drainage.

Introduction: Miliary tuberculosis is a severe form of tuberculosis resulting from the hematogenous dissemination of Mycobacterium tuberculosis. It is a therapeutic emergency that requires the immediate initiation of anti-tuberculosis treatment in any febrile miliary case. It may progress rapidly and lead to multiorgan failure. Aim: The aim of this study was to describe the epidemiological, clinical, paraclinical, and outcome characteristics of patients hospitalized for miliary tuberculosis in the Infectious Diseases Department of the Fann University Teaching Hospital. Patients and Methods: A retrospective, descriptive, observational study was conducted, including patients hospitalised for miliary tuberculosis in the Department of Infectious and Tropical Diseases of the Fann University Teaching Hospital from January 1, 2018, to December 31, 2024. Results: Among 1,115 patients hospitalized for tuberculosis, 96 presented with miliary tuberculosis, representing 8.60% of all tuberculosis cases. The median age was 37 years (IQR: 28–45). Human immunodeficiency virus (HIV) infection was the most frequent comorbidity (48.96%). The predominant general symptoms were fever (97.92%) and impaired general condition (86.46%). The most frequently affected systems were the respiratory (53.13%), neurological (39.58%), and splenic-lymph node systems (34.38%). Regarding paraclinical findings, pancytopenia was present in 10.39% of patients, while hepatic cytolysis was observed in 42.31%. Microbiological confirmation of tuberculosis was obtained in 50% of cases. The in-hospital case fatality rate was 38.54%. Conclusion: Miliary tuberculosis primarily affects young adults, often living with HIV, and is characterized by a systemic clinical presentation. The high case fatality rate highlights the importance of early diagnosis and prompt, appropriate management.

Introduction: The rapid progression of the diabetes epidemic in low-income and middle-income countries threatens the efforts made in the fight against tuberculosis. This progression could even hinder the progress achieved toward meeting the Sustainable Development Goals aimed at ending the tuberculosis epidemic by 2030. The association between diabetes and tuberculosis presents certain particularities that have been highlighted by studies. Objective: To assess the prevalence of diabetes among a population with tuberculosis admitted to the Infectious Diseases Department (SMIT) of Fann Teaching Hospital and to determine the main factors associated with death. Methodology: A retrospective cross-sectional study, both analytical and descriptive, conducted over a five-year period (2018–2023). We performed a bivariate analysis to study the relationship between death and the different variables. The Chi-square independence test was used to search for statistical associations between these variables. When the p-value was less than 5%, we concluded that statistically significant associations existed. Results: Out of 4,091 patients hospitalized during our study period, 868 presented with tuberculosis, representing a hospital frequency of 21.21%. We collected 34 cases of patients with a diabetes–tuberculosis association, corresponding to a proportional morbidity of 3.9%. A female predominance was noted (56%) with a sex ratio of 0.78. The mean age was 54 years. Half of the patients came from urban areas, and 41% were unemployed. Regarding comorbidities or underlying conditions, HIV co-infection was found in 32.35%, hypertension in 26.47%, and smoking in 9%. Previous hospitalization was reported in 58.82% of patients. Almost all patients had type 2 diabetes (94%), with diabetes evolving mostly for less than five years. Chronic degenerative complications were found in 12% of patients. The clinical presentation was insidious in 88% of patients, dominated by asthenia, followed by cough (65%) and fever (62%). Multifocal tuberculosis was the predominant form (53%), with pulmonary localization estimated at 85%. At admission, 47% of patients had fasting blood glucose above 1.26 g/L. Diabetes was poorly controlled in 66% of patients with HbA1c > 7%. The Xpert MTB/RIF test was positive in 87.7% (n=21) of tested patients, and sputum smear microscopy was positive in 70% (7 out of 10 tested patients). Thoracic imaging showed predominance of alveolar and interstitial syndromes, with a tendency toward bilaterality (60%) and lesion dissemination (36%). Regarding treatment, insulin therapy was initiated in 26% of cases before hospitalization and 20% during hospitalization. Anti-tuberculosis chemotherapy was administered to 91% of patients. The average hospital stay was 13 days. During hospitalization, 48% of patients developed non-infectious complications, particularly cardio-respiratory (18%). The mortality rate was 47.05%. Factors associated with death were mainly the duration of diabetes (p=0.016) and the presence of complications (p=0.000). Conclusion: Tuberculosis is frequently associated with diabetes, especially in resource-limited countries, due to the growing number of diabetics in these regions. Consequently, the National Tuberculosis Control Program (PNT) recommends systematic screening for diabetes in all individuals with tuberculosis.

Background: The syndemic interaction between tuberculosis (TB) and COVID-19 remains poorly characterized in high TB-burden African settings. This study investigates the clinical and epidemiological features of TB–COVID-19 co-infection in Senegal. Methods: We conducted a multicenter retrospective observational study from March 2020 to March 2022, enrolling hospitalized patients with confirmed COVID-19 (RT-PCR) and active TB (positive smear microscopy or GeneXpert). Demographic, clinical, and outcome data were systematically collected and analyzed. Results: Among 19 co-infected patients (mean age 48±20 years, 63.2% male), TB preceded COVID-19 diagnosis in 78.9% of cases. Common presentations included chronic cough (84.2%), fever (84.2%), and radiological findings of ground-glass opacities (52.6%). Notable laboratory abnormalities included lymphopenia (84.2%) and elevated inflammatory markers (CRP >12 mg/L in 100%). The case fatality rate reached 26.3%, with severe COVID-19 present in 36.8% of cases. Conclusion: Our findings show that active TB was associated with severe COVID-19 presentations and a high observed in-hospital mortality in this Senegalese cohort. These results underscore the need for integrated screening and management strategies in TB-endemic regions.

Objectives:Chronic hepatitis B is a liver-tropic disease caused by hepatitis B virus (HBV) with hepatitis B surface antigen persisting beyond 6 months. According to a 2024 report by the Pasteur Institute, the prevalence of chronic HBV infection in Senegal is alarming, ranking among the highest in the world, between 10 and 17%. Senegal currently does not have a standardized algorithm for the management of chronic hepatitis B. Since 2017, the European Association for the Study of the Liver (EASL) has proposed a new classification of chronic hepatitis B and a surveillance scheme. The objective was to evaluate the management of patients with viral hepatitis B in rural areas according to the EASL criteria. Methods:Retrospective and prospective, descriptive study with analytical aim from March 15, 2022 to December 7, 2024, at the SMIT Mame Abdou Aziz Sy Dabakh hospital in Tivaouane. Included were patients with chronic hepatitis B who had benefited from an initial management assessment according to the criteria of the EASL. Data were captured using Kobocollect software, encoded, and analyzed using R software, V.4.4.0. Ethical considerations were respected. Results:We collected 72 patients. The median age was 34 years (28-41), with a female predominance (56.9%). Housewives (34.7%) and teachers (16.7%) were the most represented. The notion of familial liver cancer (16.67%) was reported with 41.67% in the first degree as well as in the second degree. The discovery of HBV carriage was made during an assessment initiated by the practitioner (63.9%), prenatal assessment (19%), and during a blood donation (9.7%). Nine patients (12.51%) were symptomatic. The hepatitis B e-antigen dosage was negative in 69 patients (95.53%). The median alanine aminotransferase levels were 23.10 IU/l (16-32.25) and viral load 379.5 IU/ml (37-1562). Two hepatitis D virus/HBV co-infections were observed. Fibrosis (F0-F1) was found in 82.5% of cases, F2-F3 in 14.3%, and cirrhosis in 3.2%. Tenofovir disoproxil fumarate treatment was initiated in 10 patients (13.9%), according to the 2017 EASL guidelines. Ineligible patients (86.1%) were placed on surveillance, the rate and frequency of which depended on the initial phase. Among the patients lost to follow-up, 42 were under surveillance (67.64%) and four were under treatment (40%). Lack of treatment and high cost of care were the main reasons for exclusion from follow-up. In multivariate analysis, no factor was significantly associated with loss to follow-up. Conclusions:Our study highlights the challenges of managing chronic viral hepatitis B in rural areas. The high cost of monitoring and the lack of treatment for the majority of patients contribute to loss of follow-up.

Introduction: In developing countries, tetanus remains an important cause of mortality. Predictive factors of death related to this condition are rarely investigated. Objective: To identify factors associated with death among patients admitted for tetanus at the Department of Infectious and Tropical Diseases (SMIT) of Fann University Hospital, Dakar. Methods: We conducted a retrospective, descriptive, and analytical study including patients hospitalized for tetanus over a 12-year period (2010–2021). Factors associated with mortality were investigated. To compare proportions in each category, bivariate analysis was performed using the chi-square test. Logistic regression was used in multivariate analysis to estimate odds ratios (OR) with 95% confidence intervals (CI). A significance level of α = 5% was considered for statistical significance. Results: A total of 938 cases of tetanus were recorded among 10,948 hospitalized patients, representing a hospital frequency of 8.6%. The mean age was 30.06 years with a sex ratio of 4.27. Comorbidities (19.08%) were mainly hypertension (41%) and diabetes (22%). The mean delay before hospitalization was 3.6 days. The average incubation period was 14.26 days, and the invasion period 2.29 days. The main clinical signs of tetanus observed were trismus (99%), dysphagia (88%), and paroxysms (71%). The primary gateway was cutaneous (79%), and tetanus was generalized in 96% of cases. Patients were mainly classified as stage II according to Mollaret’s classification (82%). More than half of the patients (57%) had a Dakar score between 2 and 3. The mean duration of hospitalization was 11.99 ± 8.99 days. The main complications noted were cardiovascular (18%), respiratory (15%), and infectious (15%). The case fatality rate was 20.47%. In multivariate analysis, five factors were found to be associated with death: invasion < 48 hours (p=0.000); age ≥ 65 years (p=0.002); diabetes (p=0.008); tonic-clonic paroxysms (p=0.004); and occurrence of complications (p=0.000). Conclusion: Risk factors for mortality, namely advanced age and diabetes, are not taken into account in current prognostic classifications of tetanus. It is therefore important to reconsider the parameters used in prognostic scoring systems for tetanus.

Introduction : Les antibiotiques représentent un pilier essentiel dans le traitement des infections. Toutefois, leur usage inapproprié entraîne une montée de la résistance bactérienne, parallèlement à une augmentation de leur consommation. L'objectif de cette étude était d'évaluer la consommation d'antibiotiques au service des maladies infectieuses et tropicales (SMIT) de l’hôpital de Fann. Méthodologie : Cette étude rétrospective a été réalisé chez des patients hospitalisés au SMIT du 02 Janvier au 31 Décembre 2023, nous y avons inclus tous les patients ayant consommés des antibiotiques durant leur hospitalisation et exclus ceux qui n’en avaient pas consommés durant leur hospitalisation ou venus pour une simple consultation. Résultats : Nous avons analysé 113 fiches de patients dont 56,63% étaient de sexe féminin contre 43,36% pour le sexe masculin soit un sex-ratio de 0,77. La tranche d’âge la plus représentée était celle de [20,25 ans], avec 15,9 % des patients. Le Mycobacterium tuberculosis etait le germe le plus retrouvé dans les produits pathologiques (22,22%) suivi des Staphylococcus spp (14,81%), Pseudomonas aeruginosa (11,11%), Klebsiella pneumoniae (11,11%) et Escherichia coli (11,11%). La ceftriaxone était la molécule la plus consommée au SMIT avec 33,33% suivi par le cotrimoxazole avec 17,98%. La famille des bêta-lactamines était la plus consommée soit 1031 DDJ et 719 DDJ/1000JH suivies des Sulfamides antibactériens soit 658 DDJ et 459 DDJ/1000JH. Conclusion : La ceftriaxone a été la molécule la plus prescrite au SMIT et la famille des bêta-lactamines a été la famille d’antibiotique la plus consommée durant l’année 2023. Mots-clés : Antibiotiques, Maladies Infectieuses et Tropicales, Consommation.

Introduction: COVID-19 is a systemic zoonosis with predominant respiratory tropism caused by coronavirus. It was declared a public health emergency and a pandemic in March 2020. Following the opening of the first CTE at Fann in Dakar, an Outbreak Care Center was established at Kaolack Hospital. This study aimed to evaluate comorbidities and risk factors in patients hospitalized for COVID-19 at this center. Methodology: This is a retrospective, descriptive, and analytical cross-sectional study conducted from February 4 to September 28, 2021, on 76 patients with COVID-19. Results: The median age of the patients was 61.5 (18 – 90) years. The dominant age group was 60 and Males (51.3%) with a sex ratio of 1.05. Hypertension was the main comorbidity (34.2%) followed by Diabetes (23.7%). The average length of hospital stay was 6.7 days (0 - 35 days). Symptomatic patients accounted for 94.7%. The most common functional signs were cough (90.8%) and dyspnea (77.6%). Anemia was present in 69.7% and CRP 100%. Age was a significant risk factor for severity (p<0.001) and mortality (p-value<0.05). Thirteen (17.1%) patients died. Conclusion: COVID-19 disease is a serious infectious disease with severity and high lethality in senior. Effective prevention is essential.

Introduction: Bacterial meningitis remains a major public health problem in Africa, with a persistently high incidence and case fatality. The objective of this study is to describe the epidemiological, clinical, biological and therapeutic profile of bacterial meningitis, and to identify the factors associated with lethality. Patients and Methods: A descriptive and analytical retrospective study was conducted from the records of patients hospitalized for bacterial meningitis at the SMIT in Fann January 2020 and December 31, 2023. A multivariate regression analysis, with a significance threshold set at 5%, was performed using R software version 4.2.0. Results: During the study period, we collected 138 inpatient records of patients hospitalised for bacterial meningitis, representing a hospital frequency of 3.06%. The median age of patients was 35 years with IQR: [27-52]. HIV infection (17.39%), high blood pressure (8.76%) and diabetes (8.03%) were the most common comorbidities. Cerebrospinal fluid (CSF) was clear in nearly half of the cases (49.28%), and cytology found a predominantly polynuclear neutrophil white blood cell count in 50% of cases. The median length of hospital stay was 10 days with IQI [7-17]. The most commonly used antibiotic was ceftriaxone, which was administered to 92.04% of patients. During hospitalization, 49 patients died, i.e., a case fatality rate of 35.51%. Factors associated with death were HIV infection (aOR= 3.09; 95% CI [1.05-9.57]), p-value=0,041, a Glasgow score < 13 (aOR: 3.62; 95% CI [1.57-8.57]), p-value=0,03 and CRP > 96 mg/L (aOR: 2.85; 95% CI [1.25-6.72]), p-value=0,013. Conclusion: Bacterial meningitis has a high lethality rate at the Clinic of infectious and tropical diseases of Fann Hospital. Improving immunization coverage, strengthening diagnostic capacity and early management could reduce this fatality.

Introduction: The objective of this study was to examine the factors associated with the immunological response in patients living with HIV (PLHIV) following 12 months of antiretroviral therapy (ART). Patients and Methods: This was a descriptive-analytical study conducted from 2012 to 2018 in PLHIV followed at SMIT/CRCF of Fann hospital. To identify factors associated with CD4 delta (CD4 at M12 - CD4 at M0), univariate and multivariate linear regression were conducted. A significance threshold of 5% was established. Results: A total of 213 cases were collected, the mean age of the participants was 38 ± 11 years, and the sex ratio was 0.6. The most common comorbidities were diabetes (0.9%) and high blood pressure hypertension (6.1%). A total of 2.3% of patients were identified as having a history of injecting drug use. Patients were diagnosed with advanced HIV disease in 62.9% of cases. At the time of inclusion, the most common co-infections were hepatitis B (13.14%) and tuberculosis (13.6%). The mean difference between M0 and M12 was 197.8 (95% CI: 174.4; 221.3; p<0.001). In the univariate analysis, younger age (p < 0.02), the absence of HBV co-infection (p = 0.01), and therapeutic adherence (p < 0.01) were found to be associated with an increase in TCD4+ lymphocytes. After multivariate linear regression, age (β=-2.64; p=0.018) and adherence (β=188; p=0.001) were found to be independently associated with CD4 delta. Conclusion: Advancing age and poor adherence to ART are independent predictors of suboptimal immunological recovery among HIV-infected individuals. Tailored interventions targeting adherence support and age-related factors are needed in our settings to enhance immunological response and long-term prognosis.

Introduction: COVID-19, like most viral respiratory diseases, can be associated with bacterial infections requiring antibiotic prescription. However, the prescription of antibiotics must be based on clinical and biological arguments, with clear recommendations. The aim of this study was to identify the factors associated with antibiotic prescription in patients hospitalized for COVID-19. Methodology: This was a retrospective cohort study including patients hospitalized for COVID-19 at the Epidemic Treatment Center of Fann Hospital from July 31, 2021 to March 31, 2022. Data were collected using a form and entered using Excel software. Analysis was performed using R software version 4.2.2. Factors associated with antibiotic prescribing were investigated using logistic regression. Results: A total of 248 patients were included. The median age was 65 years [53, 73], with a male predominance (sex ratio M/F 2.25). Comorbidities were mainly hypertension (35.88%), cardiovascular disease (23.38%) and diabetes (21.77%). The main clinical signs were cough (60.17%), fever (40.41%) and dyspnea (22.56%). On imaging, a ground-glass appearance was found in the majority of cases (84.52%), with severe lung involvement in 31.25%. Almost all patients were treated with anticoagulation (96%) and corticosteroids (95%). Azithromycin was the most prescribed antibiotic (56.38%), and 77% of patients were on oxygen. Case fatality was 21%. In bivariate analysis, antibiotic prescription was associated with heart disease (81.25% vs. 47.83%, p=0.01), smoking (81.82% vs. 48.51%, p=0.03), signs of lung consolidation (55, 43% vs 34.43%, p=0.004), oxygen therapy (55.97% vs 36.84%, p=0.03) and the existence of a complication (62.24% vs 41.73%, p=0.002). In multivariate analysis, only smoking (OR: 5.78 [1.30-42]), fever (OR: 1.82 [1.04-3.24]) and signs of lung consolidation (OR: 2.52 [1.30-5.05]) were associated with antibiotic prescription. Conclusion: In patients infected with COVID-19, antibiotic prescription is indicated in those with clinically or biologically documented bacterial infection.