This article examines the impact of bank risks and diversification on the profitability of commercial banks in Central Africa. The results indicate that the credit risk and liquidity risk have a ...negative impact on the profitability of these banks. Moreover, credit risk is reduced more through credit rationing than through an in‐depth examination of the borrowers’ profile. Lastly, banks use diversification to compensate for revenues lost because of credit rationing.
Chronic kidney disease (CKD) is a major cause of morbidity and mortality worldwide, but few studies are available on CKD in Cote d'Ivoire. We aimed to assess the prevalence of CKD and identify its ...associated factors in the general population in Abidjan in 2016 in a cross-sectional study that included 1418 subjects. We did not receive laboratory data for 38 subjects, including serum creatinine data. Of the 1380 remaining subjects, 138 cases of CKD were included in the study (10% prevalence). We observed a female predominance (sex ratio = 0.81), and the mean age was 43.7 ± 14.5 years. Histories of hypertension (HTN) (29.7%) and diabetes (10.1%) were reported. The main clinical signs were high blood pressure (51.4%), obesity (21%), proteinuria (37.9%), and hematuria (37.4%). The glomerular filtration rate (GFR) was <60 mL/min in 8.2% of cases according to the Modification of Diet in Renal Disease equation, in 8.6% according to the CKD Epidemiology Collaboration equation, and in 12.6% according to the Cockroft-Gault (CG) equation. The other laboratory signs were hyperglycemia (51.4%), hypercholesterolemia (34.1%), and hyperlipidemia (21%). In the multivariate analysis, factors such as female sex (
P
= 0.013), age >55 years (
P
= 0.02), a history of HTN (
P
= 0.001), hypercholesterolemia (
P
= 0.010), and hyperlipidemia (
P
= 0.009) were associated with the risk of CKD. The prevalence of CKD was high in our study. The CG equation should not be used to estimate the GFR in the general population. Prevention involves managing modifiable risk factors.
Acute kidney injury (AKI) in the elderly is characterized by high mortality. The objective of this study is to identify the causes of death in the elderly with AKI. This is a prospective cohort study ...with a descriptive purpose which was carried out during the period from January 2009 to December 2014 in the Department of Nephrology-Internal Medicine of Treichville University Hospital. The diagnosis of AKI was made on the basis of serum creatinine (SCr) values determined during hospitalization, according to KDIGO classification. Our study involved 107 elderly aged 65 and older with AKI. The hospital mortality rate was 46.7% (50/107). The average age of deceased patients was 71.8 ± 7 years with extremes of 65 and 90 years. We observed a male predominance with a sex ratio (41/9) of 4.55. AKI on admission was in Stage 1 in 16% of cases, in Stage 2 in 24%, and in Stage 3 in 60% cases. SCr was normal in 8%, the AKI was in Stage 1 in 34% (P = 0.09), Stage 2 in 18% (P = 0.001), and Stage 3 in 40% (P = 0.0001). AKI in deceased patients was organic in 36% of cases, obstructive in 30%, and functional in 6%. The etiologies of AKI were infections (46%), cancer (18%), benign tumors of the urinary tract (12%), malignant hypertension (6%), decompensated heart disease (6%), and drugs (6%). The main causes of death were sepsis (28%), cardiovascular disease (22%), severe renal failure (20%), pelvic cancers (16%), and liver failure (12%). All patients with cancer (P = 0.001) or HIV infected (P = 0.009) died. Sixty-eight percent of deaths occurred the 1st week. Death was earlier by sepsis and cardiovascular disease than by cancer. Mortality is high in the elderly. The main causes of death were sepsis, cardiovascular disease, renal failure, pelvic cancer, and liver failure.
Radon, thoron and associated progeny measurements have been carried out in 71 dwellings of Douala city, Cameroon. The radon-thoron discriminative detectors (RADUET) were used to estimate the radon ...and thoron concentration, while thoron progeny monitors measured equilibrium equivalent thoron concentration (EETC). Radon, thoron and thoron progeny concentrations vary from 31 ± 1 to 436 ± 12 Bq m
-3
, 4 ± 7 to 246 ± 5 Bq m
-3
, and 1.5 ± 0.9 to 13.1 ± 9.4 Bq m
-3
. The mean value of the equilibrium factor for thoron is estimated at 0.11 ± 0.16. The annual effective dose due to exposure to indoor radon and progeny ranges from 0.6 to 9 mSv a
-1
with an average value of 2.6 ± 0.1 mSv a
-1
. The effective dose due to the exposure to thoron and progeny vary from 0.3 to 2.9 mSv a
-1
with an average value of 1.0 ± 0.4 mSv a
-1
. The contribution of thoron and its progeny to the total inhalation dose ranges from 7 to 60 % with an average value of 26 %; thus their contributions should not be neglected in the inhalation dose assessment.
Aim
To investigate the prognostic factors of acute kidney injury (AKI) in our daily practice.
Methods
We analyzed the cohort of patients hospitalized for AKI in the period from January 2010 to ...December 2015 in the Department of Internal Medicine, University Hospital of Treichville. Kaplan–Meier curves were built for survival analysis. Cox regression analysis was used to identify independent predictors of mortality.
Results
We collected 414 cases of AKI during the study period. The mean age was 48.3 ± 16.8 years. We observed a male predominance with a sex ratio (236/178) of 1.32. In multivariate analysis, the predictive factors of death were age ≥ 65 years (HR = 2.13; 95% CI = 1.28–3.55; P = 0.004), AKI stage 3 (HR = 1.69; 95%CI = 1.13–2.50; P = 0.009), haemoglobin <8 g/dL (HR = 2.91; 95% CI = 1.79–4.72; P = 0.0001), infection (HR = 1.85; 95% CI = 1.21–2.83; P = 0.004) and drug‐induced AKI (HR = 3.23; 95% CI = 1.65–6.29; P = 0.001). Factors associated with incomplete recovery or non‐recovery of renal function beyond 3 months were age ≥ 65 years (OR = 4.76; 95% CI = 1.85–12.50;P = 0.001), hypertension (OR = 2.17; 95% CI = 1.07–4.34; P = 0.03), haemoglobin <8 g/dL (OR = 6.66; 95% CI = 2.94–8.28; P < 0.001), AKI stage 3 (OR = 9.09; 95% CI = 4.54–16.66; P < 0.001) malignant hypertension (OR = 5; 95% CI = 1.67–7.27; P = 0.005) and cancer (OR = 4.69; 95% CI = 2.22–6.63; P = 0.001).
Conclusion
The aetiologies are dominated by infections. The fatality rate is high and its risk factors are advanced age, low haemoglobin level, severe AKI, infection and drug intake. Prevention is essential.
Summary at a Glance
This single centre manuscript shows that infections continue to be a main cause of AKI and has a high mortality, especially in the elderly and advanced stages.
Soil gas radon and indoor radon measurements have been carried out in Mayo-Louti and Benoué Divisions in northern Cameroon. Concentrations of radon in soil have been measured using Markus 10 at the ...depth of about 1 m. Radon concentration in soil varies from 0.9 to 13.8 kBq m
−3
with a mean value of 4.6 kBq m
−3
. Average daily indoor radon concentrations measured with RadonEye+
2
detectors vary from 7 to 60 Bq m
−3
with an average of 17 Bq m
−3
. Indoor radon concentrations measured with passive RADTRAK detectors range between 15 and 104 Bq m
−3
with a geometric value of 38 Bq m
−3
and a geometric standard deviation of 1.5. This geometric value is lower than the value of 30 Bq m
-3
given by UNSCEAR. Indoor radon inhalation dose ranges between 0.28 and 1.97 mSv a
−1
with geometric value of 0.72 mSv a
−1
(at 0.03 standard deviation). Outdoor radon inhalation ranges between 0.02 and 0.26 mSv a
−1
with a mean value of 0.09 mSv a
−1
. The total annual effective dose due to indoor and outdoor radon exposure for this study area is 0.81 mSv a
−1
, less than 1.15 mSv a
−1
the world average value given by UNSCEAR. There is no significant radiological risk for the inhabitants.
Indoor radon, thoron and thoron progeny concentrations, along with the equilibrium factor for thoron progeny and soil gas radon concentrations, have been measured to assess radiological risks in the ...centre and south regions of Cameroon. Indoor radon and thoron concentrations were estimated using radon–thoron discriminative detectors (RADUET), while thoron progeny monitors measured the equilibrium equivalent thoron concentration (EETC). Radon concentrations in the soil were determined using a MARKUS 10 detector. It was found that radon, thoron and thoron progeny concentrations range between 19 and 62 Bq m−3, 10 and 394 Bq m−3 and 0.05 and 21.8 Bq m−3, with geometric means of 32 Bq m−3, 98 Bq m−3 and 4.9 Bq m−3, respectively. The thoron equilibrium factor ranges between 0.007 and 0.24, with an arithmetic mean of 0.06 ± 0.03; this is higher than the world average value of 0.02 provided by the United Nations Scientific Commission on the Effects of Atomic Radiation(UNSCEAR, New York, USA). The level of the soil radon concentration ranges from 4.8 to 57.3 kBq m−3, with a geometric mean of 12.1 kBq m−3 at a depth of 0.7 m. Of the sampling points, 66% fall within normal radon risk areas, and 3% of the sampling areas are high radon risk areas exceeding 50 kBq m−3. The annual effective dose was found to be 0.03 ± 0.01 mSv for radon, 0.08 ± 0.05 mSv for thoron, 0.63 ± 0.12 mSv for radon progeny and 1.40 ± 0.84 mSv for thoron progeny. The total dose is estimated to be 2.14 mSv y−1. The mean estimated indoor excess lifetime cancer risk values due to radon, thoron, radon progeny and thoron progeny are 0.12 × 10−3, 0.31 × 10−3, 2.51 × 10−3 and 5.58 × 10−3, respectively. Thoron progeny contributed 60% to the effective dose. Thus, thoron progeny cannot be neglected in dose assessments, in order to avoid biased results in radio-epidemiological studies.
Background: Renal failure (RF) is a risk factor for morbidity and mortality in cancer patients. Objectives: To describe the profile of cancer patients with RF. Patients and Methods: This is a ...retrospective descriptive study of RF in patients enrolled in the national cancer registry of Abidjan, during the period from January 2012 to December 2015. The diagnosis of RF was confirmed based on a measured glomerular filtration rate (GFR) < 60 mL/min obtained using the Modification in Diet of Renal Disease (MDRD) formula. A comparison of patients with (n = 131) or without (n = 136) RF, followed by a logistic regression analysis, made it possible to identify the risk factors for RF. Results: The mean age was 54 ± 13.9 years in the group with RF versus 49 ± 14.8 years in the group without RF (P = 0.003). The etiologies of RF were urinary tract obstruction (41.2%), administration of platinum salts (19.8%) and water losses (12.2%). In multivariate analysis, age (P = 0.009), presence of hypertension (P = 0.02), uterine cancer (P = 0.0001) and prostate cancer (P = 0.014) were associated with the risk of RF in cancer patients. Factors such as male gender (P = 0.007), HIV infection (P = 0.021), GFR<15 mL/min (P = 0.002), and hemoglobin level <8 g/dL (P = 0.041) were associated with mortality in cancer patients with RF. Conclusions: Late diagnosis leads to renal complications with an increased risk of mortality.
Chronic kidney disease (CKD) has become a public health problem because of its increasing prevalence. The objective of this study was to describe the current profile of CKD in our working conditions. ...This is a descriptive retrospective study of patients admitted for CKD during the period from January 2010 to December 2014 in the Internal Medicine Department of the university hospital of Treichville in Abidjan. CKD was defined by a glomerular filtration rate below 60 mL/min lasting for at least three months. We collected 252 cases of CKD out of 3573 patients recorded during the study period, yielding a prevalence of 7%. The mean age was 39.6 ± 14 years (15-83 years). We observed a male predominance (sex ratio 1.2:1). Of the CKD patients studied, 67.1% were hypertensive, 7.9% were diabetic, and 8.7% were positive for human immunodeficiency (HIV) virus. The CKD was Stage 3 in 2.4%, Stage 4 in 3.2%, and Stage 5 in 94.4% of the patients. The etiology of CKD was hypertension in 59.9% of cases, followed by chronic glomerulonephritis (25%), HIV infection (9.1%), and diabetes (4.8%). On bivariate analysis, hypertension was the cause of CKD in 48.8% of patients under 35 years, 66.4% in patients between 35 and 64 years, and 85.4% in patients ≥65 years (P = 0.001). Chronic glomerulonephritis was the cause of CKD in 40.2% of patients under 35 years, in 14.3% between 35 and 64 years, and in 4.8% of patients ≥65 years (P = 0.0001). CKD is a common cause of hospitalization in our department. Patients generally consulted at the late stage of the disease. Risk factors are mainly hypertension, HIV infection, and diabetes.
En Côte d'Ivoire, la prévalence de l'infection au virus de l'immunodéficience humaine (VIH) est élevée. Tous les organes peuvent être atteints, en particulier le rein. Certaines études en Côte ...d'Ivoire ont retrouvé les infections opportunistes comme facteur de mauvais pronostic de l'insuffisance rénale aiguë (IRA). L'objectif de cette étude était de rechercher les éventuels autres facteurs associés à l'évolution de l'IRA chez les personnes infectées par le VIH. Une étude rétrospective, analytique, menée au Centre Hospitalier et Universitaire de Yopougon de janvier 2014 à décembre 2017. Etaient inclus tous les patients âgés de plus de 18 ans, infectés par le VIH et ayant présenté une IRA. Soixante-treize (73) patients ont été inclus, soit une prévalence de 24%. L'âge moyen des patients était de 39,32 ± 10,50 ans avec des extrêmes de 18 et 65 ans. Un sexe ratio de 1,6 en faveur des femmes. L'obésité (p=0,047; OR=8,72; IC (95%)=1,07-39,21) et le taux de CD4< 200/mm3 (p=0,000; OR=58,50; IC (95%)=10,31-55,12) étaient associés à un mauvais pronostic de l'IRA. En Côte d'Ivoire, la prévalence hospitalière l'IRA au cours du VIH demeure élevée. Son évolution est défavorable avec le décès ou le passage à la chronicité. En plus de l'immunodépression profonde déjà connue comme facteur de mauvais pronostic, cette étude a montré que l'obésité était associée à une évolution défavorable de l'IRA chez les personnes vivant avec le VIH.
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