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Introduction: With 11.7% new cases worldwide in 2020, female breast cancer is not only the first among gynaecological cancers, it is also the first cancer worldwide. Also, disease stage during diagnosis is an important cost predicting factor. Methods: It was a transversal descriptive study carried out in the Obstetrics and Gynaecology unit of the Sylvanus Olympio University Hospital (SO UH) and in the International Cancer Centre of Lome (ICCL) during July and august of the year 2022. Results: Only 146 patients were enrolled in our study, with a participation rate of 30.87%. The mean age of the patients was 48.9 ± 11.7 years with extremes of 25 and 77 years. Fifty one patients (39%) were resellers. Sixty four patients (43.8%) attended secondary education. The median cost of breast cancer diagnosis was 182080 FCFA ]55680; 487680] FCFA. The median cost of chemotherapy was 1640790 FCFA ]199820; 5208885] FCFA. The median cost of surgical treatment of breast cancer was 230 320 FCFA ]135240; 368060] FCFA. The median cost of hormonal treatment was 206200 FCFA ]36750; 494850] FCFA. The median cost of radiotherapy was 1 765 000 FCFA ]1715000; 2030 000] FCFA. Of the 146 patients, 46 had not undergone any other complementary tests apart from diagnostic tests. The median cost of the tests carried out as part of the pre-therapeutic assessment and follow-up was 21 500 FCFA (0; 824 760] FCFA. The direct medical cost of breast cancer management was 119200 FCFA [36616- 1604669] FCFA for patients with health insurance (17.1% of patients). Conclusion: The direct medical cost of breast cancer treatment is higher than the average household income in Togo. The question of what measures could be taken to increase adherence to treatment by patients living with this cancer and to reduce the large number of long-lost patients is still pending.

Introduction: Le 9 janvier 2020, les autorités sanitaires chinoises et l’OMS ont annoncé officiellement la découverte d’un nouveau coronavirus. Le professionnel de santé notamment les sages-femmes sont exposées dans l’exercice de leur profession. L’objectif de cette étude est d’évaluer leurs connaissances, attitudes et pratiques afin de limiter la transmission de COVID 19.Méthodes: Ils s’agissaient d’une enquête transversale à visée descriptive portant sur 48 sages-femmes exerçant dans le service de gynéco-obstétrique du CHU S.O. du 06 juin au 05 Août 2021.Résultats: Toutes les sages-femmes croyaient à l’existence de la COVID-19. La première source d’information était la télévision (79%). Le mode de transmission le plus cité était les aérosols dans 77,11% des cas ; la fièvre était le signe majeur le plus connu (98%). L’attitude face à un cas suspect était d’appeler le numéro vert dans 90% des cas. Les lunettes de protection et écran facial n’étaient pas disponibles dans respectivement 79% et 90% des cas. Dix-neuf pourcent (19%) n’étaient pas vaccinées.Conclusion: Les principaux modes de transmission et manifestations cliniques sont bien connus. Les attitudes observées par les participants face à un cas suspect étaient surtout l’appel du numéro vert, et l’isolement. La disponibilité de certains équipements de protection étaient faibles et d’autrespeu utilisés. Le lavage des mains était régulier. Introduction: On January 9, 2020, Chinese health authorities and the WHO officially announced the discovery of a new corona virus. Health professionals, in particular Midwives are exposed in the practice of their profession. The objective of our study is to assess their knowledge, attitude and practices in order to limit the transmission of COVID-19.Method: This was a descriptive cross-sectional survey of 48 midwives working in the gynecology-obstetrics department at the CHU SO from 06 June to 05 August 2021.Results: All midwives believed in the existence of COVID-19. The main source of information was television (79%). The most reported mode of transmission was aerosol in 77, 11% of cases; fever was the best known major sign (98%). The attitude to a suspect case was to call the toll-free number 90% of the time. Protective goggles and face shield were not available in 79% and90% of cases, respectively. 19% were not vaccinated.Conclusion: The main modes of transmission and clinical manifestations are well known. The attitudes observed by the participants in the face of a suspected case were mainly calling the toll-free number, and isolation. The availability of some protective equipment was low and others little used. Hand washing was regular.

This was a cross-sectional and descriptive study conducted from January 2nd to march 30th 2019 in the township of Hiheatro in Togo. We included in the study, women who had given birth at least once at home and who accepted to undergo the survey. Data were collected, using a pre-planned and pre-tested survey sheet, by a team of four trained interviewers under the responsibility of a supervisor. Interviews were carried out in the homes of the respondents after obtaining their informed consent. The parameters studied were the number of births at home, socio-demographic characteristics, and reasons for births at home and maternal and fetal prognosis. 411 women gave birth at home in the township. The average number of births at home per woman was 2 with extremes of 1 and 7 births per woman. The average age of the women was 28.4 years with the extremes of 15 and 38 years. The 25 - 34 age group represented 67.1% of cases. The average parity of the patients was 2. Multiparas represented 59.8% of cases. The main reasons for giving births at home by the interviewees were insufficient financial means in 36% of cases and the lack of means of transport in 28% of cases. Maternal morbidity was marked by 14.1% perineal tear, 1.6% hysterectomy. Four hundred and eleven newborns were registered. Of these newborns, 4.4% were stillborn and 8.8% did not cry at birth. Free obstetric care and increased awareness on the importance of assisted deliveries will improve the maternal-fetal prognosis.

Introduction: Obstetric Fistula (OF) is an abnormal communication between the bladder and the vagina or between the rectum and the vagina and or both. The objective was to describe the experience of OF by the victims. Methodology: The gynecology-obstetrics clinic of the CHU Sylvanus Olympio in Lome served as the framework for this study. This was a descriptive cross-sectional study, which took place from February 28 to March 19, 2011. Results: A total of 76 women with OF were interviewed. Mothers were more attentive to the problems of women with OF (38.2%). More than half of women with OF (53.9%) were rejected by non-family circle. The vast majority of them have experienced a change in their sex life (75%). Before the fistula, 77.6% had an income-generating activity. The fistula was associated with a vulvar rash (55.3%). Women with OF (93.4%) had a permanent need for cleanliness. Conclusion: The pursuit of cleanliness is an important characteristic of women with OF. The latter are often abandoned by their husbands. All this experience leads women with OF to a “social death”.

Background: Dysgerminoma is a germ cell tumor of the ovary usually found in young women. It represents 1% to 2% of all ovarian cancers. The preoperative diagnosis is generally difficult. The surgery and the pathology study are therefore essential for the diagnosis, and optimal management. The incidence of pregnancy with dysgerminoma is extremely low. The treatment and management during pregnancy often jeopardize the materno-fetal prognosis. We report a case of ovarian dysgerminoma in an 18-year-old pregnant woman. Observation: Patient was an 18-year-old, female with no known past medical history, who presented to the emergency room at 29 weeks + 3 days pregnancy with dyspnea and a voluminous uterus (height 42 cm). An ultrasound showed an active pregnancy, and a large vascularized, finely echogenic, multi-partitioned, thick-walled liquid ovarian tumor. Ca125 was 231.5 IU/ml. Ovarian dysgerminoma was suspected. The surgery and the pathology study of the surgical specimen confirmed the suspected diagnosis. Patient died on postoperative day 8. Conclusion: Ovarian dysgerminoma is a rare malignant tumor, which must be suspected in case of complex ovarian mass of young women. When diagnosed during pregnancy, its management jeopardizes the materno-foetal prognosis.

Introduction: Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. Objective: To assess the practice of AMTSL in four maternity in the commune of Kara (Kara University Hospital Center, Kara Tomde Regional Hospital Center, SOS Kara Mother-Child Hospital, and Adabawere Peripheral Care Unit). Method: This was a cross-sectional descriptive study over four months, from January 28 to May 28, 2019. Two questionnaires were used for data collection: an observation and evaluation grid AMTSL practice and a questionnaire for providers. The grid was designed and adapted to the RPC repository model for emergency obstetric and neonatal care in Africa 2018. The data was processed using the Epi Info 7 software. Results: During the study period, 528 parturients were identified and 30 providers surveyed. No provider had received ongoing training in AMTSL. The practice of AMTSL was systematic at each delivery. The practice was correct in 45.8%. Factors associated with incorrect practice were relationship between caregiver-patient (p = 0.0005), placental examination (p = 0.0003), postpartum monitoring (p = 0.0001). Conclusion and Suggestion: The practice of AMTSL is systematic, but it was incorrect regardless of the provider’s qualification. Continuing education on AMTSL is necessary to prevent postpartum hemorrhage.

Les caprins constituent au Togo la seconde espèce d’élevage après les volailles en terme d’effectif. La disponibilité de sa viande reste pourtant rare. L’Etat togolais, à travers des projets de développement, a initié la recapitalisation du cheptel national d’animaux à cycle court. L’objectif de l’étude était la connaissance des faiblesses des pratiques d’élevage des caprins au Togo en vue de proposer des axes de recherche pour son amélioration et son développement. Des enquêtes ont été menées auprès de 129 chefs de ménages des deux sexes. Les éleveurs étaient des paysans, des salariés ou des retraités. Les enquêtes ont couvert l’ensemble du pays, prenant en compte sa diversité pluviométrique et végétale. Des données sur les pratiques d’élevage, les soins vétérinaires, les maladies et les autres contraintes ont été recueillies. Les résultats ont montré que 69 % des éleveurs étaient instruits, 91 % étaient mariés, et 26 % des propriétaires étaient des femmes. La main d’œuvre familiale jouait un rôle important. Les activités liées à l’élevage étaient confiées aux femmes et aux enfants. La taille moyenne du cheptel par ménage était de 18 caprins. Les chèvres adultes constituaient 44 % de l’effectif contre 2 % de mâles adultes entiers. Le taux de productivité au sevrage était de 0,54 chevreau par mère. Les animaux disposaient d’un abri ; dans 85 % des élevages, ils recevaient périodiquement une complémentation alimentaire et dans 27 % d’entre eux un complément minéral à base de sel de cuisine. Les soins vétérinaires ont été observés dans 64 % des élevages. Cette étude a permis de révéler quelques faiblesses relatives aux soins vétérinaires, à l’utilisation de géniteurs améliorés et à la disponibilité d’abris. Des formations sur les itinéraires techniques de l’élevage des caprins sont nécessaires pour améliorer leurs performances.

Introduction: Teenage pregnancies have serious consequences for the health of mothers and their children. The aim of this work was to study the circumstances of the onset of teenage pregnancy. Methodology: This was a cross-sectional and descriptive study, which took place from July 1st to 31st, 2019 at the Peripheral Care Unit (USP) of Gbodjome in Togo. Results: A total of 100 adolescent girls were interviewed (12.6%). The average age of adolescent girls was 17.2 years (12 - 19 years). Adolescent girls were predominantly in primary school (42.0%) and single status (58.0%). Forty-two decimal zero percent of adolescent girls (42.0%) were living with their partners. In 5.0% of cases, adolescent girls were victims of sexual harassment. The pregnancy was the result of rape in 10.0% of cases. Ten decimal zero percent of adolescent girls (10.0%) had more than one sexual partner. Nearly half of the respondents (49.0%) knew at least one method of contraception, but only 8.0% used it. Financial help from the partner (57.0%) was the leading cause of sex. Conclusion: Teenage pregnancies have a negative impact on both the young mother and the unborn child. The ideal would be to make schooling for girls free, from primary school to the A-level.

Objectives: Study the prognostic, clinical and epidemiological profile of high blood pressure and pregnancy association at the Sylvanus Olympio Teaching Hospital (CHU Sylvanus Olympio) of Lome. Patients and Method: It is about a retrospective study that is carried out at the gynecology-obstetrics unit from January to December 2016. Pregnant women with High Blood Pressure after delivery were concerned. Results: In total, 767 pregnant women with High Blood Pressure out of 12107 were taken. The frequency of HBP-pregnancy association was 6.33%. The 21 to 30 bracket age was the most represented (53.71%). The most common risk factor was the overweight or over-obseness (41.98%). Other risk factors were the first delivery and maternal age superior to 30 years old. Common clinical cases described in the study are the same as a predominance of preeclampsia. Caesarean has been the common method of delivering with foetal complications of prematurity type, neonatal suffering and hypotrophy. Conclusion: HBP-pregnancy association is a public health concern with serious foetal maternal complications. The prevention of this association is of great importance.

Introduction: L’evaluation de la satisfaction montre l’adequation entre les attentes des patients et la qualite des soins recus. Objectif: evaluer la satisfaction des accouchees hospitalisees en suites de couches a la maternite de l’hopital de Be. Patientes et methode: Il s’est agi d’une etude transversale a visee descriptive et analytique menee du 1er juillet au 31 aout 2018 soit une duree de 2 mois. Elle a eu pour cadre, le secteur des suites de couches de la maternite de l’hopital de Be. La collecte des donnees par interview directe a ete faite a l’aide d’une fiche d’enquete anonyme sur le modele Saphora-MCO questionnaires Project COMPAQH et adapte a nos realites. Le traitement et l’analyse des donnees ont ete realisees grâce aux logiciels Epi data et Epi info. Resultats: Au total 300 accouchees ont accepte participer a l’etude. L’âge moyen etait de 29 ± 6,2 ans. La satisfaction globale etait de 94%. Les principaux elements de satisfaction etaient : l’accueil (94,7%), le respect de l’intimite (96,7%), la prise en charge des soins (94%), le delai d’attente (86,7%). L’insatisfaction etait due a l’insuffisance de communication des soignants (65,7%) et de proprete des chambres et des sanitaires (57%). L’âge, le niveau d’instruction, la parite, le mode d’accouchement avaient influence significativement l’insatisfaction des patientes. Conclusion: Cette etude a permis de relever les elements d’insatisfaction des clientes. Il est opportun d’associer les clients dans le processus de la qualite des soins a l’hopital de Be. Introduction: Satisfaction assessment shows the match between patient expectations and the quality of care received. Objective: to assess the satisfaction of women hospitalized in the maternity ward of the obstetrics and gynecology department of the Be hospital in order to contribute to the improvement of the quality of care in the maternity ward. Patients and method: This was a cross-sectional study with descriptive and analytical aims conducted from July 1 to August 31, 2018, i.e., a duration of 2 months. It took place in the puerperium section at the maternity of the Be hospital. Data collection by direct interview was done using an anonymous survey form on the Saphora-MCO questionnaires Project COMPAQH model and adapted to our realities. Data processing and analysis were carried out using Epi data and Epi info software. Results: A total of 300 women agreed to participate in the study. The average age was 29 ± 6.2 years. Overall satisfaction was 94%. The main elements of satisfaction were: reception (94.7%), respect for privacy (96.7%), management of care (94%), waiting time (86.7%). Dissatisfaction was due to insufficient communication from caregivers (65.7%) and cleanliness of rooms and toilets (57%). Age, level of education, parity and mode of delivery had a significant influence on the respondent’s dissatisfaction. Conclusion: This study identified factors that led to patient’s dissatisfaction. It is appropriate to involve patients in the quality of care process at the Be hospital.

Background: Breast cancer is the most common cancer in women, and its incidence and mortality rates are expected to increase significantly over the next few years, particularly in developing countries. The aim of this study was to describe the epidemiological, clinical, radiological, histopathological, and prognostic aspects of breast cancer in Togo. Materials and methods: We retrospectively analyzed at our Department of Pathology of Lomé all cases of breast cancer in women confirmed by histology over a period of 20 years (2000-2019). Results: We collected 804 cases of breast cancer in women. The median age was 46.7 years (range, 12-86 years). Patients aged Conclusion: Breast cancer is a frequent pathology in Togolese women, predominant in young adults, often diagnosed at a late stage with limited possibilities of treatment. The establishment of early care programs is essential.

Objective: To describe blood transfusion practices in obstetric at the Sylvanus Olympio University Hospital in Lome. Patients and method: Prospective, cross-sectional and descriptive study, conducted from 1 June 2017 to 31 May 2018 at the gynecology-obstetrics department. The study focused on transfused pregnant, parturient and delivered women. Study parameters were sociodemographic, clinical, therapeutic and prognostic. Results: 252 patients, aged 16 to 49 with an average age of 30.4 years, referred in 74% of cases. Hemorrhage was observed in 238 cases (94.4%) and anemia in 14 cases (5.6%). Blood transfusion was urgently used in 89.7% of cases and hemorrhagic abortion was the main indication. Blood group O+ (34.5%) was the most used and blood products were obtained after two hours in 81% of cases. Conclusion: Blood transfusion is often performed urgently and for bleeding. But the Gynecology-Obstetrics department does not have any blood in reserve, whereas the Sylvanus Olympio University Hospital collection and distribution station covers less than 10% of the needs.

We report the case of a 50-year-old patient, who was explored in mammography, ultrasound and CT for a large painful mass of the right breast that had been evolving for 30 years and gradually increasing in size. There was a typical “sausage slice” appearance with clear center macrocalcifications on the mammogram; an aspect of “breast in the breast” on ultrasound. The scanner had made it possible to specify the dimensions of the mass, which measured 21.4 cm in height; 18.6 cm wide and 9.5 cm thick. Histology after exeresis noted the adenolipofibromatous nature of the mass.

Our study aimed to describe the epidemiological, clinical and histological aspects of mammary tuberculosis in Togo. This is a descriptive cross-sectional study of breast tuberculosis for which the diagnosis was presumed on histological grounds in the pathology department (LAP) of the Lome Tokoin university hospital from January 1995 to December 2016 (20 years). A total of 28 presumed cases of mammary tuberculosis were identified. There were 26 women and 2 men, with an average age of 34.2 ± 0.3 years. The clinical signs were nodule (84.1%), tumefaction (75%), abscess (63.6%) and tumefaction with cutaneous fistulization (59.1%). Breast involvement was isolated in 31.8% of cases and associated with pleuropulmonary tuberculosis in 54.5% of cases. Co-infection with HIV was found in 63.9 % of cases. Histology showed inflammatory granulomas made of Langhans giant cells, epithelioid cells and lymphocytes around the foci of caseous necrosis. Thoracic radiography was abnormal in 16 patients (57.1%).Mammary tuberculosis is not rare in our country. Clinical presentation is often misleading and is a diagnostic challenge, more particularly with breast abscess or cancer.

Background: Core needle biopsy (CNB) under ultrasound guidance is an accepted standard of care for the diagnosis of breast lesions. It is safe, cost-effective and minimally invasive compared with surgical excision. Objective: The aim of this study was to evaluate the CNB’s results regarding the procedure, complications, histopathological findings and their correlation with the imaging data and surgical histopathological findings. Method: A cross-sectional prospective and descriptive study of a consecutive series of ultrasound-guided CNB of breast lesions in women conduced from January 2015 to December 2016 at the Sylvanus Olympio university hospital of Lome, in Togo. Results: There were 72 CNB performed under ultrasound guidance in women; from which 54 were retained for the study. The mean age was 44.9 years ± 9.8. 11.1% had a family history of breast cancer. Lesions were most often palpable (90.7%). They were located in the left breast in 54.7%. Lesions were categorized probably malignant or malignant (Birads 4 and 5) in 70.4% and probably benign (Birads 3) in 29.6%. Their mean size was 24.8 mm ± 7.6 at ultrasound. There were no major complications during the procedure. One CNB (1.9%) considered inconclusive was repeated. Histologically, invasive ductal carcinoma (61.1%) was the most common lesion. Fifty-three women underwent surgical procedure and histopathological confirmation. Ultrasound-guided CNB had a sensitivity of 97.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.8%, and an overall diagnostic accuracy of 98.1%. Breast Imaging Reporting and Data System (Birads) categorization had a sensitivity of 94.8%, specificity of 100%, positive predictive value of 100%, negative predictive value of 87.4%, and diagnostic accuracy of 96.2%. Conclusion: Ultrasound guided CNB represent accurate methods for the characterization of breast lesions, with high values of diagnostic accuracy, sensitivity, specificity and negative predictive value. It does not involve a major complication, even in tropical environments.

Objectif: déterminer les connaissances, les attitudes et pratiques en matière d’utilisation des méthodes contraceptives en milieu scolaire dans la ville de Kara.Méthodologie: Il s’est agi d’une étude transversale à visée descriptive portant sur les connaissances, attitudes et pratiques des méthodes contraceptives dans les lycées publics de la ville de Kara du 28 février au 04 juillet 2018. Au total, 349 lycéens ont accepté participer à l’enquête.Résultats: La majorité des enquêtés avait connaissance des méthodes contraceptives (91,98%). La principale source d’information était médias (34,76%). Près de la moitié utilisait les méthodes de contraceptions dont le préservatif (85,71%) et ils s’approvisionnaient des centres de santé (45,24%). Les raisons de non utilisation des méthodes contraceptives étaient l’abstinence, les effets secondaires, le manque d’information. Les élèves étaient sexuellement actifs et l’âge moyen du premier rapport sexuel était de 16,96 ans chez les garçons et 17,20 ans chez les filles. Les obstacles pour avoir accès aux services de planification familiale étaient l’influence des proches et le manque de centre approprié pour les jeunes et adolescents.Conclusion: Devant la nécessité de réduire les besoins non satisfaits des méthodes contraceptives par les jeunes et adolescents, il serait important de multiplier des stratégies spécifiques à l’endroit des différents obstacles.Mots clés: Contraception, connaissances, attitudes, pratiques, lycées, TogoEnglish Title: Knowledge, attitudes, practices of contraceptive methods in the public schools of the city of KaraEnglish AbstractObjective: to determine knowledge, attitudes and practices regarding the use of contraceptive methods in schools in KaraMethodology: This was a descriptive cross-sectional study of the knowledge, attitudes and practices of contraceptive methods in public high schools in the city of Kara from 28 February to 4 July 2018. A total of 349 students accepted participate in the study.Results: The majority of young people had knowledge of contraceptive methods (91.98%). The main source of information was media (34.76%). Nearly half used contraceptive methods, including condoms (85.71%), and they obtained their supplies from health centers (45.24%). The reasons for not using contraceptive methods were abstinence, side effects, lack of information. Students were sexually active and the mean age of first intercourse was 16.96 years for boys and 17.20 years for girls.The barriers to accessing family planning services were due to the influence of family members and the lack of appropriate facilities for youth and adolescents.Conclusion: Given the need to reduce the unmet need for contraceptive methods by young people and adolescents, it would be important to multiply specific strategies for different barriers.Keywords: Contraception, Knowledge, Attitudes, Practices, High Schools, Togo