[Priapism in children and adolescents with homozygous sickle cell disease in Brazzaville]. / Priapisme chez l'enfant et l'adolescent drépanocytaire homozygote à Brazzaville.

OBJECTIVE: To determine the prevalence of priapism, assess knowledge and appreciate its characteristics in childhood sickle cell disease. METHODOLOGY: A case-control study was conducted at the University Hospital of Brazzaville (Department of Pediatrics, Hematology and Clinical Urology). The cases consisted of 202 sickle cell anemia who are at least 5 years. Witnesses consisted of 112 children with sickle cell disease not of the same age from the same family as the previous. RESULTS: Priapism was found in 68 (34%) affected children, divided into 54 cases (79.4%) of chronic intermittent priapism and 14 cases (20.6%) of acute priapism. In the control group no cases were observed (p=0.001). Priapism was known by six (3%) patients in the group of children with sickle cell disease. In the control group, it was known by 25 (22.3%) children. It was seen in the group of sickle cell disease as any: 113 children (56%), a natural phenomenon that can occur in life: 57 children (28%), a complication of sickle cell disease: 26 children (13%). In the control group, it was considered a natural phenomenon that can occur in life: 60 children (53.6%), a complication of sickle cell disease: 52 children (46.4%). The average age of priapism occurred in the first episode was 10.4±9.5 years. CONCLUSION: The importance of the prevalence of priapism, and insufficient knowledge needed strengthening information, education and communication with children and their parents.

[Tooth decay in school environment at Brazzaville (Congo)]. / La carie dentaire en milieu scolaire a Brazzaville (Congo).

AIM: To determine the frequency of dental caries and habits that can be the cause of this disease in Brazzaville. METHODS: A prospective study was conducted in primary schools between February and May 2010. This study involved a sample of 307 students of both sexes, aged 4-15 years from school in the city of Brazzaville. RESULTS: Prevalence of dental caries was 53.4% and the index of DMFT 2.06. Use of toothbrush was 99.4%. Two children (0.7%) brushed their teeth three times a day. There was a statistical link between regularity of brushing and occurrence of caries. The prevalence of caries was of 53% in children who brushed once a day and 12.8% in those who brushed twice a day. No decay was noted in those who brushed three times a day (p = 0.001). The DMFT was 2.06 in children who used non-fluoridated toothpaste and 1.13 in those who used the fluoridated toothpaste (p = 0.002). CONCLUSION: To ensure students a better oral hygiene and healthier teeth, a module in oral health education in schools is one of the way to fight against this public health problem.

Epidemiological study of fixed drug eruption in Pointe-Noire.

A prospective study was conducted over a 27 month period in order to determine the epidemiological profile of fixed drug eruption (FDE) observed during a dermatological consultation at Pointe-Noire. During the study period 54 out of 9,070 persons consulting (0.6%) suffered from clinically diagnosed FDE. The variables studied were: age, sex, medicine and point of sale. The average age of onset was 30 years. The frequency of onset was higher in males (38 patients) than in females (16 patients). The incriminated medicines were: the sulfamides (48 patients) including Cotrimoxazole (45 patients ) and Sulfadoxine and Pyremethamine (3 patients) Coartem(®) + Doliprane(®) (1 patient), Chloramphenicol(®) (1 patient), Amidol(®) (1 patient), Duocotexin(®) + Paracetamol(®) (1 patient), Surquina(®) (1 patient), Amodiaquine(®) (1 patient). The point of sale was illicit (peddlers, markets) for 44 patients; for 10 patients it was a lawful outlet (pharmacies). This study shows that cotrimoxazole bought at illicit points of sale is the main etiology of FDE in the department, confirming that these medicines are counterfeit. The involvement of dermatologists in the fight against the illicit sale of medicines should be made a priority.

[Call for the revival of community medicine in Africa]. / Plaidoyer pour un renouveau de la médecine communautaire en Afrique.

In Africa persons seeking medical advice rarely see a physician first. The goal of initial contact is to ensure seamless interfacing with the other services of the healthcare system. The community physician in Africa is either a physician paid by contributions from people living in the region or, in most cases, a civil servant practicing at an outlying health center. Because community physicians often work in isolated locations, their colleagues at major hospital centers and in the academic world are rarely aware of their activity. As a result community physicians in Africa have little impact on the healthcare system. In fact their role should be to relieve overloading of hospitals that have become large dispensaries crowded with patients that have not received proper care in outlying facilities. In this article the authors call for community physicians in Africa to be brought out of isolation and given their true function as "clinicians with aptitudes in public health capable of assisting actions to restore and promote health and to prevent disease".