The Prevalence of migraine and associated factors among medical students in Ouagadougou (Burkina Faso) / A prevalência da enxaqueca e fatores associados entre estudantes de medicina em Ouagadougou (Burkina Faso)

Objective: To determine the prevalence, clinical characteristics and impact of migraine among medical students in the city of Ouagadougou. Methods: This across-sectional study was carried out during a period of 6 months from August 2021 to January 2022. Participants were selected by stratified random sampling according to academic level. Hetero-administered questionnaire was administred to each student. Migraine was diagnosed according to the ICHD 3rd edition criteria and the MIDAS was used to assess the impact of migraine on students' quality of life. Results: Two hundred and twenty seven students were selected for this study. The prevalence of migraineurs was 31.8%. Their mean age was 22.20±2.67 years. There was female predominance among the migraineurs (73.9%). More than half of the migraineurs had a family history of headache disorders (53.6%). Migraine without aura was the most frequent subtype (59.4%). Visual aura was predominant (78.2%). Migraine was of moderate intensity in 60.8% of cases. Insomnia and/or lack of sleep was the most common trigger (73.7%) followed by stress and fatigue in 71% of cases. Migraine caused severe disability in 15.9% of migraineurs. Conclusion: There was a high prevalence of migraine among medical students in Burkina Faso. Stress and irregular sleep were the most common triggers factors.

Objetivo: Determinar a prevalência, características clínicas e impacto da enxaqueca entre estudantes de medicina na cidade de Ouagadougou. Métodos: Este estudo transversal foi realizado durante um período de 6 meses, de agosto de 2021 a janeiro de 2022. Os participantes foram selecionados por amostragem aleatória estratificada de acordo com o nível acadêmico. Questionário heteroadministrado foi aplicado a cada aluno. A enxaqueca foi diagnosticada de acordo com os critérios da 3ª edição da ICHD e o MIDAS foi utilizado para avaliar o impacto da enxaqueca na qualidade de vida dos estudantes. Resultados: Duzentos e vinte e sete alunos foram selecionados para este estudo. A prevalência de enxaquecas foi de 31,8%. A média de idade foi de 22,20±2,67 anos. Houve predomínio do sexo feminino entre os portadores de enxaqueca (73,9%). Mais da metade dos pacientes com enxaqueca tinha histórico familiar de cefaleia (53,6%). A enxaqueca sem aura foi o subtipo mais frequente (59,4%). A aura visual foi predominante (78,2%). A enxaqueca foi de intensidade moderada em 60,8% dos casos. A insônia e/ou falta de sono foi o gatilho mais comum (73,7%), seguida de estresse e fadiga em 71% dos casos. A enxaqueca causou incapacidade grave em 15,9% dos pacientes com enxaqueca. Conclusão: Houve uma alta prevalência de enxaqueca entre estudantes de medicina em Burkina Faso. Estresse e sono irregular foram os fatores desencadeantes mais comuns.

Frequency of recurrent stroke in Burkina Faso: an observational hospital based study of 6 months.

INTRODUCTION: studies on stroke recurrence are rare in sub-Sahara Africa. The aim to this study is to determine the prevalence and risk factors for recurrent stroke in two University Teaching Hospital in Burkina Faso. METHODS: this prospective cross-sectional study was carried on 266 stroke patients admitted in two hospitals in the city of Ouagadougou from September 1, 2017 to February 28, 2018. Patients with stroke recurrence (ischemic or hemorrhagic) were included. RESULTS: of 266 acute stroke patients included, 44 (16.4%) had recurrent stroke. The mean age of patients was 66.5 ± 11.49 years with male predominance. Hypertension was the most vascular risk factors (81.8%). Previous stroke was ischemic in 61.4%, hemorrhagic in 22.7% and unknown in 15.9% of cases. Poor compliance (< 60%) was determined in patients taking antiagregant (43.6%) and statins (50%). At admission, the most neurological disorders was motor deficit (100%), aphasia (84.1%), and deglutition disorders (15.9%). CT scan showed ischemic in 82% and hemorrhagic stroke in 18% of cases. With the analysis of second stroke, recurrent stroke after intracerebral hemorrhage was hemorrhagic in 77.8% and ischemic in 22.2%. Recurrent stroke after ischemic stroke was ischemic in 100%. CONCLUSION: stroke recurrence is common in our context. Hypertension was the most common vascular risk factor in recurrent stroke. Poor compliance was determined in patients taking antiagregant agents and statins in previous stroke.

Hemorrhagic stroke following snake bite in Burkina Faso (West Africa). A case series.

BACKGROUND: Snake bites remain a major medical problem in West Africa, and hemorrhagic stroke following a snakebite has emerged as a rare secondary condition. The objective of this study was to determine the neurological complications following snake bite. METHODS: This study included all the cases of hemorrhagic stroke following snake bite admitted in the neurology Department of Yalgado Ouedraogo University Teaching Hospital during the period from January 1st, 2018 to December 31st 2019. RESULTS: Three cases of hemorrhagic stroke following snake bite were included in the study. The strokes occurred 4-15 days after the snakebite. Traditional treatment was applied in two cases. Complications were significant, including local manifestations and severe anemia in 2 patients who received blood transfusion. Snake anti-venom was applied. At admission, motor deficit, conscience disorders and fever were the most frequent complaints. Patients received repeated dose of snake anti-venom was applied, antitetanus prophylaxis and antibiotherapy during hospitalization. The majority of the patients had completely recovered. CONCLUSIONS: Hemorrhagic stroke following snake bites are rare in Burkina Faso. Clinical outcome of stroke was favorable after treatment by antivenom, anti-tetanus serum and antibiotics.

Frequency and Mortality Risk Factors of Acute Ischemic Stroke in Emergency Department in Burkina Faso.

OBJECTIVE: To determine the prevalence of ischemic stroke deaths and their predictive factors in the Emergency Department at Yalgado Ouedraogo University Teaching Hospital (YOUTH). Methodology. This was a retrospective study with an analytical and descriptive focus over a period of three years from January 1, 2015, to December 31, 2017. RESULTS: During the study period, 302 acute ischemic stroke patients with a mean age of 62.2 ± 14.26 years were included. Atrial hypertension was the most common vascular risk factor in 52.5%. On admission, 34.8% of patients had loss of consciousness. The mean time to perform brain CT was 1.5 days. The average length of stay was 4 days. Electrocardiogram, echocardiography, and cervical Doppler were not performed during hospitalization in ED. The mortality rate was 39%, respectively, 37.6% in male and 41.6% in female. The mean age of patients who died in ED was 63.6 ± 13.52 years. Hypertension was the most common vascular risk factors in 54.2% of death. After logistic regression, the predictors of death were past history of heart disease, consciousness disorders, hyperthermia, hyperglycemia on admission, poststroke pneumonia, and urinary tract infection. CONCLUSIONS: Acute ischemic stroke was frequent in Emergency Department with high mortality rate. The mortality risk factors were the same than those found in literature. This higher mortality can be avoided by early diagnosis and an adequate management.

Spontaneous Subarachnoid Haemorrhage in Neurological Setting in Burkina Faso: Clinical Profile, Causes, and Mortality Risk Factors.

To determine the prevalence, clinical profile, causes, and mortality risk factors of spontaneous arachnoid haemorrhage at Yalgado Ouedraogo University teaching Hospital, we conducted a 5-year retrospective study of 1803 stroke patients admitted to Neurology Department during the period from January 2012 to December 2016. During the study period, spontaneous subarachnoid haemorrhage accounted for 3.2 % of all stroke. The mean age of patients was 60 years (range 20-93 years). There was a female predominance in 55.9%. The common vascular risk factors were hypertension (79.7%) and chronic alcohol consumption (16.9%). The main symptoms were headache (76.2%), motor weakness (74.5%), and consciousness disorders (62.7%). Neurological examination revealed limb weakness in 76.2% and meningeal irritation in 47.4%. The best admission Glasgow Coma Scale score of 15 was found only in 37.3 % of patients. About 50.8% of patients were admitted to Hunt and Hess moderate grade (III) resulting in a mortality of 24.80%. The main cause of spontaneous subarachnoid haemorrhage was hypertension (77.9%). Cause could not be determined in 8.5 % of cases. The mortality rate was 37.3%. There was high mortality in patients with intraventricular haemorrhage and in patients with disturbances of consciousness. In conclusion, our study showed a poor frequency of spontaneous subarachnoid haemorrhage with high mortality. Hypertension was the most common cause of spontaneous subarachnoid haemorrhage.

[Hemorrhagic rupture of a giant arteriovenous malformation in a young man in Ouagadougou]. / Rupture hémorragique d'une malformation arterioveineuse géante hez un sujet jeune à Ouagadougou.

Vascular arteriovenous malformations (VAM) are aggressive vascular diseases associated with increased haemorrhagic risk in terms of morbidity and mortality. Vascular arteriovenous malformations are usually sporadic. The main symptom of VAM is hemorrhage, in 50% of cases. We here report the case of a 28 year old patient, hospitalized with right sided motor deficit of acute onset associated with consciousness disorder in the Department of Neurology at the Yalgado Ouédraogo University Hospital Center. The patient had a history of chronic headaches treated with self-medication and of right Bravais-Jacksonian seizures. Neurological examination, performed on admission, showed proportional right hemiplegia, Broca's aphasia, left eye pain associated with ptosis, left chemosis and febrile meningeal syndrome with a temperature at 40°C. On admission the NIHSS score was 21/42 and the ICH score was 2. Emergency cerebral CT scan showed cerebral hemorrhage in the basal ganglia and in the brainstem, intra-ventricular flood and basal cisterns. Blood count showed leukocytosis at 13 200/mm3 with granulocytic predominance (72.6%). Chest X-ray showed right alveolar pneumopathy. Tuberculin intradermal reaction (IDR) was positive to 17mm. Cerebral angioscanner, performed on day 24, showed arteriovenous malformation of the middle cerebral arteries and of the posterior vertebral arteries as well as thrombosis of the cavernous sinuses.