A comparison of unhealthy lifestyle practices among adults with hypertension aware and unaware of their hypertensive status: results from the 2013 WHO STEPS survey in Burkina Faso.

BACKGROUND: We compared the prevalence of unhealthy lifestyle factors between the hypertensive adults who were aware and unaware of their hypertensive status and assessed the factors associated with being aware of one's hypertension among adults in Burkina Faso. METHODS: We conducted a secondary analysis of data from the World Health Organization Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso. Lifestyle factors analysed were fruits and vegetables (FV) consumption, tooth cleaning, alcohol and tobacco use, body mass index and physical activity. RESULTS: Among 774 adults living with hypertension, 84.9% (95% CI: 82.2-87.3) were unaware of their hypertensive status. The frequencies of unhealthy lifestyle practices in those aware vs. unaware were respectively: 92.3% vs. 96.3%, p = 0.07 for not eating, at least, five FV servings daily; 63.2% vs. 70.5%, p = 0.12 for not cleaning the teeth at least twice a day; 35.9% vs. 42.3%, p = 0.19 for tobacco and/or alcohol use; 53.9% vs. 25.4%, p = 0.0001 for overweight/obesity and 17.1% vs, 10.3%, p = 0.04 for physical inactivity. In logistic regression analysis, older age, primary or higher education, being overweight/obese [adjusted odds ratio (aOR) = 3.2; p < 0.0001], intake of adequate FV servings daily (aOR = 2.9; p = 0.023) and non-use of alcohol and tobacco (aOR = 0.6; p = 0.028) were associated with being aware of one's hypertensive status. CONCLUSION: Undiagnosed hypertension was very high among Burkinabè adults living with hypertension. Those aware of their hypertension diagnosis did not necessarily practise healthier lifestyles than those not previously aware of their hypertension. Current control programmes should aim to improve hypertension awareness and promote risk reduction behaviour.

[Cerebral-meningeal hemorrhage secondary to snakebite envenomation: about two cases at the Sourô Sanou Teaching Hospital in Bobo-Dioulasso, Burkina Faso]. / Hémorragie cérébro-méningée secondaire à une envenimation par morsure de serpent : à propos de deux cas au Centre Hospitalier Universitaire Sourô Sanou de Bobo-Dioulasso, Burkina Faso.

Background: Envenomation by snakebite is a public health problem in developing countries. Neurovascular complications are uncommon. We report two cases of hemorrhagic stroke at the Sourô Sanou Teaching Hospital in Bobo-Dioulasso, which complicate an envenomation. Clinical description: The first patient was a 60-year-old woman with no history, who had been admitted 2 hours after snakebite for gingivorrhagia and consciousness disorders. Clinical examination found coma (GCS 7/15) and tetraparesis. The second patient was a 50-year-old woman with no history, who had been admitted one week after snakebite with digestive bleeding. Clinical examination found right hemiplegia and meningeal syndrome. Both patients presented hemorrhagic stroke on brain CT-scan but hemostasis assessment was normal. They received polyvalent antivenom and symptomatic treatment. The outcome was favorable for survival but with sequelae like tetraparesis for first patient and hemiparesis for second patient. Discussion - Conclusion: The hemorrhagic strokes are rare complications of snake envenomation. Venomous toxins can directly lead to the rupture of intracranial vessels apart of abnormalities of hemostasis. However, the morbidity and mortality related to envenomation by snake bite remains high in our environment.

Managing neurocysticercosis: challenges and solutions.

Taenia solium neurocysticercosis (NCC) is a major cause of neurological morbidity in the world. Variability in the neuropathology and clinical presentation of NCC often make it difficult to diagnose and manage. Diagnosis of NCC can be challenging especially in endemic and resource-limited countries where laboratory and imaging techniques are often lacking. NCC management can also be challenging as current treatment options are limited and involve symptomatic agents, antiparasitic agents, or surgery. Although antiparasitic treatment probably reduces the number of active lesions and long-term seizure frequency, its efficacy is limited and strategies to improve treatment regimens are warranted. Treatment decisions should be individualized in relation to the type of NCC. Initial measures should focus on symptomatic management, with antiparasitic therapy only to be considered later on, when appropriate. Symptomatic treatment remains the cornerstone in NCC management which should not only focuses on epilepsy, but also on other manifestations that cause considerable burden (recurrent headaches, cognitive decline). Accurate patients' categorization, better antiparasitic regimens, and definition of new clinical outcomes for trials on NCC could improve management quality and prognosis of NCC. Prevention strategies targeting tapeworm carriers and infected pigs are yielding good results in local models. If local elimination of transmission is confirmed and replicated, this will open the door to cysticercosis eradication efforts worldwide.