[Evaluation of microalbuminuria and lipid profile among type 2 diabetics]. / Evaluation de la microalbuminurie et du profil lipidique chez les diabétiques de type 2.

OBJECTIVE: To establish the respective prevalence of microalbuminuria and dyslipidemia and to evaluate their association with diabetes type 2. ANALYZE DATA: Prospective study of 195 type 2 diabetic subjects (125 women and 70 men) from a hospital in the city of Dakar (Senegal) for a check-up of diabetes. Age and sex were determined ; fasting blood glucose, glycated hemoglobin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and micro- albuminuria were measured. RESULTS: In this study, the mean age of patients was 57.9 ± 11.1 years. Age, glycated hemoglobin and microalbuminuria were significantly higher in women than in men (P < 0.01 ; P < 0.03 ; P < 0.01 respectively). The prevalence of microalbuminuria is 48.7% and that of dyslipidemia is 41.1%. Glycated hemoglobin is higher in subjects with microalbuminuria than in patients with normal microalbuminuria with a statistically significant difference (P < 0.001). There is a strong correlation (R = 0.82) between glycated hemoglobin and microalbuminuria, 1% increase in HbA1c corresponding approximately to an increase of 39.7 mg/I of microalbuminuria. CONCLUSION: Microalbuminuria and dyslipidemia are frequently found in type 2 diabetes, but the pathophysiological mechanisms of the association are not well known.

Implementing haemophilia care in Senegal, West Africa.

Despite significant progres on haemophilia care in developed world, this disease remains unknown in many sub-Saharan African countries. The objectives of this article were to report Senegalese experience on the management of haemophilia care through 18 years of follow-up. This cohort study included 140 patients (127 haemophilia A, 13 haemophilia B), followed in Dakar's haemophilia treatment centre from 1995 to 2012. Our study reported a prevalence of 2.3/100,000 male births, accounting for 11.6% of what is expected in Senegal. From the period 1995-2003 to 2004-2012, significant progress was seen including 67.9% increase in new patient's identification, 11.3 years reduction in mean age at diagnosis (from 15.5 to 4.2 years), lower mortality rate (from 15.3% to 6.8%) and age at death evolved from 6.5 to 23.3 years. Of the 50 haemophilia A patients who were tested for inhibitor presence, 10 were positive (eight severe and two moderate) that is prevalence of 20%. All patients were low responders since inhibitor titre was between 1.5 and 3.8 BU. Disabilities were seen in 36.5% of patients above 20 years old who had musculoskeletal sequels and 39% had no scholar or professional activities in our setting. Implementing haemophilia care in sub-Saharan Africa is a great challenge as this disease is not yet counted in national health problems in many countries. Lessons learned from this study show a significant improvement in diagnosis and prognosis parameters. This emphasizes the needs to set up such follow-up initiatives and to enhance medical and lay cooperation for better results.