[Prevalence and characteristics of chronic pain with neuropathic component at Parakou in northern Benin in 2012]. / Prévalence et caractéristiques des douleurs chroniques avec caractère neuropathique en population générale à Parakou au nord du Bénin en 2012.

The burden of chronic and neuropathic pain is high making it an important public health problem. The epidemiology is not well known in the general population in sub-Saharan Africa. We aimed to determine the prevalence of chronic pain with a neuropathic component at Tititou in Parakou in northeastern Benin. A cross-sectional study was conducted from 1st April to 31 May 2012 and included 2314 people in a door-to-door survey. Chronic pain was defined as pain occurring for more than three months. Neuropathic pain was assessed with the DN4 score. A neurological exam was performed by a young physician for all people with chronic pain. During the interview, sociodemographic data, past medical history, weight and height were recorded. Multivariate logistic regression was performed to analyze the main associated factors. Among the 2314 people included in this survey, 49.7% were male. The mean age was 32.3 ± 13.1 years. Nine hundred seven reported pain occurring for more than 3 months. The prevalence of chronic pain was 39.2% (CI95%: 29.3-34.7). It was more frequent in females, older people, among diabetics, people with a history of any surgery, stroke, brain trauma, and alcoholism. The prevalence of chronic pain with a neuropathic component was 6.3% (CI95%: 5.0-7.9). The main associated factors were age, matrimonial status, professional occupation, body mass index, diabetes, history of zoster, history of any surgery, brain trauma. People with neuropathic pain often reported pain with burning (87.6%), prickling (82.8%), numbness (66.9%), tingling (63.4%), and lightning pain (48.3%). The main locations were the lower limbs and low back pain. This study suggested the high frequency of chronic neuropathic pain in the general population in Parakou compared with rates reported in western countries.

[Erectile dysfonction after stroke in Brazzaville]. / Dysfonction érectile après un accident vasculaire cérébral à Brazzaville.

INTRODUCTION: Erectile dysfunction is one of the disability post-stroke the least documented. However, it affects the quality of life, not only the patient but also the couple. OBJECTIVE: The purpose of this work was to study the characteristics of erectile dysfunction after stroke. METHOD: This is a cross-sectional descriptive and analytical data collection survey conducted from February to October 2011, having identified, 104 patients for follow-up post-stroke, seen in outpatient Neurology University Hospital of Brazzaville and in the functional rehabilitation centers. Among them 54 had erectile dysfunction. The parameters studied were: age, marital status, history, vascular risk factors, and the location of the hemiplegic, the etiology of stroke, modified Rankin score and NIHSS. The clinical features and laboratory, the international index of erectile dysfunction (IIEF-5) in its French version. SPSS 12 was used for recording and statistical analysis of data. Chi(2) test was used for comparisons. The significance level was P≤0.05. RESULTS: The frequency of erectile dysfunction after stroke was 51.92%, the average age was 56.32 years. The mean time to onset of erectile dysfunction after stroke was 5 months. The onset was progressive in 70,4%. The hypercholesterolemia was well correlated with the risk of erectile dysfunction (P=0.007) and its severity (P=0,01). Erectile dysfonction was moderate in 61.1% and almost bearable in half the cases. CONCLUSION: Erectile dysfunction post-stroke is common with an impact in the lives of the couple. High cholesterol is an independent risk factor of occurrence of post-stroke.

Distal sensory polyneuropathy among HIV-infected patients at Parakou University Hospital, Benin, 2011.

Distal sensory polyneuropathy (DSP) is the most frequent neurological complication among HIV patients, and its risk increases with use of highly active antiretroviral therapy (HAART). We aimed to assess the prevalence of DSP and the factors associated with it among HIV-infected outpatients treated at Parakou University Hospital. This cross-sectional study took place from April 15 to July 15, 2011, and included 262 patients. All patients underwent a neurological examination by two neurologists with training and clinical experience in these examinations and in the Brief Peripheral Neuropathy Screening (BPNS), which was the primary tool used here. Data from nutritional status (body mass index: BMI), social and demographic information, HAART status, and CD4 count were recorded. The factors associated with DSP were studied with multivariate analysis, using a logistic regression model and a significance level of 0.05. The study included 60 men (22.9 %). Patients' ages ranged from 16 to 74 years and averaged 36.8±10 years. All patients but one patient were infected by HIV type 1 only; that one was coinfected by types 1 and 2. The mean BMI was 22.5+/-4.2 kg/m2. In all, 213 (81.3 %) received HAART, and the mean CD4 count was 355.0 cells/mm3+/-236.1. The prevalence of DSP was 42.4 %. The factors associated with it on univariate analysis were age, marital status, HAART status, duration of HIV infection, and duration of HAART. Only advanced age (OR 1.8, 95 % CI 1.1-5.3) and HAART use (OR 2.3, 95 % CI 1.5-4.9) were associated with DSP in the multivariate analysis. The main symptoms were paresthesia (numbness:75.7%; burning: 39.6%; pins and needles sensation 32.4 %) and pain (23.4 %). Vibration perception at the toes was missing or reduced for 84.4 %. According to the sensory symptoms grade, 93.7 % of patients were classified in Grades 2 or 3. This study showed that the prevalence of DSP is high and that it is associated with age and HAART.

[Factors associated with quality of life for patients with post-stroke aphasia in the Cotonou hospitals, Benin]. / Facteurs associes a la qualite de vie des aphasiques post accident vasculaire cerebral en milieu hospitalier a cotonou, Benin.

INTRODUCTION: The objective of this study was to determine the factors influencing quality of life for patients with post-stroke aphasia followed in Cotonou hospitals. METHOD: A prospective descriptive and analytical cross-sectional study was conducted in CNHU-HKM (Cotonou, Benin) from October to December 2012; focusing on patients with at least six months of post-stroke aphasia. For each patient, a SIP-65 questionnaire was administered. The Epi Info 3.5 software was used for data analysis. A multivariate analysis was performed to determine factors associated with quality of life for patients with aphasia. RESULTS: In total, 41 patients were included in this study with a sex ratio of 1.3. The average age was 55.3 ± 2.5 years. The average duration of the aphasia was 10 months. Broca's aphasia was predominant (68.3%). 60.8% of aphasia patients were able to preserve their quality of life. Multivariate analysis showed that age, family support, the type of stroke and aphasia and speech therapy were associated with quality of life. CONCLUSION: The treatment of post-stroke aphasia must incorporate these factors associated with quality of life for a better recovery of patients.

INTRODUCTION: L'objectif de ce travail était de déterminer les facteurs influençant la qualité de vie des patients aphasiques post-AVC suivis à Cotonou. MÉTHODE: Il s'agit d'une étude transversale, prospective descriptive et analytique qui s'est déroulée au CNHU-HKM de Cotonou d'Octobre à Décembre 2012; elle a inclus les patients aphasiques post-AVC d'au moins six mois. Pour chaque patient, un questionnaire SIP-65 a été administré. Le logiciel Epi info 3.5 a servi de base à l'analyse des données. Une analyse multivariée a été effectuée pour déterminer les facteurs associés à la qualité de vie des aphasiques. RÉSULTATS: Au total, 41 patients ont été inclus dans l'étude avec une sex-ratio de 1,3. L'âge moyen était de 55,3 ± 2,5 ans. La durée moyenne d'évolution de l'aphasie était 10 mois. L'aphasie de Broca était prédominante (68,3%). 60,8% des aphasiques avaient une qualité de vie préservée. L'analyse multivariée a montré que l'âge, le soutien de la famille, le type d'AVC et d'aphasie et le traitement orthophonique étaient associés à la qualité de vie. CONCLUSION: La prise en charge des aphasiques post-AVC doit intégrer ces facteurs associés à la qualité de vie pour une meilleure récupération des patients.

[Socio-cultural aspects of epilepsy in a rural community in northern Benin in 2011]. / Aspects socioculturels de l'épilepsie dans une communauté rurale au nord Bénin en 2011.

Despite the development of knowledge in diagnosis and therapeutic of epilepsy it remains to be cause of rejection and stigma. We aimed to study the knowledge, attitude and practice toward epilepsy and the stigma in a rural community. The cross-sectional study was carried out from 1st to 31st March 2011 in a rural community (Tourou) at Parakou in the northern Benin. It was a door-to-door survey and included 1 031 adults older than 15 years. The diagnosis of epilepsy was based on International League Against Epilepsy. The specific questionnaire was used and comprised 16 items which explored knowledge, attitude and practice toward epilepsy. Another questionnaire was developed to study stigma among epileptics. The associated factors to the misconception toward epilepsy have been studied. All adults have heard about epilepsy and knew the generalized tonic-clonic form of epilepsy and knew someone with epilepsy. Hereditary (98%) and witchcraft (97.9%) and social problems (65.9%) were mentioned as the most cause of epilepsy. Epilepsy was cited as contagious disease by 90.6% of respondents and the associated factors were the sex (p=0.005) and occupational status (0.024). The saliva (98.1%) and witness of the place of seizure (97.8%) were the frequently mentioned modes of transmission. 65% of all mentioned that epileptics can not get marriage and the main associated factors to this belief were the advanced age (p=0.008) and occupational status (0.004). 64.4% believed that children with epilepsy shouldn't be attend to school, age (0.004), ethnicity (0.047) and occupational status were the associated factors with this misconception. Despite 99.4% considered epilepsy as treatable disease only 12.7% would have referred epileptics to the hospital. All the seven epileptics considered themselves as victims of stigma and rejected by their family and the community. The misconceptions associated to the epilepsy can explain the stigma and the therapeutic gap in this rural community.

[Tuberculoma of the cerebellar tonsils: a case study]. / Tuberculome de l'amygdale cerebelleux: a propos d'un cas.

Tuberculoma of the cerebellum is a rare presentation of human tuberculosis and the presence of this disease in central nervous system in particular. We report the case of an immunocompetent 53 year old man who initially had an instability when walking, bitemporo-occipital headaches and insomnia, secondarily complicated state of agitation accepted into psychiatric care. The diagnosis was possible with MRI that revealed a mass in the cerebellar tonsil, not taking the contrast after gadolinium injection. The evolution under treatment for tuberculosis was positive. The control MRI performed at 15 months showed no more damage.

Le Tuberculome du cervelet est une présentation rarissime de la tuberculose humaine en général et de l'atteinte par cette maladie du système nerveux central en particulier. Nous rapportons le cas d'un homme de 53 ans immunocompétent qui présentait initialement une instabilité à la marche, des céphalées bitemporo-occipitales et une insomnie, compliquée secondairement d'état d'agitation prise en charge en psychiatrie. Le diagnostic a été possible grâce à l'IRM qui a mis en évidence une masse de l'amygdale cérébelleux, ne prenant pas le contraste après l'injection de gadolinium. L'évolution sous traitement antituberculeux a été favorable. L'IRM de contrôle réalisée à 15 mois ne montrait plus de lésion.