[Prevalence of Diabetes and Diabetes-Related Cardiovascular Risk Factors in a Rural Population in Burkina Faso]. / Prévalence du Diabète et Facteurs de Risque Cardiovasculaire Associés dans une Population Rurale au Burkina Faso.

Objective: Rural areas are currently facing lifestyle changes which greatly contribute to an increase in the prevalence of diabetes and cardiovascular diseases. The aim of this study was to estimate the prevalence of Diabetes and Diabetes-related cardiovascular diseases in a rural population in Burkina Faso. Methodology: We collected demographic and clinical data, and we also performed capillary glucose testing for all the participants aged 16 years and above in five administrative communities in the province of Zandoma. Results: In all, 970 individuals, with a mean age of 49.06 years (SD = 16.97), volunteered to participate in the screening. Most of them were aged between 40 and 65 years old (48.5%) and 57.5% were females. The prevalence of diabetes was 5.7%, and 9% of participants had an FPG level between 1.10 g/l and 1.26 g/l. A family history of diabetes was found in 4.3% of the cases. Looking at the other cardiovascular risk factors, we found 24.3% of the participant to be overweight or obese, 23.6% had High Blood Pressure. Age (p = 0.001), Employment Status (p = 0.015), Body Mass Index (p = 0.036) were significantly associated with diabetes. Conclusion: Diabetes is prevalent in rural areas in Burkina Faso, along with a significant proportion of prediabetes cases. Age, Employment Status, and BMI are the principal associated factors.

[About 98 cases of dengue hospitalized in a private clinic of Ouagadougou: epidemiology, diagnostic and evolution]. / À propos de 98 cas de dengue hospitalisés dans une clinique privée de Ouagadougou : aspects épidémiologiques, diagnostiques et évolutifs.

Extremely widespread, the dengue is a reemerging infectious disease. In Burkina Faso, dengue is a reality that was little known. The aim of this study was to study epidemiology, diagnostic and outcomes of dengue patients in Ouagadougou. A retrospective study covered a period of two years, from 1 January 2013 to 31 December 2014 in a private clinic in Ouagadougou. Patients included in the study were hospitalized for fever and painful syndrome with a positive test to the dengue non-structural antigen 1 (NS1 Ag). Ninety-eight cases of dengue on 343 suspected cases were registered. The average age of patients was 35.9 years. The sex-ratio (M/F) was 1.18. According to the professional activity, there was a predominance of civil servants (35.7%). The pain syndrome was found in 93.9% of patients. Leukopenia (73.5%), neutropenia (56.1%) and severe thrombocytopenia (57.1%) were the predominant hematological disturbances. Of the patients, 18.4% had hemorrhagic dengue and 11.2%, a dengue shock syndrome. Four patients died. The use of non-steroidal antiinflammatory drugs was associated with the severity of the infection (p=0.04). Dengue fever occurs in our context and constitutes a risk of mortality. The diagnosis of dengue should be performed systematically in front of a painful and febrile syndrome. The vector control is the best way of prevention against dengue pending the development of a vaccine.

[Antibiotic susceptibility of bacteria isolated from diabetic foot infections and prospects for empiric antibiotic therapy in Ouagadougou (Burkina Faso)]. / Étude de la sensibilité aux antibiotiques des bactéries isolées lors de l'infection du pied diabétique et perspectives d'antibiothérapie à Ouagadougou (Burkina Faso).

INTRODUCTION: The aim of this study was to study the antibiotic susceptibility of bacteria isolated from diabetic foot infections to help improve empiric antibiotic prescription in Ouagadougou, where bacteriological testing is rarely possible. METHOD: This cross-sectional study took place from July 1, 2011, to June 30, 2012, in the departments of internal medicine and general and gastrointestinal surgery in the Yalgado Ouédraogo teaching hospital. Bacteria were isolated from diabetic foot infections and their antibiotic sensitivity was tested by the qualitative method (Kirby-Bauer). RESULTS: The study included 64 patients, with a median age of 57 years (interquartile range: 48-75) and a M/F sex ratio of 1.37. Among them, 39 had received antibiotics before hospitalization. Among the 71 samples, 62 cultures (87%) were positive: 53 for a single microbe (85%) and 9 for two microbes (15%). Microorganisms were mainly aerobic and anaerobic Gram-positive cocci (76%), including Staphylococcus aureus (SA) (33%) and Streptococcus spp (18%). These Gram-positive cocci were highly sensitive to amoxicillin-clavulanic acid and oxacillin. No methicillin-resistant SA (MRSA) were isolated. Enterobacteriaceae (24 %) were highly susceptible to imipenem and ticarcillin, but not to ceftriaxone or ciprofloxacin. No extended-spectrum beta-lactamase Enterobacteriaceae (ESBL) were isolated. Pseudomonas aeruginosa was highly susceptible to ciprofloxacin and imipenem. CONCLUSION: Despite our study's limitations, our findings show that most diabetic foot infections can be successfully treated with standard antibiotics.

[The bacterial microflora of diabetic foot infection and factors determining its spectrum in Ouagadougou (Burkina Faso)]. / Écologie bactérienne et facteurs déterminant le profil bactériologique du pied diabétique infecté à Ouagadougou (Burkina Faso).

The aim of the study was to describe the bacterial microflora of diabetic foot infection and to identify the factors which determine the bacterial spectrum in order to increase empiric antibiotic prescription in Ouagadougou. The study was a cross-sectional one, carried from July 1st, 2011 to June 30, 2012 in the departments of internal medicine and general and digestive surgery in Yalgado Ouédraogo teaching hospital. Samples for bacteriological tests consisted of aspiration of pus through the healthy skin, curettage and swab of the base of the ulceration or tissue biopsy from foot lesions. The bacteria's sensitivity to antibiotics has been tested by the qualitative method (Kirby-Bauer). The frequency of diabetic foot infection was 14.45% and the monthly incidence 5.33. The mean age of patients was 56 years and the sex ratio 1.37. Foot ulcerations were chronic in 33 (51.56%), necrotic in 51 (79.69%) and associated with osteitis in 40 (62.5%) patients. Infection was grade 3 in 70.3% cases. Thirty-nine patients had received antibiotics before hospital admission. Among the 71 samples, 62 (87.32%) cultures were positive: 53 (85.48%) monomicrobial and 9 (14.52%) bimicrobial. Aerobic Gram-positive cocci (76%) were the most frequent from ulcerations: Staphylococcus aureus (32.39%), Streptococcus sp (18.30%). Negative coagulase staphylococci have been found in 23.94% cases. Aerobic gram-negative bacilli have been isolated from 24% ulcerations. No factor was associated with the type of bacteria. Gram-positive pathogen cocci showed a high sensitivity to amoxicillin-clavulanic acid and oxacillin. No methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum beta lactamase Enterobacteriaceae (ESBL) have been isolated. A better design is necessary to a clarification of bacterial flora in diabetic foot infections. Prevention of bacterial resistance is also needed.

[Characteristics of the patients "lost to follow-up" and determining factors of loss to follow-up to patients living with HIV at Ouagadougou, Burkina Faso]. / Caractéristiques des patients "perdus de vue" et facteurs déterminants de la perte de vue au cours du suivi des patients infectés par le VIH à Ouagadougou, Burkina Faso.

The objective of this study is to describe the characteristics of the patients "lost to follow-up" and determining factors of lost to follow-up at the patients infected by HIV. This is a descriptive and analytical retrospective study made on patients with or not by HAART, registered in the Day hospital of Ouagadougou. Of 5118 adult patients studied, 402 (7.9%) lost to follow-up. Among these patients, 340 (84.5%) had an unknown vital status, 28 (7%) were alive and 34 (8.5%) died. Mean age was 37.5 years. After active research, 16 from 21 patients under HAART were in treatment interruption. The main factors associated with the loss of follow-up were: no schooling (p=0,008), residing outside the capital (p=0,002) and being infected with HIV2 (p< 10(-3)). The phenomenon of loss of follow-up is important and concerned mainly not informed patients.

[Pernicious anemia: diagnosis and course in Burkina Faso]. / Maladie de Biermer : aspects diagnostiques et évolutifs au Burkina Faso.

Pernicious anemia (also known as Biermer disease or anemia, Addison or Addisonian anemia, and Addison-Biermer anemia) is an autoimmune atrophic gastritis responsible for vitamin B12 malabsorption due to a deficiency of intrinsic factor. We report eight cases of pernicious anemia in Burkina Faso, collected over a 44-month period. The three criteria for diagnosis of pernicious anemia were: vitamin B12 deficiency, gastric disease (gastric histology) with presence of anti-intrinsic factor, and/or anti-gastric parietal cell antibodies in serum. All patients had anemia, with a mean hemoglobin level of 8.75 g/100 mL. The average mean corpuscular volume (MCV) was 122.1 fL the average mean corpuscular hemoglobin (MCH) 39.3 pg, the mean reticulocyte count 12.069 10(9)/L reticulocytes, and the mean rate of megaloblast marrow cells 17.2%. The serum vitamin B12 level ranged from 35 to 71 pmol/L. Antibodies against intrinsic factor were found in all eight patients. All ABO blood groups were present with a predominance (4 cases) of group O. Endoscopy found a normal fundic mucosa in three patients. Histology showed gastric atrophy and intestinal metaplasia for six patients (85.7%). Under B12 vitamin therapy, the course was favorable in all patients; seven patients also had 10 days of iron therapy. We recommend a gastric biopsy even in the absence of macroscopic gastric lesions on the upper gastrointestinal endoscopy.

[Semiological features and risk factors associated with osteoarthritis of the hip in Ouagadougou (Burkina Faso)]. / Caractéristiques sémiologiques et facteurs de risque associés à la coxarthrose à Ouagadougou (Burkina Faso).

OBJECTIVE: To study the epidemiological and clinical aspects of osteoarthritis (OA) of the hip in Ouagadougou, as well as its risk factors. PATIENTS AND METHODS: This retrospective study covered cases treated over a 3-year period (February 2006 through January 2009) in the internal medicine department of the Yalgado Ouedraogo Teaching Hospital of Ouagadougou (Burkina Faso) and the surgery department of the private hospital Notre-Dame-de la Paix of Ouagadougou. All patients included had OA of the hip that met the Kellgren and Lawrence criteria. RESULTS: There were 46 patients who met the study criteria, but only 40 files could be used. The patients' mean age was 46.4 years ± 15.2 years (range 25-80 years; 10 patients were older than 56 years). Men accounted for more than half (n=23, 57.5%). The mean duration of disease was 6.2 years ± 4.5 years (range: 1-19 years). The right hip alone was concerned in 20 patients (50%), the left hip in 16 (40%), and the OA was bilateral in four (10%). Seventeen patients had sickle cell disease (42.5%), 11 SC and 6 SS. The risk factors included necrosis of the femoral head in 19 cases (59.37%), hip dysplasia in 6 (18.74%), hip trauma in 3 (9.37%), inflammatory arthropathy in 3 more (9.37%), and epiphysitis in one (3.13%). The OA of the hip was primary in 8 cases (20%). Three patients were at stage 1, 9 at stage 2, 15 at stage 3, and 13 at stage 4 according to the Arlet-Ficat classification. CONCLUSION: OA of the hip arises in a young population and is dominated by secondary OA. The dominant risk factor was aseptic necrosis of the femoral head associated with sickle cell disease. In view of the small number of patients with primary OA, no definitive conclusions can be drawn about it.

[Laboratory test features of newly diagnosed adult HIV-infected patients in Ouagadougou (Burkina Faso)]. / Profil biologique des patients nouvellement pris en charge pour une infection à VIH à Ouagadougou (Burkina Faso).

In a sub-Saharan African population of adults beginning care for HIV infection, we sought to describe some laboratory features and their correlation with disease progression. We retrospectively reviewed pretreatment laboratory records of recently diagnosed adults (Elisa test) beginning care at the Internal Medicine department of Yalgado Ouédraogo University Hospital between June 2009 and August 2010. The values have been classified according to WHO standards. During the study period, 177 patients were newly diagnosed as HIV-positive. Among them, 144 (81.4%) had CD4 counts below 350 cells/µL. The mean hemoglobin level was 10.3 ± 2.1 g/dL for women (n = 94) and 11.2 ± 2.8 g/dL for men (n = 67, p = 0.028), and 113 (71.1%) had anemia, 12 of them severe (7.5%). Anemia and lymphopenia were significantly correlated with a low CD4 count (p = 0.001 and 0.003 respectively). Six patients (3.4%) also had type 2 diabetes. Total cholesterol was normal in all patients, and 8 (10.4%) had hypertriglyceridemia. Hematopoietic, glycemic and lipid disorders seem relatively common in untreated black patients with HIV infection. A low CD4 count appears to predict hematopoietic cell deficits.

[Connective tissue diseases in hospital practice in Ouagadougou (Burkina Faso)]. / Les connectivites en pratique hospitalière à Ouagadougou (Burkina Faso).

To describe the semiological and immunological features of connective tissue diseases seen at the Yalgado Ouédraogo University Hospital in Ouagadougou. A retrospective study reviewed the records of patients seen in the hospital dermatology and internal medicine departments from January 1, 2004, through December 31, 2009 and diagnosed with systemic lupus erythematosus (SLE), systemic sclerosis (ScS), dermatopolymyositis (DPM), primary Gougerot-Sjögren disease (GS), polymyositis (PM) or indeterminate connective tissue disease (ICTD) meeting the criteria of the American College of Rheumatology. The study included 42 patients, 36 women and 6 men. Their mean age was 41.2 years ±11.97 (range: 15-75). SLE was the diagnosis for 10 patients, ScS for 14, DPM for 7, primary GS for 1, PM for 1, and ICTD for 9. Hematologic (93%), cutaneous (88%), and rheumatologic (81%) abnormalities were the most frequent manifestations. The specific auto-antibodies associated with SLE patients were: anti-native DNA (3/6), anti-Sm (3/6), anti-RNP (3/6), and anti-SSA (4/6); anti-Scl 70 antibodies were present in 5 patients with ScS. Connective tissue diseases seem to be rare in Africa, south of the Sahara. However, the very fragmentary studies and the weak healthcare coverage do not allow any definitive conclusions.

[Vitamin D-deficiency rickets: a case report from Burkina Faso]. / Le rachitisme carentiel: une observation au Burkina Faso.

Deficiency rickets results from a deficiency of vitamin D that is responsible for deficient calcium absorption, leading to failure of bone mineralization and cartilage bone growth, especially in children. We report the case of a 9-year-old girl who shows signs of rickets. Her family history, which includes similar malformations in several family members, led us to suggest vitamin D-resistant rickets, but all laboratory tests and response to treatment indicated deficiency rickets. Prophylaxis, at least for some very poor people, should be proposed for certain populations at risk, even in tropical zones.

[Sexuality and risk for sexual transmission of HIV among serodiscordant couples in Ouagadougou, Burkina Faso]. / Sexualité et risque de transmission du VIH chez les couples sérodiscordants suivis à l'hôpital de jour du CHU de Ouagadougou (Burkina Faso).

This article is a contribution to improve the management of serodiscordant couples in Ouagadougou. The aim of the study was to explore sexuality and the risk for sexual transmission of HIV among serodiscordant couples followed-up in CHU-YO. The study consisted of a descriptive cross-sectional study conducted over 6 months, from 1 January 2010 to 30 June 2010. A total of 80 heterosexual serodiscordant couples participated. Women were infected with HIV in most cases (75%). The mean age was 37.5 years for HIV partners and 40 years for seronegatives. Men were significantly older than women (p = 0.01). The couples weremarried (83.7%) or cohabiting (16.3%). The average of serodiscordance duration was 4 years. Seventy-four couples (92.5%) engaged in sexual intercourses, mostly vaginal intercourses. Both partners were satisfied only in 9 couples (12.2%). Although most couples (97.5%) knew the use of condoms for HIV prevention, 59.5% did not use it consistently, particularly when women were the seropositive partners (p = 0.01). The lack of privacy (37.5%) and desire of childbearing (26.25%) were the main reasons for not consistently using condoms among couples. Sexual dysfunction was a concern with 97.5% of the couples. The decrease in libido was most common (37.2%). Sexual intercourses with an outside partner were reported in 20 couples (25%), mostly regarding men (p = 0.03). Specific management could improve the quality of sexual life for couples in the light of the difficulties they face and reduce the risk for HIV transmission to negative partners.

[Eales disease: a case report in Burkina Faso]. / Maladie de Eales : à propos d'un cas au Burkina Faso.

The authors report the first case of Eales disease described in Burkina Faso. A 21-year-old man presented myodesopsia with acute visual acuity decrease in the right eye at 1/50, vitreous haemorrhage, and retinal phlebitis of the large trunks. In the left eye, visual acuity was 10/10 P2, with phlebitis associated with retinal haemorrhages, vascular occlusion, and retinal ischaemia. Laboratory investigations found a positive TST at 20mm but the Koch bacillus was not isolated. The patient received treatment for tuberculosis, corticosteroids, retinal argon laser photocoagulation, and vitrectomy in the right eye. The clinical, immunopathological, and therapeutic aspects of Eales disease are discussed.

[Prevalence and risk factors associated with infection by human immunodeficiency virus, hepatitis B virus, syphilis and bacillary pulmonary tuberculosis in prisons in Burkina Faso]. / Prévalences et facteurs associés aux infections a Virus de l'Immunodéficience Humaine et virus de l'épatite B, a la syphilis et a la tuberculose pulmonaire bacillifère en milieu carcéral au Burkina Faso.

This purpose of this study was to determine prevalences and risk factors associated with infection by human immunodeficiency virus, hepatitis B Virus, syphilis and bacillary pulmonary tuberculosis in prisons in Burkina Faso. From February 20 to March 20, 2009, 300 prisoners over 18 years of age held in Ouagadougou were selected to take part in this descriptive and analytical cross-sectional study. Sociodemographic data, confinement information (number, motive and prison time), medical history, substance addiction (alcohol, tobacco, drug), and the other risk behaviors (sexual relations, type of partners, sharing of toiletries or razor) were compiled for each prisoner. Serological tests were performed to detect anti-HIV antibodies, Hbs antigen, and anti-treponema antibody. In prisoners presenting signs of tuberculosis, BAAR detection was performed by direct examination of sputum. Men represented 95% of the study population. Median age was of 30.1 +/- 8.9 years (range, 18 and 63). The prevalences of HIV infection, Hbs antigen and positive syphilitic serology were 5%, 27.3% and 5.7% respectively. Four prisoners (1.3%) had bacillary pulmonary tuberculosis. Two prisoners reported homosexual intercourse and 44 reported drug abuse. Sharing of toiletries and razor blades was reported by 18.7% and 20% of the prisoners respectively. Immediate measures are needed reduce the spread of these infections in prisons in Africa.

[Metabolic disorders and cardiovascular risk factors observed in patients infected by the HIV with antiretroviral therapy in Burkina Faso]. / Troubles métaboliques et facteurs de risques cardiovasculaires chez les patients infectés par le VIH sous antirétroviraux au Burkina-Faso.

The purpose of this descriptive transverse study is to describe metabolic disorders and cardiovascular risk factors in HIV-infected patients undergoing antiretroviral therapy in the day-care unit of the University Hospital of Ouagadougou, Burkina-Faso. A total of 100 patients (Burkinavi cohort) undergoing antiretroviral therapy with a minimum of 42-months of follow-up (October 2005 to Mars 2009) were included. There were 77 females and 33 males with a mean age of 37 years. Most patients, i.e., 95%, were positive for HIV1. Mean body mass index was 22 kg/m2. Mean CD4 count was 280/mm3. Viral load was undetectable in 66 of the 71 patients who underwent viral load testing. Retroviral therapy consisted of the TriomuneR combination (Stavudine + lamivudine + névirapine) at a fixed dose in 27 cases. Cardiovascular risk factors included family history of high arterial blood pressure in 5 patients, smoking in 4, and obesity in 8. During follow-up, seven patients presented hypertension. Metabolic disorders included hyperglycemia (4%), hypertriglyceridemia (17%) and hypercholesterolemia (14%). Lipodystrophia was noted for 6 patients. Despite the short follow-up period, metabolic disorders and cardiovascular risk factors were observed at our patients under antiretroviral therapy.

[Prevalence and factors associated with low back pain among hospital staff in Ouagadougou (Burkina Faso)]. / Prévalence et facteurs de risque associés à la lombalgie chez le personnel hospitalier à Ouagadougou (Burkina Faso).

OBJECTIVE: The aim of our study was to determine the prevalence, risk factors, associated with low back pain among hospital staff in a developing country. PATIENTS AND METHODS: This transversal study was conducted from March 2007 to February 2008 at Yalgado Ouédraogo Teaching Hospital in Ouagadougou (CHU-YO), Burkina Faso. RESULTS: There were 256 men and 180 women with an average age of 38 +/- 8.25 years (range, 22 to 58). Mean BMI was 25.11 +/- 4.03 Kg/m2. The prevalence of chronic low back pain was 56.4% overall, 47.3% in men and 69.4% in women. Individual risk factors included female sex (p=0.000004), age (p=0.026), and high BMI (p=0.0002). Sports activity appeared to be a protective factor (p=0,035). Professional risk factors were the number of working hours per week (p=0,005) and numbers of guards per month (p=0.014) and posture during work (p=0.01). Analysis of socioprofessional consequences revealed significant impact in 43 (17,5%) patients. The loss work hours in 2007 were estimated to 1020. Three patients had to change working stations due to disability and 82 (19%) reported restricted working capacity. CONCLUSION: The prevalence of low back pain is high among hospital staff of CHU-YO. Preventive measures are needed to reduce socioprofessional consequences.

[Rheumatologic diseases and haemoglobinopathies in Ouagadougou (Burkina Faso)]. / Pathologies rhumatologiques et hémoglobinopathies à Ouagadougou (Burkina Faso).

The purpose of this study is the prevalence of the rheumatologic complications in the sickle cell disease and the associations between haemoglobinopathies and rheumatologic affections. It is a retrospective study from 29 February 2006 to 28 March 2008 conducted in the Internal Department of the University Hospital Yalgado-Ouédraogo. All patients received in the period of study and having an electrophoresis of haemoglobin realized in alkaline pH were included. These patients came from hematologic consultation. Two hundred and seventy-seven patients out of 1451 were included: 142 patients (51.30%) had haemoglobinopathies, including 21 (7.60%) with composite sickle cell disease SC and 17 patients (6.13%) had aseptic necrosis of the femoral head including 7 with haemoglobin SC. The other rheumatologic affections did not have a semiological particularity related to the type of haemoglobin. The prevalence of patients who have haemoglobinopathies is important in rheumatologic practice. The sickle cell disease is strongly associated to osteonecrosis.

[Rheumatic disorders observed in HIV infected patients undergoing highly active antiretroviral therapy (HAART): a 366 case prospective study in Burkina Faso]. / Manifestations rhumatologiques des personnes vivant avec le virus de l'immunodéficience humaine, traitées par antirétroviraux: etude prospective de 366 malades au Burkina Faso.

OBJECTIVE: The purpose of this report is to describe epidemiological aspects of rheumatic disorders observed in HIV-infected patients undergoing highly active antiretroviral therapy (HAART). Patients and methods. This cross-sectional study was conducted from January 1 to June 30, 2008 in the HIV unit of an internal medicine department in Burkina Faso. All patients who had been undergoing HAART for at least one year were included. Interviewing and thorough physical examination were performed in all cases. Radiography of the pelvis and hip was performed in some patients. Bone densitometry was never performed. RESULTS: A total of 366 patients including 265 women and 101 men (sex ratio of 0.38) were included. Mean patient age was 39.61 +/- 8.54 years. Three hundred and thirty-five patients (91.53%) were positive for HIV1, 17 (4.64%) for HIV2 and 14 (3.83%) for both HIV1 and HIV2. Mean duration of infection was 3.58 +/- 1.88 years. Mean CD4 cell count was 394.20 cell/microL. A recent HIV viral load determination was available for 285 patients including 262 who had no detectable virus. Mean duration of HAART was 35.80 +/- 15.17 months. Only 61 patients (16.66%) were treated with protease inhibitor (PI). The prevalence of rheumatic disorders was 5.73% (21 cases). A variety of disorders were observed, i.e., lower back pain in 8 patients (38.1%), arthralgia in 4 patients including 2 treated with PI, osteoarthritis of the knee in 2 patients, Pott disease in 2 patients, De Quervain disease in 2 patients including one treated with PI, tendinitis of the shoulder in one patient treated with PI, gout in one patient treated with PI and unclassifiable inflammatory rheumatism in one patient. No case of symptomatic osteonecrosis or osteoporosis was observed. CONCLUSION: Rheumatic disorders are uncommon in the HIV-infected patients undergoing HAART in Burkina Faso. The most likely explanation is that PI is not widely used.

[Arthropathic and degenerative pathology in rheumatology patients in Burkina Faso]. / Pathologie mécanique et dégénérative en consultation de rhumatologie au Burkina Faso.

OBJECTIVE: The purpose of this report is to describe epidemiologic features of arthrosic and degenerative disorders observed during the first two years of rheumatologic practice in Ouagadougou, Burkina Faso. PATIENTS AND METHODS: The files of all patients examined between March 2006 to February 2008 were reviewed. All patients presenting arthrosic or degenerative disorders were included. RESULTS: Out of 1,439 patients examined during the study period, 1,078 (74.91%) were included. Spine pain accounted for 33.7% of cases, i.e., 485 patients including 306 with lumbago. The mean age in this group was 47.8 +/- 15.19 years and the M/F sex ratio was 0,75. Osteoarthritis represented 20.43% of cases including osteoarthritis of the knee in 18%. The mean age in this group was 54.66 +/- 12.29 years and the M/F sex ratio was 0.23. Aseptic osteonecrosis (AON) of the femoral head was observed in 1.11% of cases, i.e. 16 patients including 8 with sickle cell disease (SC) The mean age in this group was 40.75 years. Abarticular rheumatism accounted for 15.98% of cases, i.e. 230 patients including 118 cases with tendinitis of the shoulder. The mean age in this group was 48.48 years. CONCLUSION: Arthrosic and degenerative disorders observed in this series from Ouagadougou presented the same semiological features as in other African series. Primary osteoarthritis of the hip was uncommon.

[Risk factors associated with osteoarthritis of the knee in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso]. / Facteurs de risque associés à la gonarthrose en consultation de rhumatologie à Ouagadougou (Burkina Faso).

The purpose of this transverse prospective study was to assess risk factors associated with osteoarthritis (OA) of the knee observed in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso. All patients presenting osteoarthritis of the knee diagnosed according to the clinical and radiological criteria of the American College of Rheumatology (ACR) were recruited over a 9-month period from November 2006 to July 2007. A total of 118 patients including 108 women were studied. Mean patient age was 55.7 +/- 10.8 years. Pain and disability scores assessed using theLequesne index were greater than 8 in 87.3% of patients. Hydarthrosis was observed in 56.5% of patients. The most common associated risk factors for development of osteoarthritis of the knee were obesity (42.4%), menopause in women (66.7%), history of OA (43.2%), and previous knee injury (19.5%). The most common associated risk factors for progression of osteoarthritis of the knee were Heberden nodes (19.5%) and genu varum (52.5%). The risk factors for development and progression of osteoarthritis of the knee in the subsahalian population of Ouagadougou are the same as in the Caucasian population of industrialized countries. An unexpected finding in this black African population was the high prevalence of Heberden nodes.

[Haematological parameters evolution during the antiretroviral therapy of HIV infected patients in Burkina-Faso]. / Evolution des paramètres hématologiques au cours du traitement antirétroviral chez les patients infectés par le VIH au Burkina Faso.

Haematological anomalies are frequent during HIV infection, and can be the fact of virus and or bone marrow toxicity of antiretroviral drugs. In order to analyze the evolution of the haematological parameters during HAART this work was carried out in the internal medicine department of the national teaching hospital Yalgado-Ouédraogo in Ouagadougou. So 107 patients receiving for the first time HAART and followed regularly were retained. The immunological efficacy at the end of the first six months was 60, 75% with an average gain of 119 CD4/mm3. The haematological changes at the end of these first six months showed: --an anaemia in 51.4% of the cases at month 6 versus 80.3% at baseline (p=0.0001). The average rate of haemoglobin was 11.8 versus 11.2 g/dl at baseline in the AZT containing HAART regimen (p=0.014) and 12.2 versus 10.7 g/dl at baseline in the group without AZT (p=0.00006). --a neutropenia in 35.5% of the cases at month 6 versus 31.7% at baseline (p=0.6). The average rate of neutrophil was 1908/mm3 versus 2267.1/mm3 at baseline in the AZT containing HAART regimen and 2150.7/mm3 versus 2001.9/mm3 at baseline in the group without AZT These results show that the therapeutic efficacy measured on the immunological answer is accompanied by a reduction of haematological anomalies. They also suggest the necessity to evaluate the cotrimoxazole impact before deciding the interruption of AZT.