Molecular characterization of high-risk human papillomavirus (HR-HPV) in women in Lomé, Togo.

BACKGROUND: The causative agent of cervical cancer referred to as Human papillomavirus (HPV) remains a real public health problem. Many countries in West Africa, such as Togo have no data on the high-risk HPV (HR-HPV) infection and genotypes distribution. In order to fill the knowledge gap in the field in Togo, the main objective of this study was to determine the prevalence of pre-cancerous lesions of the cervix and HR-HPV genotypes among Togolese women. METHODS: Samples were collected from 240 women by introducing a swab in the cervix. Then, the screening of precancerous cervical lesions using the visual inspection with acetic acid and lugol (VIA / VIL) was conducted. The HR-HPV genotypes were characterised by real-time multiplex PCR. RESULTS: Out of 240 women recruited, 128 (53.3%) were infected by HR-HPV. The most common genotypes were HPV 56 (22.7%), followed by HPV 51 (20.3%), HPV 31 (19.5%), HPV 52 (18.8%) and HPV 35 (17.2%). The least common genotypes were HPV 33 (2.3%) and HPV 16 (2.3%). Among the women, 1.3% (3/240) were positive to VIA/VIL. CONCLUSION: This study allowed HR-HPV genotypes to be characterised for the first time in Lomé, Togo. This will help in mapping the HR-HPV genotypes in West Africa.

Molecular Epidemiology of High-Risk Human Papillomavirus in High-Grade Cervical Intraepithelial Neoplasia and in Cervical Cancer in Parakou, Republic of Benin.

Human papilloma virus (HPV) infection remains a worldwide concern, especially in Sub-Saharan Africa where cervical cancer is the leading cause of cancer death in women. The aim of the study was to determine the prevalence and genotypic distribution of High-Risk HPV (HR-HPV) involved in Cervical Intraepithelial Neoplasia (CIN) II and III and in cervical cancer in Parakou. Out of a total of 149 samples of cervical tissues archived, fixed and paraffin-embedded, 78 samples with histological diagnosis of CIN-II, CIN-III and cervical cancer went through deparaffinization with xylene, followed by an extraction of HPV DNA and the detection of HR-HPV by real-time multiplex PCR. The average age of the women was 40.05±13.99 years. The samples were positive to at least one HR-HPV genotype in 76.92% (50/65) of cases. The HR-HPV genotypes which are most common in the cervical cancer and in CIN-II and III were, respectively HPV-39 (38 and 37.50%), HPV-18 (35 and 31.30%), HPV-45 (35 and 31.30%), HPV-35 (9 and 25%) and HPV-52 (9 and 12.50%). The HPV-16 was absent. This study helped to detect (in samples archived, fixed and paraffin-embedded tissues) HR-HPV involved in high-grade precancerous lesions and in cervical cancer in Parakou, some of which are not covered by currently available vaccines.

[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.

[Primary ileostomy for typhoid-related ileal perforation: a 62-case series in Ouagadougou, Burkina Faso]. / Iléostomie première des perforations iléales d'origine typhique: 62 cas à Ouagadougou (Burkina Faso).

OBJECTIVES: The purpose of this report is to evaluate the efficacy of primary ileostomy for treatment of typhoid-related ileal perforation based on our experience. METHODS: This retrospective study included all cases of typhoid-related ileal perforation treated by primary ileostomy in the Visceral Surgery Department of the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso from January 2006 to June 2008. Diagnosis was based mainly on peroperative findings revealing specific anatomical lesions. There were 45 men (72.6%) and 17 women (27.4%) with a mean age of 26 years (range, 14 to 68). Asthenic forms were observed in 41 cases (66.1%) and sthenic forms in 21 (33.9%). The mean delay for seeking treatment was 6 days (range, 1 to 30 days). RESULTS: Primary ileostomy was used for treatment of typhoid-related ileal perforation in 78.5% of cases. Most cases (80.6%) involved single perforations. A temporary ileostomy was performed in 55 cases (88.7%) and terminal ileostomy was performed in 7 (11.3%). Complications were observed in 18 patients (29.03%) including suppuration of wall in 8 cases. The mean duration for re-establishing continuity and of hospital stay was 34 and 41 days respectively. Four deaths occurred due to hypovolemic shock. CONCLUSION: In our department, primary ileostomy for typhoid-related ileal perforation reduced mortality despite high morbidity.

[Radiographic and ultrasonographic diagnosis of a left thoracic mass]. / Diagnostic radiologique et échographique d'une masse thoracique gauche.

A chest roentgenogram of a 69-year-old man undergoing a check-up before prostate surgery showed a mass in the antero-inferior zone of the lung, just above the diaphragm. At ultrasonography, it was considered to be a thoracic ectopic kidney. This radiological case illustrates the place of this anomaly in the differential diagnosis of lung solitary mass, which can be explored with ultrasonography when retroperitoneal herniation is suspected.

[Secondary school teachers' smoking in Ouagadougou, Burkina Faso]. / Le tabagisme chez les enseignants du secondaire de la ville de Ouagadougou, Burkina Faso.

This study was carried out among teachers of 10 secondary schools in Ouagadougou, Burkina Faso, in order to contribute to the development and implementation of a tobacco control programme in the school setting. The study had the following objectives: 1) to determine the extent of teachers' smoking addiction in the secondary schools in the city of Ouagadougou, 2) to describe the perceptions, attitudes and behaviour of teachers in the secondary school setting when confronted with smoking in the city's schools, 3) to determine the teachers' level of knowledge with respect to the harmful effects of smoking. The study was carried out from May 25 to June 30, 2001, and it included 300 teachers, 218 of which were men and 82 women. The study demonstrated that it is important to inform and sensitise teachers based upon their attitudes and perceptions with respect to tobacco.

[The current situation with regard to nicotine addiction in Burkina Faso: tobacco supply and data from the KAB-P survey of young people in Ouagadougou]. / Situation actuelle du tabagisme au Burkina Faso: données global sur l'offre et enquête CAPC auprès des jeunes de la ville de Ouagadougou.

Smoking is a worldwide phenomenon and many studies have demonstrated that tobacco use is a risk factor for morbidity and mortality. We investigated aspects of the supply of, and demand for, tobacco in Burkina Faso, with a view to helping the public authorities design strategies to combat this phenomenon. We used data on the importation of tobacco and the making of cigarettes in Burkina Faso and carried out a survey of adolescents and young adults (n = 289) with a mean age of 20.9 years. In 1997, Burkina Faso imported 1,905, 214 metric tons of tobacco of all kinds, with a CAF value of 5,808, 905,269 CFA francs. In the survey, 30.7% of those interviewed said that they smoked. These individuals gave various reasons for their use of tobacco including imitating friends (38.6%) and personal liberty (14.1%). These young people were generally aware of the risks of tobacco use, but this did not deter them from smoking. In countries like Burkina Faso, which is faced with many challenges, controlling tobacco advertising and providing ways and means to help young people to stop smoking or to deter them from starting to smoke are of major importance for future public health.

Neonatal hip: from anatomy to cost-effective sonography.

Therapeutic success in treating congenital dysplasia of the hip is associated with early diagnosis, but the specific neonatal anatomy makes screening difficult. The purpose of this study was to determine whether this specific neonatal anatomy is taken into account by current ultrasound (US) techniques. Anatomic studies were performed on 22 hips, US examinations on 7750 neonatal hips; 2370 untreated hips were reexamined at 1 month by US and at 3 months by X-ray. The transformation of the neonatal cartilaginous acetabulum into an osseous cavity is dependent on harmonious metaphyseal growth and a properly seated femoral head. Defects in the acetabular roof, together with displacement of the femoral head, cause an abnormal anatomical relationship which leads to further deformities. The described sonographic techniques give only partial information on these specific abnormalities. The sonographic monoplanar methods as used in Graf's technique, which relies largely on acetabular development, lead to difficulties in assessing posterior coverage of the femoral head and difficulties in assessing alignment of the metaphyseal weight-bearing surface with the femoral head. Combining Graf's morphological analysis with Novick's dynamic technique enables one to more accurately define the relationship of the femoral head and the acetabulum and increases the reliability and predictive value of the examination, while reducing the number of doubtful cases. This makes screening cost effective.

Anatomic study of the pre- and neonatal hip. Physiopathologic considerations on dysplasia and congenital dislocation of the hip.

Therapeutic success in dysplasia and congenital dislocation of the hip depends on an early diagnosis. The physiopathology remains very debatable and several concepts are propounded. For a better physiopathologic understanding, the authors have carried out a study of the morphology and development of 22 pre- and neonatal hips. At first, the acetabulum is cartilaginous and distorted by the moving femoral head; this acetabulum is histologically affected by the femoral pressure. The pathologic hip is characterized by defective posterior bony coverage of the femoral head by the acetabulum. The acetabulum ossifies during the 3 months following birth, forming a cup-like cavity under the pressure of the femoral head. Therefore, neonatal screening tests such as sonography must take place in the first weeks of life.

Anatomic basis for conservative surgery of the spleen.

100 pancreatico-splenic blocks obtained at autopsy were treated by the injection-corrosion method. The splenic artery ended in the lienorenal ligament in 64% of cases, in the pancreatic segment in 32% and in the hilar segment in 4%. In 84% of cases, the artery divided into two lobar arteries, upper and lower. In 16% the artery trifurcated. The pedicle was 20 to 60 mm long (mean 35 mm). The branches of the splenic artery were in three successive stages: the primary or lobar arteries were each associated with a lobe; the secondary or segmental arteries each supplied one of the constituent segments of a lobe; the tertiary or subsegmental arteries supplied the various areas which made up a splenic segment. Nine cases of extraparenchymal anastomoses were found. There were 32 intraparenchymal anastomoses, being either interlobar or intersegmental. There were a few interlobar anastomoses. The findings support the notion of upper and lower intersegmental and interlobar planes. The latter is almost avascular, while the former has limited vascularity. These planes make conservative surgery of the spleen possible.