May Measurement Month 2019: an analysis of blood pressure screening results from Republic of the Congo.

The aim of this study was to determine the proportion with hypertension among an opportunistic sample of the population of the Republic of the Congo. Screening was conducted during the period from 15 May to 15 June 2019. Participants included, consenting persons 18 years of age and over, from five cities: Brazzaville, Pointe-Noire, Oyo, Owando, and Ouesso. In total, 3157 participants were screened as part of the campaign. The mean age was 44.7 years (SD: ±14.9), and 47% were male. Based on the total participants, 881 (27.9%) were overweight and 447 (14.2%) were obese. A total of 583 (18.5%) participated in MMM 2017 or 2018 screenings. The proportion with hypertension was 33.5% (n = 1057), 42.6% of those were aware and 37.3% were taking antihypertensive medication. Of the participants on treatment, 62.4% were controlled (<140/90 mmHg). Overall, 23.3% of patients with hypertension were controlled. After imputation, the proportions with hypertension were 30.1% (n = 1475) according to standardized age and sex. Obesity (P < 0.001) and alcohol intake (P < 0.001) were associated with higher BP compared with normal weight and non-drinkers, respectively. With regards to the social disparities of the different regions of Congo, large scale screening is necessary, in order to report the real situation of hypertension. This will improve the overall management policy for this condition in our country.

Conceptual framework for establishing the African Stroke Organization.

Africa is the world's most genetically diverse, second largest, and second most populous continent, with over one billion people distributed across 54 countries. With a 23% lifetime risk of stroke, Africa has some of the highest rates of stroke worldwide and many occur in the prime of life with huge economic losses and grave implications for the individual, family, and the society in terms of mental capital, productivity, and socioeconomic progress. Tackling the escalating burden of stroke in Africa requires prioritized, multipronged, and inter-sectoral strategies tailored to the unique African epidemiological, cultural, socioeconomic, and lifestyle landscape. The African Stroke Organization (ASO) is a new pan-African coalition that brings together stroke researchers, clinicians, and other health-care professionals with participation of national and regional stroke societies and stroke support organizations. With a vision to reduce the rapidly increasing burden of stroke in Africa, the ASO has a four-pronged focus on (1) research, (2) capacity building, (3) development of stroke services, and (4) collaboration with all stakeholders. This will be delivered through advocacy, awareness, and empowerment initiatives to bring about people-focused changes in policy, clinical practice, and public education. In the spirit of the African philosophy of Ubuntu "I am because we are," the ASO will harness the power of diversity, inclusiveness, togetherness, and team work to build a strong, enduring, and impactful platform for tackling stroke in Africa.

[Medication-overuse and chronic headaches in Brazzaville: patients' profile and therapeutic approach]. / Abus médicamenteux et céphalées chroniques à Brazzaville: profil et parcours thérapeutique des patients.

INTRODUCTION: Medication-overuse headaches (MOHs) are the least studied of all headaches in Africa. METHODS: We conducted a longitudinal study in order to describe our experience with patients placed in Neurology Outpatient observation in Brazzaville over a period of 4 years, from September 2010 to August 2014. All patients with chronic primary headaches, according to the International Classification of Headache Disorders (ICHD) (2nd edition), were included in the study. All patient with secondary headaches or who hadn't given consent were excluded. The patients were divided into two groups: those who had progressed to medication-overuse and those who didn't meet the criteria for medication-overuse (without-MOH). The variables used were the sociodemographic characteristics of patients, the clinical features of primary headaches and MOH treatment. RESULTS: The study population was constituted by 193 patients out of 212. The average age of patients was 42 ± 14 years, of whom 66.32% were women. MOH rate was 35.75%. The associated factors were: early age (p=0.003), concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol (p=0.0001) as well as self-medication (p<0.0001). By contrast, higher education (p<0.0001) and the use of NSAID alone (0.002) were protective factors against the onset of MOH. Ambulatory withdrawal was the most practiced treatment and amitriptyline was the most commonly used medication. CONCLUSION: Medication-overuse headaches are frequent in patients placed in Neurology Outpatient observation in Africa and deserve identification for a better management.

[Contribution of Holter ECG in the etiologic diagnosis of the ischemic stroke in Brazzaville, Congo]. / Apport du Holter ECG dans le bilan étiologique des infarctus cérébraux à Brazzaville, Congo.

To determine the prevalence of the rhythmic disorders during ischemic stroke, and to identify the predictive factors of paroxysmal atrial fibrillation (PAF). It was about a cross-sectional study, descriptive and analytical, conducted to Brazzaville between january 2012 and december 2016. It related to a consecutive series of 267 patients victims of a transient ischemic attack (n = 17) or ischemic stroke (n = 250), documented by cerebral tomodensitometry or brain MRI. All these patients profited from a recording 24h Holter ECG, carried out within the framework of etiologic research. The principal recorded rhythmic anomalies were indexed and the logistic regression allowed the identification of the predictive factors of PAF. They were 164 men (61.4%) and 103 women (38.6%), old on average of 60.2 ± 12.1 years. The identified cardiovascular risk factors were hypertension (80.1%), diabetes (13.5%), and tobacco use (6.7%). The 24h Holter ECG, normal in 216 cases (81%), was pathological in 51 cases (19%). The principal recorded anomalies consisted into ventricular ectopic beats (n = 32), PAF (n = 7), supraventricular ectopic beats (n = 5), non-sustained ventricular tachycardia (n = 4), sustained ventricular tachycardia (n = 2), and type 2 atrio-ventricular block (n = 1). The frequency of PAF was 2.6%. In bivariate analysis, it was not noted correlation between PAF and sex (p = 0.55), hypertension (p = 0.42), diabetes (p = 0.64), and tobacco use (p = 0.61). In multivariate analysis, only the age was the predictive factor of PAF during ischemic stroke (p = 0.0134). It comes out from this preliminary study that the emboligenous arrhythmias are relatively rare during ischemic stroke in Brazzaville. PAF, though little attends, remains primarily correlated at the age. Its systematic research at the old subjects contributes to improve the assumption of responsibility.