[Panorama of congenital disorders of hemostasis diseases at University Hospital of Brazzaville, Congo]. / Maladies hémorragiques congnitales au Congo. Expíence du service d'hématologie du centre hospitalier et universitaire de Brazzaville.

Congenital disorders of hemostasis constitutes a group of affections that rarely occur in Sub-Saharan Africa. Many cases are overlooked due to insufficient laboratory facilities. The purpose of this retrospective study carried out between January 1998 and December 2006 was to collect epidemiological, laboratory, and clinical data on the various congenital disorders of hemostasis observed in the hematology department of the University Hospital of Brazzaville, Congo. A total of 42 patients ranging in age from 2 to 54 years (mean, 15.8 years) were diagnosed during the study period. There were 29 men and 13 women representing all ethnic groups in the Congo including 16 Kongos (38.1%), 12 Ngala (28.6%), 11 Tekes (26.2%) and 3 foreigners (7.1%). Cases involved all social and economic levels of society. Presenting symptoms leading to discovery of the hemostasis disorders were post-traumatic cutaneous hemorrhagic in 13 cases (30.9%), hematoma in 8 cases (19%), perioperative hematoma in 7 cases (16%), perioperative hemorrhage in 7 cases (16%), hemarthrosis in 6 cases (14.3%); spontaneous epistaxis in 5 cases (11.9%), findings during routine checkup in patients with a family history in 3 cases (7.1%), and genital hemorrhage in 1 case (3.8%). The targeted laboratory routine used for diagnosis included the following tests: bleeding time (IVY), cephaline activated time, serum assays for deficient factors, and confirmation by flow cytometry. The diagnosis was Von Willebrand disease in 20 cases (47.6%), hemophilia A in 16 cases (38.1%), Glandzman thrombasthenia in 5 cases with high consanguinity (11.9%), and factor VII deficiency in 1 case (2.4%).

Extensively resistant tuberculosis: Four cases in the Republic of Congo.

Extensively drug-resistant (XDR) tuberculosis is currently a major public health problem in most developing countries, including the Republic of Congo, where antituberculosis agents are repeatedly unavailable. We report four cases from by the National Program for Tuberculosis Control in collaboration with its National Reference Laboratory (NRL) of the Republic of Congo. The presence of these highly resistant strains causes therapeutic problems (treatment depends on the profile of individual mutations and the unavailability of new drugs) and public health (major risk of spread of the disease in the community).

[Extrapulmonary tuberculosis versus pulmonary tuberculosis: epidemiological, diagnosis and evolutive aspects]. / Tuberculose extrapulmonaire versus tuberculose pulmonaire : aspects épidémiologiques, diagnostiques et évolutifs.

INTRODUCTION: Tuberculosis remains a public health problem around the world. Several factors can influence its location. The objective of this research is to analyze the factors influencing the diagnostic and evolutive aspects of extra-pulmonary tuberculosis (PET) compared to pulmonary tuberculosis (PT) at the anti-tuberculosis center of Adjame (Ivory Coast). PATIENTS AND METHODS: This is a retrospective comparative study between PET and PT's patients based on the diagnostic and evolutive aspects of tuberculosis cases reported from January 1st, 2010 to December 31st, 2012 at the Adjame anti-tuberculosis center. RESULTS: During the study period, 9442 patients were enrolled. Patients at advanced ages, were more affected by PET while younger adults were more affected by PT (P=0.001). Women and Adjame's residents were respectively more affected by PT compared to men and non-Adjame's residents. The majority of patients suffering from PET were HIV-positive while those suffering from PT were predominantly HIV-negative (P=0.001). The proportion of new cases was higher among populations with PET than in subjects with PT (P=0.001). Both groups of patients (PT and PET) were positively responsive to treatments.

[Overview of the knowledge and attitudes of physicians in Brazzaville on obstructive sleep apnea syndrome]. / État des lieux des connaissances et attitudes des médecins de Brazzaville sur le syndrome d'apnée obstructive du sommeil.

INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is the leading sleep-related breathing disorder. Its complications and its repercussions on the quality of life of patients make the OSAS a real public health problem. The objective of this study is to both asses physicians knowledge of OSAS and describe their attitudes towards suspect subjects in Brazzaville. MATERIAL AND METHOD: This was a cross-sectional study of 230 doctors practicing in various hospitals in the city of Brazzaville. The data collection was done by a self-questionnaire developed after a bibliographic analysis on the OSAS. The questionnaire was completed without recourse to a source of information. RESULTS: Our sample consisted of 141 (70.50%) general practitioners and 59 (29.50%) specialist physicians. The average of the knowledge score was 9.34 points±3.03 points. The general level of physician knowledge about SAS was good in 2% of cases, average in 44% of cases and low in 54% of cases. The level of knowledge was related to the number of times the OSAS diagnosis was mentioned by the physician in his practice (P<0.001), to the doctor's grade (P=0.003); to his university of origin and to the quantity of sources of information. When faced with suspects OSAS subjects, the doctor, the doctor directed the patient in 62% of the cases in ENT and in 49% in the pulmonology. CONCLUSION: The knowledge of the doctors on the OSAS are weak; this results in poor management of this pathology in the Congo.

[Spirometric and radiographic profile of patients with pulmonary tuberculosis treated and cured at the Department of Pulmonology of Brazzaville University Hospital]. / Profil spirométrique et radiographique des patients anciens tuberculeux pulmonaires traités et guéris au service de pneumologie du CHU de Brazzaville.

INTRODUCTION: Tuberculosis is a real public health problem in Congo. Pulmonary localization can lead to sequelae of respiratory functional repercussions. OBJECTIVE: Describe the spirometric and radiographic profile of patients treated with pulmonary tuberculosis treated and cured. PATIENTS AND METHODS: This was a cross-sectional study that included 150 patients with previous pulmonary tuberculosis with positive microscopy treated and cured in the Pulmonary Department of Brazzaville University Hospital. In which we performed a functional exploration (Spirometry) and a chest X-ray. The study took place from 1st January 2016 to 31st August 2016. RESULTS: The spirometry performed in all patients was pathological in 68.67% (103 cases/150) of the cases. Among them 74.76% (77 cases/103) had a restrictive profile (FEV1/FVC >70% and CVF <80%), 9.71% (10 cases/103) an obstructive syndrome (FEV1/FVC ≤70% and CVF >80%) and 15.53% (16 cases/103) a mixed syndrome (FVC <80% and FEV1/FVC <70%). Of the 150 chest radiographs performed, 120 or 80% were pathological; the degree of parenchymal stage III destruction represented 28.33%. There was a significant correlation between the degree of parenchymal destruction and the delay in treatment on the one hand and between the degree of parenchymal destruction and the different pulmonary volumes and volumes on the other hand. CONCLUSION: The prevention of these respiratory functional disorders is based on the prophylaxis of tuberculosis on early diagnosis of the disease.

[Predictive factors of lost to follow-up status during tuberculosis treatment in Brazzaville]. / Facteurs prédictifs associés au statut de perdu de vue au cours du traitement antituberculeux à Brazzaville.

INTRODUCTION: The abandonment of TB treatment has consequences both individual by increasing the risk of drug resistance and collective seeding entourage. The aim of this study is to determine the risk factors to be lost sight of during TB treatment. PATIENTS AND METHODS: He acted in a prospective cohort study of patients with microbiologically confirmed tuberculosis, beginning TB treatment and followed for six months. The comparative study between 75 patients lost (PL) and 108 no-patients lost (NPL). RESULTS: The presence of a large distance between the home center [OR=3.73 (1.21-11.05), P=0.022], to alcohol poisoning [OR=3.80 (3.80-11.3), P=0.031], the number of compressed high (depending on the patient) [OR=7.64 (1.96-29.8), P=0.007], stigma [OR=7.85 (1.87-33), P=0.004] were related to PL status. For against the implementation of the directly observed treatment by the community [OR=0.2 (0.03-0.92), P=0.04], be [OR=0.18 (0.05-0.63), P=0.07] were linked to reduced risk of being lost. CONCLUSION: Reducing the rate of PL requires patient compliance with good attitudes in post-education and ease of access to TB centers.

[The "DRESS" syndrome in antituberculosis drugs]. / Le « DRESS ¼ syndrome aux antituberculeux.

The DRESS syndrome is a serious drug reaction that may involve life-threatening. We have to think before any skin reaction after taking drugs. We report a clinical case of a 27-year-old patient treated for pleural tuberculosis with the DRESS syndrome induced by antituberculosis. Through this work, we underline the rarity of this syndrome to antituberculosis treatment, but it should not be underestimated.