[Compliance with medical treatment in primary open-angle glaucoma in Lomé]. / Observance du traitement médical dans le glaucome primitif à angle ouvert à Lomé.

OBJECTIVE: To assess the compliance rate among glaucoma patients with medical treatment, to investigate the factors influencing their attitude and survey their expectations vis-à-vis the doctor. PATIENTS AND METHODS: This is a prospective descriptive study conducted in four eye clinics in Lomé from January 2013 to July 2013. It included all glaucoma patients aged 40 years and above who have been under medical treatment for at least 6 months, with no history of surgical treatment of glaucoma. The evaluation was performed on the basis of a questionnaire. Compliance was rated good, fair or poor according to the regularity of treatment, compliance with the prescribed dosage and schedule of instillations, good instillation technique and compliance with follow-up visits. Patients consented to participate in the survey. RESULTS: A total of 107 patients responded to our questionnaire. There were 43 men and 64 women with a sex ratio (M/F) of 0.67. The mean age was 52.40±11.03 years. In total, 7.5% of patients were illiterate. Compliance rate was estimated good in 10.3% of cases, fair in 65.4% of cases, and poor in 24.3% of cases. Only the regularity of treatment, schedule adherence and good instillation technique, as well as compliance with monitoring visits were found as significant factors (P<0.05). Concerning patients' expectations vis-à-vis the doctor, 49.5% said they expected nothing from the doctor, 12.1% were hoping for advice and moral support, and 11.2% were hoping for the prescription of effective but less expensive eye drops. CONCLUSION: A good compliance rate was very low. The improvement of this compliance rate requires better information, education and communication for behavior change, and it also requires a higher quality of care and accessibility of anti-glaucoma drugs.

[Characteristics of cup/disc ratios in a population of northern Togo aged 20-40 years]. / Caractéristiques de l'excavation papillaire dans une population jeune de 20 à 40 ans du Nord Togo.

AIM: To describe the characteristics of cup/disc ratio in a young population belonging to a homogenous ethnic group in northern Togo. PATIENTS AND METHODS: The study population comprising 1010 persons (550 men and 460 women aged 20-40 years) was selected in 12 villages in the Doufelgou area. Eye assessment was conducted in the local health center facilities using a visual acuity chart, an ophthalmoscope, and light magnification for exploration of the anterior segment. RESULTS: The mean age of the participants was 30.4 years. The mean cup/disc ratio was 0.36 (range, 0.3-0.9). The most frequently found cup/disc ratio was 0.3, in both eyes, and was predominant in the 20- to 24-year age group: 56.6% of the right eyes and 58.7% of the left eyes. Cup/disc ratios over 0.5 were found in 14.4% of the right eyes and 12.4% of the left eyes; a cut-off point over 0.7 gave an abnormal cup/disc ratio prevalence of 3.2% in the right eye and 3.5% in the left eye. In 75% of the cases, the cupping appeared round and was elliptic in 25% of the patients. The cupping position was central in 63%, temporal in 18.3%, and nasal in 18.7% of the cases. In 7.8%, cupping was asymmetric. CONCLUSION: More than 3% of the young population of northern Togo has a 0.7 or higher cup/disc ratio, which shows a high prevalence of primary open-angle glaucoma if cup/disc ratio is considered a criterion for definition.

[Intensive care management of patients with severe head traumatism in Benin from 1998 to 2002]. / Traumatismes crâniens graves en réanimation au Bénin de 1998 à 2002.

OBJECTIVE: To study in Cotonou (Benin) in tropical environment, the specific problems of severe head injury. STUDY DESIGN: Five years retrospective study in Cotonou University National and Teaching Hospital. PATIENTS AND METHODS: All patients admitted with severe head injury between January 1998 and December 2002 were included. The following parameters were studied: age, sex, traumatism cause, temperature, blood pressure, Glasgow coma scale. RESULTS: Two Hundred thirty six patients (mean age 32 +/- 18 years) essentially men, were admitted. The cause of the injury was road traffic accidents in 86% of cases. Prehospital medicalisation was achieved in only 9% of cases. A head CT-scan was performed in 5% of the cases. Respiratory resuscitation essentially used the association intubation and oxygenation (59%), 19% of the patients were ventilated and 21% were sedated. Mortality was closely related to the initial Glasgow coma scale score (GCS): GCS 3-4 = 97%; GCS 5-6 = 72% GCS 7-8 = 36%. Overall mortality was 70%. CONCLUSION: Severe head injury is a major cause of morbidity and mortality in developing countries. Limited access to highly specialised care explain a high mortality rate. An active policy of prevention from administrative authorities and a greater effectiveness of medical management may improve outcome.

[Rheumatic diseases in hospital outpatients in Lome (Togo)]. / Maladies rhumatismales observées en consultation hospitalière à Lomé (Togo).

The aim of this study was to point out the different kinds of diseases in patients attending the rheumatology unit of Lomé Hospital from October 1989 to October 1990. Eight hundred and forty three patients (456 females, 387 males) were examined. The main results of this study are as follows: degenerative spinal involvement: 39.6%; tendinitis: 13.8%; knee osteoarthritis: 12.7%; hip osteoarthritis: 0.7%; hip involvement associated with hemoglobinopathies: 1.3%; gout: 5%; spondylarthropathies/0.8%; asymmetrical oligoarthritis: 0.6%; rheumatoid arthritis/0.2%; chronic polyarthritis without joint destruction: 1.2%; osteoporosis: 0.1%; connective tissue diseases: 0.7%. The scarcity of hip osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus and osteoporosis is in accordance with previous studies. The same is true of the high frequency of degenerative spinal involvement and knee osteoarthritis. However, the high frequency of gout and the non exceptional character of spondylarthropathies are in contrast with previous studies effected in Black Africa.