Analyse des facteurs d'exposition des ouvriers spécialisés d'une entreprise togolaise du Bâtiment et Travaux Publics (BTP) aux lombalgies communes en 2015

La lombalgie commune constitue un problème de santé majeur en milieu professionnel. Objectifs : Décrire les caractéristiques épidémiologiques des ouvriers, déterminer le taux de prévalence de la lombalgie commune, identifier les facteurs de risques professionnels et décrire les conséquences. Méthodes : L'étude, transversale et analytique a été conduite du 1er février au 30 mai 2015. Elle a inclus les maçons, menuisiers et ferrailleurs répondant aux conditions de sélection. Les variables ont été recueillies à partir du questionnaire nordique modifié et adapté au contexte de l'étude. Résultats : Sur un effectif de 675 ouvriers spécialisés, 158 étaient éligibles (35,3%). La moyenne d'âge était de 33,1 ± 6,9 ans, avec des extrêmes de 20 et 58 ans ; ils étaient à 98,10% des hommes ; La moyenne d'ancienneté professionnelle était de 9,3 ± 6,6 ans, la durée hebdomadaire moyenne de travail de 44,8 ± 2,9 heures. Le taux de prévalence était de 82,3% ; en effet, 130 ouvriers sur 158 étaient lombalgiques. Les facteurs individuels étudiés n'étaient corrélés à la lombalgie. La catégorie professionnelle des menuisiers, la position debout et la durée hebdomadaire de travail prolongée au-delà de 40 heures étaient significativement liés à la lombalgie. Des 130 ouvriers lombalgiques, 43 ont bénéficié d'un arrêt de travail (33,8%). Le nombre total de journées de travail perdues a été estimé à 380. La durée moyenne d'arrêt de travail était de 15,2 ± 4 jours. La lombalgie a imposé une restriction d'activités courantes chez 49,2% des ouvriers et chez 7 (5,4%) un changement de poste. Conclusion : La prévalence des lombalgies communes est très élevée chez les ouvriers spécialisés dans cette entreprise de BTP. Elles sont positivement corrélées à des facteurs professionnels qui doivent faire l'objet des mesures de prévention

Evaluation de la protection auditive des travailleurs d'une usine de transformation de fèves de cacao de 2010 à 2011 en Côte d'Ivoire

En raison de la gravité de l'impact du bruit sur la santé des travailleurs exposés, la prévention apparaît comme l'alternative essentielle pouvant en supprimer ou en limiter l'impact.Objectif : Evaluer l'efficacité des mesures de protection auditive des opérateurs.Matériel et méthodes : Une étude descriptive et transversale d'une durée de 8 mois a été conduite dans une entreprise de transformation de fèves de cacao. L'étude comportait une étude de poste avec mesurage des niveaux sonores au moyen d'un sonomètre intégrateur conforme à la norme IEC 61672 : 2003 calibré, une analyse des équipements de protection auditive et un examen ORL avec des tests audiométriques.Résultats : L'échantillon était composé de 235 opérateurs dont 212 hommes (90%) et 23 femmes. La moyenne d'âge était de 37 ans (IC variant de 37,5 ± 17,5). Dans l'atelier de torréfaction, le bruit émis atteignait jusqu'à une intensité de 101,3 Lex, d (dB) en 2008. Le broyeur et la plate-forme produisaient une intensité sonore de 99,7 Lex, d (dB) en 2010. Les niveaux sonores variaient de 80,3 à 101,3dB. Cinq formations et 6 réunions du CHSCT ont été organisées de 2006 à 2012. Les casques 3M™ 1435 avaient un degré d'atténuation plus élevé (25dB). Les bouchons d'oreilles Ear Tracer™ présentaient un degré d'atténuation plus élevé.L'audition était normale chez 142 opérateurs dont deux groupes de 3 et de 6 personnes présentaient respectivement une surdité de perception et une surdité de transmission. Deux autres travailleurs étaient atteints d'une surdité de transmission.Conclusion : Le bruit est une nuisance professionnelle grave en raison de son impact négatif sur la santé des travailleurs. Elle est omniprésente en milieu industriel. Cependant l'observation rigoureuse des mesures de prévention permettent d'éviter ce risque ou d'en réduire la gravité

[Hearing disorders at the candidates of the National Gendarmerie's competition, Ivory Coast].

Objective: Detect the hearing deficiencies of the candi­da­tes of the gendarmerie's competition. Material and method: Pros­pec­tive study realized over 3 years (2008-2010), in the ENT service of the Gendarmerie to Agban (Abidjan). Examination included an otoscopy and a pure tone audiometry. Results: On 23121 candidates, 1245 had a plug of earwax (5.4%). They were aged from 18 to 25 years old (average age: 22.85 years). Eardrum was pathological in 0.5 % of the cases. Prevalence of hearing loss was 1.5%. Hearing loss included sensorineural hearing loss (56.7%), deafness of transmission (29.4%) and mixed deafness (13.9%). Deafness was unilateral in 79.8% and bilateral in 20.2%. Conclusion: Result of audio­gram will be useful for tracking or assessing cases of noise-induced hearing loss attributable to military service.

[Sinonasal inverted papilloma: our experiences of diagnostic and surgical care in Côte d'Ivoire]. / Papillome inversé naso-sinusien: notre expérience de la prise en charge diagnostique et chirurgicale en Côte d'Ivoire.

OBJECTIVE: To present our experience of the diagnostic and surgical care of sino-nasal inverted papilloma. MATERIAL AND METHOD: Retrospective study over 14 years (1996-2010) realised in the ENT departments in Côte d'Ivoire. Thirteen inverted papilloma confirmed and operated, after computed tomography, were included (7 men and 6 women, from 8 to 55 years old). RESULTS: The nasal obstruction was the main symptom. Twelve inverted papilloma correspond to Krouse stage T3, and 1 case T4. Surgical removal was performed by lateral rhinotomy (8 cases), Caldwell-Luc (4 cases) and De Lima (1 case). Squamous cell carcinoma was associated in 1 case. Recurrence with malignant transformation was observed in 1 case. CONCLUSION: Surgery by external approach allowed to obtaining satisfactory results. It stays of current events in our countries under equipped. Histopathological examination of the surgical specimen must be compulsory.

Analyse de 87 dossiers de maladies a caractere professionnel colliges au CHU de Yopougon a Abidjan de 1990 a 2009

Les auteurs rapportent un ca s de pheochro- mocytome ectopique. Cas clinique : patiente de 29ans; hypertendue connue depuis 8ans et diabetique depuis 7ans; admise en urgence pour perte de connaissance. L'examen clinique a montre une pression arterielle a 190/130mmHg; un pouls a 116 battements/minute et un Glasgow a 7 sans deficit hemi corporel. L'examen du fond d'oil a mis en evidence des signes de retinopathie hypertensive stade III. Le dosage plasmatique de la normetanephrine etait de 3917ng/l (normale170) et celui de la metanephrine de 59ng/l (normale73). Le scanner abdominal a montre un processsus tumoral tissulaire para-renal anterieur et polaire superieur gauche; mesurant sur une coupe axiale 73;8 X 51;3mm. Le diagnostic de pheochromocytome a ete pose. Le traitement a consiste a une exerese de la tumeur. L'evolution est favorable. Conclusion : le pheochromocytome para renal est une cause rare d'hypertension arterielle maligne

Pratique de la chimiothérapie anticancéreuse en milieu hospitalier à Abidjan : risques professionnels et stratégies de prévention

Introduction. lors de la chimiothérapie la toxicité des médicaments n'est pas dirigée de façon sélective contre les cellules tumorales. Elle concerne aussi les cellules normales. Méthode. Afin d'identifier les facteurs de risques liés à la manipulation des drogues anticancéreuses, une étude transversale a été conduite à Abidjan, sur une période de 6 mois (octobre 2011 - mars 2012) dans les principaux services hospitaliers universitaires d'Abidjan ayant un niveau d'activité élevé en matière de chimiothérapie anticancéreuse que sont les services de Cancérologie, d'Oncologie pédiatrique du CHU de Treichville et d'Hématologie clinique du CHU de Yopougon. Les données ont été recueillies par renseignement d'un questionnaire au cours d'une interview et d'une observation des conditions d'administration des drogues anticancéreuses. Résultats : La population des 40 sujets enrôlés comprenait 42,5 % d'infirmiers. L'âge moyen des travailleurs était de 35±4 ans avec une ancienneté professionnelle moyenne de 5±4 ans. Le service de cancérologie avait un indice de contact cytotoxique (ICC) à 1,06. Cet ICC correspond à un niveau 2 d'exposition. Des comportements à risque tels que la purge d'air des seringues et des tubulures sans précaution, le non lavage des mains avant et après manipulation, la prise de repas dans le local de préparation ont été observés dans respectivement 92,5 %, 60 % et 17,5 % des cas. Les projections représentaient le principal mécanisme des accidents (77,4 %) et la peau le principal siège des lésions (67 %).Les moyens de prévention collective et les procédures de travail étaient quasi-inexistants dans les trois services. En effet la majorité des travailleurs (77,5 %) n'avait pas reçu de formation sur l'utilisation des produits anticancéreux. La quasi-totalité des travailleurs (85 %) utilisait les blouses sans manchettes serrées. Discussion et conclusion : notre étude a mis en évidence l'adoption des comportements à risques des travailleurs au cours de la manipulation des médicaments anticancéreux et l'absence de mesures de prévention adaptées. Dans notre contexte, la pratique de la chimiothérapie pourrait être améliorée par la mise en place des règles de bonnes pratiques de manipulation des anticancéreux

[Submandibular dermoid cyst extended to the cervical region]. / Kyste dermoïde de la région submandibulaire étendu à la région cervicale.

INTRODUCTION: Dermoid cysts of the submandibular region are rare. We report an exceptional case with extension to the neck. OBSERVATION: The patient presented with a voluminous left submandibular cystic tumor with extension to the neck and to floor of the mouth. Ultrasonography and CT scan contributed to the diagnosis and to chose the best surgical approach in case of large cyst. In our case, the tumor was removed using a double cervical and intraoral approach. Histopathological examination confirmed a dermoid cyst. DISCUSSION: We report an exceptional case of dermoid cyst originating from submandibular region. A double surgical approach was necessary for tumor resection. Tumor removal must be complete; the submandibular gland may be removed if necessary.

[A case of nasal foreign bodies by tooth migration]. / Un cas de corps étranger des fosses nasales par migration dentaire.

Foreign bodies are a frequent reason for ENT consultation especially in children. Although the nature of the foreign body can be variable, the discovery of a tooth in a nasal cavity is a rare occurrence. The authors report a case of foreign body inside the nasal cavity caused by tooth migration and discuss its pathologic, diagnostic and therapeutic aspects.

[Risk factors for rotator cuff injury among dentists]. / Facteurs favorisants de la pathologie de la coiffe des rotateurs chez le chirurgien-dentiste.

CONTEXT: The survey appears in the setting of the politics of improvement for prevention of professional risks in hospital environment in Ivory Coast. PURPOSE: To identify the influence factors of the coif of rotators pathology among dentist surgeons and to improve the preventive measures. TYPE OF STUDY: It was a prospective case/witness survey type. It had for setting, public hospitals and private clinics in Abidjan. METHODOLOGY: We enrolled two types of population (case/witness) comparable with the criteria's of age, sex, bodily mass indication (BMI) and laterality. The data have been collected on a standardized questionnaire named "Nordic questionnaire" and have been enriched. That informed on the bodily mass indication calculated according to the method: weight/T2 (m), on the epidemiological data and the specifics data of the shoulder and the coif of the rotators. The statistical tests have been done by the test of the Khi2 of Pearson, the test of T Student, the exact test of Fischer and the test of the gap reduces. RESULTS: The study included 100 cases and as many witnesses. The middle age of apparition of the tendinitis of the shoulder was of 38,83 years. Age, sex, bodily mass and professional experience didn't have any influence on the apparition of the lesion of the shoulder. The analysis of the results established that the professional seniority encourages the apparition of the lesion of the shoulder. The length on average some seniority is of 12,7 years with extremes of 2 and 30 years. This observation rests on the fact that the risks of intervening of musculo-skeletal unrests of the superior member is equal to the length of work (effort, repetitive acts and stance) returned to the functional capacities. CONCLUSION: The tendinitis of the shoulder, because of its importance must be recognized and repaired as an indemnisable professional disease.

Microbiology of facial cellulitis related to dental infection.

OBJECTIVE: The study objective was to identify bacteria responsible for facial cellulitis of dental origin. DESIGN: Adult patients, admitted for facial cellulitis of dental origin were included. The pus sample was taken by swabbing during the surgical incision and drainage performed under general anesthesia. The bacteriological diagnosis was performed by microscopic examination and bacterial culture in aerobic and anaerobic atmosphere. RESULTS: Two hundred and seven bacterial species were isolated from 100 samplings, that is to say 2.07 bacterial species per sample. 19% of the samples contained only aerobic germs, 36% only anaerobic ones, and 45% contained mixed aerobic and anaerobic flora. Streptococcus (65.38%) and Capnocytophaga (11.54%) were the most frequently isolated aerobic bacteria. The anaerobic bacteria accounted for 62.32% of isolates and the most frequently isolated were Prevotella (55%) and Fusobacterium (16.28%). Bacterial species were not significantly different according to the age (P-value=0.06) and sex (P-value=0.584). There was a significant statistical association between aerobic or anaerobic bacteria and clinical symptoms such as cheek edema (P-value=0.03) and pus at tooth root (P-value=0.02). Patients previously treated by antibiotic therapy presented significantly more infections due to the same respiratory germ type (P-value=0.009). CONCLUSIONS: Even though the bacterial flora responsible for facial cellulitis of dental origin is polymorphic, anaerobic bacteria were predominant.

A case of middle-ear angiosarcoma.

INTRODUCTION: Middle-ear angiosarcoma is a rare malignant tumor that requires early diagnosis to allow satisfactory removal. The objective of the present study was to describe and discuss the diagnosis and treatment of this rare malignant middle-ear tumor. CASE REPORT: A 12-year-old girl was admitted for a left retroauricular mass and a budding left external auditory canal tumor without associated peripheral facial nerve palsy. CT scan showed a mastoid-region tumor extending to the external auditory canal with mastoid and occipital bone-loss. Tumor removal used a retroauricular approach. Postoperative diagnosis was of angiosarcoma. At 12 months' regular follow-up, there were no signs of local recurrence. DISCUSSION AND CONCLUSION: Middle-ear angiosarcoma is a rare tumor, in which diagnosis is late because early symptoms are not specific. A multidisciplinary approach is essential for efficient management.

[Extraction of the esophageal foreign bodies by cervicotomy: our experience about 9 cases]. / Extraction de corps étrangers oesophagiens par voie de cervicotomie: à propos de 9 cas.

OBJECTIVE: To present our experience of the extraction of the esophageal foreign bodies by cervicotomy route. PATIENTS AND METHOD: Descriptive retrospective study from 2006 to 2010 realized in the ENT Departments of Yopougon and Treichville's Teaching Hospital. RESULTS: 9 (3.3%) of 270 patients underwent surgery to remove esophageal foreign bodies. The average age of the patients was of 14.6 years (extremes: 8 months and 49 years). The foreign bodies were fish bone, hook of clothes peg, medallion, denture and weld. Cervicotomy was performed at once in 4 cases and after failure of esophagoscopy in 5 cases. There were 2 complications (pharyngostoma and suppuration of the operating site). CONCLUSION: The cervicotomy must be quickly performed in case of perforation with or without neck abscess, sharp or voluminous bodies.

[A case of nasal NK/T cell lymphoma in Africa]. / Un cas de lymphome nasal T/NK en Afrique noire.

INTRODUCTION: Nasal NK/T cell lymphoma is an aggressive, locally destructive and necrotizing lesions. It is exceptional rare in Africa. CASE REPORT: We report a 73 year-old patient's case presenting a nasal obstruction with a chronic purulent nasal discharge. The physical examination showed a chronic nasal lesion involving the nose and infiltrating the pyramid. The histopathological examination performed in a french laboratory diagnosed a nasal T cell lymphoma. Chemotherapy was initiated; radiotherapy being unavailable. CONCLUSION: The difficulties in management of nasal NK/T lymphoma cases are due to diagnostic difficulties and therapeutic problems related to the absence of radiotherapy in our work environment.

[Occupational related burns in Abidjan]. / Brulures En Milieu Proffessionnel A Abidjan.

Occupation-related burns are important issue for public health area because of its socioeconomic impact for enterprises, victims and society. We performed this study in order to define the epidemiological characteristics of these accidents. We used a retrospective study that concerned occupation-related burns notified as work accident at the national insurance fund (CNPS) for private sector in Côte d'Ivoire. 363 files were selected. Men workers (95.6 %) and the age category from 20 to 39 (71 %) were more concerned. Most of victims were skilled workers (40.4 %) and unskilled workers (36.6 %). Burns occurred mainly in industrial sector than in others (70.8 %). Heat sources were involved in 238 cases of burns (65.6 %). Injuries were mostly superficial. Total temporary disability duration less than or equal to 28 days concerned 252 workers (70.4 %) and after effects with permanent partial disability concerned 64 workers. Most of victims return at the same workstation without modification (98.9 %). Prevention measures should be implemented in high burn risk factories through a program focused on fire safety, electric safety and chemical safety.

[Thyroid localization of myxofibrosarcoma: first case in Africa]. / Myxofibrosarcome à localisation thyroïdienne: première observation en Afrique.

This case report describes a 45-year-old woman who was treated for a bulky ulcerated thyroid tumor with an offensive odor. The tumor had been ongoing for approximately 20 years. The patient had familial medical history of goiter. Histopathological diagnosis of the surgical specimen demonstrated myxofibrosarcoma associated with a classic thyroid tumor (vesicular adenoma). Based on this case, the author reviews the literature describing this rare soft-tissue tumor that is usually located on the extremities. Surgical treatment consists of radical tumor excision. A multidisciplinary therapeutic approach is necessary for efficient management by ensuring proper coordination of adjunctive treatment.

[Epilepsy and employment: a multicentric study of 55 epileptics employed in the public and private sectors in Abidjan]. / Epilepsie et travail: etude multicentrique des conditions de travail de 55 salaries dans les secteurs public et prive a Abidjan.

UNLABELLED: GOAL AND STUDY TYPE: to favour access and job conservation for the epileptic's patients, a descriptive and transversal study of word conditions of epileptic's workers have been driven for June to December 2005 at Abidjan. MATERIAL AND METHOD: study population was constituted of 55 epileptics who are regularly followed and diagnose patients during study period. They did a fixed professional activity employee and old than 15 years. Study was divided in two stapes. The first drive a questionnaire directed. She has completed by an exploitation sentence register of work accident, for balances sheet activities of medical service and filing organization of activities. Variables collected concerned socio-demographic data, medico social structures and the prevention. These data have been treated with soft ware Epi-info 6.0 dfr. RESULTS: the sample was constituted of 35 per cent of men against 35 per cent of women; 80 per cent of epileptics worked a journey and have fixed time and 24 patients, so 43,60 per cent in supplementary hours witch 8 patients (33,33 per cent) have presented an unbalanced of disease. A patient have been victim of work accident (1,8 per cent), 5 cases of cancel responsibility (9,1 per cent have pronounced and 10,9 per cent of patients have changed their job; 17 patients have profit of work stop in year (30,9 per cent). A case of invalidity have pronounced (1,8 per cent). A professional promotion has given at 5 patients (9,10 per cent). The employer was informed of the disease for 58,20 per cent of patient. Two employees have changed attitude after a new attack on their work place. CONCLUSION: the capacity of work of epileptics stay near of a noun epileptic worker for use and functions authorized.