Psychoéducation des parents de patients souffrant de schizophrénie suivis au CNHUP de Cotonou (Bénin) / NA

La prise en charge des malades mentaux nécessite d'intégrer leur famille dans l'équipe soignante. Ce travail montre l'intérêt de la psychoéducation dans la prise en charge des patients souffrant de schizophrénie. 40 parents de patients souffrant de schizophrénie ont bénéficié par groupes fermés de 10 du programme Profamille dans le but d'accroitre l'efficacité de la prise en charge. Des modules psychoéducatifs leur ont été proposés. 72,5% des participants étaient de sexe féminin. Pour tous les groupes réunis 45% ont débuté et terminé les séances. Pour 49,12% des participants les causes de la schizophrénie sont d'ordre culturel. Leurs premières réactions face à la maladie sont tardives et les troubles anxiodépressifs représentent les principales répercussions de la maladie. L'application de ce programme a permis de discuter des croyances sur la maladie, d'accroitre le niveau de connaissance des parents sur la schizophrénie, de leur faire acquérir des compétences pour y faire face. Le programme profamille permet d'accroitre l'efficacité thérapeutique.

The care of the mental sick requires to integrate their family into the medical team. This work shows the interest of psychoeducation in the management of schizophrenics. 40 parents of schizophrenics benefited by groups closed by 10 of the program profamille in order to increase the efficiency of care. The various psychoeducatif modules have been proposed to them. 72.5% of the participants were female. For all the gathered groups, 45% began and ended the sessions. For 49.12% of the participants the causes of schizophrenia are of cultural order. Their first reactions in front of the disease are late and the anxiodepressifs disorders represent the main repercussions of the disease. The application of this program allowed to discuss beliefs about the disease, to increase parents' knowledge of the schizophrenia, and to make them acquire skills to face it. The profamily program allows to increase the therapeutic efficiency.

Psychosocioprofessional and familial becoming of formers Buruli ulcer patients in Benin.

UNLABELLED: Buruli ulcer (BU), an emerging disease caused by Mycobacterium ulcerans, causes severe impairments. In literature, no survey has been devoted to the cured patients returned back home. OBJECTIVE: To analyze the long-term psychosocial, professional and family repercussions of BU on former patients. METHOD: Cross-sectional descriptive and analytic study on 244 formers patients seen at the Screening and Treatment BU Center of Allada from 2005 to 2009 and followed at home from January to July 2010. RESULTS: On the psychosocial level, 50.8% cured patients attributed the disease to witchcraft (mostly adults and teenagers); 90. 2% did not feel guilty (mostly children), 48.9% of the adults felt diminished, 31.7% are depressed and 19.5% anxious. On professional level, 81.0% of workers had gotten back to work, in the same job for 75.0% of them while 25.0% had changed jobs; 90.1% of children went back school, 29.4% followed a normal schooling but 70% did experience academic delay. On family level, 2.5% of patients were rejected by their families. CONCLUSION: After returning home, former UB patients suffered of severe psychosocioprofessional and familial repercussions that suggested an organization of their home monitoring.

[Problems of rehabilitation in patients with sickle cell disease in Cotonou, Benin]. / Problèmes de rééducation posés par la drépanocytose à Cotonou.

BACKGROUND: Manifestations of sickle cell disease (SCD) are polymorphous from childhood to adulthood. OBJECTIVE: The purpose of this study was to assess outcomes of rehabilitation in the patients with SCD. METHOD: This retrospective analytical descriptive study included 160 SCD patients rehabilitated from 1998 to 2006 at the National University Hospital in Cotonou, Benin. RESULTS: Mean patient was 31 years (range, 3 to 73 years). There was a female predominance (62.5%) with a sex ratio of 0.6. The type of SCD was HbAS in 53.1% of patients, HbSS in 21.3%, HbSC in 16.9%, and HbAC in 8.1%. The main clinical manifestations were classified as ischemic/infectious in 40% of patients, rheumatologic in 40%, and neurologic in 10%. Ischemic manifestations were observed in all patients with HbSS, HbSC, and HbAS while manifestations were preferentially neurological in patients with HbSS (p = 4,43.10(-3)) and rheumatologic in patients with HbAS (p<10(-3)). At the end of rehabilitation, persistent deficiencies, disabilities and limitations involved pain in 43.8% of patients, articular stiffness in 43.8%, muscular weakness in 46.9%, gait anomalies in 33.1%, amyotrophy in 21.2%, shortening of lower extremity in 16.9%, and tilting of the pelvis in 6.3%. CONCLUSION: This study shows that SCD is a highly debilitating disease. Although rheumatologic manifestations are not specific to SCD, the other complications described including femoral head necrosis, osteomyelitis, and stroke have been extensively documented in the literature. If primary prevention is unfeasible, early multidisciplinary management appears to be the most effective approach to reducing SCD-related disability.

[Hip paraosteoarthropathy after sciatica nerve injury by quinine intramuscular injection]. / Paraostéoarthropathie de la hanche sur lésion du nerf sciatique par injection intramusculaire de quinine.

INTRODUCTION: Often occurring in central nerve injuries, paraosteoarthropathic conditions are revealed by a stiffness or ankylosis of the joint. Their occurring during peripheral nerve injuries is rare. OBJECTIVE: To report a case of hip paraosteoarthropathy features after sciatica nerve injury by quinine intramuscular injection. MATERIALS AND METHOD: We report a case of a 24-year-old patient presenting with pain, oedema of the left buttock, limitation of bending of the left hip, and antalgic limping associated with a small step because of axonal left sciatic nerve injury. Initial pelvis X-ray and laboratory findings were normal. Reviewed 4 months later with important stiffness of the left hip, a second X-ray showed an atypical paraosteoarthropathy (POA). Chemotherapy and physiotherapy alleviated neurological muscle weakness but did not have any effect on the hip functionality. Surgical excision was the only treatment that improved the amplitude of movements. Evolution 7 years later showed the disappearance of the peripheral nerve-injury signs and the conservation of the movement amplitude obtained after excision, without a return to normal. CONCLUSION-DISCUSSION: Factors pointing to this POA were initial oedema, immobilization because of pain, and trauma by quinine intramuscular injection. The interest is the exceptional occurrence of POA on a peripheral nerve injury (sciatica nerve injury by quinine injection) outside the context of length resuscitation and that sciatica nerve injury is frequent in tropical countries but anachronistic in a developed one.

Etioepidemiologie des amputes transfemoraux à Cotonou

Introduction : l'histoire des amputes; intimement liee a celle des handicapes; date de l'antiquite. Cependant; il n'existe pas a ce jour de donnees epidemiologiques fiables sur l'amputation. Objectif : Analyser les caracteristiques epidemiologiques et etiologiques des amputes femoraux readaptes au CNHU de Cotonou sur une periode de 7 ans. Methode : Il s'agit d'une etude retrospective a visee descriptive portant sur 32 amputes transfemoraux readaptes a Cotonou durant la periode allant de juillet 1998 a juin 2005. Resultats : La frequence moyenne annuelle a ete de 4 amputes avec un maximum en 2003 ; l'age moyen des patients a ete de 42;7 ans avec des extremes de 14 et 87 ans; les hommes ont ete plus nombreux dans une proportion de 68;8; avec une sex- ratio de 2;2. Seize des amputes (50) etaient d'origine traumatique; 10 (31;2) d'origine infectieuse; 4 (12;5) d'origine vasculaire et 2 (6;2) d'origine tumorale. Le niveau des amputations etait le 1/3 moyen (50); le 1/3 sup (21;9); Gritti (21;9); et le 1/3 inferieur (6;2). Ont ete appareilles 81;2des patients ; mais seulement 56;2ont ete reeduques. Conclusion : L'amputation cree un nouvel etat pathologique dont l'issue constitue la rehabilitation. L'age; l'etiologie; le niveau de l'amputation et l'etat du moignon sont des donnees qui influencent lourdement la rehabilitation des amputes transfemoraux. La predominance des causes traumatiques et la prevalence croissante du diabete avec ses complications doivent conduire a agir plus sur les mesures preventives