Dépistage de l'artérite des membres inférieurs chez les patients ayant un pied diabétique en attente d'une chirurgie à cotonou

Objectifs : L'étude a été initiée afin de dépister l'artérite des membres inférieurs chez les patients ayant un pied diabétique. Méthodologie : L'étude est transversale, descriptive et analytique. La population d'étude est consti-tuée des diabétiques hospitalisés pour pied diabétique au CNHU-HKM de Cotonou. L'artérite des membres inférieurs est dépistée par l'échodoppler artériel.Résultats : l'artérite des membres inférieurs a été dépistée chez159 patients soit uneprévalence de 80,76%. Les facteurs associés à l'artérite sont la durée de dépistage du diabète d'au moins 10 ans, l'hypertension artérielle, les signes d'ischémie etl'absence du pouls pédieux.Conclusion : l'artérite des membres inférieurs chez les patients ayant un pied diabétique est fré-quente. Le dépistage systématique de l'artérite est fortement recommandé en cas de lésion du pied chez les diabétiques

Therapeutic status of HIV-infected patients with at least 5 years of follow-up for antiretroviral therapy in a resource-limited setting: the experience of the CNHU ambulatory treatment center in Cotonou, Benin.

OBJECTIVES: The aim of this study was to describe the therapeutic situation of patients who had been followed up for antiretroviral therapy for at least 5 years. PATIENTS AND METHODS: A retrospective and descriptive study reviewed records of the historical cohort of adults infected with HIV in the national and teaching hospital at Cotonou from January 2, 2002, to March 31, 2013. It included all patients with follow-up for ART for at least five years. Immunological success was defined as a CD4 count above 350 cells/µl at the last test during the study period, and therapeutic success by viral load determined to be undetectable at its last measurement. Data were extracted from the updated ESOPE. STATA 11 software was used for data analysis. RESULTS: In March 2013, 979 patients, accounting for 27.1% of the overall cohort at the site, had been followed up for at least 5 years for ART. Their mean age was 38.1 ± 9.6 years and the sex-ratio (M/F) was 0.7. Analysis showed that 12.3% had been lost to follow-up, 2.3% had died, and 83.6% remained in treatment. The mean CD4 count at treatment initiation was 113.4±90.7 cells/µl, at 5 years 566.6±355.2 cells/µl, and at 10 years, 557.5±311.2 cells/µl. More than half (56.1%) of patients were treated with a first-line ART combination. Immunological success was reported for 63.2% of the patients. Of the 144 patients with a last viral load available, the therapeutic success rate was 76.4%. The probability of survival was 0.95 at 5 years and 0.91 at 10 years. CONCLUSION: Improving the quality and continuity of care can help to ensure short-term survival for PLHIV under a first-line ART treatment in resource-limited countries.

[Perceptions and practices of people with diabetes to diabetes mellitus at the Centre National University Hospital Hubert Maga Koutoucou Cotonou]. / Perceptions et pratiques des diabetiques face au diabete sucre au Centre National Hospitalier et Universitaire Hubert Koutoucou Maga (CNHU-HKM) de Cotonou.

OBJECTIVES: The study was initiated to assess patient knowledge about diabetes mellitus, identify food claims and finally to identify the daily practices. MATERIEL AND METHODS: The study was sectional and descriptive. The study population consists of diabetic seen in CNHU-HKM the outpatient Cotonou. Data collection is done by a questionnaire. RESULTS: Deficiencies were noted in knowledge of patients on diabetes mellitus.Several allegations have been identified. Patients think that the diabetic should not eat fruits, rice or corn dough. The practice of physical activity is low. Difficulties were encountered preventing compliance with diet, the practice of physical activity and glycemic control. CONCLUSION: Of challenges remain to improve the knowledge, attitudes and practices of patients. Therapeutic education is necessary for all diabetics.

BUT: L'étude a été initiée afin d'apprécier les connaissances des patients sur le diabète sucré, de recenser les allégations alimentaires et enfin d'identifier les pratiques quotidiennes. MATÉRIEL ET MÉTHODES: L'étude est transversale et descriptive. La population d'étude est constituée des diabétiques vus en consultation externe du CNHU-HKM de Cotonou. La collecte des données est faite par un questionnaire. RÉSULTATS: Des insuffisances ont été relevées au niveau des connaissances des patients sur le diabète sucré. Plusieurs allégations ont été recensées notamment l'interdiction de la consommation des fruits, du riz ou de la pâte de maïs. La pratique de l'activité physique est faible. Des difficultés ont été rencontrées empêchant le respect de régime alimentaire, la pratique de l'activité physique et le contrôle de la glycémie. CONCLUSION: Des défis restent à relever afin d'améliorer les connaissances, les attitudes et les pratiques des patients. L'éducation thérapeutique est donc nécessaire pour tous les diabétiques.

[Prevalence of peripheral artery disease among diabetics in Parakou in 2013]. / Prévalence de l'artériopathie oblitérante des membres inférieurs et facteurs associés chez les diabétiques suivis en milieu hospitalier à Parakou en 2013.

We aimed to determine the prevalence of peripheral artery disease and its associated factors among diabetics. The cross-sectional study was conducted and included all diabetics admitted to the diabetic clinic at the Parakou University hospital during the period of 1st February and 31st July 2013. The diagnosis of peripheral artery disease was based on the Ankle Brachial Index (ABI)<0.9. The socio-demographics data, the data concerning the diabetes and its complications were recorded in each patient. They were 401 diabetics and 59.5 % were females. The mean age was 53.7±11.5 years. Among the diabetics, 168 fulfilled the criteria of PAD, the overall prevalence was 41.9 %. In total, 31.5 % were symptomatics according to Leriche and Fontaine classification. The main associated factors were the increase of age (P=0.01), the absence of activity with high income (P=0.004), the absence of physical activity (P=0.023), the duration of diabetes (P=0.007), the presence of peripheral neuropathy (P=0.003), the glycosylated hemoglobin≥7 % (P<0.001). After a multivariate analysis, only diabetes control was independently associated with arteriopathy (P=0,004). The PAD was more frequent among diabetics in Parakou. The associated factors must be taken into account in order to improve the management of the disease and to reduce the burden of the PAD.