[Pharmaceutical regulations in Chad: assessment of drug dispensing practices in private pharmacies in N'Djamena]. / Règlementation pharmaceutique au Tchad: état de lieux des pratiques de délivrance des médicaments dans les officines privées de N'Djaména.

Introduction: the purpose of this study was to evaluate drug dispensing practices in private pharmacies in the city of N'Djamena and, specifically, (I) to describe the characteristics of dispensaries, (ii) describe dispensing practices and (iii) assess regulatory compliance when dispensing on the basis of a prescription and an advice. Methods: we conducted a cross-sectional survey from June to December 2020. Data were collected in two stages, through interviews with pharmacists and participant observation in drug delivery practices in pharmacies. Results: in total, 26 pharmacies, or 50% of pharmacies in N'Djamena, were surveyed. The main survey findings were: private pharmacies in the city of N'Djamena employed two categories of staff, namely pharmacists and auxiliary staff (pharmacy technicians, nurses and salespeople or staff with "no health qualifications". These had not been trained in a health school recognised by the Ministry of Health) to dispense medicines. Very few pharmacies (8%) had a customer confidentiality area and a order book. The three modes of delivery were observed in more or less equal proportions (30 to 40% of dispensations). Dispensing at the patient's request was slightly predominant (40%) and the majority of medicines dispensed at the patient's request and based on dispenser's advice belonged to the different tables of toxic substances (over 70%). The noted absence of the pharmacist from the pharmacy justified why 84% of patients' requests were addressed to the pharmacy assistants. Conclusion: this study shows low compliance of pharmacies with pharmaceutical regulations for proper dispensing of medicines in the city of N'Djamena. Factors related to pharmaceutical sector governance and human resources management as well as therapeutic patient education could explain this gap.

[Prevalence and adverse effects of antihypertensive agents in patients followed up on an ambulatory basis at the University Hospital Yalgado Ouédraogo]. / Prévalence et caractéristiques des effets indésirables des antihypertenseurs chez les patients suivis en ambulatoire au Centre Hospitalier Universitaire Yalgado Ouédraogo.

Medicinal treatment of arterial hypertension (AH) may cause adverse effects which can be annoying and thus influence patient's compliance with treatment. Our study focused on these undesirable effects in patients followed up for AH on an ambulatory basis in the Department of Cardiology at the University Hospital Yalgado Ouédraogo from July to September 2015. Our aim was to determine their rates and their characteristics. Data were obtained from patients' interview, from the examination of patients' follow-up records and of medical consultation forms. A total of 278 patients were included in the study, 69.1% of them were women. The average age was 52.2 ranging between 23 and 86 years; 87.8% of patients lived in urban areas. Smoking, dyslipidemia and a family history of AH accounted for 9%, 35.6% and 57.2% of cases respectively. From a therapeutic perspective, 43.2% of patients were under monotherapy, 35.6% under bitherapy at the start of treatment. Calcium channel blockers (59.7%) were the most used therapeutic drugs. The overall incidence of adverse effects was 60.1%. Calcium channel blockers were involved in 53.6% of adverse events of patients, diuretics in 48.6%. Molecule-specific prevalence was 28.1% for the amlodipine and 24.5% for the hydrochlorothiazide. Excessive diuresis (13.7%), cough (12.9%) and vertigo (11.5%) were the most frequent adverse events reported by the patients. The central and peripheral nervous system and the osteo-muscular system were the most affected systems. Adverse effects are a major determinant of patient's compliance with antihypertensive treatments, because they may have a significant impact on patient's daily life.

[Adverse effects of antimalarial drugs spontaneously reported to pharmacovigilance national center in Burkina Faso: descriptive study and factors associated]. / Effets indesirables des antipaludiques notifies spontanement au centre national de vigilance des produits de sante au Burkina Faso: etude descriptive et facteurs associes.

AIM: To study spontaneous reporting of adverse effects of antimalarial drugs sent to pharmacovigilance national center. METHOD: A cross-sectional study was conducted to explore spontaneous reporting of adverse effects of antimalarial drugs sent to pharmacovigilance center from January 1, 2009 to December 31, 2013. RESULTS: In total 104 spontaneous reporting forms regarding antimalarial drugs were analysed. The sex ratiowas (male/female) 0,8. The majority of patients were aged over 13 years (66,3%). Self-medication and use of concomitant drug (>2) were observed in 22,1% and 46,2% of cases respectively. The artemisinin-based combination therapies (ACTs) were used in 77,8%. Several categories of adverse effects were observed among which skin and annexes disorders(34,6%), disorders of general health conditions, (29,8%), central nervous system disorders(29,8%), gastro-enterological disorders (23,0%). The most part of adverse effects was mild (67,3%).The adverse effects regarding central nervous (p=0,009)and gastro-enterological (p=0,0009) systems were significantly associated to the ACT use compared with use of other antimalarial drugs. CONCLUSION: These results show the importance to implement active surveillance of ACTs to have a safety profile in our real conditions of use.

BUT: Analyser les notifications spontanées des effets indésirables des antipaludiques transmises au centre national de pharmacovigilance. MÉTHODE: Il s'est agid'une étude transversale à visée exploratoire des notifications spontanées comportant un antipaludique, reçues au centre national de vigilance des produits de santé, du 1er janvier 2009 au 31 décembre 2013. RÉSULTATS: Au total, 104 fiches de notification ont été étudiées. Le sexe ratio hommes/femmes était égal à 0,8 et les patients de plus de 13 ans représentaient 66,3%. Les effets indésirables survenaient dans des circonstances d'automédication, de traitement concomitant de plus de deux médicaments dans 22,1% et 46,2% des cas respectivement. Les combinaisons thérapeutiques à base d'artémisinine (CTA) représentaient 77,8% des cas. Plusieurs types d'effets indésirables ont été observés, parmi lesquels les atteintes de la peau et ses annexes (34,6%), les troubles de l'état (29,8%),les troubles du système nerveux (29,8%), les troubles gastroentérologiques (23,0%). Les effets indésirables étaient le plus souvent modérés (67,3%). Ceux se rapportant au système nerveux (p=0,009) et à l'appareil gastroentérologique(p=0,0009) étaient associés significativement à l'utilisation d'une CTA. CONCLUSION: Ces résultats montrent la nécessité d'une surveillance plus intense des CTA pour mieux décrire leur profil de tolérance dans nos conditions réelles d'utilisation.