[Prevalence of Diabetes and Diabetes-Related Cardiovascular Risk Factors in a Rural Population in Burkina Faso]. / Prévalence du Diabète et Facteurs de Risque Cardiovasculaire Associés dans une Population Rurale au Burkina Faso.

Objective: Rural areas are currently facing lifestyle changes which greatly contribute to an increase in the prevalence of diabetes and cardiovascular diseases. The aim of this study was to estimate the prevalence of Diabetes and Diabetes-related cardiovascular diseases in a rural population in Burkina Faso. Methodology: We collected demographic and clinical data, and we also performed capillary glucose testing for all the participants aged 16 years and above in five administrative communities in the province of Zandoma. Results: In all, 970 individuals, with a mean age of 49.06 years (SD = 16.97), volunteered to participate in the screening. Most of them were aged between 40 and 65 years old (48.5%) and 57.5% were females. The prevalence of diabetes was 5.7%, and 9% of participants had an FPG level between 1.10 g/l and 1.26 g/l. A family history of diabetes was found in 4.3% of the cases. Looking at the other cardiovascular risk factors, we found 24.3% of the participant to be overweight or obese, 23.6% had High Blood Pressure. Age (p = 0.001), Employment Status (p = 0.015), Body Mass Index (p = 0.036) were significantly associated with diabetes. Conclusion: Diabetes is prevalent in rural areas in Burkina Faso, along with a significant proportion of prediabetes cases. Age, Employment Status, and BMI are the principal associated factors.

Rhumatologie en Afrique noire francophone et à Madagascar : état des lieux sur les rhumatologues, les pathologies rhumatologiques, les moyens diagnostiques et thérapeutiques en 2015

Objectif : Dresser l'état des lieux de la rhumatologie en Afrique Noire Francophone (ANF) sur le nombre de rhumatologues, les pathologies rhumatologiques, les moyens diagnostiques et thérapeutiques.Patients et méthodes : Etude transversale par interview auprès de rhumatologues africains pour connaître le nombre de rhumatologues, les moyens diagnostiques et thérapeutiques dans chaque pays entre juin 2014 et juin 2015. Revue de la littérature par recherche avec les mots "rheumatic diseases ; africa" sur Medline, "Médecine d'Afrique noire" électronique, "Médecine et santé tropicale" et "Société des pathologies exotiques". Les données concernaient les pays d'ANF jusqu'en juin 2015 hormis le Burundi, la République Démocratique du Congo et le Rwanda. Celles du Gabon concernaient 6050 rhumatisants vus entre janvier 2009 et décembre 2014 dans le service de médecine interne du centre hospitalier et universitaire de Libreville.Résultats : Pour une population totale de 182,14 millions d'habitants, il y avait 50 rhumatologues soit une densité de 0,03 rhumatologue pour 100.000 habitants. La pathologie la plus fréquente était l'arthrose. La goutte et les infections étaient les premières causes d'arthrites respectivement au Burkina Faso, au Congo Brazzaville, au Gabon et au Bénin, au Cameroun, en Côte d'Ivoire, au Togo. Les rhumatismes inflammatoires chroniques les plus fréquents étaient la polyarthrite rhumatoïde au Burkina Faso, au Cameroun, au Congo Brazzaville et les spondylarthrites par arthrites réactionnelles en Côte d'Ivoire, au Gabon, au Togo. La radiographie et le MTX étaient disponibles dans chaque pays. Il y avait 21 IRM, soit un appareil pour 8,673 millions d'habitants. Les biothérapies type Adalimumab et Etanercept respectivement à 1.710,36 et 1.733,23 € par mois au Gabon, restaient exceptionnellement utilisées.Conclusion : L'état des lieux de la rhumatologie en ANF en 2015 révèle surtout l'extrême carence en rhumatologues dans ces pays, principalement du fait de l'absence de formations locales dans cette spécialité

Inflammatory lumbar radiculalgia in Ouagadougou: posterior facet arthritis due to tuberculosis.

Posterior facet arthritis is rarely described. The authors report a case of arthritis of the posterior lumbar facet in a woman consulting for back pain associated with relative functional impairment. Modern imaging, in slices, enables better examination of the posterior arch and better diagnosis of pathologies. Tuberculosis is one of the conditions affecting the posterior lumbar facet, and its characteristics on MRI are well-defined. This case shows that tuberculosis is a not uncommon cause of posterior facet arthritis and should be considered even before the appearance of clinical and bacteriological signs to avoid catastrophic situations for the patient.

[Characteristics of the patients "lost to follow-up" and determining factors of loss to follow-up to patients living with HIV at Ouagadougou, Burkina Faso]. / Caractéristiques des patients "perdus de vue" et facteurs déterminants de la perte de vue au cours du suivi des patients infectés par le VIH à Ouagadougou, Burkina Faso.

The objective of this study is to describe the characteristics of the patients "lost to follow-up" and determining factors of lost to follow-up at the patients infected by HIV. This is a descriptive and analytical retrospective study made on patients with or not by HAART, registered in the Day hospital of Ouagadougou. Of 5118 adult patients studied, 402 (7.9%) lost to follow-up. Among these patients, 340 (84.5%) had an unknown vital status, 28 (7%) were alive and 34 (8.5%) died. Mean age was 37.5 years. After active research, 16 from 21 patients under HAART were in treatment interruption. The main factors associated with the loss of follow-up were: no schooling (p=0,008), residing outside the capital (p=0,002) and being infected with HIV2 (p< 10(-3)). The phenomenon of loss of follow-up is important and concerned mainly not informed patients.

[Semiological features and risk factors associated with osteoarthritis of the hip in Ouagadougou (Burkina Faso)]. / Caractéristiques sémiologiques et facteurs de risque associés à la coxarthrose à Ouagadougou (Burkina Faso).

OBJECTIVE: To study the epidemiological and clinical aspects of osteoarthritis (OA) of the hip in Ouagadougou, as well as its risk factors. PATIENTS AND METHODS: This retrospective study covered cases treated over a 3-year period (February 2006 through January 2009) in the internal medicine department of the Yalgado Ouedraogo Teaching Hospital of Ouagadougou (Burkina Faso) and the surgery department of the private hospital Notre-Dame-de la Paix of Ouagadougou. All patients included had OA of the hip that met the Kellgren and Lawrence criteria. RESULTS: There were 46 patients who met the study criteria, but only 40 files could be used. The patients' mean age was 46.4 years ± 15.2 years (range 25-80 years; 10 patients were older than 56 years). Men accounted for more than half (n=23, 57.5%). The mean duration of disease was 6.2 years ± 4.5 years (range: 1-19 years). The right hip alone was concerned in 20 patients (50%), the left hip in 16 (40%), and the OA was bilateral in four (10%). Seventeen patients had sickle cell disease (42.5%), 11 SC and 6 SS. The risk factors included necrosis of the femoral head in 19 cases (59.37%), hip dysplasia in 6 (18.74%), hip trauma in 3 (9.37%), inflammatory arthropathy in 3 more (9.37%), and epiphysitis in one (3.13%). The OA of the hip was primary in 8 cases (20%). Three patients were at stage 1, 9 at stage 2, 15 at stage 3, and 13 at stage 4 according to the Arlet-Ficat classification. CONCLUSION: OA of the hip arises in a young population and is dominated by secondary OA. The dominant risk factor was aseptic necrosis of the femoral head associated with sickle cell disease. In view of the small number of patients with primary OA, no definitive conclusions can be drawn about it.

[Connective tissue diseases in hospital practice in Ouagadougou (Burkina Faso)]. / Les connectivites en pratique hospitalière à Ouagadougou (Burkina Faso).

To describe the semiological and immunological features of connective tissue diseases seen at the Yalgado Ouédraogo University Hospital in Ouagadougou. A retrospective study reviewed the records of patients seen in the hospital dermatology and internal medicine departments from January 1, 2004, through December 31, 2009 and diagnosed with systemic lupus erythematosus (SLE), systemic sclerosis (ScS), dermatopolymyositis (DPM), primary Gougerot-Sjögren disease (GS), polymyositis (PM) or indeterminate connective tissue disease (ICTD) meeting the criteria of the American College of Rheumatology. The study included 42 patients, 36 women and 6 men. Their mean age was 41.2 years ±11.97 (range: 15-75). SLE was the diagnosis for 10 patients, ScS for 14, DPM for 7, primary GS for 1, PM for 1, and ICTD for 9. Hematologic (93%), cutaneous (88%), and rheumatologic (81%) abnormalities were the most frequent manifestations. The specific auto-antibodies associated with SLE patients were: anti-native DNA (3/6), anti-Sm (3/6), anti-RNP (3/6), and anti-SSA (4/6); anti-Scl 70 antibodies were present in 5 patients with ScS. Connective tissue diseases seem to be rare in Africa, south of the Sahara. However, the very fragmentary studies and the weak healthcare coverage do not allow any definitive conclusions.

[Management of end-stage kidney failure: a challenge for the countries of sub-Saharan Africa example of mineral and bone disorders in Burkina Faso]. / Prise en charge de l'insuffisance rénale terminale : un challenge pour les pays de l'Afrique subsaharienne Exemple des désordres minéralo-osseux au Burkina Faso.

INTRODUCTION: Meeting treatment targets for dialysis is a seemingly impossible challenge for most countries of sub-Saharan Africa. To assess this problem, we conducted this study of mineral and bone disorders in subjects undergoing hemodialysis at the Ouagadougou hemodialysis unit, the only such unit in Burkina Faso. PATIENTS AND METHODS: This cross-sectional descriptive study was conducted in January 2010. We included patients on hemodialysis for at least three months who had some minimal predialysis laboratory results available. The KDIGO guidelines served as our reference. Dialysis sessions lasted 5 h and took place once every five days. The statistical analysis of the data was performed with PASW statistical software, version 18 for Windows. RESULTS: The study included 32 of the 53 patients in the unit: 19 men and 13 women with a mean age of 43.5 ± 12.7 years. Their mean serum levels were 2.2 ± 0.2 mmol/L for calcium, 1.4 ± 0.5 mmol/L for phosphorus, 934 ± 887.4 pg/mL for intact parathyroid hormone and 193.4 ± 125.7 IU/L for total alkaline phosphatases. No patient reached the target for all three of the first three indicators. Patients with parathyroid hormone ≥ 800 pg/mL (n = 14) had a serum phosphorus (1.6 ± 0.6 vs 1.2 ± 0.4; p = 0.044) and alkaline phosphatases (287.5 ± 100.5 vs 120.2 ± 90; p < 0.001), significantly higher than those whose parathyroid hormone level was < 800 pg/mL. CONCLUSIONS: The bone and mineral status of our hemodialysis patients is worrisome and is due to suboptimal treatment conditions. The risk of deaths is high. Subsidies sufficient to provide adequate care would reduce these problems, which have, we note, an ethical dimension.

[Vitamin D-deficiency rickets: a case report from Burkina Faso]. / Le rachitisme carentiel: une observation au Burkina Faso.

Deficiency rickets results from a deficiency of vitamin D that is responsible for deficient calcium absorption, leading to failure of bone mineralization and cartilage bone growth, especially in children. We report the case of a 9-year-old girl who shows signs of rickets. Her family history, which includes similar malformations in several family members, led us to suggest vitamin D-resistant rickets, but all laboratory tests and response to treatment indicated deficiency rickets. Prophylaxis, at least for some very poor people, should be proposed for certain populations at risk, even in tropical zones.

[Metabolic disorders and cardiovascular risk factors observed in patients infected by the HIV with antiretroviral therapy in Burkina Faso]. / Troubles métaboliques et facteurs de risques cardiovasculaires chez les patients infectés par le VIH sous antirétroviraux au Burkina-Faso.

The purpose of this descriptive transverse study is to describe metabolic disorders and cardiovascular risk factors in HIV-infected patients undergoing antiretroviral therapy in the day-care unit of the University Hospital of Ouagadougou, Burkina-Faso. A total of 100 patients (Burkinavi cohort) undergoing antiretroviral therapy with a minimum of 42-months of follow-up (October 2005 to Mars 2009) were included. There were 77 females and 33 males with a mean age of 37 years. Most patients, i.e., 95%, were positive for HIV1. Mean body mass index was 22 kg/m2. Mean CD4 count was 280/mm3. Viral load was undetectable in 66 of the 71 patients who underwent viral load testing. Retroviral therapy consisted of the TriomuneR combination (Stavudine + lamivudine + névirapine) at a fixed dose in 27 cases. Cardiovascular risk factors included family history of high arterial blood pressure in 5 patients, smoking in 4, and obesity in 8. During follow-up, seven patients presented hypertension. Metabolic disorders included hyperglycemia (4%), hypertriglyceridemia (17%) and hypercholesterolemia (14%). Lipodystrophia was noted for 6 patients. Despite the short follow-up period, metabolic disorders and cardiovascular risk factors were observed at our patients under antiretroviral therapy.

[Prevalence and risk factors associated with infection by human immunodeficiency virus, hepatitis B virus, syphilis and bacillary pulmonary tuberculosis in prisons in Burkina Faso]. / Prévalences et facteurs associés aux infections a Virus de l'Immunodéficience Humaine et virus de l'épatite B, a la syphilis et a la tuberculose pulmonaire bacillifère en milieu carcéral au Burkina Faso.

This purpose of this study was to determine prevalences and risk factors associated with infection by human immunodeficiency virus, hepatitis B Virus, syphilis and bacillary pulmonary tuberculosis in prisons in Burkina Faso. From February 20 to March 20, 2009, 300 prisoners over 18 years of age held in Ouagadougou were selected to take part in this descriptive and analytical cross-sectional study. Sociodemographic data, confinement information (number, motive and prison time), medical history, substance addiction (alcohol, tobacco, drug), and the other risk behaviors (sexual relations, type of partners, sharing of toiletries or razor) were compiled for each prisoner. Serological tests were performed to detect anti-HIV antibodies, Hbs antigen, and anti-treponema antibody. In prisoners presenting signs of tuberculosis, BAAR detection was performed by direct examination of sputum. Men represented 95% of the study population. Median age was of 30.1 +/- 8.9 years (range, 18 and 63). The prevalences of HIV infection, Hbs antigen and positive syphilitic serology were 5%, 27.3% and 5.7% respectively. Four prisoners (1.3%) had bacillary pulmonary tuberculosis. Two prisoners reported homosexual intercourse and 44 reported drug abuse. Sharing of toiletries and razor blades was reported by 18.7% and 20% of the prisoners respectively. Immediate measures are needed reduce the spread of these infections in prisons in Africa.

[Prevalence and factors associated with low back pain among hospital staff in Ouagadougou (Burkina Faso)]. / Prévalence et facteurs de risque associés à la lombalgie chez le personnel hospitalier à Ouagadougou (Burkina Faso).

OBJECTIVE: The aim of our study was to determine the prevalence, risk factors, associated with low back pain among hospital staff in a developing country. PATIENTS AND METHODS: This transversal study was conducted from March 2007 to February 2008 at Yalgado Ouédraogo Teaching Hospital in Ouagadougou (CHU-YO), Burkina Faso. RESULTS: There were 256 men and 180 women with an average age of 38 +/- 8.25 years (range, 22 to 58). Mean BMI was 25.11 +/- 4.03 Kg/m2. The prevalence of chronic low back pain was 56.4% overall, 47.3% in men and 69.4% in women. Individual risk factors included female sex (p=0.000004), age (p=0.026), and high BMI (p=0.0002). Sports activity appeared to be a protective factor (p=0,035). Professional risk factors were the number of working hours per week (p=0,005) and numbers of guards per month (p=0.014) and posture during work (p=0.01). Analysis of socioprofessional consequences revealed significant impact in 43 (17,5%) patients. The loss work hours in 2007 were estimated to 1020. Three patients had to change working stations due to disability and 82 (19%) reported restricted working capacity. CONCLUSION: The prevalence of low back pain is high among hospital staff of CHU-YO. Preventive measures are needed to reduce socioprofessional consequences.

[Rheumatologic diseases and haemoglobinopathies in Ouagadougou (Burkina Faso)]. / Pathologies rhumatologiques et hémoglobinopathies à Ouagadougou (Burkina Faso).

The purpose of this study is the prevalence of the rheumatologic complications in the sickle cell disease and the associations between haemoglobinopathies and rheumatologic affections. It is a retrospective study from 29 February 2006 to 28 March 2008 conducted in the Internal Department of the University Hospital Yalgado-Ouédraogo. All patients received in the period of study and having an electrophoresis of haemoglobin realized in alkaline pH were included. These patients came from hematologic consultation. Two hundred and seventy-seven patients out of 1451 were included: 142 patients (51.30%) had haemoglobinopathies, including 21 (7.60%) with composite sickle cell disease SC and 17 patients (6.13%) had aseptic necrosis of the femoral head including 7 with haemoglobin SC. The other rheumatologic affections did not have a semiological particularity related to the type of haemoglobin. The prevalence of patients who have haemoglobinopathies is important in rheumatologic practice. The sickle cell disease is strongly associated to osteonecrosis.

[Rheumatic disorders observed in HIV infected patients undergoing highly active antiretroviral therapy (HAART): a 366 case prospective study in Burkina Faso]. / Manifestations rhumatologiques des personnes vivant avec le virus de l'immunodéficience humaine, traitées par antirétroviraux: etude prospective de 366 malades au Burkina Faso.

OBJECTIVE: The purpose of this report is to describe epidemiological aspects of rheumatic disorders observed in HIV-infected patients undergoing highly active antiretroviral therapy (HAART). Patients and methods. This cross-sectional study was conducted from January 1 to June 30, 2008 in the HIV unit of an internal medicine department in Burkina Faso. All patients who had been undergoing HAART for at least one year were included. Interviewing and thorough physical examination were performed in all cases. Radiography of the pelvis and hip was performed in some patients. Bone densitometry was never performed. RESULTS: A total of 366 patients including 265 women and 101 men (sex ratio of 0.38) were included. Mean patient age was 39.61 +/- 8.54 years. Three hundred and thirty-five patients (91.53%) were positive for HIV1, 17 (4.64%) for HIV2 and 14 (3.83%) for both HIV1 and HIV2. Mean duration of infection was 3.58 +/- 1.88 years. Mean CD4 cell count was 394.20 cell/microL. A recent HIV viral load determination was available for 285 patients including 262 who had no detectable virus. Mean duration of HAART was 35.80 +/- 15.17 months. Only 61 patients (16.66%) were treated with protease inhibitor (PI). The prevalence of rheumatic disorders was 5.73% (21 cases). A variety of disorders were observed, i.e., lower back pain in 8 patients (38.1%), arthralgia in 4 patients including 2 treated with PI, osteoarthritis of the knee in 2 patients, Pott disease in 2 patients, De Quervain disease in 2 patients including one treated with PI, tendinitis of the shoulder in one patient treated with PI, gout in one patient treated with PI and unclassifiable inflammatory rheumatism in one patient. No case of symptomatic osteonecrosis or osteoporosis was observed. CONCLUSION: Rheumatic disorders are uncommon in the HIV-infected patients undergoing HAART in Burkina Faso. The most likely explanation is that PI is not widely used.

[Arthropathic and degenerative pathology in rheumatology patients in Burkina Faso]. / Pathologie mécanique et dégénérative en consultation de rhumatologie au Burkina Faso.

OBJECTIVE: The purpose of this report is to describe epidemiologic features of arthrosic and degenerative disorders observed during the first two years of rheumatologic practice in Ouagadougou, Burkina Faso. PATIENTS AND METHODS: The files of all patients examined between March 2006 to February 2008 were reviewed. All patients presenting arthrosic or degenerative disorders were included. RESULTS: Out of 1,439 patients examined during the study period, 1,078 (74.91%) were included. Spine pain accounted for 33.7% of cases, i.e., 485 patients including 306 with lumbago. The mean age in this group was 47.8 +/- 15.19 years and the M/F sex ratio was 0,75. Osteoarthritis represented 20.43% of cases including osteoarthritis of the knee in 18%. The mean age in this group was 54.66 +/- 12.29 years and the M/F sex ratio was 0.23. Aseptic osteonecrosis (AON) of the femoral head was observed in 1.11% of cases, i.e. 16 patients including 8 with sickle cell disease (SC) The mean age in this group was 40.75 years. Abarticular rheumatism accounted for 15.98% of cases, i.e. 230 patients including 118 cases with tendinitis of the shoulder. The mean age in this group was 48.48 years. CONCLUSION: Arthrosic and degenerative disorders observed in this series from Ouagadougou presented the same semiological features as in other African series. Primary osteoarthritis of the hip was uncommon.

[Risk factors associated with osteoarthritis of the knee in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso]. / Facteurs de risque associés à la gonarthrose en consultation de rhumatologie à Ouagadougou (Burkina Faso).

The purpose of this transverse prospective study was to assess risk factors associated with osteoarthritis (OA) of the knee observed in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso. All patients presenting osteoarthritis of the knee diagnosed according to the clinical and radiological criteria of the American College of Rheumatology (ACR) were recruited over a 9-month period from November 2006 to July 2007. A total of 118 patients including 108 women were studied. Mean patient age was 55.7 +/- 10.8 years. Pain and disability scores assessed using theLequesne index were greater than 8 in 87.3% of patients. Hydarthrosis was observed in 56.5% of patients. The most common associated risk factors for development of osteoarthritis of the knee were obesity (42.4%), menopause in women (66.7%), history of OA (43.2%), and previous knee injury (19.5%). The most common associated risk factors for progression of osteoarthritis of the knee were Heberden nodes (19.5%) and genu varum (52.5%). The risk factors for development and progression of osteoarthritis of the knee in the subsahalian population of Ouagadougou are the same as in the Caucasian population of industrialized countries. An unexpected finding in this black African population was the high prevalence of Heberden nodes.

[Lumbar nerve root pain with fever in tropical area: posterior spinal tuberculosis]. / Lomboradiculalgies fébriles en zone tropicale: atteinte tuberculeuse de l'arc vertébral postérieur.

The purpose of this report is to describe the case of tuberculosis osteitis of the posterior vertebral arch in a 35-year-old man with recent history of pulmonary tuberculosis. Clinical findings were pain due to bilateral inflammation of the lumbar nerve roots, fistulised cold abcess and motor deficit in both lower extremities. The tomodensitometry demonstrated a lytic bone lesion involving the spinous process of the second lumbar vertebra in association with spondylitis and a large paravertebral abscess with calcification typical of tuberculosis. Cure was achieved by a single 12-month course of appropriate treatment.

Facteurs de risque associés à la gonarthrose en consultation de rhumatologie à Ouagadougou (Burkina Faso)

L'objectif etait d'etudier la prevalence des facteurs de risque associes a la gonarthrose dans une population noire africaine en consultation de rhumatologie a Ouagadougou. Il s'agit d'une etude transversale prospective menee de novembre 2006 a juillet 2007 soit une periode de neuf mois et portant sur tous les cas de gonarthrose symptomatique recenses pendant la periode d'etude ; tous les malades repondaient aux criteres clinico-radiologiques de l'ACR (American College of Rheumatology). Cent dix-huit malades dont 108 de sexe feminin ont ete colliges. L'age moyen des malades etait de 55;7+/-10;8 ans. Le retentissement fonctionnel apprecie par l'indice de Lequesne etait en moyenne superieur a 8 (87;3des patients). On notait la presence d'une hydarthrose dans 56;7des cas. Les facteurs de risque associes les plus frequents etaient l'obesite (42;4); la menopause chez les femmes (66;7); les antecedents familiaux (43;2); les antecedents de traumatisme du genou (19;5). Les facteurs de risque de progression les plus souvent associes etaient la presence de nodosites d'Heberden (19;5); et un genu varum (52;5). On retrouve dans la gonarthrose; a Ouagadougou en population noire urbaine; les memes facteurs de risque de survenue et de progression qu'en population occidentale ; elle apparait associee; comme dans les series occidentales; aux nodosites d'Heberden dont la rarete presumee chez les noirs semble remise en cause

[Chronic osteomyelitis at the Ouagadougou teaching hospital (Burkina Faso). A retrospective study of 102 cases (1996-2000)]. / Ostéomyélites chroniques au CHU de Ouagadou- gou (Burkina Faso). Etude rétrospective de 102 cas (1996-2000).

This is a retrospective study carried out in the orthopaedic and trauma department of the Yalgado-Ouédraogo teaching hospital. All the patients hospitalized in the service with a chronic osteomyelitis (COM) from March 1, 1996 to March 28, 2000 were included. The frequency of COM was 5.3%. The patients' average age was 17.7 with extremes of 2 and 60 years old. 63.9% were male; 80.7% had fistulized COM. A pathological fracture was observed in 16.9% of the patients. Lower limbs were affected most frequently (65%). Thirty patients (36.1%) had haemoglobin S, among them 22 had a major sickle cell disease. Staphylococcus aureus was present in the majority of the cases (more than 50%). Salmonella were observed among patients carrying haemoglobin S. One case of ceftriaxone-resistance salmonella osteomyelitis was reported. The medico-surgical and orthopaedic treatment was statistically more favourable than a medical or medico-surgical treatment without immobilization.