Détection et contrôle de l'hypertension artérielle dans une communauté péri-urbaine d'Afrique de l'Ouest.

INTRODUCTION: The detection of hypertension in African countries ranges from 15 to 40%, so more than half of hypertensive people are unaware of their condition. In Côte d’Ivoire, very little work on the detection of hypertension exists. PURPOSE OF RESEARCH: The objective was to analyze the detection and control of hypertension in the Ivorian peri-urban environment. RESULTS: Three hundred and sixty (360) participants were interviewed. Among them, 47.8% (172 participants) had their BP measured in the past 12 months. Sixty-seven individuals were classified as hypertensive of whom 30 had already been detected (44.8%). The control of hypertension was 60%. Higher probabilities of detection were associated with participation in physical activity (OR = 3.27 95% CI: 1.08-10.54). CONCLUSIONS: The detection of hypertension, although relatively high in Anonkoi 3, still concerned less than half of the hypertensives. Hence the interest in raising public awareness of systematic screening for hypertension.

Comparative study of the efficacy and tolerability of dihydroartemisinin-piperaquine-trimethoprim versus artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Cameroon, Ivory Coast and Senegal.

BACKGROUND: The ACT recommended by WHO is very effective and well-tolerated. However, these combinations need to be administered for three days, which may limit adherence to treatment.The combination of dihydroartemisinin-piperaquine phosphate-trimethoprim (Artecom®, Odypharm Ltd), which involves treatment over two days, appears to be a good alternative, particularly in malaria-endemic areas. This study intends to compare the efficacy and tolerability of the combination dihydroartemisinin-piperaquine phosphate-trimethoprim (DPT) versus artemether-lumefantrine (AL) in the treatment of uncomplicated Plasmodium falciparum malaria in Cameroon, Ivory Coast and Senegal. METHODS: This was a randomized, controlled, open-label clinical trial with a 28-day follow-up period comparing DPT to AL as the reference drug. The study involved patients of at least two years of age, suffering from acute, uncomplicated Plasmodium falciparum malaria with fever. The WHO 2003 protocol was used. RESULTS: A total of 418 patients were included in the study and divided into two treatment groups: 212 in the DPT group and 206 in the AL group. The data analysis involved the 403 subjects who correctly followed the protocol (per protocol analysis), i.e. 206 (51.1%) in the DPT group and 197 (48.9%) in the AL group. The recovery rate at D14 was 100% in both treatment groups. The recovery rate at D28 was 99% in the DPT and AL groups before and after PCR results with one-sided 97.5% Confidence Interval of the rates difference > -1.90%. More than 96% of patients who received DPT were apyrexial 48 hours after treatment compared to 83.5% in the AL group (p < 0.001). More than 95% of the people in the DPT group had a parasite clearance time of 48 hours or less compared to approximately 90% in the AL group (p = 0.023). Both drugs were well tolerated. No serious adverse events were reported during the follow-up period. All of the adverse events observed were minor and did not result in the treatment being stopped in either treatment group. The main minor adverse events reported were vomiting, abdominal pain and pruritus. CONCLUSION: The overall efficacy and tolerability of DPT are similar to those of AL. The ease of taking DPT and its short treatment course (two days) may help to improve adherence to treatment. Taken together, these findings make this medicinal product a treatment of choice for the effective management of malaria in Africa.