Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross­sectional study.

Background: The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries. Objectives: To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects. Methods: A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ² test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking. Results: Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent's father (p=0.0001) and mother (p=0.0004). Conclusion: We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority. Study synopsis: What the study adds. The study provides additional data from resource-poor settings such as Burkia Faso, where there is an overall high prevalence of Sisha smoking, and also among students who are poorly informed about the health effects of smoking. Implications of the findings. The data informs advocacy and intervention strategies to combat smoking and decrease overall tobacco use in an African setting.

[Evaluation of the risk of obstructive sleep apnea in patients awaiting general anesthesia in Burkina Faso]. / Évaluation du risque du syndrome d'apnées hypopnées obstructives du sommeil chez des patients en attente d'une anesthésie générale au Burkina Faso.

INTRODUCTION: General anaesthesia and surgery increase morbidity and mortality in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) who are not known to have OSAHS and therefore not treated before surgery. The objective of this study is to evaluate the risk of OSAHS using the STOP-BANG questionnaire (SBQ) in patients undergoing general anaesthesia in Burkina Faso. MATERIAL AND METHOD: This is a cross-sectional study concerning patients having received pre-anaesthetic consultation from 1st July 2020 to 30th June 2021. Risk of OSAHS is considered "medium to high" when the risk of obstructive sleep apnea is medium or high on SBQ. RESULTS: Our population consisted in 599 persons. A medium to high risk of OSAHS was found in 11.18%. The ASA score and the Mallampati scale were independently associated with moderate to high risk of OSAHS (P<0.001; P<0.001). ASA score of I and Mallampati class of I decreased the risk of OSAHS by 17 and 45% respectively (P=0.012; P=0.031). CONCLUSION: The risk of OSAHS in this population is comparable to that of the general population. Confirmation of OSAHS by ventilatory polygraphy or polysomnography would help to achieve further precision.

[Availability and affordability of diagnosis and treatment for asthma and COPD in Ouagadougou, Burkina Faso]. / Disponibilité et accessibilité financière aux moyens diagnostiques et thérapeutiques de l'asthme et de la bronchopneumopathie chronique obstructive dans la ville de Ouagadougou, Burkina Faso.

INTRODUCTION: Chronic respiratory diseases, particularly asthma and Chronic Obstructive Pulmonary Disease (COPD), pose a significant threat to public health. This study aims to determine the accessibility and affordability of means of diagnosis and treatment. METHODS: This was a cross-sectional study covering the period from August to December 2021 in Ouagadougou, Burkina Faso. This study involved 107 health centers and 135 pharmacies. The World Health Organization/Health Action International definition was used as a benchmark for accessibility to medicines. RESULTS: Out of 107 health centers, 29 (27.1%) had a spirometer. The average cost of spirometry represented 19.88 days of salary for a patient paid at the minimum wage. The most widely available drugs were salbutamol in a pressurized metered dose inhaler (pMDI) (88.1%) and prednisone 20mg tablet (87.4%). No disease-modifying drug was available in public pharmacies. Affordable drugs were salbutamol 4mg tablet and aminophylline 100mg tablet. CONCLUSION: The means of diagnosis and treatment of asthma and COPD are insufficiently available, especially in the public sector, which is characterized by a nearly total absence of basic treatment.

Prevalence of COPD among women and relation with cooking fuel choice in Ouagadougou, Burkina Faso.

BACKGROUND: According to the WHO, chronic obstructive pulmonary disease (COPD) will become the third leading cause of death by 2030. In sub-Saharan Africa, the burden of the disease is unknown. We assessed the prevalence and the factors associated with COPD and chronic bronchitis among women in charge of household cooking.METHODS: A cross-sectional population survey was conducted. We randomly selected women aged ≥18 years in charge of cooking in their household. COPD was defined as post-bronchodilator FEV1/FVC (forced expiratory volume in 1 sec/forced vital capacity) ratio of <0.70; chronic bronchitis was defined as cough with sputum of at least 3 months in the year for at least 2 consecutive years.RESULTS: Of the 1705 women interviewed, 835 were selected to perform spirometry and 564 provided an acceptable test result. The prevalence of COPD was 1.1% and that of chronic bronchitis was 1.2%. COPD prevalence was higher among women using biomass, women aged >40 years, those had been cooking or had been exposed to toxic gases for more than 30 years. After adjustment, only biomass fuel use and exposure to toxic products were found to be associated with COPD.CONCLUSION: Urgent action is need to accelerate the transition to the other sources of energy.

Prevalence of obstructive sleep apnoea in sleep consultations in Burkina Faso: Implications for monitoring.

BACKGROUND: Obstructive sleep apnoea syndrome (OSAS) is the most common respiratory disorder related to sleep. Its prevalence in developed countries varies from 3% to 28%. In several African countries, including Burkina Faso, this syndrome is still under-diagnosed and goes largely untreated. It is necessary to conduct studies in different contexts to determine the characteristics and develop the strategies for management of OSAS. OBJECTIVES: To determine the prevalence of OSAS in Burkina Faso. METHODS: This prospective study recruited 106 patients coming for consultation for sleep disorders at the Yalgado Ouedraogo University Hospital Center, who responded to a self-questionnaire and were diagnosed by respiratory polygraphy. RESULTS: A total of 77 patients (72.6%) had OSAS. The male to female ratio was 1.4:1 and the mean (standard deviation) age was 47.8 (12.8) years. The majority of the patients (53.8%) were obese. The main reason for consultation was snoring (84%), followed by hypopnea-apnoea reported (59.4%) and daytime sleepiness (45.3%). The most common comorbidity factor was hypertension (50%), followed by decreased libido (16%) and diabetes (13.2%). A continuous positive-pressure (CPAP) machine was prescribed to 51.25% of the patients, but only 22% were able to acquire it. CONCLUSION: The monitoring of OSAS is relatively new in Burkina Faso. This study showed the profile of patients with OSAS and difficulties in accessing continuous positive airway pressure (CPAP) devices for treatment.

Prevalence of symptoms of sleep apnoea syndrome in Burkina Faso.

INTRODUCTION: Sleep apnoea syndrome (SAS) is a frequent and underdiagnosed pathology. Epidemiological studies in sub-Saharan Africa are few. Our study aimed to determine the prevalence of SAS symptoms in an adult population in Burkina Faso. METHODS: A cross-sectional study whose data collection took place at the Yalgado Ouédraogo Teaching Hospital, from 1 September to 31 October 2014. We randomly enrolled all subjects aged at least 25 accompanying an outpatient t the time of a visit. A strong suspicion of SAS was established for every combination of ordinary snoring with excessive daytime sleepiness and/or sleep apnoea. RESULTS: The study included 311 subjects - 181 men and 130 women. The mean (standard deviation (SD)) age was 31.84 (8.25) years and the average (SD) BMI was 23.14 (3.67) kg/m². The prevalence of excessive daytime sleepiness, snoring and sleep apnoea was 4.5%, 26% and 9.6%, respectively. A strong suspicion of SAS was found in 9.6% of respondents and the risk factors associated with this strong suspicion were BMI≥25 kg/m² (odds ratio (OR) 2.7; p=0.012), and poor-quality sleep (OR 3.7; p<0.001). CONCLUSION: A significant proportion of our sample had symptoms suggestive of SAS. Testing with either respiratory polygraphy or polysomnography should be proposed to the presumptive cases for early diagnosis and treatment.

[A case of malformation of aortic arches simulating asthma]. / Un cas de malformation des arcs aortiques simulant un asthme.

INTRODUCTION: Abnomalies of the aortic arches are rare and account for 1% of congenital cardiovascular malformations. They constitute one of the causes of compression of the airways with attacks of dyspnea sometimes simulating an asthma. We report the case of an infant with an anomaly development of aortic arches with impact breathing. CASE REPORT: It was a 22-month-old infant who consulted for a dyspnea with a type of stridor associated with a fat cough. This clinical table started 45 days after its birth and led to many hospitalizations in the pediatric emergency. Clinical exam found polypnea, with a wheezing, bronchial groan and diffuse sibilants on the auscultation. The chest X-ray revealed a slightly retractile right lung. The angioscanner of the thoracic and abdominal aorta showed a double aortic arch with retro-oesophageal left ventricular artery. A thoracotomy was performed and the operative sequences were simple. CONCLUSION: The congenital anomalies of the aortic arch are rare and varied, sometimes asymptomatic. This case reminds us that, in front of any recurrent or digestive respiratory signs in the infant, malformation of the aortic arches should be considered.

Obstacles to the implementation of directly observed treatment in Ouagadougou, Burkina Faso.

SETTING: Five tuberculosis (TB) diagnosis and treatment centres in Ouagadougou, Burkina Faso. OBJECTIVE: To identify obstacles to the direct observation of anti-tuberculosis treatment (DOT) so that it can be adapted to local contexts. DESIGN: A cross-sectional study conducted between August and September 2002 among new and retreatment TB cases in the initial phase of treatment. Information and suggestions were collected on obstacles encountered in DOT. RESULTS: Among 74 patients interviewed, the main difficulties were the lack of assiduity among health personnel, the daily travel, the long distances, the high transportation costs and the high number of tablets. The main suggestions were a reduction in the number of tablets taken at a time, decentralisation of places where tablets are to be taken and weekly provision of drugs. CONCLUSION: Obstacles to DOT should be addressed to optimise the effectiveness of anti-tuberculosis treatment.

[Multidrug resistant tuberculosis among health personnel in Côte d'Ivoire]. / Tuberculose multirésistante chez le personnel de santé en Côte d'Ivoire.

UNLABELLED: Multidrug resistance tuberculosis (MDR-TB) of health workers raises the question of hospital-borne transmission of infection. OBSERVATIONS: We report 4 cases of MDR-TB confirmed at the health workers over a period of 8 years (January, 2005 to December 2012), in the 2 services of pulmonology from Abidjan to Côte d'Ivoire). It was about young grown-up patients (aged between 28 and 39 years), all HIV negatives, in a no-win situation of antituberculosis treatment (3 patients/4). The most concerned staffs were the male nurses (2/4). Two agents worked in general hospital and the only one in a pulmonology department at the time of the diagnosis. The tuberculosis was of lung seat with bilateral radiographic hurt (3/4) and multiples excavations (4/4). The case index, when it was identified (2/2), was a family case. Among 3 agents who benefited from a second line treatment, 1 died further to an extensive drug resistance and 2 are declared to be cured. The fourth died before the beginning of the treatment. These cases of cure were in touch with a premature care. CONCLUSION: Multidrug resistant tuberculosis at the health workers could have a negative impact on the antituberculosis fight imposing rigorous measures of infection control and better implication of the occupational medicine.

[Survival of malignant and paramalignant pleural effusions in Ouagadougou]. / Survie des pleurésies malignes et paramalignes à Ouagadougou.

This study aimed to present the survival of patients with malignant and paramalignant pleural effusion (MPE) in a context of resource-limited countries. We retrospectively studied patients received for malignant and paramalignant pleural effusion in three health facilities in Ouagadougou from 1st August 2009 to 30 July 2015. Survival was analyzed according to various characteristics related to patients and disease. Eighty patients with a mean age of 54 years were selected. The sex-ratio was 0.9. Sixteen patients had comorbidities. Pleural effusion was revealing, synchronous and metachronous in respectively 55 %, 26.3 % and 17.5 % of cases. Lung cancer was the most common cause of MPE (27.5 %), followed by breast cancer (18.7 %). The median overall survival was 3 months; it varied between primary cancers: 5 months for primary cancer unknown, 4 months for lung cancers and 2 months for breast cancers. Sex and the presence of comorbidities were independent factors influencing survival of patients. In this study, patient survival length is strongly compromised by inadequacies of medical technical equipment.

[Inventory of fixtures on the tolerance of the treatment) of the resistant multi-tuberculosis (Burkina Faso)]. / Etat des lieux sur la tolerance du traitement de la tuberculose multi resistante (Burkina Faso).

OBJECTIVES: Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo. PATIENTS AND METHODS: It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included. RESULTS: 71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness. CONCLUSION: The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

OBJECTIFS: Apprécier la tolérance des antituberculeux prescrits dans le traitement de la tuberculose multi résistante chez les patients suivis dans le service de Pneumologie du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU YO). PATIENTS ET MÉTHODES: Il s'est agi d'une enquête longitudinale rétrospective et prospective. Les dossiers des patients ont permis de renseigner le questionnaire pour la phase rétrospective (2010­2011), le suivi des patients durant la phase prospective (2011­2013) a permis la collecte des données. Etaient inclus tous les patients sous traitement antituberculeux de 2ème ligne entre le 1er Janvier 2010 et le 31 Aout 2013. RÉSULTATS: Au total 71 cas de tuberculose multi résistante (TB-MDR) ont été recrutés. Le sex- ratio était 3,4. La tranche d'âge de 30 à 39 était la plus représentée (39,4%). Une notion de contage tuberculeux a été retrouvée chez 18 (25,3%) des patients. Tous les patients TB-MR avaient des antécédents de traitement incluant des aminosides de durée supérieure à 2 mois. L'intolérance au traitement a été rapportée chez 57 patients. Elle prédominait chez les 30 à 39 ans et chez les sujets co-infectés Tuberculose/VIH. Les atteintes neurologiques (47,9%) et psychiatriques (47,9%) étaient les plus représentées. L'atteinte vestibulo-cochléaire était de 42,3% avec 18,3% de surdité totale. CONCLUSION: L'intolérance du traitement antituberculeux de deuxième ligne est un véritable hantise pour le clinicien. Des régimes plus courts éviteraient certainement des modifications thérapeutiques à l'origine de survenue d'échecs.

[Attitude of private pharmacists in the dispensation of asthma drugs]. / Attitude du pharmacien d'officine dans la dispensation des médicaments de l'asthme.

INTRODUCTION: Despite recommendations, asthma remains poorly controlled in many countries. Asthmatic patients see pharmacy staff regularly to obtain medications. The aim of this study was to evaluate the attitude of pharmacists in Burkina Faso about dispensing asthma drugs. METHOD: A self-administered anonymous questionnaire was used to collect data in a descriptive cross-sectional study related to pharmacists' attitudes in the management of asthma in the city of Ouagadougou (November 2010-June 2011). RESULTS: The rate of participation of pharmacists in the study was 82.4%. Of the pharmacists surveyed, 70.1% reported having received asthma patients both during acute asthma exacerbations and when stable. Only 9% of pharmacists insisted on a prescription when asthma patients came to the pharmacy without one. A total of 73.6% of pharmacists explained and demonstrated how to use the spray to the patients. Among pharmacists who demonstrated how to use devices, only 6.7% actually checked patients' technique. Inhaler technique demonstration was done verbally in 68.8% of case. Among pharmacists, 34.5% reported a good mastery of inhaler techniques. CONCLUSION: The techniques for dispensing asthma drugs are not well established among pharmacists and therefore the provision of continuous medical education to pharmacists is important.

[State of tolerance of multi resistant tuberculosis treatment (Burkina Faso)]. / Etat des lieux sur la tolerance du traitement de la tuberculose multi resistante (Burkina Faso).

OBJECTIVES: Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo. PATIENTS AND METHODS: It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included. RESULTS: 71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness. CONCLUSION: The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

OBJECTIFS: Apprécier la tolérance des antituberculeux prescrits dans le traitement de la tuberculose multi résistante chez les patients suivis dans le service de Pneumologie du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU YO). PATIENTS ET MÉTHODES: Il s'est agi d'une enquête longitudinale rétrospective et prospective. Les dossiers des patients ont permis de renseigner le questionnaire pour la phase rétrospective (2010­2011), le suivi des patients durant la phase prospective (2011­2013) a permis la collecte des données. Etaient inclus tous les patients sous traitement antituberculeux de 2ème ligne entre le 1er Janvier 2010 et le 31 Aout 2013. RÉSULTATS: Au total 71 cas de tuberculose multi résistante (TB-MDR) ont été recrutés. Le sex-ratio était 3,4. La tranche d'âge de 30 à 39 était la plus représentée (39,4%). Une notion de contage tuberculeux a été retrouvée chez 18 (25,3%) des patients. Tous les patients TB-MR avaient des antécédents de traitement incluant des aminosides de durée supérieure à 2 mois. L'intolérance au traitement a été rapportée chez 57 patients. Elle prédominait chez les 30 à 39 ans et chez les sujets co-infectés Tuberculose/VIH. Les atteintes neurologiques (47,9%) et psychiatriques (47,9%) étaient les plus représentées. L'atteinte vestibulo-cochléaire était de 42,3% avec 18,3% de surdité totale. CONCLUSION: l'intolérance du traitement antituberculeux de deuxième ligne est un véritable hantise pour le clinicien. Des régimes plus courts éviteraient certainement des modifications thérapeutiques à l'origine de survenue d'échecs.

[Contribution of bronchial fibroscopy in pneumonology services in developing countries]. / Apport de l'endoscopie bronchique dans un service de pneumologie d'un pays en développement.

Bronchial fibroscopy is a recent investigation method that requires equipment and facilities difficult to implement in respiratory diseases units in developing countries. In Burkina Faso, this technique was introduced for the first time in February 1997. The purpose of this study was to determine the contribution of bronchial fibroscopy for the diagnosis of respiratory disease in countries with limited resources. This study was conducted between February 1997 and October 1998 at the respiratory diseases unit of the Yalgado Ouedraogo National Hospital Center in Ouagadougou, Burkina Faso. Thirty-five cases of tuberculosis were diagnosed, including 29 cases with bronchial node involvement, where bronchial fibroscopy is an essential diagnostic examination, and 6 cases of bacteriologically proven pulmonary tuberculosis. Ten cases of lung cancer were diagnosed (40% squamous cell carcinoma). Malignant disease is a reality in developing countries despite low rates of diagnosis due to insufficient diagnostic facilities. For tuberculosis, the importance of specific treatment is certainly well established and should always be initiated, even if fibroscopy cannot be performed. This contrasts with the situation for malignant disease, where the high prevalence of lung cancer (9.9% of the bronchial fibroscopies performed) is associated with total lack of treatment due to the absence of a thoracic surgery unit or a radiotherapy unit, and the impossibility of providing satisfactory surveillance of anti-cancer chemotherapy.

[Primary pulmonary myxoid liposarcoma discovered fortuitously]. / Liposarcome myxoïde pulmonaire primitif de découverte fortuite.

We report a fortuitous discovery of primary pulmonary myxoid liposarcoma in an HIV-positive patient. Primary pulmonary localizations are uncommon. Generally, pulmonary localizations are metastatic. There is a male predominance and diagnosis is generally made around 40 years of age. The two main features of liposarcoma are the large tumor size and the complex histology that evolves over time. Pathology findings are rarely reproducible and vary from one pathologist to another. Macroscopically, liposarcomas can mimic benign tumors. The risk of recurrence is high after simple enucleation due to microscopic extracapsular extensions. Surgery remains the predominant treatment. Wide complete excision, if possible, provides long-term survival.

[Caseous pneumonia in a 14-month-old infant]. / Pneumonie caséeuse chez un nourrisson de 14 mois.

We report a case of caseous pneumonia in a 14-month-old HIV-negative infant. This clinical picture is usually observed in healthy young adults, rarely in infants. The clinical and radiological signs of caseous pneumonia often simulate acute non-tuberculous respiratory disease. Bacteriological confirmation is required, but the diagnosis can be suggested in case of a pulmonary syndrome with no bacterial isolate and unresponsive to well-conducted antibiotic therapy. The clinical course is rapid with caseous involution of the lung. Early diagnosis is required for specific curative treatment and to limit sequelae.

[Active tuberculosis in a patient with Hodgkin's disease. A case report]. / Tuberculose évolutive associée à une maladie de Hodgkin. A propos d'un cas.

We report a case of active tuberculosis in a patient with Hodgkin's disease. The two diagnoses were established simultaneously at the Respiratory Disease Unit of the Yalgado National Hospital, Burkina Faso. The clinical presentation was misleading as the signs and symptoms of the two disease are similar. Certain diagnosis was established after isolation of tuberculosis bacilli and histocytology findings for Hodgkin's disease. Both diseases are potentially curable. The clinical course depends on early diagnosis and treatment.

[Bronchopulmonary Kaposi's disease in 2 AIDS patients living in a zone of high tuberculosis/HIV prevalence]. / Kaposi broncho-pulmonaire au cours du SIDA en zone de forte prévalence tuberculeuse/VIH. A propos de deux cas.

The epidemic form of Kaposi's disease, called Kaposi-AIDS, was first described in 1981 by Hymmes in two young AIDS patients. Lung lesions are observed in 10 to 45% of patients with cutaneous Kaposi and are the second leading localization of visceral involvement after the digestive tract. Diagnosis and management of these visceral forms remains difficult. We report two cases of broncho-pulmonary Kaposi-AIDS in two patients treated for cutaneous Kaposi's disease. The diagnosis was made on the basis of epidemiological, clinical, biological, radiological, endoscopic, and histological evidence. The diagnosis was achieved by elimination after ruling out all other opportunistic diseases with pulmonary tropism. The fear of miliary tuberculosis remains strong in zones with a high prevalence of tuberculosis. Despite considerable improvement with antiretroviral drugs, especially antiproteases, outcome remains unpredictable with or without specific treatment.

[Well-digger's lung in Mali during the decade of 2001-2010]. / Poumon de puisatier au Mali pendant la décennie 2001-2010.

INTRODUCTION: The well-digger is a craftsman who hollows wells often manually; this trade can be source of inhalation of the particles of silica. The whole of the radio clinical signs linked to this profession is known under the term "Well-digger's lung". The goal was to study the radio clinical aspects and progression in black African's pulmonological environment. METHODS: Retrospective and descriptive study concerning the respiratory involvement of well-diggers in the Pulmonology service of the Teaching Hospital of Bamako, from January 2001 to December 2010. The admission registers were used as data verification support. RESULTS: Among 4158 admissions for lung affection, we have collected 39 cases of well-digger's lung (0.9%), all young male adults. The average of exposition period was 13 ± 9 years, correlated to the patient's age (p<0.001). The principal reason of consultation was dyspnea (94.8%). The complications were frequent (cardiac, infectious, pleural). The radiological pictures were made of bilateral big opacities associated with small opacities. The evolution was unfavorable in the majority of the cases. CONCLUSION: The well-digger's lung is a young adult pneumoconiosis linked to the inhalation of the particles of silica during the trade (profession) of well-digger that complicates frequently in chronic respiratory insufficiency.