ABSTRACT
Objectifs: Evaluer la prevalence des neuropathies peripheriques et leurs facteurs associes. Methode: Il s'agit d'une etude transversale menee du 1er fevrier au 1er juillet 2011 sur l'ensemble des patients recevant un traitement antiretroviral associant deux inhibiteurs nucleosidiques et un inhibiteur non nucleosidique de la reverse transcriptase. Le diagnostic des neuropathies peripheriques a ete pose sur la base de criteres cliniques. Les facteurs associes etaient representes par l'existence de facteurs de risque connu comme cause de neuropathies peripheriques. La numeration des lymphocytes T CD4 a ete effectuee chez tous les patients.Resultats : L'etude a porte sur 512 personnes. Parmi eux; 157 (30;7) presentaient des neuropathies peripheriques a type de paresthesies (75;2); les sensations de brulure (44;6); les douleurs franches (42;7). L'age avance; l'alcoolisme; l'immunodepression avancee et l'exposition a la stavudine etaient les facteurs. Conclusion : L'incrimination de la Stavudine dans la survenue de cette maladie justifie son retrait des protocoles ARV de premiere ligne
Subject(s)
Academic Medical Centers , Peripheral Nervous System Diseases , Prevalence , StavudineABSTRACT
Although the life expectancy of people living with HIV/AIDS (PLWH) has increased in the past years, they could experience secondary illness such as peripheral neuropathy (PN). Therefore, they need to adapt to chronic disablement which could affect their quality of life (QoL). The research that informed this article aimed at determining the prevalence of PN among adults living with HIV/AIDS and attending the outpatients' clinic at Rutongo Hospital in the Rulindo district of Rwanda. Another aim was to determine these patients' QoL. A cross-sectional descriptive quantitative research design was used. A time-constrained method was used to sample 185 adults living with HIV/AIDS and attending the outpatients' clinic at Rutongo Hospital. The subjective PN screen and the World Health Organization Quality of Life Scale Brief Version were used to collect the data. Data were analysed using the Statistical Package for the Social Sciences. Student's t-test and one-way analysis of variance were performed to determine if significant differences existed between QoL scores in participants with and without PN symptoms. The results indicated that 40.5% of respondents experienced PN. QoL in participants with PN showed significantly lower scores in the physical (p ¼ 0.013) and psychological (p ¼ 0.020) domains when compared with those who did not have PN. These results indicate a high prevalence of neuropathy among PLWH attending the outpatients' clinic at Rutongo Hospital. In addition, patients with neuropathy had lower QoL scores in the physical and psychological domains than those without neuropathy symptoms. The management of PLWH should therefore include interventions to optimise QoL as well as screening for neuropathy symptoms so that sufferers can liaise with their medical providers to find medical and supportive therapies that could assist them
Subject(s)
Acquired Immunodeficiency Syndrome , Carrier State , Chronic Disease , HIV Infections , Hospitals , Medical Assistance , Peripheral Nervous System Diseases , Prevalence , Quality of Life , RwandaABSTRACT
The diabetic foot is the commonest cause of non-traumatic lower extremity amputation in the developed and developing nations. Several risk factors predispose the diabetic patient to foot ulceration and peripheral neuropathy; with peripheral vascular disease are the commonest risk factors. Clinical examination for these risk factors is often inadequate; reasons for the low performance often hinging on the huge patient turnouts in most diabetic units; the cumbersomeness of and time delays associated with detailed clinical assessments and the subjective and sometimes poorly reproducible results associated with these assessments. Aesthesiometry; Bio-Thesiometry and hand-held Doppler ultrasound techniques are quantitative; non-invasive; rapid; reliable and reproducible methods to detect sensory neuropathy and peripheral vasculopathy. Their objectivity and ease of performance make them ideal for mass screening programs. This article recommends a four model risk selection criteria to target diabetic patients at highest risk for foot complications; such that specific preventive programs focus on this group at highest risk and so reduce rate of loss of limbs to diabetes