[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.

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.

[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.

Profil épidémioclinique et issue thérapeutique des patients hospitalisés pour COVID-19 au Centre Hospitalier Universitaire Sourô Sanou de Bobo Dioulasso Burkina Faso / Clinical presentation and outcome of patients hospitalized for COVID-19 at the Sourô Sanou University Teaching Hospital of Bobo Dioulasso (Burkina Faso)

Objectif. L'apparition de plusieurs cas de pneumopathie d'origine inconnue en Chine a conduit à l'identification du SARS-CoV-2. L'objectif de ce travail était de décrire le profil épidémioclinique et évolutif des patients hospitalisés dans notre centre de prise en charge afin de contribuer à l'amélioration de la lutte contre cette pandémie. Population et Méthodes. Il s'est agi d'une étude de cohorte rétrospective qui s'est déroulée du 19 mars au 31 septembre 2020 au CHUSS de Bobo Dioulasso. Résultats. Au total, 44 patients ont été inclus dans l'étude. La moyenne d'âge des patients était de 46,8 ans [14-84 ans]. Le sex ratio était de 0,7. La tranche d'âge la plus représentée était celle 50 et 64 ans avec 38,4% des patients. Les patients diabétiques et hypertendus représentaient respectivement 25% et 29,5% des cas. Les principaux symptômes étaient la dyspnée, la fièvre et la toux notées respectivement chez 54,5%, 54,5 % et 47,7% des cas. A la radiographie thoracique, les opacités de type micronodulaire étaient les plus représentées dans 66,7% des cas. L'oxygénothérapie a été nécessaire dans 38,6% des cas. Le protocole Covid-19 en vigueur dans le pays était instauré chez 90,9% des cas. Avec une durée d'hospitalisation moyenne de 12,4 jours, l'évolution clinique a été marquée par un décès chez 22,7 % des cas. Conclusion. Dans notre contexte, cette maladie reste l'apanage des sujets âgés présentant des comorbidités. L'une de difficultés de sa prise en charge était l'insuffisance du plateau technique expliquant en grande partie ce fort taux de létalité.

Objective. The occurrence of several cases of pneumonia of unknown origin in China led to the identification of SARS-CoV-2. The aim of this study was to describe the epidemiological and clinical profile of patients admitted to our care center to contribute to the improvement of the control of this pandemic. Population and methods. This was a retrospective cohort study which took place from 19 March to 31 September 2020 at the CHUSS of Bobo Dioulasso. Results. A total of 44 patients were included in the study. The mean age of the patients was 46.8 years [14- 84 years]. The sex ratio was 0.7. The most represented age group was 50-64 years with 38.4% of patients. Diabetic and hypertensive patients represented 25% and 29.5% of the cases respectively. The main symptoms were dyspnea, fever and cough, which were noted in 54.5%, 54.5% and 47.7% of cases respectively. On chest X-ray, micronodular opacities were the most common in 66.7% of cases. Oxygen therapy was required in 38.6% of cases. The Covid-19 protocol in force in the country was implemented in 90.9% of cases. With an average hospital stay of 12.4 days, the clinical course was marked by death in 22.7% of cases. Conclusion. In our context, this disease remains the prerogative of elderly subjects with comorbidities. One of the difficulties of its management was the insufficiency of the technical platform explaining in large part this high rate of lethality.

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.

Assessment of asthma control in pulmonary consultation in Ouagadougou, Burkina Faso

Background: Despite the recommendations now in force for the management of asthma, evidence suggests that many asthmatic patients still have their disease uncontrolled. Objective: to assess asthma control and to identify the fac-tors associated with uncontrolled disease among the patients received for consultation in the department of Pneumology in Ouagadougou, Burkina Faso.Patients and methods: We conducted a cross-sectional study from 02/01/2015 to 01/31/2016 in the department of Pneu-mology of Yalgado Ouedraogo University Hospital in Oua-gadougou. All asthma patients seen during this time frame participated in this study. The 2014 GINA criteria were used to assess the asthma control status.Results: One hundred and two asthmatic patients were in-cluded (76 women and 26 men) with a mean age of 38.7 ± 18.6 years. Asthma was found to be well controlled in 26.5% of cases, partially controlled in 34.3% of cases and uncontrolled in 39.2% of cases. The following factors were found to be associated with an uncontrolled asthma: age >36 years (p = 0.002), low level of education (p = 0.04), allergic rhinitis (p = 0.01), overweight (p = 0.03), duration of asthma ≥ 10 years (p = 0.04), therapeutic non-compliance (p = 0.00).Conclusion: Asthma was insufficiently controlled in our study. A tremendous emphasis must be put on not only on the therapeutic education of asthma patients, but also on a better management of comorbiditie

[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.

[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.

[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.

[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.

Les cancers broncho-pulmonaires primitifs à Ouagadougou

Le cancer bronchique primitif est la deuxieme cause de mortalite dans le monde apres les pathologies cardiovasculaires. En Afrique; l'introduction de l'endoscopie a entraine l'augmentation de son 'incidence. Pour avoir une recente idee sur cette affection; nous avons decide de mener une etude retrospective et descriptive a Ouagadougou du 1er janvier 2002 au 31 decembre 2011. Ainsi avons-nous observe une preponderance masculine et un age moyen de 58 ans. La consommation moyenne de tabac a ete evaluee a 15 paquets-annee. Il y avait une predominance de l'atteinte de l'arbre bronchique droit et du carcinome epidermoide. La place du tabagisme a encore ete confirmee comme facteur etiologique

[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.

[Actor of health in Asthmatic patients management in Burkona Faso]. / Acteurs de sante dans la prise en charge de l'Asthme au Burkina Faso.

OBJECTIVE: Identify the obstacles with the best coverage of the patient asthmatic by the actors of the health in Ouagadougou. METHOD: Transverse Study with descriptive aim from January till December 2012, associated with a review of the literature concerning the role of the actors of health in the coverage of the asthma. RESULT: the technique of demonstration of the grip of the spray measuring glass was known to 46 % of the doctors. A medical prescription was required by 9 % of the pharmacists before the delivery of medicine asthmatic. The check of the conformity of the prescription was made by 30 % of the pharmacists, the demonstration of the grip of the spray measuring glass to the pharmacy was assured by 73,6 % of the pharmacists and mastered well by 34,5 %.Within the framework of the treatment of the asthma, 43,2 % of the male nurses knew that ß2-mimetic and corticoids were the most used medicine. ß2-mimetic inhaled by quick action was recommended by 40,6 % of the male nurses in the occasional asthma, this prescription is not in compliance with the recommendations of GINA. CONCLUSION: A need for training / recycling is expressed by almost all of the actors of health occurring in the coverage of the asthma in Burkina Faso.

OBJECTIF: Identifier les entraves à la meilleure prise en charge du patient asthmatique par les acteurs de la santé à Ouagadougou. MÉTHODE: Etude transversale à visée descriptive de Janvier à décembre 2012, associée à une revue de la littérature portant sur le rôle des acteurs de santé dans la prise en charge de l'asthme. RÉSULTAT: La technique de démonstration de la prise de l'aérosol doseur était maitrisée chez 46% des médecins. Une ordonnance médicale était exigée par 9% des pharmaciens avant la délivrance des médicaments asthmatiques. La vérification de la conformité de la prescription médicale était faite par 30% des pharmaciens, la démonstration de la prise de l'aérosol doseur à l'officine était assurée par 73,6% des pharmaciens et bien maîtrisée par 34,5%. Dans le cadre du traitement de l'asthme, 43,2 % des infirmiers savaient que les bronchodilatateurs et les corticoïdes étaient les médicaments les plus utilisés. Les bronchodilatateurs inhalés d'action rapide étaient recommandés par 40,6 % des infirmiers dans l'asthme intermittent, cette prescription n'est pas conforme aux recommandations de la GINA. CONCLUSION: Un besoin de formation/recyclage est exprimé par la quasi-totalité des acteurs de santé intervenant dans la prise en charge de l'asthme au Burkina Faso.

[Pulmonary tuberculosis: knowledge, beliefs and practices of tubercular patients' carers in Ouagadougou]. / Tuberculose pulmonaire: connaissances, croyances et pratiques des accompagnateurs des patients tuberculeux a Ouagadougou.

OBJECTIVE: Describe the knowledge, beliefs and practices on tuberculosis of tubercular patients' carers in Ouagadougou. METHODS: A prospective descriptive transversal study was carried out. Participants were sourced from the four Centers of Diagnosis and Treatment, the National Center for the Fight Against Tuberculosis and the department of Pneumology of the Yalgado Ouédraogo University hospital. The recruitment was exhaustive and included the carers of tubercular patients (pulmonary tuberculosis with positive microscopy). RESULTS: The average age of the carers was 36 years ± 14, with a majority of them bring male. In 33.7% of the cases the carer was a sibling and not schooled in 45.2%. A good understanding of tuberculosis was found at 20.2 % of the carers. Among the subjects which had a good understanding, 71.4 % were schooled and 88.1% came from an urban environment. Understanding tuberculosis is associated with academic level. Knowledge of the modes of contamination of tuberculosis was low (48,1%). Among the carers, 37% did not know that the tubercular patient should not be isolated by their circle of acquaintances, 19.2% assured the supervision of medicine intake. Respectively, 1.4% and 5.8% believe that tuberculosis is associated with witchcraft and divine punishment. Approximately two thirds of the carers refused to share the same dish as the tubercular patient. CONCLUSION: An insufficient general knowledge of tuberculosis emerges from our work and modes of contamination. The beliefs and behavioral practices of the carers towards the tubercular patients tend to increase the stigmatization of tuberculosis.

OBJECTIF: Décrire les connaissances, croyances et pratiques sur la tuberculose des accompagnateurs des patients tuberculeux à Ouagadougou. MATÉRIELS ET MÉTHODES: Étude transversale prospective à passage unique et à visée descriptive. Les sites de recrutement étaient représentés par les quatre Centres de Diagnostic et de Traitement, le Centre National de Lutte Anti Tuberculeuse et le service de Pneumo-phtisiologie du Centre Hospitalier Universitaire Yalgado Ouédraogo. Le recrutement a été exhaustif et a concerné les accompagnateurs des patients tuberculeux. RÉSULTATS: L'âge moyen des accompagnateurs était de 36 ans ± 14, une prédominance masculine a été observée. Ils étaient dans 33,7% des cas représentés par la fratrie (frère et/ou sœur) et non scolarisés dans 45,2%. Une bonne connaissance de la tuberculose était retrouvée chez 20,2% des accompagnateurs. Parmi ceux qui avaient une bonne connaissance, 71,4 % étaient scolarisés et 88,1% provenaient du milieu urbain. La connaissance de la tuberculose était associée au niveau d'instruction. La connaissance des modes de contamination de la tuberculose était faible (48,1%). Parmi les accompagnateurs 37% ne savaient pas que le tuberculeux ne devrait pas être isolé de l'entourage, 19,2% assuraient la supervision des prises des médicaments. Respectivement 1,4% et 5,8% d'entre eux croyaient que la tuberculose relevait de la sorcellerie et d'une punition divine. Environ deux tiers des accompagnateurs refusaient de partager le même plat avec le patient tuberculeux. CONCLUSION: Une insuffisance des connaissances générales sur la TB et des modes de contamination a été observée. Les croyances et pratiques comportementales des accompagnateurs vis-à-vis des patients tuberculeux tendent à stigmatiser d'avantage la tuberculose.

Acteurs de sante dans la prise en charge de l'asthme au Burkina Faso

Objectif : Identifier les entraves a la meilleure prise en charge du patient asthmatique par les acteurs de la sante a Ouagadougou. Methode: Etude transversale a visee descriptive de Janvier a decembre 2012; associee a une revue de la litterature portant sur le role des acteurs de sante dans la prise en charge de l'asthme. Resultat: La technique de demonstration de la prise de l'aerosol doseur etait maitrisee chez 46 des medecins. Une ordonnance medicale etait exigee par 9 des pharmaciens avant la delivrance des medicaments asthmatiques. La verification de la conformite de la prescription medicale etait faite par 30 des pharmaciens; la demonstration de la prise de l'aerosol doseur a l'officine etait assuree par 73;6 des pharmaciens et bien maitrisee par 34;5. Dans le cadre du traitement de l'asthme; 43;2 des infirmiers savaient que les bronchodilatateurs et les corticoides etaient les medicaments les plus utilises. Les bronchodilatateurs inhales d'action rapide etaient recommandes par 40;6 des infirmiers dans l'asthme intermittent; cette prescription n'est pas conforme aux recommandations de la GINA. Conclusion : Un besoin de formation/recyclage est exprime par la quasi totalite des acteurs de sante intervenant dans la prise en charge de l'asthme au Burkina Faso

[Knowledge, attitudes and practices of general practitioners about asthma in the city of Ouagadougou]. / Connaissances, Attitudes Et Pratiques Des Medecins Generalistes Sur L'Asthme A Ouagadougou.

INTRODUCTION: In spite of a better understanding of the physiopathology of asthma and the existence of effective molecules, morbidity and mortality of asthma across the world are constantly increasing. International guidelines are not apparently applied. This study intended to assess the knowledge, attitudes and practices of general practitioners on asthma in Ouagadougou. METHODS: This was a cross-sectional anonymous self-administered questionnaire involving 93 General Practitioners practicing in Ouagadougou. RESULTS: The participation rate was 63.4% or 59 respondents. The majority of General Practitioners (88%).know the chronic nature of asthma and 61% of them had good knowledge of severe asthma signs. The post-exercise asthma and medication asthma were known respectively by 22% and 15% of General Practitioners. Knowledge of the technique of using pressurized metered dose inhalers was bad in 54% of General Practitioners. In intermittent asthma, 52.5% of General Practitioners prescribed steroids including 27% in oral form. Inhaled corticosteroids were associated with ß2-agonists by 34% of General Practitioners in persistent asthma. After initial treatment, 44% of study physicians routinely referred their patients to pulmonologists. Drug costs, lack of in-service training and lack of national guidelines were perceived as barriers by 56%, 66% and 44% of General Practitioners. CONCLUSION: The management of asthma is not optimal. The training of General Practitioners on the management of asthma is essential.