[Guillain-Barré syndrome in hospitals in Togo]. / Syndrome de Guillain-Barré en milieu hospitalier au Togo.

Introduction: In sub-Saharan Africa characterized by limited resources especially in health facilities and a relatively higher frequency of infectious diseases, studies on Guillain-Barré syndrome (GBS) are rare. Objectives: The objectives of this work are to describe the characteristics of GBS in Togo through a cohort of patients followed in the neurology unit of the Campus University Hospital of Lomé. Methodology: The study took place from May 2015 to July 2019. Patients with GBS of levels 1 to 3 of the Brighton criteria for diagnostic certainty were included consecutively and assessed at admission, at 6 months and at 1 year with the GBS disability score and the MRC sum score. Qualitative and quantitative variables were expressed, respectively, in frequency and median (interquartile range). Results: Out of 7012 hospitalized patients, 28 (0.39%) including 20 women (71%) with a median age of 40 (27-53) years, presented GBS. The clinical presentation mainly consisted of bilateral sensory-motor disorders predominantly in the lower limbs associated with facial diplegia and preceded by an infectious event. On admission, 39% of patients (n=11) were able to walk (GBS score 0 to 3) and the median MRC sum score was 28 (12-38). Cytoalbuminologic dissociation was present in 654% of patients (13 of 20 patients who underwent lumbar puncture). The demyelinating and axonal subtypes each accounted for 47% (9 of 19 patients who underwent an electroneuromyography examination). Immunoglobulins and intravenous corticosteroid therapy were administered in 18% (n=5) and 50% (n=14) of patients, respectively. Lethality rate during hospitalization was 11% (n=3). The median MRC sum score at 6 and 12 month-outcome were 40 (38-49) and 51 (46-58), respectively. After one year of evolution, case fatality rate was 18% (n=5), and 78% of survivors (n=14) could walk without assistance, of which 17% (n=3) were asymptomatic. Conclusion: In Togo, GBS, with a low hospital prevalence, remains a serious condition due to its high morbidity and lethality related to non-optimal treatment and delayed management.

[Sexual behavior, knowledge and attitudes to AIDS and sexually transmitted diseases of students at the University of Benin (Togo)]. / Comportements sexuels, connaissances et attitudes des étudiants de l'Université du Bénin (Togo) face au sida et aux maladies sexuellement transmissibles.

Many studies have shown that in Africa, particularly in Togo, the 20- to 29-year-old age group is the age group most frequently affected by AIDS. This age group accounts for 84% of the students of the University of Benin. We studied students, most of the age group thought to be most at risk, investigating sexual behavior, knowledge and attitudes to AIDS and sexually transmitted diseases (STDs). The level of knowledge about the problems of AIDS and STDs was similar for both sexes and for all ages and levels of education of the students. Students had a reasonable knowledge of AIDS, particularly concerning the transmission of HIV (88.6% of students aware), risk behavior (80.8%), AIDS treatment (57.0%) and more general information about HIV (49.4%). They were poorly informed about the transmission (42.9%) and complications (0.69%) of other STDs. Most students had positive attitudes towards HIV issues, particularly the use of preventive measures (3.41 in 5) and the acceptance of infected individuals (3.98 in 5). However, few had seriously considered that AIDS and STDs might impact on their own sex lives (1. 84 in 5) and some were even fatalistic concerning HIV infection. The students were highly sexually active, having intercourse a mean of 31 times per year. Their sexual behavior depended on age and sex. The 15- to 19-year-olds preferred occasional partners. They had sexual intercourse 1 to 3 times per month and used condoms 10 to 20% of the time. The 20- to 29-year-olds had multiple partners. They had sexual intercourse 3 to 5 times per month and used condoms more than 30% of the time. Students over the age of 30 had many partners in addition to their regular partner. They had sexual intercourse 5 to 10 times per month and used condoms 0 to 20% of the time. Significantly more women than men had high-risk sexual behavior (40. 5% of men claimed to regularly use condoms, versus only 22.7% of the women and 11.9% of the women accepted anal penetration versus only 8. 4% of men). The general assumption is that students, who have a high level of education, should be well informed concerning AIDS and STDs and should therefore have positive attitudes and responsible sexual behavior. This study demonstrates that the assumption bears no resemblance to reality. The students were aware of the way in which HIV is transmitted and of what construes risky behavior, but there was nonetheless a high frequency of high-risk behavior (e.g. multiple sexual partners, anal and oral sex, homosexuality, intravenous drug use). The behavior of the students was not significantly different from that of young people living on the streets of Lomé. There were significant relationships between knowledge and attitudes and between some types of sexual behavior and knowledge. However, there was no correlation between attitudes and behavior. The education of young people should focus on both the prevention of AIDS and STDs and on facing up to these diseases.

Peripheral facial paralysis (PFP) and HIV infection in Togo.

OBJECTIVES: The purpose of this study was to determine the seroprevalence of HIV in a group of 150 patients with PFP and to study the semiological and evolutive aspect of PFP in patients with or without HIV. MATERIAL AND METHODS: This semilongitudinal study was conducted during 6 years (1990-1995) at the Lomé teaching hospital. Patients consulting for PFP had the HIV test and regular controls. RESULTS: The HIV seroprevalence was 52%. The average age was 31.4+/-8.81 years There was no difference on clinical features between patients with or without HIV infection. Cerebrospinal fluid was normal in patients without HIV infection, but it showed pleiocytosis in patients with HIV infection (87.88%). Of the HIV carriers 14% presented a recurrence. A total of 26.32% of the patients screened in 1990 developed AIDS when followed up. CONCLUSION: Peripheral facial paralysis is frequently associated to HIV infection. An HIV test must be proposed to all patients with PFP in Africa.

[Cysticercosis in patients with neurologic diseases in hospital milieu in Lomé, Togo]. / La cysticercose chez des malades neurologiques en milieu hospitalier à Lomé, Togo.

The aim of this study was to determine the frequency and clinical presentation of cysticercosis in patients consulting in the neurology unit of the Lomé, Togo Teaching Hospital. Among the 2.064 patients examined, 38 had cysticercosis. All 38 were males, age ranged 18 to 50 years. Diagnosis was established on the basis of multiple subcutaneous cysticercosis (n = 33), cerebral cysticercosis scan findings (n = 5), serology (n = 7) and cerebrospinal fluid findings (n = 3) of specific antibodies using the ELISA method. Recurrent epileptic seizures occurred in 33 patients. Three other were in a confusional state, one had headaches and one had hemiplegy. The results of this study contrast with the reported scarcity of cerebral cysticercosis in hospitals in other West African countries.

[Cerebral toxoplasmosis in a hospital environment in Lomé (Togo)]. / Toxoplasmose cérébrale en milieu hospitalier a Lomé (Togo).

The authors report the clinical, serological and neuroradiological results of a study about 23 cases of cerebral toxoplasmosis in the Teaching Hospital of Lome. Response to antitoxoplasmic treatment was rapidly favourable with all patients. Cerebral toxoplasmosis was the inaugural manifestation of AIDS in 20 of the 23 patients.