[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.

Inhospital outcome of elderly patients in an intensive care unit in a Sub-Saharan hospital.

BACKGROUND: In Burkina Faso, demographics are changing and we are seeing a growing prevalence of older patients in intensive care units. Elderly people have increased health care needs but there is a lack of geriatric specialists. This study aimed to analyze in-hospital outcome of patients aged over 65 years, admitted to the Intensive Care Unit (ICU) at Yalgado Hospital. METHODS: We carried out a 5-year retrospective study in the ICU of Yalgado Ouédraogo Hospital. Elderly patients with completed records were included. Baseline characteristics, clinical and outcome were analyzed. RESULTS: Two thousand one hundred sixteen patients were admitted to ICU, 237 (11.2%) of whom were included. There were 70 females and 167 males. The median age was 71.7 ± 6.1 years. The overall mortality rate in ICU was 73%, of whom 90% died within 7 days after admission. In multivariate analysis, shock (Odds Ratio: OR = 2.2, p = 0.002), severe brain trauma (OR; 9.6, p = 0.002), coma (OR 5.8 p < 0.003), surgical condition (OR = 4.2, p = 0.003), ASAPS Score ≥ 8 (OR = 4.3, p = 0.001), complication occurring (OR = 5.2, p = 0.001) and stroke (OR = 3.7, p = 0.001) were independent factors. CONCLUSION: Elderly patients were frequent in ICU and their mortality rate was high. Stroke, severe brain trauma, surgery, complications occurring during hospitalization were independent risk factors of death.

Les peritonites aigues generalisees en milieu rural au Burkina Faso : a propos de 221 cas

But. Etudier les peritonites aigues en milieu rural au Burkina Faso. Materiel et methode : Etude transversale descriptive sur trois ans allant du 1er janvier 2007 au 31 decembre 2009 des patients operes pour peritonite aigues generalisee dont le diagnostic a ete confirme en per operatoire au centre hospitalier regional de Dedougou. Resultats : En trois ans; 221 cas peritonites aigues generalisees ont ete operees. Ces peritonites ont represente 31;2 des urgences abdominales. L'age moyen de nos patients etait de 24;34 ans avec des extremes de 1 an et de 79 ans. L'etiologie typhique venait en tete avec 42;5 suivie de l'etiologie appendiculaire 33 et la perforation d'ulcere gastroduodenale avec 6;8. Les peritonites primitives representaient seulement 3;2. On a note 40;2 de complications dont la suppuration parietale constituait 56;2. La mortalite globale etait de 19

[Assessment of knowledge and pain management by traumatological emergencies staff of the teaching hospital of Ouagadougou]. / Evaluation des connaissances et pratiques du personnel des urgences traumatologiques de Ouagadougou sur la prise en charge de la douleur.

INTRODUCTION: Pain is a frequent reason of consultation in traumatological emergencies. Its management is characterized by oligoanalgesia whose causes are multiple. The purpose of this study is to assess the knowledge and practices of pain management by traumatological emergencies staff of the teaching hospital Yalgado Ouedraogo of Ouagadougou. MATERIALS AND METHODS: A questionnaire survey of health workers performing in traumatological emergencies has been conducted. Two different questionnaires, one for medical staff and one for the paramedics were administered. RESULTS: A total of 67 health workers participated in the study with a participation rate of 98% and 100%, respectively, for the medical and paramedical staff. According to their report, 65.3% of medical and 77.7% of paramedical staff had never received training on pain and its management. For 85.7% of physicians, pain should be assessed before treatment, but 79.6% of them didn't know any conventional pain assessment method. All the nurses and 40.8% of physicians felt that pain in the emergency services should not be treated immediately to prevent misdiagnosis. Morphine and regional anesthesia were not used for pain treatment in the emergency room. 10.2% of medical staff and 27.8% of the paramedics said that they systematically search for the analgesicsside effects. CONCLUSION: The knowledge of health workers about pain and its management is insufficient. The lack of training of health workers on the management of pain is the cause and contributes to explain the oligoanalgesia in this service.

INTRODUCTION: La douleur est un motif fréquent de consultation aux urgences traumatologiques. Sa prise en charge est caractérisée par une oligoanalgésie dont les causes sont multiples. Le but de cette étude est d'évaluer les connaissances et pratiques du personnel des urgences traumatologiques du Centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou sur la prise en charge de la douleur. MATÉRIEL ET MÉTHODE: Une enquête par questionnaire auprès du personnel de santé exerçant aux urgences traumatologiques a été menée. Deux questionnaires différents, l'un pour le personnel médical et l'autre pour le personnel paramédical ont été administrés. RÉSULTATS: Au total, 67 agents de santé ont participé à l'étude avec un taux de participation de 98% et 100% respectivement pour le personnel médical et paramédical. Selon leur déclaration, 65,3% du personnel médical et 77,7% du personnel paramédicaux n'avaient jamais bénéficié de formation sur la douleur et sa prise en charge. Pour 85,7% des médecins, la douleur devrait être évaluée avant traitement mais 79,6% d'entre eux ne connaissaient aucune méthode conventionnelle d'évaluation de la douleur. L'ensemble des infirmiers et 40,8% des médecins estimaient que la douleur aux urgences ne devrait pas être traitée d'emblée afin d'éviter des erreurs diagnostiques. La morphine et l'anesthésie locorégionale n'étaient pas utilisées aux urgences pour traiter la douleur. 10,2% du personnel médical et 27,8% du personnel paramédical ont affirmé rechercher systématiquement les effets secondaires des antalgiques. CONCLUSION: Les connaissances des agents de santé sur la douleur et sa prise en charge sont insuffisantes. L'absence de formation du personnel de santé en algologie en est la cause et contribue à expliquer l'oligoanalgésie observée dans ce service.

Le noma de l'enfant en milieu hospitalier de Bobo-Dioulasso (Burkina-Faso): aspects épidemiologiques et diagnostiques

Introduction: Le noma est une affection peuconnue au Burkina Faso. Cette étude décrit les aspectsépidémiologiques et diagnostiques de 59 cas de nomaà Bobo-Dioulasso (Burkina Faso).Méthodologie C'est une étude rétrospective sur10 ans incluant tous les enfants de moins de 15 ans,hospitalisés pour noma.Résultats : L' incidence du noma est de sept cas/an. La tranche de 1-5 ans a été la plus touchée. Dans46 cas (78%), le noma est survenu sur un terrain demalnutrition, associé à une mauvaise hygiène bucco-dentaire dans 45 cas (76,3%). Le tableau clinique estcelui d'un noma évolutif dans 51 cas (51/59) et d'unnoma séquellaire dans huit cas (8/59).Discussion-conclusion : Notre incidence de 7 cas/an est plus élevée que dans certaines études. D'autrestravaux trouvent comme nous que la tranche de 1-5ans a été la plus touchée. Le noma survient sur unterrain malnutri (78%) et d'hygiène orale défec-tueuse. Il devrait être mieux connu pour un traite-ment préventif adapté

Burkitt's lymphomain Burkina Faso hospital center : therapeutic and course.

Summary A retrospective study of 41 cases of children sent to hospital and treated for the Burkitt's lymphoma for a period of 10 years has been carried out in the hospital of Bobo-Dioulasso in order to study the progressing and therapeutic features of the disease. The therapeutic means were the ablation surgery of voluminous tumors (19.5%) and the monochimiotherapy with cyclophosphamid (83%) according to Burkitt's procedure (64.7%) and N'gu procedure (35.3%). The mortality under chimiotherapy was 8.8%. The immediate evolution has shown 58.8% of complete remission, 26.5% of partial remission, 11.8% of resistance to the treatment.

The child's noma in an hospital center in Burkina Faso : Clinical features and course.

In order to study the therapeutic and developing aspect the child's noma in Burkina Faso, we have undertaken a retrospective study on a ten-years-period, with the files of 59 children hospitalized in the hospital of Bobo-Dioulasso, completed with a visit to the children's families after their leaving the hospital. The medical treatment has allowed to reach a recovery rate of 79.6% at the cost of aesthetic and functional after-effects which aren't negligible. The death rate in hospital was 13.7%. 31 children have profited from the restoring surgery of lesions. The care out of hospital has showed that the surgical results were mitigated.

Le lymphome de Burkitt en milieu hospitalier du Burkina Faso: Aspects thérapeutiques et évolutifs

Une étude rétrospective portant sur 41 dossiers d'enfants hospitalisés et traités pourlymphome de Burkitt, sur une période de 10 ans, a été effectuée dans les services de pédiatrie et de chirurgie maxillo-faciale de l'hôpital de Bobo-Dioulasso aux fins d'étudier les aspects thérapeutiques et évolutifs de la maladie. Les moyens thérapeutiques ont été la chirurgie d'ablation des volumineuses tumeurs (19,5%) et la monochimiothérapie au cyclophosphamide (83%) selon les procédés de Burkitt(64,7%) et de N'gu (35,3%). La létalité sous chimiothérapie était de 8,8%. L'évolution immédiate a montré 58,8% de rémission complète, 26,5% de rémission partielle, 11,8% de résistance au traitement

[Comparative study of neonatal bacterial meningitis in Lomé, Bobo-Dioulasso, Casablanca and Lyon]. / Analyse comparative des méningites bactériennes néonatales à Lomé, Bobo-Dioulasso, Casablanca et Lyon.

UNLABELLED: Bacterial meningitis in new-borns remains a serious event because of its high mortality and morbidity rates in Africa. OBJECTIVE: To identify the clinical and bacteriological epidemiology and the outcome of neonatal bacterial meningitis in three African cities. METHOD: We have analysed and compared three hospital studies done in humid tropical, Sahelian, and desert Africa with a European study. RESULTS: Compared with the European study this African study is characterized by a high mean frequency of neonatal meningitis (6 cases per year against 1.4), more important risk factors linked to pregnancy and childbirth (50% against 33%), high rates of death (61 to 68% against 5%) and sequelae (25 to 40% against 30%), rarity of Streptococcus agalactiae (7 to 15% against 38%) and absence of Listeria. Enterobacteriaceae were predominant both in African (50 to 68%) and European (43%) studies. E. coli appeared as the most frequent germ in both European and African studies and Salmonella as more frequent in Sub-Saharan Africa than in occidental countries. CONCLUSION: The epidemiological, bacteriological and evolutional aspects of the neonatal meningitis were identical in the three African cities. The African studies were different from the European only by their high incidence, the rarity of S. agalactiae and Listeria and the difficulties of bacterial diagnosis and management, all might explain the high rates of death and sequelae. An epidemiological survey and adequate antimicrobial therapy according to antibiotic susceptibility may improve the outcome.

[Post-hemolytic renal failure in children with glucose-6-phosphate dehydrogenase deficiency at the University Hospital Center in Lome]. / Insuffisance rénale post-hémolytique chez l'enfant déficient en glucose-6-phosphate déshydrogénase au Centre Hospitalier Universitaire de Lomé.

The purpose of the study was to identify predisposing factors for acute hemolysis and post-hemolytic renal failure in children with glucose-6-phosphate dehydrogenase deficiency (G6PD). Any child presenting hemoglobinuria during the study period was prospectively evaluated. Evaluation included detection of the presence of hemolytic agents, laboratory tests to measure hemolysis, G6PD activity, infection and renal failure, and assessment of outcome and management of hemolysis and renal failure. G6PD deficiency was documented in 32.1% of the 230 children admitted with hemoglobinuria. Anuric renal failure occurred during the hemolysis episode in 35.1% of patients with G6PD deficiency (21 boys and 5 girls between 30 months to 13 years old). Acute hemolysis associated with infection occurred before any treatment in 53.8% of cases and after beginning treatment in 46.1%. In 84.6% of cases, occurrence of acute hemolysis involved association of drugs considered as nonhemolytic either with themselves or with other drugs. Anuric renal failure occurred after beginning treatment in all cases and was most severe in patients with of multiple-germ infection (30.7%) and drug association (84.6%). Renal failure was reversible in 80.7% and fatal in 19.2%. Multiple-germ infection and drug association appeared as the main predisposing factors for post hemolytic anuric renal failure in patients with G6PD deficiency. The high frequency of these factors in tropical areas suggests implication of local endemic infections.

[Analysis of the results of 1221 colonoscopies in the hospitals of Burkina Faso, 1994-1997]. / Analyse des résultats de 1221 coloscopies en milieu hospitalier au Burkina Faso, 1994-1997.

The authors report the results of 1221 colonoscopies. It appears from their analysis that whereas functional diseases of the colon remain predominant and topical, organic diseases appear to be increasing in frequency (polyps, polyposis, rectocolic cancer, parasitical colitis, diverticulis). Inflammatory bowel diseases are also beginning to be seen. The reported cases of Crohn's disease and ulcerative colitis are, so far as they know, the first in their country.

[Congenital malarial disease due to Plasmodium falciparum in high-infection-risk newborn]. / Paludisme congénital-maladie à Plasmodium falciparum chez le nouveau-né à risque infectieux.

UNLABELLED: The aim of this work was to differentiate in an endemic area congenital malaria diseases (CMD) from congenital malaria infestations (CMI) or other maternal-fetal infections. METHODS: Four hundred and seventy-five newborn (0-7 d) suspected of infection were prospectively studied. CMD was diagnosed when clinical manifestations were associated with positive thick and thin blood films in a mother and her newborn. The diagnosis of CMI was retained when despite positive parasitemia, no clinical manifestations were observed. RESULTS: Forty newborns (1.7% of the cases of maternal malaria) were diagnosed as CMD and ninety-one (19% of live births) were considered as CMI. The main clinical manifestations were related to cerebral (100%), respiratory (95%) and hemodynamic (90%) systems. Hematologic signs were present in 95% of cases. The level of parasitemia varied from 700 to 3,000 parasites/mL in CMD and from 360 to 870 parasites/mL in CMI. Death occurred in ten cases (25%) of CMD. CONCLUSION: In this malaria-endemic area, neither clinical manifestions nor parasitemia allow one to distinguish CMD from CMI associated with bacterial materno-fetal infections. Studying placental or systemic immunity and antimalaria IgM in the newborn could be of interest to clarify this problem.

[Sleeping sickness in children at Bobo-Dioulasso Hospital Center: apropos of 3 cases]. / La maladie du sommeil chez l'enfant au Centre hospitalier de Bobo-Dioulasso: à propos de 3 observations.

The authors report three observations of trypanosomiasis in children aged 3 to 13 years from Ivory Coast and Burkina Faso. Two cases were imported from Côte d'Ivoire and one originated from an old endemic area of Bobo-Dioulasso region in Burkina Faso. Clinical features were comparable to classical descriptions in adults but neurological findings were dominant. Two children were at the lymphatic stage. Treatment with melarsoprol in two cases and eflornithine in one case led to complete recovery. Active epidemiologic surveillance of this zoonosis should be maintained and the devastating pandemic of the beginning of the century should be remembered.

[Clinical profile of cryptosporidiosis in a pediatric hospital environment in Burkina Faso]. / Profil clinique de la cryptosporidiose en milieu hospitalier pédiatrique au Burkina Faso.

Data concerning Cryptosporidium parvum infection in Black Africa are highly fragmentary. A 12-month study was carried out on 1392 stool specimens from children under 36 months of age with (n = 756) or without diarrhea (n = 629) in the Pediatric Department of Bobo Dioulasso Hospital in Burkina Faso. In 558 children HIV blood tests were also performed. The phenicated fuchsin technique was used to identify Cryptosporidia oocysts. Results were positive in 72 of the 1392 stool specimens tested (5.2%) and in 59 of the 756 stool samples from children with diarrhea (7.8%). Oocysts were not detected in any child under the age of 6 months and the highest incidence of infection was between 6 and 23 months. Detection of oocysts during this year long study was significantly higher from April to June, which corresponds to the beginning of the rainy season in Burkina Faso. Occurrence of diarrhea was not significantly correlated with parasite density. Presence of oocysts was correlated with malnutrition (p < 0.01) and rotavirus infection (p < 0.05). Of the 558 children who underwent HIV testing, only one was positive. In contrast the incidence of HIV infections in the overall population tested was 7%. This study indicates that cryptosporidiasis is a major factor in development of diarrhea and dehydration in the pediatric hospital setting of Burkina Faso. Two other notable findings are that occurrence of cryptosporidiosis is closely linked to hygiene in the population but is not significantly correlated with HIV infection in the pediatric setting in Africa.

Morbidite et mortalite dans le service de medecine digestive du Centre Hospitalier National Yalgado Ouedraogo (CHN-YO) Ouagadougou

Au cours de l'annee 1992; le service de medecine digestive de l'hopital de Ouagadougou a recu en hospitalisation 1498 malades dont 69;9 pour cent d'hommes et 30;7 pour cent de femmes; ages de 15 a 74 ans. Les motifs d'hospitalisation etaient domines par les diarrhees chroniques liees au VIH (39 pour cent); les hepatopathies occupant la deuxieme place des affections digestives (15;5 pour cent). 281 deces (18;75) repartis en 29;9 pour cent de femmes et 70;1 pour cent d'hommes ont ete deplores; dus principalement aux diarrhees chroniques (38;8 pour cent); aux hepatopathies chroniques (25;7 pour cent) et aux affections non digestives (22 pour cent). Ces deces touchent surtout les adultes jeunes (21 a 40 ans). la survenue surtout nocturne de ces deces (70;1 pour cent) repose le probleme de la dotation minimale du service en medicaments d'urgence