Knowledge, Attitudes, and Management of General Practitioners of the Hospital Districts of Ouagadougou about Migraine (Burkina Faso).

BACKGROUND: Migraine is a common neurological disorder characterized by severe headache attacks that may be debilitating. The objective of this study is to determine the knowledge and attitudes of general practitioners in the hospital districts of the city of Ouagadougou on migraine. METHODS: This cross-sectional study was carried out in hospital districts of Ouagadougou. The data were collected during three months from February 1 to April 30, 2020. RESULTS: The study included 116 general practitioners. Thirteen percent of them were suffering from migraine. All participants had previous experience with migraine diagnosis before the survey. Eighty percent of general practitioners had a good level of knowledge of ICDH-3 criteria (knowing 6-7 criteria). The most widely recognized IHS criteria were pulsatility quality (93.1%), photophobia or sonophobia (80.2%), and mild-to-moderate intensity (80%). Ninety-five (81.9%) general practitioners rarely ordered brain imaging. The most common acute treatments were nonsteroidal inflammatory drug (39.47%), paracetamol (44.74%), and derivate of ergot (3.95%). The most common preventive treatments were amitriptyline (27.8%), derivate of ergot (18.9%), and NSAID (16.7%). The majority of general practitioners (56.9%) have referred headache patients to a colleague or specialist. CONCLUSIONS: Our study found that diagnostic criteria and acute treatment of migraine were well known by the majority of general practitioners, in contrast of preventive treatment.

[Prevalence of mental disorders in the general population of Burkina Faso]. / Prévalence des troubles mentaux en population générale au Burkina Faso.

OBJECTIVES: To determine, with the use of the Mini-International Neuropsychiatric Interview (MINI), the prevalence of mental disorders in the general population of Burkina Faso; To identify the factors associated with the occurrence of these disorders. METHODS: We conducted a cross-sectional descriptive and analytical survey of a representative sample of the general population aged 18 years and over (n=2587). The only non-inclusion criterion was absence from the place of residence during the investigation period for whatever reason. This approach allowed us to select at random 840 households with a total number of 2587 persons aged 18 years and over. The data collection tools we used were a written questionnaire, developed by ourselves, and the Mini International Neuropsychiatric Interview or MINI questionnaire. On the ethical level, the protocol of this research and its appendices have received the prior approval of the Ethics Committee for Health Research of Burkina Faso as well as support from local customary and administrative authorities. RESULTS: The surveyed population consisted of 1 479 women (57.17 %) and 1108 men (42.83 %). Of the 2 587 people surveyed, 1 072 or 41.43 % met the criteria for at least one of the mental disorders. The prevalence rate was significantly higher among women than men (46.24 % versus 35.01 %). The depressive episode was the most frequent disorder in the surveyed population (11.60 %). Gender, place of residence and marital status were the main factors significantly associated with the occurrence of mental disorders. CONCLUSION: This first national survey revealed a high prevalence of mental disorders. Considering the importance of mental disorders in the general population, it is important to train and involve more nurses and general practitioners in the identification and management of these disorders as there are very few specialists in the field at present.

[Epidemiological and clinical characteristics of dissociative disorders and somatoform disorders in Burkina Faso]. / Caractéristiques épidémiologiques et cliniques des troubles dissociatifs et somatoformes au Burkina Faso.

OBJECTIVE: The aim of this study was to determine the epidemiological and clinical features of dissociative and somatoform disorders in the psychiatry department of the Centre Hospitalier Universitaire Yalgado Ouédraogo, in Burkina Faso. METHOD: We carried out a retrospective and descriptive study over five years, from January 2003 to December 2007, of patients admitted in the psychiatric department for dissociative and somatoform disorders. The data were extracted from the medical notes and registers of consultation. After identification of the patients, the medical notes were exploited with a structured collect form for data on sociodemographic characteristics, life events and ICD-10 diagnoses. All the data were recorded by the same person. Data analysis was performed with Epi info 2007. RESULTS: During a period of 5 years, 3967 patients were registered, 179 had the diagnosis of dissociative and somatoform disorders (3.65% of the admissions) and 145 were included in our study. The majority of the patients were followed as outpatients (71%). Women were more represented with a sex ratio of four women to one man. The majority of the patients were young with an average age of 30 and mostly single (57.9%). The majority of the patients had a low academic standard, in connection with young age of the population. A striking biographic event was found in the majority of the cases; essentially family difficulties and death. Neurological symptoms were the most frequent in 63% of the cases. According to ICD-1O, dissociative disorders were most frequent (65.6%). Depression was mainly associated in15 cases. DISCUSSION: Dissociative disorders and somatoform disorders are frequent in our hospital; we must overcome the difficulties due to the complexity of the diagnosis and the cultural resistances to modern health care to determine the real prevalence of these disorders among the population in Burkina Faso.

[Hysteria in children: Briquet's syndrome (a case report)]. / Hystérie de l'enfant: le syndrome de Briquet (à propos d'une observation).

In this case report, the authors studied the difficulties to set up the diagnosis of hysteria in the Briquet's Syndrome. The description presented here is about an eleven years old girl patient without any particular family background and who, after her tonsils have been out against her will, presented a hysteria in the form of Briquet's Syndrome. All the explorations showed no abnormalities. It is the questioning, and the analysis of facts from informations by the patient and her family which allowed to conclude the diagnosis of hysteria. She received a chemotherapy, associated with a psychotherapy and a family guidance. The course was favourable after two months. The authors compare these findings with some data of the literature and underline the diagnostic and therapeutic difficulties they faced. How physicians should approach such form of hysteria to set up the diagnosis is to proceed by elimination because the disease can simulate all sorts of medical or psychiatrical affections.

[Prevalence and clinical aspects of puerperal mental disorders at the University Hospital Center of Dakar]. / Prévalence et formes cliniques des troubles psychiques de la puerpéralité au CHU de Dakar.

This is a contribution to the survey on psychiatric disorders of puerperality. We are particularly interested in the clinical signs and the ethiopathogenical facts of psychiatric disorders of the post-partum which appear-in our point of view-to be the main point on which we could probably act to reduce the effect of the disease. It is a retrospective survey going from January, 1st 1992 to December, 31st 1996. Here are included all the female patients whose age is more than 15, hospitalised during survey period and who presented a mental pathology linked with puerperality in accordance with diagnosis criterions of World Health Organization. In 1 627 hospitalisations, there were 658 women among whom 52 presented puerperality psychical disorders, that's meaning 7.9% of the female patients hospitalised in psychiatry, with an average age of 24.5 years. Concerning the classification of the diseases, the acute delirious psychosis and the depressive disorders are more important with respectively 56% and 19% of the sample. 92% of the women gave birth by the vaginal normal way and 61.5% presented disorders in the first week following their delivery. The married women are 94%. Concerning their occupations, 98% are house keepers. 52% are primiparas and 48% are multiparas. Psychical disorders of puerperality are frequent in Dakar. Acute psychosis and mood disorders are the main clinical aspects. The management of the future mother to her new roles by health education and prenatal check-ups in health centers by skilled and appropriate personnal is necessary.

[Mental confusion and multifocal lymphatic and pulmonary tuberculosis. A case report]. / Confusion mentale et tuberculose multifocale ganglionnaire et pulmonaire. A propos d'un cas.

This report describes a case of mental confusion associated with ongoing adenitis and pulmonary tuberculosis in a 20-year-old man with no history of psychiatric disorders. Diagnosis was based on clinical and laboratory findings. Tranquillizers improved mental status and antituberculosis treatment was administered before referring the patient to an internal medicine department. The authors emphasize the rarity of these cases in the Senegalese medical literature and discuss possible diagnostic pitfalls.

[Traditional concept of madness and therapeutic difficulties in the Moose of Kadiogo.]. / Concept traditionnel de la folie et difficultés thérapeutiques psychiatriques chez les Moosé du Kadiogo.

The practice of psychiatry in the south of the Sahara in Africa collides with many problems of acceptability of care for the ill and their families. The frequent rejection of the psychiatrist's therapeutic approach can often be explained by the inadaptation of the etiopathogenic approach. Indeed, in black Africa, responsibility of illness differs according to the fact that one has been schooled or not. The western world teaches minorities having the chance to live there or learn about it, that the human body can be assaulted by bacteria, viruses, mycoses or be self-assaulted by changes of its own physiology. Traditional education, for its part, regards the body as a mysterious entity susceptible of being penetrated or eaten by geniuses and anthrophagic sorcerers following a mystico-religious mechanism linked to beliefs and customs. In the majority of the Moose of the Moaga plateau in Burkina Faso, especially regarding madness, these assailants are ancestral geniuses or geniuses from the bush. Psychological suffering caused by a family, social or intrapsychic conflict independent of the invisible world is ultimately delirious for them thus provoking a resistance to give up complete charge of their mentally ill to psychiatric care. For us, an analysis of probable causes of this resistance appeared necessary. Interviews have shown that the psychiatric institution is experienced by the Moose of Kadiogo as a stage in the therapeutic itinerary of their mentally ill, a stage in the course of which their demand for care is reduced to the elimination of inconvenient symptoms. For them, the elimination of the cause derives from a knowledge that psychiatry does not possess, which renders the therapeutic relationship frustrating for both parties.

Traitement des affections mentales par la priere : experience de deux centres d'acceuil et de priere au Burkina Faso

Les auteurs ont observe et analyse les methodes therapeutiques et leur impact sur les patients de deux centres reputes celebres pour le traitement de maladies par la priere. Par l'observation participative; les interviews et un questionnaire standardise; des donnees sur la presentation physique des centres et les therapeutiques employees ont ete recueillies. Les resultats ont montre que les malades mentaux y sont systematiquement enchaines; n'absorbant aucune medication et que les traitements consistent en des prieres d'exorcisme. Cette modalite de prise en charge des 31 malades que les auteurs y ont rencontres semble leur donner satisfaction ainsi qu'a leur famille. Les auteurs ont; du fait de l'importance de la frequentation de ces centres qui est la preuve de leur acceptabilite; compare les techniques de soins a ceux d'autres pays africains ou l'impact est tout aussi positivement apprecie par les populations

[Socio-cultural aspects of grand mal epilepsy in Dakarians: investigation on knowledge, attitudes and practice]. / Aspects socio-culturels de l'épilepsie grand mal en milieu Dakarois: enquête sur les connaissances, attitudes et pratiques.

Epilepsy "grand Mal" is well known since antiquity. Préjudices make epileptic patients look like mythic and mystic person out of circuits of production and consumption. We wanted to evaluate the persistence of such prejudices among the "dakarian" (Senegal) with a questionnaire about knowledges, attitudes and practices on epilepsy. We find a decrease of such prejudices and a good tolerance of the epileptic patient.

Femmes et psychiatrie

Les activites regulieres de prise en charge au niveau du pavillon de consultations psychiatriques du Centre Hospitalier de Fann peuvent constituer un repere en matiere de pathologie psychiatrique de la femme au Senegal. Une etude portant sur l'annee 1990 essaie de mettre en evidence cette pathologie et d'en faire une approche epidemiologique et psyhopathologique. Les resultats obtenus et leurs commentaires peuvent etre une source d'eclairage non negligeable dans ce domaine complexe de la medecine qu'est la psychiatrie