[State of knowledge on sleep apnea syndrome, attitudes and practices of doctors in Niamey, Niger]. / État des lieux des connaissances, attitudes et pratiques des médecins de Niamey sur le syndrome d'apnées obstructives du sommeil.

RATIONALE: Sleep apnea syndrome (SAS) is a public health problem. In African countries, it is an underdiagnosed pathology. Our objective was to assess SAS knowledge, attitudes and practices among doctors in Niamey, Niger. METHOD: A 6-month descriptive cross-sectional study was conducted from December 1, 2018 to May 31, 2019, involving 307 doctors working in health facilities in Niamey. RESULTS: Two hundred and seventy-two doctors (88.59%) responded, of whom 51.47% (n=140) were medical specialists, 32.35% (n=88) general practitioners and 16.18% (n=44) specialist doctors. Their level of knowledge was insufficient or fair in 77.94% (n=212) and 16.91% (n=46) of cases respectively. Their main source of information was the education they had received during university courses (61.03% [n=166]). The most commonly cited types of SAS were obstructive in 66.18% (n=180) of their responses and central in 30.15% (n=82). For adults, the main perceived risk factor for SAS was obesity (79.41% [n=216]) and among children, enlarged tonsils (68.75% [n=187]). For the most part, they were not familiar with the scale for assessing degree of daytime sleepiness (87.13% [n=237]) or with the baseline diagnostic examination for SAS (75.40% [n=205]). More than ¾ (n=221 or 81.25%) of the doctors never mentioned SAS to their patients and 59.93% (n=163) and 56.99% (n=155) of them referred a suspected case of SAS to an ENT specialist or a pulmonologist, respectively. Almost all of the doctors (94.85% [n=258]) wished to receive training on SAS. CONCLUSION: In a majority of cases, level of relevant knowledge was insufficient. Doctors need training on sleep apnea syndrome.

[The current situation with sputum positive pulmonary tuberculosis in Niamey (Niger)]. / État des lieux de la tuberculose pulmonaire à bacilloscopie positive à Niamey (Niger).

Tuberculosis is a major public health problem and the main reason for hospital admission in developing countries. No study of tuberculosis has been undertaken in the pulmonary/tuberculosis service of Lamordé National Hospital in Niamey since its foundation in April 2009. The aim of our study is to assess the current situation of sputum positive new and relapsed cases of tuberculosis and to determine their epidemiological, clinical and therapeutic profiles. It comprised a retrospective four-year study of the records of patients hospitalized for sputum positive pulmonary tuberculosis (433 patients), both new and relapsed cases, in the pulmonary/tuberculosis service of the Lamordé National Hospital. The latter is the unique reference and management centre for lung disease for the capital of Niger. Of the 975 patients admitted to the pulmonary/tuberculosis centre 433 had sputum positive tuberculosis, both new and relapsed cases, making up 44.5% of admissions. 76.2% were male giving a sex ratio of 3.2. The mean age of the patients was 42.6 years with a range of 2-85 years. More than half of the patients (54.7%) came from the Niamey region and 68.6% were referred from there. Antecedents were tuberculosis, HIV infection and smoking in 8.3%, 6.2% and 6%, respectively. Weight loss (80.4%), productive cough (63%) and fever (68%) were the main general and functional signs identified. Sputum examination revealed the diagnosis in 99.8% of cases and 62.1% had a chest X-ray before starting treatment. Cavitation was present in 67.3% and infiltration in 46.9%. Serology for HIV was positive in 17.1%. A treatment regime was instituted in 89.6% of new cases and 10.4% of relapsed cases. The rate of recovery was 74.6% and pleurisy, which was the most common complication, developed in 5.6%. Tuberculosis constitutes the main cause of hospitalization in the pulmonary/tuberculosis service of the Lamordé National Hospital in Niamey. It is therefore necessary to educate the public and reinforce the training of health care professionals in the management of tuberculosis.