[Rheumatologic diseases and haemoglobinopathies in Ouagadougou (Burkina Faso)]. / Pathologies rhumatologiques et hémoglobinopathies à Ouagadougou (Burkina Faso).

The purpose of this study is the prevalence of the rheumatologic complications in the sickle cell disease and the associations between haemoglobinopathies and rheumatologic affections. It is a retrospective study from 29 February 2006 to 28 March 2008 conducted in the Internal Department of the University Hospital Yalgado-Ouédraogo. All patients received in the period of study and having an electrophoresis of haemoglobin realized in alkaline pH were included. These patients came from hematologic consultation. Two hundred and seventy-seven patients out of 1451 were included: 142 patients (51.30%) had haemoglobinopathies, including 21 (7.60%) with composite sickle cell disease SC and 17 patients (6.13%) had aseptic necrosis of the femoral head including 7 with haemoglobin SC. The other rheumatologic affections did not have a semiological particularity related to the type of haemoglobin. The prevalence of patients who have haemoglobinopathies is important in rheumatologic practice. The sickle cell disease is strongly associated to osteonecrosis.

[Arthropathic and degenerative pathology in rheumatology patients in Burkina Faso]. / Pathologie mécanique et dégénérative en consultation de rhumatologie au Burkina Faso.

OBJECTIVE: The purpose of this report is to describe epidemiologic features of arthrosic and degenerative disorders observed during the first two years of rheumatologic practice in Ouagadougou, Burkina Faso. PATIENTS AND METHODS: The files of all patients examined between March 2006 to February 2008 were reviewed. All patients presenting arthrosic or degenerative disorders were included. RESULTS: Out of 1,439 patients examined during the study period, 1,078 (74.91%) were included. Spine pain accounted for 33.7% of cases, i.e., 485 patients including 306 with lumbago. The mean age in this group was 47.8 +/- 15.19 years and the M/F sex ratio was 0,75. Osteoarthritis represented 20.43% of cases including osteoarthritis of the knee in 18%. The mean age in this group was 54.66 +/- 12.29 years and the M/F sex ratio was 0.23. Aseptic osteonecrosis (AON) of the femoral head was observed in 1.11% of cases, i.e. 16 patients including 8 with sickle cell disease (SC) The mean age in this group was 40.75 years. Abarticular rheumatism accounted for 15.98% of cases, i.e. 230 patients including 118 cases with tendinitis of the shoulder. The mean age in this group was 48.48 years. CONCLUSION: Arthrosic and degenerative disorders observed in this series from Ouagadougou presented the same semiological features as in other African series. Primary osteoarthritis of the hip was uncommon.

Neonatal haemoglobinopathy screening in Burkina Faso.

AIMS: To report our experience of neonatal screening for sickle cell disease in Ouagadougou (Burkina Faso) and to discuss the feasibility of neonatal screening in this country. METHODS: Between the years 2000 and 2004, there were about 2,341 births in five maternity services in Ouagadougou. These babies were screened for sickle cell disease in a universal screening pilot programme. In 2006, 53 babies born to selected couples were screened. The specimens were collected either by cord blood sampling or from a dried blood spot on filter paper. The screening was performed using an isoelectric focusing technique. RESULTS: In the first stage (2000-4), the incidence of sickle cell disease was 1:57. In the second stage, six of 53 babies of selected couples were found to have major haemoglobinopathies: one was homozygous for haemoglobin S and five were compound heterozygotes for haemoglobins S and C. CONCLUSIONS: The results suggest that a national screening programme should be implemented in Burkina Faso with effective newborn and subsequent follow-up, but a methodology needs to be developed.

[Sickle cell disease: an anonymous survey of physicians in Burkina Faso]. / Les syndromes drépanocytaires majeurs: une enquête anonyme auprès du corps médical au Burkina Faso.

The purpose of this survey was to evaluate the experience of physicians in Burkina Faso with haemoglobinopathy (particularly sickle cell disease). Survey findings showed that these pathologies were encountered in daily medical practice but that resources necessary to insure proper prevention, follow-up and treatment were insufficient. Practitioners expressed the need for better continuous medical education and for information campaigns to familiarize the public.

Les leucémies lymphoides chroniques au CHU Yalgado Ouedraogo de Ouagadougou

20 cas de leucemie lymphoide chronique (LLC) ont ete diagnostiquees entre janvier 1995 et juin 2003 au Centre Hospitalier et Universitaire (CHU) Yalgado Ouedraogo de Ouagadougou au Burkina Faso. On y a compte 14 femmes et 6 hommes (doit deux femmes pour un homme) dont l'age moyen a ete de 53; 8 ans. Les patients ont chaque fois mis un long delai entre la survenue du premier symptome et la presentation a la consultation. Le motif de consultation le plus frequent a ete une masse abdominale en rapport a une splenomegalie associes ou non a des adenopathies. La lymphocytose sanguine en moyenne de 53.250/mm3 (extremes : 12;910-387.000/mm3) et l'anemie ont ete les perturbations biologiques essentielles. Sur les 20 observations; 16 etaient de mauvais pronostic car classees aux stades III et IV de Rai

Les syndromes drepanocytaires majeurs : une enquete anonyme aupres du corps medical au Burkina Faso

Cette etude evalue l'experience medicale vis-a-vis des hemoglobinopathies et en particulier des syndromes drepanocytaires au Burkina Faso. Un questionnaire a reponses a choix multiple et a reponses libres a ete utilise. L'etude montre que ces pathologies sont rencontrees dans la pratique quotidienne; mais que les moyens mis a disposition des medecins pour la prevention; le suivi et le traitement de celles-ci sont limites. Une amelioration dans la formation medicale continue et dans l'information du public ont ete souhaitees par les medecins interroges

[Chronic osteomyelitis at the Ouagadougou teaching hospital (Burkina Faso). A retrospective study of 102 cases (1996-2000)]. / Ostéomyélites chroniques au CHU de Ouagadou- gou (Burkina Faso). Etude rétrospective de 102 cas (1996-2000).

This is a retrospective study carried out in the orthopaedic and trauma department of the Yalgado-Ouédraogo teaching hospital. All the patients hospitalized in the service with a chronic osteomyelitis (COM) from March 1, 1996 to March 28, 2000 were included. The frequency of COM was 5.3%. The patients' average age was 17.7 with extremes of 2 and 60 years old. 63.9% were male; 80.7% had fistulized COM. A pathological fracture was observed in 16.9% of the patients. Lower limbs were affected most frequently (65%). Thirty patients (36.1%) had haemoglobin S, among them 22 had a major sickle cell disease. Staphylococcus aureus was present in the majority of the cases (more than 50%). Salmonella were observed among patients carrying haemoglobin S. One case of ceftriaxone-resistance salmonella osteomyelitis was reported. The medico-surgical and orthopaedic treatment was statistically more favourable than a medical or medico-surgical treatment without immobilization.

[Haematological parameters evolution during the antiretroviral therapy of HIV infected patients in Burkina-Faso]. / Evolution des paramètres hématologiques au cours du traitement antirétroviral chez les patients infectés par le VIH au Burkina Faso.

Haematological anomalies are frequent during HIV infection, and can be the fact of virus and or bone marrow toxicity of antiretroviral drugs. In order to analyze the evolution of the haematological parameters during HAART this work was carried out in the internal medicine department of the national teaching hospital Yalgado-Ouédraogo in Ouagadougou. So 107 patients receiving for the first time HAART and followed regularly were retained. The immunological efficacy at the end of the first six months was 60, 75% with an average gain of 119 CD4/mm3. The haematological changes at the end of these first six months showed: --an anaemia in 51.4% of the cases at month 6 versus 80.3% at baseline (p=0.0001). The average rate of haemoglobin was 11.8 versus 11.2 g/dl at baseline in the AZT containing HAART regimen (p=0.014) and 12.2 versus 10.7 g/dl at baseline in the group without AZT (p=0.00006). --a neutropenia in 35.5% of the cases at month 6 versus 31.7% at baseline (p=0.6). The average rate of neutrophil was 1908/mm3 versus 2267.1/mm3 at baseline in the AZT containing HAART regimen and 2150.7/mm3 versus 2001.9/mm3 at baseline in the group without AZT These results show that the therapeutic efficacy measured on the immunological answer is accompanied by a reduction of haematological anomalies. They also suggest the necessity to evaluate the cotrimoxazole impact before deciding the interruption of AZT.

[Primary gastric lymphoma complicating HIV infection]. / Lymphome gastrique primitif au cours d'une infection VIH.

This report describes a case of non-Hodgkin's lymphoma in a 31-year-old patient in whom HIV infection was subsequently diagnosed. The woman consulted for epigastralgia. Her medical history included gastritis caused by Helicobacter pylori that was given specific treatment. Clinical examination demonstrated type III splenomegaly and blood film examination demonstrated hypochromic microcytic anemia and neutropenia. Outcome was rapidly fatal and the patient died before start up of anti-retroviral therapy. This case suggests that a possible link between HIV and/or Helicobacter pylori and lymphomagenesis.

[Influence of fetal haemoglobin rate (FHb) on the oxidizing stress in homozygote sickle cell patient living in Abidjan, Côte-d'Ivoire]. / Influence du taux d'hémoglobine foetale (HbF) sur le stress oxydant chez le drépanocytaire homozygote vivant a Abidjan, Cote-d'Ivoire.

Sickle cell anemia being involved in oxidizing stress, our objective was to study the influence of the fetal haemoglobin rate (FHb) on the lipoperoxidation markers in homozygote sickle cell patient in tropical African surroundings. The study population was composed of 73 subjects among whom 57 homozygote sickle cell subjects and 16 healthy control cases. These subjects were distributed in 4 groups according to FHb rate: group 1 (FHb rate under 10%), group 2 (FHb rate ranging from 10 and 20%), group 3 (FHb rate above 20%), group 4 (control cases with no sickle cell disease). On the biological level, the markers of plasma lipoperoxidation represented by substances reacting with thiobarbituric acid (TBARS) significantly increased in sickle cell patients comparatively to control cases (p = 10(-6)). A strong positive correlation (r = +0,70, p<0,01) was found between HbS and the TBARS rate. Comparison of biological parameters of homozygote sickle cell patients according to HbF rate shows that TBARS rate is all the more low as the HbF rate is high (p = 0,02). Moreover the number of irreversible and reversible sickle cells is higher in the group 1 which has the highest rate of TBARS. This observation is confirmed by a coefficient of positive correlation between TBARS and reversible sickle cells (r = +0,40, p < 0,01). This study strengthens the role played by HbF on the modulation of physiopathology of homozygote sickle cell anemia by the control, among others, of free radicals.

[Haematological and biochemical outline of patients with sickle cell disease SS and SC in steady state in the National Hospital Center Yalgado Ouedraogo of Ouagadougou]. / Profil hematologique et biochimique des drepanocytaires ss et SC en phase stationnaire au Centre Hospitalier National Yalgado Ouedraogo de Ouagadougou.

Burkina Faso belongs to the sicklemic's belt of LEHMAN and is the epicenter of haemoglobin C. This is the reason of this study on the haematological and biochemical parameters of homozygotes SS and double heterozygotes SC in stationary stage. These parameters will be use for comparison during crisis and to evaluate the therapy efficiency. So 20 homozygotes and 20 double heterozygotes were studied. The blood film showed anaemia with an haemoglobin rate average of 7.8 g/dl for SS against 9.8 g/dl for SC (p < 0.001). An serum's iron elevated in 26.3% of the SS with an average of 23 micromoles /l against 36.8% with an average of 21.7 micromoles /l in the SC (p < 0.001). These results show the importance of SS anaemia's and biochemical's disorders in comparison to the SC.

Aspects epidemiologiques des leucemies aigues en Cote d'Ivoire

Les auteurs rapportent un etude epidemiologique des leucemies aigues allant d'octobre 1991 a fevrier 1999. La prevalence hospitaliere est de 23;86pour 1000 malades hospitalises. Il y avait 59;09de leucemies aigues lymphoblastique (LAL) et 40;91de leucemies aigues myeloide (LAM). L'age global etait de 29;13 ans et 60;60des patients etaient ages de 2 a 30 ans. Il a ete note une legere predominance masculine. Les hydrocarbures aromatiques (benzene et ses derives) sont fortement incrimines