Tuberculosis prevalence and associated factors among persons with diabetes mellitus after intensified case finding in three West African countries.

BACKGROUND: To determine the prevalence of tuberculosis (TB) and associated factors in persons with diabetes mellitus (DM) in Benin, Guinea and Senegal. PATIENTS AND METHOD: A cross-sectional study was conducted in the largest DM center in each country. Participants systematically underwent clinical screening and chest radiography. Participants who were symptomatic or with abnormal radiography underwent bacteriological investigations (sputum smear, Xpert MTB/RIF and culture) on sputum. Participants with no TB at enrolment were re-examined for TB six months later. Logistic regression was performed to identify factors associated with TB. RESULTS: There were 5,870 DM patients: 1,881 (32.0%) in Benin, 1,912 (32.6%) in Guinea and 2,077 (35.4%) in Senegal. Out of these, 114 had bacteriologically-confirmed TB, giving a pooled prevalence of 1.9% (95%CI=1.6-2.3). TB prevalence was 0.5% (95%CI=0.3-1.0), 2.4% (95%CI=1.8-3.2) and 2.8% (95%CI=2.2-3.6), respectively, in Benin, Guinea and Senegal. Factors associated with an increased odds of TB diagnosis were a usual residence in Guinea (aOR=2.62;95%CI=1.19-5.77; p=0.016) or in Senegal (aOR=3.73;95%CI=1.85-7.51; p<0.001), the age group of 35-49 years (aOR=2.30;95%CI=1.11-4.79; p=0.025), underweight (aOR=7.34;95%CI=4.65-11.57; p<0.001) and close contact with a TB case (aOR=2.27;95%CI=1.37-3.76; p=0.002). Obesity was associated with lower odds of TB (aOR=0.20; 95%CI=0.06-0.65; p=0.008). CONCLUSION: TB is prevalent among DM patients in Benin, Guinea and Senegal and higher than among the general population. The findings support the need for intensified case finding in DM patients in order to ensure systematic early detection of TB during the routine consultation process.

Diabetes Care During Hajj.

Diabetes mellitus affects over 463 million individuals worldwide. Religious activities such as the Hajj pilgrimage have a major impact on patients with diabetes mellitus, including increasing the risk of hyperglycaemia and hypoglycaemia. This increased risk is due to dietary changes and intense physical activity during pilgrimage while being on antidiabetic medications. Approximately 20% of the pilgrims with underlying illnesses who visit Mecca are diabetic, and complications, such as diabetic ketoacidosis, nonketotic hyperosmolar state, and fatigue/unconsciousness due to hypoglycaemia, have been observed among these patients. Diabetic patients are also at a high risk for foot complications and infections. To avoid any aggravation of the diabetes, a complete biochemical evaluation of the patient must be conducted before Hajj, and the patients must be provided contextualized educational guidance to avert these potential health challenges. This counselling should include the importance of carrying with them at all time their relevant medical history, summaries of the current treatment regimen and emergency snacks. In addition, to reduce the risk of hypoglycaemia, the dosage of insulin should be reduced in selected patients by 20% and that of sulfonylurea should be reduced as needed. Basal insulin and glucagon-like peptide 1 receptor agonists are associated with fewer complications and can be preferentially prescribed. Those patients with type 1 diabetes can continue with the use of insulin pump with suitable education prior to Hajj. For the prevention of foot problems, the use of padded socks and well-fitting shoes is recommended along with an insistence on not walking barefoot. After Hajj, the patient must be followed up, and necessary investigations must be made along with readjustment of insulin dosage in those patients for whom it was reduced. Until the pandemic situation abates, all diabetic patients should avoid making the Hajj journey.

Availability of equipment and medications for non-communicable diseases and injuries at public first-referral level hospitals: a cross-sectional analysis of service provision assessments in eight low-income countries.

CONTEXT AND OBJECTIVES: Non-communicable diseases and injuries (NCDIs) comprise a large share of mortality and morbidity in low-income countries (LICs), many of which occur earlier in life and with greater severity than in higher income settings. Our objective was to assess availability of essential equipment and medications required for a broad range of acute and chronic NCDI conditions. DESIGN: Secondary analysis of existing cross-sectional survey data. SETTING: We used data from Service Provision Assessment surveys in Bangladesh, the Democratic Republic of the Congo, Ethiopia, Haiti, Malawi, Nepal, Senegal and Tanzania, focusing on public first-referral level hospitals in each country. OUTCOME MEASURES: We defined sets of equipment and medications required for diagnosis and management of four acute and nine chronic NCDI conditions and determined availability of these items at the health facilities. RESULTS: Overall, 797 hospitals were included. Medication and equipment availability was highest for acute epilepsy (country estimates ranging from 40% to 95%) and stage 1-2 hypertension (28%-83%). Availability was low for type 1 diabetes (1%-70%), type 2 diabetes (3%-57%), asthma (0%-7%) and acute presentations of diabetes (0%-26%) and asthma (0%-4%). Few hospitals had equipment or medications for heart failure (0%-32%), rheumatic heart disease (0%-23%), hypertensive emergencies (0%-64%) or acute minor surgical conditions (0%-5%). Data for chronic pain were limited to only two countries. Availability of essential medications and equipment was lower than previous facility-reported service availability. CONCLUSIONS: Our findings demonstrate low availability of essential equipment and medications for diverse NCDIs at first-referral level hospitals in eight LICs. There is a need for decentralisation and integration of NCDI services in existing care platforms and improved assessment and monitoring to fully achieve universal health coverage.

Plantains: Gluco-friendly usage.

Plantains are a staple food for a large proportion of the world's population. Rich sources of carbohydrates, they are considered taboo by most diabetes care providers. For persons living with diabetes, however, they are a preferred food item. This multi country authored article discusses the nutritional and culinary qualities of plantains. It discusses how to consume the fruit in a glucose-safe manner, by reducing the glycaemic load and total caloric load due to a low glycaemic index. Simple ways of modifying plantain preparation and serving are suggested, to help patients take this foodstuff without impacting glucose control.

Impact of polyelectrolytes on lysozyme properties in colloidal dispersions.

In this work, we investigated the impact of different polyelectrolytes (polyacrylic acid, polystyrene sulfonate, dextran sulfate, and chondroitin sulfate) on lysozyme properties when they form colloidal complexes. To this aim, we characterized (i) the size and stability of the different polyelectrolyte-lysozyme complexes upon addition of NaCl (different concentrations) by diffusion light scattering, and (ii) the structure and accessibility of lysozyme active site in such complexes by fluorescence quenching and time resolved fluorescence analysis. We then used these results to explain the antibacterial activity variations among colloidal complexes and compared with free lysozyme. Our findings show that colloidal complexes that are more prone to swelling (i.e., lysozyme complexed with polystyrene sulfonate) are less stable upon salt addition. In these colloids, the enzymatic site is also more accessible. However, the antibacterial activity does not depend on the swelling properties because no large structural modification of the active site occurs.

[Clinical and progressive profile of skin and soft tissue lesions in diabetics in 2017 at the dressing room of the Marc Sankale Center in Dakar]. / Profil clinique et évolutif des lésions de la peau et des parties molles chez les diabétiques en 2017 à la salle de pansement du Centre Marc Sankale de Dakar.

INTRODUCTION: This study aims to determine the clinical and evolutionary profile of skin and soft tissue lesions in diabetics followed up at the dressing room. METHODS: We conducted an observational descriptive and analytical study in the dressing room of the Marc Sankalé Diabetes Center, Dakar from 1 January to 31 December 2017. Our study focused on diabetics who were examined in the dressing room. RESULTS: A total of 37.173 procedures were recorded at the Marc Sankalé Diabetes Center; 16.418 patients were treated in the dressing room, representing a prevalence of 14.16%. The average age of patients was 56,6 ±12 years, the sex ratio (M/F) was 0,88. Type 2 diabetes predominated (78,97%) and the average disease duration was 8.06 ± 7.9 years. The mean capillary blood glucose concentration was 2.4±1 g/l. Diabetic neuropathy was found in 72.33% of patients. Limb lesions were found in 93,98% of patients(1185 cases). The most common lesions included: ulcer (46,76%), abscess (13.46%), phlegmon (13.20%), gangrene (8.41%), erysipelas (3.78%), perforating ulcer (3.53%), intertrigo (3.95%). The lesions were be divided into infectious lesions (61,41), non-infectious lesions(33,50%), pure vascular lesions (1.57%) and mixed lesions (3.70%). Out of 1189 patients 7.57% had had osteitis. The germs found were Gram-positive bacteria (12.70%), Gram-negative bacteria (23.80%). Amputation was performed according to the topographical features of the lesion (p=0.00), the type of lesion (p=0.000), the seniority of diabetes (p=0.02), the type of diabetes (p=0.008), the presence of osteitis (p=0.006). Minor amputation was performed in 43,33% of cases, major amputation in 37.43% of cases; 70 deaths were recorded (5.89%). CONCLUSION: Skin and soft tissue lesions were dominated by diabetic foot. Mortality is not negligible and the risk of amputation was statistically related to the topographical features of the lesion, the type of lesion, the seniority and the type of diabetes and the presence of osteitis.

Evaluation of agreement between hemoglobin A1c, fasting glucose, and fructosamine in Senegalese individuals with and without sickle-cell trait.

Fasting glucose (FG) and glycated hemoglobin A1c (HbA1c) perform sub-optimally in people of African origin, especially in individuals with sickle-cell trait (SCT). The purpose of this study was to compare the relationships between HbA1c, FG, and fructosamine in individuals from Senegal with and without SCT. HbA1c, FG, and fructosamine were measured in 203 adults from Senegal (100 control: 45 with type 2 diabetes (T2D); 103 SCT: 51 with T2D). Significant, positive correlations were observed between HbA1c and FG, fructosamine and FG, and fructosamine and HbA1c in both groups. The limits of agreement were inappropriately large in both groups for the Bland-Altman plots of HbA1c and FG (control: -95.97 to 83.97%; SCT: -115.9 to 91.52%), fructosamine and FG (control: -100.6 to 99.89%; SCT: -105.6 to 100.6%), and fructosamine and HbA1c (control: -52.03 to 38.98%; SCT: -88.04 to 71.41%). In both groups, the greatest proportion of subjects were considered above the clinical cut-point for hyperglycemia when fructosamine was used as the criterion (control: 33%; SCT: 44.6%), and the lowest percentage of subjects were classified as over the clinical cut-point when HbA1c was used as the criterion (control: 21%; SCT: 27.7%).Substantial disparities between HbA1c, FG, and fructosamine were observed in both groups, and these differences were exaggerated in the SCT group. Therefore, these three biomarkers should not be considered to be interchangeable measures of glycemic control. These biomarkers should be used thoughtfully, and special care should be taken when using them in individuals with SCT.

[Idiopathic thyroid abscess: a case study conducted at Marc Sankale Center Dakar]. / Abcès idiopathique de la thyroïde: à propos d'un cas colligé au Centre Marc Sankale Dakar.

Thyroid abscess is a very rare disease due to its anatomical position and the physiology of the gland. It most often occurs in the immunosuppressed population. The diagnosis is easy and is based on ultrasound. However it is often unrecognised. Bacteriological examination allows to identify the germ responsible for this condition. We report the case of a Mauritanian patient living in the said country presenting with painful cervical swelling associated with fever. The diagnosis was based on ultrasound and confirmed by fluid examination. Bacteriological assessment didn't identify the cause of this condition. Patient's outcome was marked by regression of symptoms under antibiotic therapy, with normalization of the gland structure after two months.

[Prevalence of cardiovascular risk factors in semi-rural area in Senegal]. / Prévalence des facteurs de risque cardio-vasculaire en milieu semi-rural au Sénégal.

OBJECTIVES: We aim to determine the prevalence of cardiovascular risk factors in the semi-rural population of the community of Gueoul in Senegal. PATIENTS AND METHOD: This is a cross-sectional, observational and descriptive study. We conducted an exhaustive survey in 2012 according to the STEPS wise approach of the world health organization against Senegalese aged of 35 years and over who resided for at least 6 months in semi-rural area in the community of Gueoul. Pregnant women were excluded. Classical cardiovascular risk factors were collected and data analyzed using SPSS 18.0 software. The significance level was agreed for a value of P<0.05. RESULTS: We examined 1411 subjects (1052 women) with a mean age of 48.5±12.68 years. The main cardiovascular risk factors were dyslipidemia (61,1%), physical inactivity (56.2%), abdominal obesity according to the International Diabetes Federation (53.9%), hypertension (46.4%), global obesity (13%), diabetes (7.2%) and smoking (2.5%). Hypertension was significantly associated with diabetes (P=0.001), abdominal obesity (P=0.001) and global obesity (P=0.0001). Sedentarity (P=0.001), global obesity (P=0.0001) and hypertension (P=0.001) were more frequent in women. CONCLUSION: Cardiovascular risk factors are frequent and often associated in semi-rural area of Senegal, particularly in women. This condition should lead to develop prevention strategies of cardiovascular complications.

[Left ventricular hypertrophy in black African subjects with artery hypertension: Results of a cross-sectional survey conducted in semi-rural area in Senegal]. / L'hypertrophie ventriculaire gauche chez le sujet noir Africain hypertendu : résultats d'une enquête transversale, réalisée en milieu semi-rural au Sénégal.

OBJECTIVES: To assess the prevalence of left ventricular hypertrophy according to electrocardiographic and echocardiographic criteria among hypertensive patients living in semi-rural Senegalese area. PATIENTS AND METHODS: According to the World Health Organization STEPSwise approach, we conducted, in November 2012, a cross-sectional and exhaustive study in the population aged at least 35 years old and living for at least six months in the semi-rural area of Guéoul. We researched electrocardiographic and echocardiographic left ventricular hypertrophy in hypertensive subjects. Data were analyzed with SPSS 18.0 software version. The significance level was agreed for a value of P<0.05. RESULTS: We examined 1411 subjects aged on average of 48.5±12.7 years. In total, 654 subjects were hypertensive and screening of left ventricular hypertrophy (LVH) was effective in 515 of them. According to Sokolow-Lyon index, 86 subjects (16.7%) presented electrocardiographic LVH, more frequently in men (P=0.002). According to Cornell index and Cornell product, LVH was founded respectively in 66 (12.8%) and 52 subjects (10.1%), more frequently in female (P=0.0001; P=0.004). It was more common in grade 3 of hypertension however criteria. In echocardiography, prevalence of LVH was 2.2% (13 cases) according to the left ventricular mass, 9.3% (48 cases) according to the left ventricular mass indexed to body surface area and 8.2% (42 cases) according to the left ventricular mass indexed to height2.7. LVH was significantly correlated with the electrocardiographic LVH according to Sokolow-Lyon index (P<0.0001) and the grade 3 of hypertension (P=0.003). CONCLUSION: Although rare in hypertensive Senegalese living in semi-rural area, left ventricular hypertrophy is correlated with severity of grade of hypertension. Screening by electrocardiogram will allow better follow-up of these hypertensive subjects.

[Prevalence of atherosclerotic carotid plaques in semi-rural Gueoul, Senegal: Survey of 1411 subjects]. / Prévalence des porteurs de plaques d'athérome carotidiennes dans la population semi-rurale de Guéoul au Sénégal : enquête sur 1411 sujets.

AIMS: The purpose of this study was to investigate the prevalence of atherosclerotic carotid plaques and association with cardiovascular risk factors and vascular diseases in a semi-rural area of Gueoul in Senegal. PATIENTS AND METHOD: This was a cross-sectional, descriptive study over a period of one month in 2012 in Senegalese people who were older than 35 years, and resided in semi-rural Gueoul for at least six months. Carotid plaques were measured with a portable Doppler Diadop 50(®) and defined by an intima-media thickness greater than 1.5mm. P-values less than 0.05 were considered statistically significant. RESULTS: The survey involved 1411 individuals with a sex ratio of 2.93 and an average age of 48.5 years. Prevalence of risk factors was high: dyslipidemia (61.1 %), physical inactivity (56.2 %), abdominal obesity (53.9 %), hypertension (46.4 %), obesity (12 %), diabetes (7.2 %) and smoking (2.5 %). Prevalence of atherosclerotic carotid plaques was 6.8 %, including 42.7 % with bilateral plaques. Prevalence increased with age (P=0.001), hypertension (P=0.0001), diabetes (P=0.004) and metabolic syndrome (P=0.008). There were no significant associations with the other risk factors. The presence of carotid plaques was associated with medical history of stroke (P=0.01), myocardial infarction (P=0.02) and peripheral artery obstructive disease (P=0.5). CONCLUSION: Prevalence of atherosclerotic carotid plaques seems weak but it is associated with many cardiovascular risk factors. It requires measures for early diagnosis and prevention of cardiovascular diseases in Senegal.

Study of the effect of altitude on the measurement of glycated haemoglobin using point-of-care instruments.

We measured the glycated haemoglobin (HbA1c) levels of a total of 24 non-diabetic volunteers and diabetic patients using a point-of-care (POC) analyser in three Cameroonian cities at different altitudes. Although 12 to 25% of duplicates had more than 0.5% (8 mmol/mol) difference across the sites, HbA1c values correlated significantly (r = 0.89-0.96). Further calibration studies against gold-standard measures are warranted.

Type 2 diabetes control and complications in specialised diabetes care centres of six sub-Saharan African countries: the Diabcare Africa study.

AIM: The Diabcare Africa project was carried out across six sub-Saharan African countries to collect standardised and comparable information for the evaluation of diabetes control, management and late complications in diabetic populations at specialist clinics. METHODS: A cross-sectional, descriptive study of 2352 type-2 diabetes patients who were treated at specialist clinics for at least 12 months prior to the study. RESULTS: The mean age of patients was 53.0±16.0 years and had 8.0±6.0 years known duration of diabetes. 47% had their HbA1c assessed in the past year (mean 8.2±2.4%) with 29% achieving a level <6.5%. 21% had BP within 130/80 mmHg and 65% were treated for hypertension. Fasting lipids were assessed in 45% of the patients with mean cholesterol level of 4.9±1.2 mmol/L, HDL-cholesterol of 1.3±0.7 mmol/L and triglycerides of 1.2±0.7 mmol/L. 13% of the patients were treated for hyperlipidaemia, mostly with statins. Background retinopathy (18%) and cataract (14%) were the most common eye complications. Macrovascular disease was rare, and 48% had neuropathy. CONCLUSIONS: Half of the patients benefitted from standard care, and a third had appropriate glycaemic control - attributed to access to, rather than quality of care. This study provided evidence to support appropriate interventions to diabetic populations of sub-Saharan origin.

[Ketoacidosis in type 1 diabetes mellitus: 73 cases in Dakar]. / Acidocetose Chez Le Sujet Diabetique De Type 1 : A Propos De 73 Cas Colliges A Dakar.

INTRODUCTION: The follow-up of diabetes mellitus in children and teenagers remains a challenge. Ketoacidosis is the most frequent acute metabolic complication and is of bad prognosis. The objective of this study was to evaluate etiologicals factors of decompensation and evolutions in type 1 diabetes. PATIENTS AND METHODS: We conducted a transversal and prospective study from January 2009 to October 2010. All type 1 diabetic patients hospitalized for ketoacidosis had been included. For every patient, we have studied the epidemiologicals, etiologicals and clinicals factors as well as the outcomes. RESULTS: The prevalence was to 55.3 % among all ketoacidosis. Sex-ratio (Men/Women) was 0.78, mean age to 25.73 years and mean duration of diabetes was 3.9 years. Ketoacidosis was inaugural in 26 % of cases. Except Kussmaul dyspnea, prevailed digestives symptoms (87.6 %). Coma was noted in 82.1 % among whom 54.7 % had no previous diabetic follow-up. A decompensation factor was found in 93.1 % of which an infection (78 %) or stop insulin (53.42 %). Prevailing infectious sites were urogenitals (24.6 %), respiratories (20.5 %). The outcome was fatal in 6.8 % of the cases. It was about 24.3 years middle-aged, 1,6 year diabetes mellitus mean duration, without regular follow-up in 80 % of the cases. Other associated factors were coma stage 2 or 3 (80%), infection (60 %), hypokalemia (40 %). CONCLUSION: Ketoacidosis is frequent in type 1 diabetic patients and has a bad prognosis. Infection and stop insulin are major factors of decompensation. Its prévention requires an adapted therapeutic education associated to a regular follow-up of patients.

Etude des relations entre le diabete de type 1 et les parodontites chez des enfants senegalais

Introduction : Le diabete sucre ou diabete de type 1 est une affection metabolique frequente qui concerne a la fois les adultes et les enfants. Il se traduit par des atteintes du parodonte qui aboutissent a des pertes dentaires. L'objectif de cette etude etait d'evaluer les relations entre le diabete sucre de type 1 et la survenue de la parodontite chez l'enfant au Senegal. Patients et methode : Il s'agit d'une etude transversale a vise etiologique qui a porte sur 50 enfants diabetiques de type 1 et 50 non diabetiques ages de 6 a 15 ans. L'etat bucco-dentaire et parodontal a ete evalue dans les deux groupes. La presence de parodontite etait objectivee par l'existence de toute poche parodontale 3 mm sur les incisives permanentes et premieres molaires qui ont fait leur eruption complete. L'evaluation du niveau d'hygiene a ete effectue avec l'indice de plaque de Silness et Loe; le saignement evalue par l'indice de Loe et Silness. Resultats : Le niveau socio-economique des parents des enfants diabetiques et non diabetiques etait similaire. L'hygiene buccale des enfants diabetiques etait significativement plus defectueuse que celle des non diabetiques (p= 0;00) et les parodontites etaient statistiquement plus importantes chez les diabetiques. Il y avait une correlation significative et positive entre l'age et la survenue de parodontite chez les enfants ages de 13-15 ans (p=0;00) mais il n'y a pas de relation avec l'equilibre glycemique; ni avec l'anciennete du diabete. Conclusion : Le diabete de type I se traduit se traduit chez l'enfant et l'adolescent senegalais par des parodontites. Cette atteinte n'est pas en rapport avec l'equilibre glycemique; ni avec l'anciennete du diabete

[Descriptive study of diabetic foot at the Marc Sankale Diabetes Center. Report of 105 cases]. / Etude descriptive du pied diabetique au centre du diabete marc sankale. A propos de 105 cas.

INTRODUCTION: Diabetic foot is a major complication of diabetes due to its frequency and its high risk of evolution to amputation. We report 105 cases recruited at the diabetes centre Marc Sankale. METHOD: It's a prospective study including all diabetic patients who attended the diabetes centre for any foot lesion during a one year period. Besides clinical examination data, results of glycaemia, foot X-ray Doppler and bacteriological analysis of the pus were collected. RESULTS: foot lesion represented 2.8% of diabetologist causes of consultation. Mean age of occurrence was 55 +/- 14 years in 63% women and 37% men. Diabetes was type 2 in 90% cases, poorly controlled in 63.92 % cases. Foot lesion was dominated by infection (97%), isolated or associated to peripheral vascular disease (32.4%) or neuropathy (13.3%). 67 patients had medical treatment and healed their wounds in 3 months in 76% cases. 38 other cases needed surgery : major amputation (15%), minor amputation (13%) debridment (9%) and revascularization (1%). CONCLUSION: Diabetic foot is a frequent reason for consultation at the National diabetes centre. Despite all the improvements made after the implementation of the patient's educational program, treatment starts late because of economical and cultural reasons that increase morbidity.

[Toxic nodular goiter]. / Les goîtres nodulaires toxiques.

INTRODUCTION: To date no study in our country was specifically dedicated on toxic nodular goiter. They were just mentioned in generally studies about hyperthyroidism. METHOD: The authors report a retrospective series of 62 cases of toxic nodular goitre collected between 1979 and 1999 at the internal medical clinic of Dakar teaching hospital. The diagnostic of toxic nodule was retained on following criteria: to existence of one or several thyroid nodule with signs or thyrotoxicosis, the existence of a hyperfixating nodule at 131 iodine scintigraphy. Increasing of T3 and/or T4 thyroide hormone. The aims of the study was to analyse the epidemiological, clinical, and therapeutics aspects. RESULTS: We are collected 49 cases of solitary nodule (79.03%) and 13 cases of multi nodular goitre (20.97%). In the cases of solitary nodule, mean age was 40 years, sex ratio of 0.04 (47 female, 2 men). The nodule was clinically diagnosed in 47 cases (95.9%) and extinctive in 73.5%. 34.3% of patients have cardiothyreosis. In the cases of multi nodular goitre mean age was 45 years, all cases were female, goitre was clinically identified in 95.3% (12 patients) and 46.5% had cardiothyreosis. 62% of patients were lost to follow up during medical treatment. Only 2 patients on the 37 who were addressed for surgery come back after thyroidectomy. CONCLUSION: This study confirm the predominance of toxic nodular goitre in young female, its severity related to cardiothyreosis and underlines the difficulties limited to the therapeutical care.

[Frequency of microalbuminuria during diabetes in Dakar, Senegal]. / Fréquence de la microalbuminurie au cours du diabète a Dakar (Senegal).

Nephropathy is one of the complications occuring during diabetes and it is diagnosed via microalbuminuria. From 1992 to 1999, five hundred and eighty seven (587) diabetic patients were recruited and distributed into two groups, A (n = 270) and B (n = 317). Microalbuminuria was determined by immunonephelemetry for group A and immunoturbidimetry for group B. The results showed respectively 15.5% and 20.19% pathological cases in the two groups (NS). Considering the distribution of patients with microalbuminuria according to the type of diabetes, there were 16.12% type 1 and 15.07% type 2 in group A against 22.60% and 18.13% in group B; no statistically significant differences were observed either in the same group or from one group to another. These frequencies might reflect the situation in the nineties; they are lower than those encountered in other populations. Nevertheless monitoring is needed through a regular schedule to prevent nephropathy.

[Frequency of micoalbuminuria during diabetes in Dakar (Senegal)]. / Frequence de la microalbuminurie au cours du diabète à Dakar (Sénégal).

Nephropathy is one of the complications occuring during diabetes diagnosed via microalbuminuria. From 1992 to 1999, five hundred and eighty seven (587) diabetic patients were recruited in groups A (n = 270) and B (n=317). Microalbuminuria was determined by immunonepheletry for A and immunoturbidimetry for B. The results pointed out respectively 15.5% and 20.19% pathological cases (NS). Considering the distribution of patients with microalbuminuria according to the type of diabetes there were 16.12% type 1 and 15.07% type 2 in group A against 22.60% and 18.13% in group B ; no stastically significant differences were observed either in the same group or from one group to another. These frequencies would reflect the situation in the nineties; they are lower than those encountered in other populations. Nevertheless monitoring is needed through a regular schedule to prevent nephropathy.

[Hypercholesterolemia in diabetes in Dakar. Sociodemographic and etiological factors and therapeutic bases]. / Hypercholestérolémie au cours du diabète à Dakar. Facteurs socio-démographiques et étiologiques et bases thérapeutiques.

This study took place between January and September 1996. The inclusion criteria was a blood cholesterol concentration of at least 2.5 g/l. Thirty-three patients were included. They were aged from 37 to 77 years, with a mean age of 59 (+/- 9.4) years. Twenty-six were women and seven were men. The mean age of the women was 58.9 (+/- 10) years and that of the men was 61 (+/- 6.1) years. Sixteen patients were from urban areas, 14 from semi-rural areas and 3 were of rural origin. The mean duration of diabetes was 9 (+/- 6.5) years. Mean post-prandial blood glucose concentration was 2.2 (+/- 1.0) g/l. Mean body mass index was 25.6 (+/- 5.6). Mean systolic blood pressure was 15.0 (+/- 2.5) cm Hg and mean diastolic blood pressure was 9.0 (+/- 1.3) mm Hg. Blood cholesterol concentration was between 2.5 g/l and 5.6 g/l, and mean HDL cholesterol concentration was 0.7 (+/- 0.4) g/l. Mean blood triglyceride concentration was 1.0 (+/- 0.4) g/l. Body mass index was negatively correlated with high cholesterol levels (r = -0.29). Hypercholesterolemia was primary, with no associated high triglyceride concentration. Cholesterol levels were also negatively correlated with post-prandial blood glucose concentration (r = -0.1). Thus, treatment should involve the prescription of drugs to reduce blood lipid concentration rather than just the restriction of lipid intake.