Prevalence of obstructive sleep apnoea in sleep consultations in Burkina Faso: Implications for monitoring.

BACKGROUND: Obstructive sleep apnoea syndrome (OSAS) is the most common respiratory disorder related to sleep. Its prevalence in developed countries varies from 3% to 28%. In several African countries, including Burkina Faso, this syndrome is still under-diagnosed and goes largely untreated. It is necessary to conduct studies in different contexts to determine the characteristics and develop the strategies for management of OSAS. OBJECTIVES: To determine the prevalence of OSAS in Burkina Faso. METHODS: This prospective study recruited 106 patients coming for consultation for sleep disorders at the Yalgado Ouedraogo University Hospital Center, who responded to a self-questionnaire and were diagnosed by respiratory polygraphy. RESULTS: A total of 77 patients (72.6%) had OSAS. The male to female ratio was 1.4:1 and the mean (standard deviation) age was 47.8 (12.8) years. The majority of the patients (53.8%) were obese. The main reason for consultation was snoring (84%), followed by hypopnea-apnoea reported (59.4%) and daytime sleepiness (45.3%). The most common comorbidity factor was hypertension (50%), followed by decreased libido (16%) and diabetes (13.2%). A continuous positive-pressure (CPAP) machine was prescribed to 51.25% of the patients, but only 22% were able to acquire it. CONCLUSION: The monitoring of OSAS is relatively new in Burkina Faso. This study showed the profile of patients with OSAS and difficulties in accessing continuous positive airway pressure (CPAP) devices for treatment.

[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.

Assessment of asthma control in pulmonary consultation in Ouagadougou, Burkina Faso

Background: Despite the recommendations now in force for the management of asthma, evidence suggests that many asthmatic patients still have their disease uncontrolled. Objective: to assess asthma control and to identify the fac-tors associated with uncontrolled disease among the patients received for consultation in the department of Pneumology in Ouagadougou, Burkina Faso.Patients and methods: We conducted a cross-sectional study from 02/01/2015 to 01/31/2016 in the department of Pneu-mology of Yalgado Ouedraogo University Hospital in Oua-gadougou. All asthma patients seen during this time frame participated in this study. The 2014 GINA criteria were used to assess the asthma control status.Results: One hundred and two asthmatic patients were in-cluded (76 women and 26 men) with a mean age of 38.7 ± 18.6 years. Asthma was found to be well controlled in 26.5% of cases, partially controlled in 34.3% of cases and uncontrolled in 39.2% of cases. The following factors were found to be associated with an uncontrolled asthma: age >36 years (p = 0.002), low level of education (p = 0.04), allergic rhinitis (p = 0.01), overweight (p = 0.03), duration of asthma ≥ 10 years (p = 0.04), therapeutic non-compliance (p = 0.00).Conclusion: Asthma was insufficiently controlled in our study. A tremendous emphasis must be put on not only on the therapeutic education of asthma patients, but also on a better management of comorbiditie

[HIV/TB co-infection in rural settings of Benin: case of the Djougou-Ouake-Copargo sanitary district (north-west Benin)]. / Co-infection VIH/Tuberculose en milieu rural au Benin: cas de la zone sanitaire Djougou-Ouake-Copargo (nord-ouest Benin).

AIMS: we measured the burden of TB/HIV co-infection in a rural setting of Benin, and assessed the outcome of tuberculosis treatment at the end of the intensive phase of TB treatment. METHODS: This is a retrospective, cross-sectional, descriptive study, covering January 2006 to December 2011. RESULTS: A total of 256 patients were included, 67 (26.1%) were HIV +. A minority, 25% of co-infected HIV / PTB, had TB bacilli high density (+++) versus 45% of mono-infected (P = 0.005). The smear conversion was obtained in 96% of coinfected versus 93% in HIV- at the end of the intensive phase (P = 0.5). The cure rate was 86% and 93.1% respectively in co-infected and HIV-. A proportion of 13.5% of co-infected died versus 3% in HIV- (P = 0.005). 21% of co-infected with CD4 <200 died versus 3.6% of those with CD4> 200 (P = 0.041). CONCLUSION: This work underlines the high prevalence of HIV / TB co-infection in this region. Co-infected patients respond well to treatment, but their mortality is high when they are very immunocompromised.

BUTS: nous avons mesuré le fardeau que constitue la co-infection VIH/ tuberculose chez des tuberculeux en milieu rural au Bénin ; et évaluer l'issue du traitement antituberculeux à la fin de la phase intensive. MÉTHODES: Il s'agit d'une étude transversale rétrospective, descriptive couvrant Janvier 2006 à Décembre 2011. RÉSULTATS: Au total 256 patients ont été colligés, 67 (26,1%) étaient VIH+. Une proportion de 25 % des co-infectés VIH/TPM+ avaient une densité bacillaire à trois croix (+++) contre 45% des tuberculeux VIH- (P=0,005). La négativation de la bacilloscopie était obtenue chez 96% des patients co-infectés contre 93% chez les tuberculeux VIH- à la fin de la phase intensive (P=0,5). Le taux de guérison était respectivement de 86% et 93,1% chez les co-infectés et les non VIH. Une proportion de 13,5% des co-infectés étaient décédés contre 3% chez les VIH- (P=0,005). 21% des co-infectés ayant un CD4<200 étaient décédés contre 3,6% de ceux dont le CD4>200 (P=0,041). CONCLUSION: Ce travail souligne la forte prévalence de l'infection par le VIH chez les tuberculeux de cette région. Les co-infectés répondent bien au traitement, mais leur taux de mortalité est plus élevé, surtout s'ils sont très immunodéprimés.

[HIV/TB co-infection in rural settings of benin: case of Djougou-Ouake-Copargo district (north-west Benin]. / Co-infection VIH/Tuberculose en milieu rural au benin: cas de la zone sanitaire Djougou-Ouake-Copargo (Nord-ouest Benin).

AIMS: We measured the burden of HIV/tuberculosis (HIV/TB) co-infection in people infected by TB in rural settings of Benin, and assessed the outcome of TB treatment at the end of the intensive phase. METHODS: This is a retrospective, cross-sectional, descriptive study, covering January 2006 to December 2011. RESULTS: A total of 256 patients were gathered, 67 (26.1%) were HIV +. A proportion of 25% of co-infected HIV / PTB had TB bacilli high density (+++) versus 45% of mono-infected (P = 0.005). The smear conversion was obtained in 96% of coinfected versus 93% in HIV- at the end of the intensive phase (P = 0.5). The cure rate was 86% and 93.1% respectively in co-infected and HIV-. A proportion of 13.5% of co-infected died versus 3% in HIV- (P = 0.005). 21% of co-infected with CD4 <200 died versus 3.6% of those with CD4> 200 (P = 0.041). CONCLUSION: This work underlines the high prevalence of HIV / TB co-infection in this region. Co-infected patients respond well to treatment, but their mortality is high when they are very immunocopromissed.

BUTS: Nous avons mesuré le fardeau que constitue la co-infection VIH/ tuberculose chez des tuberculeux en milieu rural au Bénin; et évaluer l'issue du traitement antituberculeux à la fin de la phase intensive. MÉTHODES: Il s'agit d'une étude transversale rétrospective, descriptive couvrant Janvier 2006 à Décembre 2011. RÉSULTATS: Au total 256 patients ont été colligés, 67 (26,1%) étaient VIH+. Une proportion de 25 % des co-infectés VIH/TPM+ avaient une densité bacillaire à trois croix (+++) contre 45% des tuberculeux VIH- (P=0,005). La négativation de la bacilloscopie était obtenue chez 96% des patients co-infectés contre 93% chez les tuberculeux VIH- à la fin de la phase intensive (P=0,5). Le taux de guérison était respectivement de 86% et 93,1% chez les co-infectés et les non VIH. Une proportion de 13,5% des co-infectés étaient décédés contre 3% chez les VIH- (P=0,005). 21% des co-infectés ayant un CD4<200 étaient décédés contre 3,6% de ceux dont le CD4>200 (P=0,041). CONCLUSION: Ce travail souligne la forte prévalence de l'infection par le VIH chez les tuberculeux de cette région. Les co-infectés répondent bien au traitement, mais leur taux de mortalité est plus élevé, surtout s'ils sont très immunodéprimés.