Women Anesthesiologists in Sub-Saharan Africa in the Pre-COVID Era: A Multinational Demographic Study.

BACKGROUND: Gender imbalance and poor representation of women complicate the anesthesiology workforce crisis in sub-Saharan Africa (SSA). This study was performed to obtain a better understanding of gender disparity among medical graduates and anesthesiologists in SSA. METHODS: Using a quantitative, participatory, insider research study, led by female anesthesiologists as the national coordinators in SSA, we collected data from academic or national health authorities and agencies. National coordinators were nominees of anesthesiology societies that responded to our email invitations. Data gathered from 13 countries included information on medical graduates, anesthesiologists graduating between 1998 and 2021, and number of anesthesiologists licensed to practice in 2018. We compared data between Francophone and Anglophone countries, and between countries in East Africa and West Africa/Central Africa. We calculated anesthesiology workforce densities and compared representation of women among graduating anesthesiologists and medical graduates.Data analysis was performed using linear regression. We used F-tests on regression slopes to assess the trends in representation of women over the years and the differences between the slopes. A value of P < .050 was considered statistically significant. RESULTS: Over a 20-year period, the representation of female medical graduates in SSA increased from 29% (1998) to 41% (2017), whereas representation of female anesthesiologists was inconsistent, with an average of 25%, and lagged behind. Growth and gender disparity patterns were different between West Africa/Central Africa and East Africa. Representation of female anesthesiologists was higher in East Africa (39.4%) than West Africa/Central Africa (19.7%); and the representation of female medical graduates in East Africa (42.5%) was also higher that West Africa/Central Africa (33.1%). CONCLUSIONS: On average, in SSA, female medical graduates (36.9%), female anesthesiologists (24.9%), and female anesthesiology residents projected to graduate between 2018 and 2022 (25.2%) were underrepresented when compared to their male counterparts. Women were underrepresented in SSA, despite evidence that their representation in medicine and anesthesiology in East African countries was rising.

The Management of Primary Hyperaldosteronism in a Poor Technology Environment.

We report a case of Conn's adenoma in a 35-year-old female successfully managed in a poor hospital technology environment.

Risk of obstructive sleep apnea and quality of sleep among adults with type 2 diabetes mellitus in a sub-Saharan Africa city.

INTRODUCTION: diabetes mellitus (DM) and Obstructive Sleep Apnea (OSA) are two major and interconnected non-communicable diseases. Both negatively impact on sleep quality. This study aimed to determine among persons with type 2 DM, the proportions at high risk of OSA and of self-reported poor sleep quality along with their associated-factors in Parakou city, Benin. METHODS: this was a cross-sectional prospective study of 100% (n=383) outpatient adults with type 2 DM, conducted between April and August 2019 in the three top centres managing diabetic persons in Parakou city. They were interviewed, examined and investigated using capillary fasting blood glucose tests. The STOP-Bang Questionnaire (SBQ) was used to determine the risk of OSA. RESULTS: overall, their mean age was 57.37 (11.45) years. They were 61.62% (n=236) females and 38.38% (n=147) males. Sleep duration was insufficient in 26.89% (n=103). Nocturia was reported in 49.35% (n=189). The risk of OSA was high in 14.10% (n=54), intermediate in 24.80% (n=95) and low in 61.10% (n=234). Friedman Position Tongue Grade 3 (Adjusted Odds Ratio, aOR=2.48; 95%CI=1.11 - 5.55; p=0.025) and 4 (aOR=4.65; 95%CI=1.26 - 15.90; p=0.015) were independently associated with a high risk of OSA. The prevalence of reported poor sleep quality was 27.42% (n=105). Female gender (aOR=2.08; 95%CI=1.18-3.83; p=0.014), diabetic foot (aOR=5.07; 95%CI=1.15-23.63; p=0.031), nocturia (aOR=1.96; 95%CI=1.18-3.29; p=0.010), tiredness (aOR=2.77; 95%CI=1.26-6.23; p=0.012) and a high risk of OSA (aOR=3.31; 95%CI=1.28-8.93; p=0.015) were independently associated with a greater risk of reported poor sleep quality. CONCLUSION: in Parakou, the proportions of patients with type 2 DM at increased risk of OSA and with poor quality of sleep are relatively high. There is need for better systematic screening of OSA in persons with DM.

Apport de l'endoscopie bronchique dans la prise en charge des pathologies respiratoires basses au Bénin

Introduction : L'endoscopie bronchique est un outil diagnostique important pour le pneumologue. Peu d'études existent dans la littérature noire africaine sur la pratique de cet examen. L'objectif de ce travail était d'évaluer la pratique de l'endoscopie bronchique au Centre National Hospitalier et Universitaire de Pneumo-Phtisiologie et ses résultats.Patients et Méthode: Etude descriptive menée entre Janvier 2011 et Juillet 2013 chez des patients ayant eu une endoscopie bronchique. Les informations sur les conditions de réalisation, les caractéristiques diagnostiques, les lésions macroscopiques, les résultats des examens microbiologiques et histologiquesétaient colligées et analysées avec EpiData.Résultats: Au total 116 patients étaient inclus, sex-ratio (H/F) égal à 2,05, âge moyen de 51,4 ans. Un examen en moyenne était réalisé par semaine, le plus souvent demandé par des prescripteurs du centre (67,2%). Les indications étaient diagnostiques (112), pour une surveillance (1) et thérapeutiques (3); les plus fréquentes étant une suspicion de cancer bronchique (33,6%) et une pneumopathie infectieuse trainante (23,2%). La tolérance de l'examen était jugée acceptable par 60,9%. Les principaux prélèvements effectués étaient les biopsies bronchiques (58,9%) et les aspirations bronchiques (54,5%). La bactériologie et la parasitologie/mycologie étaient contributives respectivement dans 6,9% et 35,7%. Les cancers bronchiques (39,7%) et les broncho-pneumopathies infectieuses(13,8%) étaient les plus fréquents diagnostics finalement retenus. Chez trois enfants qui avaient inhalé des punaises, l'extraction était réussie chez deux.Conclusion: L'évaluation de la pratique de l'endoscopie bronchique au Bénin montre des résultats encourageants mais améliorables