Panorama of inflammatory arthropathies in rheumatologic consultations in Northern Togo.

To determine the frequency and epidemiological profile of inflammatory arthropathies seen during rheumatologic consultations in Togo. This retrospective study examined the records of patients with inflammatory arthropathy seen at a rheumatologic consultation at Kara Teaching Hospital (Northern Togo) over a four-year period. Among the 2361 patients with rheumatic disorders, 152 (6.43%) had an inflammatory arthropathy: 57.24% were men and 42.76% women. The main causes observed were: chronic inflammatory rheumatism (CIR) and connective tissue disease (49.34%), infectious arthritis (26.32%), and gout (24.34%). The mean age of the 75 patients with CIR at the onset of the disease was 40 years and the average duration of evolution was 3.11 years. The main clinical forms of CIR were rheumatoid arthritis (11 cases), spondylarthropathies (20 cases within 11 cases of reactive arthritis), connective tissue diseases (4 cases), and unclassified CIR (31 cases). Nine patients with reactive arthritis were HIV positive. The infectious arthritis was caused by a banal germ in 31 cases and by Koch bacillus in nine other cases. Gout patients (35 men and 2 women) had a mean age of 43 years at the onset of the disease, and the mean duration of the disease was 4.1 years. Gout was monoarticular in 8 cases, oligoarticular in 19 cases and polyarticular in the other 10 cases. This study demonstrates the high incidence of chronic inflammatory rheumatism in Northern Togo.

[Infectious arthritis in hospital patients in Lomé, Togo]. / Arthrites infectieuses en consultation rhumatologique a Lomé (Togo).

OBJECTIVE AND METHODS: The purpose of this study was to determine the frequency and semiological profile of infectious arthritis in the outpatient clinic of the Tokoin University Hospital Center in Lomé, Togo. PATIENTS AND METHODS: This study was based on a review of the charts of patients hospitalized in the rheumatology department over a period of 16 years. RESULTS: During the 16-year study period, 198 of the 13517 patients (1.5%) examined were hospitalized for infectious arthritis. There were 100 women and 98 men with a mean age of 36.3 +/- 17.5 years. Mean disease duration was 9.3 +/- 9.8 months. Diagnosis was banal germ arthritis in 157 cases (79.3%) and likely tuberculosis arthritis in 41 (20.7%). The knee was the most common location (34.3%). Arthritis affected a single joint in 159 cases (80.3%). Isolation of offending microorganism was achieved in 39 patients (19.7%). The most frequently identified agent was Staphylococcus aureus (42.5%). In addition to underdevelopment and poor hygiene observed in most patients in this series, risk factors included human immunodeficiency virus infection in 28 cases, alcoholism in 10, sickle cell anemia in 8, cancer in 3, and diabetes mellitus in 2. Outcome was favorable in 181 patients (88.7%). Four patients died. CONCLUSION: The frequency of infectious arthritis is correlated with underdevelopment and poor hygiene in black Africa.

[Risk factors of hip osteoarthritis in Lomé, Togo]. / Facteurs de risque de la coxarthrose a Lomé (Togo).

The medical records of the Lomé Teaching Hospital Rheumatology Unit (Togo) were retrospectively reviewed to study risk factors for osteoarthritis of hip. Among the 14,090 patients examined over a period of 17 years, 89 (0.63%) including 37 women and 52 men had osteoarthritis of the hip as defined according to the criteria of Kellgren and Lawrence. The mean duration of osteoarthritis of the hip was six years. Involvement was unilateral in 77 patients (86.5%) and bilateral in 12 (13.5%). Osteoarthritis of the hip was primary in 41 patients (46.1%) and secondary in 48 (53.9). Risk factors for secondary osteoarthritis of the hip were necrosis of the femoral head (n = 14), epiphysitis (n = 13), dysplasia (n = 11), traumatism (n = 6) including two femoral neck fractures, and tuberculosis of the hip joint (n = 2). In the 14 subjects with necrosis of the femoral head, hemoglobin was type SC in three cases and SS in two. Necrosis of the femoral head appears to be the main risk factor for osteoarthritis of the hip in black Africa. The impact of this risk factor may increase with longer life expectancies of subjects with hemoglobin SS and SC.

[Spondylodiscitis at a hospital outpatient clinic in Lome, Togo]. / Spondylodiscites infectieuses en milieu hospitalier à Lomé (Togo).

PURPOSE: This investigation was carried out to determine the frequency and features of spondylodiscitis in patients attending the Tokoin University Hospital Center in Togo. PATIENTS AND METHODS: A retrospective study of patients examined in the Rheumatology Outpatient Clinic over a 17-year period was conducted. RESULTS: Out of 14,708 patients examined during the study period, 222 (1.5%) presented spondylodiscitis. There wire 108 women and 114 men with a mean age of 38 years. The mean duration of symptoms was 6 months. Spondylodiscitis was related to presumptive tuberculosis in 169 patients (76.1%). The most common locations were the lumbar (56.8%) or thoracic (21.6%) spine. It was associated with a pulmonary location in 39 patients (17.6%). In addition to underdevelopment and poor hygiene in most patients, risk factors for spondylodiscitis included HIV infection (n=23), alcoholism (n=27), diabetes mellitus (n=7), and sickle cell anemia (n=7). Response to medical treatment was favorable in 197 patients (88.7%). CONCLUSION: Spondylodiscitis is still a frequent reason for seeking medical care in Black Africa.

Facteurs de risque de la coxarthrose a Lome (Togo)

Objectif et methodes. Une etude retrospective sur dossiers a ete menee afin de determiner les facteurs de risque de la coxarthrose en consultation rhumatologique a Lome (Togo). Resultats. 89 des 14 090 patients (52 hommes; 58;4et 37 femmes; 41;6) examines en 17 ans (0;6) souffraient d'une coxarthrose repondant aux criteres de Kellgren et Lawrence. La duree moyenne d'evolution de la coxarthrose etait de six ans. L'atteinte etait unilaterale chez 77 patients (86;5) et bilaterale chez les 12 autres (13;5). La coxarthrose etait primitive chez 41 patients (46;1) et secondaire chez les 48 autres (53;9). L'osteonecrose aseptique de la tete femorale (14 cas); les sequelles d'epiphysite de croissance (13 cas); la dysplasie (11 cas); le traumatisme de la coxo-femorale (6 cas); la fracture du col femoral (2 cas) et la tuberculose de la coxo-femorale (2 cas) etaient les facteurs de risque associes aux formes secondaires. Trois des 14 patients atteints d'osteonecrose aseptique de la tete femorale etaient porteurs d'hemoglobine SC et deux patients porteurs d'hemoglobine SS. Conclusion. L'osteonecrose aseptique de la tete femorale semble constituer le premier facteur de risque de la coxarthrose en Afrique Noire. Son impact risque de se renforcer avec l'allongement de l'esperance de vie des sujets drepanocytaires homozygotes et des doubles heterozygotes SC