Incidence, prevalence, and mortality of type 1 diabetes in children and youth in Burkina Faso 2013-2022.

AIM: There are no data on type 1 diabetes (T1D) incidence and prevalence in Burkina Faso. We aimed to determine these in persons aged <25 years (y) since the implementation of Life for a Child (LFAC) program in 2013. PATIENTS AND METHODS: Data were collected from the prospective program register. Diagnosis of T1D was clinical, based on presentation, abrupt onset of symptomatic hyperglycemia, need for insulin replacement therapy from diagnosis, and no suggestion of other diabetes types. RESULTS: We diagnosed 312 cases of T1D <25y in 2013-2022. Male-to-female ratio was 1:1. T1D incidence <25y per 100,000 population/year increased from 0.08 (CI 95% 0.07-0.60) in 2013 to 0.34 (CI 95% 0.26-0.45) in 2022 (p=0.002). Incidence <15y/y rose from 0.04 (CI 95% 0.01-0.10) to 0.27 (CI 95% 0.18-0.38) per 100,000/year in 2013 and 2022, respectively (p < 0.002). Prevalence per 100,000 population <25y was 0.27 (CI 95% 0.19-0.37) in 2013 and rose to 1.76 (CI 95% 1.546-1.99) in 2022 (p<0.0001). Mortality rate was 20 (CI 95% 13-29.6) per 1,000-person y. CONCLUSIONS: There is a low but sharply rising T1D incidence and prevalence rates in children and youth in Burkina Faso since LFAC program implementation. It is very likely this is partly due to improved case detection. Mortality remains substantial.

Comparison of regular with NPH insulin vs. premix insulin in children and adolescents with type 1 diabetes in a resources-limited setting: a retrospective data analysis.

OBJECTIVES: Few studies addressed the efficacy of human insulin regimens (mostly premix insulin) used in many low-and-middle income countries on glycemic control of children and adolescents with diabetes. The aim of this study was to assess the efficacy of the premix insulin on the glycated hemoglobin (HbA1c) in comparison to the regular with NPH insulin scheme. METHODS: A retrospective study was carried out from January 2020 to September 2022 on patients with type 1 diabetes aged below 18 years followed in Burkina Life For A Child program. They were categorized into three groups, on regular with NPH insulin (Group A), on premix insulin (Group B) and on regular with premix insulin (Group C). Outcome was analyzed based on HbA1c level. RESULTS: Sixty-eight patients with a mean age of 15.38 ± 2.26 years and the sex ratio (M/W) 0.94 were studied. There were 14 in Group A, 20 in Group B, and 34 patients in Group C. The mean HbA1c value in the corresponding insulin regimen was 12.8 ± 1.39%, 9.87 ± 2.18%, and 10.66 ± 2.1%, respectively. Glycemic control was better in Groups B and C than Group A (p<0.05) but there was no difference between groups B and C. CONCLUSIONS: Our results indicate that the use of premix insulin gives a better glycemic control than NPH insulin. However, further prospective study of these insulin regimens with a strengthening education strategy and glycemic control by continuous glucose monitoring and HbA1c is required to corroborate these preliminary findings.

Evaluation de la satisfaction des patients hospitalisés dans les services du département de Médecine du Centre hospitalier universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso, Burkina Faso

La satisfaction des usagers des établissements sanitaires fait partie de l'appréciation de la qualité des soins. L'objectif était d'étudier la satisfaction des patients hospitalisés dans les services du département de médecine du Centre hospitalier universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso, Burkina Faso. Il s'est agi d'une étude transversale à visée analytique conduite en 8 mois. Les domaines de satisfaction ont été calculés selon le modèle SAPHORA (version 7). Des 294 patients éligibles, 250 (85,0 %) patients ont été retenus dont 42,0 % de femmes. L'âge moyen des patients était de 47,1 (± 17,9) ans. Les domaines à score faible étaient : niveau global de satisfaction, accueil, communication avec le personnel, restauration et organisation de la sortie. Les patients plus âgés et ceux à durée d'hospitalisation plus longue étaient plus satisfaits. Les 94,0 % des patients sans assurance maladie étaient moins satisfaits.Les scores des domaines de satisfaction par service et le score global de satisfaction étaient inférieurs à 50,0 %. Les différences entre les services étaient en lien avec : accueil, qualité humaine du personnel, soins médicaux, hôtellerie, restauration, coûts, et niveau global de satisfaction. L'amélioration de la satisfaction des patients hospitalisés requiert le respect des besoins fondamentaux des patients et une réorganisation des services avec un personnel engagé, pour l'offre de soins et services de santé de qualité

[Electrocardiography coupled with transthoracic echocardiography at rest in the diagnosis of cardiac impairments in type 2 diabetics: lessons learned from a cross-sectional case series in Burkina Faso]. / Electrocardiographie couplé à l'échocardiographie transthoracique de repos dans le diagnostic des atteintes cardiaques chez le diabétique de type 2: les enseignements d'une série transversale au Burkina Faso.

Diabetes is a powerful independent cardiovascular risk factor. The aim of this study is to describe the electrocardiographic and echocardiographic abnormalities observed in patients with type 2 diabetes treated in the Department of Medicine at the University Hospital in Bobo-Dioulasso. We conducted a descriptive cross-sectional study of all patients with type 2 diabetes who gave consent from April to September 2014. We gathered clinical data from all the patients. They, moreover, underwent electrocardiography and doppler echocardiography. A total of 155 diabetics were investigated. The average age of patients was 55 years (IQR: 47-64) with a female predominance (sex ratio 0.5). Electrocardiographic abnormalities included repolarization abnormalities (31%) and atrial rhythm disorders (16,12%). Echocardiographic examination showed left ventricular hypertrophy (LVH) in 20,64% of cases. Left atrium was dilated in 14.19% of cases, LV was dilated in 1.3% of cases. Abnormal left ventricular ejection fraction was detected in 3.87% of cases. Nosological entities included hypertensive heart disease in 27 cases (54%), ischemic heart disease in 19 cases (38%), dilated cardiomyopathy in 2 cases (4%) and diabetic cardiomyopathy in 2 cases (4%). Heart failure was detected in 22 cases (44%) independently from cardiac impairment. Electrocardiographic and echocardiographic abnormalities are frequent in type 2 diabetes population at the University Hospital in Bobo-Dioulasso. Improved cooperation between cardiologists and diabetologists as well as the establishment of adequate technical screening equipment would be prerequisite for better cardiac risk stratification in this population.

High Nasal Carriage Rate of Staphylococcus aureus Containing Panton-Valentine leukocidin- and EDIN-Encoding Genes in Community and Hospital Settings in Burkina Faso.

The objectives of the present study were to investigate the rate of S.aureus nasal carriage and molecular characteristics in hospital and community settings in Bobo Dioulasso, Burkina Faso. Nasal samples (n = 219) were collected from 116 healthy volunteers and 103 hospitalized patients in July and August 2014. Samples were first screened using CHROMagar Staph aureus chromogenic agar plates, and S. aureus strains were identified by mass spectrometry. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar. All S. aureus isolates were genotyped using DNA microarray. Overall, the rate of S. aureus nasal carriage was 32.9% (72/219) with 29% in healthy volunteers and 37% in hospital patients. Among the S. aureus isolates, only four methicillin-resistant S. aureus (MRSA) strains were identified and all in hospital patients (3.9%). The 72 S. aureus isolates from nasal samples belonged to 16 different clonal complexes, particularly to CC 152-MSSA (22 clones) and CC1-MSSA (nine clones). Two clones were significantly associated with community settings: CC1-MSSA and CC45-MSSA. The MRSA strains belonged to the ST88-MRSA-IV or the CC8-MRSA-V complex. A very high prevalence of toxinogenic strains 52.2% (36/69), containing Panton-Valentine leucocidin- and EDIN-encoding genes, was identified among the S. aureus isolates in community and hospital settings. This study provides the first characterization of S. aureus clones and their genetic characteristics in Burkina Faso. Altogether, it highlights the low prevalence of antimicrobial resistance, high diversity of methicillin-sensitive S. aureus clones and high frequency of toxinogenic S. aureus strains.

Caractéristiques thérapeutiques des diabétiques suivis au chu de Bobo-Dioulasso, Burkina Faso

Objectif. Le diabète est un problème majeur de santé publique, notamment dans les pays à ressources limitées d'Afrique, où sa prévalence ne cesse de croitre. L'objectif de notre étude était de déterminer les caractéristiques thérapeutiques des diabétiques suivis au Centre Hospitalier Universitaire de Bobo-Dioulasso, au Burkina Faso.Méthodes. Nous avons entrepris une étude transversale descriptive de septembre 2010 à juillet 2011, dans le Département de Médecine dudit centre hospitalier, qui a concerné 388 diabétiques consentants, suivis dans le département depuis au moins un an. Les données ont été collectées par revue documentaire, interview, examens physique et complémentaires.Résultats. L'âge moyen des sujets était de 53,5±13,5 ans. Les femmes étaient majoritaires et représentaient 58,0% de l'effectif. Le diabète de type 2 représentait 91,2% des cas, celui de type 1 8,5% des cas. Tous les patients ont déclaré suivre un régime sans sucre d'absorption rapide. Près de sept diabétiques de type 2 sur dix, étaient sous antidiabétiques oraux, à base de biguanides et/ou de sulfamides hypoglycémiants. L'insulinothérapie faisait appel essentiellement aux insulines ordinaire et intermédiaire. L'administration de l'insuline était assurée par le patient lui-même dans environ deux-tiers des cas, cette différence étant statistiquement associée à l'ancienneté du diabète. Seuls 1,5% des diabétiques bénéficiaient d'une assurance-maladie.Conclusion. La prise en charge du diabète est essentiellement assurée par le patient et sa famille au Centre Hospitalier Universitaire de Bobo-Dioulasso. La mise en place de structures de soutien telles l'assurance maladie et les mutuelles de santé, permettrait de soutenir les sujets souffrant de cette pathologie chronique grave