Profil respiratoire et performance motrice chez les patients congolais atteints de broncho-pneumopathie chronique obstructive lors du test de marche de six minutes

Objectifs : Identifier et analyser chez les broncho-pneumopathes chroniques obstructifs (BPCO) en état stable, les facteurs déterminants de la distance parcourue au test de marche de six minutes (TDM) et de la dyspnée en fin de test. Patients et méthodes : Les patients BPCO ont été évalués par épreuves fonctionnelles, questionnaire de Saint-Georges (QRSG) et TDM avec mesures de capacité respiratoire (CI) et d'oxymétrie. Résultats : Quatre-vingt-deux patients (volume expiré par seconde [VEMS] moyen 56 ± 19%) ont été étudiés. La distance moyenne au TDM était de 477 ± 89% (72 ± 14% valeurs prédites [VP]). La distance au TDM (cm) était corrélée avec le VEMS, le rapport CI/CPT, la CPT, le CI avant le test et le rapport capacité de diffusion du monoxyde de carbone ramenée au volume aléatoire (DLCO/VA). En pourcentage VP, la distance au TDM était corrélée à la capacité résiduelle fonctionnelle (CRF), à la CI avant le test et au score activité du QRSG. La dyspnée fine de TDM était corrélée avec la CRF, la dyspnée pré-TDM et avec les scores activités et totale du QRSG.Conclusion : Les facteurs déterminants de la dyspnée au cours du TDM sont complexes ; ils dépendent de facteurs fonctionnels et non-fonctionnels. Le TDM est un test d'exploration à valeur intégrative dans la BPCO

Variations de la lactatemie a l'effort et au cours de la recuperation chez des sportifs fumeurs

But : Evaluer l'influence du tabagisme et du niveau de dependance nicotinique sur la variation de la lactatemie pendant l'effort et apres la recuperation chez des sportifs. Materiel et methodes : 126 footballeurs (63 fumeurs et 63 non fumeurs) evoluant dans le championnat d'elite congolais ont ete soumis a un test d'effort rectangulaire et sous maximal; sur un cycloergometre. Des dosages repetes de lactates sanguins ont ete effectues et les variations de la lactatemie durant et apres l'effort ont ete comparees entre les deux groupes; en fonction de la dependance nicotinique. Resultats : nous avons observe une evolution de la lactatemie en deux phases dans les deux groupes ; une phase croissante et une decroissante. La lactatemie etait toutefois plus elevee lors de la phase croissante (p0;001); de meme que la vitesse d'elimination des lactates etait lus lente chez les fumeurs. Le taux des lactates etait directement proportionnel au degre de dependance nicotinique (p0;01). Conclusion : le tabac expose les footballeurs a une hyperlactatemie au cours de l'effort. Cette elevation est proportionnelle au degre de dependance nicotinique. Nos resultats renforcent l'interet des campagnes anti-tabac en milieu sportif dans le but d'ameliorer les performances des facteurs

[Sexual behaviour among adolescents in Brazzaville, Congo]. / La sexualité de l'adolescent à Brazzaville, Congo.

AIM: Estimate sexual activity among Congolese adolescents in Brazzaville and appreciate the influence of sociocultural and economic factors on sexual behaviour. METHODS: Data were collected from 900 adolescents (389 males and 511 females) aged 10-19 years in the seven urban areas of Brazzaville. These subjects were randomly recruited by a two stage sampling. The data were gathered by an anonymous face-to-face questionnaire. Relative risk estimations were calculated for early or first sexual intercourse, multiple sexual partnerness and safe sex. RESULTS: A total of 474 respondents indicated that they were sexually active. Females were more sexually active, 270 compared with 204 males (p<0.05). The mean early age of coital debut was 14.6 years (S.D.=1.7 years). Early intercourse (before 14 years) was found in 73 males and 39 females (p<0.001). Multiple sexual partnerness was found in 81.3% of males, while the frequency of females was 51.1%. Risk factors for pregnancy and multiple sexual partnerness were unemployment mother, non school situation, early puberty and non sexual education. In contrast, regular religious activity was recognized as factor that had significant protection impact on sexual activity. The total use ratio of the condom was estimated at 42.2% in males. More females (41.7%) were using Ogino method of contraception. In addition, 102 females (36.8%) claimed to have already a pregnancy and the mean age was 16.1 years (S.D.=1.2 years). In 64.7% of these cases, teenagers chose the abortion as solution of an unwanted pregnancy. After the birth of a child, it was reported that 82.4% of adolescents gave up with school. CONCLUSION: Our results show the importance of problems associated to sexual activity among Congolese adolescents in Middle Africa. These data should be taken into account when planning the prevention of risk of sexual behaviours among adolescents.

Tabagisme chez l'adolescent a Brazzaville (Congo)

Objectifs : Evaluer la prevalence du tabagisme chez l'adolescent et en identifier les facteurs determinants. Methode : Il s'agit d'une enquete transversale realisee d'octobre 2005 a Aout 2006 dans les sept arrondissements de Brazzaville (Congo). L'echantillonnage s'est effectue selon la methode de sondage en grappes a partir des sept arrondissements de Brazzaville. Resultats : 4135 adolescents de cette etude; 444 d'entre eux soit 10;3fumaient. La consommation de tabac apparaissait significativement elevee chez les garcons que chez les filles (p0;01); chez les 15-19 ans que chez les 10-14 ans (p0;001); chez les non scolarises (p0;05); en l'absence de pratique religieuse (p0;01); et chez les adolescents issus de familles nulli et monoparentales. En revanche; il n'existait pas de difference significative entre les adolescents fumeurs ayant une activite sportive (42;6) et les autres (57;4). Enfin; parmi ces adolescents; 65fumaient moins de 5 cigarettes par jour et 3plus de 20 cigarettes. Conclusion : Malgre une prevalence inferieure a celle observee dans les pays temperes; le tabagisme a Brazzaville merite une attention particuliere; en raison du risque potentiel d'aggravation

[A nutrition survey among schoolchildren in Brazzaville, Congo]. / Profil alimentaire de l'écolier à Brazzaville, Congo.

OBJECTIVE: To identify nutritional characteristics among schoolchildren in Brazzaville, Congo. POPULATION AND METHODS: A 3-day feeding survey was undertaken in 3 primary education schools in the Brazzaville borough. The study was conducted among 1066 schoolchildren (534 boys, 532 girls) ranging from 6 to 14 years. The subjects were divided into 4 age groups: 6-7, 8-9, 10-11 and 12-14 years old. The evolution of the feeding was studied according to age, and the nutritional intakes were compared with recommended dietary allowances. RESULTS AND DISCUSSION: The energy intakes were low, the mean caloric intake was 1984.9+/-448 Kcal. They increased between 6 and 14 years, especially between 13 and 14 years, where mean increase was twice as important as between 6 and 7 years. Energy provided by the evening meal was equivalent to 67.5% of mean caloric intake per day. The quantities of aliments taken increased with age. In addition, there were excesses and insufficiencies common or specific to the Congolese children of 4 age groups. High natrium intakes were observed at age 12 years, insufficient intakes of phosphore and lipids at 10 years. CONCLUSION: On the basis of the observation of the schoolchildren's behavior at Brazzaville, poverty seems to influence the schoolchildren's nutritional status. But, one could propose dietary advices, in order to improve the problems described here.

[Body composition in Negro African children suffering from sickle cell disease. A mixed cross-sectional longitudinal study in Brazzaville, Congo]. / Composition corporelle d'enfants drépanocytaires homozygotes congolais. Etude longitudinale a Braz- zaville, Congo.

This study evaluates the changes of body composition in homozygous children suffering from sickle cell disease and appreciates the interaction between some factors of severity of the disease. A mixed cross-sectional longitudinal study with control cases cohort was conducted in Brazzaville (Congo) among 91 children with sickle cell disease (45 boys and 46 girls) and 95 healthy children (48 boys and 47 girls), aged of 8-17 years old. Each group was initially divided into three subgroups of age: 8, 11, 14. These children were subsequently followed for 3 years. Each year, at the same period, body mass, percentage of body fat, lean body mass and body mass index were evaluated in the two groups and then compared. The effects of frequency of painful episodes, the number of severe anaemia crisis and haemoglobin F on different variables were also appreciated. The children with sickle cell disease had stunting, lower values of body mass (p < 0.001), percentage of fat (p < 0.01), lean body mass (p < 0.01), and body mass index (p <0.001) between 8 and 17 years of age. In addition, we observed a non linear association between body mass index and fat percentage, but this interaction was stronger in girls. Finally the yearly frequency of painful episodes, the number of severe anaemia crisis and haemoglobin F had most of the time an influence on body composition. Children with sickle cell disease had a decreased body composition influenced by the complications associated with the disease . These limitations are modulated by haemoglobin F but the body composition is affected by painful episodes and severe anaemic crisis. Therefore more care and attention are recommended for the children suffering from sickle cell disease in order to control this severe disease.

[The effects of smoking and the degree of nicotine dependence on aerobic capacity in sportsmen]. / Effets du tabagisme et du niveau de dépendance nicotinique sur la capacité aérobie chez le sportif.

AIM: To assess the effects of smoking and the degree of nicotine dependence on aerobic capacity in smokers undergoing endurance training. METHODS: 126 smokers aged between 18 and 31 years playing in the football teams of the Congolese first (n = 64) and second divisions (n = 64) co-operated voluntarily in the study. Aerobic capacity was determined by Cooper's running test. Absolute VO2max and that related to body weight were subsequently calculated. The degree of nicotine dependence of each subject was assessed by the Fagerstrom questionnaire. A control group consisted of 125 non-smokers playing at the same level. RESULTS: The values of VO2max achieved by the smokers were significantly less (p < 0.05) than those achieved by the non-smokers. The first division players had a higher aerobic capacity than the second division players. Moreover the analysis of variance showed an influence of nicotine dependence on aerobic capacity. The subjects who were heavily dependent on nicotine had lower VO2max values than those less dependent. Moreover for the same level of dependence there were differences between the first and second division players. CONCLUSION: The inhalation of tobacco smoke leads to an alteration in aerobic capacity. This is directly influenced bythe degree of nicotine dependence whatever the level of training of the subject.

[Recovery from exercise in trained smokers]. / Récupération post-exercice chez le sportif fumeur.

AIM: Assess the influence of tobacco on recovery after exercise in sportsmen. METHODS: Sixty-three smokers aged 18-33 years, practising soccer, participated in this study. These subjects belonged to second division congolese league clubs. Heart rate (HR) was studied during recovery of moderate exercise (Ruffer's test), but also recovery index and arterial pressure. Kinetics of the HR was studied for 7 min for recovery. A control group consisted of 50 non smokers, practising soccer at similar level. RESULTS: Smokers showed heart rate values significantly higher (P < 0.001). Non smokers presented a low recovery index. The recovery has generally two components: the first is slow in smokers, while the second is a fast one. However, recovery rate for the smokers was more rapid during the alactic phase. There exists also differences with regards to smoking tobacco dependence: when compared to great smokers, lower smokers exhibited a faster first phase and a slower second phase. These differences were significant. DISCUSSION AND CONCLUSION: The smokers and non smokers differences are discussed with reference to the effects of nicotinemia and carbon monoxide on sympathetic-parasympathetic balance. Cardiovascular changes during exercise have a twofold control: decrease a vagal tone and increase of sympathetic activity. The comparison of smokers and non smokers concerning recovery led to suppose that there exists a difference in regards of the catecholaminergic sensitivity. The problem of thermoregulation must not be neglected during recovery. As smokers are considered, cutaneous thermolysis is perhaps important when these subjects perform exercise in ambient hot air. Here against, it is known that thermolysis mechanisms are not similar in smokers and non smokers. In conclusion, this study showed that smoking tobacco induce a lower physical condition in sportmen. Recovery rate after exercise may function as a predictor of fitness in smokers.

[Effect of smoking on weight and cardiopulmonary capacities in young athletes]. / Effets du tabagisme sur le poids corporel et les capacités cardiorespiratoires de jeunes sportifs.

The aim of the study was to determine wether smokers practising sports have reduced weight, if recuperation time after moderate exercise and maximal aerobic power were lowered. Thousand young soldiers [50 smokers (S), 50 no smokers (NS)] averaging 24 years in age were studied. The subjects performed to exhaustion on Ruffier test, then a maximal exercise with Cooper test. Several biometrical and physiological parameters were evaluated: weight (W), percent of body fat (PBF), body mass index (BMI), maximal oxygen uptake (VO2 max) and recuperation index (RI). Kinetics of heart rate (HR) were studied for 7 min considering time constant (1 min) and delay for recovery. The smokers showed significant differences for W (p < 0.001), PBF (p < 0.05), VO2 max (p < 0.01) and recuperation index (p < 0.001). Maximal aerobic power were 45.8 +/- 2.7 and 50.3 +/- 3.2 ml/kg/min for S and NS, and RI were 7.5 +/- 0.9 (S) and 5.0 +/- 1 (NS). figure 1 shows that HR recovery of S has generally two components: the first was fast, the second was a slone none. The smokers who presented a great dependence to tobacco smoking had a significant lower RI (p < 0.001) as those subjects with little tobacco dependence (Table 5). The smokers had lower values of VO2 max, and there exists a tobacco dependence difference. Recuperation time for the aerobically well trained S subjects was more rapid during the lactic phase. Note that correlations obtained between the VO2 max and RI were significant (r = - 0.788; p < 0.05). The smokers and no smokers differences are discussed with reference to nicotinemia effects and the sympathetic-parasympathetic unbatance of influences. The comparison of smokers groups concerning cardiovascular data led to suppose that there exists a tobacco dependence difference in regards of the catecholaminergic sensitivity. In conclusion, this study showed that smoker practising a physical activity have a reduced weight, a higher recuperation time and an anaerobic limitation influenced by the state of tobacco dependence.