Diet, Alcohol Consumption and Cognitive Disorders in Central Africa: A Study from the EPIDEMCA Program.

Western research into dementia has focused on finding effective means of prevention, particularly through nutrition. To date, however, little is known about the relationship between diet and cognitive disorders in Africa, where the number of people with dementia is expected to increase most over the coming decades. The objective of the study was to investigate the relationship between diet and alcohol intake and cognitive disorders among elderly people in Central Africa. Between 2011 and 2012, a cross-sectional multicentre population-based study was carried out in rural and urban areas of the Central African Republic (CAR) and the Republic of Congo (ROC). Participants aged ≥65 years were interviewed using the Community Screening Interview for Dementia (CSI-D). Elderly people who performed poorly (COGSCORE≤24.5/30) were clinically assessed by neurologists and underwent further psychometric testing. DSM-IV and Petersen criteria were required for a diagnosis of dementia or mild cognitive impairment (MCI), respectively. A food frequency questionnaire assessed the intakes of dairy products, fruit, vegetables, starches, legumes, oleaginous foods, meat or fish, eggs and sweet foods over the previous three days. We also collected data on alcohol intake. Sociodemographic, vascular, and psychological factors were documented. Multivariate multinomial logistic regression models were used to estimate the associations. In fully adjusted models, a lower consumption of oleaginous foods was associated with MCI (OR=3.7 [1.4-9.9]) and dementia (OR=2.8 [1.0-7.7]) in a rural area of CAR. Alcohol consumption was associated with reduced probability of dementia in CAR (OR=0.3 [0.1-0.8]). In ROC, food groups and alcohol intake were not associated with MCI or dementia. In conclusion, our study provides new data about the association between diet and cognitive disorders in Africa. Further studies should investigate the relationship between diet and cognitive disorders at the level of specific foods rather than food groups.

[Recurrent quadric paralysis in an 11-year-old girl with spinal tuberculosis]. / Tétraplégie récidivante chez une enfant de 11 ans présentant un mal de Pott cervical.

The authors report a recurring quadric paralysis in a 11-year-old girl with cervical, pulmonary and mediastinal tuberculosis. The diagnosis was belated. After the first treatment with anti tuberculosis drugs and immobilization with a surgical collar, an improvement has been obtained; but at the 8th month of this treatment, a partial paralysis of superior members and total paralysis of inferior members appeared. A treatment with streptomycin, ethambutol, rifampicin, pyrazinamide, isoniazide, and prednisone was undertaken. The spontaneous motility was observed at 37 days of treatment. However, at the 8th months of this treatment, quadric paralysis happened again after a fall down. After immobilization with a new surgical collar and prednisone, the spontaneous motility came back again 3 months later.