[Diagnosis of arthritis in black Africa. Apropos of 473 cases in Congo]. / Le diagnostic des arthrites en Afrique noire. A propos de 473 cas au Congo.

A cross-sectional study of arthritis was conducted in the Rheumatology Department of the Brazzaville Teaching Hospital, Congo. A total of 473 patients with arthritis seen between 1989 and 1991 were subjected to the limited tests available. Gout was the leading diagnosis (n = 83). Septic arthritis (n = 82) and infectious discitis (n = 55) were the most common reasons for admission. Tests often failed to identify the causative organism; Staphylococcus was the most commonly recovered organism. Tuberculous discitis was less common than discitis due to pyogenic bacteria. HIV-related arthritis (n = 57) usually manifested as severe, febrile, asymmetrical, nonerosive, polyarthritis. Cases of rheumatoid arthritis (n = 29) fit the classical description of the disease. In 83 patients with monoarthritis, oligoarthritis, or polyarthritis, no etiology could be identified.

[Uterine rupture in an African environment. 59 cases at the University Hospital Center in Brazzaville]. / Les ruptures utérines en milieu africain. 59 cas colligés au CHU de Brazzaville.

A retrospective study of 59 uterine ruptures was conducted at the University Hospital in Brazzaville. The frequency fo uterine ruptures in this institution was found to by 0.7% among the 8,138 women who delivered between 28 ans 42 weeks amenorrhoea. The duration of this study was 26 months from 1 September 1989 to 31 October 1991. The mean age of the women was 26.5 years. Most had been transferred from peripheral centres (84.7%). The predominant aetiological circumstances were: multiparity (94.9%), cicatricial uterus (35.6%), poorly controlled use of ocytocic agents (32.2%) and mechanical dystocia (30.5%). The uterine ruptures were often complete (64.4%) and diagnosed in the perpartum period (54.2%). Maternal and foetal outcome was often fatal with 4 maternal deaths (6.7%) and 40 foetal deaths (67.8%). The main effort for prevention and reduction of this dramatic situation in Africa requires personnel training, equipping peripheral centres and improved highway system in order to allow rapid access to well equipped hospitals.