RESUMO
OBJECTIVE: To investigate visceral comorbidities observed during gout. PATIENTS AND METHOD: A descriptive and analytical cross-sectional study of gout patients diagnosed according to the ACR 1977 criteria, followed between January 1, 2012 and January 31, 2017 in the Rheumatology Department of the Brazzaville University Teaching Hospital in Congo. Patients were assessed for visceral cardiovascular, renal, and cerebral comorbidities. RESULTS: 105 patients with gout were identified during the study period, 75 (71.43%) of whom met the inclusion criteria, thus constituting the study population. There were 60 men and 15 women (sex ratio 4/1), mean age 60 +/- 11.47 years (range: 30-82 years). Visceral co-morbidities were represented in 50.67% of cases. These included renal failure (21.33%), coronary heart disease (14.67%), stroke (12%) and heart failure (2.67%). The presence of comorbidities was associated with irregular follow-up in 86.56% of cases (P = 0.025) and therapeutic nonobservance in 93.75% of cases (P = 0.006). CONCLUSION: Gout is a serious disease because of the frequency of its visceral comorbidities. Irregular monitoring and therapeutic nonobservance are the main factors associated with this.
OBJECTIF: Rechercher les comorbidités viscérales observées au cours de la goutte. PATIENTS ET MÉTHODE: Etude transversale descriptive et analytique, portant sur les patients goutteux diagnostiqués selon les critères ACR 1977, suivis entre le 1erjanvier 2012 et le 31 janvier 2017 dans le service de Rhumatologie du CHU de Brazzaville au Congo. Les patients ont été évalués à la recherche de comorbidités viscérales cardiovasculaires, rénales et cérébrales. RÉSULTATS: 105 patients goutteux ont été répertoriés durant la période d'étude, dont 75 (71,43%) qui répondaient aux critères d'inclusion, constituant ainsi la population d'étude. Il s'agissait de 60 hommes et de 15 femmes (sex-ratio de 4/1), d'âge moyen de 60 +/- 11,47 ans (extrêmes: 30-82 ans). Les comorbidités viscérales étaient représentées dans 50,67 % des cas. Il s'agissait de l'insuffisance rénale (21,33%), la maladie coronarienne (14,67%), les AVC (12%) et l'insuffisance cardiaque (2,67%). La présence des comorbidités était associée à un suivi irrégulier dans 86,56% des cas (P=0,025) et une mauvaise observance thérapeutique dans 93,75% des cas (P=0,006). CONCLUSION: La goutte est une maladie grave de par la fréquence de ses comorbidités viscérales. Le suivi irrégulier et l'inobservance thérapeutique en sont les principaux facteurs associés.
RESUMO
Objectif : Rechercher les comorbidités viscerales observees au cours de la goutte. Patients etMethode : Etude transversale descriptive et analytique, portant sur les patients goutteux Diagnostiques selon les criteres ACR 1977, suivis entre le 1erjanvier 2012 et le 31 janvier 2017 dans le Service de Rhumatologie du CHU de Brazzaville au Congo. Les patients ont ete evalues a la recherche De comorbidites visceralescardiovasculaires, renales et cerebrales. Resultats : 105 patients goutteux Ont ete repertories durant la periode d'etude, dont 75 (71,43%) qui repondaient aux criteres D'inclusion, constituant ainsi la population d'etude. Il s'agissait de 60 hommes et de 15 femmes (sexratioDe 4/1), d'age moyen de 60 +/- 11,47 ans (extremes: 30-82 ans). Les comorbidites viscerales Etaient representees dans 50,67 % des cas. Il s'agissait de l'insuffisance renale (21,33%), la maladie Coronarienne (14,67%), les AVC (12%) et l'insuffisance cardiaque (2,67%). La presence des Comorbidites etait associee a un suivi irregulier dans 86,56% des cas (P=0,025) et une mauvaise Observance therapeutique dans 93,75% des cas (P=0,006). Conclusion : La goutte est une maladie Grave de par la frequence de ses comorbidites viscerales. Le suivi irregulier et l'inobservance Therapeutique en sont les principaux facteurs associes
Assuntos
Congo , Doença da Artéria Coronariana , GotaRESUMO
Outbreaks of Ebola virus hemorrhagic fever (EVHF) have been reported since 2001 in the Cuvette Ouest department, a forested area located in the Western North of Congo. At the end of October 2003 a new alarm came from this department which was quickly confirmed as being an epidemic of EVHF. The outbreak response was organized by the ministry of health with the assistance of an international team under the aegis of WHO. The case management of suspect cases was done in an isolation ward set up at the hospital; when patients refused to go to the ward for care they were isolated in their house according to a protocol "transmission risks reduction at home". Safe burials were performed by specialized teams which respected the major aspects of the funeral to allow the process of mourning of the families. An active surveillance system was set up in order to organize the detection of new cases and the follow-up of their contacts. A case definition was adopted. From October 11 to December 2, 2003, 35 cases including 29 deaths were reported, 16 cases were laboratory confirmed. The first four cases had been exposed to monkey meat (Cercopithecus nictitans). The epidemic spread was due to family transmission. The population interpretation of the disease, in particular questions around wizards and evil-minded persons, is a factor which must be taken into account by the medical teams during communication meetings for behavioral change of the populations. The case management of patient in isolation wards to prevent the transmission of the virus in the community remains the most effective means to dam up Ebola virus hemorrhagic fever outbreaks. The good perception by the community of the safe funerary procedures is an important aspect in the establishment of confidence relations with the local population.
