Mortalite des accidents vasculaires cerebraux a la phase aigüe au centre Hospitalier Universitaire Souro Sanou Bobo-Dioulasso; Burkina Faso

Introduction: Les accidents vasculaires cérébraux (AVC) sont des urgences médicales fréquentes dans le monde, en particulier en Afrique, où ils sont grevés d‘une lourde mortalité.Objectif : Notre objectif était d‘analyser la mortalité et les facteurs liés au pronostic vital des patients  hospitalisés pour AVC au centre hospitalier Sourô SANOU de Bobo-Dioulasso.Méthodologie: Il s‘agit d‘une étude rétrospective portant sur les dossiers de 331 malades hospitalisés pour AVC du 1er janvier 2009 au 31 décembre 2013.Résultats: L‘âge moyen était de 61,01 ±13 ans avec un sex-ratio de 1,58 en faveur des hommes. Les principaux facteurs de risque cérébro-vasculaires retrouvés étaient l‘HTA chronique (68,23 %), le tabagisme (18,85 %), l‘antécédent d‘AVC (17,69 %), le diabète (7,35 %). Le délai moyen de consultation des cas d‘AVC était de 24 heures (42,54%). Les troubles de la conscience étaient notés chez 38,20% des AVC. La mortalité intra hospitalière était de 28,21% avec des décès survenant principalement dans les 24 premières heures (86,67%). Les facteurs associés à la mortalité étaient l‘âge (p=0,001; OR 2,4 ; IC95%1,4-4,1), le coma (p<0,001; OR= 3,8 ; IC95% :1,8-8,1), le type d‘AVC (p=0,007; OR= 2,0 ; IC95%:1,2-3,3), la prescription de mesures de réanimation (p <0,001; OR= 3,5 ; IC95%:1,6-7,8) ainsi que l‘hospitalisation en unité de réanimation (p <0,001; OR= 9,9 ; IC95%: 4,8-20,6).Conclusion: La mortalité intra hospitalière des AVC à Bobo Dioulasso reste élevée et survient surtout à la phase aigüe.   English title: Mortality among patients admitted for acute stroke in Sourô Sanou Teaching Hospital of Bobo-Dioulasso; Burkina Faso Introduction: Strokes are frequent medical emergencies in the world, especially in Africa, where they are burdened by a heavy mortality.Objective: Our objective was to analyze mortality and factors linked to the prognosis for survival of the patients hospitalized for stroke in Sourô SANOU teaching hospital of Bobo-Dioulasso.Methodology: It was a retrospective study concerning the cases of 331 patients admitted to hospital for stroke from January 1st, 2009 to December 31st, 2013.Results: The mean age was 61.01 (±13 years). The sex-ratio was 1.58. Chronic high blood pressure (68.23 %), smoking (18.85 %), history of stroke (17.69 %), diabetes (7.35 %) were the most frequent cerebro-vascular risk factors in past medical history. The average time for consultation was 24 hours (42.54 %). Loss of consciousness was noted in 38.20 % of the stroke patients. The fatality rate was 28.21 % occurring mostly during the first 24 hours. The factors associated with mortality were age (p=0.001; OR 2.4 ; IC95% :1.4-4.1), coma (p<0.001; OR= 3.8 ; IC95% :1.8-8.1), type of stroke (p=0.007; OR= 2.0 ; IC95%:1.2-3.3), prescription of resuscitation‘s measures (p <0.001; OR= 3.5 ; IC95%:1.6-7.8) and hospitalization in resuscitation unit (p <0,001; OR= 9.9 ; IC95%: 4.8-20.6).Conclusion: The in hospital m rtality remains high and occurs mainly in acute stage in stroke patients in Bobo Dioulasso

Prevalence of and factors associated with human cysticercosis in 60 villages in three provinces of Burkina Faso

Background : Taenia solium, a zoonotic infection transmitted between humans and pigs, is considered an emerging infection in Sub-Saharan Africa, yet individual and community-level factors associated with the human infection with the larval stages (cysticercosis) are not well understood. This study aims to estimate the magnitude of association of individual-level and village-level factors with current human cysticercosis in 60 villages located in three Provinces of Burkina Faso. Methodology/Principal Findings : Baseline cross-sectional data collected between February 2011 and January 2012 from a large community randomized-control trial were used. A total of 3609 individuals provided serum samples to assess current infection with cysticercosis. The association between individual and village-level factors and the prevalence of current infection with cysticercosis was estimated using Bayesian hierarchical logistic models. Diffuse priors were used for all regression coefficients. The prevalence of current cysticercosis varied across provinces and villages ranging from 0% to 11.5%. The results obtained suggest that increased age, being male and consuming pork as well as a larger proportion of roaming pigs and percentage of sand in the soil measured at the village level were associated with higher prevalences of infection. Furthermore, consuming pork at another village market had the highest increased prevalence odds of current infection. Having access to a latrine, living in a household with higher wealth quintiles and a higher soil pH measured at the village level decreased the prevalence odds of cysticercosis. Conclusions/Significance : This is the first large-scale study to examine the association between variables measured at the individual-, household-, and village-level and the prevalence odds of cysticercosis in humans. Factors linked to people, pigs, and the environment were of importance, which further supports the need for a One Health approach to control cysticercosis infection

Frequency of recurrent stroke in Burkina Faso: an observational hospital based study of 6 months

Introduction: studies on stroke recurrence are rare in sub Sahara Africa. The aim to this study is to determine the prevalence and risk factors for recurrent stroke in two University Teaching Hospital in Burkina Faso. Methods: this prospective cross-sectional study was carried on 266 stroke patients admitted in two hospitals in the city of Ouagadougou from September 1, 2017 to February 28, 2018. Patients with stroke recurrence (ischemic or hemorrhagic) were included. Results: of 266 acute stroke patients included, 44(16.4%) had recurrent stroke. The mean age of patients was 66.5 ± 11.49 years with male predominance. Hypertension was the most vascular risk factors (81.8%). Previous stroke was ischemic in 61.4%, hemorrhagic in 22.7% and unknown in 15.9% of cases. Poor compliance (< 60%) was determined in patients taking antiagregant agents (43.6%) and statins (50%). At admission, the most neurological disorders was motor deficit (100%), aphasia (84.1%), and deglutition disorders (15.9%). CT scan showed ischemic in 82% and hemorrhagic stroke in 18% of cases. With the analysis of second stroke, recurrent stroke after intracerebral hemorrhage was hemorrhagic in 77.8% and ischemic in 22.2%. Recurrent stroke after ischemic stroke was ischemic in 100%. Conclusion: stroke recurrence is common in our context. Hypertension was the most common vascular risk factor in recurrent stroke. Poor compliance was determined in patients taking antiagregant agents and statins in previous stroke

Data-driven analyses of behavioral strategies to eliminate cysticercosis in sub-Saharan Africa

The multi-host taeniosis/cysticercosis disease system is associated with significant neurological morbidity, as well as economic burden, globally. We investigated whether lower cost behavioral interventions are sufficient for local elimination of human cysticercosis in Boulkiemdé, Sanguié, and Nayala provinces of Burkina Faso. Province-specific data on human behaviors (i.e., latrine use and pork consumption) and serological prevalence of human and pig disease were used to inform a deterministic, compartmental model of the taeniosis/cysticercosis disease system. Parameters estimated via Bayesian melding provided posterior distributions for comparing transmission rates associated with human ingestion of Taenia solium cysticerci due to undercooking and human exposure to T. solium eggs in the environment. Reductions in transmission via these pathways were modeled to determine required effectiveness of a market-focused cooking behavior intervention and a community-led sanitation and hygiene program, independently and in combination, for eliminating human cysticercosis as a public health problem (<1 case per 1000 population). Transmission of cysticerci due to consumption of undercooked pork was found to vary significantly across transmission settings. In Sanguié, the rate of transmission due to undercooking was 6% higher than that in Boulkiemdé (95% CI: 1.03, 1.09; p-value < 0.001) and 35% lower than that in Nayala (95% CI: 0.64, 0.66; p-value < 0.001). We found that 67% and 62% reductions in undercooking of pork consumed in markets were associated with elimination of cysticercosis in Nayala and Sanguié, respectively. Elimination of active cysticercosis in Boulkiemdé required a 73% reduction. Less aggressive reductions of 25% to 30% in human exposure to Taenia solium eggs through sanitation and hygiene programs were associated with elimination in the provinces. Despite heterogeneity in effectiveness due to local transmission dynamics and behaviors, education on the importance of proper cooking, in combination with community-led sanitation and hygiene efforts, has implications for reducing morbidity due to cysticercosis and neurocysticercosis

Deux ans de pratique d’électroencéphalographie au Centre Hospitalier Universitaire Régional de Ouahigouya

L’électroencéphalographie est un examen fonctionnel, indolore de base et incontournable pour détecter et localiser toute activité électrique anormale du cerveau. Il permet aussi de diagnostiquer et surveiller les épilepsies. Son interprétation est performante qu’avec les données cliniques précises et les traitements reçus par les patients.L’objectif de ce travail était d’évaluer les 2 années de pratique de base de l’électroencéphalographie du 01 Juin 2020 au 30 Juin 2022, au Centre Hospitalier Universitaire Régional de Ouahigouya. Il a porté sur les 275 patients ayant effectué des tracés colligés par un échantillonnage exhaustif

Epilepsies à pointes centro-rolandiques au Centre Hospitalier Universitaire Régional de Ouahigouya

L’épilepsie est une affection chronique fréquente en consultation de neurologie au centre hospitalier régional de Ouahigouya. L’objectif de ce travail est d’étudier les épilepsies à pointes centro-rolandiques au centre universitaire régional de Ouahigouya. Il s’agissait d’une étude rétrospective à visée descriptive, conduite du 01 janvier 2016 au 31 décembre 2021 au service de consultation de neurologie du Centre Hospitalier Universitaire Régional de Ouahigouya. Soixante-quinze patients avec un âge inferieur ou égal à 15 ans, ont été colligés par échantillonnage exhaustif. La fréquence hospitalière de l’épilepsie à pointes centro-rolandiques était de 29,18% de l’ensemble des enfants épileptiques reçus

Development of a health education intervention strategy using an implementation research method to control taeniasis and cysticercosis in Burkina Faso

Background: Taeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite transmitted between humans and pigs, leading to considerable economic loss and disabilities. Transmission of the parasite is linked to environmental and behavioural factors such as inadequate sanitation and hygiene, poor pig management, and consumption of infected pork. This study used implementation research method to design a health education intervention strategy for reducing T. solium infections in Burkina Faso, a country endemic for the parasite. Methods: Eighteen group discussions were conducted with 8-18 participants each in three villages. In addition, structured interviews were conducted among 4 777 participants and 2 244 pig owners, who were selected through cluster random sampling in 60 villages of three provinces of Burkina Faso. Both approaches assessed knowledge and practices related to T. solium. The information obtained was used to develop a community-adapted health education intervention strategy to control taeniasis and cysticercosis in Burkina Faso. Results: The group discussions revealed that participants had a poor quality of life due to the diseases as well as inadequate access to latrines, safe water, and healthcare services. In addition, it was found that pig production was an important economic activity, especially for women. Furthermore, financial and knowledge constraints were important limitations to improved pig management and latrine construction. The survey data also showed that open defecation and drinking unboiled water were common behaviours, enhanced by a lack of knowledge regarding the transmission of the parasite, perceived financial barriers to the implementation of control measures, lack of public sensitization, as well as a lack of self-efficacy towards control of the parasite. Nevertheless, the perceived financial benefits of controlling porcine cysticercosis could be emphasized by an education program that discourages open defecation and encourages drinking safe water. The final intervention strategy included a Participatory Hygiene and Sanitation Transformation (PHAST) approach, as well as a 52-min film and an accompanying comic booklet. Conclusions: The main problem in the study communities regarding the transmission of T. solium cysticercosis is the random disposal of human faeces, which can be contaminated with parasite eggs. Prevention of open defecation requires the building of latrines, which can be quite problematic in economically challenged settings. Providing the community with the skills to construct durable latrines using low-cost locally available materials would likely help to resolve this problem. Further studies are required to implement and evaluate the T. solium control strategy developed in this study