Polyarthrite Rhumatoïde au Niger : États des Lieux

Objectif : faire une revue des données de la littérature sur les aspects épidémiologiques, cliniques, paracliniques et thérapeutiques de la polyarthrite rhumatoïde au Niger. Méthodes : Cette revue des données de la littérature sur la polyarthrite rhumatoïde au Niger a été réalisée en utilisant les bases de données MEDLINE (via PUBMED) et de Google Scholar. Les critères d’inclusion comprenaient des études publiées chez des adultes de plus de 18 ans ayant reçu un diagnostic de polyarthrite rhumatoïde. L’extraction des données a été réalisée grâce à un formulaire préétabli. Résultats : La recherche dans la littérature a identifié 5 articles. Finalement, quatre articles ont été inclus pour la revue. La fréquence de la polyarthrite rhumatoïde a été rapportée dans trois études, celle-ci variait de 1,24% à 3,7%. Le genre féminin représentait 79 (79,79%) des patients. L’âge moyen globale était de 43,41 ans. Le délai moyen avant le diagnostic était de 53,2 mois. La polyarthrite rhumatoïde a été diagnostiqué en utilisant les critères ACR 1987 et les critères ACR/EULAR 2010. Tous les patients avaient consulté pour une polyarthrite. Le coup de vent cubital était retrouvé chez 27 (27,27%) patients. Les nodules rhumatoïdes ont été retrouvé chez 12 (12,12%) patients. Les facteurs rhumatoïdes étaient positifs chez 56 (56,56%) patients. Les anticorps anti peptides cycliques citrullinés étaient positif chez 7 (7,07%) patients. Le méthotrexate était le traitement de fond chez 67 (67,67%) patients et l’hydroxychloroquine chez 43 (43,43%) patients. Conclusion : Le diagnostic de la polyarthrite est tardif au Niger. La création d’un registre national des patients ayant une polyarthrite rhumatoïde permettra un meilleur suivi des patients.   Objective: To review the epidemiologic, clinical, paraclinical and therapeutic aspects of rheumatoid arthritis in Niger. Methods: This review of literature on rheumatoid arthritis in Niger was conducted using MEDLINE (via PUBMED) and Google Scholar databases. Inclusion criteria included studies published in adults over 18 years of age with a diagnosis of rheumatoid arthritis. Data extraction was done using a pre-designed form. Results: The literature search identified 5 articles. Four articles were finally included in the review. The frequency of rheumatoid arthritis was reported in three studies and ranged from 1.24% to 3.7%. Females accounted for 79 (79.79%) of the patients. The mean age was 43.41 years. The mean time to diagnosis was 53.2 months. Rheumatoid arthritis was diagnosed according to ACR 1987 and ACR/EULAR 2010 criteria. All patients had a history of polyarthritis. Ulnar gale was found in 27 (27.27%) patients. Rheumatoid nodules were found in 12 (12.12%) patients. Rheumatoid factors were positive in 56 (56.56%) patients. Anti-cyclic citrullinated peptide antibodies were positive in 7 (7.07%) patients. Methotrexate was the background treatment in 67 (67.67%) patients and hydroxychloroquine in 43 (43.43%) patients. Conclusion: Polyarthritis is diagnosed late in Niger. The creation of a national registry of rheumatoid arthritis patients will allow better follow-up of patients

Polyarthrite Rhumatoïde au Niger : Etats des Lieux

 Objectif : Faire l’état des lieux sur les aspects épidémiologiques, cliniques, paracliniques et thérapeutiques de la polyarthrite rhumatoïde au Niger. Méthodes : Cette revue des données de la littérature sur la polyarthrite rhumatoïde au Niger a été réalisée en utilisant les bases de données MEDLINE (via PUBMED) et de google scholar. Les critères d’inclusion comprenaient des études publiées chez des adultes de plus de 18 ans ayant reçu un diagnostic de polyarthrite rhumatoïde. L’extraction des données a été réalisée grâce à un formulaires préétablis. Résultats : La recherche dans la littérature a identifié 5 articles. Finalement, quatre articles ont été inclus pour la revue. La fréquence de la polyarthrite rhumatoïde a été rapportée dans trois études, celle-ci variait de 1,24% à 3,7%. Le genre féminin représentait 79 (79,79%) des patients. L’âge moyen globale était de 43,41 ans. Le délai moyen avant le diagnostic était de 53,2 mois. La polyarthrite rhumatoïde a été diagnostiqué en utilisant les critères ACR 1987 et les critères ACR/EULAR 2010. Tous les patients avaient consulté pour une polyarthrite. Le coup de vent cubital était retrouvé chez 27 (27,27%) patients. Les nodules rhumatoïdes ont été retrouvé chez 12 (12,12%) patients. Les facteurs rhumatoïdes étaient positifs chez 56 (56,56%) patients. Les anticorps anti peptides cycliques citrullinés étaient positif chez 7 (7,07%) patients. Le méthotrexate était le traitement de fond chez 67 (67,67%) patients et l’hydroxychloroquine chez 43 (43,43%) patients. Conclusion : Le diagnostic de la polyarthrite est tardif au Niger. La création d’un registre national des patients ayant une polyarthrite rhumatoïde permettra un meilleur suivi des patients.   Objective: To review the epidemiologic, clinical, paraclinical and therapeutic aspects of rheumatoid arthritis in Niger. Methods: This review of literature on rheumatoid arthritis in Niger was conducted using MEDLINE (via PUBMED) and google scholar databases. Inclusion criteria included studies published in adults over 18 years of age with a diagnosis of rheumatoid arthritis. Data extraction was done using a pre-designed form. Results: The literature search identified 5 articles. Four articles were finally included in the review. The frequency of rheumatoid arthritis was reported in three studies and ranged from 1.24% to 3.7%. Females accounted for 79 (79.79%) of the patients. The mean age was 43.41 years. The mean time to diagnosis was 53.2 months. Rheumatoid arthritis was diagnosed according to ACR 1987 and ACR/EULAR 2010 criteria. All patients had a history of polyarthritis. Ulnar involvement was found in 27 (27.27%) patients. Rheumatoid nodules were found in 12 (12.12%) patients. Rheumatoid factors were positive in 56 (56.56%) patients. Anti-cyclic citrullinated peptide antibodies were positive in 7 (7.07%) patients. Methotrexate was the background treatment in 67 (67.67%) patients and hydroxychloroquine in 43 (43.43%) patients. Conclusion: Polyarthritis is diagnosed late in Niger. The creation of a national registry of rheumatoid arthritis patients will allow better follow-up of patients

Occlusion intestinale aigue révélant un lymphome T digestif associé à la maladie coeliaque, à propos d’un cas

Le lymphome T intestinal associé à une entéropathie ou Enteropathy associated T-cell lymphoma (EATL), est une complication rare de la maladie coeliaque (MC). Nous rapportons l’observation d’un lymphome T associée à une MC révélé par une occlusion intestinale aigue. Une patiente maghrébine de 38 ans, aux antécédents de stérilité et de douleurs abdominales chroniques, était admise en urgence pour occlusion intestinale aigue. L’intervention chirurgicale retrouvait une tumeur au dépend du grêle avec des adénopathies mésentériques. L’histologie et l’immunohistochimie de la pièce opératoire objectivait un lymphome T digestif CD3+ et le bilan immunologique de la maladie coeliaque était positif. Le diagnostic d’EATL était ainsi retenu. La patiente était mise sous chimiothérapie (CHOEP) et régime sans gluten avec une réponse complète au traitement. L’EATL est une complication rare de la MC qui peut être révélée par une occlusion intestinale. Son pronostic peut être amélioré par une prise en charge précoce associant chirurgie et chimiothérapie. Sa prévention passe par un diagnostic précoce de la MC et un régime sans gluten.Pan African Medical Journal 2016; 2

Disseminated Herpes Zoster in the Immunocompetent, A Case at Zinder National Hospital

Introduction: Herpes zoster, shingles, is a secondary pathology due to a reactivation of the varicella-zoster virus (VZV) and common in the general population. It is responsible for a painful skin rash localized in the area of the body innervated by a nerve root. The rash can be widespread affecting several dermatomes especially in the immunocompromised subject. Observation: We report an observation of disseminated shingles in an immunocompetent adult hospitalized in the Internal Medicine Department of Zinder National Hospital. AT 55 years old, was admitted for management of a very painful skin rash. Pruriginous vesicles extended diffusely out of the metameric topography to all the enveloping membranes of the body including vulvo-vaginal and oral enanthem. Biologically, blood count (CBC), blood glucose, and renal function were normal. Human immunodeficiency virus (HIV) status was negative. The clinical course was uneventful characterized by apyrexia at 48 hours and drying of the lesions. Medical care was based on symptomatic treatment. Conclusion: Shingles is a common viral disease, but potentially serious in some situations. The disseminated form is exceptional in the immunocompetent subject. Its detection and early treatment ensure a reduction in the severity of the complications. &nbsp

Facteurs prédictifs de décès au cours de la TB pulmonaire chez les PvVIH au CNHU Fann de Dakar

Objectives: In sub-Saharan Africa, tuberculosis is the first pulmonary-located opportunistic infection and the leading cause of death among people living with HIV (PLWHA). This paper focuses on studying the predictive factors of death in people co-infected with pulmonary tuberculosis and HIV at the Ibrahima DIOP MAR clinic for infectious and tropical diseases at the CHNU Fann in Dakar. Materials and Methods: This was a retrospective, descriptive, and analytical study conducted from 1st January 1998 to 31st December 2009. It has been of interest to all patients with a successful pulmonary tuberculosis diagnosis and positive HIV status. Epidemiological, clinical, para-clinical, and progressive parameters were studied. Results: A total of 665 cases of tuberculosis/HIV co-infection were observed during the study period, of which 207 deaths or lethality (31.37%) was recorded. The average age of patients was 39±9 years with extremes of 5 and 74 years. The average length of hospitalization was 31.67 ± 20.67 with extremes of 4 and 312 days for surviving patients compared to 19.00 ± 16.42 with extremes of 1 to 90 days for deceased patients. Immunosuppression was significantly associated with death (p=0.001) with a median CD4 of 32.50 elts/mm3. Lethality was significantly elevated in the presence of dyspnea (p= 0, 00014), consciousness disorder (p=10-6 ), motor deficit (p= 0.008), and hemoptysis (p= 0.03). Conclusion: Tuberculosis/HIV co-infection is a common association in Africa. Here, we are talking about a deadly duo. Taking it requires a good knowledge of the factors of poor prognosis and a good integration of the two programs

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Genital tract of zebu (Bos indicus) cows in Niger

Les caractéristiques anatomiques et les structures ovariennes et pathologiques du tractus génital de 500 femelles zébus (Bos indicus), appartenant à quatre races bovines (Azawak, Bororo, Djelli, Goudali), ont été étudiées à l’abattoir de Niamey au Niger du 15 août au 15 décembre 2011. Chaque animal a été examiné avant abattage. Ces vaches et génisses, âgées en moyenne de 8 ± 2,5 ans, ont eu une note d’état corporel moyenne de 1,6 ± 0,6 et un poids moyen de carcasse de 113 ± 21 kg. Les caractéristiques anatomiques du tractus génital n’ont pas présenté de différences entre les races (p > 0,05). Les caractéristiques suivantes ont été observées : diamètre du col 3,4 ± 1,1 cm, longueur du col 8,1 ± 2,5 cm, longueur des cornes 21,6 ± 5,2 cm, diamètre des cornes 1,6 ± 0,5 cm, longueur et largeur de l’ovaire droit respectivement 19,8 ± 4,4 et 11,2 ± 3,8 mm, de l’ovaire gauche 18,8 ± 4,5 et 10,2 ± 3,3 mm, et poids des ovaires droit et gauche respectivement 2,9 ± 1,8 et 2,5 ± 1,6 g. Un corps jaune a été identifié dans seulement 14 p. 100 des cas et l’absence de follicules visibles à la surface de l’ovaire a été notée dans 32 p. 100 des cas. Ces caractéristiques ont été significativement (p < 0,05) influencées par l’âge de l’animal. Parmi les femelles examinées, 7,4 p. 100 ont été confirmées gravides. Diverses pathologies de l’appareil génital (kystes, infections utérines, free-martinisme, pyomètre ) ont été observées sur 10,4 p. 100 des tractus génitaux.The anatomical characteristics, and the ovarian and pathological structures of the genital tract of 500 zebu (Bos indicus) females belonging to four breeds (Azawak, Bororo, Djelli, Goudali) were studied at Niamey’s slaughterhouse in Niger from August 15 to December 15, 2011. Each animal was examined before slaughter. The cows and heifers were on average 8 ± 2.5 years old. Their mean body condition score was 1.6 ± 0.6 and mean carcass weight 113 ± 21 kg. The anatomical characteristics of the genital tract did not show differences between breeds (p > 0.05). The following characteristics were observed: cervix diameter 3.4 ± 1.1 cm, cervix length 8.1 ± 2.5 cm, horn length 21.6 ± 5.2 cm, horn diameter 1.6 ± 0.5 cm, length and width of the right ovary 19.8 ± 4.4 and 11.2 ± 3.8 mm, of the left ovary 18.8 ± 4.5 and 10.2 ± 3.3 mm, and weight of the right and left ovaries 2.9 ± 1.8 and 2.5 ± 1.6 g, respectively. A corpus luteum was identified in only 14% cases and no visible follicles were found on the surface of the ovaries in 32% cases. These characteristics were significantly (p < 0.05) influenced by the age of the animal. Among the examined females, 7.4% were confirmed pregnant. Various genital tract diseases (cysts, uterine infection, free martinism, pyometra...) were observed in 10.4% of the genital tracts

From problem to progress: Rodent management in agricultural settings of sub-Saharan Africa and calling for an urban perspective

International audienceHighlights: • In Africa, agricultural intensification and urbanization are major changes. • These changes increase the risk of rodent proliferation in rural and urban habitats. • Conventional rodent control relies on reactive, inappropriate use of rodenticides. • Ecologically-Based Rodent Management has been poorly tested in sub-Saharan Africa. • This method can be a realistic, sustainable and environment-friendly alternative.Abstract: In sub-Saharan Africa, agricultural intensification and urbanization have increased the risk of proliferation of rodents in rural and urban habitats. Management of rodent populations is a challenge in terms of food security and public health. However, conventional efforts to manage rodents are currently reactive and based on the inadequate use of synthetic chemical rodenticides, including first- and second-generation anticoagulants and acute rodenticides. This approach carries substantial environmental and health risks and has yielded limited success in terms of reduction of rodent populations sustainably. In this paper, which is the second part of a diptych, we advocate for a shift towards more sustainable and environmentally friendly approaches, such as Ecologically-Based Rodent Management (EBRM), as a realistic alternative to synthetic rodenticides. This method is based on a good knowledge of habitat use, species diversity and population dynamics of major rodent pests, and involves community-based interventions aimed at reducing rodent abundance to economically and hygienically acceptable levels in the long term. We present for the first time a comprehensive compilation of published and unpublished information derived from observational field studies conducted in Ethiopia, Niger, Nigeria, Benin, Mali, Mauritania and Senegal with the aim to provide an overview of EBRM case studies in these countries of sub-Saharan Africa. This paper intends to serve as a catalyst for change, encouraging the transformation of rodent management practices towards sustainable methods. We aim at stimulating further research and interventions that promote EBRM in Africa, ultimately fostering more environmentally conscious and effective solutions.Graphical abstract: https://ars.els-cdn.com/content/image/1-s2.0-S0261219424001017-ga1.jp

Land, Climate, Energy, Agriculture and Development in the Sahel: Synthesis paper of case studies under the Sudano-Sahelian Initiative for Regional Development, Jobs, and Food Security

This paper synthesizes a set of national case studies conducted in the Sahelian countries during 2019-2020 as a collaboration between national universities and research institutes, and the Center for Development Research (ZEF), University of Bonn, with contributions from the Agrhymet Regional Centre, Permanent Interstate Committee for Drought Control in the Sahel (CILSS). These case studies provide up-to-date knowledge and critical insights on the nexus of land degradation, climate change and energy in the Sahel. The current synthesis paper highlights their major findings and provides crosscutting and cross-regional analytical conclusions. First, the synthesis paper explores current trends in the Sahel region on land use and land degradation, energy use and supply, climate change projections and impacts, as well as their interactions and links to agricultural growth, food security, poverty reduction, and peace in the region. Second, technological, socio-economic and policy solutions at the nexus of land, water, energy and climate challenges that enable environmentally sustainable and socially inclusive rural development in the Sahel are discussed, including their interactions and implications for peace and stability in the region. The findings show that such socio-economic solutions as improving access to markets, strengthening social safety nets, increasing investments to transport and energy infrastructures, promoting land tenure security, expanding off-farm employment opportunities can greatly contribute to rural development in the Sahel, particularly by aiding climate change resilience and sustainable land management. Key technological innovations highlighted across the case studies include expanding irrigation and adopting water use efficient irrigation techniques, crop diversification, expanding agricultural mechanization, investing into restoring and rehabilitating degraded lands through reforestation, afforestation and agroforestry practices. The key lessons learnt from ongoing national policy initiatives for sustainable development highlight the importance of active stakeholder consultation and participation in policy formulation, institution of effective policy monitoring and assessment mechanisms, and avoiding of excessive reliance on external sources of funding for the successful implementation of sustainable development policies and programs. Based on these findings, the synthesis paper proposes an agenda for applied research to provide guidance to and accompany promising development strategies in and for the region