Prevalence of atopy, asthma and COPD in an urban and a rural area of an African country

SummaryThe objectives of this study were to determine the prevalence of asthma, atopy and COPD in Rwanda and to identify risk factors. The survey was conducted in Kigali, the Capital of Rwanda, and in Huye District, a rural area located in southern Rwanda.MethodsA total of 2138 subjects were invited to participate in the study.1920 individuals (90%) answered to questionnaires on respiratory symptoms and performed spirometry, 1824 had acceptable spirograms and performed skin-prick test. In case of airflow obstruction (defined as pre-bronchodilator ratio FEV1/FVC < LLN) a post bronchodilator spirometry was performed. Reversibility was defined as an increase in FEV1 of 200 ml and 12% above baseline FEV1 after inhalation of 400 mcg of salbutamol.ResultsThe mean age was 38.3 years; 48.1% of participants were males and 51.9% females. Airflow obstruction was found in 256 participants (14%); 163(8.9%) subjects were asthmatics and 82 (4.5%) had COPD. COPD was found in 9.6% of participants aged 45 years and above. 484 subjects had positive skin-prick tests (26.5%); house dust mite and grass pollen mix were the main allergens. Risk factors for asthma were allergy, female gender and living in Kigali. COPD was associated with cigarette smoking, age and male sex.Conclusionthis is the first study which shows the prevalence of atopy, asthma and COPD in Rwanda. Asthma and COPD were respectively diagnosed in 8.9% and 4.5% of participants. COPD was diagnosed in 9.6% of subjects aged ≥45 years.The prevalence of asthma was higher in urban compared to rural area

Prevalence of dilated cardiomyopathy in HIV-infected African patients not receiving HAART: A multicenter, observational, prospective, cohort study in Rwanda

Introduction: Several studies performed before the introduction of highly active antiretroviral therapy (HAART) have shown that HIV-1 infection is an important cause of dilated cardiomyopathy. However, factors associated with the development of HIV-associated cardiomyopathy in developing countries are still debated. Objectives: To assess the prevalence of dilated cardiomyopathy, diagnosed by echocardiography, in HIV-infected Rwandese patients not receiving HAART and the risk factors associated with its development. Methods: A sample of 416 HIV-infected african patients, without a previous definite history of cardiovascular disease, attending University hospitals in Rwanda, from January to December 2005, were included in a multicenter, observational. prospective, cohort study, with the collaboration of two European Clinical Centers (in France and in Italy). Clinical and laboratory tests along with echo card in graphic examination were performed in all patients included in the study. Results: Out of 416 patients included in the study, dilated cardiomyopathy was documented by echocardiography in 71 (17.7%). By both univariate and multivariate analysis, low socio-economic status, estimated duration of HIV-1 infection, CD4 count, HIV-1 viral load, CDC stage B and C of HIV disease and low plasmatic level of selenium were factors significantly associated with the development of cardiomyopathy. Alcohol consumption and smoking were factors associated with the development of cardiomyopathy only by univariate analysis. Conclusions: HIV-associated cardiomyopathy is a significant clinical problem in HIV-infected patients not receiving HAART in Rwanda. Early tracking of cardiomyopathy in african HIV-infected patients is therefore recommended. Before administering HAART, clinicians should be aware of a possible existing cardiomyopathy to ensure appropriate, comprehensive, and rational patient care