Qualite de vie du Personnel Hospitalier Lombalgique A Lome (Togo)

Objectif: Décrire les conséquences de la lombalgie commune sur la qualité de vie du personnel hospitalier du CHR Lomé Commune (CHR LC). Patients et Méthode: Il s’est agi d’une étude transversale réalisée du 15 décembre 2018 au 15 mars 2019 par autoquestionnaire auprès de 126 membres du personnel soignant hospitalier du CHR LC. La qualité de vie a été évaluée par le Questionnaire d’Owestry. Résultats: Soixante-dix neuf travailleurs sur 126 (62, 7 %) ont rapporté une lombalgie au cours des 12 mois précédant l’enquête. Le score d’Owestry a mis en évidence une incapacité minimale chez 74,2% des soignants, modérée chez 17,9%, sévère chez 3,2% et extrême chez 1,6% d’entre-eux. Les domaines les plus fréquemment affectés ont été : le port d’objets lourds (69%), les positions debout (65%) ou assise (51,3%) prolongées, la marche (50,7%), et l’intensité de la douleur (48,8%). Conclusion: L’impact de la lombalgie sur la qualité de vie des soignants est réel au CHR LC. Les positions debout et assise, le port d’objets lourds, et la vie sociale sont les domaines où l’incapacité est la plus sévère. La mise en oeuvre de programmes de prévention de la lombalgie est necessaire pour réduire cet impact. Objective: To describe the relationship between low back pain and quality of life among health professionals in CHR Lomé Commune (CHR LC). Patients and methods: A cross-sectional study was performed from December 2018 to March 2019 and included 126 staff members who filled-in the French version of the Oswestry Disability Index. Results: One hundred and twenty-six health professionals (70.8%) responded to the survey. Seventynine (62.7%) of the hospital staff reported low back pain during the preceding year. Professional activity was restricted in six workers (7,5%). The Owestry Index reflected minimal disability in 74,2% of care providres, and moderate disability to severe disability in 25.8% of them. Lifting (69%), standing (65%), sitting (51,3%), travelling (50,7%), and pain intensity (48,8%) were the most commonly reported. Conclusion: Impact of low back pain on the health professionals’ quality of life is serious in CHR LC. Standing, sitting, lifting, and sex are the most seriously affected. Strategies should be implemented to prevent occupational back pain

Prevalence et Facteurs de Risque de Lombalgie Chez Le Personnel Soignant A Lome (Togo)

Objectif: Décrire la fréquence et les facteurs de risque associés à la lombalgie commune chez le personnel soignant du CHR Lomé Commune (CHR LC). Patients et Méthode: Il s’est agi d’une étude transversale réalisée du 15 décembre 2018 au 15 mars 2019 par autoquestionnaire auprès de 126 membres du personnel soignant hospitalier du CHR LC. Résultats: 79 travailleurs sur 126 ont rapporté une lombalgie au cours des 12 mois précédant l’enquête soit une prévalence de 62, 7 %. Ils se répartissaient en 51 femmes et 28 hommes. Il s’agissait majoritairement d’infirmiers (37 cas, 29,4%) et de gardes malades (24cas, 19%). L’âge moyen des lombalgiques était de 42 ± 8,1 ans. Les facteurs de risque identifiés étaient l’âge (p=0,002), le sexe féminin (p=0,026), et la non connaissance des règles d’hygiène de la colonne vertébrale (p=0,034). La prise en charge de la lombalgie a été essentiellement symptomatique et a reposé sur les antalgiques (88,9%), les AINS (80,5%), et la kinésithérapie (53,2%). Seuls 28 soignants (26,6%) connaissaient les règles d’hygiène de la colonne. Trente-quatre soignants (43%) avaient bénéficié d’un arrêt de travail d’une durée moyenne de 09 jours ± 7,5. Le nombre total de journées de travail perdues était 281. Deux soignants (2,5%) avaient bénéficié d’un changement de poste, et quatre soignants (5,1%) d’un aménagement de poste (sortie du tour de garde). Conclusion: L’impact de la lombalgie sur la vie professionnelle des soignants justifie une senbilisation de ceux-ci aux facteurs de risque et aux mesures préventives. Objective: To describe the prevalence and the factors associated with low back pain among the health professionals in CHR Lomé Commune (CHR LC) in Togo. Patients and methods: A cross-sectional study was performed from December 2018 to March 2019 and included 126 staff members who filled-in a self-reported questionnaire. Results: 79 health workers (62.7%) among the 126 hospital staff reported low back pain during the preceding twelve months. They were 51 women and 28 men. The mean age of LBP patients was 42±8.1 years. The majority were nurses (37 cases, 29.4%) and nurse aides (24 cases, 19%). Their mean age was 42 ± 8,1 years. Factors associated with Low back pain included age (p=0.002), female gender (p=0.026), and lack of knowledge of back care techniques (p=0.034). Analgesics (88.9%), NSAID (80.5%), and physiotherapy (53.2%) were the most used tratements. Only 21 staff members (26,6%) knew back care techniques. Days off duty (absenteeism) has been observed in 34 (43%) of the hospitalstaff (mean : 09 days ± 7,5, total number of 281 days during the period of the survey). Professional activities were restricted in 6 cases (7,5%). Conclusion The professionnal impact of low back pain on health professionals is considerable. Risk factors and preventive measures should be taught

Lomboradiculalgie Du Sujet Âgé En Consultation Rhumatologique À Lomé, Togo

Objective: To study the epidemiological, diagnostic, therapeutic and outcome aspects of low back pain with radicular pain in rheumatology ward at Sylvanus Olympio Teaching Hospital at Lome, TOGO. Methods: It is a cross sectional study of 298 patients of 65 years and above, suffering from low back pain with radicular pain. They were admitted in the rheumatology ward of Sylvanus Olympio Teaching Hospital from January 2010 to December 2015. Results: 298 out of 768 patients examined within a period of five years (38.80%) were suffering from low back pain with radicular pain. These 298 patients comprises of 215 women (72.15%) and 83 men (27.85%) with an average age of 62.04 years at the onset. The mean age at the consultation was 70.72 ± 5.5 years. The mean duration of the diseases was 10.28 ± 23.81 months. The major diseases observed were degenerative disc (279 cases : 93.61%), bone tumors (16 cases : 5.38%), and spondylodiscitis (03 cases : 1.01%). The clinical manifestations of the degenerative disc of the lumbar spine were the LBP (209 cases : 74,91%) European Scientific Journal October 2017 edition Vol.13, No.30 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 223 and the narrowed lumbar canal (47 cases : 16.85%). The bone tumors were dominated by prostate cancer (five cases : 12,02%). The spondylodiscitis, probably of tuberculous origin, affected three patients, among whom was one Human Immunodeficiency Virus (HIV) patient. Conclusion: Degenerative disc is a frequent pathology nowadays, both in the Togolese population and in the elderly in particular. Nevertheless, efforts should be made to eliminate specific back pain in the elderly, whose clinical picture may be misleading

Profil Des Infections Ostéoarticulaires En Consultation Rhumatologique Au CHU- Kara (Togo)

Introduction: Osteoarticular infections remain public health problems in Africa. We aim at determining the clinical forms, topographic and etiological osteoarticular infections in a rheumatology unit of northern Togo. Methods: We conducted a cross-sectional study from April 2012 to March 2015 on inpatient records having suffered from musculoskeletal infection. Results: Of the 1813 patients admitted to the department in three years, 86 (4.74%) suffered from musculoskeletal infection. Of them, 36 (41.86%) were men and 50 (58.1% 4) were women, with a sex ratio (M/F) of 0.72. The mean age of the patients was 45 years. The mean duration of disease progression was 3.5 months. The different clinical forms observed were: spondylitis (47 patients, 54.65%), infectious arthritis (31 cases, 36.05%) and osteomyelitis (eight cases; 9.30%). The infection was likely tuberculous in 53 patients (61.63%), including 44 cases of Pott's disease. A banal germ was mentioned in the 33 others patients (38.37%). In four cases, the germ was isolated: Staphylococcus aureus (three cases) and Staphylococcus epidermidis (one case). The joints most affected by the infection were the hip (nine patients) and the knee (eight patients). Infection was multifocal in 14 cases (16.27%). The main risk factors for the infection identified were: promiscuity and poor hygiene (59.30%), alcoholism (26.74%) and retroviral infection (12.79%). Conclusion: This study and joint infections are a common reason for rheumatology consultation in northern Togo with a significant share of multifocal forms

The Signal-Chain at 'Proton – das freie Radio' : from Outplay to FM-Signal

nicht vorhande

Profil de la polyarthrite rhumatoïde en consultation rhumatologique à Lomé (Togo)

Objective: To determine epidemiological, clinical, therapeutic aspects and outcomes of rheumatoid arthritis (RA) in rheumatologic consultation at lome (Togo). Patients and method: This was retrospective study carried out from 1 stJanuary 1990 to 31 stDecember 2015 in the rheumatology department. The study included all patients suffered from RA in rheumatologic consultations and who fulfilled the 2010 ACR and EULAR’s criteria. Results: Ninety two (77 women and 15 men) out of 25.992 patients (0.3%) examined in 25 years had suffered from RA. The mean age at admission was 42 years (range: 17-82 years). The median duration of the diseases was four years (range: 14days – 20 days). The diseases onset was polyarticular with 86% of the patients and oligoarticular with the thirteen others (14%). The proximal interphalangeal (PIP) joints and metacarpophalangeal (MCP) joints are involved in 81,5 % of cases; and the wrists in 77,2% of cases. The rheumatoid hip was observed in four patients. Forty-two of the patients (45,6%) presented RA deformities. Bilateral MCP and IPP joint early erosion was observed in 36 patients (39,1%) and bilateral carpal diffuse osteoporosis in 44 patients (47,8%). The ankylosis of the carpal bones was observed in 26 patients (28,2 %). Rheumatoid factor was positive in 44% of patients. Methotrexate was the most commonly disease-modifying antirheumatic drugs used in 44,4% of the patients. The disease was improved in 89% of patients. Conclusion: Rheumatoid arthritis seems relatively rare in Togo. It’s diagnosis is often made at the established phase and methotrexate remains the cornerstone of the treatment

Prise En Charge Infirmière De La Douleur Chez L’adulte Au CHU-Kara (Togo)

Introduction: Pain is a frequent reason for consultation in health facilities. Thus, nurses are in the forefront in the fight against pain. The aim of this study was to determine the role of the nurse in the management of the painful adult patient. Methodology: It was a cross-sectional study conducted in 11 departments of Kara teaching hospital during two weeks. Nurses who had managed a painful adult in the past seven days were included in the study. Results: Thirty nurses participated in the study. They were made of 24 men (76.67%) and six women (23.33%). The average age of nurses was 35 years (extremes: 23 years old and 50 years old) and 43.33% of them had less than five years of work experience. The main etiologies of pain managed were: trauma (22%), headache (18%) and abdominal pain (14%). Pain assessment tools were almost non-existent. Fifty percent of nurses did not know pain assessment tools. The evaluation of pain was performed with conventional tools by 16% of nurses. The analogical visual scale was the most used (three out of five nurses). Nursing intervention was dominated by counseling (43%) and thermal stimulation (22%). The use of analgesics was carried out in 83.33% of cases. Conclusion: This study shows that few nurses evaluated the pain during its management in adults. Therefore, it is necessary to initiate medical training for Togolese nurses on the management of the painful patient in order to make them more effective

Prévalence De La Douleur Neuropathique Chez Des Patients Souffrant De Lomboradiculalgie Commune En Consultation Rhumatologique À Lomé (Togo)

Objective: To determine the prevalence and factors associated with neuropathic pain in patients with non-specific low back pain. Methods: This was a cross-sectional study conducted from May to July 2016 in the Rheumatology, Neurology and Neurosurgery departments of Lome. The DN4 questionnaire was used for the diagnosis of neuropathic pain in the 200 patients with low back pain included in this study. Results: Of the 200 patients (147 women and 53 men) included in the study, neuropathic pain was present in 92 (46%). The average age of the 92 patients (67 women vs 25 men, p = 0.04) was 55.5 ± 12.4 years (women 55.2 ± 12.8 vs. men 54.6 ± 11.4, p = 0.5). The characteristics of neuropathic pain mainly found were: burning sensation (n = 67, 72.8%); electrical discharges (n = 64, 69.6%); tingling (n = 90; 97.8%); tickling (n = 57; 62%); numbness (n = 89; 96.7%); hypoesthesia (n = 52; 56.5%). Factors significantly associated with the presence of neuropathic pain in LBP were age (p = 0.005), duration of LBP (p = 0.04), high blood pressure (p = 0.001), radicular pain (p = 0.00002) and the past history of the LBP (0.000000). Conclusion: Neuropathic pain is common in patients with LBP at Lome. The duration of LBP, past history of LBP, previous NSAID use, BMI, pain severity and radicular pain appear to be predictive of the occurrence of these neuropathic pains

Le Syndrome Du Canal Carpien À Lomé (Togo)

Objectif: Décrire les caractéristiques sociodémographiques, cliniques et thérapeutiques des patients souffrant d’un syndrome du canal carpien à Lomé, au Togo. Patients et Méthode: Il s’est agi d’une étude transversale menée sur dossiers du 1er janvier 2011 au 31 décembre 2018 dans les trois Services Hospitaliers de Rhumatologie de Lomé (Togo). Résultats: Cent quatre-vingt-douze patients (166 femmes, 126 hommes) ont présenté un syndrome du canal carpien pendant la période d’étude. Leur âge moyen était de 54, 2 ±13 ans (extrêmes: 26 et 83 ans). L’indice de masse corporelle moyen était de 28, 8 ± 6, 1 kg/m2 (extrêmes: 18 et 55, 4). Le sexe féminin, l’obésité (p=0,001), et le travail prolongé à l’ordinateur (p=0,005) ont été identifiés comme des facteurs de risque de SCC. Les manifestations cliniques ont été dominées par les paresthésies à type de fourmillements (77,1% des patients) et la douleur (57,8% des patients). L’atteinte était bilatérale chez 120 patients (62,5%). Cent neuf patients (56,8%) ont présenté un signe de Tinel, et 39 patients (20,3%) ont présenté un signe de Phalen associé au signe de Tinel. La presence du signe de Tinel était corrélée à l’obésité (p=0,001). Le traitement était représenté par les infiltrations locales de cortioïdes (147 patients, 76,6%), les antalgiques et les antiinflammatoires non stéroïdiens(104 patients, 54,2%). Conclusion: Le SCC à Lomé est habituellement idiopathique. Le sexe féminin, l’obésité, et le travail prolongé à l’ordinateur sont des facteurs de risque. Les infiltrations locales de corticoïdes sont efficaces. Objective: To describe the socio-demographic, clinical and therapeutic characteristics of patients with carpal tunnel syndrome (CTS) in Lomé (Togo). Patients and methods: This was a cross-sectional study. Data were collected from 1 st of January 2011 to 31st of December 2018 in three Rheumatologic Hospital Wards in Lomé. Results: One hundred and ninetytwo patients were diagnosed with CTS (166 women and 26 men). Their average age was between 54.2 ±13 years (range from 26 to 83 years). The average body mass index of male and female patients was 28, 8 ± 6, 1 kg/m2 (range 18 and 55.4). Female gender, obesity (p=0,001), and prolonged computer use (p=0,005) were identified as key risk factors. The main symptoms were: tingling paresthesia (77.1%) and pain (57.8%). The symptoms were bilateral in 120 patients (62.5%). The Tinel sign was positive in 109 patients (56.8%), and 39 patients (20,3%) had both the Tinel sign and the Phalen sign. The Tinel sign was related to obesity (p= 0,001). Management of CTS was performed by local steroid injections (147 patients, 76,6%), pain killers and NSAID (104 patients, 54,2%). Conclusion: CTS is usually idiopathic in Lomé. Female gender, obesity and prolonged computer use are risk factors. Local infiltration of steroids is an effective treatment