Lipid profile frequency and the prevalence of dyslipidaemia from biochemical tests at Saint Louis University Hospital in Senegal

Introduction: The aim of this study was to evaluate the frequency of lipid profile requests and the  prevalence of dyslipidemia in patients at the biochemistry laboratory of St. Louis University Hospital, as well as their correlation with sex and age. Methods: This was a retrospective study reviewing 14,116  laboratory results of patients of both sexes, over a period of six months (January-June 2013) regardless of the indication for the request. The lipid parameters included were: Total cholesterol, HDL-cholesterol, LDL-cholesterol, trig lycerides with normal values defined as follows: Total cholesterol (<2g/l), HDL- cholesterol (>0,40g/l), LDL- cholesterol (<1,30g/l) and Triglycerides (<1,50g/l). Results: The average age of our study population was 55.15 years with a female predorminance (M/F=0.60). The age group most represented was that between 55-64 years. The frequency of lipid profile request in our sample was 9.41% (or 1,329). The overall prevalence of isolated hypercholesterolemia, hyperLDLaemia,  hypoHDLaemia, hypertriglyceridaemia, and mixed hyperlipidemia were respectively 60.91%, 66.27%, 26.58%, 4.57% and 2.75%. Hypercholesterolemia, hyperLDLaemia, hypertriglyceridaemia and mixed hyperlipidaemia were higher in women with respectively 66.22%, 67.98%, 4.58%, 2.89% than in men (52.01%, 62.81%, 4.44% and 2.40% respectively). On the other hand, the prevalence of hypoHDLaemia was higher in males (32.19%) compared to females (23.76%). Hypercholesterolemia correlated  significantly with age and sex. Conclusion: Our study showed a relatively low request rate for lipid profile and a high prevalence of dyslipidaemia hence the importance of conducting a major study on the prevalence of dyslipidaemia and associated factors in the Senegalese population.Key words: Lipid profile, dyslipidaemia, prevalence, Senega

Dyslipidemia, obesity and other cardiovascular risk factors in the adult population in Senegal

Introduction: According to the WHO, 50% of deaths worldwide (40.1% in developing countries) are due to chronic non-communicable diseases (NCDs). Of these chronic NCDs, cardiovascular diseases remain the leading cause of death and disability in developed countries. The Framingham study has shown the importance of hypercholesterolemia as a primary risk factor. In Senegal, the epidemiology of  dyslipidemia and obesity are still poorly understood due to the lack of comprehensive studies on their  impact on the general population. This motivated this study to look into the key epidemiologic and socio-demographic determinants of these risk factors. Methods: It was a cross-sectional descriptive epidemiological survey which included 1037 individuals selected by cluster sampling. Data were collected using a questionnaire following the WHO STEPwise approach. Socio-demographic, health and biomedical variables were collected. P value Results: The average age was 48 years with a female predominance (M: F of 0.6). The literacy rate was 65.2% and 44.7% of participants were from rural areas. The prevalence of hypercholesterolemia, hyperLDLemia, hypoHDLemia, hypertriglyceridemia and mixed hyperlipidemia were 56%, 22.5%, 12.4%, 7.11% and 1.9% respectively. One in four was obese (BMI> 30kg/m2) and 34.8% had abdominal obesity. The main factors significantly associated with dyslipidemia were obesity, urban dwelling, physical inactivity and a family history of dyslipidemia. Conclusion: The prevalence of dyslipidemia, obesity and other risk factors in the population was high needing immediate care for those affected and implementation of prevention strategies.Key words: Dyslipidemia, obesity, cardiovascular, risk factors, Saint Loui

Profil épidémiologique de la Tuberculose, Sénégal, 2009-2018: Epidemiological profile of Tuberculosis, Senegal, 2009-2018

Introduction: Le fardeau de la tuberculose (TB) pose un grave problème de santé publique au Sénégal. Nous avons analysé les données de surveillance de la tuberculose pour décrire le poids et la tendance de la tuberculose au Sénégal. Méthodes: Nous avons effectué une analyse secondaire des données de surveillance de la tuberculose du 1er janvier 2009 au 31 décembre 2018 du programme national de lutte contre la tuberculose (PNT). Résultats: Au total, 128 836 cas de tuberculose toutes formes ont été analysées dont 67,42% de nouveaux cas de TB pulmonaire confirmée par microscopie. Les personnes âgées de 25-34 ans représentaient 29,66%. Le sex-ratio H/F était de 2,33. Dakar avait rapporté la plupart des cas 44,17%. L'incidence pour 100 000 habitants était de 91, 87 et 86 en 2009, 2008 et 2011, de 93, 95 et 95 en 2012, 2013 et 2014 et de 92, 86, 87 et 84 en 2015, 2016, 2017 et 2018. La majorité des cas (77%) avaient été testés pour le VIH, dont 6,84% co-infectés. Le taux de TB multirésistante (TB-MR) était de 11%. Conclusion: Au Sénégal, l'incidence de la tuberculose a légèrement diminué en raison du faible taux de détection qui était de 62% en 2018. Le nombre de cas détecté a augmenté entre 2013 et 2014, mais elle restait inférieure à celle estimée par l'organisation mondiale de la santé. Une surveillance accrue de la tuberculose et un suivi des tuberculeux pour éviter la pharmaco-résistance sont nécessaires. Introduction: The burden of tuberculosis (TB) is a serious public health problem in Senegal. We analysed TB surveillance data to describe the burden and trend of TB in Senegal. Method: We conducted a secondary analysis of TB surveillance data from 1 January 2009 to 31 December 2018 from the national TB control programme (NTP). Results: A total of 128,836 cases of all forms of tuberculosis were analysed, of which 67.42% were new cases of microscopically confirmed pulmonary TB. Persons aged 25-34 years accounted for 29.66%. The sex ratio M/F was 2.33. Dakar reported most cases 44.17%. The incidence per 100 000 populations was 91, 87 and 86 in 2009, 2008 and 2011, 93, 95 and 95 in 2012, 2013 and 2014 and 92, 86, 87 and 84 in 2015, 2016, 2017 and 2018. The majority of cases (77%) had tested positive for HIV, with 6.84% co-infected. The rate of multidrug-resistant TB (MDR-TB) was 11%. Conclusion: In Senegal, the incidence of TB has slightly decreased due to the low detection rate which was 62% in 2018. The number of detected cases increased between 2013 and 2014, but it remained below that estimated by the World Health Organization. Increased surveillance of TB and monitoring of TB patients to avoid drug resistance is needed. &nbsp

Right-heart infective endocarditis: apropos of 10 cases

The prevalence and characteristics of right heart endocarditis in Africa are not well known. The aim of this study was to describe the epidemiological, clinical and laboratory profiles of patients with right-heart infective endocarditis. This was a 10-year retrospective study conducted in 2 cardiology departments in Dakar, Senegal. All patients who met the diagnosis of right heart infective endocarditis according to the Duke's criteria were included. We studied the epidemiological, clinical as well as their laboratory profiles. There were 10 cases of right-heart infective endocarditis representing 3.04% of cases of infective endocarditis. There was a valvulopathy in 3 patients, an atrial septal defect in 1 patient, parturiency in 2 patients and the presence of a pacemaker in one patient. Anaemia was present in 9 patients whilst leukocytosis in 6 patients. The port of entry was found to be oral in three cases, ENT in one case and urogenital in two cases. Apart from one patient with vegetations in the tricuspid and pulmonary valves, the rest had localized vegetation only at the tricuspid valve. However, blood culture was positive in only three patients. There was a favorable outcome after antibiotic treatment in 4 patients with others having complications; three cases of renal impairment, two cases of heart failure and one case of pulmonary embolism. There was one mortality. Right heart infective endocarditis is rare but associated with potentially fatal complications.Pan African Medical Journal 2015; 2

Associated factors to hypertension, known poorly controlled hypertension and newly diagnosed hypertension among people aged 18-70 in Senegal

Introduction: In this study, we aimed to determine the factors associated with hypertension, known poorly controlled hypertension and newly diagnosed hypertension in 2015 in order to improve the prevention of this pathology in our country. Materials and Methods: This was a secondary analysis of the national WHO STEPwise survey database. It was quantitative, descriptive with an analytical aim. The sampling was done in stratification in three stages of sampling. Statistical analysis was performed using Rstudio 4.0.2 software. It was a descriptive, bivariate and multivariate analysis using binomial logistic regression for explanatory purposes. Results: The risk factors for being hypertensive among 18-70-year-olds in Senegal in 2015 are: having taken their blood pressure at least once in their life, having taken their cholesterol levels at least once in their life, having received advice to reduce salt consumption, have received advice on how to reduce the amount of sugar, be lean BMI, overweight, obesity III, be between 35-39 and 65-70 years old. The protective factors are: checking the salt content indicated on the labels, Consuming salt-rich dishes “often” compared to “never”, The risk factors for being newly diagnosed with hypertension among 18-70-year-olds in Senegal in 2015 are: having a history of stroke, having a resting heart rate greater than 80 beats per minute, consuming palm oil, have high fasting blood sugar. The protective factors are: Having a high average number of meals eaten per week not prepared at home, checking the salt content indicated on the labels, and being of the female sex. The risk factors for being known to have poorly controlled hypertension among 18-70-year-olds in Senegal in 2015 are: judging their reduction in salt consumption “Very important”, and having received advice to reduce their salt consumption. The protective factors are: performing physical activity only when traveling and limiting the consumption of salty-ready meals. Conclusion: Senegalese family cooking exposes to hypertension, small actions limiting salt consumption strongly protect against hypertension, and simple physical activity during travel strongly protects against hypertension, but the health system is very little proactive in the primordial and primary prevention of hypertension

La fibrillation atriale, fréquence, facteurs étiologiques, évolution et traitement dans un service de cardiologie de Dakar, Sénégal

INTRODUCTION: La fibrillation atriale est le trouble du rythme cardiaque soutenu le plus fréquent. Les objectifs de ce travail étaient d’étudier la fréquence, les facteurs étiologiques, l’évolution et le traitement de la fibrillation atriale dans un service de cardiologie de Dakar au Sénégal. METHODES: Il s’agit d’une étude rétrospective réalisée sur cinq ans et portant sur l’analyse de 150 dossiers de patients hospitalisés pour une fibrillation atriale. RESULTATS: La fréquence de la fibrillation atriale était de 5,35 % et représentait 66% des troubles du rythme cardiaque avec une prédominance féminine (sex-ratio H/F = 0,45) et un âge moyen de 57,06 ± 18,64 ans. L’origine de la fibrillation était valvulaire dans 36,7% des cas. Les complications thromboemboliques étaient plus fréquentes dans la fibrillation atriale non valvulaire (p=0,006), chez les sujets d’âge > 50 ans (p=0,01) et en cas de dilatation de l’oreillette gauche (p=0,05). Une anticoagulation par anti-vitamine K était instaurée dans 62% des cas et un traitement de contrôle de la fréquence cardiaque dans 87,33%. CONCLUSION: La fibrillation atriale est fréquente en milieu hospitalier africain et concerne des sujets relativement jeunes. L’hypertension artérielle et les valvulopathies rhumatismales sont les principaux facteurs étiologiques. Le traitement reste essentiellement médicamenteux par contrôle de la fréquence cardiaque