Bovine Tuberculosis Prevalence Survey on Cattle in the Rural Livestock System of Torodi (Niger)

BACKGROUND: Bovine tuberculosis (BTB) is a widespread zoonosis in developing countries but has received little attention in sub-Saharan Africa, especially in Niger. Recent investigations confirmed the high incidence of the disease in cattle slaughtered in an abattoir in Niamey. The fact that most of the animals in which M. bovis has been identified were from the rural area of Torodi implied the existence of a probable source of BTB in this region. This study aimed to determine the prevalence of BTB infection in cattle and to identify risk factors for infection in human and cattle populations in Torodi. METHODS AND PRINCIPAL FINDINGS: A survey was carried out at the level of households keeping livestock (n = 51). The questionnaire was related to the potential risk factors and the presence of clinical signs of TB both in animals and humans. Comparative Intradermal Tuberculin Test was conducted to determine the TB status in cattle (n = 393). The overall apparent individual animal prevalence of tuberculin reactors was 3.6% (CI: 95%, 1.9-5.9), whereas the individual true prevalence was estimated at 0.8% (CI: 95%, 0.0-5.0). Using a multivariate logistic regression analysis and a classification tree analysis, the only household level risk factor that significantly influenced the presence of BTB in cattle was the presence of animals coughing in the herd (OR = 4.7, 95% CI: 1.12-19.71, p-value = 0.034). The lack of the practice of quarantine was borderline significant (OR = 4.2, 95% CI: 0.96-18.40, p-value = 0.056). CONCLUSION/SIGNIFICANCE: The study confirmed that BTB is endemic in cattle in Torodi and the risk of the transmission of the disease to humans is potentially high. For the control of the disease in livestock, slaughtering of infected animals and the compensation of the owners is needed. Collaboration between the veterinary and the medical sectors, in the diagnosis, monitoring, prevention and control of BTB is strongly encouraged

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral

Resultats du traitement chirurgical des kystes poplites au Burkina Faso

Le kyste poplite est le kyste synovialle plus frequent. Cependant, sa  symptomatologie demeure peu connue et ses modalires therapeutiques restent controversees. L'Objectif de notre etude a ere de decrire les aspects cliniques des kystes poplires a l'hOpital regional de Tenkodogo et rapporter les resultats de la kystectomie posterieure a ciel ouvert. Nous avons realise, de janvier 2010 a decembre 2014, une etude descriptive portant sur 32 kystes poplites symptomatiques operes a l'hOpital regional de Tenkodogo au Burkina Faso. Le diagnostic de kyste poplite a ete pose a l'examen clinique eta l'echographie doppler. Tous les patients ont beneficie d'une kystectomie posterieure a ciel ouvert. Nous avons utilise les criteres de Rauschning et Lindgren pour I' evaluation des resultats. Trente-deux patients ont ete indus dans I' etude. L'age moyen des patients a ete de 48 ans (cr = 2,6 ans). La predominance feminine a ete notee, avec 21 cas (65 % ). Les motifs de  consultation ont ete principalement representes par la douleur et la tumefaction ala face posterieure du genou. L'echographie a retrouve une masse poplitee a contenu liquidien et communicant avec la cavite articulaire. Tous les patients ont ete operes par un abord posrerieur a ciel ouvert. La duree minimale du suivi post operatoire a ete de 12 mois. La tumefaction et les  douleurs spontanees ont regresse dans tousles cas. Aucune recidive n'a ete notee au bout d'un an. La kystectomie par voie posterieure donne des resultats satisfaisants en termes de remission cliniques.Mots-cles : kyste poplire, kyste de Baker, chirurgie a ciel ouvert.Outcomes of surgical treatment of popliteal cysts in Burkina FasoIntroduction: popliteal cyst is the most common synovial cyst. However, its  symptoms remain relatively unknown and its treatment modalities are controversial.Aim: the purpose of this study was to describe the clinical aspects of popliteal cysts in the regional hospital of Tenkodogo and to report the results of cystectomy using open posterior approach. We conducted, from January 2010 to December 2014, a prospective study, involving cases of symptomatic popliteal cysts that underwent surgery in the regional hospital of  Tenkodogo. The popliteal cyst diagnosis was made on clinical examination and on Doppler ultrasound. All patients underwent  surgery using open posterior approach. We used the Rauschning and Lindgren criteria for evaluation. Thirty-two patients were included in the study. The average age of patients was 48 years. There were 21 women (65%). Patients were admitted  primarily for pain in the posterior side of the knee and paraesthesia. Ultrasound found swelling in the popliteal region, with fluid content and communicating with the knee joint cavity. All patients underwent surgery. The mean duration of  postoperative follow-up was 12 months. No recurrence was noted after one year. The swelling and spontaneous pain decreased in all cases. Popliteal cyst is common in current practice. Cystectomy using open posterior approach yields satisfactory results in terms of clinical remission.Keywords: popliteal cyst, Baker's cyst, surgery, open posterior approac

Particularités de l’appendicite aiguë du sujet âgé en milieu hospitalier burkinabè

L’appendicite aiguë du sujet âgé reste une affection au diagnostic difficile. Son pronostic demeure réservé. Le but de cette étude a été de décrire les aspects cliniques et thérapeutiques de l’appendicite aiguë du sujet âgé à l’hôpital régional de Tenkodogo et de dégager les particularités. Nous avons conduit dans le service de chirurgie générale de l’hôpital régional de Tenkodogo, une étude transversale descriptive qui a couvert la période allant de 2010 à 2014. Tous les patients âgés de 65 ans et plus, admis durant cette période et chez qui le diagnostic d’appendicite aiguë a été posé, ont été inclus dans l’étude. Au total, 41 patients ont été  répertoriés. Leur âge moyen a été de 71 ans (s = 3,2 ans). La prédominance masculine a été notée, avec 27 cas (65,8 %). Le délai moyen de consultation a été de 4 jours (s =1,7 jours). Les douleurs abdominales et les vomissements ont été les principaux motifs de consultation. L’association douleur et défense de la fosse iliaque droite a été retrouvée dans 8 cas (19,5 %). L’échographie a été le principal examen complémentaire réalisé. Elle a retrouvé une augmentation des dimensions de l’appendice dans 24 cas (58,5 %). Le délai moyen de diagnostic à partir de l’admission a été de 1,8 jour (s = 0,3 jour). Tous les patients ont bénéficié d’une appendicectomie par laparotomie. Des complications post opératoires ont été notées chez 15 patients (36,6 %). La durée moyenne d’hospitalisation a été de 7 jours (s = 1,1 jour). Un décès a été enregistré, soit un taux de mortalité de 2,4 %.L’appendicite aiguë est une urgence abdominale courante chez le sujet âgé. Le délai de diagnostic est long et la morbidité est importante.Mots-clés : appendicite aiguë, sujet âgé. Particularities of acute appendicitis in the elderly in Burkina Faso Acute appendicitis in the elderly remains a disease that is difficult to diagnose. Its prognosis is not reassuring. The aim of this study was to describe the clinical and therapeutic aspects of acute appendicitis in the elderly at the regional hospital of Tenkodogo. We led into the surgery department of the regional hospital of Tenkodogo, a retrospective study which covered the period going from 2010 to 2014. All patients aged 65 and over who had acute appendicitis were included. 41 patients were identified, representing 9% of all acute appendicitis diagnosed during the study period. Their mean age was 71 years. Men were more numerous, with 27 cases (65.8%). The average delay of consultation was 4 days. Abdominal pain and vomiting were the main reasons for consultation. Pain and abdominal tenderness in the right iliac fossa were found in 8 of 41 cases (19.5%).  Ultrasonography was the main supplementary examination. It showed an increase of the appendix dimensions in 24 cases (58.5%). The average time to diagnosis was 1.8 days. All patients underwent open surgery. Post-operative  complications were noted in 15 patients (36.6%). The mean hospital stay was 7 days. One death was recorded, representing a mortality rate of 2.4%. Acute appendicitis is a common abdominal emergency in the elderly. The diagnosis period is long and morbidity is important.Keywords: acute appendicitis, elderly

Caracteristiques microbiologiques des peritonites aigues generalisees au Centre hospitalier universitaire Souro Sanou de Bobo-Dioulasso

L' objectif de notre etude etait de decrire les caracteristiques microbiologiques des peritonites aigues generalisees excepre les peritonites post-operatoires dans notre hOpital afin de proposer une antibiotherapie probabiliste. Nous avons realise une etude prospective de dix (10) mois qui a concerne tousles cas de peritonites aigues generalisees excepre les peritonites post-operatoires operees et ayant beneficie en per operatoire d'un prelevement de pus. Au total, 72 patients ont ere inclus avec une moyenne d'age de 27,3 ans avec des extremes de 14 mois et 67 ans. L' analyse des 72 echantillons de pus a permis de confirmer 39 cas dont 53 souches bacteriennes isolees ; il y avait une predominance des enterobacteries (58 %) suivi des cocci Gram positif (36 % ). Parmi les enterobacteries, E. coli etait de loin le plus frequent avec 47 %. Chez les cocci Gram positif, les streptocoques predominaient a 22 %. Dans notre serie, une sensibilire plus elevee des germes ala gentamicine, ala ceftriaxone eta la Ciprofloxacine a ere notee. Ces resultats  suggerent une antibiotherapie probabiliste des peritonites dans notre contexte associant les cephalosporines de troisieme generation (C3G) aux aminosides plus un imidazole pour couvrir eventuellement les anaerobies.Mots-cles : peritonites, microbiologie, antibiotherapie. Microbiological characteristics of generalized acute peritonitis at Souro Sanou teaching hospital of Bobo-DioulassoThe objective of this study was to describe microbiological characteristics of  generalized acute peritonitis except the post-operatoire peritonitis in our hospital in order to propose a probabilistic antibiotic therapy. We realized a 10-month transversal prospective study, from July 1", 2012 till May 30'\ 2013.1t concerned all the cases of generalized acute peritonitis except the post-operatoire peritonitis operated and having benefited a taking of pus during surgery. Bacteriological analyses were realized according the protocol of treatment of pus in the laboratory. 72 patients were included. The mean age was of 27, 3 years with extremes of 14 months and 67 years. The analysis of 72 samples of pus allowed to confirm 39 cases and led to identification of 53 bacterial strains. The most common strains were enterobacteriaceae in 58.0%, gram-positive cocci in 36.0%. Escherichia coli  was the most common species (47%) followed by Streptococcus species (22% ). The microbiological confirmation of peritonitis was more frequent in the intervalle 20-30 years old. In our study, a higher  sensibility to gentamycin, ceftriaxon and Ciprofloxacin was noted. On the other hand amoxicillin just like clavulanic  acid-amoxicillin association showed a low activity on the isolates. These findings suggest a probability antibiotic treatment of the peritonitis in our context associating the third generation cephalosporin with aminosides more an imidazol to cover possibly the anaerobic.Keywords: peritonitis, microbiology, antibiotherapy

Trichoberoard gastrique : Premier cas observe en milieu bur kina be

Le trichobezoard est une concretion de cheveux, de poils ou de fibres de tapis et de debris alimentaire, localisee habituellement dans l'estomac. Le trichobezoard est une pathologie rare qui survient habituellement chez des adolescentes presentant des troubles psychiques. La premiere observation de trichobezoard a ete rapportee en 1 779 par Baudamant lors d'une autopsie chez un homme mort suite a une peritonite par perforation gastrique. Nous rapportons le premier cas en milieu burkinabe, observe en 2013 dans le service de chirurgie generale et digestive du Centre Hospitalier Universitaire Y algado Ouedraogo de Ouagadougou. ll s' est agi d'une jeune femme de 20 ans admise pour une masse epigastrique associee a des vomissements alimentaires. L'interrogatoire avait retrouve des antecedents de trichotillomanie et de trichophagie datant de 4 ans. La fibroscopie digestive haute avait montre un trichobezoard gastrique. Une laparotomie mediane sus-ombilicale, puis une gastrotomie avait permis !'extraction d'un trichobezoard mesurant 32 x 9 x 6 em, pesant 900 g. Les suites operatoires avaient ete simples. La patiente etait sortie au huitieme jour postoperatoire. Elle a ete confiee par la suite a un psychiatre pour suivi therapeutique.Mots-cles : trichobezoard, trichotillomanie, trichophagie, estomac.Gastric trichobezoar : first report case in Burkina EnvironmentThe trichobezoar is a concretion of hair or carpet and food debris fiber, usually  located in the stomach. The first observation trichobezoar was reported in 1779 by Baudamant at autopsy in a man died following gastric perforation with peritonitis. We report the first case in Burkina environment observed in 2013 in General and  Digestive Surgery department of University Hospital Y algado Ouedraogo of Ouagadougou. He acted in a 20 year old woman admitted for epigastric mass  associated with food vomiting. The interrogation had found a history of  trichotillomania and trichophagia dating 4 years. The gastroscopy showed a gastric hairball. A supra-umbilical midline laparotomy and a gastrostomy allowed extracting a hairball measuring 32 x 9 x 6 em, weighing 900 g. The postoperative were simple. The patient was out in the eighth postoperative day. She was later assigned to a psychiatrist for therapy monitoring. The hairball is a rare disease that usually occurs in adolescents with mental disorders.Keywords: trichobezoar, trichotillomania, trichophagia, stomach

Scarification traditionnelle, tumeurs royales surinfectees et chirurgie, dans Ia maladie de Von Recklinghausen : A propos de deux cas a Ouagadougou (Burkina Faso)

L'exerese chirurgicale est indiquee dans la tumeur royale, surtout dans certains cas selectionnes ou les complications des lesions cutanees, muqueuses et viscerales entravent le pronostic fonctionnel et meme vital des patients. Elle est rare mais de pratique ancienne et n' accroit pas le risque de degenerescence maligne. 11 s'agissait d'une etude retrospective incluant les cas de tumeurs royales  surinfectees par des scarifications traditionnelles et admis dans le service de chirurgie generale et digestive entre 2012 et 2014. Pour chaque cas, nous nous sommes inreresses aux aspects cliniques et aux modalires therapeutiques. Les auteurs rapportent deux cas de tumeur royale necrotique chez deux femmes ayant consulte au CHU Yalagado Ouedraogo. Elles etaient agees de 60 et 62 ans. La scarification et I' application de produit traditionnel ont ete le point de depart des surinfections. La tumeur siegeait au niveau de la region hypogastrique pour la 1"' et au niveau de la region crurale droite pour la 2e. Elle etait surinfectee, nauseabonde et handicapante chez ces deux patientes qui presentaient en outre, chacune des nodules dissemines a tout le corps, evoluant depuis plusieurs annees. Une exerese chirurgicale de la masse a ete realisee en urgence et a permis d'ameliorer la qualire de vie et le pronostic fonctionnel des deux patientes. Meme si elle n'est que palliative, le benefice de la chirurgie est reel sur le pl an fonctionnel, psychologique et esthetique surtout devant des tumeurs royales infectees. Elle permet d' ameliorer la qualite de la vie et de restaurer 1' autonomie des malades. La sensibilisation contre la scarification eviterait la surinfection.Mots-cles : tumeur royale, Recklinghausen, scarification, chirurgie.Traditional scarification, superinfected royal tumors and surgery in the Von Recklinghausen disease: two cases report in Ouagadougou (Burkina Faso)Surgical resection is indicated in cases of royal tumor; especially in selected cases where complications from skin, mucous membranes and visceral lesions hinder the functional and vital prognosis of patients. It is rare and an ancient practice; surgical resection does not increase the risk of malignant degeneration. We report two cases of royal necrotic tumor from women seen at the Yalagado Ouedraogo University  Hospital. They were aged 60 and 62 years. Scarification and application of  traditional products were the starting point of the infections. The tumor was located in the hypogastric region for the first patient and at the right leg for the second. The tumors were superinfected, nauseating and debilitating. These two patients had also nodules scattered throughout the body, which lasted for several years. Surgical resection of the mass was performed in emergency and improved the quality of life and functional outcomes of the two patients. Although it is only palliative, the benefits of the surgery are appreciated at the functional, psychological and  aestheticallevel, especially in the case of royal infected tumors. It improves the quality of life and restores the patients' autonomy. Awareness campaign against scarification would avoid superinfections. Keywords: Royal tumor, superinfection, Recklinghausen, scarification, surgery

La tuberculose iléo-caecale : à propos de deux cas au CHU Yalgado Ouedraogo

La tuberculose iléo-caecale est rare et simule souvent un abdomen chirurgical aigü. L'objectif de ce travail a été de préciser les difficultés diagnostiques et thérapeutiques de cette affection dans le milieu burkinabè. Il a été recensé deux cas de tuberculose iléo-caecale en cinq ans, dans le service de chirurgie viscérale du CHU-YO. Il s’est agi d’une femme et d’un homme. L’âge moyen était de 61,5 ans avec des extrêmes de 61 et 62 ans. Dans un cas, il a été noté des antécédents de tuberculose. La sérologie VIH était négative dans les 2 cas. Ces deux malades ont été reçus en urgence pour un syndrome abdominal aigu. Le diagnostic de tuberculose iléo-caécale a été soupçonné en per-opératoire devant une masse inflammatoire de la jonction iléocaecale avec de nombreuses adénopathies mésentériques. L’examen anatomopathologique de la pièce opératoire d’hémicolectomie droite, a mis en évidence des lésions caséeuses folliculaires épithéliales et gigantocellulaires. Ces lésions ont orienté vers le diagnostic de tuberculose iléocoécale. Le traitement antituberculeux instauré était conforme au protocole du programme national burkinabè de lutte contre la tuberculose. L’évolution a été favorable dans les deux cas.Mots clés: tuberculose - jonction iléocaécale - traitement antituberculeux - chirurgieEnglish AbstractThe ileo-caecal tuberculosis is rare and often simulates a surgical acute abdomen. The objective of this work was to clarify the diagnostic and therapeutic difficulties of this disease in the Burkina community. It was identified two cases of ileo-caecal tuberculosis in five years in the visceral surgery department of CHU-YO. It came from 01 woman and 01 man. The average age was 61.5 years with extremes of 61 and 62 years. In one case, it was noted a history of tuberculosis. The HIV serology was negative in the two cases. These two patients were received in emergency for acute abdominal syndrome. The diagnosis of ileocoecal tuberculosis was suspected intraoperatively to an inflammatory mass of ileo-caecal junction with many mesenteric lymphadenopathy. Pathological examination of the surgical specimen of the right hemicolectomy, showed caseous, follicular, epithelial and gigantocellular lesions. These lesions were oriented ileocaecal tuberculosis diagnostic. The introduction of the treatment antituberculosis was consistent with the national protocol program against tuberculosis of Burkina Faso. The outcome was favorable in two cases.Keywords: tuberculosis - ileocecal jonction - antituberculeux treatment - surger