Prévalence de la migraine dans une population de travailleurs à cotonou au bénin

Introduction La migraine est une affection fréquente ayant un important retentissement sur la vie socioprofessionnelle des migraineux. L’objectif de ce travail était de déterminer la prévalence de la migraine dans une population de travailleurs de la ville de Cotonou.Cadre et méthode Il s’agit d’une étude transversale prospective réalisée dans 5 milieux de travail de la ville de Cotonou. Elle aété menée selon une technique de sondage aléatoire systématique à 3 degrés et porté sur 938 travailleurs. Le diagnostic de la migraine était basé sur les critères IHS de 1988 avec une modification sur la durée ou le nombre des accès (IHS + probable) Résultats La prévalence des céphalées était de 24,8% (IC95% : [22,1-27,8]). La prévalence de la migraine était de 8,9% (IC95% : [7,2-10,9]) celle de la migraine IHS étant de 2,3%, celle de la migraine probable de 6,6%. Elle est significativement plus fréquente chez les femmes 20,8% (

Factors associated with balance impairments amongst stroke survivors in northern Benin: A cross-sectional study

BACKGROUND: Balance impairment is the predominant risk factor for falls in stroke survivors. A fear of falling after stroke can contribute to sedentary lifestyles, increased disability and risk of recurrence, leading to poor quality of life. OBJECTIVE: To determine the frequency and factors associated with balance impairments amongst stroke survivors at the University Hospital of Parakou. METHOD: This cross-sectional study included adult stroke survivors. Stroke survivors after discharge were enrolled at the University Hospital of Parakou between 01 January 2020 and 30 September 2020. Balance impairments were measured by using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) and the Get Up and Go (GUG) tests. RESULTS: A total of 54 stroke survivors were included, with a mean age of 58.37 ± 12.42 years and a male predominance of 68.52%. The mean BBS score was 36.87 ± 14.34 with a minimum and a maximum of 10 and 56, respectively. Thirteen (24.07%) had balance impairments (BBS score ≤ 20), 34 (62.96%) had a TUG score ≥ 14 s (abnormal), 9 (16.67%) presented a moderate risk of falling and 6 (11.11%) presented high risk of fall with the GUG test. Post-stroke duration (odds ratio [OR] = 0.04; 95% CI: 0.04-0.30; p < 0.01), severity of disability (OR = 8.33; 95% CI: 1.03-67.14; p = 0.03) and the number of physiotherapy sessions (OR = 0.18; 95% CI: 0.03-0.93; p = 0.02) were significantly associated with balance impairments. CONCLUSION: Our results showed that almost one quarter of stroke survivors after discharge at the University Hospital of Parakou had balance impairments. Post-stroke duration, severity of disability and the number of physiotherapy sessions were significantly associated with balance impairments. CLINICAL IMPLICATIONS: [AQ1] Balance should be regularly assessed in people post-stroke. Further studies should document the content of rehabilitation and any rehabilitative efforts to improve balance in people post-stroke in Benin

Primary stroke prevention worldwide: translating evidence into action

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course

Stroke in Africa: Profile, progress, prospects and priorities

Funding text 1 R.O.A. is supported by the UK Royal Society/African Academy of Sciences FLAIR Grants FLR/R1/191813 and FCG/R1/ 201034, and a GCRF Networking Grant from the UK Academy of Medical Sciences. R.O.A., M.O.O., B.O. and F.S.S. are also supported by grants U54HG007479 and U01HG010273 from the US National Institutes of Health (NIH) as part of the H3Africa Consortium. M.O.O., B.O., R.O.A. and F.S.S. are further supported by NIH grant R01NS107900. R.N.K.’s research on elderly survivors of stroke has been supported by the Medical Research Council, RCUK Newcastle Centre for Brain Ageing and Vitality (MRC G0500247), Alzheimer’s Research UK, the Dunhill Medical Trust, UK, and the Newcastle National Institute for Health Research Biomedical Research Centre in Ageing and Age-Related Diseases, Newcastle upon Tyne Hospitals National Health Service Foundation Trust. Funding text 2 funds provided by the Wellcome Trust and the NIH. The NIH-funded SIREN study is exploring the genetic architecture of stroke among Indigenous Africans. More than 4,000 case–control pairs have already been recruited to the study and several publications on stroke phenom-ics and preliminary candidate gene analyses have been generated. The SIREN study has also undertaken the first-ever GWAS to unravel the genetic architecture of stroke in Indigenous Africans and the results are eagerly awaited. Stroke neurobanking resources consisting of blood fractions, extracted DNA, neuroimages and databases of clinical information are also being built in Africa and could facilitate data science-driven trans-omics research (including epigenomics, tran-scriptomics, proteomics and metabolomics) as well as the development of precision medicine products such as Afrocentric risk calculators, polygenic risk scores, biomarkers and drug targets23–25,227,307,308. The SIREN neurobiobank comprises a group of constantly monitored ultra-low-temperature (–86 °C) freezers located in Ibadan, Nigeria, constantly powered –20 °C chest freezers located in Ibadan and other recruitment sites, barcode scanners and printers, a laboratory information management system, a secure multi-terabyte server,Stroke is a leading cause of disability, dementia, and death worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disabilities occur in low-income and middle-income countries. At the turn of the century, the most common diseases in Africa were communicable diseases, whereas non-communicable diseases, including stroke, were considered rare, particularly in sub-Saharan Africa. However, evidence indicates that today, Africa could have up to 2–3-fold greater rates of stroke incidence and higher stroke prevalence than western Europe and the USA. In Africa, data published within the past decade show that stroke has an annual incidence rate of up to 316 per 100,000, a prevalence of up to 1,460 per 100,000, and a 3-year fatality rate greater than 80%. Moreover, many Africans have a stroke within the fourth to sixth decades of life, with serious implications for the individual, their family, and society. This age profile is particularly important as strokes in younger people tend to result in a greater loss of self-worth and socioeconomic productivity than in older individuals. Emerging insights from research into stroke epidemiology, genetics, prevention, care, and outcomes offer great prospects for tackling the growing burden of stroke on the continent. In this article, we review the unique profile of stroke in Africa and summarize current knowledge on stroke epidemiology, genetics, prevention, acute care, rehabilitation, outcomes, cost of care, and awareness. We also discuss knowledge gaps, emerging priorities, and future directions of stroke medicine for the more than 1 billion people who live in Africa. © 2021, Springer Nature Limited.Newcastle National Institute for Health Research Biomedical Research Centre in Ageing and Age-Related Diseases Newcastle upon Tyne Hospitals National Health Service Foundation Trust RCUK Newcastle Centre for Brain Ageing and Vitality Royal Society/African Academy of Sciences: FCG/R1/ 201034,FLR/R1/191813 National Institutes of Health (NIH): R01NS107900 Wellcome Trust (WT) Medical Research Council (MRC): G0500247 Dunhill Medical Trust (DMT) Academy of Medical Sciences: U01HG010273,U54HG007479 Alzheimer’s Research UK (ARUK

Primary stroke prevention worldwide : translating evidence into action

Funding Information: The stroke services survey reported in this publication was partly supported by World Stroke Organization and Auckland University of Technology. VLF was partly supported by the grants received from the Health Research Council of New Zealand. MOO was supported by the US National Institutes of Health (SIREN U54 HG007479) under the H3Africa initiative and SIBS Genomics (R01NS107900, R01NS107900-02S1, R01NS115944-01, 3U24HG009780-03S5, and 1R01NS114045-01), Sub-Saharan Africa Conference on Stroke Conference (1R13NS115395-01A1), and Training Africans to Lead and Execute Neurological Trials & Studies (D43TW012030). AGT was supported by the Australian National Health and Medical Research Council. SLG was supported by a National Heart Foundation of Australia Future Leader Fellowship and an Australian National Health and Medical Research Council synergy grant. We thank Anita Arsovska (University Clinic of Neurology, Skopje, North Macedonia), Manoj Bohara (HAMS Hospital, Kathmandu, Nepal), Denis ?erimagi? (Poliklinika Glavi?, Dubrovnik, Croatia), Manuel Correia (Hospital de Santo Ant?nio, Porto, Portugal), Daissy Liliana Mora Cuervo (Hospital Moinhos de Vento, Porto Alegre, Brazil), Anna Cz?onkowska (Institute of Psychiatry and Neurology, Warsaw, Poland), Gloria Ekeng (Stroke Care International, Dartford, UK), Jo?o Sargento-Freitas (Centro Hospitalar e Universit?rio de Coimbra, Coimbra, Portugal), Yuriy Flomin (MC Universal Clinic Oberig, Kyiv, Ukraine), Mehari Gebreyohanns (UT Southwestern Medical Centre, Dallas, TX, USA), Ivete Pillo Gon?alves (Hospital S?o Jos? do Avai, Itaperuna, Brazil), Claiborne Johnston (Dell Medical School, University of Texas, Austin, TX, USA), Kristaps Jurj?ns (P Stradins Clinical University Hospital, Riga, Latvia), Rizwan Kalani (University of Washington, Seattle, WA, USA), Grzegorz Kozera (Medical University of Gda?sk, Gda?sk, Poland), Kursad Kutluk (Dokuz Eylul University, ?zmir, Turkey), Branko Malojcic (University Hospital Centre Zagreb, Zagreb, Croatia), Micha? Maluchnik (Ministry of Health, Warsaw, Poland), Evija Migl?ne (P Stradins Clinical University Hospital, Riga, Latvia), Cassandra Ocampo (University of Botswana, Princess Marina Hospital, Botswana), Louise Shaw (Royal United Hospitals Bath NHS Foundation Trust, Bath, UK), Lekhjung Thapa (Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Kathmandu, Nepal), Bogdan Wojtyniak (National Institute of Public Health, Warsaw, Poland), Jie Yang (First Affiliated Hospital of Chengdu Medical College, Chengdu, China), and Tomasz Zdrojewski (Medical University of Gda?sk, Gda?sk, Poland) for their comments on early draft of the manuscript. The views expressed in this article are solely the responsibility of the authors and they do not necessarily reflect the views, decisions, or policies of the institution with which they are affiliated. We thank WSO for funding. The funder had no role in the design, data collection, analysis and interpretation of the study results, writing of the report, or the decision to submit the study results for publication. Funding Information: The stroke services survey reported in this publication was partly supported by World Stroke Organization and Auckland University of Technology. VLF was partly supported by the grants received from the Health Research Council of New Zealand. MOO was supported by the US National Institutes of Health (SIREN U54 HG007479) under the H3Africa initiative and SIBS Genomics (R01NS107900, R01NS107900-02S1, R01NS115944-01, 3U24HG009780-03S5, and 1R01NS114045-01), Sub-Saharan Africa Conference on Stroke Conference (1R13NS115395-01A1), and Training Africans to Lead and Execute Neurological Trials & Studies (D43TW012030). AGT was supported by the Australian National Health and Medical Research Council. SLG was supported by a National Heart Foundation of Australia Future Leader Fellowship and an Australian National Health and Medical Research Council synergy grant. We thank Anita Arsovska (University Clinic of Neurology, Skopje, North Macedonia), Manoj Bohara (HAMS Hospital, Kathmandu, Nepal), Denis Čerimagić (Poliklinika Glavić, Dubrovnik, Croatia), Manuel Correia (Hospital de Santo António, Porto, Portugal), Daissy Liliana Mora Cuervo (Hospital Moinhos de Vento, Porto Alegre, Brazil), Anna Członkowska (Institute of Psychiatry and Neurology, Warsaw, Poland), Gloria Ekeng (Stroke Care International, Dartford, UK), João Sargento-Freitas (Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal), Yuriy Flomin (MC Universal Clinic Oberig, Kyiv, Ukraine), Mehari Gebreyohanns (UT Southwestern Medical Centre, Dallas, TX, USA), Ivete Pillo Gonçalves (Hospital São José do Avai, Itaperuna, Brazil), Claiborne Johnston (Dell Medical School, University of Texas, Austin, TX, USA), Kristaps Jurjāns (P Stradins Clinical University Hospital, Riga, Latvia), Rizwan Kalani (University of Washington, Seattle, WA, USA), Grzegorz Kozera (Medical University of Gdańsk, Gdańsk, Poland), Kursad Kutluk (Dokuz Eylul University, İzmir, Turkey), Branko Malojcic (University Hospital Centre Zagreb, Zagreb, Croatia), Michał Maluchnik (Ministry of Health, Warsaw, Poland), Evija Miglāne (P Stradins Clinical University Hospital, Riga, Latvia), Cassandra Ocampo (University of Botswana, Princess Marina Hospital, Botswana), Louise Shaw (Royal United Hospitals Bath NHS Foundation Trust, Bath, UK), Lekhjung Thapa (Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Kathmandu, Nepal), Bogdan Wojtyniak (National Institute of Public Health, Warsaw, Poland), Jie Yang (First Affiliated Hospital of Chengdu Medical College, Chengdu, China), and Tomasz Zdrojewski (Medical University of Gdańsk, Gdańsk, Poland) for their comments on early draft of the manuscript. The views expressed in this article are solely the responsibility of the authors and they do not necessarily reflect the views, decisions, or policies of the institution with which they are affiliated. We thank WSO for funding. The funder had no role in the design, data collection, analysis and interpretation of the study results, writing of the report, or the decision to submit the study results for publication. Funding Information: VLF declares that the PreventS web app and Stroke Riskometer app are owned and copyrighted by Auckland University of Technology; has received grants from the Brain Research New Zealand Centre of Research Excellence (16/STH/36), Australian National Health and Medical Research Council (NHMRC; APP1182071), and World Stroke Organization (WSO); is an executive committee member of WSO, honorary medical director of Stroke Central New Zealand, and CEO of New Zealand Stroke Education charitable Trust. AGT declares funding from NHMRC (GNT1042600, GNT1122455, GNT1171966, GNT1143155, and GNT1182017), Stroke Foundation Australia (SG1807), and Heart Foundation Australia (VG102282); and board membership of the Stroke Foundation (Australia). SLG is funded by the National Health Foundation of Australia (Future Leader Fellowship 102061) and NHMRC (GNT1182071, GNT1143155, and GNT1128373). RM is supported by the Implementation Research Network in Stroke Care Quality of the European Cooperation in Science and Technology (project CA18118) and by the IRIS-TEPUS project from the inter-excellence inter-cost programme of the Ministry of Education, Youth and Sports of the Czech Republic (project LTC20051). BN declares receiving fees for data management committee work for SOCRATES and THALES trials for AstraZeneca and fees for data management committee work for NAVIGATE-ESUS trial from Bayer. All other authors declare no competing interests. Publisher Copyright: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseStroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.publishersversionPeer reviewe

The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis

Background A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. Methods In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. Findings Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity (I 2 of > 75%) between estimates for almost half of the outcomes. Interpretation To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. Funding Public Health Wales. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licens

An Estimate of the Incidence and Prevalence of Stroke in Africa:A Systematic Review and Meta-Analysis

Background: Stroke is increasingly becoming a challenging public health issue in Africa, and the non-availability of data has limited research output and consequently the response to this burden. This study aimed to estimate the incidence and prevalence of stroke in Africa in 2009 towards improved policy response and management of the disease in the region. Methods: A systematic search of Medline, EMBASE and Global Health for original population-based or hospital-based studies on stroke was conducted. A random effect meta-analysis was conducted on crude stroke incidence and prevalence rates, and a meta-regression-like epidemiological model was applied on all data points. The fitted curve generated from the model was used to estimate incident cases of stroke and number of stroke survivors in Africa at midpoints of the United Nation population 5-year age groups for the year 2009. Results: The literature search yielded a total of 1227 studies. 19 studies from 10 African countries were selected. 483 thousand new stroke cases among people aged 15 years or more were estimated in Africa in 2009, equivalent to 81.2 (13.2– 94.9)/100,000 person years. A total of 1.89 million stroke survivors among people aged 15 years or more were estimated in Africa in 2009, with a prevalence of 317.3 (314.0–748.2)/100000 population. Comparable figures for the year 2013 based on the same rates would amount to 535 thousand (87.0–625.3) new stroke cases and 2.09 million (2.06–4.93) stroke survivors, suggesting an increase of 10.8% and 9.6% of incident stroke cases and stroke survivors respectively, attributable to population growth and ageing between 2009 and 2013. Conclusion: The findings of this review suggest the burden of stroke in Africa is high and still increasing. There is need for more research on stroke and other vascular risk factors towards instituting appropriate policy, and effective preventive and management measures

Toxoplasmose Cerebrale En Milieu Hospitalier A Cotonou (Benin)

Introduction La toxoplasmose est une parasitose ubiquitaire et cosmopolite redoutée dans sa forme congénitale. Depuis quelques années, dans sa forme cérébrale, elle est au premier plan de l\'actualité médicale avec l\'ampleur du SIDA dont elle est une affection opportuniste. Objectif Le but de ce travail est d\'étudier les caractéristiques générales de la toxoplasmose cérébrale en milieu hospitalier à Cotonou. Méthode Il s\'agit d\'une étude prospective transversale à visée descriptive menée à la Clinique Universitaire de Neurologie du CNHU-HKM de Cotonou de Janvier 2001 à Avril 2003. Elle a porté sur dix patients dont les données ont été traitées et analysées à l\'aide du logiciel EPI-INFO version 6.04d fr. Résultats La fréquence de la toxoplasmose est de 2,8%. Les 10 sujets recrutés étaient âgés de 39,7 &#61617; 14,39 ans et dominés par les hommes (6 cas). La séméiologie clinique était dominée par 4 signes : l\'hyperthermie, le déficit moteur, les crises convulsives et les céphalées. Le scanner cérébral réalisé dans 8 cas a montré des lésions évocatrices dans 6 cas. La sérologie toxoplasmique était positive à 100% ; neuf patients étaient VIH positifs avec une lymphopénie à 777,28 ± 301,18. Le cotrimoxazole et l\'association Sulfadiazine - Pyriméthamine ont été utilisés en première intention. La surveillance a été seulement clinique et a objectivé une amélioration au bout de 16,5 jours en moyenne de traitement. Conclusion Ces résultats suggèrent l\'existence de la toxoplasmose cérébrale à une fréquence non négligeable en milieu hospitalier à Cotonou. Introduction The toxoplasmosis is an ubiquitary parasitose and cosmopolit who was retoutable and fearsome because of its congenital form. But, since many years, in its cerebral form, its is part of the affections of first rank of medical actuality with width of VIH SIDA whom its is an opportunist affection. Objective The main objective of this work is to study general caracteristics of the toxoplasmose cerebral in hospital environment in Cotonou (Benin). Method The transversal study cross-examined and conducted in clinical universitary of neurology of CNHU-HKM of cotonou with sighting descriptive, from January 2001 to April 2003. This stand on ten (10) patients whom data have been treated and analysed by aid of logiciel EPI-INFO version 6.04 d fr. Results The frequency of the toxoplasmose in hospital environment was 2,8%. The 10 subjects recruted were aged of 39,7 ± 14,39 years and dominated by men (6 cases). The clinical semeilogy is dominated by 4 signs: hyperthermy , motor deficit, convulsive crisis and pains. The scanner cerebral realized in 8 cases showned suggestive lesions in 6 cases.The serology was positive in 100% of cases ; nine patients were VIH + with lymphocytes at 777,28 &#61617; 301,18. Cotrimoxazol and sulfadiazim - Pyrimethamin have been utilized in first intention. The follow up was only clinical and has noted an improvement as from16,5 days in average. Conclusion Toxoplasmose cerebral must be take in count in hospital environment in Cotonou. Keywords: Africa, Benin, Cerebral Toxoplasmosis, Cotrimoxazol, AIDS, Afrique, Bénin, Cotrimoxazole, Sida, Toxoplasmose cérébrale African Journal of Neurological Sciences Vol. 24 (2) 2005: pp. 48-5