Qualite de vie des aphasiques post-AVC a Brazzaville

Aphasia is one of the most disabling consequences of stroke; its impact on quality of life is poorly studied. The aim of our study is to report the perceived quality of life among aphasic patients in Brazzaville.Methods It is a longitudinal study conducted in neurological department of the University Hospital of Brazzaville and in liberal consultation, from March 2010 to February 2011, including all patients with aphasia after stroke by dating six months at least. For each patient a SIP (Sickness Impact Profile-65) was administered, Age, sex, educational level, occupation, marital status, functions or not of head in the family or neighborhood variables were studied. Statistical analysis was performed by SPSS 11.0.Results Twenty nine patients were enrolled including 16 males and 13 females with mean disease duration of 9 months of aphasia (6-23mois). The mean age of 59 (34 - 80 years). The majority of patients had an average level of education. Broca’s aphasia was predominant. Most of our patients responded "false" to more than half the questions, except for communication, and the resumption of work. Multivariate analysis showed that only age and level of education were associated with impaired quality of life.Conclusion Aphasia is a common condition after stroke, affecting the quality of life, especially the resumption of work. The high age and low education levels contribute to mpaired quality of life.L’aphasie constitue avec le déficit moteur une source importante de handicap après un accident vasculaire cérébral. Son impact sur la qualité de vie des patients reste encore largement méconnu. Le but de notre étude est de rapporter la qualité de vie d’une série de patients aphasiques au décours d’un accident vasculaire cérébral suivis à Brazzaville.Patients et Méthodes Il s’est agit d’une étude longitudinale, prospective, en consultation de neurologie entre Mars 2010 et Février 2011, incluant tout patient aphasique post-AVC d’au moins six mois. Pour chaque patient un questionnaire Sickness Impact Profile ou SIP-65 a été administré. L’âge, le sexe, le niveau d’instruction, la profession, le statut matrimonial, la fonction ou non de chef dans la famille ont été des variables étudiées. L’analyse statistique a été réalisée par un logiciel SPSS 11.0.Résultats Vingt neuf patients ont été inclus dont 16 hommes, avec une durée moyenne d’évolution de 9 mois, un âge moyen de 59 ans. L’aphasie de Broca était prédominante. La plupart de nos patients ont répondu « faux » à plus de la moitié des questions, sauf pour la communication, et la reprise du travail. L’analyse multivariée a montré que seuls l’âge et le niveau de d’instruction étaient associés à une altération de la qualité de vie.Conclusion L’aphasie a un impact significatif ou sélectif sur la qualité de vie, surtout concernant la reprise d’une activité professionnelle, plus encore chez le sujet âgé et peu instruit. Ces éléments doivent être pris en compte dans le cadre d’une prise en charge de rééducation

Dementia in the developing world

Article de Presse paru dans le journal "Medical Daily

Dépistage de l'artériopathie oblitérante des membres inférieurs chez les personnes âgées de 65 ans et plus à Brazzaville.

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Analyse des facteurs de risque des démences en Afrique Centrale.

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Polysomnography as a diagnosis and post-treatment follow-up tool in human African trypanosomiasis: a case study in an infant.

International audienceGambian (Trypanosoma brucei gambiense) human African trypanosomiasis (HAT) evolves from the hemolymphatic stage 1, treated with pentamidine, to the meningoencephalitic stage 2, often treated with melarsoprol. This arseniate may provoke a deadly reactive encephalopathy. It is therefore crucial to diagnose precisely the stages of HAT, especially when clinical and biological examinations are doubtful. We present here the case of a 30-month old girl (E20 KOLNG) diagnosed with stage 1 HAT during a field survey in June 2007 in Congo. She was followed-up every six months for 18 months in a village dispensary facility at Mpouya. Her health status deteriorated in December 2008, although cerebrospinal fluid (CSF) white blood cell (WBC) count was normal. The child was hospitalized at Brazzaville and a daytime polysomnographic recording (electroencephalogram, electrooculogram, and electromyogram) was performed (Temec Vitaport 3® portable recorder) to avoid a new lumbar puncture. The child presented a complete polysomnographic syndrome of HAT with a major disturbance of the distribution of sleep and wake episodes and the occurrence of sleep onset REM periods (SOREMPs). The relapse at stage 2 was confirmed by a new CSF examination that showed an elevated WBC count (23cells*μL(-1)) with the presence of B lymphocytes. Melarsoprol treatment was undertaken. A post-treatment recording was immediately performed, showing the resolution of sleepwake pattern abnormalities. Another polysomnography, taken four months later, confirmed the normalization of sleep-wake patterns indicating healing. We therefore propose that polysomnography, being a non-invasive technique, should be used in children to alleviate burden caused by HAT staging procedures, especially regarding lumbar punctures in remote African villages

Dementia in central Africa.

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Prévalence des démences en Afrique Centrale (Bangui et Brazzaville).

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Behavioral disorders among older adults with dementia, Mild Cognitive Impairment and normal cognition living in Central Africa (EPIDEMCA study).

International audienceObjective: The aim of our study was to estimate the prevalence of behavioral symptoms and associated factors in the elderly in the Central African Republic and the Republic of Congo.Methods: An analysis of baseline data was performed from the EPIDEMCA (Epidemiology of Dementia in Central Africa) multicenter population-based study carried out in rural and urban areas of the Central African Republic and the Republic of Congo between 2011 and 2012 in elderly aged 65 and over. Cognitive disorders were assessed in two phases. The first phase was cognitive screening using the Community Screening Interview in Dementia. Following cognitive screening, in the second phase, participants suspected of dementia underwent clinical assessment based on the abridged version of the neuropsychiatric inventory (NPI) which assesses 12 behavioral disorders in the elderly over the previous 30 days. Results: NPI data were available for 532 out of participants examined in the second phase of EPIDEMCA. Among the 532 elderly included in the analytic sample, 284 were cognitively normal, 130 were demented, 113 had Mild Cognitive Impairment (MCI) and 5 remained without diagnosis. The median age was 75 and most were female. At least one behavioral disorder was reported by 333 elderly (63.7%) with 16.6% reporting 1 or 2 behavioral disorders and 47.1% reporting 3 or more symptoms. In participants with no cognitive impairment, 48.7% reported at least one symptom. The prevalence of behavioral disorders was 73.4% in people with MCI and 89.9% in people with dementia. In our sample, the most frequent symptoms were depression/dysphoria (45.3%), anxiety (28.1%) and irritability (23.7%).Discussion: Behavioral disorders are common in this population. Our data are comparable to those reported in previous population-based studies in Nigeria and Tanzania. It would be important to carry out additional studies to better characterize behavioral disorders in others countries in Africa

Les représentations socioculturelles de l'épilepsie dans la population estudiantine de Brazzaville (Congo)

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Abdominal epilepsy to the child concerning two cases in Pointe-Noire (Congo)

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