Profile of cervicobrachial neuralgia among rheumatology patients in Lomé, Togo

Objectives: To determine the frequency and the different clinical forms of cervicobrachial neuralgia in a rheumatological setting in Lomé, Togo.Design: This was a cross-sectional multicenter study conducted from January 2012 to December 2018 on the records of patients seen in the three rheumatology units in Lomé, Togo.Methods: Patients who reported for consultation purposely because of cervicobrachial neuralgia were included. Diagnosis of the various clinical forms of degenerative cervical spine disease was essentially clinical, whereas radiological imaging findings contributed to the diagnosis of spondylodiscitis and neoplastic disease.Results: Cervicobrachial neuralgia was the reason for the clinic visit in 143 (0.69%) out of the 14,346 patients examined over the eight year study period. These 143 patients comprising 84 women (58.74%) and 59 men (41.26%) had a mean age of 53.36±13.33 years. The average time to consultation was two years. Degenerative disease (138 cases,96.5%) was the most commonly observed pathology. It included the following clinical forms: cervical osteoarthritis (n=120; 83.91%), cervical myelopathy (n=13; 9.10%) and herniated disc (n=5; 3.49%). Disc degeneration in isolation (60.83%) was the main radiographic finding in patients with degenerative disease. Spondylodiscitis was probably due to tuberculosis in the four patients who had it and two of them were HIV- positive. Bone metastasis from prostate cancer was found in one case.Conclusion: Cervicobrachial neuralgia appears to be significant among rheumatology patients in Lomé. It predominantly affects adult women in professional activity. Althoughmainly dominated by degenerative pathology, its aetiologies can also be infectious as well as neoplastic, hence the relevance of modern imaging modalities. Key words: Cervicobrachial neuralgia, Osteoarthritis, Spondylodiscitis, Tumours, Sub-Saharan Afric

Medication prior to rheumatology consultation in a Togolese Teaching Hospital

Objective: To determine the frequency and nature of the medication prior to specialized consultation in rheumatic patients. Design: This was a cross- sectional study of patients admitted for the first time for rheumatology consultation at CHU-SO in Lomé, Togo.Methods: The data relating to the medication prior to the consultation were collected by questioning. The diagnosis of the conditions covered by the consultation was based on clinical and para-clinical examinations. Results: Two hundred and eleven patients (151 women and 60 men) with a mean age of 49 years were included in the study. Forty-five patients (21%) were covered by health insurance because of their status as state employees, unlike the other 166 (79%) working in the informal sector. Spinal degenerative pathology (76%), knee osteoarthritis (20%) and tendinitis (10%) were the main diseases observed. One hundred and ninety- five patients(92%) were on medication prior to the rheumatology consultation. Non-steroidal anti- inflammatory drugs (118 cases, 75%) and analgesics (93 cases, 59%) were the most common therapeutic classes that were used. Self-medication was observed in 141 patients (67%) at all levels of education combined. Eighty- four of the 141patients(60%) have used street drugs, and 98 of them (70%) were oriented by word of mouth. General medical practitioners (25%) and medical assistants (19%) were the main prescribers before the rheumatology consultation. Epigastric pain (16 cases) was the main side effect observed. One hundred and forty- four patients (66%) had no idea of the risks of self-medication, added to lack of money by 122 (87%) patients and lack of knowledge of rheumatology by 67 (48%) patients. Conclusion: Self-medication, the frequency of which is known all over the world, is more notable in Africa and in rheumatic diseases where pain is the main symptom and its relief is one of the criteria for evaluating the effect of any therapy. Key words: Self-medication, Rheumatology, Togo, Afric