Prevalence of Diabetes and Hypertension on World Diabetes Day 2022 in Guinea

Introduction: Diabetes mellitus and hypertension are chronic diseases that are on the rise and pose a major public health problem among the priorities of healthcare systems. Objectives: Determine the prevalence of diabetes and hypertension and describe the sociodemographic characteristics of those screened. Materials and Methods: This was a cross-sectional study organized during a diabetes and hypertension screening campaign that took place in Conakry and five (05) inland regions on November 14, 2022. Results: 2050 people were screened, of whom 33.12% were housewives, the average age was 44.78 ± 16.23 years, and 55.27% were women. The screening sites were the city of Conakry 741 (36.15%), the Labé region 424 (20.68%), the N’Zérékoré region 298 (14.54%), the Faranah region 241 (11.75%), the Mamou region 210 (10.24%) and the Boké region 136 (6.63%). The prevalence of diabetes and hypertension were respectively 12.5% and 43.38% for the Boké region;6.19% and 16.19% for the Mamou region;3.02% and 21.81% for the N’Zérékoré region;31.95% and 13.69% for the Faranah region;9.67% and 20.28% for the Labé region;2.83% and 20.28% for the city of Conakry. Conclusion: Despite the limitations of the study duration, our series highlighted the high prevalence of diabetes and hypertension among people screened on World Diabetes Day 2022. Raising public awareness of a healthy lifestyle is essential for the prevention and control of diabetes and hypertension.

Diabetes Screening and Cardiovascular Risk in Tuberculosis Patients in Conakry and Surrounding Towns

Objective: To determine the prevalence of diabetes and the level of cardiovascular risk in tuberculosis patients treated in Conakry and surrounding towns. Method: This was a cross-sectional study carried out at tuberculosis treatment centers in Conakry and surrounding towns (Coyah and Dubréka) on World TB Day, November 14, 2022, among 350 tuberculosis patients. We determined the proportion of TB patients with diabetes and high hyperglycemia. We determined the Chi-square to identify the factors associated with the occurrence of diabetes in tuberculosis patients, and a significance threshold with p Results: The average age of participants was 33.5 ± 14.5 years, and they were predominantly male (59.7%). The majority of participants lived in Conakry (96.3%). 5.7% were known diabetics and 4.6% were known hypertensives. We found a prevalence of diabetes of 9.4%. Among diabetics, 39% were diabetes discoveries. 30% were hypertensive or had high blood pressure. Of these hypertensive patients, 26.4% were unrecognized hypertensives. Age and hypertension were statistically significantly associated with the onset of diabetes in tuberculosis patients. Medium, high and very high levels of cardiovascular risk were present in 23.4%, 8.9% and 3.4% respectively. Conclusion: Diabetes is common in tuberculosis patients. Cardiovascular risk factors, notably hypertension and cardiovascular risk level, are frequently associated with tuberculosis. Tuberculosis patients with cardiovascular risk factors should be screened for diabetes.

Practice of Glycemic Self-Monitoring in Diabetic Patients Followed at the Endocrinology Department of Donka University Hospital in Guinea

Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.

Frequency and Risk Factors of Neonatal Macrosomia at Labe Regional Hospital in Guinea

Macrosomia is defined as a term birth weight greater than or equal to 4000 grams, or greater than the 90 percentile of intrauterine growth curves. Excessive weight has harmful consequences for the newborn and is a major health concern. Objectives: To determine the frequency of neonatal macrosomia, describe risk factors and neonatal and maternal complications. Materials and methods: This was a cross-sectional study carried out between January and December 2022, involving newborns whose birth weight was greater than or equal to 4000 grams admitted to the neonatology unit of the Labe regional hospital. Results: 591 deliveries were recorded, 15 of which were macrosomic, representing a frequency of 2.54%. The average age of the women was 30.26 years. History of fetal macrosomia and diabetes was 93.33 and 71.43% respectively. The mean gestational age was 38.71 ± 0.75 SA, the mean antenatal consultation was 3 ± 0.8 and the mode of delivery was caesarean section (66.67%). Third-trimester ultrasound was performed in 53.33% of cases. Macrosomic newborns were male in 80% of cases. Neonatal complications were asphyxia (60%), hypoglycemia (20%) and hypocalcemia (13.33%). Factors associated with neonatal macrosomia were diabetes (P < 0.001), history of macrosomia (P Conclusion: this study shows that the frequency of neonatal macrosomia is 2.54% with high neonatal morbidity among newborns hospitalized in the neonatology unit of the Labé regional hospital. Screening for macrosomia risk factors during pregnancy is essential to prevent perinatal complications.

Dietary Habits of an Ambulatory Diabetic Population at the University Hospital of Conakry, Guinea

Background: A healthy diet is essential for optimal diabetes management. However, dietary habits vary from one region to another, making it challenging to standardize practices. Objective: To describe the diet habits of patients living with diabetes in Guinea. Methods: We conducted a dietary habits survey among 102 patients living with diabetes followed-up at the University Hospital of Conakry in Guinea between January and March 2012. Data were collected by individual interview on the basis of a three-item questionnaire: diabetes data, diet mode, and food composition. Results: In total, 85% of patients were consuming 3 meals daily;13.7% had a collation and 25% had snacking habits. The meal was individual in 82.4% and collective in 17.6% of patients. The main foods consumed daily were: rice (93.1%), fish (93.1%), palm oil (91.1%), bread (87.2%). Foods consumed regularly (2 to 3 times a week) were: meat (49%), eggs (23.5%), dairy products (34.3%), fruit (43.1%), vegetables (40.2%) and peanut oil (21.5%). The food bans reported were: regular sugar (100%), sodas (62.7%), peanuts (84.3%) and sweetened fruits (55.8%). Conclusion: Combining dietary recommendations and dietary habits is essential for appropriate management of diabetic patients. The assessment of local food glycemic indexes and the training of dietitians remains a challenge in our context.

Graves’ Disease in 100 Cases in Conakry: Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects

Context and Objective: Graves’ disease is an autoimmune disorder of the thyroid gland that occurs in genetically predisposed individuals. It represents the most frequent cause of hyperthyroidism with a clear female predominance. The objective of our work was to report the sociodemographic, clinical, therapeutic, and evolutionary characteristics of Graves’ disease at the University Hospital of Conakry. Methods: This was a cross-sectional, descriptive study, over the period from December 2016 to June 2021, at the endocrinology consultation of Donka University Hospital. Epidemiological, clinical, therapeutic, and evolutionary variables of patients followed up for Graves’ disease were collected and analyzed. The diagnosis of Graves’ disease was based on the presence of clinical signs of thyrotoxicosis, diffuse goiter, exophthalmos, and or T-RAK positivity. Results: Graves’ disease was related to 33% of thyroid consultations and 64% of hyperthyroidism. The sex ratio M/F was 0.07. The median age of the patients was 39.4 ± 13 years. The main reason for consultation was thyrotoxicosis syndrome, dominated by cardiovascular signs (92%). TRAK was performed in 38 patients with a positive result in 89%, i.e., a mean level of 17.93 mUI/l. All patients were treated with synthetic antithyroid drugs, with a favorable clinical evolution. Surgery was considered in 4 patients after the stabilization of the thyroid function. The follow-up was considered regular in 49 patients (49%). Conclusion: Graves’ disease is the most frequent hyperthyroidism in Conakry with a clear predominance of women, especially young women. Efforts should be focused on improving diagnosis and the access to treatment for better patient compliance.

Epidemiology and Clinical Profile of Behcet’s Disease in a Sub-Saharan Country: About Five Observations

Behçet’s disease (BD) is a multi-systemic vasculitis characterized by a triad made up of oral aphthosis, genital aphthosis and uveitis which may or may not be associated with visceral involvement. Other times described in the ancient silk road, BD is increasingly found in countries south of the Sahara with the mixing of populations. Our objective was to describe the epidemiology and clinical characteristics of BD in an African country. Methodology: This was a five-year retrospective study in the internal medicine department of Donka National Hospital. We used international criteria finding BD. Urinary dipstick was use for finding kidney disease. Result: During the period, five cases of Behçet’s disease were collected. The average age was 35 years old. The male sex was more represented with 3 out of 5 cases. The most common clinical manifestation was oral aphthosis in all patients (100%), followed by genital aphthosis in 4 cases (80%). The other clinical manifestations observed were uveitis in 3 cases (60%), joint manifestations such as arthralgia in 3 cases (60%) and neurological manifestations such as chronic headache in one case (20%). HLA-B51 was found in two cases. The pattergic test done in two patients came back positive (100%). The patients received colchicine and oral corticosteroid therapy. Two patients were lost to sight. We deplored a death probably in a neuro-Behçet table before the rebellious headaches. Conclusion: Behçet’s disease is a multi-systemic vasculitis that must be evoked and managed quickly in a tropical environment, especially since the prognosis, vital and functional prognosis can be engaged.

Biermer’s Disease at the Donka National Hospital in Guinea—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department

Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.

Prevalence and Risk Factors Associated with Pulmonary Tuberculosis in Diabetics in Conakry

Objectives: To determine the prevalence of pulmonary tuberculosis in diabetics, to identify risk factors associated with pulmonary tuberculosis in diabetics, and to describe the clinical features of the association of pulmonary tuberculosis and diabetes. Materials and method: This was a cohort study that took place from November 18, 2015 to January 31, 2018 at the Department of Endocrinology, Diabetology and Metabolic Diseases of the University Hospital of Donka. Results: among the 1912 diabetic patients screened for tuberculosis, 46 had bacteriologically confirmed pulmonary tuberculosis, i.e. a prevalence of 2.4% and 01 had clinically diagnosed pulmonary tuberculosis with 0.1%. A female predominance was noted with a sex ratio of 0.8. The 45 - 54 age group was the most affected with a mean age of 46 years. Body Mass Index (p = 0.001), smoking (p = 0.0101) and history of infection (p = 0.001) were significantly associated with pulmonary tuberculosis. The history of smoking (p = 0.0101), the notion of contagion (p = 0.001), the cough (p = 0.001), the fever (p = 0.001), the nocturnal sweat (p = 0.001) and the hemoptysis (p = 0.001) were the clinical characteristics significantly associated with pulmonary tuberculosis. Conclusion: The results of this study show a remarkably high prevalence of tuberculosis in diabetic patients in Guinea highlighting the need for urgent action to better understand and treat the double burden of tuberculosis and diabetes.

Hypothyroidism in Conakry: Epidemiological, Clinical and Therapeutic Aspects

Hypothyroidism is a frequent endocrine disorder that can occur at any age and predominantly affects women. The etiologies are diverse and may vary according to the geographical and socio-demographic context. The objective of our work was to describe the epidemiological, clinical and therapeutic characteristics of hypothyroidism in Conakry, Guinea. Materials and Method: This was a descriptive study with prospective data collection, over the period from December 2016 to May 2021. It focused on patients seen at the endocrinology consultation of Conakry University Hospital. Epidemiological, clinical, etiological, therapeutic, and evolutionary variables of patients diagnosed or followed-up for hypothyroidism were collected and analyzed. The diagnosis of hypothyroidism was defined by elevated TSH and/or decreased FT4/FT3. Results: Out of a total of 290 patients who consulted for thyroid pathology, hypothyroidism concerned 49 patients, i.e. , a frequency of 14%. Women were the most affected with a sex ratio of 0.13. The mean age of patients was 48.65 ± 19.93 years with extremes of 2 years and 80 years. Hypo-metabolic syndrome was the main clinical sign and was manifested mainly by constipation found in 48.89% of cases. TSH was elevated in all cases with a mean level of 24.56 ± 14.17 mIU/ml. Hypertension was the most frequently associated pathology (57%). Three etiological groups of hypothyroidisms were found. These were thyroidectomy in 42.85% of cases, thyroiditis in 34.69% of cases and post synthetic antithyroid hypothyroidism. All patients were treated with L-thyroxin, with a favorable clinical course. Follow-up was regular in 16 patients (32.65%). Conclusion: Hypothyroidism is common in this population, and primarily affects women. Thyroid surgery was the main cause of hypothyroidism in this work.

Scleroderma in Guinea’s African: Epidemiological, Clinical and Therapeutic Aspects

Introduction: Scleroderma is a generalized condition of the connective tissue, arterioles and micro-vessels characterized by tissue fibrosis, vascular obliteration and abnormal humoral and cellular immune responses. The aim of this study was to describe the epidemiological, clinical, therapeutic and evolutionary aspects of scleroderma at the Department of Dermatology-Venerology at Donka National Hospital. Methods: This was a descriptive cross-sectional study with a retrospective collection of data for a period of 11 years, from January 1, 2000, to December 31, 2010, covering all inpatient records of Scleroderma in the service. Results: We collected 17 cases of scleroderma out of 3289, a frequency of 0.04%. The average age of patients was 33.33 years with extremes of 10 and 60 years. A female predominance was noted with a sex ratio M/F of 0.13. Cutaneous induration was the main symptom associated with the phenomenon of Raynaud, and disorders of pigmentation. The extra-skin manifestations were mainly dominated by gastrointestinal involvement (32%), pulmonary involvement (24%), cardiac (20%), articular (20%) and renal (12%) involvement. The systemic form was the most common (99.45%). Corticotherapy was the most prescribed treatment (24.59%). Clinical improvement was noted in (93.2%) of the cases. Conclusion: Scleroderma, although rare, deserves special attention at all levels for early diagnosis.

Diagnostic Itinerary of Patients Monitored for Thyroid Disease at the Conakry University Hospital in 2022

Introduction: Thyroid pathologies are either the cause or a consequence of certain pathologies with which they interact, manifesting themselves through a polymorphic and non-specific clinic. They affect different devices and/or systems, making the clinical picture more complex or even a delay in diagnosis and treatment. These latter aspects, being then multidimensional, could be preceded by a very specific patient itinerary for the diagnosis and management of cases of thyroid gland pathologies. Methods: This was a descriptive cross-sectional study whose data were collected from May 1 to October 30, 2022. It focused on patients followed for thyroid diseases at the Conakry University Hospital. The objectives were to describe the patient’s journey before their diagnosis of thyroid disease. Results: The subjects were 86.1% women with a mean age of 43.7 ± 28 years. Of the total, 67.85% had a comorbidity including diabetes and/or hypertension/heart disease. They are followed for goiters/simple nodules (22.78%), hypothyroidism (16.46%) and hyperthyroidism (60.76%). They spend at least 9 months before resorting to a healthcare facility. The general medicine services of the Conakry University Hospital are the first recourse (51.9%) of these subjects. They consult 2 to 4 times before the diagnosis is suggested. Hyperthyroidism, hypothyroidism and goiters/simple nodules spend 5.4;6.4 and 13.7 months respectively before the diagnosis is made. 31.6% were hospitalized and treated mainly for malaria (19.0%), hypertension (13.1%), salmonellosis (13.1%) and diabetes (8.3%). A third of patients used traditional therapy before being in contact with the endocrinology department by referral (73.4%). Conclusion: This study made it possible to show a pre-diagnostic pathway which has a particular character concerning patients followed for thyroid pathologies in Guinea.