Profile of Malignant Bone Tumors among Rheumatology Inpatients in Lome (Togo)

Background: The reel impact of malignant bone tumors in adults seems unclear in Black Africa. Aim: The aim of this study is to determine the epidemiological and the semiological profile of malignant bone tumors in rheumatology inpatients at Hospital University Center Sylvanus Olympio in Lome. Methods: It was a retrospective study of recorded cases conducted over a period of 19 years in the rheumatology department at Hospital University center Sylvanus Olympio in Lome, Togo. Results: One hundred and sixty-six patients (68 women and 98 men) suffered from a bone tumor. The average age of patients was 55 years old with some extremes cases of 14 and 98 years old. The most affected age group was the one between 46 and 55 years old (40 cases, 24.1%). The disease’s average duration was 17 months. These tumors were primary in 43 cases (26%) and secondary in 123 (74%). Metastases were those of prostate (44 cases, 35.7%), breast (12 cases, 9.7%), bronchus (7 cases, 5.7%), cervix (5.7%), and liver (2 cases, 1.6%). Myeloma (34 cases;79.0%) and osteosarcoma (9 cases;20.9%) were the main primary malignant bone tumors. However, 41 cases (33.3%) of malignant bone tumors had not been able to label. The spine was the predilection part for all above-mentioned tumors. Conclusion: This study shows the significant part occupied by malignant bone tumors in musculoskeletal diseases within the sub-Saharan population in general and Togo in particular.

Anxiety and Depression Disorders in Chronic Non-Specific Low Back Pain in Lomé(Togo)

Chronic non-specific low back pain has an important psychological impact. Objectives: To determine the prevalence of anxiety and depressive disorders (ADD) and factors associated to their apparition in patients suffering from chronic non-specific low back pain in rheumatological consultation in Lomé. Patients and Methods: It was a cross-sectional study, conducted from October 1st, 2015 to 31st March 2016. This study focused on all patients suffering from common chronic low back pain without psychiatric history in the Rheumatology Ward at the Sylvanus Olympio’s Teaching Hospital of Lomé and who have given their consent. The psychological evaluation was carried out through Hamilton scale. The processing, the statistical treatment and analysis of our data have been carried out using Epiinfo software, version 7.1.5. The investigation was approved by the local Ethics Committee. Results: 48 (39 women and 09 men) out of 123 patients with chronic lower back pain presented anxiety and depressive disorders (ADD) accounting for a prevalence rate of 39%. Their average age was 50.3 years old. The most frequent ADD was: psychic anxiety (58.6%), depressive mood (51.3%), difficulties to feel asleep (47.9%) and disturbed or agitated sleep (43.1%). Factors associated with the anxiety and depressive disorders in common chronic low back pain were: female gender (p = 0.02), dependent children (p = 0.02), occupation (reseller (p = 0.002), liberal profession (p = 0.009), monthly financial income (p = 0.002), surroundings family (0.009), medical history (p = 0.0002) and pain’s intensity > 7 (p = 0.04). Conclusion: This study shows the high frequency of anxiety and depressive disorders in common chronic low back pain and their influence by socio-economic and demographic factors.

Profile of Secondary Bone Cancer in Lomé(Togo)

Objectives: To determine the epidemiological, clinical and paraclinical profile of bone metastases cancer. Patients and Methods: It was a retrospective study performed on a series of cases, admitted in Rheumatology department of the University Teaching Hospital of Lomé, Togo from October 1989 to December 2008. The diagnosis of bone metastasis was made because of the existence of inflammatory bone pain, or pathological fracture, or bone swelling and a bone condensing or mixed or osteolytic radiological image. The anatomopathological evidence was made after biopsy of the bone lesion or primary cancer. 2018 patients were hospitalized in rheumatology, and among them 77 had documented bone metastasis. Results: There were 53 men (68.8%) and 24 women (31.2%) with a sex ratio of 2.2. The mean age was 56.6 ± 12.6 years, ranging from 21 to 82 years. The primary cancer most frequently found was that of the prostate, representing 57.1% of bone metastasis and breast in 15.6%. The main manifestations of patients with bone metastases were inflammatory bone pain (76.6%) and alteration of general condition (75.3%). The spine was the main area of pain (64.9%). The metastasis was bone condensing in 48.1% of cases, osteolytic in 40.3% and mixed in 11.6%. The average survival was 22 months. Conclusion: The clinical and radiological presentation remains classic. Cancer of the prostate and breast are the main neoplasia responsible for bone metastasis in our series. The diagnosis of the primary tumor is often made at the stage of metastasis in black Africa.

Human Immunodeficiency Virus Can Affect the Semiology of Osteoarticular Infections?

Objective: To compare the epidemiological, the clinical and the paraclinical profile of osteoarticular infections in HIV-positive patients and in HIV-negative patients. Patients and Methods: patients with Osteoarticular infections recognized on the basis of radioclinical and epidemiological arguments were included in this study. The comparison that was based on the existence or was not of HIV infection focused on various clinical and biological components. Of these 15,800 rheumatic patients admitted in 18 years, 461 have suffered from Osteoarticular infection (2.9%). The 461 patient objects of this study were divided into 235 cases of infectious arthritis including 38 cases of co-infection with HIV and 225 cases of infectious spondylodiscitis including 21 cases of HIV co-infection. Results: There were 246 women (53.4%) and 215 men (46.4%) with a sex ratio of 1.1. The mean age was 37.7 ± 13.6 years. The data comparison of HIV-negative patients and HIV-positive patients had not shown statistically significant difference in the infectious spondylodiscitis group and in the group of infectious arthritis patients. Only fever was statistically significant in both groups and weight loss in the group of infectious arthritis (p < 0.001). Conclusion: HIV seems not to particularly influence the semiological profile of Osteoarticular infections in Lomé.

Etiology of Arthritis in Lomé(Togo)

Aim: Determine the frequency and respective proportion of the various etiological forms of arthritis in Lomé (Togo). Patients and Methods: Transversal study carried out over 15 years on files of arthritis infected patients and submitted to rheumatologic consultation. Results: 1081 out of 13,517 patients examined (8%) were suffering from arthritis. Those 1081 patients (456 women, 42.2% and 625 men, 57.8%) were in average 38 years old and enjoyed an average duration of evolution of three years. The chronic inflammatory rheumatisms (CIR) (602 cases, 56.9%), the metabolic arthropathies (233 cases, 22%) and the infections (198 cases, 16.6%), were the main etiologies that were observed. The average age of 198 patients with infectious arthritis was 36 years and the average duration of 9 months. Infectious arthritis was preferably located at the knee (34.3%), and was essentially caused by a banal germ (157 patients;79.3%) and associated with HIV in 25 patients (15.9%). The remaining 233 patients (9 women, and 224 men) suffering from metabolic arthritis were in average 52 years old and enjoyed an average duration of evolution of five years. The chronic inflammatory rheumatisms were mainly represented by spondyloarthropathies (90 cases, 14.9%) and the arthritis rheumatoid (64 cases, 10.6%). 399 out of 602 cases of the CIR were not classified while 52 cases were associated with HIV. The connective tissue diseases were dominated by the polymyositis (9 cases, 18.7%). Conclusion: The chronic inflammatory rheumatisms were the first causal form of arthritis in rheumatologic consultation in Lomé.