Quality of Diabetes Annual Management in the Internal Medicine Department in Yalgado Ouédraogo Teaching Hospital, Ouagadougou

Introduction: The periodic management of diabetes improves disease’s prognosis. We aimed to evaluate the quality of diabetes annual management and the effectiveness of its treatment in Ouagadougou. Material and Method: It was a cross-sectional and descriptive study, from retrospective records in the internal medicine department, Yalgado Ouédraogo Teaching Hospital (CHU-YO). Diabetic patient’s (15 years old and more) files that were registered between January, 2012 and December, 2016 have been analyzed. Files containing less than 80% data were excluded. Data relating to the baseline characteristics of the patients, the therapeutic education dispensation, the clinical and paraclinical assessment of the initial and annual visits at the first year of patient’s follow-up have been collected. The 2007 diabetes management standards of the French “Haute Autorité de Santé” as well as the biological standards of the same instance have been used. The quantitative variables were expressed as means and standard deviations and qualitative variables were expressed as absolute and relative frequencies. Results: 317 patients, including 218 women (68.77%) were studied. The mean age of women was 51.67 ± 12.46 years, and that of men 55.71 ± 10.63. Diabetes was type 2 in 302 (95.26%) patients. The mean duration since the diagnosis of diabetes was 2.9 years. The completeness rate of therapeutic education at the annual visit was 10.46%. That of the clinical examinations was at best 38.17% and 44.23% for the measurement of weight and blood pressure;otherwise it was less than 5%. About the paraclinical data, apart from the measurement of the fasting blood glucose which completeness rate was 71.61%, that of the others exams were less than 10%. At the annual visit, the mean value of HbA1C was 7.5%, and the target for HbA1C was achieved in 47.90% patients. Conclusion: The quality of diabetes annual management is unsatisfying. A structural improvement and the adaptation of guidelines are needed.

Thoracic Aortic Aneurysm Revealed by Haemoptysis on a 10-Year-Old Girl at Paediatrics Department of Yalgado Ouedraogo University Hospital

Thoracic aortic aneurysm is a rather rare disorder in children and difficult to diagnose. It is generally linked to congenital heart defects or connective-tissue diseases. Our case is a 10-year-old girl admitted in the pediatric emergency care unit on January 19th, 2015 for massive haemoptysis and severe anaemia. Examination revealed severe anemia and a silent left lung. The Chest X-Ray revealed an abnormal mass on the upper left side of the mediastinum, and left lower lobe consolidation. The thoracic CT scan highlighted a 64 mm aneurysm of the subisthmic aorta with a thin 5 mm hole. It also showed pseudocoarctation of the aorta. Treatment in intensive care consisted of blood transfusion and iron supplement. She was due to travel abroad for cardio vascular surgery, but died on November 2016. Thoracic Aortic Aneurysm in our setting was discovered incidentally. In spite the fact that it is an extreme surgical emergency, in Burkina Faso, treatment can only be possible abroad upon medical evacuation.

Prevalence of Malocclusions and Normative Orthodontic Treatment Need Using IOTN Index for Patients in Yalgado Ouédraogo Teaching Hospital

Introduction: The assessment of health care needs must be reproducible, independent of the operator, hence the use of indexes like the Index of Orthodontic Treatment Need (IOTN). The aim of this study was to assess both, the prevalence of malocclusions among patients received in the Dental Surgery Unitat Yalgado Ouédraogo Teaching Hospital and their care needs according to IOTN index. Materials and Methods: It is a prospective, cross-cutting diagnostic study of malocclusions at Yalgado Ouédraogo Teaching Hospital (CHUYO), conducted from January 1 to December 31, 2016. The examiner with an examination tray records on the 12- to 16-year-old patients’ medical recorded, the variables based on the polychromatic pictures series, the IOTN rule, and the dental health component table. Results: On the whole, 81 patients were included, with 60.5% of girls and 39.5% of boys. 16- and 12-year-old patients were dominant. The average age was 14.05 years old. Various types of malocclusions were encountered. The need for orthodontic care was 56.8%. For 14 patients, 17.28%, their aesthetic component score is higher than the assessment made by the orthodontist. Conclusion: Aesthetics was an important factor in the need for orthodontic care. The aesthetic deficit entails a psychological impact that should be taken into account in the assessment of care needs.

Ulcerative Colitis in Infant: A Case Report at the University Hospital Yalgado Ouedraogo, Ouagadougou in Burkina Faso

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD), characterized by acute exacerbations and remissions. We report the clinical case of an infant, an 8 months female baby. The time between disease onset and diagnosis of the disease was 6 months. It was from an unknown etiology. The main clinical picture was weight stagnation, mucoid bloody diarrhea, and rectal bleeding. The macroscopic aspect in anorectoscopy was an erythematous mucosa with healthy beaches intervals. The mucosa was bleeding easily on contact. Pathological examination realized within the various lesions of the association was highly suggestive. The suggested treatment was made of symptomatic, corticosteroids and immunosuppressant’s therapy. Conclusion: Ulcerative colitis is rare in infants and difficult to manage in our tropical context.

Clinical Evaluation of the Safety and Efficacy of the Phytomedicine APIVIRINE Based on Aqueous Extracts of Dichrostachys glomerata (Forssk.). Chiov. (D. cinerea) in COVID-19 Patients without Signs of Severity

Background: Since the appearance of the COVID-19 pandemic, several drugs have also been proposed for the treatment of the COVID-19, but the therapeutic effectiveness of those drugs is not satisfactory. This situation has led to the search for therapeutic solutions based on recipes from traditional medicine. Aims: This study aimed to evaluate the clinical safety, efficacy and tolerability of the phytomedicine APIVIRINE in patients with non-severe COVID-19. Methods: Patients were included following defined criteria and followed on an outpatient basis until recovery in accordance with national guidelines for the management of single cases of COVID-19 in Burkina Faso. Vital signs, anthropometric parameters as well as electrocardiographic, hematological and biochemical examinations were measured on D4, D7, D14 and D21. Adverse events were recorded during maintenance. Results: The present study included 45 patients. The clinical signs present at inclusion were mostly cough (44.44%), asthenia (42.22%), headache (40%), and anosmia (35.55%). Dyspnoea and chest pain were less represented in 05 (11.11%) and 06 (13.33%) patients. Cough, dyspnoea, chest pain, fever, sore throat, headache, and nasal obstruction present at inclusion disappeared before Day 4 of treatment. Anosmia and asthenia disappeared before Day 7. At the inclusion visit (Day 1), CRP, WBC, and blood glucose were abnormal in 15 (33.33%), 13 (28.89%), and 11 (24.44%) patients respectively. In addition, 3 (6.66%) patients had elevated creatinine levels. Transaminases Alanine aminotransferase (ALAT) were elevated in 05 (11.11%) patients while Aspartate aminotransferase (ASAT) was elevated in 04 (8.89%) patients. After 4 days of treatment, the cure rate was 33.33% of patients and 48.89% after 7 days. The cumulative cure rate was 86.67% after 14 days of treatment. Conclusion: No serious side effects or allergic reactions were observed during treatment. No clinical complications were observed and all symptoms present resolved on the 7th day of treatment.

Meningitis Outbreak Caused by Neisseria meningitidis Serogroup C ST 10217 in 2019 in Diapaga, Burkina Faso

Introduction: Meningitis caused by Neisseria meningitidis constitutes a burden for the countries in the meningitis belt of sub-Saharan in general and particularly for Burkina Faso. In 2019 the Diapaga health district experienced a meningitis epidemic due to N. meningitidis serogroup C. Methods: This is a cross-sectional study with a descriptive aim in the health district of Diapaga where all cases of meningitis were included in this work. Rapid diagnostic tests (RDTs), culture as well as real-time PCR were used for the biological analysis of cerebral spinal fluid (CSF) samples. Results: Of 155 CSF samples analysed, 42% (65/155) were tested positve. Of them, N. meningitidis C accounted for 83% of all positive cases. Likewise, all thirteen (13) NmC strains were susceptible to oxacillin, ceftriaxone, penicillin and chloramphenicol. All strains of NmC belonged to the sequence type (ST) 10 217 and to the clonal complex (CC) 10 217. These CCs belonged to the same variant PorA type: P1.21-15.16;FetA type: F1-7;PorB type: 3-463. Conclusion: Burkina Faso had known an epidemic of meningitis caused by NmC in 2019 in the health district of Diapaga. This outbreak was contained in time due to the performance of the epidemiological surveillance system which made it possible to investigate on time and introduce the vaccine against the pathogen NmC.

Trends of Kalemia at Diagnosis of Acidosis versus Non-Acidosis Diabetic Ketosis Décompensations in Ouagadougou (Burkina Faso)

Introduction: Electrolyte’s profile in non-acidosis diabetic ketosis is poorly specified. We aimed to determine the nature of diabetic ketosis decompensations as well as the profile of kalemia and factors associated with its disorders at diagnosis of acidosis compared to non-acidosis diabetic ketosis. Methods: The study was retrospective from 1 January 2010 to 31 December 2011 in Yalgado Ouédraogo teaching hospital. Diabetic in-patients suffering from simple ketosis, keto-acidosis or mixed decompensation, who achieved blood electrolytes assessment before intensive insulin therapy were included. Results: Sixty two patients were studied. The sex ratio was 0.7 and the mean age was 41.7 years. Keto-acidosis, simple ketosis and mixed decompensation were diagnosed respectively in 18 (29%), 32 (51.6%) and 12 (19.4%) patients. Kalemia was normal in 42 (67.7%), while hypokalemia and hyperkalemia were reported respectively in 11 (17.8%) and 9 (14.5%) patients. Kalemia was often normal in all types of ketosis decompensation and disorders of kalemia occurred more in patients with keto-acidosis (50%) than those with simple ketosis (21.9%);p = 0.04. Renal failure was diagnosed in 10 patients (50%) with and 2 (4.8%) without kalemia’s disorders;p = 0.0001. Seven patients (35%) with and 4 (9.5%) without kalemia’s disorders suffered from unconsciousness;p = 0.02. It happens more in hyperkalemia (44.4%) than in normal kalemia condition (9.5%);p = 0.02. Conclusion: If kalemia is often normal in all types of diabetic ketosis emergencies, hypokalemia is the most initial frequent potassium disorder.

Ocular Manifestations among HIV Infected Children in Ouagadougou, Burkina Faso

Ocular manifestations among HIV infected children are diverse and global incidence varies from 7% to 75%. At this age, eye lesions are often unnoticed because of the incapacity to express eye discomfort. The purpose of this study is to describe ocular manifestations among HIV-infected children and hence associated factors in the Department of Paediatrics at the Yalgado Ouédraogo Teaching Hospital. This was a cross-sectional descriptive and analytical study conducted between July 2014 and December 2014. A complete ophthalmic examination was systematically done to all HIV-positive children attending the clinic, as part of their routine medical visit. The most recent socio-demographic, clinical, biological and treatment data were registered. Seventy-nine children had an ocular examination and among them 92.4% were on ARV treatment. The incidence of ocular manifestations was 46.7%. Median age was 8 years old (interquartile 6 - 12 years old). Sex ratio was 1.3. The risk of ocular manifestations involvement among boys was twice than that of girls. More than half (59.5%) of children who had ocular problems had not expressed ocular discomfort. Ocular adnexal lesions were more common (35.4%) compared to eye segments (8.9%) lesions. Anterior segment and posterior segment lesions were statistically associated with immune system depression (p = 0.003 and 0.001). However, this relationship was not statistically significant (p = 0.15). Five out of seven children who had eye fundus lesions had CD4 count 3. Ocular manifestations were very common among HIV infected children in our context. Ophthalmic examination should be systematic at admission and regularly repeated during follow-up.

Depression in HIV-Infected Compared to Their Seronegative Partners in Serodiscordant Couples in Ouagadougou (Burkina Faso)

Introduction: Depression is common in HIV/AIDS. We aim to investigate the frequency and the grade of this mental disorder in partners and determine its influence on sexual dysfunctions in serodiscordant couples in Ouagadougou. Patients/Method: This cross-sectional study was monitored from 1 January to 31 June 2010 in the internal medicine department of CHUYO, Ouagadougou. HIV-infected patients and their seronegative partners who gave their consent were included. Depression was diagnosed using the Beck Depression Inventory 13 items (BDI-13). Results: Eighty heterosexual and monogamous serodiscordant couples were studied. 31 (38.7%) HIV-infected and 23 (28.7%) seronegative partners were affected by depression;p = 0.18. The score of depression was 3.5 ± 2.1 in HIV-infected and 3.3 ± 1.6 in seronegative partners;p = 0.85. Depression was diagnosed in both partners in 13 couples (16.2%) and in only one partner in 28 couples (35%). Depression was diagnosed at least for one partner in 40 (51.3%) couples where sexual dysfunctions affected partner (s) and in 1 (50%) couple where no sexual dysfunction was reported. Conclusion: Psychological assessment is needed for a better management of HIV/AIDS in serodiscordant couples.

ST of Streptococcus pneumonia Circulating in Burkina Faso before the Introduction of PCV-13, 2013

Introduction: Burkina Faso experiences regular cases of Streptococcus pneumoniae meningitis. As part of the strategy to reduce cases of meningitis, the 13-valent pneumococcal conjugate vaccine (PCV-13) has been introduced in the Expanded Programme on Immunisation (EPI). Despite these efforts, there are some cases of pneumococcal meningitis including both vaccine and non-vaccine serotypes. The objective of this study was to describe the pneumococcal sequence types (ST) circulating in Burkina Faso before the introduction of the 13-valent pneumococcal conjugate vaccine (PCV-13). Methods: It was a descriptive cross-sectional study that took place from 27th October 2013 to 7th January 2014. S. pneumoniae strains were collected in Burkina Faso and Multi Locus Sequence Typing (MLST) was performed at the Pneumococcal Laboratory at the Centers for Disease Control and Prevention (CDC) in the USA (United States of America). MLST consists of 4 steps: amplification, purification, sequencing and interpretative reading of the results. The amplification used 7 primers consisting of sequences of aroe, gdh, gki, recP, spi, xpt, ddl genes. Results: Of 37 strains tested, 10 serotypes were identified. Serotype 1 was prevalent in 48.7% (18/37) followed by serotype 25F in 10.8% (4/37). Serotypes 5 and 12F/12A/12B/44/46 were 8.1% (3/37) each. Serotype 1 contained 5 STs including ST303 24.3% (9/37), ST217 8.1% (3/37) and ST618 8.1% (3/37);followed by serotype 25F with ST105 10.8% (4/37), serotype 5 with ST289 8.1% (3/37) and serogroup 12F/12A/12B/44/46 with ST 989 8.1% (3/37). Conclusion: Pneumococci are characterised by their great variability both in number of serotypes and in ST within the same serotype. Thus, 10 serotypes have been identified. Also, within serotype 1, 5 different STs have been described. These data indicate the complexity of the pneumococcus which is strongly involved in purulent bacterial meningitis at national level. This requires continuous surveillance of pneumococcal meningitis through laboratory capacity building.

Surgical and Orthodontic Treatment of Dental Retentions: A Case Report

This paper reports the case of K.Z, a 15 year-old child received in the Dental Surgery Unit of the Yalgado Ouédraogo Teaching Hospital for consultation for some aesthetic reasons due to dental retentions. On his X-ray, the premolars 25, 34, 35, 44, 45 and the molar 47 were deeply impacted, retained by supernumerary teeth. The treatment consisted in the removal of persistent temporary teeth and supernumerary teeth with poor radicular set, except one premolar. The removal of this premolar located between the roots of tooth 36, was source of major risk;therefore, it was put under clinical supervision. After these extractions, a fixed orthodontic appliance enabled bringing impacted teeth to a functional position. Orthodontic treatment lasted 3 years with a monthly check-up. Ours results are stable after one year of decline.

Prevalence of intestinal opportunistic parasites infections in the University hospital of Bobo-Dioulasso, Burkina Faso

Background:Gastrointestinal parasites infections are widespread in Africa and their prevalence infections vary from country to country.This study aimed at assessing the prevalence of opportunistic intestinal parasites infection and other gastrointestinal parasites infection among patients attending the laboratory of Parasitology and Mycology of the University Hospital Souro Sanou of Bobo-Dioulasso.Methods:A hospital cross-sectional based study was conducted from April to August,2012.Participants were persons whom parasitological examination of stools has been prescribed by a clinician.The stools examination methods included direct wet saline examination,lugol’s iodine staining technique,formol-ether concentration and modified Ziehl-Neelsen staining.We recorded age and sex information for each patient.Results:The overall prevalence of intestinal parasite infections was 65.3%(190/291).Majority of the parasitic infections was waterborne(64.3%)consisting of high prevalence of Cryptosporidium sp.(26.5%)and Entamoeba histolytica/dispar(23.4%).The prevalence of opportunistic parasites was 28.9%and Cryptosporidium sp.was the most prevalent species followed by Blastocystis sp.(1.0%),Cyclospora sp.(0.7%)and Isospora belli(0.7%).The prevalence of intestinal helminthes was 1.7%.Conclusions:The prevalence of intestinal parasitism in general remains high in Bobo-Dioulasso requiring the establishment of adequate diagnostic techniques,treatment and prevention.

Epidemiological and clinical aspects of urogenital schistosomiasis in women, in Burkina Faso, West Africa

Background:Because infections with Schistosoma Haematobium usually peak in childhood,the majority of studies on schistosomiasis have focused on school-aged children.This study aimed to assess the epidemiological and clinical aspects of urogenital schistosomiasis in women in Burkina Faso,West Africa.Methods:A cross-sectional study was conducted in a mesoendemic region(Kombissiri)and a hyperendemic region(Dori)for schistosomiasis in Burkina Faso.A total of 287 females aged 5 to 50 years were included in the study.S.haematobium infection was assessed using the urine filtration method and dipsticks were used for the detection of hematuria.Interviews were conducted to identify clinical aspects and risk factors related to urogenital schistosomiasis.Results:The overall prevalence of S.haematobium infection in Dori was 21.3%,where as Kombissiri was less affected with a prevalence of 4.6%.The most affected age group was the 10-to 14-year-olds(41.2%),followed by the 15-to 19-year-olds(26.3%).Risk factors significantly associated with schistosomiasis(P<0.05)were place of residence,age,contact with open water in the past year,and distance of home to open water.The percentage of participants who had contact with open water was significantly higher among the women living in Dori compared to Kombissiri.Females over 15 years of age showed a significant higher rate of water contact compared to the 5-to 15-year-olds.A significant correlation between schistosomiasis and hematuria was established.Microhematuria showed a sensitivity of 80.6%,a specificity of 92.7%,and a positive predictive value of 61.7%,whereas macrohematuria had a sensitivity of 47.2%,a specificity of 99.2%,and a positive predictive value of 89.5%.The mass distribution of praziquantel in Burkina Faso is well established.However,over half of the participants with schistosomiasis in this study said they took praziquantel in the past 6 months,which indicates a high reinfection rate.This may be associated with a lack of knowledge about the transmission of schistosomiasis.Only 6%of the participants in Kombissiri and 1.5%in Dori knew about the correct mode of transmission.Conclusions:The results of our study indicate that distribution campaigns should be extended from school-aged children to young women.Our data also demonstrate the necessity of combining already established mass distribution campaigns with information campaigns,so that long-term elimination,or at least reduction,of schistosomiasis can be achieved.