Frontal Sinus Fractures: Management at the Yalgado Ouedraogo University Hospital Centre (Burkina Faso)

Introduction: Frontal sinus fractures are potentially serious. They are defined as a solution of continuity, open or closed, of one or both bone tables of the frontal sinus. This study aims to report on the management of them at the Yalgado OUEDRAOGO University Hospital Centre. Methodology: It is a descriptive cross-sectional study with retrospective collection from January 01, 2016 to December 31, 2018. Patients with frontal sinus fractures were managed at the Yalgado OUEDRAOGO University Hospital Centre through CT-scan proof. Results: Over three years, a total of 102 cases of frontal sinus fractures were collected with 29.9 years as average age. There were 96 men. Workers in the informal sector and pupils/students represented 58.90% of patients. The residence of the patients was urban in 68.80% of cases and rural in 31.40%. Road traffic accidents (RTAs) happened in 90.20%, and involved 2-wheelers in 98.20%. None of these drivers was wearing a helmet. The type III frontal fracture of Ioannides et al. represented 51.9% of cases. In 89.21% of cases, other facial and/or cranioencephalic injuries were compounded to frontal sinus fractures. No surgical management was observed in 82 (80.39%) patients and surgical management in 20 (19.61%) patients. The outcome was favourable, but sequelae and/or complications were noted in 10 patients who had surgery and 30 patients who did not. Conclusion: These results enforce helmet wearing for all riders of two-wheeled machines. In addition, vaccinations to prevent meningitis in frontal sinus fractures with dural breach should be systematic.

Evaluation of the Adequacy between the Workload and the Number of State Midwives and Maieuticians Practicing in the Gynecology-Obstetrics Departments of the University Hospitals of Burkina Faso

Objective: To evaluate the adequacy between the workload and the number of midwives and state midwives practicing in the gynecology-obstetrics services of the university hospitals of Burkina Faso. Methodology: This is a multicenter study conducted in 4 university hospitals representing this country (for brevity referred here to as A, B, C, and D) from May 1, 2018, to April 30, 2019. The Workload Indicators of Staffing Need (WISN) method was used to analyze the workload. Results: Dystocic delivery was the activity that took the most time. Inpatient activities were the most performed in terms of volume. At the University Hospitals D and C, there was an over-staffing of midwives and maïeuticians with a ratio of 1.93 and 2.12 respectively. At University Hospital B, the workload was in line with the existing number of State midwives and maieuticians. A low workload pressure (04%) was found at the University Hospital A. Conclusion: In most of the University Hospital Centers, there was no match between the workload and the number of midwives and maïeuticians. These results highlight the need for redeplayment of midwives and maïeuticians in order to ensure good health coverage for midwives and maïeuticians.

Sleep Disorders among Professional Oil Tanker Drivers in Ouagadougou Burkina Faso

Introduction: Sleep disorders among professional drivers are a major road safety problem. They cause fatigue and drowsiness at the wheel, which can lead to road traffic accidents and even accidents at work. The aim of this study was to assess sleep disorders among professional drivers of oil tankers in Ouagadougou, Burkina Faso. Methods: This was a descriptive and analytical cross-sectional study carried out from 11 April 2020 to 11 September 2020 in the national hydrocarbon company’s fuel depot. All the drivers present at the time were included and accomplished a questionnaire incorporating the commonly scales using to assess sleep disorders, sleep quality and sleep apnoea. Data analysis using R 3.6.1 software enabled to perform univariate and multivariate analyses to identify associated factors. Adjusted odd ratios were used to measure the strength of association. The significance level chosen was p ≤ 0.05. Results: All the 339 respondents were male. A proportion of 33.6% suffered from insomnia, including 12.7% with moderate to severe insomnia, and 18.58% were at risk of sleep apnoea. On the Epworth scale, 26.6% of drivers showed sleep debt and 4.1% excessive daytime sleepiness. The risk factors associated with insomnia were the use of psychostimulants. A history of diabetes and insomnia were risk factors associated with sleep apnoea syndrome. Conclusion: The prevalence of sleep disturbance and insomnia among the respondents were 52.2% and 33.6% respectively. Use of psychostimulants was the identified risk factor. The prevalence of SAS was 4.72%, with diabetes and insomnia as associated factors.

Upper Gastrointestinal Endoscopy at University Hospital Souro Sanou Bobo-Dioulasso (Burkina Faso), about 1022 Cases: Signs and Lesions Observed

Upper gastrointestinal endoscopy is an excellent way for the diagnosis of high digestive pathology. We report the results of 1022 upper gastrointestinal endoscopy performed at Bobo-Dioulasso CHU-SS, in western Burkina Faso (West Africa). The aim of this study was to document the indications and lesions found in high endoscopy at the CHUSS. Patients and Methods: It was a cross-sectional study, prospective to describe the results of gastroscopy performed from 1st January 2015 to 30th June 2016 at the digestive endoscopy unit CHU-Souro Sanou Bobo-Dioulasso. Results: In the study period, 1022 upper gastrointestinal endoscopies were performed. The main indications were: The epigastric pain (48.6%), portal hypertension (10.7%) and gastroesophageal reflux disease (9.9%). The pathologies observed were dominated by gastropathies (48.11%), peptic ulcer (27%) and oesophageal varices (9.68%). Epigastralgias were the main circumstance for the discovery of: 52.3% of esophagitis, 49.17% of gastropathies and 46.12% of peptic ulcers. Histopathologically, the results of the 236 biopsies were dominated by gastritis (88.56%), stomach cancers (7.63%) and esophagus (3.81%). Conclusion: The main indication of the UGIE at the CHU-Souro Sanou in Bobo-Dioulasso was epigastralgia. The pathologies observed were dominated by gastropathy, esophagitis and PUD.

Can the Urine Dipstick Test Be an Alternative in the Screening of Urinary Tract Infections for Inpatients in the Context of a Low-Income Country?

Background: Urinary Tract Infection (UTI), a prevalent bacterial infection in adults, heavily relies on cytobacteriological examination of urine (CBEU) for diagnosis. However, in resource-limited countries, accessibility to CBEU remains hindered by cost and availability. This study aims to assess the utility of the Urinary Dipstick Test (UDT) in diagnosing UTIs among hospitalized patients in the context of limited resources. Methods: A cross-sectional study was conducted from February to May 2019, encompassing hospitalized patients who underwent CBEU at the bacteriology unit of Sour? Sanou University Hospital. UDT and CBEU were concurrently performed, and UDT’s analytical and diagnostic performance was evaluated against CBEU, considered the gold standard. Results: A total of 274 CBEU requests were registered, involving 274 patients (159 males) with a mean age of 45.8 ± 21.3 years (ranging from 1 to 90 years). UTI was confirmed in 90 patients, yielding a frequency of 32.85%. The UTI bacteriological profile was dominated by Enterobacteriaceae (75.23%), primarily Escherichia coli (60.55%). Nitrite and Leukocytes were positive in 54 (19.8%) and 157 (53.6%) of the samples tested. Among patients with confirmed UTI, Nitrite, and Leukocytes were positive in 30 (33%) and 71 (79%) patients respectively. UDT demonstrated variable performance based on nitrite and leukocyte combination: Sensitivity (57%-82%), Specificity (7%-98%), Positive Predictive Value (PPV) (43%-57%), Negative Predictive Value (NPV) (43%-67%). UDT performed slightly better in women (NPV = 88%) and inpatients without urinary catheters (NPV = 75% and PPV = 80%). Conclusion: This study underscores UDT’s potential utility in excluding UTIs among women, younger patients, and inpatients without urinary catheters, albeit with limited confidence. The UDT emerges as a complementary tool for UTI screening, particularly in resource-limited settings.

Quality of Life of Patients with Urticaria in Ouagadougou (Burkina Faso)

Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to evaluate the clinical and therapeutic socio-demographic profile and quality of live of patients followed for urticaria in the dermatology-venereology department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Methodology: We conducted a descriptive cross-sectional study over a 5-year period from 1 January 2015 to 31 December 2019. The data were collected retrospectively by analysing the files and prospectively by evaluating the quality of life with DLQI. All the records of patients treated for urticaria at the Dermatology-Venerology Department of the Yalgado Ouédraogo University Hospital during the period were included. Results: Urticarial frequency is 1.91%. There were 36 men (25.71%) and 104 women (74.28%), i.e. a sex ratio of 0.34. The median age was 31 years with extremes of 4 to 70 years. The 30 - 45 age group accounted for 51.42%, followed by the 16 - 29 age group (31.42%), then the 46 - 65 age group (9.28%), the 4 - 15 age group (5.71%) and the over 66 age group (2.14%). In terms of occupation, pupils/students accounted for 37.1%, housewives for 18.6% and workers for 44.3%. As for the residence of the patients, 88.57% lived in Ouagadougou Personal history of atopy, it concerned 19.26% of patients, with precisely 9.28% having asthma history, 7.14% having rhino-sinusitis history, 1.42% of atopic dermatitis and allergic conjunctivitis respectively. For clinical aspects, 97.14% of the patients had superficial urticaria, and 2.86% had facial angioedema. There were 35% (49) patients with acute urticaria and 65% (91) with chronic urticaria. Chronic urticaria was spontaneous in 55% (50) and physically inducible in 10% (9) (sweating, pressure or friction). 97.14% of patients received antihistamines associated with systemic corticoids in 2.86%. For Quality of life, the mean DLQI score was 7.51, indicating a moderate effect of urticaria on patients’ quality of life. The quality of life of women was more affected than that of men, especially in the professional and social spheres. Conclusion: In hospital frequency of urticaria is low in Ouagadougou, a predominance of chronic spontaneous urticaria whose management involves the use of second generation antihistamines at a dosage and duration that do not meet international recommendations. The patients’ quality of life was moderately impaired.

Retinoblastoma: The Situation in Burkina Faso over Ten Years

Context: In Burkina Faso, there is only one retinoblastoma treatment center located in the capital. Nowadays, the treatment of retinoblastoma has benefited from the contribution of scientific progress. Objective: The aim was to take stock of the situation of retinoblastoma in the pediatric oncology department from January 1, 2010 to December 31, 2019. Materials and Methods: This was a descriptive cross-sectional study with retrospective data collection over a 10-year period, based on records of patients admitted to pediatric oncology department of CHU-YO. Data were analysed using CS Pro version 7.2 software. Categorical variables were compared using Pearsons Chi-square test at the 5% significance level. Overall survival was estimated using the Kaplan-Meier method. Operational definitions were used for lost to follow-up, consultation and diagnosis delays. Results: We collected a total of 204 cases in 10 years, i.e. an annual average of 20.4 cases/year. The mean age at diagnosis was 37.5 months for unilateral cases and 26.4 months for bilateral cases. Male predominance was noted, with a sex ratio of 1.31. The majority of patients came from disadvantaged backgrounds (72% farming fathers and 91% housewives). Clinically, leukocoria and exophthalmos were the main presenting features. The average time to consultation was long (8.73 months) and unilateral localization was predominantly unilateral at 77%. In terms of treatment, 102 patients were eligible for curative treatment and 80 for palliative treatment. The prognosis was poor, with 41% death and numerous cases of lost to follow-up (18%). Overall survival was estimated at 32%. The factor associated with the lethality of retiniblastoma was the extension of the tumor to other organs. Conclusion: Recognition of the early clinical signs of retinoblastoma can anticipate the occurrence of this cancer. Health professionals should be encouraged to perform the Buckner test every time they come into contact with children aged 0 to 5, and the public should be encouraged to examine their childrens eyes.

Chest Radiography: General Practitioners’ Compliance with Recommendations

Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.

Extracranial Carotid Atherosclerosis and Acute Ischemic Stroke in a Tertiary Hospital in Burkina Faso

Objective: To determine the prevalence and risk factors of carotid atherosclerosis among ischemic stroke patients in a tertiary hospital in Burkina Faso. Methodology: This was a descriptive and analytical retrospective study of patients admitted at neurology department of Yalgado Ouedraogo University Teaching Hospital with ischemic stroke and cerebral large vessel atherosclerosis in the period from January 1, 2012 to December 31, 2016. Results: The prevalence of extracranial carotid atherosclerosis was 23.9%. The mean age of patients was 63.5 years (Range 31 - 90 years). The study population included 65% of men and 35% of women. Hypertension was the most common vascular risk factor (75.6%). Stroke was mostly located in the anterior circulation in 23.9%. Low HDL-C was present in 52% of patients. The majority of plaque was homogeneous (85.2%). Plaque were located in carotid bulbar artery (38.5%) followed by common carotid artery (28.2%) and extracranial internal carotid artery (18.6%). According to cerebral lesion, plaque was bilateral in 45.5%, ipsilateral in 42.3% and contralateral in 12.1% of cases. Tight stenosis was found in 30.1% of patients. There was a significant link between male gender and tight stenosis (p = 0.004). Aspirin was the most antiplatelet therapy used (95.5%). Statin therapy was used in 91% of patients. The mean duration of hospitalization was 12.5 days with a mortality rate of 7.1%. Conclusions: Our study showed that extra carotid atherosclerosis was the most common cause of ischemic stroke in Burkina Faso. Man gender was most represented than women.

Management of a Total Coalescence of the Labia Majora in an 11-Year-Old Girl Following a Female Genital Mutilation: A Case Report

Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of the people who suffer them and are the source of various complications. We report a case of FGM complications in the form of total coalescence of the labia majora with a small hole from which urine flows permanently. The management was a disinfubilation with suturing of the edges and urethral reimplantation and the evolution was favorable with complete healing after two (2) weeks.

Frequency and Factors Associated with Depression during Chronic Lumbosciatica in Sub-Saharan African Black Patients

Objective: This study was focused on depression rate and associated factors in chronic lumbosciatica in sub-Saharan African black patients. Patients and Methods: We conducted a prospective descriptive and analytical study in chronic lumbosciatica cases seen in rheumatology/internal medicine, neurology and neurosurgery departement at the Yalgado ouédraogo University Hospital Center from April 31, 2016 to July 31, 2016. The diagnosis of depression was based on Hamilton scale. Its frequency was evaluated and the associated factors were analyzed. Results: One hundred and forty-nine patients were included in the study. Their average age was 49.5 years and the sex ratio was 0.42 (44 men/105 women). Thirty-eight patients lived alone (25.5%). Pain intensity was severe in 46 patients (30.9%) and moderate in 77 patients (51.7%). Neuropathic pain was present in 108 patients (72.5%). One hundred and ten patients had depression (73.8%). Depression was severe in 38 patients (25.5%), moderate in 35 patients (23.5%), and mild in 37 patients (24.8%). Factors associated with depression were living alone (Odds-Ratio 3.5), high (Odds-Ratio 11.1) or moderate (Odds-Ratio 5.9) intensity of pain, and the presence of neuropathic pain (Odds-Ratio 2.5). Conclusion: Depression was frequent during chronic lumbosciatica in sub-Saharan African black patients. Its associated factors were living alone, presence of moderate or severe pain, and neuropathic pain.

Knowledge,attitudes and practices concerning epilepsy among nurses and midwives working in primary health care settings in Ouagadougou of Burkina Faso

Background In developing countries,there is a lack of epilepsy knowledge among health workers.The objective of this study was to assess the knowledge,attitude and practice concerning epilepsy among nurses and midwives working in primary health care settings in Ouagadougou.Methods We carried out a cross-sectional study in the health districts of Ouagadougou from August 1st to September 15th,2017.All nurses and midwives working in three health districts were included in this study.Results A total of 213 participants with a mean age of 39.5 years were included in the survey;79.81%of them had a general certification in secondary education and 62%had a professional experience of more than 10 years.About 99%of the participants had not received training on epilepsy-related care during the last six months.In addition,74.5%of the participants had a good knowledge on epilepsy and 65%had a good practice toward epilepsy.The level of knowledge was associated with the workplace,years of training,and the professional experience.The level of knowledge about epilepsy was also associated with the level of education,while there was a significant link between professional status and nurses’level of practice in the management of seizures.Conclusions Efforts must be made to provide continuing education for nurses in order to improve their knowledge on epilepsy.

Knowledge and attitudes of driver license applicants and instructors about driving of patients with epilepsy in Burkina Faso

Background:Epilepsy is the most common neurological disease in the world.The objective of the study was to determine the knowledge,attitude and practice of driver's license applicants and instructors in driving schools on epilepsy in Burkina Faso.Method:This cross-sectional study was carried out from January 7th to March 7th 2020 in 21 driving schools approved by the National Driver License Authority in the city of Ouagadougou.Fifteen driver applicants and one instructor were selected in each driving school,resulting in a total of 315 driver applicants and 21 instructors in the study.Results:The mean age of participants was 29.91±7.63 years.One of the driver applicants included in the study was once experienced a seizure attack.All respondents had heard of epilepsy.The main source of epilepsy information was from family(42.5%).Two hundred and twenty-six respondents(673%)had witnessed an epileptic seizure.A majority of participants(55.9%)believed that persons with epilepsy be not permitted to drive a motor vehicle.About 44.0% of participants thought that people with epilepsy should be permitted to drive under certain conditions.One hundred and four(30.9%)participants suggested that people with epilepsy be permitted to drive a light vehicle.One hundred and forty-one(42.0%)suggest to withdraw the driving license for lifetime if a driver had an epileptic seizure attack;while twenty-three(6.8%)participants recommended suspension of driver license for 12 months.Conclusion:Efforts should be made to improve awareness and education among license applicants and instructors on the driving by people with epilepsy.