Dominique Doupa

Dyslipidemia, obesity and other cardiovascular risk factors in the adult population in Senegal

Introduction According to the WHO, 50% of deaths worldwide (40.1% in developing countries) are due to chronic non-communicable diseases (NCDs). Of these chronic NCDs, cardiovascular diseases remain the leading cause of death and disability in developed countries. The Framingham study has shown the importance of hypercholesterolemia as a primary risk factor. In Senegal, the epidemiology of dyslipidemia and obesity are still poorly understood due to the lack of comprehensive studies on their impact on the general population. This motivated this study to look into the key epidemiologic and socio-demographic determinants of these risk factors. Methods It was a cross-sectional descriptive epidemiological survey which included 1037 individuals selected by cluster sampling. Data were collected using a questionnaire following the WHO STEPwise approach. Socio-demographic, health and biomedical variables were collected. P value <0.05 was considered to be statistically significant. Results The average age was 48 years with a female predominance (M: F of 0.6). The literacy rate was 65.2% and 44.7% of participants were from rural areas. The prevalence of hypercholesterolemia, hyperLDLemia, hypoHDLemia, hypertriglyceridemia and mixed hyperlipidemia were 56%, 22.5%, 12.4%, 7.11% and 1.9% respectively. One in four was obese (BMI> 30kg/m2) and 34.8% had abdominal obesity. The main factors significantly associated with dyslipidemia were obesity, urban dwelling, physical inactivity and a family history of dyslipidemia. Conclusion The prevalence of dyslipidemia, obesity and other risk factors in the population was high needing immediate care for those affected and implementation of prevention strategies.

Epidemiology of chronic kidney disease in northern region of Senegal: a community-based study in 2012.

Introduction Chronic kidney disease (CKD) is an emerging worldwide epidemic but few data are available in African populations. We aimed to assess prevalence of CKD in adult populations of Saint-Louis (northern Senegal). Methods In a population-based survey between January and May 2012, we included 1,037 adults aged =18 years living in Saint-Louis. Socio-demographical, clinical and biological data were collected during household visits. Serum creatinine was measured by Jaffé method. We estimated glomerular filtration rate (eGFR) using the 4-variables MDRD equation and CKD was defined by eGFR < 60 mL/min/1.73m2 and/or albuminuria > 1g/L. A multivariate logistic regression was performed to identify factors associated with CKD. Results Mean participants’ age was 47.9 ±16.9 years (18-87) and sex-ratio was 0.52. Majority of participants lived in urban areas (55.3% rural) and had school education (65.6%). Overall prevalences of hypertension, diabetes and obesity were 39.1%, 12.7% and 23.4% respectively. Prevalence of CKD was 4.9% (95% CI= 3.5 – 6.2) and 0.9% had GFR < 30 mL/min/1.73m2. Albuminuria >1g/l was found in 3.5% of people. CKD was significantly more frequent among hypertensive patients compared to normotensive participants. Only 23% of patients were aware of their disease before the survey. After multivariate logistic analysis, presence of CKD was significantly associated with hypertension (OR=1.12, p= 0.02) and age (OR=1.03, p= 0.02). Conclusion CKD is frequent in adult population living Northern Senegal. Main associated factors are hypertension and age. Prevention strategy is urgently needed to raise awareness and promote CKD detection and early treatment in both urban and rural areas.

Prevalence of Chronic Kidney Disease and Associated Factors in Senegalese Populations: A Community-Based Study in Saint-Louis

Background: Chronic kidney disease (CKD) is an emerging worldwide epidemic but littledata concerning African populations are available. Objectives: We aimed to assess prevalence of CKD in adult populations of Saint-Louis, northern Senegal. Patients and Methods: In a population-based survey between January and May 2012, we included 1037 adults ≥ 18 years of age who resided in Saint-Louis. Socio-demographic, clinical, and biologic data were collected during household visits. Serum creatinine was measured by Jaffé method. We estimated glomerular filtration rate (eGFR) using the four-variable Modification of Diet in Renal Disease (MDRD) equation and CKD was defined by eGFR< 60 mL/min/1.73 m2 and/or albuminuria > 1 g/L. A multivariate logistic regression was performed to identify factors associated with CKD. Results: The mean of participants’ age was 47.9 ± 16.9 years (range, 18-87) and sex ratio (male to female) was 0.52. Majority of participants lived in urban areas (55.3%) and had school education (65.6%). Hypertension, diabetes, and obesity were present respectively in 39.1%, 12.7%, and 23.4% of participants. Overall CKD prevalence was 4.9% (95% CI, 3.5-6.2) with eGFR< 30 mL/min/1.73 m2 in 0.9%. Albuminuria > 1 g/L was found in 3.5% of patients. CKD was significantly more frequent among hypertensive patients in comparison with normotensive ones. Risk factors associated with CKD were hypertension (12% of risk excess) and age (3% of risk excess). Conclusions: CKD is frequent in adult population living in Northern Senegal. Main associated factors are hypertension and age. Prevention strategies are urgently needed to raise public awareness and promote early CKD detection and treatment in both urban and rural areas.

Lipid profile frequency and the prevalence of dyslipidaemia from biochemical tests at Saint Louis University Hospital in Senegal

Introduction The aim of this study was to evaluate the frequency of lipid profile requests and the prevalence of dyslipidemia in patients at the biochemistry laboratory of St. Louis University Hospital, as well as their correlation with sex and age. Methods This was a retrospective study reviewing 14,116 laboratory results of patients of both sexes, over a period of six months (January-June 2013) regardless of the indication for the request. The lipid parameters included were: Total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides with normal values defined as follows: Total cholesterol (<2g/l), HDL- cholesterol (>0,40g/l), LDL- cholesterol (<1,30g/l) and Triglycerides (<1,50g/l). Results The average age of our study population was 55.15 years with a female predorminance (M/F = 0.60). The age group most represented was that between 55-64 years. The frequency of lipid profile request in our sample was 9.41% (or 1,329). The overall prevalence of isolated hypercholesterolemia, hyperLDLaemia, hypoHDLaemia, hypertriglyceridaemia, and mixed hyperlipidemia were respectively 60.91%, 66.27%, 26.58%, 4.57% and 2.75%. Hypercholesterolemia, hyperLDLaemia, hypertriglyceridaemia and mixed hyperlipidaemia were higher in women with respectively 66.22%, 67.98%, 4.58%, 2.89% than in men (52.01%, 62.81%, 4.44% and 2.40% respectively). On the other hand, the prevalence of hypoHDLaemia was higher in males (32.19%) compared to females (23.76%). Hypercholesterolemia correlated significantly with age and sex. Conclusion Our study showed a relatively low request rate for lipid profile and a high prevalence of dyslipidaemia hence the importance of conducting a major study on the prevalence of dyslipidaemia and associated factors in the Senegalese population.

Clinical efficacy of African traditional medicines in hypertension: A randomized controlled trial with Combretum micranthum and Hibiscus sabdariffa

Medicinal plants are widely used as a first-line therapy for hypertension, often without comparative clinical data. A prospective, randomized controlled trial was conducted to assess efficacy of Combretum micranthum (kinkeliba) and Hibiscus sabdariffa (bissap), in the galenic form of capsules of plant powder, on blood pressure in adult patients with non-complicated hypertension (u2009>u2009140/90u2009mmu2009Hg). One hundred and twenty five patients were randomly allocated into group 1 (kinkeliba leaves 190u2009mgu2009×u20092/day), or group 2 (bissap calyx 320u2009mgu2009×u20092/day), or group 3 (ramipril 5u2009mg /day) during four consecutive weeks. Blood and urinary samples were collected on day 0 and 28 while patients’ blood pressure was measured weekly. In all three groups SBP and DBP decreased over 3 weeks of treatment (Pu2009<u20090.001). For SBP, mean decrease was higher with ramipril (−16.7u2009±u20098.4u2009mmu2009Hg) than with kinkeliba (−12.2u2009±u20096.6u2009mmu2009Hg, Pu2009=u20090.016) and bissap (−11.2u2009±u20093.3u2009mmu2009Hg, Pu2009=u20090.001). For DBP, mean decrease with ramipril (−6.7u2009±u20093.6u2009mmu2009Hg) was more important than with kinkeliba (−5.0u2009±u20093.0u2009mmu2009Hg, Pu2009=u20090.011) but not statistically different to bissap group (−6.0u2009±u20094.7u2009mmu2009Hg, Pu2009=u20090.271). A significant natriuretic effect was observed in the kinkeliba and bissap groups but not in patients under ramipril treatment. At the end of the four weeks, 39% [95% CI: 25.7–54.3] of patients in the ramipril group, 37% [95% CI: 23.6–51.9] of patients in the kinkeliba group and 21% [95% CI: 11.7–35.9] of those taking bissap had normalized their BP.

Profil biochimique et hématologique des patients drépanocytaires homozygotes en phase stationnaire au centre National de Transfusion Sanguine de Dakar

La drepanocytose est caracterisee par une grande variabilite d’expression clinique et biologique qui depend de plusieurs facteurs. L’objectif de ce travail etait d’etudier les perturbations biologiques des patients drepanocytaires homozygotes en phase stationnaire. Il s’agit d’une etude prospective transversale ayant inclus 100 drepanocytaires homozygotes en phase stationnaire d’âge superieur a 15 ans. Chaque patient a beneficie de deux tubes de prelevements pour l’etude des parametres hematologiques et pour les dosages biochimiques. Un questionnaire a ete utilise pour recueillir les variables epidemiologiques, cliniques et biologiques. Ces donnees ont ete saisies et analysees par le logiciel Epi-info 7.2. Une valeur p ≤ 0,05 a ete consideree comme significative. L’âge moyen des patients etait de (28 ± 8,94) ans, les extremes (15-57 ans) et le sex-ratio (H/F) de 0,75. Le taux d’hemoglobine de base etait en moyenne de (8,2 ± 1,4g/dl), les globules blancs de (12352 ± 6.906/ mm 3 ), les plaquettes (439.920 ± 139.000/mm 3 ), la TCMH (31,18pg ± 4,12 pg). Le taux d’hemoglobine S etait en moyenne de (87,79 ± 8,19 %) et l’hemoglobine F (HbF) (9,5 ± 8,3%). Le taux HbF etait associee de facon significative avec le syndrome thoracique aigu et la lithiase biliaire (r=0,56 ; p=0,003). Cette etude a montre que les perturbations biologiques sont frequentes chez les dans la drepanocytaires homozygotes. Leur connaissance servira de base de comparaison lors des crises et pour evaluer l’efficacite du traitement.

Prévalence des dyslipidémies au laboratoire de biochimie du CHU Aristide le Dantec de Dakar, Sénégal

Introduction Lobjectif de cette étude était dévaluer la prévalence des dyslipidémies chez les patients reçus au laboratoire de Biochimie de lHôpital Aristide Le Dantec pour le dosage dun paramètre lipidique au cours de lannée 2013. Méthodes Il sagit dune étude rétrospective portant sur 1356 patients âgés de 10 à 94 ans reçus au laboratoire de Biochimie du CHU Le Dantec de janvier à décembre 2013. Etaient inclus dans létude, tous les patients ayant au moins un paramètre du bilan lipidique dont les résultats étaient enregistrés dans le registre du laboratoire. Le cholestérol total, le cholestérol HDL, le cholestérol LDL ainsi que les triglycérides ont été dosés grâce à des méthodes enzymatiques sur un automate de Biochimie de type Cobas Integra 400 (Roche Diagnostics). Résultats La prévalence des dyslipidémies dans notre population détude est de 39,30%. Les prévalences de lhypercholestérolémie, lhypoHDLémie, lhyperLDLémie, lhypertriglycéridémie et lhyperlipidémie mixte étaient respectivement : 30,89% ; 7,30% ; 31,19% ; 0,51% ; 7,22%. Les sujets de 40 à 59 ans semblaient être plus exposés et on note une prédominance féminine en ce qui concerne lhypercholestérolémie (54,17% vs 45,82%), lhypoHDLémie (54,54% vs45, 45%), et lhyperlipidémie mixte (51,08% vs 48,97%). Enfin les dyslipidémies étaient fortement corrélées à lHTA et lobésité. Conclusion La forte prévalence des dyslipidémies retrouvée dans notre étude démontre lintérêt détudier la prévalence des facteurs de risque cardio-vasculaires en particulier les dyslipidémies dans la population sénégalaise.