Moussiliou Noël Paraïso

Cognitive Impairment and Dementia in Elderly People Living in Rural Benin, West Africa

Background/Aims: Dementia is increasing as a priority public health problem because of the ageing of the world population. Our goal was to estimate dementia and cognitive impairment prevalence in an elderly population of rural Benin. Methods: In a door-to-door survey, elderly people aged 65 years and above were screened using the Community Screening Interview for Dementia and the Five-Word Test. Results: The prevalence of cognitive impairment was 10.4% and that of dementia was 2.6%. Age, current depressive disorder and absence of the APOE ε2 allele were significantly associated with cognitive impairment. Conclusion: Prevalence of dementia and cognitive impairment appears to be lower in this study than in developed countries.

Prevalence of dementia in elderly living in two cities of Central Africa: the EDAC survey.

Background: Data on dementia from low- and middle-income countries are still necessary to quantify the burden of this condition. This multicenter cross-sectional study aimed at estimating the prevalence of dementia in 2 large cities of Central Africa. Methods: General population door-to-door surveys were conducted in the districts of Bangui (Republic of Central Africa) and Brazzaville (Congo) in elderly aged ≧65 years. The subjects were screened with the Community Screening Interview for Dementia and the Five-Words Test. Diagnosis of dementia was made according to the DSM-IV criteria and to the clinical criteria proposed by the NINCDS-ADRDA for Alzheimer’s disease. Results: We enrolled 496 subjects in Bangui and 520 in Brazzaville. The prevalence of dementia was estimated at 8.1% (95% CI = 5.8–10.8) in Bangui and 6.7% (95% CI = 4.7–9.2) in Brazzaville. Conclusion: The prevalence of dementia in urban areas of Central Africa is close to those observed in high-income countries.

Migraine Among University Students in Cotonou (Benin)

Background.— Few data are available on migraine among students in Africa. The aim of this study was to estimate the prevalence of migraine and describe its clinical features and associated conditions among students of the Faculty of Health Sciences of Abomey‐Calavi University, in Cotonou, Benin.

Prevalence of dementia among elderly people living in Cotonou, an urban area of Benin (West Africa)

Background/Aims: The population of Benin is, like those of most developing countries, aging; dementia is therefore a major concern. Our goal was to estimate the prevalence of dementia in an elderly population living in urban Benin. Methods: In a cross-sectional community-based study, people aged 65 years and above were screened using the Community Screening Interview for Dementia and the Five-Word Test. Results: The prevalence of dementia was 3.7% (95% CI 2.6–4.8) overall. The figure increased with age and was higher among women than men. Conclusion: Dementia was slightly more prevalent than previously reported in a rural area of Benin, but the rate was similar to that recorded in other cities in developing countries.

Factors Associated with Dementia Among Elderly People Living in Two Cities in Central Africa: The EDAC Multicenter Study

Risk factors for dementia in American and European countries have been well investigated. However, little research has been carried out in sub-Saharan Africa, where life events as well as environmental, socio-economic, and modifiable risk factors (i.e., cardiovascular risk factors) may differ. Two cross-sectional surveys were conducted in representative samples of the older general population living in Bangui (Central African Republic) and Brazzaville (Congo). Dementia was defined according to the DSM-IV criteria. Multivariate regression analyses were performed in order to identify independent factors associated with dementia. Among the 977 elderly Africans included in this analysis, 75 (7.6%) were diagnosed as having dementia. Increasing age, female gender, hypertension, a body mass index <18.5 kg/m2, depressive symptoms, and the lack of a primary education were significantly associated with dementia. Among life events, the death of one parent during childhood and recently having moved house were also associated with dementia. Beyond the usual risk factors for dementia, this study highlights the role of stressful events in low-income countries. Factors associated with dementia in African countries seem different from established factors in high-income countries and require further investigation.

Épidémiologie des démences chez les personnes âgées dans le troisième arrondissement de la ville de Bangui (République Centrafricaine)

Given the gradual improvement of living conditions and aging, dementia and related syndromes are becoming serious problems in the developing countries. A cross-sectional door to door type study in neighbourhood, was conducted from October 2008 to January 2009, in the general population in Bangui, order to help get a better understanding of the prevalence and risk factors of dementia among people over 65 living in the Central African capital. Of the 496 elderly respondents, 188 had cognitive disorders. After a neuropsychological examination, 40 of these subjects were diagnosed with dementia. The prevalence of dementia was 8.1% (IC 95% = [5.7-10.5]). The average age of subjects with dementia, ranging from 65 to 90 years, was 76.0 ± 7.1 years. There was a significant risk of developing dementia for an increase of ten years old (OR = 2.6, 95% CI [1.5 to 4.5]). The sex-ratio was 6/34. 82.5% of the demented had never attended school. 70.0% showed a state of malnutrition (BMI ≤ 18,5 kg/m(2)), significantly associated with dementia (OR = 3.3; IC 95% = [1.5-7.3]). The blood pressure was high in 67.5% of demented which is significantly associated with dementia (OR = 2.4; IC 95% = [1.1-5.4]). A recent change in financial status was a factor significantly associated with dementia (OR = 6.4; IC 95% = [1.8-22.5]). These results support the existence of dementia in urban Africa. The observed prevalence is close to those found in high-income countries. Further studies should be conducted which includes both the rural and urban Africa, to better understand the problem and solutions consider to comprehensive care and prevention axes adapted to our context.

Epidemiology of dementia in elderly living in the 3rd borough of Bangui (Central African Republic)

Given the gradual improvement of living conditions and aging, dementia and related syndromes are becoming serious problems in the developing countries. A cross-sectional door to door type study in neighbourhood, was conducted from October 2008 to January 2009, in the general population in Bangui, order to help get a better understanding of the prevalence and risk factors of dementia among people over 65 living in the Central African capital. Of the 496 elderly respondents, 188 had cognitive disorders. After a neuropsychological examination, 40 of these subjects were diagnosed with dementia. The prevalence of dementia was 8.1% (IC 95% = [5.7-10.5]). The average age of subjects with dementia, ranging from 65 to 90 years, was 76.0 ± 7.1 years. There was a significant risk of developing dementia for an increase of ten years old (OR = 2.6, 95% CI [1.5 to 4.5]). The sex-ratio was 6/34. 82.5% of the demented had never attended school. 70.0% showed a state of malnutrition (BMI ≤ 18,5 kg/m(2)), significantly associated with dementia (OR = 3.3; IC 95% = [1.5-7.3]). The blood pressure was high in 67.5% of demented which is significantly associated with dementia (OR = 2.4; IC 95% = [1.1-5.4]). A recent change in financial status was a factor significantly associated with dementia (OR = 6.4; IC 95% = [1.8-22.5]). These results support the existence of dementia in urban Africa. The observed prevalence is close to those found in high-income countries. Further studies should be conducted which includes both the rural and urban Africa, to better understand the problem and solutions consider to comprehensive care and prevention axes adapted to our context.

Assessment of the Performance of Out-patient Acute Malnutrition Management in Children under 5 Years in the Northern Benin Setting

Aims: To assess the performance of out-patient acute malnutrition management in children under 5 years. Study Design: Cross-sectional study. Place and Duration of Study: Northern Benin, health district of Djougou-Ouake-Copargo, from 1 Original Research Article Paraïso et al.; IJTDH, 19(4): 1-11, 2016; Article no.IJTDH.27752 2 to 30 June, 2014. Methodology: Fifteen functional out-patient malnutrition management centres (out the 27 existing) were included in the study. Data on acute malnutrition management were collected in thirty skilled health workers by using questionnaire and observation. Data were also collected in 296 children who suffered from acute malnutrition through medical records, reference documents and supervisions note books. The performance of out-patient acute malnutrition management was assessed through three components “input/resources”, “process” and “results” using predetermined score of two scales seeking for achievement of criterions according to WHO reference for the evaluation of the performance of the health system. Results: The performance of the out-patient management of acute malnutrition in the health district was rated low. Conclusion: The performance of out-patient management of acute malnutrition in the health district was suboptimal. Adequate monitoring of malnourished treated child and a greater mobilization of community volunteers in the active search of drop out patients are required to improve the performance of out-patient management of acute malnutrition in health district of Djougou-CopargoOuaké in Benin.

P5a-32 Prévalence et facteurs de risque des troubles cognitifs et démence chez les personnes âgées vivant en Afrique Centrale : Bangui & Brazzaville

Introduction Avec le vieillissement de la population mondiale, les demences et syndromes apparentes sont en passe de devenir des problemes prioritaires de sante publique dans les pays en developpement. A ce jour, peu de recherches ont ete menees dans les pays en developpement, notamment en Afrique ou les donnees sont rares en comparaison avec les pays developpes. Methodes Deux etudes en population generale ont ete menees en Afrique Centrale (Republique Centrafricaine et Republique du Congo). Ces enquetes de type porte a porte dans des quartiers de Bangui et Brazzaville ont ete realisees aupres des personnes âgees de plus de 65 ans. Les participants etaient interroges sur leurs antecedents medicaux, donnees sociodemographiques, facteurs psychosociaux et troubles depressifs, et passaient les tests cognitifs du CSI-D et le test des 5 mots. Les sujets ayant une mauvaise performance aux tests cognitifs du CSI-D ( Resultats Sur les 499 sujets interroges a Bangui, 188 (37,5%) etaient suspects de troubles cognitifs ou demence, dont 165 (32,9%) ont ete reexamines par un neurologue. A Brazzaville, sur 520 participants, 148 (28,5%) etaient suspects de troubles cognitifs ou demence et 133 (25,6%) ont ete cliniquement evalues. Apres cette etape de confirmation, 32 sujets (6,4%) ont ete diagnostiques dements a Bangui & actuellement 17 sujets (3,3%) a Brazzaville (etape non terminee). La description clinique des cas de demences et l’analyse des facteurs de risque seront presentees pour les deux villes. Conclusion La faible prevalence des demences chez les personnes âgees vivant dans les pays d’Afrique sub-saharienne se confirme. Ces resultats s’ajoutent au peu de donnees disponibles sur les pays en developpement. La comparaison des prevalences avec d’autres etudes, particulierement dans les pays developpes, peut conduire a des nouvelles hypotheses physiopathologiques.