Sidy Mohamed Seck

Diabetes Burden in Urban and Rural Senegalese Populations: A Cross-Sectional Study in 2012

Diabetes represents a challenging global health issue in the 21st century. Data from sub-Saharan African populations are scarce and are usually restricted to urban settings. The objective of this study was to compare prevalence and risk factors of diabetes in rural and urban areas in Senegal. Methods. In a community-based survey between January and May 2012, we included 1027 adults aged ≥18 years living in northern Senegal. Sociodemographic, clinical, and biological data were collected during household visits. Multivariate logistic regression was performed to identify factors associated with diabetes. Results. Mean age of participants was 48.0 ± 16.9 years and 65.7% were female. Participants from urban area represented 55.7%. The age-standardized prevalence of diabetes was 7.6% (6.0% in men versus 9.0% in women). Prevalence of diabetes was higher in urban areas (8.1%) compared to rural areas (4.6%). Disease awareness rate was 43%. After multivariate analysis, age (OR = 1.63, p = 0.001), familial history of diabetes (OR = 1.42, p = 0.001), and abdominal obesity (OR = 1.17, p = 0.05) were associated with diabetes. Conclusion. Diabetes is frequent in urban and rural areas in Senegal. Awareness rate is very low among populations. Age, family history of diabetes, and abdominal obesity are the main risk factors identified.

Pseudopheochromocytoma: An uncommon cause of malignant hypertension

A 42-year-old black African patient was admitted in the emergency department with severe headache, dizziness, and visual problems. He had been treated for hypertension diagnosed eight months ago after a similar episode. He was taking atenolol 100 mg /day, amlodipine 10 mg/day, and a combination of lisinopril 20 mg/hydrochlorothiazide 12.5 mg daily but experienced several hypertension peaks and hypotension. He adhered to treatment and was neither using traditional herbal medication nor illicit drugs. He did not smoke, but used to drink 1–2 glasses of wine after dinner. At admission, his blood pressure was 235/145 mm of Hg. His body mass index was 25.5 kg/m2 and the waist/hip ratio was 0.9. Physical examination was unremarkable. Fundoscopic examination revealed hypertensive retinopathy. Biochemical and imaging explorations were compatible with diagnosis of pseudopheochromocytoma. Evolution was favourable after treatment with alpha-1 and beta-blokers.

Obstetric Cortical Renal Necrosis, Even Reality in the Tropics

Obstetric cortical renal necrosis is a serious complication that can lead to chronic renal failure and the need for dialysis for life in some cases. In Africa, despite progress, much remains to provide in order to prevent this complication. Difficulties in health care access and lack of monitoring of pregnancies are contributing factors. We propose through 5 cases report the characteristics of obstetric renal cortical necrosis in the tropics.

Schistosoma hematobium-associated glomerulopathy.

Schistosomiasis is the second most devastating tropical parasitic disease worldwide and is responsible for many urological complications. However, glomerular injury is a rare complication mainly described with Schistosoma mansoni. We report a case of membranoproliferative glomerulonephritis (MPGN) associated with Schistosoma hematobium infection in a young Senegalese boy living in a rural area. Clinical presentation was with steroid-resistant with nephrotic syndrome. Renal biopsy showed type 1 MPGN with the presence of S. hematobium eggs surrounded by a gigantocellular granuloma. Despite therapy with antihelminthic and immunosuppressive drugs, evolution was characterized by progression to end-stage renal disease over 1 year. More efforts should be made on the prevention and early detection of schistosomiasis among at-risk populations.

218 Traumatismes oculaires chez l’enfant de 0 à 15 ans au Sénégal

But Etudier les traumatismes oculaires chez les enfants de 0 a 15 ans afin d’en cerner les caracteristiques epidemiologiques pouvant servir de base de prevention. Materiels et Methodes Il s’agit d’une etude retrospective de 1991 a 2005 portant sur 437 dossiers de patients hospitalises pour un traumatisme oculaire. L’âge, le sexe, le delai de consultation, le type de traumatisme, l’agent et les circonstances du traumatisme, les donnees de l’examen clinique et les resultats anatomiques et fonctionnels ont ete releves. Les traumatismes examines apres un mois et ceux ayant un suivi inferieur a 3 mois ont ete exclus. Resultats L’âge moyen est de 8,5 ans et la tranche d’âge de 6 a 10 ans la plus atteinte. Les garcons representent 62,7 % de la serie. Le sex-ratio est de 1,6/1. 56 % des patients ont consulte dans les 24 heures suivant le traumatisme. Les jeux sont en cause dans 42 % des traumatismes suivis des accidents domestiques 24,5 %, des rixes 14 %, des sevices 11 % et des accidents de la circulation 3 %. Les coups recus d’autrui, 34,5 % des cas sont le mode le plus frequent, suivi des projectiles, 28 % des cas et des objets piquants, 21,5 % des cas. Les jets de pierre 21,4 % des cas, representent avec les bouts de bois 11,6 % des cas, les principaux agents traumatisants. Le traumatisme est ouvert dans 62 % des cas. Les eclatements ou rupture contusive du globe, 26 % des cas ; les plaies penetrantes 24 % des cas et les contusions isolees et fermees, 23,4 % des cas, sont les lesions le plus frequentes. Les sequelles anatomiques graves concernent 54,8 % des patients tandis que 67 % ont pratiquement perdu la fonction de l’oeil atteint. Seuls 25 % ont recupere une acuite visuelle superieure ou egale a 5/10 compatible avec une vision binoculaire. Les sequelles sont fonctions de la gravite des lesions et ne semblent pas etre influencees par l’âge. Conclusion Les traumatismes chez l’enfant sont particulierement graves dans notre etude. Les etiologies assez particulieres par rapport aux donnees de la litterature semblent evitables dans la majorite des cas grâce a une bonne sensibilisation des populations.

Erectile Dysfunction in Chronic Hemodialysis Patients in Dakar: a Cross-Sectional Study in 2012

Background: Patients with chronic kidney disease (CKD) experience multiple complications including erectile dysfunction (ED). It involves more than 50% of patients on dialysis or transplant. In Africa, the true extent of ED in CKD is unknown although some studies have been done in this regard. Objectives: This study aimed to determine the prevalence and identify risk factors of ED in patients on hemodialysis. Patients and Methods: This cross-sectional multicenter study was conducted from January 2, 2012 through April 30, 2012 in four hemodialysis centers in Dakar. We included all patients on chronic hemodialysis who aged ≥ 18 years old and freely consented to participate in the study. Sociodemographic, clinical, and hemodialysis data were collected through a questionnaire. Erectile function was assessed by a short version of International Index of Erectile Function (IIEF-5). Results: Among a target of 80 patients, 73 met the inclusion criteria and were included in this study. Mean dialysis vintage was 27.3 months (range, 1-156). Their mean age was 53.81 ± 12.52 years, with a higher proportion of age group of 50 to 69 years old. Fifty-six patients were married (37 monogamous and 19 polygamous) and six were singles. Overall prevalence of ED was 84.9% and it was severe in 14 patients (19.2%). Hypertension and diabetes were the most frequent etiologies and antihypertensive treatment was used in 95.5%. The main factors associated with ED were age > 50 years old and polygamy. Conclusions: ED is a common problem among patients on hemodialysis in Dakar with a high prevalence. Aging and diabetes represent most common causes. More efforts are needed for its early detection, prevention, and multidisciplinary management.