Youssouf Joseph Drabo

Obesity and Metabolic Syndrome in a Burkina Faso Urban Area: Prevalence,Associated Factors and Comorbidities

Background: The prevalence of obesity and metabolic syndrome is not just a problem of the developed countries but is also with a growing trend in developing countries, especially in urban areas. We aimed to estimate the prevalence of obesity and metabolic syndrome in the urban population living in Ouagadougou, Burkina Faso, and to investigate the factors and comorbidities associated with them. Methods: Data were collected in two rounds (in March and December 2011) from two different neighbourhoods (peripheral and central) of Ouagadougou. We included all over 20 year old volunteers’ subjects (excluding pregnant women). All characteristics were collected during face-to-face interviews. We used international standards to define obesity, hypertension and metabolic syndrome. The statistical analysis used chi-square (chi 2) tests and odds ratio with 95% confidence interval. Results: 632 subjects with a mean age of 41.3 ± 6.8 years [20-75 years] and sex ratio (men/women) of 0.9were included in this survey. Overall crude prevalence of overweight, obesity and metabolic syndrome were respectively 30.5%, 22% and 7%. Compared with normal weight participants, obese individuals had more hypertension, diabetes or impaired fasting glucose (p=0.000), and they were more likely to be older, women, employed and living in the central neighbourhood. Obesity was found in 81.8% of subjects with metabolic syndrome. On bivariate analysis, those with the metabolic syndrome were female, older, and obese Conclusion: The prevalence of obesity and metabolic syndrome in urban Burkina Faso is high. There is a need to pay closer attention to combating these health disorders. An important place must be reserved for the prevention and the fight against obesity by appropriate lifestyle.

The bacterial microflora of diabetic foot infection and factors determining its spectrum in Ouagadougou (Burkina Faso)

The aim of the study was to describe the bacterial microflora of diabetic foot infection and to identify the factors which determine the bacterial spectrum in order to increase empiric antibiotic prescription in Ouagadougou. The study was a cross-sectional one, carried from July 1st, 2011 to June 30, 2012 in the departments of internal medicine and general and digestive surgery in Yalgado Ouédraogo teaching hospital. Samples for bacteriological tests consisted of aspiration of pus through the healthy skin, curettage and swab of the base of the ulceration or tissue biopsy from foot lesions. The bacterias sensitivity to antibiotics has been tested by the qualitative method (Kirby-Bauer). The frequency of diabetic foot infection was 14.45% and the monthly incidence 5.33. The mean age of patients was 56 years and the sex ratio 1.37. Foot ulcerations were chronic in 33 (51.56%), necrotic in 51 (79.69%) and associated with osteitis in 40 (62.5%) patients. Infection was grade 3 in 70.3% cases. Thirty-nine patients had received antibiotics before hospital admission. Among the 71 samples, 62 (87.32%) cultures were positive: 53 (85.48%) monomicrobial and 9 (14.52%) bimicrobial. Aerobic Gram-positive cocci (76%) were the most frequent from ulcerations: Staphylococcus aureus (32.39%), Streptococcus sp (18.30%). Negative coagulase staphylococci have been found in 23.94% cases. Aerobic gram-negative bacilli have been isolated from 24% ulcerations. No factor was associated with the type of bacteria. Gram-positive pathogen cocci showed a high sensitivity to amoxicillin-clavulanic acid and oxacillin. No methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum beta lactamase Enterobacteriaceae (ESBL) have been isolated. A better design is necessary to a clarification of bacterial flora in diabetic foot infections. Prevention of bacterial resistance is also needed.

Too Sweet/Too Fatty Food Consumption: Determinants among Secondary School Pupils in the City of Bobo-Dioulasso (Burkina Faso)

Introduction: Nutrition, particularly when too sweet or too fatty, is a major determinant of chronic diseases. This study aims to determine the frequency and associate factors of the excessive consumption of sweet drinks and fried food among secondary school pupils. Methods: It is cross-sectional study which was conducted from March to April 2016 among 1st, 4th and 7th form pupils of public and private schools in the city of Bobo-Dioulasso. Nutritional investigation methods consisted in a reminder of the last 24 hours associated with a questionnaire on food consumption frequency. Excessive consumption of sweet drinks was defined as a consumption of more than 3 sweet drinks (soda) or sugary juice per day (~33 cl × 3); and excessive consumption of fried food as a consumption of more than 1 intake of fried food per day. Results: In total, 1993 pupils were interviewed. The mean age was 17.5 ± 3.6 years and sex-ratio 0.7. Excessive consumption of sweet drinks and fried food was recorded in 12.7% (n = 253) and 28.2% (n = 561) of pupils, respectively. The factors associated with excessive consumption of sweet drinks were: sex/female, sedentarily, desire to gain weight, lean or normal corpulence of the mother and breakfast intake; those associated with excessive consumption of fried food were: sex/female, being in 1st or 4th form, physical exercise practice and breakfast intake. But the fact to attend a private secondary school, to have a mother of normal corpulence and a concordance between self-image and actual weight status, were protective against excessive consumption of fried foods. Conclusion: This study has displayed prominently the fact that eating too sweet and too fatty concerned respectively 1/10 and 3/10 of pupils in the city of Bobo-Dioulasso. The main modifiable factors of these eating habits included the level of education, the composition of breakfast and the influence of mothers. An intervention program in the form of a Communication for Continuous Behavioral Change intended for pupils and their mothers could help to improve this situation.

Food Behavior of Pupils in the City of Bobo-Dioulasso (Burkina Faso)

Introduction: Diet is a determinant of chronic non transmissible diseases. The aim of this study was to describe pupils’ diet in the city of Bobo-Dioulasso (Burkina Faso). Methods: This was a descriptive cross-sectional study that took place from March to April 2016, among 1st, 4th and 7th form pupils of public and private schools in the city of Bobo-Dioulasso. Diet survey methods were a reminder of the last 24 hours and the questionnaire of consumption frequency. Results: A total of 1993 pupils were surveyed. The mean age was 17.5 ± 3.6 years and the sex ratio 0.7. The majority of pupils (90.5%) reported eating at least 3 meals a day. Dietary recommendations were different according to food groups. For example, vegetables (90.0%), fruits (75.4%) and dairy products (79.3%) were the least well consumed foods compared to recommendations. Protein and starch intake were inadequate among these pupils with 39.7% and 58.2% respectively. Almost 1/4 had a regular weekly alcohol consumption (23.4%) while an excessive consumption of sweet drinks and fried foods was noted in 12.7% and 28.2% of them, respectively. Conclusion: This study has revealed a general insufficiency in the recommended dietary intakes of fruit, vegetables, proteins, starchy foods and dairy products among pupils, and on the other hand, a regular consumption of fatty, sugary and alcoholic foods for about a fifth of them. An intervention program such as “Communication for Continuous Behavior Change” would help improve these habits.

Profiles of Elderly People Infected with HIV and Response to Antiretroviral Treatment in Burkina Faso: A Retrospective Cohort Study

Background: In sub-Saharan Africa, few studies exist on elderly HIV-positive populations. Therefore, we aimed to examine the profiles of elderly people living with HIV (PLHIV) in Burkina Faso and their response to antiretroviral therapy (ART). Methods: We reviewed the monitoring and treatment of PLHIV over the age of 50 years and then compared with the monitoring and treatment of PLHIV under 50 years. Results: A total of 3367 patients were included. The median age of elderly people was 54.5 years and of young people was 34.9 years (P = .03). In both the groups, screening was performed following clinical suspicion (64.9% in elderly versus 56% in young people; P < .001). Cardiovascular risk factors were generally more significant in the elderly people. The risk of death while on ART was 2.3 times higher in elderly people (P < .001). Conclusion: HIV infection in older people occurs in those who already have some cardiovascular risk factors. Particular attention should be given to multidisciplinary care for the elderly individuals.

À propos de 98 cas de dengue hospitalisés dans une clinique privée de Ouagadougou : aspects épidémiologiques, diagnostiques et évolutifs

Extremely widespread, the dengue is a reemerging infectious disease. In Burkina Faso, dengue is a reality that was little known. The aim of this study was to study epidemiology, diagnostic and outcomes of dengue patients in Ouagadougou. A retrospective study covered a period of two years, from 1 January 2013 to 31 December 2014 in a private clinic in Ouagadougou. Patients included in the study were hospitalized for fever and painful syndrome with a positive test to the dengue non-structural antigen 1 (NS1 Ag). Ninety-eight cases of dengue on 343 suspected cases were registered. The average age of patients was 35.9 years. The sex-ratio (M/F) was 1.18. According to the professional activity, there was a predominance of civil servants (35.7%). The pain syndrome was found in 93.9% of patients. Leukopenia (73.5%), neutropenia (56.1%) and severe thrombocytopenia (57.1%) were the predominant hematological disturbances. Of the patients, 18.4% had hemorrhagic dengue and 11.2%, a dengue shock syndrome. Four patients died. The use of non-steroidal antiinflammatory drugs was associated with the severity of the infection (p=0.04). Dengue fever occurs in our context and constitutes a risk of mortality. The diagnosis of dengue should be performed systematically in front of a painful and febrile syndrome. The vector control is the best way of prevention against dengue pending the development of a vaccine.

Characteristics and Follow-up of Newly Managed HIV-Infected Patients in the National Referral Center in Ouagadougou, Burkina Faso

Background: In sub-Saharan countries, HIV testing and treatment facilities are available, especially at subsidized rates for the past few years. Methods: A prospective and descriptive review was conducted at Yalgado Ouédraogo Teaching Hospital Internal Medicine department in Ouagadougou, using personal case report forms, between June 2009 and August 2010 in all newly diagnosed adults with positive HIV antibody. Results: The study participants consisted of 191 patients at a median age of 37 years (range, 18-65 years) and sex ratio (men/women): 0.66. In all, 110 (57.6%) patients were symptomatic. Fourteen patients were lost to follow-up. Of the 177 patients, 144 had CD4 count <350 cells/mm3 and all have been treated. At the ninth month, weight gain and immune restoration were significant (P < .01); only 79 of the 144 patients had viral load measurement, and 76 of the 79 were undetectable. Mortality rate of treated patients was 6.25%. Conclusion: Laboratory tests and highly active antiretroviral therapy make the management of patients easier, but a majority of them still presented late and were still lost to follow-up. Nevertheless, we have excellent treatment success.

Risk Factors for Early Mortality on Antiretroviral Treatment of Elderly People Infected with HIV in Burkina Faso

Background: Age is a key determinant of mortality due to diseases including HIV infection. Methods: A retrospective and descriptive cohort study used a computerized database to compare HIV-infected patients diagnosed in late adulthood to a group of patients diagnosed before their 49 years of age, without matching the characteristics of HIV infection. The study included patients who visited the day hospital (outpatient clinic) of the Sanou Souro Teaching Hospital of Bobo-Dioulasso, in Burkina Faso, from January 2007 to December 2011. Older adults were defined as those aged 50 years and more. Results: Participants in the study consisted of 2572 patients (265 older adults and 2307 young patients living with HIV. Based on Markov chain method, 32.1% of the older adults living with HIV were found to be seroconvert at 50 years or older. The median follow-up time on antiretroviral treatment (ART) was 32.7 months (range 0.03-65.4 months). Two hundred and ninety-five (11.5%) patients died, including 21.1% of older adults and 10.4% of young (P < .01). World Health Organization stage 3 or 4 and the lowest CD4 count reached <200 cells/mm3 were the factors associated with early mortality of older adults on ART. Conclusion: Mortality rate of older adult patients living with HIV in Burkina Faso is high. Early diagnosis, early treatment, and primary prevention of HIV infection in the older adults are the main keys that could help reduce such mortality.

Écologie bactérienne et facteurs déterminant le profil bactériologique du pied diabétique infecté à Ouagadougou (Burkina Faso)

The aim of the study was to describe the bacterial microflora of diabetic foot infection and to identify the factors which determine the bacterial spectrum in order to increase empiric antibiotic prescription in Ouagadougou. The study was a cross-sectional one, carried from July 1st, 2011 to June 30, 2012 in the departments of internal medicine and general and digestive surgery in Yalgado Ouédraogo teaching hospital. Samples for bacteriological tests consisted of aspiration of pus through the healthy skin, curettage and swab of the base of the ulceration or tissue biopsy from foot lesions. The bacterias sensitivity to antibiotics has been tested by the qualitative method (Kirby-Bauer). The frequency of diabetic foot infection was 14.45% and the monthly incidence 5.33. The mean age of patients was 56 years and the sex ratio 1.37. Foot ulcerations were chronic in 33 (51.56%), necrotic in 51 (79.69%) and associated with osteitis in 40 (62.5%) patients. Infection was grade 3 in 70.3% cases. Thirty-nine patients had received antibiotics before hospital admission. Among the 71 samples, 62 (87.32%) cultures were positive: 53 (85.48%) monomicrobial and 9 (14.52%) bimicrobial. Aerobic Gram-positive cocci (76%) were the most frequent from ulcerations: Staphylococcus aureus (32.39%), Streptococcus sp (18.30%). Negative coagulase staphylococci have been found in 23.94% cases. Aerobic gram-negative bacilli have been isolated from 24% ulcerations. No factor was associated with the type of bacteria. Gram-positive pathogen cocci showed a high sensitivity to amoxicillin-clavulanic acid and oxacillin. No methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum beta lactamase Enterobacteriaceae (ESBL) have been isolated. A better design is necessary to a clarification of bacterial flora in diabetic foot infections. Prevention of bacterial resistance is also needed.

Écologie bactérienne et facteurs déterminant le profil bactériologique du pied diabétique infecté à Ouagadougou (Burkina Faso) The bacterial microflora of diabetic foot infection and factors determining its spectrum in Ouagadougou (Burkina Faso)

The aim of the study was to describe the bacterial microflora of diabetic foot infection and to identify the factors which determine the bacterial spectrum in order to increase empiric antibiotic prescription in Ouagadougou. The study was a cross-sectional one, carried from July 1st, 2011 to June 30, 2012 in the departments of internal medicine and general and digestive surgery in Yalgado Ouédraogo teaching hospital. Samples for bacteriological tests consisted of aspiration of pus through the healthy skin, curettage and swab of the base of the ulceration or tissue biopsy from foot lesions. The bacterias sensitivity to antibiotics has been tested by the qualitative method (Kirby-Bauer). The frequency of diabetic foot infection was 14.45% and the monthly incidence 5.33. The mean age of patients was 56 years and the sex ratio 1.37. Foot ulcerations were chronic in 33 (51.56%), necrotic in 51 (79.69%) and associated with osteitis in 40 (62.5%) patients. Infection was grade 3 in 70.3% cases. Thirty-nine patients had received antibiotics before hospital admission. Among the 71 samples, 62 (87.32%) cultures were positive: 53 (85.48%) monomicrobial and 9 (14.52%) bimicrobial. Aerobic Gram-positive cocci (76%) were the most frequent from ulcerations: Staphylococcus aureus (32.39%), Streptococcus sp (18.30%). Negative coagulase staphylococci have been found in 23.94% cases. Aerobic gram-negative bacilli have been isolated from 24% ulcerations. No factor was associated with the type of bacteria. Gram-positive pathogen cocci showed a high sensitivity to amoxicillin-clavulanic acid and oxacillin. No methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum beta lactamase Enterobacteriaceae (ESBL) have been isolated. A better design is necessary to a clarification of bacterial flora in diabetic foot infections. Prevention of bacterial resistance is also needed.