Consumer Preference for Rice Grain Quality in the South Kivu and Tanganyika Provinces, Eastern DR Congo

In Africa, rice has always been a staple food in some countries and the fastest growing food source there. In the Democratic Republic of Congo (DRC), in terms of cereal production, rice is ranked second after maize and is an important source of income for the rice farmer. The objective of this study was to analyze and understand consumers' preferences and behaviors towards local and imported rice in the South Kivu and Tanganyika provinces, DRC. Data collected on 1565 rice-consuming households in eastern DRC showed that there is a great opportunity for the rice value chain and food policy development, and the promotion of local rice consumption. Consumers focus on local rice because it is cheaper, but it does not always meet their desired needs. Indeed, only urban consumers were more willing to pay for higher-quality rice. The development of the demand for local rice calls for strong investment in improving production, post-harvest practices, and market aspects. It was found that over 90% of rice consumers know about local rice production and over 84% have consumed it. In rural areas, there is typically lower consumption of imported rice. However, as households require more rice, they tend to rely more on imported varieties due to their availability in the market. The most preferred rice attributes were flavor, aroma, purity, swelling capacity, breakage rate, and whiteness. Therefore, rice producers should consider the habits and needs of consumers to improve market demand. In addition, good packaging, labeling, and marketing can also enhance local rice preference and competitiveness in South Kivu and Tanganyika provinces in eastern DRC. The findings of this study indicated that research aimed at improving local rice varieties with regard to yield, disease resistance, and organoleptic qualities could enable the population to consume more locally produced rice, which is often more affordable than imported rice. This could in turn significantly reduce the need for rice imports. These results suggest that research carried out to improve the yield and organoleptic qualities of local rice in this area can allow it to be more competitive on the market and can reduce the importation of rice.

Association Mapping of Candidate Genes Associated with Iron and Zinc Content in Rice (Oryza sativa L.) Grains

Micronutrient deficiencies, particularly of iron (Fe) and zinc (Zn), in the diet contribute to health issues and hidden hunger. Enhancing the Fe and Zn content in globally staple food crops like rice is necessary to address food malnutrition. A Genome-Wide Association Study (GWAS) was conducted using 85 diverse rice accessions from the Democratic Republic of Congo (DRC) to identify genomic regions associated with grain Fe and Zn content. The Fe content ranged from 0.95 to 8.68 mg/100 g on a dry weight basis (dwb) while Zn content ranged from 0.87 to 3.8 mg/100 g (dwb). Using MLM and FarmCPU models, we found 10 significant SNPs out of which one SNP on chromosome 11 was associated with the variation in Fe content and one SNP on chromosome 4 was associated with the Zn content, and both were commonly detected by the two models. Candidate genes belonging to transcription regulator activities, including the bZIP family genes and MYB family genes, as well as transporter activities involved in Fe and Zn homeostasis were identified in the vicinity of the SNP markers and selected. The identified SNP markers hold promise for marker-assisted selection in rice breeding programs aimed at enhancing Fe and Zn content in rice. This study provides valuable insights into the genetic factors controlling Fe and Zn uptake and their transport and accumulation in rice, offering opportunities for developing biofortified rice varieties to combat malnutrition among rice consumers.

Assessing milk products quality, safety, and influencing factors along the dairy value chain in eastern Democratic Republic of the Congo

Dairying is one of the new promising economic sectors in eastern Democratic Republic of Congo (DRC), but still not explored enough to ensure consumers' safety. This study aimed to assess the health risks and nutritional profile of milk products along the value chain in South-Kivu and Tanganyika provinces. A total of 288 milk actors, including 160 producers, 35 collectors and 93 vendors, were concerned for interview and milk samples collection. A total of 302 milk samples (159 raw, 44 pasteurized, 76 fermented and 19 white cheese so-called “Mashanza”) were collected for physicochemical [pH, fat, non-fat dry matter (NFDM), lactose, protein, freezing point, density] and microbiological (total Aerobic Mesophilic Flora, Escherichia coli, Total Coliforms, Fecal Coliforms, Salmonella and Staphylococci) analyses. Results revealed that the physicochemical characteristics of the milk mostly varied according to the type of milk and the regions. The pasteurized milk from Tanganyika presented the best physicochemical parameters [crude protein (CP) = 4.36%, Fat = 4.06%, NFDM = 12%, lactose = 5.4%, density = 1.02 and pH = 6.59] compared to other types of milk. For microbiology, no E. coli was recorded but Salmonella and Staphylococci were found in all the milk types with the values not exceeding 3 × 104 CFU ml−1 and 3 × 103 CFU ml−1, respectively. This implies a long-term consumers' health issue if appropriate measures are not taken by milk actors along the value chain. The microbiological quality was influenced by the ecologies of production axis (representing the production zones) and by handling methods and infrastructures used by the actors involved along the value chain. Factors related to animal husbandry, milking method, milk processing and packaging had no significant effect on the physicochemical parameters under study. These results indicated that health risks for milk consumers are accrued by production practices and handling by milk actors due to shortage of required skills and appropriate equipment along the milk value chain. Observance of hazard analysis critical control point (HACCP) measures is carefully required along the milk value chain nodes to improve the quality of milk produced and sold and thus reduce the risks among consumers in South-Kivu and Tanganyika provinces.

Genotypic Variation in Grain P Loading across Diverse Rice Growing Environments and Implications for Field P Balances

More than 60% of phosphorus (P) taken up by rice (Oryza spp.) is accumulated in the grains at harvest and hence exported from fields, leading to a continuous removal of P. If P removed from fields is not replaced by P inputs then soil P stocks decline, with consequences for subsequent crops. Breeding rice genotypes with a low concentration of P in the grains could be a strategy to reduce maintenance fertilizer needs and slow soil P depletion in low input systems. This study aimed to assess variation in grain P concentrations among rice genotypes across diverse environments and evaluate the implications for field P balances at various grain yield levels. Multi-location screening experiments were conducted at different sites across Africa and Asia and yield components and grain P concentrations were determined at harvest. Genotypic variation in grain P concentration was evaluated while considering differences in P supply and grain yield using cluster analysis to group environments and boundary line analysis to determine minimum grain P concentrations at various yield levels. Average grain P concentrations across genotypes varied almost 3-fold among environments, from 1.4 to 3.9 mg g^-1. Minimum grain P concentrations associated with grain yields of 150, 300, and 500 g m^-2 varied between 1.2 and 1.7, 1.3 and 1.8, and 1.7 and 2.2 mg g^-1 among genotypes respectively. Two genotypes, Santhi Sufaid and DJ123, were identified as potential donors for breeding for low grain P concentration. Improvements in P balances that could be achieved by exploiting this genotypic variation are in the range of less than 0.10 g P m^-2 (1 kg P ha^-1) in low yielding systems, and 0.15-0.50 g P m^-2 (1.5-5.0 kg P ha^-1) in higher yielding systems. Improved crop management and alternative breeding approaches may be required to achieve larger reductions in grain P concentrations in rice.

[The significance of PSA density as predictive factor in Afro-Caribbean patients eligible for active surveillance by the French protocol criteria]

OBJECTIVES

Study the interest of addition of PSA density (PSAD), to the selection criteria of the French protocol for inclusion patients Afro-Caribbean on active surveillance prostate cancer.

METHODS

A retrospective analysis of 1505 patients who had, in turn, a radical prostatectomy for cancer between 2000 and 2012, in a single reference center. One hundred and forty-one patients was eligible, at the time of their diagnosis, for active surveillance by the criteria of the French protocol. This population was divided into 2 groups according to the histological analysis of the prostatectomy specimen confirmed indolent cancer or overturned. The median PSAD of each group was calculated to be compared. Secondarily, the most discriminating PSAD was investigated by the method of ROC after constitution tables intrinsic validity in this population. This threshold has secondary conducting a comparative analysis of the underestimation of cancer in terms of aggressiveness and/or extension between patients selected according to the criteria of the French protocol and "on-selected" patients according to these criteria and their PSAD.

RESULTS

Of the 141 patients identified for analysis, histological examination of the prostatectomy specimen has to show that 42 patients (29.7 %) were actually more aggressive cancer (20.6 % of Gleason ≥ 7), wider (4.2 % ≥ pT3) or larger and more aggressive (4.9 %) than foreshadowed criteria French protocol. The median PSAD these 42 patients were significantly higher than the median PSAD patients correctly estimated (0.18 vs. 0.14, p-value=0.046). The application of the most discriminating threshold: 0.15 ng/ml/cm(3) in this population allowed to significantly improve the selection of candidates of the 79 "on-selected" patients, six (20.2 %) were actually more aggressive cancer (13.9 % of Gleason ≥ 7), wider (2.5 % ≥ pT3) or larger and more aggressive (3.8 %).

CONCLUSION

The criteria for the French protocol for active surveillance, applied to the Caribbean population underestimate 29 % of non-latent cancers. Adjuvants criteria that must be inexpensive, sensitive and specific seem necessary in this population. A PSAD<0.15 ng/ml/cm(3) could be one of these criteria.

[Radiotherapy with androgen deprivation in high-risk prostate cancer: what outcomes on a Caribbean population?]

OBJECTIVE

To analyze in a Caribbean population at 90% of African descent, the results of radiotherapy with androgen deprivation (AD) in high-risk prostate cancer (PCa).

PATIENTS AND METHODS

Fifty-nine consecutive patients with a high-risk PCa as defined by the D'AMICO classification and treated by radiotherapy with AD between January 2003 and April 2009 in our center were analyzed. The median dose of radiation and the median duration of AD were 70Gy and 37months respectively. Biochemical recurrence (BF), as primary outcome was defined according to the PHOENIX criteria (nadir PSA+2ng/mL). Multivariate analysis was performed to identify predictive factors of BF. The median follow-up was 47months.

RESULTS

Eight (13.6%) patients had BF and four (6.8%) developed metastases. Six (10.2%) died during the follow-up. The 5years acturial biochemical disease-free survival was 79.7%. Multivariate analyses have shown that Gleason sum (GS) superior to 7 (P=0.029), AD duration less than 24months (P=0.004) and the rate of Nadir PSA greater or equal to 0.5ng/mL (P=0.011) were independent predictive factors of BF.

CONCLUSION

This study was the first to our knowledge, to provide that radiotherapy associate with AD for HRPC among Caribbean men is effective as observed in other populations. Patients with GS superior to 7 could be considered for more aggressive treatments in clinical trials.

Which anaesthesia should be recommended for prostate biopsy?

OBJECTIVE

Although transrectal ultrasound-guided prostatic biopsies are associated with significant discomfort and pain, most urologists do not use any kind of anaesthesia. We therefore compared the efficacy of two local anaesthetics, namely, the rectal administration of lidocaine gel and lidocaine periprostatic infiltration prior to biopsies.

DESIGN AND METHODS

Three hundred and fifty-six randomized patients received either 15 mL of 2% lidocaine gel administered intrarectally ten minutes before prostate biopsies in group 1 (180 patients) or 10 mL of 1% lidocaine given under ultrasound guidance in two periprostatic injections of 5 mL, four minutes before the biopsies in group 2 (176 patients). A visual analogue scale (VAS) was used to assess the pain score during anaesthesia (VAS 1), during the biopsies (VAS 2) and 30 minutes after them (VAS 3).

RESULTS

Patients receiving lidocaine gel experienced statistically less pain than the lidocaine injection group for mean VAS 1 (0.1 vs 1.4, p < 0.0001) and mean VAS 3 (0.8 vs 1.4, p < 0. 001) but VAS 2 showed no statistically significant difference (2.0 vs 2.1). No major morbidity was noted with either anaesthetic.

CONCLUSION

Rectal administration of lidocaine gel is both safe, simple and effective and results are more satisfactory than with lidocaine periprostatic infiltration.

Laparoscopic promontory sacral colpopexy: is the posterior, recto-vaginal, mesh mandatory?

OBJECTIVE(S)

The aim of our retrospective study was to determine if systematic placement of a posterior mesh, in addition to an anterior vesico-vaginal mesh, is necessary for laparoscopic treatment of pelvic organ prolapse.

METHODS

A laparoscopic promontory sacral colpopexy was performed in 108 patients, including 55 patients with a concurrent laparoscopic Burch procedure (50.9%). We compared 33 patients treated with a single anterior mesh (SAM) and 71 treated with a double, anterior and posterior, mesh (DM).

RESULTS

The difference between the SAM and DM groups was statistically significant in terms of posterior compartment failure (rectocele and/or enterocele): 31.3% and 5.9%, respectively (p=0.0006). This significant difference persisted in the Burch (B) group (p=0.001), but not in the non-Burch (NB) group (p=0.98). Among the SAM group, this difference between the B and NB groups, was significant (57.1% versus 0%; p=0.0015) and above all not a single posterior failure was observed in the NB group.

CONCLUSION(S)

The placement of a posterior mesh, if highly effective, appeared unnecessary in the absence of an associated Burch procedure or a patent posterior prolapse. The posterior mesh also increased risk of postoperative complications and side effects.

Rat Leydig cells use apolipoprotein E depleted high density lipoprotein to regulate testosterone production

Rat HDL are known to increase testosterone production by cultured Leydig cells either following gonadotropin stimulation or cholesteryl ester depletion. However, rat HDL contain apolipoprotein E and have a high affinity for the members of the low density receptor family such as LDL receptor, LDL receptor related protein and VLDL receptor. In contrast with the adrenal cells, the contribution of apo A-I and apo E pathways in HDL cholesterol uptake has not been yet evidenced in rat Leydig cells. Recent data provided evidence that hCG stimulates scavenger receptor BI expression in testes. In order to investigate if testosterone production can be stimulated by apo E depleted HDL, we compared the level of testosterone stimulation by HDL with or without apo E first, in presence of saturating dose of hCG (1 IU/ml) and second, after depletion of cholesterol synthesis by pravastatin, an inhibitor of HMG-CoA reductase. In presence of hCG, HDL with or without apo E increased testosterone production respectively by 37 and 25%. Pravastatin at 100 microg/ml inhibited the cholesterol synthesis and the testosterone production by 25% and decreased the cholesteryl content by 25%. The addition of HDL with or without apo E (50 microg protein HDL/ ml) completely overcame the depletion of cellular cholesteryl esters and the inhibition of testosterone production induced by pravastatin. In the presence of heparin, apo E depleted HDL overcame the testosterone production induced by pravastatin, indicating that uptake of HDL without apo E via a secretion of apo E by the cells themselves was not involved. Therefore, in absence of apo E, it is suggested that rat Leydig cells used HDL to regulate steroidogenesis via an apolipoprotein A-I pathway.

Evaluation of cholesteryl ester transfer in the seminiferous tubule cells of immature rats in vivo and in vitro

Sertoli cells and germ cells are separated from the interstitial blood capillaries by an extracellular matrix and the peritubular cells, which constitute a barrier to the movement of plasma lipoproteins. The present study was undertaken to evaluate in vivo and in vitro the high density lipoprotein (HDL) cholesteryl ester transfer from plasma to seminiferous tubule cells in the testis of 30-day-old rats. Firstly, the transfer of HDL cholesteryl oleate from plasma to testicular compartments was evaluated and, secondly, the role of apolipoproteins A-I and E in the uptake of cholesteryl ester by Sertoli cells was investigated. At 2 h after the administration of HDL reconstituted with [3H]cholesteryl ester, dimyristoyl phosphatidylcholine and apolipoproteins, the tissue space in the interstitial cells (740 +/- 60 microliters g-1 cell protein) was fourfold higher than that in the seminiferous tubule cells (170 +/- 10 microliters g-1). Sertoli cells were isolated and incubated with [3H]cholesteryl ester HDL reconstituted with apolipoprotein A-I or E to evaluate the mechanisms of cholesteryl ester influx. At the same apolipoprotein concentration (50 micrograms apolipoprotein ml-1 medium), the uptake of [3H]cholesteryl oleate from phospholipid-apolipoprotein E vesicles was twofold higher than that with phospholipid-apolipoprotein A-I vesicles. The presence of heparin reduced the uptake of cholesteryl ester from apolipoprotein E vesicles but not with apolipoprotein A-I vesicles, indicating that uptake of apolipoprotein A-I vesicles via a secretion of apolipoprotein E by the cells themselves was not involved. These results demonstrate that plasma lipoprotein cholesterol is able to cross the testis lamina propria and that Sertoli cells take up cholesteryl ester for seminiferous tubule cell metabolism mainly via an apolipoprotein E pathway.

Evaluation of cholesteryl ester transfer in the seminiferous tubule cells of immature rats in vivo and in vitro

Sertoli cells and germ cells are separated from the interstitial blood capillaries by an extracellular matrix and the peritubular cells, which constitute a barrier to the movement of plasma lipoproteins. The present study was undertaken to evaluate in vivo and in vitro the high density lipoprotein (HDL) cholesteryl ester transfer from plasma to seminiferous tubule cells in the testis of 30-day-old rats. Firstly, the transfer of HDL cholesteryl oleate from plasma to testicular compartments was evaluated and, secondly, the role of apolipoproteins A-I and E in the uptake of cholesteryl ester by Sertoli cells was investigated. At 2 h after the administration of HDL reconstituted with [3H]cholesteryl ester, dimyristoyl phosphatidylcholine and apolipoproteins, the tissue space in the interstitial cells (740 +/- 60 microliters g-1 cell protein) was fourfold higher than that in the seminiferous tubule cells (170 +/- 10 microliters g-1). Sertoli cells were isolated and incubated with [3H]cholesteryl ester HDL reconstituted with apolipoprotein A-I or E to evaluate the mechanisms of cholesteryl ester influx. At the same apolipoprotein concentration (50 micrograms apolipoprotein ml-1 medium), the uptake of [3H]cholesteryl oleate from phospholipid-apolipoprotein E vesicles was twofold higher than that with phospholipid-apolipoprotein A-I vesicles. The presence of heparin reduced the uptake of cholesteryl ester from apolipoprotein E vesicles but not with apolipoprotein A-I vesicles, indicating that uptake of apolipoprotein A-I vesicles via a secretion of apolipoprotein E by the cells themselves was not involved. These results demonstrate that plasma lipoprotein cholesterol is able to cross the testis lamina propria and that Sertoli cells take up cholesteryl ester for seminiferous tubule cell metabolism mainly via an apolipoprotein E pathway.

Etiologic study of genitourinary infections in women of childbearing age in Bobo-Dioulasso, Burkina Faso, 1992

BACKGROUND AND OBJECTIVES

Genitourinary infections have a major impact on public health, especially in Africa. Relative distribution of the different pathogens is unknown in Bobo-Dioulasso.

GOAL

To describe the etiology of genitourinary infections, to establish the sensitivity of Neisseria gonorrhoeae to antibiotics, and to provide epidemiologic and biologic evidence to optimize the treatment of genitourinary infections.

STUDY DESIGN

Clinical and biologic diagnoses were performed on 223 women with genitourinary infections.

RESULTS

Etiologies found were trichomoniasis (27.8%), chlamydia (26.9%), bacterial vaginosis (19.7%), candidiasis (16.6), and N. gonorrhoeae infection (10.9%). Human immune deficiency virus antibodies were present in 42% of the patients. Spectinomycin or ceftriaxone should be recommended for the treatment of gonorrhoeae in Bobo-Dioulasso.

CONCLUSIONS

The prevalence of Chlamydia trachomatis is higher than that of N. gonorrhoeae in Bobo-Dioulasso. This should be taken into account in clinical management of sexually transmitted diseases in this setting.

Transfer of cholesterol between high density lipoproteins and cultured rat Sertoli cells

In the testes, the Sertoli cells are separated from the blood capillaries by the basement membrane, thereby excluding the passage of low density lipoproteins (LDLs) but allowing the passage of high density lipoproteins (HDLs). The present study examines first the capacity of Sertoli cells to uptake cholesterol from HDL and secondly the role of apolipoproteins (apo) A-I and E in cholesterol flux between HDL and cultured rat Sertoli cells. In the presence of HDL in cultured medium, rat Sertoli cells accumulated few amounts of esterified cholesterol. Incubation of [14C] cholesterol-labelled Sertoli cells with [3H]cholesterol-labelled HDL showed that the amount of cholesterol influx slightly exceeded its efflux, thus resulting in a net uptake of cholesterol from HDL to rat Sertoli cells. The amount of HDL-cholesterol converted to steroids by Sertoli cells was about 32% of influx. Uptake of cholesterol by Sertoli cells was three times higher with phospholipid-apo A-I vesicles and seven times higher with phospholipid- apo E vesicles than that with phospholipid vesicles without apolipoprotein. Phospholipid- apo A-I vesicles promoted cholesterol efflux at the same rate as native HDL and twice as efficiently as phospholipid- apo E vesicles. Thus, this study shows that rat Sertoli cells have the capacity to take up HDL-cholesterol for membrane renewal and steroid production mainly by apo E dependent pathways.

Sexually transmitted diseases and human immunodeficiency virus infection among women with genital infections in Burkina Faso

This study reports the prevalence of sexually transmitted diseases (STDs) among gynaecological outpatients presenting at the Bobo-Dioulasso Hospital (Burkina Faso) with genital infections and examines the factors associated with HIV infection in this population. Of 245 eligible non-pregnant women, 220 consented to participate in the study. Seventy-seven per cent had sexually transmitted infections. The most common were: Trichomonas vaginalis (28%), Chlamydia trachomatis (27%), bacterial vaginosis (20%), Candida albicans (17%), Neisseria gonorrhoeae (11%). The prevalence of HIV infection was 42% (95% c.i. 35.3, 48.3). Logistic regression analyses revealed Neisseria gonorrhoeae to be the only STD significantly associated with infection with HIV (P = 0.04). A sedimentation rate greater than or equal to 100 mm in the first hour was also associated with HIV infection (P < 0.001). Women consulting for genital infections constitute a high risk group for HIV infection and other STDs. Management of these women should focus on the early diagnosis and treatment of STDs.

Effect of lipoproteins on cholesterol synthesis in rat Sertoli cells

Lipoprotein metabolism has been investigated in cultured rat Sertoli cells. Cells incubated with low-density lipoproteins (LDLs) or high-density lipoproteins (HDLs) showed a concentration-dependent decrease of sterol synthesis, indicating a net cholesterol delivery to the Sertoli cells. At 50 micrograms/mL, lipoproteins inhibited the incorporation of [14C]acetate into free cholesterol by 83% for the LDL and 47% for the HDL. Electron microscopic examinations of the Sertoli cells provide evidence of the internalization of gold-labelled HDL into coated pits and coated vesicles. Competitive studies between human LDL and rat HDL indicate that Sertoli cells take up cholesterol from LDL and HDL containing apolipoprotein (apo) E by common pathways. These results suggest that Sertoli cells possess apo B and E receptors for the uptake and degradation of LDL and HDL, although the basement membrane excludes the passage of LDL from blood capillaries to the Sertoli cells. At 50 micrograms/mL, apo-E-depleted HDL inhibited the incorporation of [14C]acetate into free cholesterol by 34%. Thus, this study shows that Sertoli cells are capable of taking up apo-E-depleted HDL cholesterol for cell metabolism.

[Etiologic and nosologic considerations apropos of 574 cases of cardiac decompensation in Conakry]

The authors analyze 574 cases of heart failure observed in the Cardiology Department of the University Hospital Ignace-Deen in Conakry, in a period of 5 years (1981-1985), from the etiological and nosological standpoints. The result is that cardiac insufficiency is very frequent in the department and the patients, in most cases, are found in stage IV of the NYHA (64.98%). There are more men (59.75%) than women (40.25%). Age varies from 15 to 80 years (mean: 49.2 years). Hypertension (37.47%), senile cardiopathies (20.20%), various myocardiopathies (17.24%), rheumatoid valvulopathies (13.95%) are the most frequently encountered etiologies. Pericarditis is rare (0.34%).

[Profile and course of cardiovascular morbidity and mortality in Conakry. Apropos of 268 cases seen at the Cardiology Department of the Ignace-Deen University Hospital 1986-1987]

Over a period of two years (1986-1987), the authors have studied the morbidity and mortality of various cardiovascular diseases in a hospital population of 268 patients. By comparing it with a previous similar study conducted over 5 years (1981-1985), they have reached the following conclusions: the prevalence of the main nosological groups is equivalent (H.B.P., rheumatoid valvulopathies, chronic pulmonary heart, ischemic cardiopathies; severity of the valvulopathies and their prognosis which raise social and medical problems especially that of cardiac surgery, still inexistent in Guinea; increased prevalence of diseases such as hypertension and rheumatoid valvulopathies. They suggest early screening, especially for rheumatoid valvulopathies and hypertension, which cause major social problems because of their complications. Besides, it would be desirable that visits at regular intervals be made mandatory in schools and universities and at preemployment examinations and in all SMI (?) centers in the country.

[Chronic pulmonary heart. Apropos of 41 cases at the Cardiology Department of the Ignace-Deen University Hospital in Conakry]

In 5 years, 41 cases of chronic pulmonary heart were observed at the University Hospital Ignace-Deen in Conakry, representing 7.14 p. cent of hospitalized patients, thus ranking 4th after Hypertension, various myocardiopathies, and valvulopathies. These patients are from a rural background in 65.21 p. cent of the cases. Chronic bronchitis, 4 p. cent of the cases, and bronchial asthma, 27 p. cent of the cases, represent the main causes. An important factor is that all patients were hospitalized with heart failure, at different stages of NYAH.