[About 98 cases of dengue hospitalized in a private clinic of Ouagadougou: epidemiology, diagnostic and evolution]

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 of the patients "lost to follow-up" and determining factors of loss to follow-up to patients living with HIV at Ouagadougou, Burkina Faso]

The objective of this study is to describe the characteristics of the patients "lost to follow-up" and determining factors of lost to follow-up at the patients infected by HIV. This is a descriptive and analytical retrospective study made on patients with or not by HAART, registered in the Day hospital of Ouagadougou. Of 5118 adult patients studied, 402 (7.9%) lost to follow-up. Among these patients, 340 (84.5%) had an unknown vital status, 28 (7%) were alive and 34 (8.5%) died. Mean age was 37.5 years. After active research, 16 from 21 patients under HAART were in treatment interruption. The main factors associated with the loss of follow-up were: no schooling (p=0,008), residing outside the capital (p=0,002) and being infected with HIV2 (p< 10(-3)). The phenomenon of loss of follow-up is important and concerned mainly not informed patients.

[Metabolic disorders and cardiovascular risk factors observed in patients infected by the HIV with antiretroviral therapy in Burkina Faso]

The purpose of this descriptive transverse study is to describe metabolic disorders and cardiovascular risk factors in HIV-infected patients undergoing antiretroviral therapy in the day-care unit of the University Hospital of Ouagadougou, Burkina-Faso. A total of 100 patients (Burkinavi cohort) undergoing antiretroviral therapy with a minimum of 42-months of follow-up (October 2005 to Mars 2009) were included. There were 77 females and 33 males with a mean age of 37 years. Most patients, i.e., 95%, were positive for HIV1. Mean body mass index was 22 kg/m2. Mean CD4 count was 280/mm3. Viral load was undetectable in 66 of the 71 patients who underwent viral load testing. Retroviral therapy consisted of the TriomuneR combination (Stavudine + lamivudine + névirapine) at a fixed dose in 27 cases. Cardiovascular risk factors included family history of high arterial blood pressure in 5 patients, smoking in 4, and obesity in 8. During follow-up, seven patients presented hypertension. Metabolic disorders included hyperglycemia (4%), hypertriglyceridemia (17%) and hypercholesterolemia (14%). Lipodystrophia was noted for 6 patients. Despite the short follow-up period, metabolic disorders and cardiovascular risk factors were observed at our patients under antiretroviral therapy.

[Eales disease: a case report in Burkina Faso]

The authors report the first case of Eales disease described in Burkina Faso. A 21-year-old man presented myodesopsia with acute visual acuity decrease in the right eye at 1/50, vitreous haemorrhage, and retinal phlebitis of the large trunks. In the left eye, visual acuity was 10/10 P2, with phlebitis associated with retinal haemorrhages, vascular occlusion, and retinal ischaemia. Laboratory investigations found a positive TST at 20mm but the Koch bacillus was not isolated. The patient received treatment for tuberculosis, corticosteroids, retinal argon laser photocoagulation, and vitrectomy in the right eye. The clinical, immunopathological, and therapeutic aspects of Eales disease are discussed.

[Haematological parameters evolution during the antiretroviral therapy of HIV infected patients in Burkina-Faso]

Haematological anomalies are frequent during HIV infection, and can be the fact of virus and or bone marrow toxicity of antiretroviral drugs. In order to analyze the evolution of the haematological parameters during HAART this work was carried out in the internal medicine department of the national teaching hospital Yalgado-Ouédraogo in Ouagadougou. So 107 patients receiving for the first time HAART and followed regularly were retained. The immunological efficacy at the end of the first six months was 60, 75% with an average gain of 119 CD4/mm3. The haematological changes at the end of these first six months showed: --an anaemia in 51.4% of the cases at month 6 versus 80.3% at baseline (p=0.0001). The average rate of haemoglobin was 11.8 versus 11.2 g/dl at baseline in the AZT containing HAART regimen (p=0.014) and 12.2 versus 10.7 g/dl at baseline in the group without AZT (p=0.00006). --a neutropenia in 35.5% of the cases at month 6 versus 31.7% at baseline (p=0.6). The average rate of neutrophil was 1908/mm3 versus 2267.1/mm3 at baseline in the AZT containing HAART regimen and 2150.7/mm3 versus 2001.9/mm3 at baseline in the group without AZT These results show that the therapeutic efficacy measured on the immunological answer is accompanied by a reduction of haematological anomalies. They also suggest the necessity to evaluate the cotrimoxazole impact before deciding the interruption of AZT.

[Management of the diabetic foot, apropos of 42 cases at the Ougadougou University Hospital Center]

Feet lesions are the most important cause of diabetic's consultation in general surgery. A retrospective study was conducted in Ouagadougou National Teaching Hospital, in order to analyse epidemiology, clinic, and evolutive aspects of this affection. In the same period, 222 cases of diabetes mellitus were admitted in general surgery and internal medicine. We noticed 42 cases of feet lesions. The mean age of patients was 53 years. Anterior knowledge of diabetes has not been a factor of early consultation. Consultation mean delay was a month. In 28 cases, feet lesions were 4 or 5 Wagner grade. The role of ischemia and neuropathy have not been evaluated, but sepsis was highly determinant factor. Insulin has been used in 83.3% of cases. Amputation concerned 19 patients. Mean length of hospital stay was 16.6 days and mortality rate was 38.1%. Prevention of complications can be much more effective if it is applied as a part of global approach to diabetes mellitus management.