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High-intensity interval training (HIIT) has been shown to benefit stroke patients when implemented three months post-stroke. This study examined HIIT's feasibility and clinical effectiveness in the early post-stroke stage in Benin. This was a prospective interventional study comprising an HIIT programme executed on a recumbent bike, three times/week, 20–30 min/session for 6 weeks, added to a conventional physiotherapy. The primary outcomes were feasibility, credibility and expectancy assessed with credibility and expectancy questionnaire. A maximal exercise test, 6-min walking test (6MWT), 10-m walking test (10mWT), Berg balance scale (BBS) and five repetitions sit-to-stand test (5 R-STS) were performed before and after the training programme. Ten outpatients, with a median age [P25-P75]: 63.5[56.7–71.2] years; time since stroke: 15.0[9.7–21.0] days, started and completed all training sessions without serious adverse events. High scores were observed on the Credibility subscale at admission (27.0[25.7–27.0]), which remained so after intervention (26.5[25.7–27.0]). Expectancy subscale scores were high at admission (25.5[24.0–27.0]) and post-training (25.5[24.5–27.0]). Peak workload (p < 0.001), BBS (p < 0.001), 6MWT (p < 0.001), 10mWT (p < 0.001) and 5 R-STS (p = 0.004) were all improved. HIIT is feasible and safe in the early subacute post-stroke stage and is perceived by patients as highly credible, meeting their expectations of recovery. [ABSTRACT FROM AUTHOR]

Currently, little is known on the relationships between cardiorespiratory fitness (CF), physical activity (PA), and functional outcomes after stroke, especially in low- and middle-income countries. We examine the relationships between CF, PA, and functional outcomes in one-year poststroke in Benin, a lower middle-income country. A case–control study was carried out in northern Benin. Twenty-one participants with chronic strokes were matched to 42 controls according to sex and age. PA patterns and associated energy expenditure (EE) were assessed with a BodyMedia's senseWear armband. CF was evaluated with the Physical Working Capacity at 75% of the predicted maximal heart rate index. The functional outcomes were evaluated using the modified Rankin scale (mRS) and the ACTIVLIM-Stroke scale. Both people with stroke and the healthy pairs spent much time in sedentary behavior (median [P25; P75]: 672 [460; 793] min vs 515 [287; 666] min, p = 0.006). Although people with chronic stroke performed fewer steps compared to healthy controls (median: 2767 vs 5524, p = 0.005), results showed that total EE was not statistically significant in either group (median: 7166 Kcal vs 8245 Kcal, p = 0.07). In addition, the mRS score (r = 0.47, p = 0.033) and the ACTIVLIM-Stroke measure (r = 0.52, p = 0.016) were moderately associated with the CF index of people with chronic stroke. The study showed clear trends for lower levels of PA in both people with chronic stroke and health controls. A correlation exists between CF, disability, and functional outcomes among stroke patients. [ABSTRACT FROM AUTHOR]

INTRODUCTION: La coronaropathie serait fréquente chez les survivants d´accident vasculaire cérébral (AVC). L´objectif de l´étude était de déterminer la prévalence de la coronaropathie chez les survivants d´AVC suivis au centre hospitalier universitaire départemental Borgou-Alibori (CHUD/B-A). METHODES: il s´est agi d´une étude transversale menée du 1er mars au 31 août 2019. Elle a inclus tous les patients victimes d´AVC, d´âge = 18 ans, reçus dans l´unité de neurologie du CHUD/B-A entre janvier 2012 et juillet 2019, ayant survécu à la phase aiguë, et chez qui le consentement éclairé écrit ou celui d´un tuteur (patients sévèrement handicapés) a été obtenu. Un entretien individuel, des mesures anthropométriques, un examen physique, un électrocardiogramme et une revue du dossier médical ont été effectués. La présence de coronaropathie a été définie par un antécédent documenté, des anomalies ST/T et/ou Q évocatrices (critères de Minnesota) ou un questionnaire de dépistage de l´angine de poitrine positif. Les facteurs associés à la coronaropathie ont été recherchés par une régression logistique. RESULTATS: un total de 101 patients était inclus avec un âge moyen de 57,2±10,5 ans. Le délai médian depuis la survenue de l´AVC était de 11 mois [2,0-23,5]. Les AVC ischémiques prédominaient (57,4%). La prévalence de la coronaropathie était estimée à 49,5%. Les facteurs associés à la coronaropathie étaient la non-scolarisation (p=0,036), l´obésité (p=0,036) et le tabagisme ancien (p=0,044). CONCLUSION: cette étude montre une fréquence élevée de coronaropathie chez les survivants d´AVC. Il est important de dépister la coronaropathie dans cette cible afin d´optimiser la prise en charge.

INTRODUCTION: les accidents vasculaires cérébraux (AVC) constituent une des principales causes acquises de l'épilepsie de l'adulte mais peu de données sont disponibles sur l'incidence de l'épilepsie après un AVC en Afrique. L'objectif de cette étude était d'estimer l'incidence de l'épilepsie chez les patients victimes d'AVC à Parakou. METHODES: il s'est agi d'une étude de type cohorte dynamique ayant inclus 203 patients victimes d'AVC et hospitalisés dans le service de neurologie du CHU de Parakou. Les patients aux antécédents d'épilepsie étaient exclus du suivi. Les patients étaient suivis sur une période de 21mois allant du 1er Janvier 2013 au 30 Septembre 2014. L'épilepsie était définie selon les critères de la Ligue Internationale contre l'Epilepsie. RESULTATS: ils étaient âgés de 18 à 99 ans avec une moyenne de 58,4 ans , 14,2 ans. Le délai moyen de consultation après l'installation des symptômes était de 54,3h (+/-112,9h). Les AVC ischémiques représentaient 45,8%, les hémorragiques 31% et 23,2% d'indéterminés. L'incidence cumulée de l'épilepsie était de 17. La densité d'incidence de l'épilepsie était de 9,8 pour 100 personnes-années. Les facteurs associés à la survenue de l'épilepsie étaient le niveau d'instruction, la durée d'hospitalisation et le score de BARTHEL. CONCLUSION: l'incidence de l'épilepsie reste très élevée et la prise en compte des facteurs associés dans les stratégies de prise en charge pourrait permettre de réduire sa charge globale.

Purpose: The study aimed to review the content and evaluate the effects of CBR on quality of life (QoL), balance, and walking capacity for people post stroke, compared to other rehabilitation protocols or no care. Methods: A systematic search and meta-analysis of clinical trials of CBR interventions for stroke survivors was conducted. Five online electronic databases (MEDLINE/PubMed, Web of sciences, Scopus, Hinari, and Pedro) were searched for articles published in English and French languages, from inception up to December 2021. Sixteen studies were included that reported on QoL outcomes from CBR interventions involving 1755 adults post stroke. Results: The different CBR interventions that were selected were grouped into three clusters: a) exercise programmes, b) task-oriented training, and c) educational and taking-charge programmes. CBR interventions were more effective than other rehabilitation protocols (SMD=0.16[0.02, 0.30], P=0.03, I² =40%) on QoL for people with chronic stroke. The effects of interventions on walking capacity and balance demonstrated non-significant difference (SMD=0.31[-0.02, 0.64], P=0.06, I² =88%, and SMD= 0.20[-0.12, 0.53], P=0.22, I² =68%, respectively). Conclusion: Current data indicates that CBR can be used in many forms or in combinations to benefit people with chronic stroke. Also, CBR is as effective as other rehabilitative protocols or no care on walking capacity and balance, while being more while being more effective than institution-based rehabilitation or no care effective than institution-based rehabilitation or no care, in improving quality of life which is a well-recognised goal in the rehabilitation of people with chronic stroke. [ABSTRACT FROM AUTHOR]

Migraine is a disabling disease that inflicts a heavy burden on individuals who suffer from it. Significant advances are being made in understanding the pathophysiology and treatment of the disease. The role of lifestyle modifications has become increasingly predominant. We reviewed the current and available data on the role of a healthy lifestyle in the management of migraine. Physical activity, management of obesity, a healthy diet, and a better lifestyle, such as adequate sleep and avoidance of drug abuse, significantly contribute to reducing the frequency and severity of attacks. It is important to consider these factors in the overall management strategies for migraine sufferers. [ABSTRACT FROM AUTHOR]

Background: The burden of stroke is high in sub-Saharan Africa; however, few data are available on long-term mortality. Objective: To estimate over one-month stroke case fatality in sub-Saharan Africa. Methods: A systematic review and meta-analysis were performed according to meta-analysis of observational studies in epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO protocol: CRD42020192439), on five electronic databases (PubMed, Science direct, AJOL, EMBASE, and Web of Sciences). We searched all studies on stroke case fatality over one month in sub-Saharan Africa published between 1st January 2000 and 31st December 2019. Results:We included 91 studies with a total of 34,362 stroke cases. The one-month pooled stroke case-fatality rate was 24.1% [95% CI: 21.5-27.0] and 33.2% [95% CI: 23.6-44.5] at one year. At three and five years, the case-fatality rates were respectively 40.1% [95% CI: 20.8-63.0] and 39.4% [95% CI: 14.3-71.5] with high heterogeneity. Hemorrhagic stroke was associated with a higher risk of mortality at one month, but ischemic stroke increased the risk of mortality over six months. Diabetes was associated with poor prognosis at 6 and 12 months with odds ratios of 1.64 [95% CI: 1.22-2.20] and 1.85 [1.25-2.75], respectively. Conclusion: The stroke case fatality over one month was very high, compared to case fatalities reported in Western countries and can be explained by a weak healthcare systems and vascular risk factors. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to determine knowledge of stroke risk factors and signs in an urban population of northern Benin. Methods: A door-to-door purposeful sampling survey was conducted in resident population (age ≥15 years) of the district of Titirou in the city of Parakou (N = 255,478) in Benin between March 15 and July 15, 2016. In-person interviews were conducted with data collection on structured questionnaires with close and open questions, according to standard definitions. Multivariable logistic regression was used to assess predictors of good knowledge, defined by provision of a correct response in pre-defined set of questions on stroke risk factors and warning signs. Results: Of 4,671 participants (mean age 27.7 ± 12.9 years; females 50.6%), only 404 (8.6%) knew at least 1 stroke risk factor. Knowledge level of stroke risk factors (odds ratio, 95% confidence interval) was related to age (1.37, 1.27–1.48), level of education (2.54, 1.73–3.72), and family history of stroke (3.01, 2.08–4.26). Only 230 (4.9%) were able to cite at least 1 stroke symptom, and this knowledge was great with increasing age (1.04, 1.02–1.06), family (3.63, 2.41–5.49) and personal history of stroke (3.71, 1.86–7.42), and high level of education (4.35, 2.68–7.07). Conclusion: Knowledge of stroke risk factors and signs is low in northern Benin. Greater public education and awareness campaigns are required to address the burden of stroke. [ABSTRACT FROM AUTHOR]

Objective  The main purpose of this article is to define prognosis of pregnancies in epileptic women in Benin. Methods  This was a case–control study that included 54 epileptic women who had at least one pregnancy matched to 162 controls on age, pregnancy term, and monitoring center. Information about epilepsy, treatment, pregnancy, and childbirth were collected. A logistic regression with odds ratio (OR) calculation was used to study the association. Results  During pregnancy 22.22% of epileptic women experienced an increase in seizure frequency. Epileptics had more frequent miscarriages (OR: 1.84 [1.01–3.51]), more incidents during pregnancy (OR: 4.03 [1.04–15.60]), and were more often hospitalized (OR: 3.35 [1.46–7.69]) than women without epilepsy. They, more often, had premature children before 37 weeks of amenorrhea (OR: 2.10 [1.12–3.91]) and gave birth to low-birth-weight children (OR = 2.17 [1.00–4.76]). Conclusion  Occurrence of a pregnancy in an epileptic woman in Benin is at risk and requires multidisciplinary monitoring by both neurologist and obstetrician to reduce complications. [ABSTRACT FROM AUTHOR]

Introduction: The number of people living with dementia is growing worldwide and most rapidly in low- and middle-income countries. Little is known about dementia in Benin. We estimated the prevalence of dementia among retired people in Parakou, a northern city in Benin, and then assessed associated factors. Methods: A cross-sectional study was performed in Parakou from July to August 2014. Participants were recruited at 2 centers, the National Center of Social Security and the Public Treasury of Benin. Participants with cognitive impairment were defined as having a low cognitive score (<7) for the brief version of the Community Screening Interview for Dementia and were invited to neurological examination. DSM-IV-TR criteria were used to diagnose dementia and the HACHINSKI score was used to differentiate dementia subtypes. A logistic regression model was performed to identify factors associated with dementia. Results: Overall, 440 retired people were included in the study. They were mainly male (92.3%) and their mean age was 64.9 ± 6.0 years. The prevalence of cognitive impairment was 7.7% (95% CI 5.2–10.2). Fourteen participants were diagnosed with dementia, representing a prevalence of 3.2% (95% CI 1.5–4.8). Alzheimer disease was the most frequent subtype (64.3%), followed by vascular dementia (21.4%). Retired people diagnosed with dementia were all men and were aged between 61 and 71 years. Most of them were living alone. The main factors associated with dementia were older age, low fruit and vegetables consumption, and living alone. Discussion: This study showed a low prevalence of dementia among retired older people in Benin. Despite this, greater attention must be given to the potential burden dementia places on families for better care, before the expected aging of the population becomes more significant. [ABSTRACT FROM AUTHOR]

To build a model of prediction of social participation of community-dwelling stroke survivors in Benin at 1 month, 3 months, and 6 months. An observational study with evaluations at 1 month, 3 months, and 6 months poststroke. Correlational analyses and multivariate linear regressions were performed. Outpatient rehabilitation centers in Benin. A volunteer sample of 91 stroke patients was enrolled at baseline; 64 (70%) patients completed all the study (N=64): 70% male and 52% right hemiparesis. Not applicable. Participants were evaluated with the Participation Measurement Scale, ACTIVLIM-Stroke (activities of daily living [ADL]), Stroke Impairment Assessment Set, 6-minute walk test, Hospital Anxiety and Depression Scale, and the modified Rankin Scale. The significant predictors of social participation after controlling the confounders were the following: at 1 month ADL (0.4 [0.3, 0.6]) and depression (‒0.6 [‒0.8, ‒0.2]) with total model R 2=0.44; at 3 months ADL (0.58 [0.4, 0.7]) and depression (‒0.58 [‒0.5, ‒0.7]) with total model R 2=0.65; and at 6 months ADL (0.31 [0.2, 0.5]), impairments (‒0.82 [‒0.5, ‒0.7]), and depression (‒0.94 [‒0.8, ‒0.2]) with total model R 2=0.78. Using socioculturally tailored tools, the present study identified ADL performance (ACTIVLIM-Stroke), depression (Hospital Anxiety Depression Scale), and overall impairments (Stroke Impairment Assessment Set) as the significant determinants of social participation (Participation Measurement Scale) poststroke in Benin. These findings will be a valuable resource for rehabilitation stakeholders in evaluating interventions, programs, and policies designed to encourage social participation for stroke patients. [ABSTRACT FROM AUTHOR]

Résumé: La dépression représente la complication psychiatrique la plus fréquente après un accident vasculaire cérébral (AVC). En Afrique sub-saharienne, la plupart des études rapportent la prévalence de la dépression après un AVC, mais il n'existe à notre connaissance aucune donnée sur son incidence que nous proposons d'étudier. L'objectif de cette étude était d'estimer l'incidence de la dépression chez les patients victimes d'AVC à Parakou. Il s'agit d'une étude de type cohorte dynamique ayant inclus 203 patients victimes d'AVC et hospitalisés dans le service de neurologie du CHU de Parakou, Bénin. Les patients suivis pour une dépression avant la survenue de l'AVC étaient exclus du suivi. Les patients étaient suivis sur une période de 21 mois allant du 1er janvier 2013 au 30 septembre 2014. La dépression était définie selon les critères du DSM-IV (Diagnostic and statistical manual of mental disorders; fourth edition). Ils étaient âgés de 18 à 99 ans avec une moyenne de 58,4 ans ± 14,2 ans. Le délai moyen de consultation après l'installation des symptômes était de 54,3 h (+/- 112,9 h). Les AVC ischémiques représentaient 45,8 %, les hémorragiques 31 % et 23,2 % d'indéterminés (n'ayant pas eu d'imagerie cérébrale). L'incidence cumulée de la dépression était de 30. La densité d'incidence de la dépression était de 18,5 pour 100 personnes-années. Les facteurs associés à la survenue de la dépression étaient l'état de conscience à l'admission (score de Glasgow élevé), la sévérité du déficit initial (score NIHSS élevé), le handicap fonctionnel (score de Barthel bas) et l'existence d'un antécédent de diabète. L'incidence de la dépression après un AVC reste très élevée dans notre contexte et devrait être recherchée systématiquement chez toute personne victime d'AVC. La prise en compte des facteurs associés dans les stratégies de prise en charge pourrait permettre de réduire sa charge globale. Depression is a frequent psychiatric complication after a stroke. In a Sub-Saharan Africa, the majority of the studies are about their prevalence, but the incidence of post-stroke depression was rarely estimated. We aimed to estimate this incidence in Parakou, Benin. We had conducted a dynamic cohort study with 203 stroke patients in the department of neurology of the university hospital in Parakou. Patients with a history of depression were excluded. Patients were followed during a period of 21 months from January 1, 2013 to September 30, 2014. Depression was defined according to the criteria of DSM-IV. They were 18 to 99 years old with an average age of 58.4±14.2 years. In average, consultation was made 54.3h±112.9h after onset symptoms. Concerning the type of stroke, 45.8% were ischemic, 31% hemorrhagic and 23.2% were indeterminate. The cumulative incidence of depression was 30%. The incidence rate of depression was 18.5 per 100 person-years. The factors associated with the occurrence of depression were initial coma, initial severity of stroke, disability and history of diabetes. The incidence of depression remains very high and must be evaluated. Considering the associated factors of depression in post-stroke and including them among the management strategies could reduce overall burden. [ABSTRACT FROM AUTHOR]

Objective To develop a valid stroke-specific tool, named the Participation Measurement Scale (PM-Scale), for the measurement of participation after stroke. Design Observational study and questionnaire development. Setting Outpatient rehabilitation centers. Participants Patients with stroke (N=276; mean age, 58.5±11.1y; 57% men). Interventions Not applicable. Main Outcome Measures Participants completed a 100-item experimental questionnaire of the PM-Scale. Items were scored as “not at all,” “weakly,” or “strongly.” The Hospital Anxiety and Depression Scale was used to evaluate depression, and the modified Rankin Scale was used to categorize the severity of disability on the basis of observation. Results After successive Rasch analyses using unrestricted partial credit parameterization, a valid, unidimensional, and linear 22-item scale for the measurement of participation was constructed. All 22 items fulfilled the measurement requirements of overall and individual item and person fits, category discrimination, invariance, and local response independence. The PM-Scale showed good internal consistency (person separation index, .93). The test-retest reliability of item difficulty hierarchy ( r =.96; P <.001) and patient location ( r =.99; P <.001) were excellent. This patient-based scale covers all 9 International Classification of Functioning, Disability and Health domains of participation. Conclusions The PM-Scale has good psychometric qualities and provides accurate measures of participation in patients with stroke in Africa. [ABSTRACT FROM AUTHOR]

We report the case of a 30-year-old human immunodeficiency virus (HIV)-positive HIV patient who was poorly followed. She was admitted on November 30, 2017, for the management of febrile encephalitis syndrome with motor deficit of the left hemicorps and generalized seizures. In biology, we found a nonspecific inflammatory syndrome. The cerebral imaging without and with injection found a cystic formation multilobed right fronto-parietal of approximately 83 mm × 62 mm, the presence of an annular calcification of approximately 8 mm with a commitment under falcator, and a contralateral ventricle dilation. Treatment with antiepileptic, antibiotic, antiparasitic, and corticosteroid therapy was marked by death the day before the neurosurgical procedure after initial improvement. [ABSTRACT FROM AUTHOR]

Introduction: Several factors including grades obtained in the Baccalaureate can influence academic performance of first year medical students.. The aim of this study was to evaluate the relationship between results achieved by students taking Baccalaureate exam and student academic success during the first year of medical school. Methods: We conducted an analytical study that included the whole number of students regularly enrolled in their first year of medical school at the university of Parakou in the academic year 2010-2011. Data for the scores for each academic discipline and distinction obtained in the Baccalaureate were collected. Multivariate analysis using logistic regression and multiple linear regression made it possible to determine the best predictors of success and grade point average obtained by students at the end of the year. SPSS Statistics 17.0 was used to analyse data and a p value p < 0.05 was considered significant. Results: Among the 414 students regularly enrolled, we could exploit the data on 407 students. They were aged 15-31 years; 262 (64.4%) were male. 98 were enrolled with a success rate of 23.7%. Concerning men, the scores obtained in mathematics, in physical sciences, the grade point average obtained in the Baccalaureate and honors obtained in the Baccalaureate were associated with their success at the end of the year, but in multivariate analysis only a score in physical sciences > 15/20 was associated with success (OR: 2,8 [1,32-6,00]). Concerning the general average grade obtained at the end of the year, only an honor obtained in the Baccalaureate was associated (standard error of the correlation coefficient: 0,130 Beta =0,370 and p=0,00001). Conclusion: The best predictors of student academic success during the first year were a good grade point average in physical sciences during the Baccalaureate and an honor obtained in the Baccalaureate The inclusion of these elements in the enrollement of first-year students could improve academic performance. [ABSTRACT FROM AUTHOR]