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International audience; Le cancer du sein est le premier cancer chez la femme au Bénin aussi bien en termes d’incidence que de mortalité et affecte des patientes jeunes. Bien que la connaissance des types moléculaires de cancer du sein des femmes béninoises reste encore limitée, les études disponibles montrent clairement que ces femmes font plus de cancers triples négatifs, formes particulièrement agressives. Objectifs: Actuellement, aucune analyse génétique du cancer du sein au Bénin n’a été effectuée et donc aucune information sur les gènes qui abritent le plus souvent des mutations pathogènes dans cette population n’est disponible. Les objectifs de nos travaux sont d’évaluer la survie en fonction du stade de diagnostic, de l’accès au traitement mais aussi d’identifier les gènes du cancer du sein qui abritent le plus souvent des mutations pathogènes dans la population béninoise.Méthodes/Résultats: Les progrès technologiques permettent aujourd’hui de rechercher des mutations sur plusieurs gènes de façon simultanée. Une étude prospective et rétrospective à partir de bloc de paraffine est réalisée, le séquençage à haut débit va nous permettre de tester un ensemble de gènes susceptibles d’intervenir dans la prédisposition au cancer du sein et d’identifier des variations dont il faudra définir le caractère délétère ou non (selon la classification en 5 classes). Afin de classer les variants de signification inconnue potentiellement identifiés lors de cette étude, des tests fonctionnels seront développés. Conclusion: Compte tenu des ressources limitées pour le dépistage chez les béninoises par mammographie, ces informations génétiques sont d’autant plus importantes pour l'identification des femmes présentant un risque particulièrement élevé de cancer du sein, utile pour concentrer les efforts de dépistage et leur proposer un suivi personnalisé.

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Introduction: In sub-Saharan Africa, many older people experience vision impairment (VI) and its adverse health outcomes. In this study, we examined separately the association between VI and each adverse health conditions (cognitive disorders, vision-related quality of life [VRQoL], and daily functioning interference [DFI]) among Congolese older people. We also explored whether VI had a significant effect on VRQoL components in our population. Method: We performed cross-sectional analyses on data from 660 Congolese people aged ≥65 years who participated in the 2013 survey of the EPIDEMCA population-based cohort study. VI was defined as having a near visual acuity Results: VI was not associated with cognitive disorders after adjustment for residence area (adjusted odds ratio = 1.7; 95% confidence interval [CI]: 0.6; 4.7), but it was associated with a low VRQoL score (adjusted β = −12.4; 95% CI: −17.5; −7.3) even after controlling for several covariates. An interaction between VI and age (p = 0.007) was identified, and VI was associated with DFI only among people aged >73 years (adjusted β = 0.5; 95% CI: 0.2; 0.8). Our exploratory analysis showed that all components of VRQoL decreased with a decrease in visual acuity (corrected p ≤ 0.05). Conclusion: VI was associated with poor VRQoL and high DFI. Residence area seems to play a confounding role in the association between VI and cognitive disorders. Our findings suggest that targeting interventions on vision could reduce DFI among older people and improve their well-being.

International audience; Objectives: Older people are vulnerable to mental and cognitive health issues. Studies reported that depressive or anxious older people are more likely to present or to develop dementia over time. The relations between these psychiatric disorders and dementia are poorly explored in sub-Saharan Africa. Therefore, we investigated the association between depression, anxiety and dementia among older people living in two Central Africa countries.Methods: A multicenter cross-sectional study was carried out between 2011 and 2012 in Republic of Congo (ROC) and in Central African Republic among people aged ≥65 years. An annual follow-up was performed only in ROC until 2015. Data were collected using a standardized questionnaire and participants underwent a short physical examination. Depression and anxiety symptoms were collected at baseline and were ascertained using a community version of the Geriatric Mental State (GMS-B3). Probable cases were defined as having a GMS-AGECAT score ≥3. Dementia diagnosis was performed by a neurologist according to DSM-IV criteria. Cross-sectional and longitudinal associations between depression, anxiety and dementia were investigated using logistic and competing-risk regression models respectively.Results: Sample for cross-sectional analyses was 1773 participants (median age: 72 [interquartile range: 67-77] years) and 1053 (59.4%) were female. In total, 650 (36.7%), 133 (7.5%) participants presented respectively depression and anxiety symptoms, and 135 (7.6%) participants were diagnosed with dementia. After accounting for several covariates, depression significantly increased the odds of dementia (adjusted Odds Ratio= 1.62; 95%CI: 1.05-2.50), while anxiety was not associated with dementia (aOR= 0.81; 95%CI: 0.40-1.65). The effects of both psychiatric disorders on dementia incidence within the Congolese participants will be presented in detail.Conclusions: Many Central African older people experience depression more than anxiety and are more likely to present dementia. Promoting and strengthening social support around depressive older people could help to delay or manage dementia in this population.

International audience; Introduction: Depression and anxiety are two very common psychiatric disorders in late-life. They are markers of poor quality of life and are strongly associated with death among older people. Yet, few studies on these comorbidities have been conducted in the African population. This study aims to present the epidemiology of depression and anxiety among older people in Central Africa.Method: A cross-sectional population-based study was carried out in Republic of Congo (ROC) and Central African Republic (CAR) between 2011 - 2012 among older people aged ≥ 65 years (EPIDEMCA study). Data were collected using a standardized questionnaire and participants underwent a brief physical examination. Depression and anxiety symptoms were ascertained using a community version of the Geriatric Mental State (GMS-B3) and the Automated Geriatric Examination for Computer Assisted Taxonomy diagnostic system (AGECAT), probable cases were defined as having a GMS-AGECAT level of 3 or more. Logistic regression models were used to investigate the association between potential risk factors collected and each symptom.Results: Overall 2002 participants were included in the EPIDEMCA study (500 in Brazzaville and 529 in Gamboma in ROC, 500 in Bangui and 473 in Nola (473) in CAR). Median age of the participants was 72 years [interquartile range: 68 – 78 years] and females were mostly represented (61.8%). Prevalence was 38.1% (95% Confidence Interval: 35.9% - 40.2%) for depression, 7.7% (95% CI: 6.5% - 8.9%) for anxiety and 5.7% (95% CI: 4.6% - 6.7%) for the co-occurrence of both disorders. For all three outcomes, prevalence was significantly higher among females and in rural areas. Only depression increased with age. Preliminary analyses showed that female sex, living in a rural area, and living without a partner were associated with the three outcomes (Odds Ratios from 1.59 to 3.27; p

International audience; Objective:It is recognized that some cardiovascular risk factors (CVRF) are involved in poor ocular health. The deleterious effects are potentially more pronounced among older adults. However, it is unknown whether CVRF areassociated independently or not to Visual Impairment (VI) among African older people while both (CVRF and VI) are verycommon in sub-Saharan Africa. Therefore, we investigated the association between CVRF and near VI amongCongolese older people.Methods: Participants were Congolese older people aged ≥ 65 years included in EPIDEMCA-FU (Epidemiology ofDementia in Central Africa - Follow-up) population-based cohort carried out from 2011 to 2015. Visual acuity wasassessed at 30 cm using a Parinaud chart. Near VI was defined as having a visual acuity < 20/40. A cohort design wasused taking all CVRF and covariates at baseline and visual acuity at 1st follow-up. Associations were investigated usingmultivariate logistic regression.Results: 549 participants were included in our analyses. Participants median age was 72 years [interquartile range: 68-78 years] and 331 (60.3%) were females. In total, 378 had near VI (328 had mild/moderate near VI, 38 had severe VI and12 were blind). Prevalence of near VI was 68.8% [95% Confidence Interval: 64.9% - 72.7%] and higher in males (71.1%;95%CI: 65.1% - 77.1%) than females (67.4%; 95% CI: 62.3% - 72.4%). Of the CVRF explored, we found that having highBMI ≥ 25 kg/m2 (adjusted Odds Ratio = 2.31 [95%CI: 1.25 – 4.28]), diabetes (aOR=2.14 [95%CI: 1.07 – 4.29]) andhypertension (aOR=1.65 [95%CI: 1.03 – 2.66]) were independently associated with near VI. However, after adjustmenton cognitive status, hypertension (full-adjusted OR=1.58 [95%CI: 0.97 – 2.58]) was no longer significantly associated withVI. There was no interaction between these CVRF. We found no significant association for alcohol consumption(p=0.541), smoking status (p=0.88), and indirect marker of poor diet (0.33) in our sample.Conclusion: Prevalence of near VI was high among Congolese older people. High BMI, diabetes, and hypertension wereindependently associated to near VI in this population. Our study suggests that these CVRF could represent targets for VIprevention. However, further studies are required to clarify underling mechanisms because these associations may bemediated by the presence of ocular conditions/eye diseases.

International audience; Objective: To study the frequency of neurological disorders associated to HIV infection. Methods: This cross-sectional study was carried out from 16th June to 16th September 2014 and included all 289 HIV-outpatients admitted to the Parakou University hospital. All data were recorded, physical examination was performed and the medical sheet of each patient was assessed. The diagnosis of neurological disorder (central and peripheral) was based on clinical features, past medical history, biological test and CT-scan data after multidisciplinary staff. Epi-data and Epi-Info 6.04C were used to perform analysis. Results: They were 73 (25.3%) male with a mean age of 38.0 years +/− 10.1 years. The mean duration of disease was 48.5 months +/− 37.1 months. 150 (51.9%) of them were at Stage 3 of the disease. All patients (99.7%) were infected by HIV1, 188 (76.1%) had CD4 cells at the onset of the follow-up less than 350 cells/mm3 and 260 (90.0%) were on ART. Among the 289 patients, 110 had at least one neurological disorder, the frequency of neurological disorders was 38.1%. The main neurological disorders were peripheral neuropathy (34.3%), isolated headache (5.2%), stroke (0.7%), cerebral toxoplasmosis (0.7%) and one case of dementia (0.7%). The main associated factors were the age of patient and exposure on neurotoxic drug, especially ART. Conclusion: The neurological disorders were more frequent among HIV patients with a high frequency of peripheral neuropathy probably due to ART.

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International audience; 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. Méthodes: 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. Résultats: 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.

International audience; The main objective of this study was to evaluate the knowledge, attitudes, and practices (KAP) of health sciences students regarding epilepsy at the end of their curriculum in Benin.MethodsWe conducted a cross-sectional survey among medical, pharmacy, nursing, and midwife students in their last year of health sciences training in the University of Abomey-Calavi in Benin. Students completed a self-administered questionnaire, containing items addressing demographics, epilepsy treatment, diagnosis, clinical practice, and social tolerance regarding a person with epilepsy (PWE).ResultsThe response rate to our survey was 87.7% (n = 164). The sample consisted of 64 medical students, 22 pharmacy students, 43 nursing students, and 35 midwife students. They were divided into 95 female subjects and 69 males; sex ratio was 0.7. The mean age of participants was 23.6 ± 1.8 years. The mean scores for epilepsy knowledge, practices, and attitudes were respectively 7.6 ± 1.7 out of a maximum score of 11, 3.9 ± 1.8 out of 8, and 9.6 ± 0.8 out of 10. The KAP overall score was 21.1 ± 3.4 out of a maximum score of 29.0. The variables associated with the overall KAP score were training school, gender, having heard about epilepsy before health sciences studies (p = 0.017), and having a relative with epilepsy (p = 0.001). Male students and medical school students had significantly better overall KAP score than female students or the other training schools respectively (p

International audience; The main objective of this study was to evaluate the knowledge, attitudes, and practices (KAP) of health sciences students regarding epilepsy at the end of their curriculum in Benin.MethodsWe conducted a cross-sectional survey among medical, pharmacy, nursing, and midwife students in their last year of health sciences training in the University of Abomey-Calavi in Benin. Students completed a self-administered questionnaire, containing items addressing demographics, epilepsy treatment, diagnosis, clinical practice, and social tolerance regarding a person with epilepsy (PWE).ResultsThe response rate to our survey was 87.7% (n = 164). The sample consisted of 64 medical students, 22 pharmacy students, 43 nursing students, and 35 midwife students. They were divided into 95 female subjects and 69 males; sex ratio was 0.7. The mean age of participants was 23.6 ± 1.8 years. The mean scores for epilepsy knowledge, practices, and attitudes were respectively 7.6 ± 1.7 out of a maximum score of 11, 3.9 ± 1.8 out of 8, and 9.6 ± 0.8 out of 10. The KAP overall score was 21.1 ± 3.4 out of a maximum score of 29.0. The variables associated with the overall KAP score were training school, gender, having heard about epilepsy before health sciences studies (p = 0.017), and having a relative with epilepsy (p = 0.001). Male students and medical school students had significantly better overall KAP score than female students or the other training schools respectively (p

International audience; 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.

International audience; The main objective of this study was to evaluate the knowledge, attitudes, and practices (KAP) of health sciences students regarding epilepsy at the end of their curriculum in Benin.MethodsWe conducted a cross-sectional survey among medical, pharmacy, nursing, and midwife students in their last year of health sciences training in the University of Abomey-Calavi in Benin. Students completed a self-administered questionnaire, containing items addressing demographics, epilepsy treatment, diagnosis, clinical practice, and social tolerance regarding a person with epilepsy (PWE).ResultsThe response rate to our survey was 87.7% (n = 164). The sample consisted of 64 medical students, 22 pharmacy students, 43 nursing students, and 35 midwife students. They were divided into 95 female subjects and 69 males; sex ratio was 0.7. The mean age of participants was 23.6 ± 1.8 years. The mean scores for epilepsy knowledge, practices, and attitudes were respectively 7.6 ± 1.7 out of a maximum score of 11, 3.9 ± 1.8 out of 8, and 9.6 ± 0.8 out of 10. The KAP overall score was 21.1 ± 3.4 out of a maximum score of 29.0. The variables associated with the overall KAP score were training school, gender, having heard about epilepsy before health sciences studies (p = 0.017), and having a relative with epilepsy (p = 0.001). Male students and medical school students had significantly better overall KAP score than female students or the other training schools respectively (p

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International audience; Background: Sub-Saharan Africa (SSA) is facing a growing burden of cardiovascular diseases (CVD) due to increasing urbanization and changing lifestyle. Available tools for prediction of CVD are adapted from western regions data. So, there is a need for building appropriate tools from SSA population-based cohorts.Purpose: The aim of the pilot phase of TAHES was to explore the feasibility of CVD cohort study in a rural setting in SSA.Methods: TAHES is a prospective cohort ongoing since February 2015 among all people aged 25 years or above living in a village. Risk factors data were collected using a standardized questionnaire adapted from the WHO STEPS instrument through a baseline door-to-door survey, followed by annuals visits. A daily medical network surveillance was implemented for recording events of interest: lower extremity artery disease (LEAD), myocardial infraction, stroke, congestive heart failure and deaths. To offset the low coverage and limited use of modern health services, a community-based surveillance through household and traditional healers weekly visit was added. Community agent notified events and administrated a verbal autopsy in case of death. Lack of street-address and civil registration were fixed by collecting geographic data for each household and identifying each subject using a composite 8 digit ID number, including specifics numbers for area (1 digit), house number (3 digits), household number (2 digits) and individual number (2 digits).Results: During 3 years, 1793 participants were enrolled, equaling to 4068.7 persons years of follow-up. Women represented 61.1% and the mean age was 42.7±16.5 years. Baseline prevalence was 2.3% (95% CI: 1.7%-3.2%) for smoking, 9.15% (95% CI: 7.9%-10.6%) for harmful use of alcohol, 9.3% (95% CI: 8.0%-10.8%) for obesity, 32.1% (95% CI: 29.9%-34.3%) for hypertension, and 3.5% (95% CI: 2.7%-4.5%) for diabetes.Surveillance recorded 9 non-fatal events and 55 deaths. Non-fatal events were stroke (6) and congestive heart failure (3). Causes of death were stroke (14.5%), congestive health failure (9.0%), sudden death (3.6%), LEAD (1.8%), infectious diseases (25.4%), others noncommunicable diseases (25.4%) and undetermined causes (20,0%). The mean age at death occurrence was 71.4±25.2 years. Overall incidence of CVD events was 25 cases equaling to 6.1 cases per 1000 person-year. The CVD mortality rate was 48,0%.Conclusion: A CVD is possible in rural SSA but need adaptation to face local specific challenges. The burden of CVD was high and associated with a high mortality rate.

International audience; Background: Data on epidemiology of lower extremity artery disease (LEAD) in general population in Sub-Saharan Africa (SSA) are sparse.Purpose: This study aims to estimate the prevalence of LEAD among participants of TAHES, a cohort about cardiovascular diseases (CVD) in a rural setting in SSA.Methods: The cohort was launched since 2015 among adults aged over 25 years based on daily follow up for recording events and annual visit for global evaluation. Ankle-brachial index (ABI) was measured for the first time during the third visit in 2017. Data about risk factors were collected using the WHO STEPS adapted questionnaire in a systematic door-to-door survey. The LEAD was defined as ABI 25) (27.7%), raised blood pressure (36.8%) and raised blood glucose (5.4%). Prevalence of LEAD was estimated at 5.5% (95% CI: 4.2%-7.1%) for all, 7.0% (95% CI: 5.1%-9.4%) for women and 3.1% (95% CI: 1.7%-5.5%) for men. Five individuals (0.5%; 95% CI: 0.2%-1.2%) had incompressible arteries (ABI >1.40), including four men. In multivariate analysis, LEAD was significantly associated with age >55 years (OR: 2.17; p=009) and female gender (OR: 2.00; p=0.04).Conclusion: Prevalence of LEAD is high in this population and predominates among women and people over 55 years old.

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International audience; Contexte: L’incidence des maladies cardiovasculaires (MCV) est mal connue en Afrique, et les outils de prévention et de prédiction adaptés des données de l’occident.Objectif: Etudier l’incidence et les facteurs de risque des MCV en population générale au Bénin.Méthodologie: Il s’agit d’une cohorte prospective incluant les sujets de 25 ans et plus vivant à Tanvè au Bénin. Les facteurs de risque de MCV ont été collectés à l'aide d'un questionnaire standardisé adapté de l'instrument STEPS de l'OMS par le biais d'une enquête de base porte-à-porte, suivie de visites annuelles. Une surveillance quotidienne a été mise en place par un réseau sanitaire complété par un réseau communautaire pour enregistrer les 5 événements d'intérêt: artériopathie oblitérante des membres inférieurs (AOMI), infarctus du myocarde (IDM), accident vasculaire cérébral (AVC), insuffisance cardiaque décompensée (ICD) et décès.Résultats: A date, 1793 participants ont été inscrits, équivalent à 4068,7 personnes-années de suivi. Les femmes représentaient 61,1% et l'âge moyen était de 42,7+16,5 ans. Les prévalences était de 2,3 % (IC à 95 %: 1,7-3,2) pour le tabagisme, 9,15 % (IC à 95 %: 7,9-10,6) pour la consommation nocive d'alcool, 9.3% (95%CI: 8,0-10,8) pour l’obésité, 32,1% (95%CI: 29,9-34,3) pour l'hypertension artérielle et 3,5% (95%CI: 2,7-4,5) pour le diabète.Au cours des 3 ans de suivi, 64 événements ont été enregistrés: 55 décès, 6 AVC et 3 ICD. L'âge moyen du décès était de 71,4+25,2 ans. Les MCV représentent 29,0% des causes de décès par l’AVC (8/55), l’ICD (5/55), la mort subite (2/55) et l’AOMI (1/55).L'incidence globale des MCV était de 25 cas, soit 6,1 cas par 1 000 personnes-année. Le taux de mortalité due aux MCV était de 48,0 %.Conclusion: Les maladies cardiovasculaires ont un lourd fardeau pour cette population rurale et sont associées à un taux de mortalité élevé.

International audience; L’association des troubles du comportement aux troubles cognitifs est fréquente. Leur apparition témoigne souvent de l’aggravation de la maladie. Il existe peu d’études sur ces symptômes chez les sujets âgés en Afrique.L’objectif général de nos travaux est de contribuer à une meilleure connaissance et une meilleure prise en charge des troubles du comportement chez les sujets âgés (déments ou non) en Afrique subsaharienne.Les objectifs spécifiques sont de :1- Décrire les troubles du comportement chez les sujets âgés,2- Evaluer l’association entre les troubles du comportement et le déclin cognitif,3- Evaluer la faisabilité des interventions de psychosocio-éducation sur le fardeau de l’aidant de la personne démente.Nos travaux s’inscrivent dans la suite des travaux des programmes EPIDEMCA et EPIDEMCA-FU qui avaient pour but de contribuer à une amélioration des connaissances des démences et de la maladie d’Alzheimer (MA) dans deux pays d’Afrique Centrale.Une étude transversale multicentrique en population générale a été menée de Novembre 2011 à Décembre 2012 en zones rurales et urbaines des dits pays. Les enquêtes étaient en 2 phases : dépistage des troubles cognitifs puis confirmation du diagnostic de démence. Notre étude a inclus les participants à la deuxième phase ayant bénéficié de l’inventaire neuropsychiatrique qui évalue les troubles du comportement.Notre premier objectif a fait l’objet d’une étude qui a été valorisée à travers deux communications orales, deux posters et la rédaction d’un article en attente de soumission.Pour le deuxième objectif, une étude sur l’association entre l’Apolipoprotéine E et les troubles du comportement fera l’objet d’un e-poster en Mars 2018.Le 3ième objectif quant à lui a abouti à la rédaction d’un projet sur la faisabilité d’une intervention psychosocio-éducative sur les aidants de la personne démente. Ce projet est en attente de soumission à des appels à projets.

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International audience; Objective: We aim to study the relationship between migraine and obesity at Titirou in Parakou in 2017. Method: It was a case-control study which included 66 migrainers according to International Headache Society (IHS) criteria 2013 (case) matched to 132 controls by age, sex and residence. Size and weight have been measured in each subject. Body mass index has been calculated. Migraine history and sociodemographic information have been collected from 1st May to 31st August 2017 and analyzed by using Epi Info 7 software. The association between migraine and obesity was estimated by odds ratio and their confidence interval. Results: There has been no difference among those suffering from migraine and controls according to sociodemographic characteritics. Obesity has significantly been associated with migraine with OR 4.24 (1.93 - 9.25). The weight more than 70 Kg has been associated with the migraine with OR: 2.02 (1.06 - 3.90). The overweight and obesity have been associated with migraine OR with respectively 1.9 (1.1 - 3.9) and 4.4 (2.0 - 9.5). No difference has been found between migraine and the clinical characteristics of migraine (type, severity, intensity). Conclusion: Obesity has been associated with migraine and has to be taken into account in migraine management.

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International audience; Introduction: La migraine est une maladie neurologique fréquente en population, source de handicap et classée 13ème des affections les plus handicapantes par l’OMS. L’objectif de cette étude était d’étudier la prévalence de la migraine à Titirou en 2017. Méthodes: Il s’est agi d’une étude transversale de type porte-à-porte menée sur 2065 sujets âgés de 18 à 65 ans. L’enquête a été effectuée sur une période de 4 mois allant du 10 avril au 05 août 2017. Les critères diagnostiques de l’International Headache Society (IHS) de 2013 ont servi de base pour le diagnostic de la migraine. Les informations sociodémographiques, le poids et taille et les données relatives à la fréquence et l’intensité des céphalées furent collectés. Les données ont été saisies, traitées et analysées grâce au logiciel Epi Info version 2.2.0.165. Résultats: Il y avait une prédominance masculine avec un sex-ratio de 1,41. Les sujets étaient âgés de 18 à 65 ans avec une moyenne d’âge de 31,87±8,37ans. La prévalence des céphalées était de 63,49%. La prévalence de la migraine à Titirou était de 3,82% [IC95% : (3,06%-4,72%)] (79 sur les 2065). Les facteurs associés à la migraine étaient l’âge (p=0,0026), le sexe (p=0,0001), le niveau d’instruction (p=0,0039), la profession (p

International audience; Background:The literature on amyotrophic lateral sclerosis (ALS) in Africa is limited. A few studies have been performed, mostly case series with variable methodology, sample sizes and data collection (1). In recent years, there has been increased interest in the epidemiologic and phenotypic variability of ALS among different populations (23).Objective:We aimed to describe and compare demographics, clinical features, management and survival of ALS in Africa.Methods:A hospital-based multi-centre cohort study was undertaken in African countries. ALS patients diagnosed from 2005 to 2017 in the participant centres were included. An ALS expert neurologist confirmed the diagnosis through medical records. Patients were categorized at diagnosis according to El Escorial revised criteria and follow-up assessments were performed. Descriptiveand analytical statistics were conducted. Subgroup analyses were performed according to subcontinent, based on the United Nations Statistics Division. Survival analyses were carried out with the Kaplan-Meier method.Results:10 centres from 89 African countries participated. An overall 185 patients were included: 114 in Northern Africa, 30 in Southern Africa and 41 in Western Africa. A male predominance was found with a sex ratio (male/female) of 2.9 overall. Median age at onset was 54 years (interquartile range (IQR) 4 64). Western African patients had younger age at onset (47 years) compared with Northern and Southern Africa, p¼ 0.0001. Themedian diagnostic delay was 12 months. Onset was bulbar in 22.7% of cases. Median ALS Functional Rating Scale Revised (ALSFRS-R) was 38 at diagnosis. 59 cases presented with atypical signs (32%), of which nearly 40% had cognitive impairment. Concerning the management, 80% had a medical or traditional treatment. However, only 47 cases had access to riluzole, mostly in Northern Africa. Overall, the median survival sincediagnosis was 14 months. Longer survival was observed in Northern Africa with a median of 19 months compared with Southern Africa (11 months) and Western Africa (6 months), log rank p¼ 0.001.Conclusions:This is the first ALS multi-centre cohort study in African countries. Our research contributes to improving the clinical and survival understanding of ALS in Africa. However, we are aware that hospital-based studies are limited by selection bias. Further studies are needed to clarify variability in clinical features. Genetic research should also be included for a more comprehensive approach on ALS in African populations.

International audience; Introductionles affections neurologiques constituent un véritable problème de santé publique d’où la nécessité de disposer de données épidémiologiques en population générale au Bénin.Objectifsdéterminer la prévalence des principales affections neurologiques et les facteurs associés chez les sujets de 15 ans et plus, dans le 3ème arrondissement de Cotonou.Patients et méthodesIl s’agissait d’une étude prospective transversale à visée descriptive et analytique conduite de septembre à Octobre 2015. Elle a porté sur 1050 sujets sélectionnés selon la technique de sondage aléatoire à 4 degrés et s’est déroulée en 2 phases. La première était celle de l’enquête porte à porte à l’aide du questionnaire Bower JH en vue de la détection des cas suspects. La seconde était celle de la confirmation des cas par un neurologue. Les données étaient saisies et analysées avec Epi-info 7.1.5.0.RésultatsLa prévalence des principales affections neurologiques était de 40,5 %. Celle des céphalées était de 35,6 % dont 24,8 % de céphalée de tension et 10,9 % de migraine. 4,3 % présentait une neuropathie périphérique ; 1,2 % avait un accident vasculaire cérébral (AVC), 1 % était épileptique. La prévalence des démences et du syndrome parkinsonien était de 0,2 %. Les facteurs associés aux affections neurologiques étaient le niveau d’instruction (p = 0,02), la profession (p = 0,01) et l’âge (p = 0,0008).DiscussionLes affections neurologiques sont assez fréquentes dans notre population et corroborent les résultats retrouvés en Afrique. Par contre, cette prévalence est plus faible en occident que dans notre étude. Ce constat s’explique par l’absence de consultation des populations au Bénin en cas d’affections neurologiques et donc un défaut de prise en charge.ConclusionCette étude a permis de se rapprocher de la population pour la détermination des affections neurologiques qu’elle présente et dote le Bénin de données épidémiologiques exploitables pour la prise de décision.

International audience; Introduction : La littérature sur la Sclérose Latérale Amyotrophique (SLA) en Afrique est limitée (1). La variabilité épidémiologique et phénotypique dans différentes populations suscite un intérêt croissant (2,3).Objectif : Décrire et comparer les facteurs sociodémographiques, cliniques, la prise en charge et la survie des patients atteints de SLA en Afrique.Méthodes : Une étude multicentrique de cohorte hospitalière a été mise en place dans des pays d’Afrique. Les patients des différents centres, dont le diagnostic a été réalisé de 2005 à 2017 ont été inclus. Les critères d’El Escorial révisés ont été utilisés pour catégoriser les patients et des suivis ont été réalisés. Les analyses en sous-groupes ont été réalisées selon la classification en sous-continent (ONU). L'estimation de la survie est effectuée par la méthode de Kaplan-Meier.Résultats : Dix centres de huit pays africains ont participé. 185 patients ont été inclus : 114 en Afrique du Nord, 30 en Afrique Australe et 41 en Afrique de l'Ouest. On remarque une prédominance masculine nette (sex-ratio : 2,9), un âge médian de début de 54 ans. Les patients d'Afrique de l'Ouest ont eu un âge plus jeune de début par rapport à ceux de l'Afrique du Nord et de l'Afrique Australe, p = 0,0001. Le début bulbaire est présent dans 22.7% des cas. La médiane du ALSFRS-R était de 38 au diagnostic. Peu de patients ont eu accès au Riluzole (26%), et la plupart était en Afrique du Nord. La survie médiane était de 14 mois. Une survie plus longue a été observée en Afrique du Nord par rapport à l'Afrique Australe et à l'Afrique de l'Ouest, log rang p = 0,001.Conclusion : C’est la première étude multicentrique de cohorte hospitalière en Afrique qui contribuera à améliorer la compréhension clinique et de la survie de la SLA en Afrique.

International audience; IntroductionL’estimation des apports alimentaires en sodium (Na) et potassium (K) repose sur plusieurs méthodes : études de portions témoins, enquêtes alimentaires et prélèvements urinaires. Le dosage sur les urines de 24 heures est considéré comme le « mètre-étalon », étant donné que 85 à 90 % du sodium ingéré est excrété dans les urines. Du fait de la contrainte majeure de cette méthode qu’est le recueil complet de toutes les urines émises pendant 24 heures, le spot urinaire est parfois utilisé dans les enquêtes épidémiologiques. L’objectif de cette étude était de déterminer la concordance entre les mesures d’un spot urinaire et celles des urines de 24 heures pour estimer la consommation alimentaire de sodium et de potassium.MéthodesEn zones rurale (Tanvé) et urbaine (Bohicon) au Bénin, 402 sujets, âgés de 25 à 64 ans, sex-ratio = 1, ont été sélectionnés par un sondage en grappes avec probabilité proportionnelle à la taille (PPT). Un spot urinaire était prélevé lors de la deuxième urine de la matinée chez chaque participant ayant consenti librement et respectant les conditions de l’étude. Un second recueil d’urines de 24 heures était collecté dans des contenants plastiques maintenus fermés. Les heures de début et de fin de collecte étaient soigneusement marquées. Des échantillons d’urine de 2 mL étaient prélevés puis conservés immédiatement à −20° jusqu’à leur acheminement au laboratoire de biochimie et de génétique moléculaire du CHU de Limoges. Ils étaient dosés par potentiométrie (méthode de Jaffé). La créatinine était également dosée pour valider les valeurs de sodium et potassium. La consommation prévisionnelle du sodium et du potassium à partir du spot urinaire est calculée par la formule :Na prévisionnel (g) = [Na spot (g) × Créatinine 24 h (mg)]/Créatinine spot (mg)K prévisionnel (g) = [K spot (g) × Créatinine 24 h (mg)]/Créatinine spot (mg)La concordance entre les mesures du spot urinaire et celles des urines de 24 heures est effectuée par le graphique de Bland-Altman.RésultatsAu total, 354 résultats ont été analysés ; 48 résultats de sodium et potassium ont été éliminés pour les raisons suivantes : valeurs de créatinine faible (n = 30), usage de diurétique (n = 1), glucosurie positive (n = 7), rejet par le laboratoire d’analyse (n = 10). Les consommations moyennes de sodium et de potassium au sein de la population générale étaient respectivement de 10,2 ± 4,9 g et 2,9 ± 1,4 g. Les consommations prévisionnelles moyennes de sodium et de potassium calculées à partir du spot étaient respectivement de 10,7 ± 7 g et 3,9 ± 2,1 g. La concordance entre les mesures du spot urinaire et celle des urines de 24 heures était globalement bonne pour le sodium et le potassium. Les coefficients de concordance étaient respectivement de 0,61 avec d = −0,5, (d ± 2 sdd = −11 et 10,1) pour le sodium et de 0,61 avec d = −1, (d ± 2 sdd = −3,8 et 1,8).ConclusionL’étude montrait que la concordance par le graphe de Bland-Altman pour les mesures du spot urinaire et celles des urines de 24 heures était bonne pour le sodium et le potassium. Cependant le spot urinaire surévaluait les valeurs du sodium.

International audience

International audience

International audience; Despite the development of knowledge in diagnosis and therapeutic of epilepsy it remains to be cause of rejection and stigma. We aimed to study the knowledge, attitude and practice toward epilepsy and the stigma in a rural community. The cross-sectional study was carried out from 1st to 31st March 2011 in a rural community (Tourou) at Parakou in the northern Benin. It was a door-to-door survey and included 1 031 adults older than 15 years. The diagnosis of epilepsy was based on International League Against Epilepsy. The specific questionnaire was used and comprised 16 items which explored knowledge, attitude and practice toward epilepsy. Another questionnaire was developed to study stigma among epileptics. The associated factors to the misconception toward epilepsy have been studied. All adults have heard about epilepsy and knew the generalized tonic-clonic form of epilepsy and knew someone with epilepsy. Hereditary (98%) and witchcraft (97.9%) and social problems (65.9%) were mentioned as the most cause of epilepsy. Epilepsy was cited as contagious disease by 90.6% of respondents and the associated factors were the sex (p=0.005) and occupational status (0.024). The saliva (98.1%) and witness of the place of seizure (97.8%) were the frequently mentioned modes of transmission. 65% of all mentioned that epileptics can not get marriage and the main associated factors to this belief were the advanced age (p=0.008) and occupational status (0.004). 64.4% believed that children with epilepsy shouldn't be attend to school, age (0.004), ethnicity (0.047) and occupational status were the associated factors with this misconception. Despite 99.4% considered epilepsy as treatable disease only 12.7% would have referred epileptics to the hospital. All the seven epileptics considered themselves as victims of stigma and rejected by their family and the community. The misconceptions associated to the epilepsy can explain the stigma and the therapeutic gap in this rural community.

International audience

International audience

International audience

International audience

International audience