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Since December 2019, the pandemic caused by coronavirus disease 2019 (COVID-19) raises a real public health problem. COVID-19 appeared in Wuhan (Hubei province) in China. Drugs that have been used in rheumatology for decades seem to be effective in this infection and are for the most part being studied. The rational use of these anti-rheumatic drugs is based on the cytokinic storm (hyperproduction of IL1, IL6, TNF α) in the body by COVID-19 in its severe form. In this review, the authors make the difference between the infectious and auto-inflammatory part of COVID-19; the disease does not seem to be a risk factor for admission to the intensive care unit for patients suffering from inflammatory rheumatism; however, the poverty of studies on this subject should be noted. The authors also review anti-rheumatic drugs while studying COVID-19 treatment.

Objective: This study was focused on depression rate and associated factors in chronic lumbosciatica in sub-Saharan African black patients. Patients and Methods: We conducted a prospective descriptive and analytical study in chronic lumbosciatica cases seen in rheumatology/internal medicine, neurology and neurosurgery departement at the Yalgado ouedraogo University Hospital Center from April 31, 2016 to July 31, 2016. The diagnosis of depression was based on Hamilton scale. Its frequency was evaluated and the associated factors were analyzed. Results: One hundred and forty-nine patients were included in the study. Their average age was 49.5 years and the sex ratio was 0.42 (44 men/105 women). Thirty-eight patients lived alone (25.5%). Pain intensity was severe in 46 patients (30.9%) and moderate in 77 patients (51.7%). Neuropathic pain was present in 108 patients (72.5%). One hundred and ten patients had depression (73.8%). Depression was severe in 38 patients (25.5%), moderate in 35 patients (23.5%), and mild in 37 patients (24.8%). Factors associated with depression were living alone (Odds-Ratio 3.5), high (Odds-Ratio 11.1) or moderate (Odds-Ratio 5.9) intensity of pain, and the presence of neuropathic pain (Odds-Ratio 2.5). Conclusion: Depression was frequent during chronic lumbosciatica in sub-Saharan African black patients. Its associated factors were living alone, presence of moderate or severe pain, and neuropathic pain.

Objective: To study the frequency and factors associated with depression in rheumatoid arthritis (RA) among Black African patients. Patients and methods: It was a case-control study with a group of patients with RA (case) and a group of healthy subjects without rheumatoid arthritis (con-trols) matched by age and sex. All patients admitted to the rheumatologic department during February 2015 to July 2015 for rheumatoid arthritis meeting the criteria ACR/EULAR 2010, were included. Patients with high blood pressure, diabetes mellitus, renal failure or HIV infection have been excluded. Depression was assessed by the Hamilton Rating Scale for Depression. Results: Fifty patients with RA were included and compared to 100 healthy controls. For RA patients, it was 39 (78%) female and 11 (22%) male with a sex ratio of 0.28. In the control group, it was 77 (77%) female and 23 (23%) male with a sex ratio of 0.29. Twenty-seven (54%) patients with RA had depression compared with 17 (17%) subjects in the control group (p = 0.000). Impaired quality of life and a DAS 28 score greater than 3.2 were statistically associated with depression during RA with a p value respectively of 0.021 and 0.0000231. Conclusion: Depres-sion is significantly more common during RA than in non-RA controls. RA patients should be screened routinely for depression in order to ensure improved treatment and management.

Coronavirus disease 2019 (COVID-19) is a viral infection that appeared in December 2019. The risk of infection seems to be increased in chronic inflammatory rheumatic diseases due to both immune disturbances related to the disease and treatment. In this case report, we describe the clinical features of 5 rheumatic immune disease patients with the concomitant presence of COVID-19. Among these patients, 3 had rheumatoid arthritis and 2 had systemic lupus erythematosus. Patients’ age ranged between 38 and 63 years. Only one patient (SLE) had a severe subtype of COVID-19. All the patients were cured of COVID-19 and were subsequently discharged.

Introduction: A bite from another human is an unusual cause of maxillo-facial traumatology. Our objective was to describe the epidemiologic and clinical characteristics of labial lesions caused by this kind of bite. Patients and methods: A descriptive prospective study was carried out at the University hospitals of Yalgado OUEDRAOGO and Blaise COMPAORE in Ouagadougou in Burkina Faso between June 2012 and May 2017. Results: We collected a sample of 28 patients with an average age of 32.5 years. The sex ratio was about 0.3. All the bites had been inflicted by women. The victims generally came from an underprivileged socioprofessional background. The bite had occurred during a brawl in 26 patients (92.9% cases) and in some context of aggression among 2 patients. The lesions were located on the lower lip among 21 patients, the upper lip among 4 patients, and along the commissure among 3 patients and resulted in a loss of tissue among 23 patients (82.1%). The treatment was surgical in nature, using trimming and labialization with satisfactory results in all cases. Conclusion: The circumstances surrounding the bites are not always clear and the lesions are almost always serious and require delicate treatment.

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

La varicelle est une virose dont l'épidémiologie est mal connue au Burkina Faso. Cette étude s'est donnée pour objectif de décrire le profil hospitalier de la pathologie dans le service des maladies infectieuses du Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU-YO). Il s'est agi d'une série de 19 patients hospitalisés entre le 1er janvier 2005 et le 31 décembre 2014. Ont été inclus, tous les patients avec un dossier complet et exploitable, dont le diagnostic positif de varicelle a été fait. La proportion périodique de varicelle était de 6,2% et a représenté 14,6% des éruptions fébriles. Elle était plus fréquente en 2011, de janvier à mars. L'âge médian était de 19 ans, et la moitié des patients avaient entre 6 et 30 ans. Les comorbidités étaient dominées par l'infection à VIH et l'herpès. Sur le plan clinique, la fièvre et le prurit étaient les symptômes communs et la vésicule la principale éruption. A l'admission, les principales complications étaient pulmonaires, hématologiques et cutanées. La durée médiane d'hospitalisation était de 5 jours, avec des extrêmes de 0 et 13 jours. Les principaux traitements étaient antiviral dans 9 cas, antipyrétique dans 19 cas, local dans 17 cas et antihistaminique dans 11 cas. Sur 19 cas de varicelle, 14 ont guéri et deux sont décédés, dont un adulte sur 10 et 1 enfant sur 9. Si la varicelle est une affection habituellement bénigne, elle peut être fatale chez l'adulte et l'enfant en cas de complications graves.

Objective: To study the quality of life of patients with knee OA with the questionnaire OAKHQOL (OsteoArthritis of Knee Hip Quality Of Life). Patients and Methods: This was a cross-sectional study over a period of six months, in patients with symptomatic knee osteoarthritis. All patients met the clinical and radiological criteria of the ACR. The OAKHQOL questionnaire was used to investigate the quality of life of patients. Results: One hundred and six patients were included. There were 94 (88.7%) women and 12 (11.3%) men with a sex ratio of 0.12. The average age of patients was 55 ± 10.4 years. The average pain intensity was 55.1 ± 22.4. The majority of patients (69.8%) had stage 3 of Kellgren and Lawrence classification. The dimension “pain” had the lowest normalized score (60.6). There was a significant correlation between the age range of 30 to 40 years and declining mental health (49.5) . The patients with over 60 years of age had a decrease in pain tolerance and reduced social activities. Lequesne score was associated with severe all dimensions except “social support” of the patient. Conclusion: The knee has an impact on quality of life of patients followed in rheumatology by OAKHQOL questionnaire.

Le psoriasis est une dermatose inflammatoire erythemato-squameuse, d’evolution chronique. Ses aspects sociodemographiques et ses variantes cliniques sont peu connus en Afrique de l’ouest. Il s’est agit d’une etude retrospective et prospective menee du 1er janvier 2009 au 30 juin 2012. Tous les patients qui avaient un dossier exploitable etaient inclus. Nous avons recense 94 cas de psoriasis sur 14952 consultants, soit une prevalence hospitaliere de 0,62%. Mais 84 cas repondaient aux criteres d’inclusion. L’âge moyen des patients etait de 34,53 ans, le sex-ratio de 1,47. Les menageres, les eleves et les fonctionnaires etaient les plus representes. Le prurit etait retrouve dans 54,8% des cas. Les lesions elementaires cutanees etaient surtout erythemato-squameuses (79 cas). Celles ungueales etaient surtout a type de depression cupuliforme (8 cas). Le cuir chevelu, les coudes et les genoux etaient les zones bastions les plus touchees (respectivement 53,57%, 45,23%, et 40,47%). Le psoriasis etait vulgaire dans 30 cas et grave dans 7 cas. L’examen histopathologique etait realise chez 11 patients. Malgre certaines insuffisances de description qui ne nous ont pas permis de calculer le score de PASI, cette etude a atteint ses objectifs. Les particularites de cette serie etaient la predominance masculine, la prevalence elevee du prurit et l’atteinte elevee du cuir chevelu. Les formes graves de psoriasis doivent faire rechercher une association a l’infection a VIH. Une etude en population permettrait de determiner avec exactitude la prevalence du psoriasis au Burkina Faso. Pan African Medical Journal 2016; 23:110

Joint Bone Spine - In Press.Proof corrected by the author Available online since vendredi 18 mars 2016

Resume L'atteinte du rachis cervical est habituelle mais le plus souvent tardive au cours du rhumatisme psoriasique. Nous rapportons deux observations ou l'atteinte cervicale etait precoce et dominait le tableau clinique. Les lesions cervicales touchaient le rachis cervical superieur avec une synovite periodontoidienne et une arthrite des articulations interapophysaires dans le premier cas et une arthropathie erosive de C1–C2 et de l'odontoide avec luxation atloidoaxoidienne dans le second cas. Il n'y avait pas de lesion articulaire peripherique, sacro-iliaque, dorsale ou lombaire. Les antalgiques et les anti-inflammatoires usuels etaient peu efficaces. Le traitement par anti-TNF alpha (infliximab puis etarnacept) dans un cas et par butazolidine dans le second cas ont permis d'amender la symptomatologie et de faire regresser le pannus.

Psoriatic arthritis was infrequently reported in sub-Saharan Africa before the HIV pandemic. Here, we review the available data on the prevalence of psoriatic arthritis in sub-Saharan Africa. No population-based data on the prevalence of psoriasis are available for this part of the continent. Hospital-based studies, nearly all of which were done in dermatology departments, found prevalences of 0.05 to 0.9% in West Africa and 2.8 to 3.5% in South Africa. These substantially lower values compared to those reported in Caucasians despite a higher frequency of the HLA-CW6 allele in black Africans (15.1%) than in Caucasians (9.6%) suggests a role for other factors, which may be environmental and/or genetic. The prevalence of psoriasis seems to have increased markedly in the HIV era (5.15% among HIV-positive individuals). The prevalence of psoriatic arthritis in the general population of sub-Saharan Africa is unknown. Psoriatic arthritis was reported before the beginning of the HIV pandemic (41.6% among 61 patients with psoriasis. Several cases of psoriatic arthritis were identified in HIV-positive individuals (40 to 96%) in hospital-based studies, many of which had small sample sizes. The available studies were biased by limitations to healthcare service access by the population, variability in the diagnostic criteria used, and the sometimes atypical presentation of cutaneous psoriasis, particularly in HIV-positive patients. Thus, the association between psoriatic arthritis and HIV infection deserves to be studied further in sub-Saharan Africa.

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

To describe the semiological and immunological features of connective tissue diseases seen at the Yalgado Ouedraogo University Hospital in Ouagadougou. A retrospective study reviewed the records of patients seen in the hospital dermatology and internal medicine departments from January 1, 2004, through December 31, 2009 and diagnosed with systemic lupus erythematosus (SLE), systemic sclerosis (ScS), dermatopolymyositis (DPM), primary Gougerot-Sjogren disease (GS), polymyositis (PM) or indeterminate connective tissue disease (ICTD) meeting the criteria of the American College of Rheumatology. The study included 42 patients, 36 women and 6 men. Their mean age was 41.2 years ±11.97 (range: 15-75). SLE was the diagnosis for 10 patients, ScS for 14, DPM for 7, primary GS for 1, PM for 1, and ICTD for 9. Hematologic (93%), cutaneous (88%), and rheumatologic (81%) abnormalities were the most frequent manifestations. The specific auto-antibodies associated with SLE patients were: anti-native DNA (3/6), anti-Sm (3/6), anti-RNP (3/6), and anti-SSA (4/6); anti-Scl 70 antibodies were present in 5 patients with ScS. Connective tissue diseases seem to be rare in Africa, south of the Sahara. However, the very fragmentary studies and the weak healthcare coverage do not allow any definitive conclusions.

In some developing countries wire is still widely used in facial fractures internal fixation. This study presents the effectiveness and complications of wire osteosynthesis in a university teaching hospital in Burkina Faso and discusses some of its other benefits and disadvantages. Notes of 227 patients with facial fractures treated by wire internal fixation at department of stomatology and maxillofacial surgery of CHU Souro Sanou, Burkina Faso between 2006 and 2010 are reviewed retrospectively. A satisfactory treatment outcome was recorded in 91.2% of the 227 patients. Complications occurred in 8.8% of the patients who had operative site infection (3.1%), malocclusion (1.8%), sensory disturbance (1.8), facial asymmetry (1.3%), delayed bone union (0.9%) or enophtalmos (0.4%). The overall complications rate was 7.4% after mandibular osteosynthesis, 6.9% after Le Fort osteosynthesis and 6.5% after zygoma osteosynthesis. Post operative infections occurred irrespective to the surgical site. The other complications were more specific to the surgical site. Wire internal fixation may be a reasonable alternative for the surgical treatment of non-comminuted facial fractures and those without bone substance loss, in the setting of limited resources.

Resume Nous rapportons un cas de sclerodermie diffuse (atteinte cutanee, articulaire, œsophagienne, syndrome de Raynaud) chez un homme caucasien de 41 ans atteint d’une spondylarthrite ankylosante (SPA) depuis 15 ans dont l’evolution a ete marquee par la survenue d’une myocardite severe en 2003 d’origine indeterminee. Le typage HLA a mis en evidence a la fois l’allele B 27 de susceptibilite a la SPA et les alleles B35, DRB1 11 et DQB1 03 decrits pour etre associes a la sclerodermie. Notre observation vient confirmer la possibilite d’une association de deux rhumatismes inflammatoires chez un meme individu d’autant que celui-ci possede un ou deux alleles de susceptibilite a ces deux maladies.

To study the prevalence and semiotic characteristics of neuropathic pain in the common low back pain to the Black African subject. This was a prospective cross-sectional survey carried on from April 1 2009 to August 31 2009 in consultations of rheumatology, neurology, and neurosurgery at the University Hospital Yalgado Ouedraogo in Ouagadougou (Burkina Faso). All patients with a low back pain or a common lomboradiculalgie were included. DN4 questionnaire was used for the diagnosis of neuropathic pain. One hundred and seven patients have been recruited during the study period; Sixty-four (59.80%) were female (sex ratio M/F: 0.67). The average age was 34.11 ± 13.46 years of age with extremes of 20 and 79. The average duration of disease was 48.53 months with extremes of 10 days and 50 years. Eighty-seven patients (81.31%) had a disease duration, which was 3 months longer. Sixty-six patients (61.70%) had a predominant lomboradiculalgie; among the remaining 41, low back pain predominated. Average intensity of pain was 62.81 ± 22.43 (on a scale of 100). A sign of Laseque was present in the 41 (38.30%) patients. Fifty-three (49.5%) patients had a neuropathic pain. The prevalence of neuropathy signs according to the DN4 questionnaire was as follows: burning (n = 37; 34.58%), painful cold (n = 13; 12.15%), electric shocks (n = 31; 38.97%), pins and needles (n = 34; 31.77%), tingling (n = 35; 32.71%), numbness (n = 45; 42.05%), itching (n = 18; 16.82%), touch hypoesthesia (n = 35; 32.71%), pinprick (n = 33; 30.84%), and tactile allodynia (n = 21; 19.62%). Among the studied variables, the presence of a radiculalgy was statistically associated with neuropathic pain. The lomboradiculalgie of the Black African subject associates neuropathic pain observed in half of patients. Treatment must therefore always take account of this association. However, further studies are needed before any definitive conclusion.

The objective of this work was to study the clinical and serological profiles of rheumatoid arthritis in Burkina Faso (West Africa). It is a cross-sectional study conducted from March 2006 to February 2009 in the Internal Medicine Department of the University Hospital Yalgado Ouedraogo. All patients seen in the rheumatologic consultation unit during this period, with rheumatoid arthritis fulfilling the ACR criteria, were routinely selected. The determination of anticyclic citrullinated peptide antibodies (ACPA) was carried out with a computerized method (Elia CCP, Phadia AB, Uppsala, Sweden). Values higher than 10 IU/l were considered positive. Forty-eight cases of rheumatoid arthritis (RA) were recruited throughout the study period among 2,194 (2.2 %) patients. Forty-two files were subjected to the study. There were 34 women and 8 men. The average age was 41.70 ± 13 years with extremes of 22 and 71 years. The average duration of the disease was 86.17 ± 82.01 months with extremes of 8 and 360 months. Rheumatoid factors (RF) were positive in 21 out of 30 patients (70.0%). The determination of ACPA carried out in all the patients was positive in 34 (81%) patients; their average value was 217 IU/l with extremes of 38 and 1,170. RF and ACPA were associated to bones erosions (p = 0.0001). Twenty-two patients were placed on methotrexate, eight on hydroxychloroquine, and three on salazopyrine. Nine were given only NSAIDs or prednisolone. No patients had had a biotherapy agent. The frequency of RA was low in our study compared to other African studies published so far. The particularity of RA cases reported in African series, including ours, is the rarity of extra-articular manifestations of the disease. The severity of the disease at presentation in the rheumatology clinic may be due to their late consultation among other causes.

The aim of this work was to study ankylosing spondylitis (AS) prevalence and its clinical, radiological and genetic features in Ouagadougou. This was a cross-sectional study over two first years of rheumatologic practice (March 2006 to March 2008). All the patients having AS met the modified criteria of New York. HIV serology was negative. Thirteen cases of AS (0.9%) with 11 men were diagnosed among 1,439 rheumatologic patients. The average age of the patients at the beginning of the disease was 27.1 +/- 11.5 years. Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index mean scores were, respectively, 47.8/100 and 44.46/100. No patient had presented extra-articular manifestations. Four (31%) patients had hip joint involvement. HLA B 27, among 11 patients, was positive in six (55%). Semiological features of AS among patients seen in Ouagadougou were similar to those of white race. HLA B27 prevalence in AS patients of Burkina Faso was similar to those of Afro-Americans.

We report a case of diffuse systemic sclerosis (skin, joints, esophagus, and Raynaud's phenomenon) in a 41-year-old Caucasian male with a 15-year history of ankylosing spondylitis and an episode of severe myocarditis of unknown origin. His HLA type included both the B27 allele conferring susceptibility to ankylosing spondylitis and the B35, DRB1 11, and DQB1 03 described as associated with systemic sclerosis. This case-report confirms that two inflammatory joint diseases may co-exist, particularly in patients carrying one or two susceptibility alleles to both diseases.

Cervical spine involvement is common but usually delayed in patients with psoriatic arthritis. We report two cases with early and predominant involvement of the upper cervical spine. Synovitis of the atlanto-odontoid joint and fusion of multiple facet joints were noted in one patient. In the other patient, the main finding was atlanto-axial subluxation with erosions of the odontoid process and anterior arch of C1. No abnormalities were noted in the peripheral joints, sacroiliac joints, or thoracolumbar spine. Analgesics and conventional antiinflammatory agents were only minimally effective. TNFalpha antagonist therapy (infliximab followed by etanercept) in one patient and phenylbutazone therapy in the other improved the symptoms and led to shrinkage of the pannus.

Septic arthritis is a medical emergency. The causative organisms are primarily staphylococcus and streptococcus. Aeromonas hydrophila septic arthritis seems to be rare. We report one case observed in a 58-year-old patient infected with HIV serotype 1 and treated by zidovudine, lamivudine and nevirapine. CD4 count was 413 cells per microliter and viral load undetectable. Two blood cultures were A. hydrophila positive. The evolution was favorable after treatment by ceftriaxone and gentamicin.