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To determine, with the use of the Mini-International Neuropsychiatric Interview (MINI), the prevalence of mental disorders in the general population of Burkina Faso; To identify the factors associated with the occurrence of these disorders.We conducted a cross-sectional descriptive and analytical survey of a representative sample of the general population aged 18 years and over (n=2587). The only non-inclusion criterion was absence from the place of residence during the investigation period for whatever reason. This approach allowed us to select at random 840 households with a total number of 2587 persons aged 18 years and over. The data collection tools we used were a written questionnaire, developed by ourselves, and the Mini International Neuropsychiatric Interview or MINI questionnaire. On the ethical level, the protocol of this research and its appendices have received the prior approval of the Ethics Committee for Health Research of Burkina Faso as well as support from local customary and administrative authorities.The surveyed population consisted of 1 479 women (57.17 %) and 1108 men (42.83 %). Of the 2 587 people surveyed, 1 072 or 41.43 % met the criteria for at least one of the mental disorders. The prevalence rate was significantly higher among women than men (46.24 % versus 35.01 %). The depressive episode was the most frequent disorder in the surveyed population (11.60 %). Gender, place of residence and marital status were the main factors significantly associated with the occurrence of mental disorders.This first national survey revealed a high prevalence of mental disorders. Considering the importance of mental disorders in the general population, it is important to train and involve more nurses and general practitioners in the identification and management of these disorders as there are very few specialists in the field at present.

Resume Chez le sujet âge, la depression est de loin l’affection la plus frequente des troubles psychiques, les etudes rapportant des taux de prevalence ponctuelle de 1 a 3 % d’episodes depressifs majeurs apres 65 ans. Au Burkina Faso, la frequence de la depression en general et chez le sujet âge en particulier n’est pas connue. Une etude effectuee sur la periode allant du 1er janvier 1988 au 31 decembre 2007 au centre hospitalier Yalgado Ouedraogo (CHU-YO) a rapporte seulement 57 cas de depression chez des sujets de 60 ans et plus. Malgre la presence d’un personnel technique qualifie dans le service de psychiatrie, 34 % ne sont pas revenus apres la premiere consultation. Selon certains parents, plusieurs de ces patients avaient ete ramenes dans leurs villages d’origine. Cette resistance a la demande de soins est la resultante du statut social de la personne âgee qui, etant sensee controler son langage et son comportement, n’est pas autorisee a exprimer sa souffrance et sa plainte. Son incapacite psychique, ressentie comme une honte pour sa famille, est interpretee comme une punition par les ancetres pour un comportement passe ou present inacceptable, ou pour les fautes de ses lignees ascendantes ou descendantes. Les soins traditionnels minimums sont alors assures, la communaute preferant engager le processus du retour vers les ancetres.

Malgre l’existence d’un vaccin antiamaril dans le programme elargi de vaccination (PEV) au Burkina Faso, les cas de fievre jaune continuent d’etre observes dans ce pays. En collaboration avec l’OMS, les autorites sanitaires nationales ont mis sur pied un systeme de surveillance impliquant le laboratoire national de reference OMS au Centre Muraz (Bobo-Dioulasso). Tous les echantillons de cas d’ictere febrile provenant des 63 districts sanitaires du pays ont fait l’objet, dans ce laboratoire, d’une recherche d’immunoglobulines M par Elisa (enzyme linked immunosorbent assay). Les echantillons positifs ont ete envoyes a l’institut Pasteur de Dakar (Senegal) pour confirmation par la technique RT-PCR (polymerase chain reaction avec utilisation de la transcriptase inverse). De 2003 a 2005, le nombre de cas confirmes de fievre jaune etait respectivement de 1/413 (0,24 %), 14/616 (2,27 %) et 19/618 (3,07 %). Cette augmentation de la proportion etait statistiquement significative. Ensuite, de 2006 a 2008, la proportion de cas confirmes etait respectivement de 0,35, 0,27 et 0,54 %, sans difference significative (p = 0,69). Les investigations entomologiques conduites en 2004 a Bobo-Dioulasso ont montre que les canaris constituent 48,11 % des gites des moustiques, suivis des futs metalliques, avec une forte representation de Culex quinquefasciatus (48,7 %), suivi par Aedes aegypti (43,3 %), comme vecteurs dans les zones domestiques, avec des variations d’un secteur de residence a l’autre. Ces resultats suggerent qu’il faudrait sensibiliser davantage les autorites sanitaires nationales et la communaute internationale a cette maladie.

Resume Le Burkina Faso, pays sahelien enclave de l’Afrique de l’Ouest, s’etend sur une superficie de 274 000 km2 et compte soixante ethnies qui parlent soixante langues tres differentes les unes des autres. Les donnees de l’Institut National de la statistique (INSD) estimaient, en 1996, le nombre des personnes âgees de 55 ans et plus a seulement 791 128 âmes, soit 8% de la population. Or, 88,83% de ces « personnes âgees » vivent en milieu rural. Dans ce pays, les endemo-epidemies, les maladies infantiles, le Sida et les multiples carences nutritionnelles sont sources de mort precoce, situant l’esperance de vie a 50 ans a la naissance. Par ailleurs, la sante de la personne âgee n’est pas une priorite des politiques de sante : les croyances ethnoculturelles des populations burkinabe considerent la maladie du sujet âge comme une etape preparatoire au retour vers les ancetres et vers Dieu. Cette maladie, rarement objet de soins adaptes, declenche les rites qui precedent, organisent et finalisent l’enterrement. La mort du sujet âge oblige a des ceremonies rituelles et festives qui accompagnent l’individu sur son chemin vers la maison des ancetres. Ainsi donc, la plainte du sujet âge est rarement audible et difficilement perceptible. La douleur pour l’individu lui-meme est une epreuve face a laquelle il mobilise ce qui lui reste comme courage, force et fierte.

Description En Afrique subsaharienne, l’amelioration progressive des conditions de vie a pour corollaire l’emergence accrue de certaines pathologies en rapport avec l’âge dont la demence. L’objectif de cette etude etait de decrire les differents aspects des demences au Centre Hospitalier Universitaire Yalgado Ouedraogo. Methodes C’est une etude transversale qui a inclus pendant deux ans les sujets âges de plus de 15 ans hospitalises ou ayant consulte dans les services de Neurologie, Psychiatrie, Cardiologie et Neurochirurgie et repondant aux criteres diagnostiques de demence du DSM-IV. Resultats Soixante-douze demences ont ete diagnostiquees soit une prevalence hospitaliere de 4,55 pour mille patients et 2,21 % des patients hospitalises. L’âge moyen etait de 62,20 ans avec un sex ratio de 2. L’installation des troubles cognitifs et comportementaux a ete insidieuse et progressive dans la plupart des cas. La demence etait severe avec un score MMS inferieur a 9 dans la majorite des cas. Les demences secondaires dites curables etaient les plus frequentes (68,05 %), dominees par les demences vasculaires et les causes neurochirurgicales. Seulement 18 % des demences etaient degeneratives avec a leur tete les demences de type Alzheimer. L’entourage familial reste fortement implique dans la demarche de soins et la prise en charge. Conclusion La demence est une realite au Burkina Faso, avec une prevalence sous-estimee. Il est donc necessaire de mener des etudes en population dans le but d’envisager des mesures preventives et de prise en charge adaptees a notre contexte.

Despite the existence of antiamaril vaccine in the routine Expanded Program of Immunization (EPI) in Burkina Faso, yellow fever cases still occur in the country. In collaboration with WHO, the national health authorities set up a surveillance system through the national reference laboratory in Centre Muraz (Bobo-Dioulasso). All samples of feverish icterus cases of the 63 health districts of the country were analysed in this lab for M Immunoglobulin using Enzyme Linked Immunosorbent Assay (Elisa). Positive Elisa samples were sent to Pasteur Institute of Dakar (Senegal) for confirmation using a Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) assay. From 2003 to 2005, the number of confirmed cases of yellow fever was respectively of 1/413 (0.24%), 14/616 (2.27%) and 19/618 (3.07%). This increasing of the proportion was statistical different. Then, from 2006 to 2008, the confirmed case proportion was respectively 0.35%, 0.27 and 0.54% without significant difference (P = 0.69). The entomological investigations conducted in 2004 in Bobo-Dioulasso showed that the water pots constitute 48.11% mosquitoes lodgings, followed by metal drums with a strong representation of Culex quinquefasciatus (48.7%), followed by Aedes aegypti (43.3%), as vectors in domestic areas with sectorial variations. These results suggest that more attention must be paid by the national health authorities and international community regarding this disease.

The practice of psychiatry in the south of the Sahara in Africa collides with many problems of acceptability of care for the ill and their families. The frequent rejection of the psychiatrist's therapeutic approach can often be explained by the inadaptation of the etiopathogenic approach. Indeed, in black Africa, responsibility of illness differs according to the fact that one has been schooled or not. The western world teaches minorities having the chance to live there or learn about it, that the human body can be assaulted by bacteria, viruses, mycoses or be self-assaulted by changes of its own physiology. Traditional education, for its part, regards the body as a mysterious entity susceptible of being penetrated or eaten by geniuses and anthrophagic sorcerers following a mystico-religious mechanism linked to beliefs and customs. In the majority of the Moose of the Moaga plateau in Burkina Faso, especially regarding madness, these assailants are ancestral geniuses or geniuses from the bush. Psychological suffering caused by a family, social or intrapsychic conflict independent of the invisible world is ultimately delirious for them thus provoking a resistance to give up complete charge of their mentally ill to psychiatric care. For us, an analysis of probable causes of this resistance appeared necessary. Interviews have shown that the psychiatric institution is experienced by the Moose of Kadiogo as a stage in the therapeutic itinerary of their mentally ill, a stage in the course of which their demand for care is reduced to the elimination of inconvenient symptoms. For them, the elimination of the cause derives from a knowledge that psychiatry does not possess, which renders the therapeutic relationship frustrating for both parties.

In this case report, the authors studied the difficulties to set up the diagnosis of hysteria in the Briquet's Syndrome. The description presented here is about an eleven years old girl patient without any particular family background and who, after her tonsils have been out against her will, presented a hysteria in the form of Briquet's Syndrome. All the explorations showed no abnormalities. It is the questioning, and the analysis of facts from informations by the patient and her family which allowed to conclude the diagnosis of hysteria. She received a chemotherapy, associated with a psychotherapy and a family guidance. The course was favourable after two months. The authors compare these findings with some data of the literature and underline the diagnostic and therapeutic difficulties they faced. How physicians should approach such form of hysteria to set up the diagnosis is to proceed by elimination because the disease can simulate all sorts of medical or psychiatrical affections.

Schizophrenia is a chronic mental disease severe and disabling, which affects young adults. It is a frequent disease which, due to its disabling nature concerns as well the society, the family as the individual. We have gone throughout the files of 61 inpatients in the psychiatric department of the National Hospital Centre Yalgado Ouedraogo of Ouagadougou, using the diagnosis of schizophrenia according the criteria of the World Health Organization. The aim of our study was to draw up the socio-demographic profiles and the symptoms of these schizophrenic patients. Our results emphasize the importance of delirious productions (80.3%) and disorders of the perceptive field, particularly auditive hallucinations (51.5%) in the semiology of the disease. On the diagnostic plan, paranoid forms prevailed (74.5%) in our series. The long course of the schizophrenia process preceding the consultation often makes the diagnosis easy at the patient's arrival. Clinical forms with noisy symptomatology, usually not much tolerated by families, often ask for medical care, sometimes after unsuccessful traditional therapy.