IntroductionAccording to the WHO, 50% of deaths worldwide (40.1% in developing countries) are due to chronic non-communicable diseases (NCDs). Of these chronic NCDs, cardiovascular diseases remain the leading cause of death and disability in developed countries. The Framingham study has shown the importance of hypercholesterolemia as a primary risk factor. In Senegal, the epidemiology of dyslipidemia and obesity are still poorly understood due to the lack of comprehensive studies on their impact on the general population. This motivated this study to look into the key epidemiologic and socio-demographic determinants of these risk factors.MethodsIt was a cross-sectional descriptive epidemiological survey which included 1037 individuals selected by cluster sampling. Data were collected using a questionnaire following the WHO STEPwise approach. Socio-demographic, health and biomedical variables were collected. P value <0.05 was considered to be statistically significant.ResultsThe average age was 48 years with a female predominance (M: F of 0.6). The literacy rate was 65.2% and 44.7% of participants were from rural areas. The prevalence of hypercholesterolemia, hyperLDLemia, hypoHDLemia, hypertriglyceridemia and mixed hyperlipidemia were 56%, 22.5%, 12.4%, 7.11% and 1.9% respectively. One in four was obese (BMI> 30kg/m2) and 34.8% had abdominal obesity. The main factors significantly associated with dyslipidemia were obesity, urban dwelling, physical inactivity and a family history of dyslipidemia.ConclusionThe prevalence of dyslipidemia, obesity and other risk factors in the population was high needing immediate care for those affected and implementation of prevention strategies.

IntroductionChronic kidney disease (CKD) is an emerging worldwide epidemic but few data are available in African populations. We aimed to assess prevalence of CKD in adult populations of Saint-Louis (northern Senegal).MethodsIn a population-based survey between January and May 2012, we included 1,037 adults aged =18 years living in Saint-Louis. Socio-demographical, clinical and biological data were collected during household visits. Serum creatinine was measured by Jaffé method. We estimated glomerular filtration rate (eGFR) using the 4-variables MDRD equation and CKD was defined by eGFR < 60 mL/min/1.73m2 and/or albuminuria > 1g/L. A multivariate logistic regression was performed to identify factors associated with CKD.ResultsMean participants’ age was 47.9 ±16.9 years (18-87) and sex-ratio was 0.52. Majority of participants lived in urban areas (55.3% rural) and had school education (65.6%). Overall prevalences of hypertension, diabetes and obesity were 39.1%, 12.7% and 23.4% respectively. Prevalence of CKD was 4.9% (95% CI= 3.5 – 6.2) and 0.9% had GFR < 30 mL/min/1.73m2. Albuminuria >1g/l was found in 3.5% of people. CKD was significantly more frequent among hypertensive patients compared to normotensive participants. Only 23% of patients were aware of their disease before the survey. After multivariate logistic analysis, presence of CKD was significantly associated with hypertension (OR=1.12, p= 0.02) and age (OR=1.03, p= 0.02).ConclusionCKD is frequent in adult population living Northern Senegal. Main associated factors are hypertension and age. Prevention strategy is urgently needed to raise awareness and promote CKD detection and early treatment in both urban and rural areas.

Background:Chronic kidney disease (CKD) is an emerging worldwide epidemic but littledata concerning African populations are available.Objectives:We aimed to assess prevalence of CKD in adult populations of Saint-Louis, northern Senegal.Patients and Methods:In a population-based survey between January and May 2012, we included 1037 adults ≥ 18 years of age who resided in Saint-Louis. Socio-demographic, clinical, and biologic data were collected during household visits. Serum creatinine was measured by Jaffé method. We estimated glomerular filtration rate (eGFR) using the four-variable Modification of Diet in Renal Disease (MDRD) equation and CKD was defined by eGFR< 60 mL/min/1.73 m2 and/or albuminuria > 1 g/L. A multivariate logistic regression was performed to identify factors associated with CKD.Results:The mean of participants’ age was 47.9 ± 16.9 years (range, 18-87) and sex ratio (male to female) was 0.52. Majority of participants lived in urban areas (55.3%) and had school education (65.6%). Hypertension, diabetes, and obesity were present respectively in 39.1%, 12.7%, and 23.4% of participants. Overall CKD prevalence was 4.9% (95% CI, 3.5-6.2) with eGFR< 30 mL/min/1.73 m2 in 0.9%. Albuminuria > 1 g/L was found in 3.5% of patients. CKD was significantly more frequent among hypertensive patients in comparison with normotensive ones. Risk factors associated with CKD were hypertension (12% of risk excess) and age (3% of risk excess).Conclusions:CKD is frequent in adult population living in Northern Senegal. Main associated factors are hypertension and age. Prevention strategies are urgently needed to raise public awareness and promote early CKD detection and treatment in both urban and rural areas.

Objective: Evaluation of the hemodynamic, respiratory and fetal side effects of two protocols for spinal anesthesia (P1: bupivacaine-fentanyl; P2: ropivacaine-fentanyl). Material and Method: Prospective pseudo-randomized study comparing two spinal anesthesia protocols for emergency cesarean section conducted in the operating room of the regional hospital center of Saint Louis in Senegal. Study duration was 4 months. We studied, age, indication for Caesarean section, medical and surgical history, P1 and P2 protocols, hypotension, bradycardia, Apgar scores at birth and at 5min. Univariate and bivariate analysis was performed on the R software. Result: A total of 115 patients were collected, with a mean age of 27.1 years (E: 15 - 45) and a standard deviation of 7.6. Indications for Caesarean section were maternal and fetal dystocia for 67 patients (58%), fetal distress for 39 parturients (34%), and pre-eclampsia for 5 patients (4%). The P1-Bupi spinal protocol was used in 42 patients (36.5%) and the P2-Ropi spinal protocol was used in 73 patients (63.5%). Anesthetic complications such as low blood pressure, bradycardia and desaturation were found in a total of 30 patients, i.e. in 26% of cases. The mean Apgar score at birth for newborns from the P1-Bupi protocol was 8 (Extremes: 7, 9); the mean Apgar score at birth for newborns from the P2-Ropi protocol was 7.5 (Extremes: 2, 10). There was a significantly negative correlation between the P1-bupi protocol and the appearance of hypotension with p-value: 0.04 and a significantly positive correlation between the P2-ropi protocol and the appearance of hypotension with p-value: 0.04. Discussion/ Conclusion: Ropivacaine certainly has a better cardiovascular and neurological tolerance and a better efficacy in terms of analgesia. However, during caesarean sections, it is important to consider the risk of hypotension and possible fetal complications related to its use. Keywords: Ropivacaine - Bupivacaine - Spinal anesthesia - Caesarean section

No abstract