IntroductionLes maladies cardiovasculaires (MCV) occupent une place importante dans la mortalité en Afrique, situation inquiétante traduisant une transition épidémiologique rapide. La connaissance des groupes nosologiques les plus mortelles devrait aider à l’élaboration de politiques en matière de traitement et de prévention.MéthodesIl's agit d une étude rétrospective du 1er janvier 2006 au 31 décembre 2010, ayant inclus les patients hospitalisés pour une MCV selon la classification Internationale des maladies (CIM-10).RésultatsLa fréquentation hospitalière pour maladie MCV a augmenté au fil du temps; les maladies hypertensives étaient le premier motif d hospitalisation (66.8%). Les autres pathologies fréquentes étaient la maladie thromboembolique (9.1%), les syndromes coronaires aigus (SCA) (7.3%), l'insuffisance cardiaque (5.5%), les cardiomyopathies (5.3%). La majorité des sujets étaient jeunes (âge moyen: 55.1 ans) et il n'y avait pas de corrélation entre la durée d'hospitalisation et l’âge: r = + 0.024, p = 0.09. La mortalité globale était élevée (11%) et les taux de létalité élevés dans le SCA (27.9%), l'embolie pulmonaire (25%) et la péricardite (25%).ConclusionLes MCV sont responsables d'une hospitalisation croissante dans nos hôpitaux. L'absence d unité de soins intensifs cardiologiques et des méthodes de revascularisation coronaire, le manque de personnels qualifiés associés l'inexistence de sécurité sociale expliquent une mortalité élevée dans nos pays en voie de développement qui sans avoir achevé leur transition démographique entre en pleine transition épidémiologique.
Background. The purpose of this study was to determine the rate of non-adherence to antihypertensive therapy and to investigate factors that may explain this non-adherence. Methods. This is a cross-sectional study conducted from March to December 2017 in two public hospitals in the city of Kara. It included hypertensive patients known to have been on treatment for at least six months, and who were able to provide information to the Girerd self-questionnaire. A survey form was used to collect sociodemographic, clinical and therapeutic data. Results. Of the 216 received patients, 35.2% had good adherence and 64.8% had difficulties in adhering to their treatment (16.7% had minor adherence problems and 48.1% had poor adherence). The low level of education (OR=1.87; 95% CI=1.01-3.44; p=0.04), the short duration of progression (<5 years) of hypertension (OR=2.90; 95% CI=1.62-5.17; p=0.001), lack of financial resources (OR=2.78; 95% CI=1.37-5.64; p=0.04), nonstaff status (OR=2.89; 95% CI 1.60-5.20, p<0.001) and the high number of tablets to be taken per day (OR=3.32; 95% CI 1.80-6.10; p≤ 0.001) were predictive factors for treatment non-compliance. Conclusion. Adherence to antihypertensive therapy was low in a hypertensive population in Northern Togo. Low education level, a duration of hypertension evolution of less than five years, lack of financial means, non-civil servant status and high number of tablets were the factors associated with nonadherence to treatment.
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