Background Ebola Virus Disease (EVD) is a deadly and feared infectious disease, which can be responsible of debilitating physical and psychological sequelae in survivors including depression and anxiety disorders. Unfortunately, there are scarce data on survivor sequelae in Democratic Republic of the Congo. So this study assessed PTSD, depression and anxiety symptoms among EVD survivors enrolled in the follow-up program of the psychosocial care team of Beni town’s general hospital. Methods A cross-sectional study used consecutive sampling to recruit 144 Ebola virus disease survivors who came for follow up from October 23 to November 13; 2019. Basic socio-demographic data, presence of headache and short-term memory function were assessed. The Post-traumatic Checklist Scale and Hospital Anxiety and Depression Scale were used to assess psychological burden among participants. Descriptive statistics were used to summarized data and Pearson’s or likelihood chi-square were used to test association between psychiatric disorders and associated factors. Results The prevalence of PTSD, depression and anxiety was 24.3, 24.3 and 33.3% respectively. Being male (OR = 0.42, 95% CI: 0.16, 0.95, p = 0.049), suffering from persistent headache (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014), losing a loved one because of EVD (OR: 2.60, 95% CI: 1.11, 6.15, p = 0. 015) and being young − 18-24 years - (OR: 0. 261, 95% CI: 0. 08, 0.82, p = 0,026) were statistically associated with PTSD diagnosis. Having short-term memory impairment and suffering from persistent headache were statistically associated with depression and anxiety diagnoses (OR = 2.44, 95% CI: 1.03, 5.82, p = 0.026); (OR = 2.24, 95% CI: 1.04, 4.85, p = 0.025); (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014); (OR = 2.31, 95% CI: 1.06, 5.01, p = 0.020). Conclusion The prevalence of PTSD, depression and anxiety is high among EVD survivors. Development of specialized psychiatric services to sustain psychiatric and psychological health amongst survivors in the cultural context of the Eastern part of the DRC should be considered by the teams fighting against EVD in the DRC.
Inappropriate seizure management may result in high morbidity and mortality. We assessed the adherence of health professionals in southern Rwanda to a national protocol for pharmacological management of seizures in children. A questionnaire featuring a 5-year-old child with generalized prolonged seizures was administered. The questions focused on the choice of initial treatment and the sequence of management following failure of the initial treatment choice. Benzodiazepine was chosen as initial therapy by 93.7% of physicians and 90.9% of nurses. Only 49.2% of physicians and 41% of nurses would repeat the initial treatment in case of failure of the first dose and 47% of doctors would wait 30 min to intervene. In case of refractory status epilepticus, 34% of physicians would give three doses of benzodiazepine, whereas 19% did not know what to do. These results suggest poor adherence to national protocol.
Le syndrome de Lyell ou la nécrolyse épidermique toxique (TEN) est une des rares complications majeures du traitement par phénobarbital. Sa prise en charge n'est pas encore codifiée. Il requiert une intervention urgente, lourde et adaptée à chaque patient afin d'en réduire la mortalité. Nous décrivons un cas du syndrome de Lyell survenu une dizaine de jours après initiation du traitement antiépileptique par phénobarbital chez un enfant rwandais de deux ans. La complexité des lésions cutanéomuqueuses et leurs répercussions sur le plan général soulignent l'importance d'une prescription responsable et justifiée des médicaments antiépileptiques.
Objective:To determine the pattern, management, and outcome of headaches among patients treated at Outpatient Neurology Clinic.Methods:A retrospective study was conducted at the Out-Patient Neurology Clinic of the Butare University Teaching Hospital, University of Rwanda, Butare, Rwanda between February and May 2015. We extracted the demographic data, headache characteristics, and associated conditions, prior pain-relieving medication use, waiting time before consultation, the results of paraclinical investigations, final diagnosis according to the International Classification of Headache Disorders, management, and 3-month clinical outcome from the medical records of all patients who consulted for headache over 36-month period. Epi Data and Statistical package for Social sciences software version 21.0 (SPSS Inc, Chicago, IL, USA) software were used for data processing.Results:Headache disorders represent a quarter of all neurological consultations. Patients were predominantly female (67%) and young (78% <45 years old). One-third (34%) presented with chronic tension-type headache. Neuroimaging demonstrated an abnormality in a significant minority (14%). Amitriptyline was the most commonly used drug (60%) in management. Forty percent of those patients followed for 3 months did not experience any clinical improvement.Conclusion:Headache is among the most common medical complaints in the Outpatient Neurology Clinic, with a wide array of underlying diagnoses, and a significant yield on neuroimaging. A significant proportion of those suffering from headache disorders have poor short-term outcomes. Novel approaches, such as headache support groups and alternative pharmacological agents, should be investigated for these patients.
L'aplasie cutanée circonscrite du cuir chevelu ou aplasia cutis congenita, en nomenclature latine, est une malformation rare du cuir chevelu caractérisée par une absence de ce dernier. Elle peut intéresser l’épiderme ou toute la peau. La prise en charge d'une telle malformation est assez délicate. Elle est généralement chirurgicale et le pronostic dépend en grande partie de malformations vasculaires associées. Le risque infectieux et/ou hémorragique est élevé. Cette malformation peut être isolée, ne se limitant qu’à la peau du cuir chevelu; tout comme elle peut faire partie d'un syndrome polymalformatif associant l'atteinte d'autres tissus ou organes tel qu'on peut l'observer dans le syndrome d'Adams-Oliver. Nous rapportons le cas d'un nouveau-né rwandais chez qui on a constaté, à la naissance, une absence du cuir chevelu, parcellaire, intéressant une grande partie du vertex fronto-pariétal et la région pariétale gauche. Une IRM avec séquences angiograpiques réalisée plusieurs jours plus tard, montre une agénésie de la partie frontale du sinus longitudinal supérieur. A notre connaissance, aucune observation faisant état de cette malformation n'a jamais été publiée en Afrique Centrale.
Background Ebola Virus Disease (EVD) is a deadly and feared infectious disease, which can be responsible of debilitating physical and psychological sequelae in survivors including depression and anxiety disorders. Unfortunately, there are scarce data on survivor sequelae in Democratic Republic of the Congo. So this study assessed PTSD, depression and anxiety symptoms among EVD survivors enrolled in the follow-up program of the psychosocial care team of Beni town’s general hospital. Methods A cross-sectional study used consecutive sampling to recruit 144 Ebola virus disease survivors from October 23 to November 13; 2019. Basic socio-demographic data, presence of headache and short-term memory function were assessed. The Post-traumatic Checklist Scale and Hospital Anxiety and Depression Scale were used to assess psychological burden among participants. Descriptive statistics and a binary logistic regression model were used for analysis. Results The prevalence of PTSD, depression and anxiety was 24.3%, 24.3% and 33.3% respectively. Being male (p = 0.049 ; OR = 0. 42 (CI : 0. 16–0.95), suffering from persistent headache (p = 0. 014 OR = 2.62 CI (1.12–6.14), losing a loved one because of EVD (p = 0. 015 ; OR : 2.60 (CI : 1.11–6.15) and being young − 18–24 years - (p = 0,026 ; OR : 0. 261 (IC : 0. 018-0.055).) were statistically associated with PTSD diagnosis. Having short-term memory impairment and suffering from persistent headache were statistically associated with depression and anxiety diagnoses (p = 0.026 OR = 2,44 (CI : 1.03–5.82) ; (p = 0. 025 OR = 2.24 (CI : 1.04–4.85) ; (p = 0.014 OR = 2.62 (CI : 1.12–6.14) ; (p = 0. 020 OR = 2.31 (CI : 1.06–5.01) Conclusion The prevalence of PTSD, depression and anxiety is high among EVD survivors. Development of specialized psychiatric services to sustain psychiatric and psychological health amongst survivors in the cultural context of the Eastern part of the DRC should be considered by the teams fighting against EVD in the DRC.
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