Summary:Purpose: Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas. The purpose of this article was to evaluate the relationship between CM and epilepsy in Gabon.Methods: A matched case-control study was carried out on a sample of subjects aged six months to 25 years and hospitalized between 1990 and 2004 in three hospitals in Libreville, Gabon. Cases were defined as patients suffering from epilepsy and confirmed by a neurologist. Controls were defined as patients without epilepsy. The exposure of interest was CM according to WHO criteria. Results:In total, 296 cases and 296 controls were included. Of these, 36 (26 cases and 10 controls) had a CM history. The adjusted odds ratio (aOR) to develop epilepsy after CM was 3.9 [95% CI: 1.7-8.9], p < 0.001. Additional risk factors were identified: family history of epilepsy: aOR = 6.0 [95% CI: 2.6-14.1], p < 0.0001, and febrile convulsions: aOR = 9.2 [95% CI 4.0-21.1], p < 0.0001.Conclusions: This first case-control study on that issue suggests that epilepsy-related CM is an underrecognized problem. It emphasizes the need for further studies to better evaluate the role of convulsions during CM.

IntroductionLes accidents vasculaires cérébraux constituent un véritable problème de santé publique en Afrique avec une charge importante. Les données fiables sur sa réelle charge économique sont rares en Afrique. L'objectif de cette étude était d’évaluer le coût direct hospitalier des AVC à Parakou au Bénin.MéthodesIl s'agissait d'une étude transversale économique ayant inclus des patients hospitalisés pour un AVC à l'hôpital de Parakou entre le 1er Juin 2010 au 31Mai 2011. Les données concernant les différents postes de consommation ont été collectées selon la méthode dite bottom-up. Le coût était envisagé du point de vue de la société et du patient. L'unité du coût était le franc CFA (valeur en 2011). Une régression linéaire multiple était utilisée pour déterminer les meilleurs prédicteurs du coût.RésultatsIls étaient 78 patients dont 52 hommes, âgés en moyenne de 57 ans ± 10.9. Le NIHSS moyen était de 14,4. Le taux de mortalité était de 20,5%. Le coût direct moyen était de 316.810,3 (±230.774,8) F CFA (environ 704 ± 512 Euros). Les grands postes de consommation étaient les explorations paracliniques (34.3%) les soins et médicaments (28.4%) et les frais d'hospitalisation (17.9%). Les meilleurs prédicteurs du coût élevé étaient un AVC hémorragique, un NIHSS élevé à l'admission et une longue durée d'hospitalisation.ConclusionCette étude suggère un coût élevé de la prise en charge actuelle des AVC à Parakou.

Background: The distal sensory polyneuropathy (DSP) was more frequent among diabetics, although its determinant was not well known among diabetics in Benin. Objective: We aimed to assess the frequency of DSP and its determinants among diabetics at Parakou. Methods: It was a cross-sectional study carried out from 1 March to 31 August 2012 and included 336 diabetics followed at the diabetes unit of Parakou hospital. The diagnosis of DSP was based on DNS (Diabetic Neuropathy Score) criteria and other criteria. All data concerning the diabetes mellitus were recorded. We used Epi-Info and SPSS 16.0 software to perform analysis. Results: They were 187 females (56.0%) with the mean age of 54.9 ± 10.9 years. 298 patients fulfilled criteria for DSP; the overall prevalence of DSP was 88.7%. The main associated factors in multivariate analysis were treatment duration of diabetes more than 4 years: OR = 36.7 [4.0-336.9]; the elevated glycaemia: OR = 3.1 [1.4-7.1]; the activity with high income: OR = 0.2 [0.0-0.8]; the ethnicity: nagots/fon: OR: 3.7 [1.4-12.5]. Conclusion: Those results suggested the high frequency of DSP among diabetics at Parakou.

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