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Post-Stroke Epilepsy within a Teaching Hospital in Cotonou, Benin

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Neuroscience & Medicine 2017年第4期8卷 47-52页

作者： Dieu Donné Gnonlonfoun constant adjien Mendinatou Agbetou Thierry Adoukonou Jennifer Mapaga Gérard Goudjinou Dismand Houinato Department of Neurology National University Hospital Centre Cotonou Bénin Department of Neurology National University Hospital Centre Parakou Bénin

Seizures occurring after stroke are risk factors for the onset of ensuing epilepsy. However, the incidence of vascular epilepsy is low. The purpose of this study was to study vascular epilepsy features in a teaching university. It was a retrospective, descriptive and analytical study, conducted from 1st January 2015 to 31st December 2016 in Cotonou Teaching Hospital (CNHU-HKM), Benin. It involved 35 patients brought together through comprehensive sampling. Vascular epilepsy hospital attendance rate was 2%. There were simple partial seizures in 74.28% of cases while cerebral ischemia was recorded in 44.44% of patients. Neurological consultation after stroke occurrence was a protective factor against the occurrence of vascular epilepsy with significant p at 0.001.

关键词： Post-Stroke Epilepsy Vascular Epilepsy Cotonou Benin

Factors associated with stroke direct cost in francophone West Africa, Benin example

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World Journal of Neuroscience 2013年第4期3卷 287-292页

作者： Dieu Donné Gnonlonfoun Thierry Adoukonou constant adjien Emma Nkouei Dismand Houinato Dossou Gilbert Avode Pierre Marie Preux Department of Medecine CHD Parakou Benin Department of Neurology CNHU-HKM Cotonou Benin Research Institute of Tropical Neurology Diseases Limoges France

Background: In sub-Saharan Africa, stroke constitutes a public health issue. Few studies were conducted to assess the cost involved in its treatment. Objective: To determine the factors involved in direct cost of stroke in Cotonou-Benin. Method: It consists in a transversal and prospective research of economic type with analytical and descriptive aim. It was conducted from 20thFebruary 2011 to 30thSeptember 2011. The research dealt with 122 stroke patients. With regard to the economic approach, bottom-up was the data collection technique which was adopted. Cost was estimated not only based on the patient himself/herself but considering societal aspect. Cost estimation period was hospitalization period. Data analysis was conducted via software such as Epi info and SPSS. Results: Overall expenses in terms of direct cost varied from $144.9 to $9393.9;average expenses were $1030.1 ± $101.7. Patients aged 50 and above had higher stroke hospitalization cost ($1277.4) than those aged below 50 ($857.4) p = 0.001;male patients made more expenses than females (FCFA 1157.5 against $831.8) p = 0.01;direct cost of stroke was increased in proportion to neurological deficit (score NIHSS) p = 0.043. This cost was higher in cases of hemorrhagic stroke than ischemic stroke (FCFA $1375 against $1098) p = 0.002. Stroke direct cost was also increased in proportion to severance of disability level of patients. Stroke type (hemorrhagic) and RANKIN score were firmly correlated to stroke hospitalization cost. Conclusion: Stroke is very expensive for patientsin Benin and they constitute a burden for both patients and their family. There is a great need to increase awareness regarding risk factor control in order to reduce the cost involved in treating this malady.

关键词： Stroke Cost Benin

Stroke: Medium and long-term mortality and associated factors in French-speaking West Africa, case of Benin

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World Journal of Neuroscience 2014年第1期4卷 68-74页

作者： Dieu Donné Gnonlonfoun constant adjien Paul Macaire Ossou-Nguiet Isaac Avlessi Gérald Goudjinou Octave Houannou Jocelyn Acakpo Dismand Houinato Gilbert Dossou Avode Epidemiology Institute FSS/UAC Cotonou Benin Neurology Department CHU Brazzaville Congo Neurology Department CNHU-HKM Cotonou Benin

Introduction: Stroke is the leading cause of mortality and physical disability in sub-Saharan Africa. Objective: Determining medium-term and long-term mortality for stroke and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved patients who have known stroke for at least 6 months, and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Then, the number of deceased was systematically recorded with precision of death time-limit. Results: The overall mortality rate was 29%. Mortality was higher with patients over 70 years with a frequency of 57.1%. The medium-term mortality rate was 25% against 4% for long-term. The average time-limit for death occurrence after the vascular incident was 7 months ± 6.4 months. Prognostic factors of mortality were: the age of the patient (IC95% = 7.73 [1.49 - 39.99], p = 0.015 ), marital status (IC95% = 0.27 [0.08 to 0.94], p = 0.039 ) and the presence of aphasia (IC95% = 5.52 [1.45 to 20.94 ], p = 0.012). Conclusion: Stroke mortality still remains significant, even after the patients have been discharged from hospital. A good psychological family support and efficient aphasia coverage are essential for its reduction.

关键词： Mortality Stroke Medium Term Long Term Cotonou

Primary Headache Disorders in HIV-Infected Patients within a Hospital Setting in Sub-Saharan Africa, Benin Case: Prevalence and Associated Factors

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World Journal of Neuroscience 2019年第4期9卷 282-293页

作者： Dieu Donne Gnonlonfoun Mendinatou Agbetou Armand Wanvoegbe constant adjien Ronald Gnimavo Arlos Sowanou Rodrigue Domingo Joseph Adoco Djimon Marcel Zannou Dismand Houinato Department of Neurology Teaching Hospital Center Cotonou Benin Department of Neurology Teaching Hospital Center Parakou Benin Department of Internal Medicine Teaching Hospital Center Cotonou Benin Department of Public Health Ouidah Benin

Introduction: Headache disorders are common in HIV-infected patients. These disorders are either primary or secondary. Objective: Determine prevalence and factors associated with primary headache disorders in HIV+ patients. Method: It was a cross-sectional, descriptive and analytical study conducted from 2nd May 2017 to 2nd August 2017 which included HIV+ patients aged 18 years and above. Diagnosis of primary headache disorders was carried out by a Neurologist on the basis of ICHD-II diagnostic criteria. The?dependent variable was primary headache disorders. Epi Info Version 7.***.1.0 and STATA11 were used for data analysis. P Results: Primary headache disorders prevalence was 25.2% (124/493).Tension-type headache represented 77.41%. HIV+ patients were aged 42.63 ± 10.14 years. Sex-ratio was estimated at 0.14. Factors associated with primary headache disorders in HIV+ patients were: male (0.36 [0.17 - 0.77];P = 0.008), Dendi ethnicity (14.8 [2.08 - 101.99];P = 0.007), trader (3.09 [01.25 - 7.62];P = 0.02), WHO clinical stage (3.20 [1.43 - 7.17];P = 0.005), screening duration (1.01 [1.00 - 1.01];P = 0.00), hypertension (10.28 [4.44 - 23.83];P ≤ 0.001). Conclusion: This study helped to determine the standard profile of HIV+ patient with primary headache disorders. It will contribute to save costs associated with paraclinical examinations, while in search of secondary etiologies within an African context with limited financial resources.

关键词： Primary Headache HIV Benin

Prevalence of Dementia and Its Associated Factors in Cotonou Teaching Hospital, Benin

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Advances in Alzheimer's Disease 2014年第2期3卷 94-106页

作者： Dieu Donné Gnonlonfoun constant adjien Paul Macaire Ossou-Nguiet Lansana Laho Diallo Octave Houannou Jocelyn Acakpo Gérard Goudjinou Dismand Houinato Dossou Gilbert Avode Epidemiology Institute FSS/UAC Cotonou Benin Neurology Department Brazzaville Teaching Hospital Brazzaville Congo Neurology Department CNHU-HKM of Cotonou Cotonou Benin Neurology Department Conakry Teaching Hospital Conakry Guinea

Introduction: Dementia constitutes a public health hazard in developing countries. There is little data in the sub-Saharan region of African especially in Benin. Objective: Determining dementia hospitalization prevalence and identifying its associated factors in CNHU-HKM, Cotonou. Method: It was a cross-sectional, prospective, descriptive and analytical research conducted from October 2012 to July 2013 in the neurology department;it involved 251 patients aged 50 and above. Dementia screening was conducted using a modified and adapted Mini Mental Scale Examination (MMSE). Dementia clinical and etiological diagnoses were respectively conducted based on DMS-IV and HACHINSKI criteria. Results: Patients were averagely aged 60.9 ± 8.1. Sex ratio (Male/Female) was 1.07. Dementia prevalence was 8.8%. This rate increased proportionally with age, from 5.3% with patients aged below 60 to 12.7% with patients aged above 60. Degenerative dementia was the most predominant type (50%). Following multi-varied analysis, smoking (RC = 6.05 [IC 95% = 1.26 - 29.38] p = 0.0001) and stroke past records (RC = 6.05 [IC 95% = 1.26 - 29.38] p = 0.001) revealed to be the factors associated with dementia. Conclusion: This research showed that dementia affects a significant part of the aging population in CNHU-HKM. It is imperative to combat its associated factors so as to defuse its prevalence.

关键词： Prevalence Dementia Elders MMSE DSMIV Cotonou Benin

Post-Stroke Cognitive Disorders and Associated Factors in French Speaking West Africa, Benin Case

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Neuroscience & Medicine 2014年第1期5卷 32-41页

作者： Dieu Donné Gnonlonfoun Paul Macaire Ossou-Nguiet Lansana Laho Diallo constant adjien Isaac Avlessi Gérard Goudjinou Octave Houannou Dismand Houinato Gilbert Dossou Avode Neurology Department Centre Hospitalier et Universitaire de Conakry Conakry Guinée Neurology Department Centre Hospitalier et Universitaire of Brazzaville Brazzaville Congo Neurology Department Centre National Hospitalier et Un-iversitaire Hubert Koutoukou MAGA de Cotonou (CNHU-HKM) Cotonou Benin

Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35-4.59], p = 0.004), consciousness disorders (15.67 [1.46-168], p = 0.04), and convulsion disorders (3.77 [1.01 -14.00], p = 0.003) was associated with cognitive decline. From multi-varied analysis, the sole presence of convulsive attacks (11.5 [1.79-73.58], p = 0.01) was individually associated with post-stroke cognitive decline. Conclusion: This study reveals the importance of CD after stroke. The occurrence of convulsions at stroke acute stage is a prognostic factor of CD medium or long-term occurrence. The overall coverage improvement depends on the integration of these data in stroke reach-out programs.

关键词： Stroke Cognitive Decline Dementia Benin

Stroke after Hospitalization: Assessment of Functional Prognosis through Disability and Dependency in CNHU-HKM, Cotonou, Benin

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Neuroscience & Medicine 2014年第3期5卷 139-148页

作者： Dieu Donné Gnonlonfoun Paul Macaire Ossou-Nguiet Lansana Laho Diallo constant adjien Isaac Avlessi Octave Houannou Gérald Goudjinou Jocelyn Acakpo Dismand Houinato Dossou Gilbert Avode Epidemiology Institute Faculté des Sciences de la Santé de l’Université d’Abomey Calavi (FSS/UAC) Cotonou Benin Neurology Department Centre Hospitalier et Universitaire (CHU) Brazzaville Congo Neurology Department Centre Hospitalier et Universitaire (CHU) Conakry Guinea Neurology Department Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin

Introduction: Stroke results in severe disability, with impacts that are sometimes socially, emotionally or professionally dramatic and also dramatic for the cost involved in care and treatment. Objective: Assessing the functional prognosis after hospitalization and identifying associated factors. Method: It consisted in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved 100 patients who have known stroke for at least 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Disability and dependency were then measured respectively with the Rankin score and Barthel index. The STATA/IC11.0 statistical software was used as the basis for data analysis. Unvaried and multi-varied analyzes helped to identify associated factors. Results: The overall disability and dependency rates were respectively 69% and 57.7%. And the highest rate of disability (38.8%) was observed between 50 and 60 years old. However, dependency prevalence was higher in subjects above 70 years old (37.3%). Regarding gender, the prevalence of disability was 59.2% in men and rather 41.5% in women. Predictors of disability and dependency were paralysis on admission (IC95% = 0.26 [0.77 - 0.92];p = 0.036), obesity (IC95% = 0.26 [0.77 - 0.92];p = 0.012) and monthly income lower than 70$US (IC95% = 0.05 [0.01 - 0.56];p = 0.015). Conclusion: This study enabled us to assess the functional outcome of patients once discharged. The significance of motor deficit on stroke occurrence, obesity and the low monthly income were factors of poor functional prognosis.

关键词： Prognosis Functional Stroke Rankin Barthel Cotonou Benin

Dementia and Diabetes Mellitus in Porto-Novo: Frequency and Determining Factors

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Open Journal of Internal Medicine 2021年第4期11卷 246-257页

作者： Finangnon Armand Wanvoegbe Dieu Donne Gnonlonfoun Kouessi Anthelme Agbodande Arnaulde Amoussou-Guenou Fandi Muriel Bernice Gnanguenon Angèle Azon-Kouanou constant adjien Daniel Amoussou-Guenou Djimon Marcel Zannou Dismand Houinato Internal Medicine and Endocrinology Department-Oueme-Plateau Teaching Hospital of Porto-Novo Porto-Novo Benin Neurology Department-Teaching Hospital HKM of Cotonou Cotonou Benin Internal Medicine Department-Teaching Hospital HKM of Cotonou Cotonou Benin Saint Gérard Clinic of Porto-Novo Porto-Novo Benin

Background: Chronic hyperglycemia promotes the development of degenerative diseases such as dementia. Our objective is to study dementia in diabetic patients in a hospital environment in Porto-Novo. Methods: This is a cross-sectional, prospective study with a descriptive and analytical aim that took place from May 18 to September 18, 2017, i.e. 4 months. The study population consists of all diabetic patients who consulted in the internal medicine departments of the Oueme-Plateau Teaching Hospital and at Saint Gérard clinic in Porto-Novo during the study period and who gave their enlightened consent. Results: The study included 246 patients with a mean age of 56.47 ± 11.97 years. There were 172 (69.9%) women, i.e. a sex ratio of 0.43. Diabetes had been known for less than 10 years in the majority (67.9%). Type 2 diabetics were in the majority (95.5%). Of the 246 patients, 42 (17.1%) had a Mini Mental State Examination (MMSE) less than or equal to 24. Of these 42 patients, 32 met the DSM V (Diagnostic and Statistical Manual disorders, 5th edition) criteria for dementias, i.e. a frequency of 13.0%. Of the 32 demented patients, 21 (65.6%) had vascular dementia and 34.4% had degenerative dementia. We did not note a mixed etiology. Dementia was severe in 15.6% of cases. In multivariate analysis, only age (OR = 10.09;95% CI [4.19 - 24.27];p Conclusion: Screening for dementia should be systematic in diabetics, especially at old age.

关键词： Dementia Diabetes Porto-Novo Benin

Epidemiological, Clinical and Etiological Aspects of Sciatica in Hospital Setting, CNHU-HKM Cotonou

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Neuroscience & Medicine 2018年第4期9卷 171-179页

作者： constant Kodjo adjien Dieudonné Gnonlonfoun Cyriaque Dochamou Accrombessi Donald Dismand Houinato Neurology Teaching and Research Unit Faculty of Health Sciences University of Abomey Calavi Cotonou Benin Neurology University Clinic CNHU HK-Maga Teaching Hospital Cotonou Benin

Sciatica, mostly clinical-based diagnosis, is a potentially debilitating condition as a result of disco-radicular conflict between L4 and L5 or L5 and S1. This study aims at describing the epidemiological, clinical and etiological aspects of sciatica in Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) of Cotonou. It was a prospective, descriptive and analytical study conducted in CNHU-HKM Cotonou neurology department from 1st January to 30th June 2016. The study population comprised 115 low back pain patients seen in consultation. Data collection was carried out through a standard information sheet with socio-demographic, clinical, para-clinical, etiological and therapeutic data. Epi data 3.1 was used for data entry and Stata11 for processing. Frequency of sciatica was 18.6%, with 95% CI [11.5% - 25.7%]. The study population age ranged from 29 to 73 years, with 52 ± 16 as mean value, while sex ratio was estimated at 0.6. Bilateral sciatica representing 53% was present in L5 and S1 nerve roots in 44.4% of cases. It was exacerbated in prolonged standing (24.4%) and relieved in supine position (44.3%), with paresthesia (59.1%) and intermittent radicular claudication (40.9%). Spinal osteoarthritis was the most prevalent etiology (47%). Sciatica is becoming increasing prevalent and should be regarded as problem of health concern.

关键词： Sciatica Prevalent Cotonou