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Diabetes Complications and Associated Factors in Type 2 Diabetic Patients in Cotonou

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Journal of Diabetes Mellitus 2014年第4期4卷 311-315页

作者： francois djrolo Noel MParaiso Oumou Diarra Michel Makoutode Departement de Medecine Interne Facultedes Sciences de la SanteUnited’Endocrinologie et Maladies MetaboliquesCotonouBenin Institut Regional de SantePublique OuidahBenin

Long-term complications are the main sources of morbidity and mortality in diabetic patients. Aims: The aims of the study were to determine the rate of long-term complications in type 2 diabetic patients and to identify factors associated to these complications. Patients and method: Successive type 2 diabetic patients attending the diabetic center were submitted to a questionnaire and to clinical examination. Data were completed by consulting their medical reports. Chi square test was used for statistical analysis. Results: In 150 diabetic patients included in the study, the global rate of complications was 78.0%. Specific rate for itch complication investigated was 57.7% for peripheral neuropathy, 75.0% for erectile dysfunction, 20.0% for nephropathy, 36.6% for retinopathy, 40% for macroangiopathy and 8.0% for foot ulcer. Factors significantly associated with high rate of complications were age above or equal to 50 years (p = 0.001), the male gender (p = 0.000), high blood pressure (p = 0.0001), the absence of familial history of diabetes (p = 0.02), the duration of the disease above 5 years (p = 0.001) and high HbA1c level (p = 0.001). Conclusion: This study revealed that type 2 diabetic patients followed up in the diabetic center in Cotonou showed a high rate of chronic complications which often occurred in a younger age than in developed countries. Numerous socio-demographic and biological factors were significantly associated with the high rate of complications.

关键词： Diabetes Complications Associated Factors

Diabetes in Borgou Department in Benin: Prevalence and Associated Factors

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Journal of Diabetes Mellitus 2015年第2期5卷 90-96页

作者： francois djrolo Thierry Adoukonou Corine Houehanou Josel DHouinato Dismand Houinato Department of Internal Medicine Faculty of Health SciencesEndocrinology and Metabolic Diseases UnitCotonouBenin Faculty of Medicine University of ParakouParakouBenin National Program against Non-Communicable Diseases Ministry of HealthCotonouBenin

An epidemic trend is observed in the evolution the epidemiology of diabetes mellitus worldwide. In a nationwide survey conducted in 2008, prevalence of diabetes was estimated to 2.6% in the hole Beninese population and to 4.6% in Borgou department representing the highest in the country. Aim: To determine the prevalence of diabetes mellitus in the adult population and investigate associated factors in Borgou department. Method: A survey was conducted from September 30th to November 20th 2011. In a random sampling using the STEP wise approach of surveillance of chronic diseases recommended by the World Health Organization, 4597 subjects over 18 years old (1935 men and 2662 women) were selected. After informed consent, every subject was submitted to the STEP questionnaire and anthropometric measures. Capillary blood was drawn in fast condition to determine glycaemia. Diabetes was defined by fasting glycaemia above 1.26 g/l. Chi square test was used for statistical analysis and difference was considered significant with p < 0.05. Results: Prevalence of diabetes was 12.4%. There was not a significant difference between men (8.5%) and women (9.4%), p = 0.33. Prevalence of previously known diabetes was 1.2% suggesting a large proportion of undiagnosed diabetes. Prevalence of diabetes increased significantly with age (p < 0.0001). There was no association with instruction level (p = 0.21). Other factors significantly associated with diabetes were place of residency (p < 0.0001), ethnicity (p = 0.002), marital status (p < 0.0001), obesity (p = 0.017) and high blood pressure (p < 0.0004). Conclusion: There is a rapid increase in diabetes prevalence in Borgou department in Benin confirming the epidemic trend of the disease. A large proportion of these diabetic subjects remained undiagnosed, so untreated and then, exposed to precocious chronic complications and precocious mortality. These results strongly support need for active intervention program with objectives of primary,

关键词： Diabetes Impaired Fasting Glycaemia Prevalence Associated Factors

Prevalence of Risk Factors for Chronic Non-Communicable Diseases to the National Teaching Hospital “HKM” of Cotonou

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Journal of Diabetes Mellitus 2015年第3期5卷 155-163页

作者： Annelie Kerekou-Hode Stephane Dismand Houinato Mylidia Bocovo Daniel Amoussou-Guenou francois djrolo University Clinic of Endocrinology and Metabolic Diseases of Cotonou University of Abomey-CalaviCotonouBenin Neurology Unit of Cotonou University of Abomey-CalaviCotonouBenin Internal Medicine Unit of Cotonou University of Abomey-CalaviCotonouBenin

Background: In 2008 Non-communicable diseases (NCDs) were responsible for 63% of deaths worldwide and 80% of these deaths occurred in developing countries. Four of them were responsible for more than 80% of mortality from NCDs, which were cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. They shared the same risk factors. Objective: To determine the prevalence of NCD risk factors in patients admitted to consult in the outpatient unit of the National Teaching Hospital of Cotonou. Patients and Methods: This was a transversal, descriptive and analytical study which took place from 15 June 2011 to 16 September 2011. It focused on 1000 subjects found after a recruitment of all patients coming to consult during the study period. The collection technique was a questionnaire followed by physical measures (weight, height, blood pressure and waist) and biological measures (fasting glucose and cholesterol). The data were analyzed with the software Epi-3.3.2 info. Results: The mainly prevalent behavioural risk factors were smoking (10.2%), alcohol consumption (60.3%), insufficient intake of fruits and vegetables (84.2%), and physical inactivity (57.6%). The prevalent physical risk factors were hypertension (47.4%), obesity (27.5%), and overweight (35.3%). The prevalent biological risk factors were diabetes (28.5%), and hypercholesterolemia (10.4%). The level of cardiovascular risk was higher than 40% in 81 people (8.1%). Conclusion: This study shows the importance of risk factors for NCDs in outpatient Unit in the National Teaching Hospital of Cotonou.

关键词： Prevalence Chronic Non-Communicable Diseases Risk Factors Benin

Study of the Management of Diabetic Metabolic Emergency in the National Teaching Hospital HKM of Cotonou

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Journal of Diabetes Mellitus 2014年第4期4卷 359-370页

作者： Annelie Kerekou Eugene Zoumenou Medard Agbantey Corneille Tiomon Daniel Amoussou-Guenou francois djrolo Martin Chobli Clinical Service of Endocrinology and Metabolism National Teaching Hospital HKM of CotonouUniversity of AbomeyCalaviBenin Clinical Service of Emergency Aid National Teaching Hospital HKM of CotonouUniversity of AbomeyCalaviBenin

Objective: To study the epidemiological, clinical and therapeutic profile of diabetic metabolic emergencies. Patients and methods: This was a prospective study in descriptive and analytical referred conducted over a period of 6 months in the National Teaching Hosptial HKM of Cotonou December 1, 2011 to May 31, 2012. The patients included in the case of our study were those who, conscious or comatose, had submitted a diabetic hypoglycemia or abnormal blood sugar (2.5 g/l), with a positive glycosuria and ketonuria positive or not. All patients gave their consent for this study. Results: 2786 patients were admitted to the emergency room, 57 (2%) of acute metabolic decompensation of diabetes. DKA accounted for 1.1%, hyperosmolar hyperglycemic syndrome 0.5% and 0.4% hypoglycemia. For hyperglycemic decompensation, sex ratio was 0.8 for females with a mean age of 50.7 ± 16.9 (16-84). For hypoglycemia, male gender was predominant. As decompensation factors for hyperglycemia, infection was found in 54% (n = 30) of cases and stroke by 29% hypertension (n = 15). As for hypoglycemia triggers were dominated by dietary error (50%) and therapeutic errors (25%). 63% (n = 36) of patients underwent resuscitation. More than 3 out of 4 patients were resuscitated to insulin. 98% of patients were rehydrated. The outcome was favorable in 56% of cases. The death rate was 25 % (n = 14). Conclusion: Diabetes mellitus is a serious condition and its severity is mainly due to complications which can be acute or chronic.

关键词： Ketoacidosis Diabetes Decompensation Ketosis

Thyroid Function in Pregnant Women from a West-African Population

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Open Journal of Molecular and Integrative Physiology 2018年第1期8卷 1-11页

作者： Bonaventure Awede Mariane SHounnou Christiane Tshabu-Aguemon Grace Adehan francois djrolo Marcellin Amoussou-Guenou Anatole Laleye Unite de Physiologie Faculte des Sciences de la SanteUniversite d’Abomey-CalaviCotonouBenin Unite de Gynecologie et d’Obstetrique Faculte des Sciences de la SanteUniversite d’Abomey-CalaviCotonouBenin Unite de Biophysique et de Medecine Nucleaire Facultédes Sciences de la SanteUniversite d’Abomey-CalaviCotonouBenin Unite d’Endocrinologie et de Nutrition Faculte des Sciences de la SanteUniversite d’Abomey-CalaviCotonouBenin Unite de Biologie Humaine Faculte des Sciences de la SanteUniversite d’Abomey-CalaviCotonouBenin

Thyroid dysfunction is frequent in pregnant women and is often associated with an increased risk of adverse maternal and fetal outcome. In the present work, thyroid function of pregnant women from Benin republic was studied. Two hundred forty (240) pregnant women, without thyroid disease history, have been included in the study. A blood sample was drawn for measurement of TSH, free T3 and free T4 serum levels. From the first to the third trimester, plasma levels of free T3 and free T4 decreased when plasma levels of TSH increased. Using recommendations of the 2011 American Thyroid Association (ATA) guidelines, thyroid dysfunction was observed in 24.17% of subjects. Hypothyroidism was present in 22.50% of subjects with 19.17% of subclinical hypothyroidism, 0.83% of overt hypothyroidism and 2.50% of hypothyroxinemia and hyperthyroidism was observed in 1.67% of subjects. An increase from 15.52% to 28.07% was observed in the frequency of hypothyroidism from the first to the third trimester of pregnancy. When an upper cut-off value of 4 mU/L was used for TSH, as recommended in the 2017 ATA guidelines, prevalence of thyroid disorders was 14.58% with 12.91% of hypothyroidism but no hypothyroidism was observed in women in the first trimester of pregnancy. A rise in hypothyroidism frequency was observed when pregnant women age increased. Hypothyroidism was very common in pregnant women in Benin. To allow accurate assessment of thyroid status in pregnant women in Benin, pregnancy specific range for plasma level of TSH and thyroid hormones should be established.

关键词： Pregnancy Thyroid Function Hypothyroidism

Therapeutic Itinerary and Causes of Delay in Specialized Consultation of Patients Admitted for Diabetic Foot

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Journal of Diabetes Mellitus 2018年第4期8卷 125-130页

作者： Comlan Jules Gninkoun Mensah S.Attikleme Roberto Dossou Tores Prudencio Adebayo Sabi Cossi Alassani francois djrolo Endocrinology Metabolism and Nutrition UnitFaculty of Health Sciences of CotonouCotonouBenin University Clinic of Internal Medicine and Medical Oncology CotonouBenin Teaching Hospital of Borgou-Alibori ParakouBenin

Introduction: Amputation remains a common practice in patients admitted for diabetic foot. The delay in consultation is one of the main reasons. The objective of this work was to analyze patients’ itinerary care and to identify the causes of delay in consultation in patients admitted for diabetic foot. Method: This is a descriptive cross-sectional study, including all patients hospitalized for diabetic foot. A wait of at least seven (7) days before consulting the Endocrinology department of Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) after the foot injury occurred was considered as delay in consultation. The data were recorded and analyzed in the EPI INFO software. The description of the sample was made according to the usual statistics (frequency, average, standard deviation). Results: Seventy-six (76) diabetic foot cases were admitted during the period of the study. The mean age of the patients was 56.64 ± 10.71 years with extremes of 29 years and 84 years. Patients were most often received at an advanced stage of the foot injury, 3D stage of Texas classification in 87% of cases and Wagner grades 4 and 5 in 52% of cases. The amputation rate was 38.16%. An analysis of the first care places reveals that 90.8% of patients had consulted conventional medicine, 13.2% in traditional medicine;1.2% had religious practices and 18.7% had declared self-medication at home. Consultation period at CNHU HKM was more than 7 days in 80% of cases and less than 7 days in 20% of cases. The average consultation time was 44.08 ± 26.43 days with extremes of 1 and 480 days. The main reasons for the delay in seeking hospital care cited by diabetic patients were fear of amputation (47.8% of cases), economic difficulties (32.5% of cases) and awareness lack of the situation seriousness (22.4%). Conclusion: The therapeutic itinerary of patients with diabetic foot was particularly long. The main reasons of late appeal to specialized care were fear of amputation and economic difficulties.

关键词： Therapeutic Itinerary Diabetic Foot Delay Complication Amputation

Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa

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World Journal of Diabetes 2015年第16期6卷 1312-1322页

作者： Koffi Alouki Hélène Delisle Stéphane Besancon Naby Baldé Assa Sidibé-Traoré Joseph Drabo francois djrolo Jean-Claude Mbanya Serge Halimi Department of Nutrition Faculty of MedicineUniversity of MontrealDowntown Station Santé-Diabète (NGO) Mali Chapter Endocrinology Department Donka Teaching Hospital Internal Medicine Department Bamako University Hospital Internal Medicine Department Ouagadougou University Hospital Endocrinology Department National University Health Centre Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical SciencesUniversity of Yaoundé I University Joseph Fourier and University Hospital Centre

AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularlypatients with ***: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin,Burkina Faso,Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines,published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications. RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes(in the public sector) would amount to 21%-34% of the country's gross national income per capita,26%-47% in the presence of retinopathy,and above 70% for nephropathy,the most expensive complication. CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction,it is innovative and of interest for several stakeholders.

关键词： Diabetes Non-communicable diseases Africa Advocacy Cost-of-illness

Prevalence and Associated Factors of Diabetes Mellitus in Benin

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Open Journal of Epidemiology 2015年第3期5卷 163-171页

作者： Alphonse Kpozehouen francois djrolo Charles J.Sossa Akpa R.Gbary Yessito Chouehanou Dieudonné Fambo Yessouf Tchabi Roger Salamon Dismand S. Houinato Assistant Professor Biostatistics/Epidemiology Institut Régional de Santé Publique Route des Esclaves Université d'Abomey-Calavi Ouidah Bénin Professor of Diabetology Faculty of Health Sciences Cotonou Benin Assistant Professor Nutrition/Public Health Institut Régional de Santé Publique Route des Esclaves Université d'Abomey-Calavi Ouidah Bénin Associate Professor of Epidemiology/Public Health Institut Régional de Santé Publique Route des Esclaves Université d'Abomey-Calavi Ouidah Bénin Programme National de Lutte contre les Maladies non Transmissibles Ministère de la Santé Cotonou Bénin Professor of Epidemiology ISPED Université de Bordeaux 2 Bordeaux France Professor of Neurology and Epidemiology Laboratory of Chronic and Neurological Diseases Epidemiology (LEMACEN) Faculty of Health Sciences Cotonou and National Program for Non-communicable Diseases Control Ministry of Health Cotonou Benin

Background: Data on diabetes mellitus in general population in Benin is scarce. This study aimed therefore to assess prevalence and risk factors of diabetes mellitus in Benin. Methods: The study consisted of a cross-sectional survey, using the World Health Organisation (WHO)’s instrument for stepwise surveillance (STEPS) of non-communicable diseases risk factors. A five-stage random sample of 25 to 64 years old male and female adults living in Benin participated in structured interviews and their size, weight and blood pressure were measured according to standardized procedures. Glycaemia was measured using ACCUTREND? test strips for capillary blood glucose. Prevalence and means were computed with their 95% confidence interval and standard error respectively, taking into account the sampling design. Prevalence was compared by Khi2 and means by Student’s t test. Univariate and multivariate logistic regressions were performed to identify socio-demographic diabetes’s risk factors. Results: A total of 3772 adults participated in the study. The average age of respondents was 44.2 years. Overall, 68.3% of subjects were illiterate, 82.4% lived in rural areas, 82.57% were self-employed, 20% overweight, 7.51% obese and the prevalence of hypertension was 29.5 p.100. The prevalence of diabetes mellitus was 1.4 p.100 [CI95% = (0.94:2.05)]. This prevalence was higher in men than in women (2.1% vs. 0.8%, p = 0.0031). This prevalence was higher in urban areas than in rural areas. The Littoral department had the highest prevalence (3.4%), followed by the Collines department (2.7%), Donga (2.4%) and Borgou (2.3%). As many as 49.3% of subjects diagnosed with diabetes mellitus were not aware of their status. The age group of 56 - 64 years had the highest risk [OR = 6.6, IC95% = (1.6;22.4)]. The risk of diabetes was higher in people living in urban areas than in people living in rural areas [OR = 3.04 CI95% = (1.6;6.0)]. After controlling for confounding factors, risk factors of diabet

关键词： Prevalence Risk Factors Diabetes Mellitus Benin