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Impact of Tension-Type Headaches in the Workplace in Brazzaville

Neuroscience & Medicine 2024年第2期15卷 77-91页

作者： Happhia Dinah Boubayi Motoula Latou Josué Euberma Diatewa Ghislain Armel Mpandzou Prince Eliot Galieni Sounga Bandzouzi Jean Brice Mouendenguia Karen Lise Obondzo Aloba paul macaire ossou-nguiet Faculty of Health Sciences Universit Marien Ngouabi Brazzaville Congo Department of Neurology Brazzaville University Hospital Congo Department of Neurology Loandjili General Hospital Pointe-Noire Congo

Introduction: Tension-type headaches are the most widespread of the primary headache disorders. Due to their high prevalence, tension-type headaches represent a major public health problem with an enormous socio-economic burden. Determining their impact remains a challenge. Objective: To assess the impact of occupational tension-type headache in Brazzaville and identify associated factors. Population and Methods: This was an analytical case-control study conducted in public and private companies in the city of Brazzaville over a period of four (04) months. The case population consisted of cephalalgic employees;the control population was drawn from the same companies and was free of tension-type headaches. Study variables were divided into socio-professional, clinical and individual impact variables. Individual impact variables were represented by: the HIT-6 score, which incorporates a very broad conception of disability, covering several domains, namely: severity of pain during attacks and the restrictive and limiting nature of attacks. Results: Individual impact was severe in 18 (62.1%) men and 11 (37.9%) women. Mean age was 36.3 6.14 years for cases with severe impact. The mean duration of headache was 40.3 32.7 months for cases with severe impact. Tension headache evolved in attacks in 22 (75.9%) cases with severe impact, and continuously in seven (24.1%) cases. The average number of attacks per month was 2.52 1.04 for cases with severe impact. Cases with severe impact included 14 (48.3%) with chronic headache and 15 (51.7%) with episodic headache. Pain of severe intensity present in 48.3% of cases was associated with a severe impact of tension-type headache: OR = 151.66 [2.36 - 44245.95] and p-value = 0.037. At least one days absence from work per year was observed in 47.4% of our cases. The number of days off work per year due to tension-type headache had an interquartile range between 0 and 3 days and extremes from 0 to 14 days. It was the consequence of a severe impact on daily and/or professional activiti

关键词： Impact Tension Headache Workplace

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Mortality from Stroke in Young People in Brazzaville

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World Journal of Neuroscience 2024年第1期14卷 37-55页

作者： Motoula Latou Happhia Dinah Boubayi Josué Euberma Diatewa Ghislain Armel Mpandzou Prince Eliot Galieni Sounga Bandzouzi Elizeth Richtellah Fouti Kouapele Karen Lise Obondzo Aloba paul macaire ossou-nguiet Faculty of Health Sciences Université Marien Ngouabi Brazzaville The Republic of the Congo Department of Neurology Brazzaville University Hospital Brazzaville The Republic of the Congo Department of Neurology Loandjili General Hospital Pointe-Noire The Republic of the Congo

Introduction: Cerebrovascular accidents (CVA) are an absolute neurovascular emergency and the main cause of mortality and acquired disability in adults. In the Congo, stroke is the leading cause of mortality and the leading cardiovascular emergency, with a hospital frequency of between 49.74% and 56.2%. The aim of the study was to identify the mortality factors associated with stroke in young people in Brazzaville. Patients and Methods: This is a longitudinal analytical study conducted from February to period from February to September 2019 in the neurology, general intensive care and medical emergency departments of the Brazzaville University Hospital (CHUB). All subjects aged 18 - 55 years of completed age, admitted for arterial stroke confirmed by brain imaging, were included. Study variables were: age, gender, socioeconomic level, laterality, time to admission and CT scan, vascular risk factors, history of cardiomyopathy, atrial fibrillation, TIA (transient ischemic attack) or stroke, NIHSS (National Institutes of Health Stroke Scale) score, Glasgow score, blood pressure, temperature, heart rate, occurrence or non-occurrence of complications, blood glucose, creatinine, lipid profile and blood count. Data were analyzed using SPSS 21 software. Descriptive analyses were performed using SPSS 21 software. Results: 103 patients were included in the study, of whom 45 (43.7%) had ischemic stroke and 58 (56.3%) with hemorrhagic stroke. Mortality was high at 29.1% in our study, and mainly concerned hemorrhagic strokes (73.7%). Two-week mortality in our study accounted for 63.33% of total lethality. After simple logistic regression, the factors associated with death within two weeks were age between 40 - 44 years (OR (odds ratio) = 2.95;p = 0.01), hemorrhagic stroke (OR = 1.41;p = 0.07), mass effect (OR = 3.26;p 15 (OR = 5.89 (2.90 - 11.95);p < 0.001) and bronchopulmonary infection (OR = 30,

关键词： Brazzaville Mortality Stroke Young Subjects

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Clinical and Therapeutic Aspects of Migraine in Brazzaville

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World Journal of Neuroscience 2024年第1期14卷 56-71页

作者： Motoula Latou Happhia Dinah Boubayi Josue Diatewa Prince Eliot Galieni Sounga Bandzouzi Ghislain Armel Mpandzou Héloïse Stéphanie Ongoly Ikora Karen Lise Obondzo Aloba paul macaire ossou-nguiet Faculty of Health Sciences Marien Ngouabi University Brazzaville The Republic of the Congo Department of Neurology Brazzaville University Hospital Brazzaville The Republic of the Congo Department of Neurology Loandjili General Hospital Pointe-Noire The Republic of the Congo

Introduction: Migraine is the most common primary headache, and can cause significant disability. There are two types, migraine without aura and migraine with aura. The diagnosis of migraine is essentially clinical. Worldwide prevalence was estimated at 11.6% in 2009. In Africa, it is estimated at 10.4%. Objective: To describe the clinical and therapeutic aspects of migraine in Brazzaville. Patients and Methods: This was a door-to-door cross-sectional study conducted from 1st May to 1 st July 2018 in the city of Brazzaville. Subjects over 18 with clearly expressed consent were included. The questionnaire covered demographic characteristics, diagnostic criteria for migraine according to the IHS, treatments taken. The degree of disability was determined using the Migraine Disability Assessment Scale (MIDAS). Statistical analysis was performed using SPSS 22.0 for MAC. Results: Of the 1017 subjects interviewed in this study, 115 (39.9%) had migraine, including 73 women (63.47%) and 42 men (36.52%). In the group of migraine sufferers, the number of cases of definite migraine was 61 (53.04%) and that of probable migraine 54 (46.95%). For 81 migraine sufferers (70.43%), stress was the triggering factor. The frequency of attacks was weekly and monthly for 30 (26.1%) and 19 (16.5%) sufferers respectively. The location of the migraine was unilateral in 38% of cases and tilted in 24.3%. The intensity of the attack was described as moderate and severe in 41.7% and 57.4% of subjects respectively. Phonophobia/photophobia accompanied the migraine in 65.2% of cases. One hundred and eight subjects were treated. Of these, 106 (98.1%) were on medication. Eleven (10.37%) had received a medical prescription, and ninety-seven (89.8%) were self-medicating. Five and three subjects were under the care of a general practitioner and a neurologist respectively. Conclusion: Migraine is a frequent pathology in Brazzaville. Its preponderance among young people and women calls for the implementation of effective prevention

关键词： Migraine Clinic Therapeutics Brazzaville

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Cost of Stroke Care at Public Hospitals in Brazzaville and Implication of Third Parties in Stroke Care Expenditure

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World Journal of Neuroscience 2022年第2期12卷 82-92页

作者： Josué Euberma Diatewa Ghislain Armel Mpandzou Patrice Bruno Mokoko Dinah Happhia Boubayi Motoula-Latou Eliot Prince Galiéni Sounga-Banzouzi paul macaire ossou-nguiet Neurology Department University Hospital of Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Neurology Department Loandjili General Hospital Pointe Noire Congo

Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a health insurance system. Objectives: To evaluate the in-hospital costs of stroke care in Brazzaville;to determine the factors influencing the total mean in-hospital cost of stroke care;to identify third parties contributing to stroke care expenditure. Methods: This was a cross-sectional prospective and analytical study. It was carried out at 4 public hospitals in Brazzaville (University Hospital Center, Chinese and Congolese Friendship Hospital, Talangaï Hospital and Makélékélé Hospital), from May to August 2019 (4 months). It focused on patients who had a first episode of stroke confirmed by brain imaging and were at least 18 years old. The bottom-up approach was used to determine the in-hospital costs of stroke care. Results: This study included 109 patients who fulfilled inclusion criteria. Their mean age was 59.2 ± 13.7 years old, with limits of 35 and 90 years old. The total direct in-hospital cost of stroke care was 47,308,330 francs CFA (72,122 euro). The total mean in-hospital cost of stroke care was 1,389,590 francs CFA (2118 euro). The mean cost of intracerebral hemorrhage care was 510,988 francs CFA (779 euro) versus 373,457 francs CFA (569 euro) for cerebral arterial infarction care. The following factors affected the total mean cost of stroke care: type of hospital (p < 0.0001), length of hospital stay (p = 0.001), type of stroke (p = 0.01), stroke severity (p = 0.001) and complications (p = 0.001). The level of contribution to stroke care expenditure covered by third parties was: 78% for patient families;2.8% for community self-help associations. Conclusion: In Congo, the mean in-hospital cost of stroke care is elevated considering the guaranteed minimum wage of 70,000 francs CFA (107 euro). Five factors affect the total mean cost of stroke care. Patient families are the main finan

关键词： Stroke Hospital Cost Associated Factors Brazzaville

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Role of CD4+ and CD8+ T Lymphocyte in the Onset of Stroke in People Living with HIV in Pointe-Noire

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World Journal of Neuroscience 2022年第1期12卷 1-7页

作者： Prince Eliot Galieni Sounga Bandzouzi Ghislain Armel Mpandzou Josué Euberma Diatewa Dina Happia Motoula-Latou Charles Godefroy Koubemba paul macaire ossou-nguiet Donatien Moukassa Faculty of Health Sciences Marien N’Gouabi University Brazzaville Republic of Congo Department of Neurology Loandjili General Hospital Pointe-Noire Republic of the Congo Department of Neurology University Hospital Center of Brazzaville Brazzaville Republic of Congo

Objective: To determine the role of CD4+ and CD8+ T lymphocytes in the onset of stroke in people living with HIV. Methodology: This was a descriptive, cross-sectional study from January to July 2019, in the neurology department of loandjili general hospital, including any patient hospitalized for a first episode of stroke confirmed by brain scan. The study variables were: age, sex, CRP value, serum T cell CD4+, CD8+. The statistical analysis was carried out using the EPI info 7 software. Results: Twenty stroke patients were included. The relative frequency of HIV was 20%. The risk factors were potentiated by immunosuppression of CD4+ T cells. Sixty percent (60%) of the patients had a CD4+ count 3 and the mean CD4+ count was ±191/mm3. Stroke was the predominant mechanism of injury with a frequency of 70%, the only injury mechanism of stroke in patients with CD8+ T cell count > 800/mm3 (p = 0.04). Conclusion: Risk factors are potentiated by TCD4+ lymphocyte immunosupression, also CD8+ lymphocytes of immune system activation marker are a cardiovascular risk factor for living people with HIV.

关键词： CD4+ CD8+ T Lymphocytes HIV Stroke Pointe-Noire

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Knowledge about Stroke among Workers in Public and Private Enterprises in Brazzaville and Their Attitudes towards Stroke Victims

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World Journal of Neuroscience 2022年第4期12卷 163-180页

作者： Josué Euberma Diatewa Cécilia Océane Kwama-Matiti Ghislain Armel Mpandzou Dinah Happhia Boubayi Motoula-Latou Eliot Prince Galiéni Sounga-Banzouzi paul macaire ossou-nguiet Neurology Department University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Neurology Department Loandjili General Hospital Pointe Noire Republic of the Congo

Background: Stroke causes multiple complications, sequelae and a high mortality rate. Therefore, it is important to initiate or improve stroke awareness. Objectives: To assess knowledge about stroke among workers, explore workers’ attitudes towards stroke victims and identify factors influencing knowledge about stroke and workers’ attitudes. Methods: It was an analytical cross-sectional study. It was conducted from 16 August to 30 December 2020 (4.5 months). It was carried out in public and private enterprises in the formal sector in Brazzaville. It focused on workers aged 19 years and above. The study variables were socio-professional, psychosocial, epidemiological and clinical. Results: This study included 543 workers who fulfilled inclusion criteria. The knowledge scores for at least one warning sign and one risk factor were 74% and 77.7%, respectively. The average knowledge scores for warning signs and risk factors were 11.4% and 16.7%, respectively. For prevention measures, average knowledge score was 16.5%. The average score of knowledge for items related to post-stroke life of stroke victims was 78.3%. The average rate of positive attitudes of workers towards stroke victims was 81.4%. The determinants of knowledge about stroke were education (p = 0.039) and information (p = 0.040). The factors influencing workers’ normal attitude were education (p = 0.023) and knowledge about stroke (p Conclusion: Although the attitudes towards stroke victims are overall good, the level of knowledge about warning signs, risk factors and prevention measures is low. Because of this, it is important to organize public regular awareness and education campaigns in order to improve and increase knowledge about stroke.

关键词： Stroke Knowledge Attitudes Enterprises Brazzaville

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Knowledge about the Management of Anti-Epileptic Drug Treatment among General Practitioners in Brazzaville, Congo

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Neuroscience & Medicine 2023年第2期14卷 9-28页

作者： Josué Euberma Diatewa Inès Frédérique Nsondé-Mondzié Dinah Happhia Boubayi Motoula-Latou Eliot Prince Galiéni Sounga-Banzouzi Yacouba Kaba Ghislain Armel Mpandzou paul macaire ossou-nguiet Neurology Department University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Neurology Department Loandjili General Hospital Pointe Noire Republic of the Congo

Background: Epilepsy is a chronic brain disorder. It often leads to disabilities and handicaps. In Africa, epilepsy is almost exclusively treated by general practitioners (GPs) because of a shortage of epilepsy specialists. It is therefore important to know the level of knowledge about epilepsy among GPs in order to improve their skills. Objectives: To assess the level of knowledge about the management of anti-epileptic drug treatment among GPs in Brazzaville;to investigate the relationship between demographic factors and GPs’ knowledge. Methods: This was a cross-sectional analytical study. It was conducted from 20 July to 1 September 2021. It focused on GPs working in public hospitals and private care centers in Brazzaville. Information on treatment aspects was collected through a standardized 11-item questionnaire. Results: Among the 137 participants, there were 84 (61.3%) men and 53 (38.7%) women. Of these participants, 36 (26.3%) were trained in Congo versus 101 (73.7%) in other countries. Only 21 (15.3%) GPs had good knowledge about the management of anti-epileptic drug treatment. The overall average knowledge score among GPs was low (31.4%). No significant associations were found between low and good levels of knowledge and gender (OR = 1.03;95% CI = 0.40 - 2.68;p = 1.000), age groups (OR 0.05), training country (OR = 0.62;95% CI = 0.19 - 1.98;p = 0.591), practice hospital (OR = 0.40;95% CI = 0.05 - 3.20;p = 0.695) and duration of professional experience (OR 0.05). Conclusion: The study population has insufficient knowledge about the management of anti-epileptic drug treatment. Demographic factors have no impact on GPs’ knowledge. Epilepsy education programs are needed to improve GPs’ knowledge and skills.

关键词： Epilepsy Drug Treatment General Practitioners Knowledge Brazzaville

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Epileptic Seizures in Neonates Treated with Hypothermia for Hypoxo-Ischemic Encephalopathy in Brazzaville, Congo: Types and Evolution

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Neuroscience & Medicine 2023年第4期14卷 63-75页

作者： Josué Euberma Diatewa Dinah Happhia Boubayi Motoula-Latou Benoîte Gracia Diatewa Gabrielle Ontsira Grâce Kadidja Cléona Nkounkou-Milandou Eliot Prince Galiéni Sounga-Banzouzi Ghislain Armel Mpandzou Jean Robert Mabiala-Babela paul macaire ossou-nguiet Neurology Department University Hospital of Brazzaville Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Neonatology Department Blanche Gomez Mother and Child Hospital Brazzaville Republic of Congo Neonatology Department University Hospital of Brazzaville Brazzaville Republic of Congo Neurology Department Loandjili General Hospital Pointe Noire Republic of Congo

Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However, some neonates may experience epileptic seizures during therapeutic hypothermia (TH). Data on the electrophysiologic and evolutionary aspects of these seizures are scarce in African countries. Objectives: To determine the types of epileptic seizures caused by HIE in neonates in Brazzaville;to describe the evolution of background EEG activities during TH and rewarming;to report the evolution of epileptic seizures. Methods: This was a cross-sectional, descriptive study conducted from January 2020 to July 2022. It took place in Brazzaville in the Neonatology Department of the Blanche Gomez Mother and Child Hospital. It focused on term neonates suffering from moderate or severe HIE. They were treated with hypothermia combined with phenobarbital for 72 hours. Results: Among 36 neonates meeting inclusion criteria, there were 18 boys and 18 girls. Thirty-one (86.1%) neonates had grade 2 and 5 (13.9%) grade 3 HIE. In our neonates, HIE had induced isolated electrographic seizures (n = 11;30.6%), electroclinical seizures (n = 25;69.4%), and 6 types of background EEG activity. During TH and rewarming, there were 52.8% of patients with improved background EEG activity, 41.7% of patients with unchanged background EEG activity, and 5.5% of patients with worsened background EEG activity. At the end of rewarming, only 9 (25%) patients still had seizures. Conclusion: Isolated electrographic and electroclinical seizures are the only pathological entities found in our studied population. In neonates with moderate HIE, the applied therapeutic strategy positively influences the evolution of both seizures and background EEG activity. On the other hand, in neonates with severe HIE, the same therapeutic strategy is ineffective. .

关键词： Epileptic Seizures Neonate Hypoxo-Ischemic Encephalopathy Therapeutic Hypothermia Antiepileptic Drugs Brazzaville

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Spectrum of Neurological Disorders Related to Autoimmune Diseases in Brazzaville, Congo

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World Journal of Neuroscience 2023年第1期13卷 21-38页

作者： Josué Euberma Diatewa Ghislain Armel Mpandzou Rovalez Edgar Mouandza Ongouya Dinah Happhia Boubayi Motoula-Latou Karen Lyse Obondzo Aloba Yacouba Kaba Régis Moyikoua Dominique Marline Nguiegna Estelle Boudzoumou Diakabana Eliot Prince Galiéni Sounga-Banzouzi Franck Ladys Banzouzi paul macaire ossou-nguiet Neurology Department University Teaching Hospital of Brazzaville Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Radiology Department University Hospital Teaching of Brazzaville Brazzaville Republic of Congo Neurology Department Loandjili General Hospital Pointe Noire Republic of Congo

Background: Autoimmune diseases, which are among the leading causes of morbidity and mortality in the world, are pathologies caused by a dysfunction of the immune system. They can affect the central nervous system, the peripheral nervous system or both nervous systems. Objectives: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutive aspects of neurological disorders related to autoimmune diseases. Methods: This was a prospective cohort study. It was carried out from 1 January 2015 to 31 December 2019 (5 years). It focused on patients aged 15 years and above, who were hospitalized or followed as ambulatory patients for neurological disorders related to autoimmune diseases in the neurology department of the university teaching hospital in Brazzaville. Results: Among the 41 patients who fulfilled inclusion criteria, there were 29 (70.73%) women and 12 (29.27%) men. The average age of patients was 38.3 ± 13.8 years. An increase in the frequency of neurological disorders related to autoimmune diseases was observed every year. The main neurological disorders were neuromyelitis optica spectrum disorders (n = 14;34.15%), acute polyradiculoneuropathies (n = 13;31.71%), chronic polyradiculoneuropathies (n = 4;9.75%) and acute disseminated encephalomyelitis (n = 3;7.31%). The treatments administered, which consisted of corticosteroids and immunosuppressive drugs, had significantly improved the vital prognosis and functional status of patients (p = 0.025). Conclusion: In our study population, neurological disorders related to autoimmune diseases are rare. The neurological clinico-pathological entities diagnosed are similar to those reported in the literature. The therapeutic approaches used improve the quality of life of patients.

关键词： Autoimmune Diseases Neurological Disorders Brazzaville

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Anterior Cerebral Infarction by Fronto-Basal Meningioma

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Neuroscience & Medicine 2013年第4期4卷 277-289页

作者： paul macaire ossou-nguiet Dieu Donné Gnonlonfoun Karen Obondzo-Aloba Hugues Brieux Ekouélé-Mbaki Gilbert Fabrice Otiobanda Department of Intensive Care University Hospital of Brazzaville Brazzaville Congo Department of Neurology University Hospital of Brazzaville Brazzaville Congo Department of Neurology University Hospital of Cotonou Cotonou Benin

The association between stroke and meningioma is rarely reported in the data. In most etiology classification, there is no compressive cause. The association between meningioma and stroke is increasingly reported. We report a case of 52-year-old woman, previously healthy, presented with sudden right hemiplegia with some transient mood disorders. The CT-scan revealed acute left anterior cerebral artery infarction associated with fronto-basale meningioma infiltrating both anterior cerebral arteries. She was treated by corticosteroid and rehabilitation, with partial recovery. No stroke prevention was used before surgical treatment.

关键词： Infarction Anterior Cerebral Artery Meningioma

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