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Introduction: Malignant skin tumors are very frequent lesions, induced by sustained sun exposure. Cutaneous squamous cell carcinoma is a dangerous cancer of the skin. It’s more frequent in white people than black people. Squamous cell carcinomas sometimes pose a real problem of local reconstruction after their removal. Reconstructions may involve the production of regional pedunculated flaps to repair the loss of substance. We report the case of a labio-jugal squamous cell carcinoma in an HIV-positive patient. The excision of the tumor required repair by a musculocutaneous flap of the pectoralis major. The aim of this paper is to show the dangerousness of that cancer, the particularity of its location around the mouth. We also want to call for a reflection about the recurrence of that disease on HIV infection ground, despite correct resection. Clinical Case: This was a 47-year-old HIV-positive patient on antiretroviral therapy (ARVs), treated 23 years ago for pulmonary tuberculosis. He presented with an ulcerated lower lip wound extending to the right labial commissure, right cheek, and the right lateral third of the upper lip. This lesion had progressed for about 6 months without a tendency to spontaneous healing. There was no palpable lymphadenopathy, especially in the cervicofacial region. The biopsy of the lower labial lesion concluded that it was a differentiated, mature, infiltrating squamous cell carcinoma. The craniofacial CT scan did not note any regional tumor invasion. We indicated tumor excision, functional lymph node dissection, and reconstruction by a flap of the pectoralis major muscle. The operative procedure was performed under general anesthesia. The edge cuts after carcinoma removal were healthy. Three months later, the patient is seen again with a local right submandibular recurrence. Radiotherapy was offered to him. Discussion: Squamous cell carcinomas are frequent in sub-Saharan Africa with preferential localization to oropharynx and oral cavity. More and more viral infections such as HIV, HBV and HCV are implicated in the occurrence of squamous cell carcinomas of the ENT and neck and facial sphere. HIV appears to be a contributing factor in young populations. Multidisciplinary management with anti-infective treatment coupled with new therapies could reduce the risk of recurrence and metastases.

Background Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo. Methods We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality. Results The median age of the 650 older adults included in the study period was 61 years, IQR: [55–70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4–20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5 and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases. Conclusion Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

Objectives: Study the prognostic, clinical and epidemiological profile of high blood pressure and pregnancy association at the Sylvanus Olympio Teaching Hospital (CHU Sylvanus Olympio) of Lome. Patients and Method: It is about a retrospective study that is carried out at the gynecology-obstetrics unit from January to December 2016. Pregnant women with High Blood Pressure after delivery were concerned. Results: In total, 767 pregnant women with High Blood Pressure out of 12107 were taken. The frequency of HBP-pregnancy association was 6.33%. The 21 to 30 bracket age was the most represented (53.71%). The most common risk factor was the overweight or over-obseness (41.98%). Other risk factors were the first delivery and maternal age superior to 30 years old. Common clinical cases described in the study are the same as a predominance of preeclampsia. Caesarean has been the common method of delivering with foetal complications of prematurity type, neonatal suffering and hypotrophy. Conclusion: HBP-pregnancy association is a public health concern with serious foetal maternal complications. The prevention of this association is of great importance.

Objectives: To evaluate the practice of self-care in diabetic patients monitored at the Kara Teaching Hospital, known as CHU Kara. Method: We conducted a quantitative, descriptive and cross-sectional study of 40 diabetic patients monitored at the Kara CHU. The data collection took place from February 20 to May 28, 2018 and the data was collected anonymously. Results: Out of the forty (40) respondents, 60% were male with a sex ratio of 1.5 and an average age of 56.15 years. Two-thirds (2/3) of the patients did not have the blood glucose meter. More than half (52%) did not know the normal blood glucose value and 82.5% were on a low carbohydrate diet. Eighty-two point fifty percent (82.50%) were under Oral antidiabetic (ADO). Forty percent (40%) of patients often forgot their medication. Forty-seven point-fifty percent reported frequent episodes of hypoglycaemia with dizziness (58%), tremors (53%), hunger (53%), sweat (37%), tingling (26%) and the most common gestures were: sugar ingestion (53%) and glycemic control (26%). Eighty-five (85%) said they used to feel hyperglycemia with fatigue (76%), polyuria (65%), polydipsia (44%) the most common precursors and the most frequent interventions were taking hypoglycemic drugs (74%) and controlling blood glucose (24%). Conclusion: The practice of self-care remains risky for diabetic patients. Hence the need for the establishment of adequate therapeutic education programs.

The target of the study was to identify patients living with Compound high blood pressure and describe the epidemiological, treatment and progressive aspects. We had realized retrospective and descriptive study completed throughout twelve months from 1st January to December 31, 2011. The study took into account 250 hypertensives known or not admitted in the cardiology and medical intensive care units at the Sylvanus Olympio Teaching Hospital in Lome. In total, the frequency of complications of the High Blood Pressure was 33.3% with a male predominance. Patients’ average age was 52.4 years. The most frequent reasons of admission were coma (32%) and hypertensive eruption (28%). The excessive consumption of salt and alcohol were other dominant modifiable risks factors with respectively 36.8% and 22.8%. Neurologic complications were the most frequent of cerebrovascular accidents (CVA) (66%) among which strokes represented 69.7%. Cardiac complications came in second position (31.2%). Double treatment was optional in 62.2% cases with IEC+ Ica++ associated. In 56.6% cases patients with renal disease in terminal stage had been dialysed. The level of total lethality was 34%. The main cause of death was CVA (cerebrovascular accidents) (85.9%). High Blood Pressure is then a very plague with regard to its complications. Its effective caretaking is nothing but through primary prevention based on sensitization, education of the entire grass-roots and it requires the mobilization of all social components.

To determine the hospital frequency of diabetic patients with a rapid decline in their renal function, to look for the associated factors.Descriptive and analytical cross-sectional study carried out over 12 months (May 1, 2019 to April 31, 2020). Were included all patients aged 18 and over, having achieved at least 3 creatinine during the previous 2 years but spaced at least 6 months apart and having an eGFR calculated from their last creatinine greater than 30 mL/min by the formula of CDK-EPI. We evaluated the eGFR by the CDK-EPI formula using the calculator developed by the Poitiers University Hospital and the Inserm unit of the Francophone Diabetes Society.A total of 80 patients medical files were retained. The rapid decline in renal function was found in 28 patients, either a frequency of 35%. The sex ratio M/F was 1.5. The mean age was 62.93 years (range 18-85 years). Hypertension was the most common comorbidity (92.5%). The very high cardiovascular risk was predominant in 82.5% of cases. The very high renal risk was found in 20 patients, either 25%. Univariate and multivariate analysis showed that the rapid decline in renal function was associated with very high cardiovascular risk (P=0.037) and glomerular filtration rate (P˂0.001).this study showed a high hospital frequency of the rapid decline in renal function in Togo (35%). Our results have identified the very high cardiovascular risk and glomerular filtration rate as risk factors. The originality of our study was the demonstration of the high proportion of very high cardiovascular risk (82.5%) and very high renal risk (25%) in the evaluation of renal and cardiovascular risk.

Background In December 2019, the COVID-19 outbreak began in China and quickly spread throughout the world and was reclassified as a pandemic in March 2020. The first case of COVID-19 was declared in Togo on March 5. Two months later, few data were available to describe the circulation of the new coronavirus in the country. Objective This survey aimed to estimate the prevalence of SARS-CoV-2 in high-risk populations in Lomé. Materials and methods From April 23, 2020, to May 8, 2020, we recruited a sample of participants from five sectors: health care, air transport, police, road transport and informal. We collected oropharyngeal swabs for direct detection through real-time reverse transcription polymerase chain reaction (rRT-PCR) and blood for antibody detection by serological tests. The overall prevalence (current and past) of infection was defined by positivity for both tests. Results A total of 955 participants with a median age of 36 (IQR 32–43) were included, and 71.6% (n = 684) were men. Approximately 22.1% (n = 212) were from the air transport sector, 20.5% (n = 196) were from the police sector, and 38.7% (n = 370) were from the health sector. Seven participants (0.7%, 95% CI: 0.3–1.6%) had a positive rRT-PCR test result at the time of recruitment, and nine (0.9%, 95% CI: 0.4–1.8%) were seropositive for IgM or IgG against SARS-CoV-2. We found an overall prevalence of 1.6% (n = 15), 95% CI: 0.9–2.6%. Conclusion The prevalence of SARS-CoV-2 infection among high-risk populations in Lomé was relatively low and could be explained by the various measures taken by the Togolese government. Therefore, we recommend targeted screening.

Introduction Strokes are the first cause of non-traumatic disability and the second cause of death worldwide. Data analysis is useful to improve their care. Our purpose was to describe the epidemiological profile of stroke cases admitted at the Sylvanus Olympio University Hospital (CHU-SO) from 2017 to 2018. Method We conducted a descriptive study that included all stroke cases admitted at Internal Medicine Department of CHU-SO from January 2017 to December 2018. Socio-demographic and clinical data were collected by medical records reviewing and patients' interview and thereafter compiled and analyzed with Epi Info 7.2.1.0. Results The overall prevalence was 7.6% (173/2, 270) and 11.4% in patients aged 50 and over. Median age was 58.5 years, Interquartile interval (IQ) [48-65] and M/F sex ratio was 1.16. The median delay for admission to CHU-SO was one day, IQ [0-2]. Among patients' medical history, high blood pressure, strokes, alcoholism and diabetes accounted for 68.2% (118/173), 16.8% (29/173), 15.0% (26/173) and 12.1% (21/173) respectively. Hemorrhagic stroke cases accounted for 80.6% (29/36) in patients aged less than 50, while ischemia's accounted for 64.2% (61/95) among those aged 50 and over. Recovery occurred in 30.1% (52/173) with 80.8% (42/52) of sequelae. Deaths occurred in 62.4% (108/173) and were associated with the absence of the head CT scan (OR=2.71; 95% CI [1.14-6.73]). Conclusion Strokes affected mainly active people with high mortality exacerbated by the absence of the head CT scan. Early availability of the head CT scan and implementation of other specific strategies carried out of an action plan could contribute to reduce the burden of stroke at CHU-SO.

The aim of this work is to evaluate the role of Ultrasound-Doppler in the hemodynamic study of hepatic vessels during the liver cirrhosis in Togo. Method: This was an analytic cross-sectional study that measured the velocimetric parameters of hepatic vessels in cirrhotic patients and in non-cirrhotic patients. Results: The velocimetric parameters of the hepatic artery, the portal vein, and the hepatic veins were measured in 50 cirrhotic patients and 50 non-cirrhotic The caliber of the portal vein was significantly increased in cirrhotic patients compared to non-cirrhotic patients with 13.11 ± 2.16 mm versus 11.45 ± 1.02 (p < 0.00006). The systolic velocity and the hepatic artery resistance index were significantly raised in the cirrhotic patients compared to the non-cirrhotic with 67.32 ± 22.77 versus 49.97 ± 17.24 (p-value < 0.00004) respectively, and 0.78 ± 0.07 against 0.72 ± 0.08 (p < 0.00006). The caliber of the hepatic veins was significantly decreased in the cirrhotic patients compared to the non-cirrhotic patients (p < 0.0003). There was no correlation between the gender of the patients and the change in the hemodynamics of the hepatic vessels. Conclusion: The hemodynamic study of the hepatic vessels can and must rightly be a diagnostic argument for liver cirrhosis.

Objectives: Appreciate the Medical direct cost for cerebrovascular accident on medical recovery at the Sylvanus Olympio Teaching Hospital of Lome. Patients and method: This was a prospective and cross study that took place from 01st October 2015 to 31st July 2016 in the medical recovery Unit of Sylvanus Olympio Teaching Hospital of Lome. Results: Of the 91 stroke patients surveyed, the average age was 55.1 years; the sex-ratio (Men/women) was 1.3 and only 8.8% of patients had benefited from INAM (National Institute of Health Insurance) granting of benefits. The proportion of ICVA was 73.6% compared to 26.4% for the MCVA. The average overall cost of granting benefits of a CVA patient was 312,245 FCFA for an average stay of 18.6 days. This cost was 399.115 FCFA in MCVA for an average stay of 19.0 days against 281.130 FCFA in ICVA for an average stay of 16.1 days. Conclusion: CVAs on the one hand inflict losses of national productivity by its handicap, and a heavy economic burden for both patients and their families on the other hand, by its high cost of granting of benefits; Hence there is the need for assistance of all kinds by national and international health actors.

Background: Tuberculosis primarily affects lungs, but all organs may be affected. Extra-pulmonary forms of tuberculosis cause a big public health problem as it is diagnosed late. This delay in diagnosis is not only due to the delay in the examination, but also due to difficulties related to extra-pulmonary tuberculosis diagnostic. Aim: To describe the different locations of extra-pulmonary Tuberculosis and its aspects in Togo. Patients and Methods: A retrospective analysis of all extra-pulmonary tuberculosis cases diagnosed by imaging over five years (January 2010 to December 2015) was done. All the cases were confirmed either by direct examination of biological fluids or by histological analysis of biopsy and surgical samples or by culture on specific area. Data were collected from the Department of Radiology, from Microbiology Laboratory of the Pneumo-phthisiology unit and from Pathology Laboratory of Sylvanus Olympio Teaching Hospital of Lome. Results: A total of 83 cases of extra-pulmonary Tuberculosis had been taken into account: 45 men and 38 women, with a maximum number of cases (66.3%) in the age group between 20 to 40 years old. An HIV infection was known in 51 patients (61.4%). Pulmonary damage was associated in 21 patients (25.3%). A total of 116 extra-pulmonary tuberculosis locations were recorded. Damages were pleural in 37.1% (43), ganglion in 24.1% (28), osteo-articular in 15.5% (18), abdominal in 12.9% (15), military represented 8.6% (10), a case of testicular damage, and a case of mammary tuberculosis. Conclusion: The medical scanning based on conventional radiography, ultrasonography and TDM is indispensable for the diagnosis and the care taking of extra-pulmonary tuberculosis since some locations may be confused with many other diseases and lead to misdiagnosis errors and delay the treatment.

Resume Contexte Dans la nuit du 11 au 12 janvier 2013, le grand marche de Lome, « poumon » economique du pays, a ete victime d’un incendie suivi de scenes de pillage. Les « revendeuses » ont ete des temoins impuissants de cette situation. Le ministere de la Sante a decide de depecher sur les lieux une equipe d’urgence medico-psychologique afin d’assurer les premiers soins et le soutien psychologique des victimes. Objectif Ce travail a pour but de decrire, a partir de cette intervention, les representations, les attentes et les besoins psychologiques des sujets aux prises avec cet evenement traumatique. Methodologie Apres avoir presente les modalites pratiques d’intervention et de prise en charge immediates, nous exposerons les differentes articulations du suivi psychologique. La description clinique et une analyse critique de la symptomatologie immediate post-traumatique observee restent au centre de notre reflexion. Conclusion Des particularites culturelles importantes doivent etre integrees lors d’eventuels evenements delicats et/ou traumatiques.

Objective: Assess the quality of life (QOL) of the patients suffering from chronic liver diseases in our service. Patients and Method: A transversal prospective study conducted at the service of hepatology and gastroenterology at the University health center Campus of Lome from August 1, 2013 to August 31, 2014. We have used the short form 36 health survey questionnaire (SF-36). Patients of cirrhosis and hepatocellular carcinoma admitted during the said period were selected. Patients suffering from any other chronic diseases such as psychiatric or emotional troubles; linguistic or cognitive deficiencies that could hamper the dependability of the questionnaire were excluded. Results: The average age of the patients was 46 ± 12 years old with a male predominance (sex-ratio: 2.9). Our patients were distributed into 47.4% of cirrhosis and 52.6% of CHC. Those chronic liver diseases etiologies were alcoholic (57%), B viral (66%) and C viral (12.3%). The assessment of QOL showed an overall average score of 76.34 ± 21.1; a mean score of 30.4 ± 86.8 for the physical dimension and 36.5 ± 10.3 for the mental dimension. Patients with viral liver disease had poorer physical summary score (p = 0.000) and poorer mental summary score (p = 0.014) compared to alcoholic patients. Alcohol influenced the physical dimension of the patients (p = 0.000) while the mental dimension was more affected by the age of patients (p = 0.0035). Conclusion: The quality of life is altered by the patients suffering from chronic liver diseases (p = 0035) with regard to our context. This is so in particular with those identified to be viral infected.

Objective : To determine the prevalence of hypertension and other cardiovascular risk factors in the general adult population of Lome. Methods : A cross-sectional household survey was conducted in Lome from October 2009 to January 2010, which focused on hypertension and other cardiovascular risk factors in 2 000 subjects 18 years and older. The World Health Organisation's STEPS-wise approach on non-communicable diseases was used. During the first session, blood pressure (BP) was measured on three successive occasions, one minute apart, and the mean was recorded. A second measurement session was done three weeks later in patients with BP ≥ 140/90 mmHg during the first session. Hypertension was defined as BP > 140/90 mmHg after the second session, or on antihypertensive treatment. The other risk factors were studied by clinical and blood analysis. Results : We found 532 hypertensive patients out of a total of 2 000 subjects. The prevalence of hypertension was 26.6%. The mean age of hypertensive patients was 45 ± 10 years, ranging from 18 to 98 years. The prevalence of other cardiovascular risk factors was: stress (43%), sedentary lifestyle (41%), hypercholesterolaemia (26%), obesity (25.2%), hypertriglyceridaemia (21%), smoking (9.3%), alcohol use (11%) and diabetes (7.3%). Conclusions : The prevalence of hypertension and other cardiovascular risk factors in the population of Lome is high. These findings should draw the attention of authorities to define a national policy to combat hypertension and other cardiovascular risk factors.

Le syndrome KID est une affection génétique rare associant kératite, ichtyose et surdité. Nous rapportons un cas dont la surdité s'est compliquée de mutisme chez un enfant togolais issu d'un mariage consanguin.Il s'agissait d'une fillette de 9 ans admise en dermatologie pour une peau sèche et une kératodermie palmoplantaire évoluant depuis l'enfance, une surdité sévère et un mutisme total évoluant depuis la naissance. Il n'y avait pas d'histoire familiale connue de syndrome KID. Les parents de cet enfant sont des cousins germains. A l'examen, on notait une kératodermie palmoplantaire typique en cuir grossier, une peau sèche ichtyosiforme finement squameuse avec un aspect pachydermique aux genoux et un aspect arlequin aux jambes. L'examen ophtalmologique avait noté une blépharo-conjonctivite, une xérophtalmie, une photophobie et une absence de sourcils. L'examen ORL avait objectivé une hypotrophie des pavillons des oreilles, une surdité sévère et un mutisme total. La particularité de cette observation réside dans la sévérité de l'atteinte auditive qui s'est compliquée de mutisme. Notre enfant étant née de parents consanguins sains, sans histoire familiale de KID, nous pensons que le mode de transmission est probablement sporadique. Une étude moléculaire du cas index et de ses parents, non réalisée à cause de notre plateau technique limité aurait pu le confirmer.

Introduction : notre etude a consiste en l'identification les principales valvulopathies retrouvees en milieu hospitalier a Lome (Togo). Methodes : il s'agit d'une etude retrospective, transversale, multicentrique menee du 1er janvier 2006 au 31 decembre 2010 et portant sur les dossiers de patients suivis dans le service de cardiologie du CHU Campus de Lome. Resultats : du 1er janvier 2006 au 31 Decembre 2010,5412 patients ont ete consulte dans le service de cardiologie du CHU Campus. Parmi eux, 241 (4,45%) presentaient une valvulopathie. On notait une predominance feminine avec un sex-ratio H/F a 0,60. La moyenne d'âge etait de 62,32 ans avec des extremes allant de 16 a 89 ans et un ecart type de 14,27. Les antecedents le plus souvent retrouves etaient l'hypertension arterielle (26,97%) et le diabete (8,29%). Parmi les motifs de consultations, les plus frequents etaient la dyspnee (39,00%), les precordialgies (32,78%) et les palpitations (21,16%).A l'examen physique 30,70% des patients presentaient des signes de d'insuffisance cardiaque. A l'echographie, on notait des atteintes d'une seule valve (77,17%), de 02 valves (17,42%) ou 03 valves (5,4%). L'insuffisance mitrale (56,84%) et l'insuffisance aortique (30,70%) ont ete les valvulopathies les plus frequemment retrouvees. La maladie mitrale a ete notee chez 05 patients. Les principales etiologies etaient degeneratives et ischemiques. Conclusion : les valvulopathies sont relativement frequentes a Lome. L'insuffisance cardiaque est leur principal mode de revelation. Les plus retrouvees sont l'insuffisance mitrale et aortique.

Introduction: l'hémorragie digestive haute est une urgence, qui constitue souvent pour les patients un danger mortel suscitant inquiétude et agitation. Dans cet état, le patient dépend de ses accompagnants pour ses soins et pour honorer le traitement ; mais souvent, il a été observé une discordance entre l'urgence et les comportements des accompagnants. Le but de cette étude était de décrire les facteurs socioéconomiques et psychologiques pouvant influencer les comportements des accompagnants des patients admis pour HDH, estimer l'indice de relation entre ces comportements et les facteurs associés d'une part et le vécu des patients admis pour HDH d'autre part.Méthodes: il s'agit d'une étude prospective menée de Septembre 2010 à Juin 2011 (soit 10 mois). Nous avions utilisé l'entretien semi-dirigé et l'observation directe pour collecter nos données, ces dernières avaient été traitées par les méthodes statistiques et d'analyse de contenu.Résultats: dans la présente étude, les comportements des accompagnants des patients admis pour HDH sont en majorité marqués par l'abandon (84%) et le manque de sollicitude (80,2%). Ces comportements sont souvent stimulés par les facteurs socioéconomiques tels que les difficultés économiques (83,2%), des conflits intrafamiliaux (85,1%) et des représentations (maladie incurable ou envoûtement) de la maladie par les accompagnants (73,3%) des cas. Quant aux patients, ils vivent ces comportements comme étant des menaces de mort ou des rejets (77,20%) et comme étant une dévalorisation ou une humiliation de la part de leurs accompagnants (70,30%). Les résultats confirment l'existence de lien significatif entre les comportements des accompagnants et les facteurs socio économiques, entre les comportements des accompagnants et des facteurs psychologiques, et entre le vécu des patients admis pour l'HDH et les comportements des accompagnants.Conclusion: des études ultérieures devraient aborder les points non touchés dans cette étude. Certes, elle a apporté un plus dans la compréhension du vécu des patients admis pour HDH et des comportements de leurs accompagnants. Cependant, elle est loin d'avoir épuisé les différents contours de la problématique de la présente étude.Key words: Hémorragie digestive haute, vécu, représentation, comportement, accompagnant

Background: The aim of this study was to evaluate pain management in paediatric surgery at Sylvanus Olympio University Teaching Hospital, Lome. Patients and Methods: A prospective descriptive study was conducted in the Department of Anaesthesiology and Intensive Care at Sylvanus Olympio teaching hospital from 1 January to 30 June 2012. Data collected include:demography, type of surgery, American Society of Anaesthesiologists (ASA) classification, anaesthetic protocol, analgesia technique, post-operative complications and cost of analgesia.Results: The study includes 106 post-operative children. Abdominal surgery was performed in 41.5% and orthopaedic surgery in 31.1%. A total of 75% of patients were classified ASA 1. General anaesthesia (GA) wasperformed in 88%. Anaesthetists supervised postoperative care in 21.7% cases. Multimodal analgesia was used in every case and 12% of patients received a regional block. The most frequently unwanted effects of analgesics used were nausea and/or vomiting in 12.3%. At H24, child under 7 years have more pain assessment than those from 7 to 15 years (46% vs 24%) and this difference was statistically significant (chi-square = 4.7598; P = 0.0291 < 0.05). The average cost of peri-operative analgesia under loco regional analgesia (LRA) versus GA during the first 48 h postoperative was US $23 versus $46.Conclusion: Our study showed that post-operative pain managementin paediatric surgery is often not well controlled and paediatric loco regional analgesia technique is under practiced in sub Saharan Africa.Key words: Paediatric anaesthesia, post-operative pain, Togo

Nous avons mene une revue de la litterature portant sur les AVC au Togo a partir des theses, des publications, des memoires, disponibles a la Bibliotheque Universitaire et sur les bases de donnees internationales; en Afrique sub-saharienne a partir des publications disponibles sur les bases de donnees internationales. Treize theses ont repondu a nos criteres d’inclusion au Togo. En Afrique sub-saharienne, des publications concernant douze pays ont ete retenues. L’incidence des AVC au Togo est de 62,36 pour 100.000 habitants. La prevalence varie entre 1,7 et 2,44 pour 1000 habitants. L’âge moyen de survenue est de 57,47 ans. En Afrique sub-saharienne, l’incidence se situe entre 26 et 30 pour 100.000 habitants. La prevalence est de l’ordre de 58 a 243 pour 100.000 habitants. L’âge moyen se situe entre 44,5 et 60,4 ans. Les AVCI predominent mais le taux des AVCH est tres eleve. Il se situe entre 28 et 60%. L’HTA represente le facteur de risque majeur : 68-85%, suivie des cardiopathies et du diabete. Les AVC demeurent une pathologie couteuse et responsable d’une morbi-mortalite importante. Les publications sur cette pathologie en Afrique sub-saharienne sont rares. Les rares etudes epidemiologiques estiment que sa prevalence et son incidence restent faibles par rapport aux donnees des pays du nord ou la repartition des types d’AVC est differente de celle decrite avec une frequence elevee des hemorragies cerebrales de l’ordre de 28 a 60%. Cette difference ne semble pas etre due seulement a des biais methodologiques mais il existerait probablement des facteurs genetiques, environnementaux ou socioculturels. Normal 0 false false false MicrosoftInternetExplorer4 st1\:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}