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Background: Patients with renal failure have a higher risk or cardiovascular events. However, the prevalence of renal failure in Sub Saharan Africa communities remain poorly documented. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency subjects aged between 18 and 80 years. However, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure and anthropometric measurements were performed in addition to blood tests including plasma creatinine. Renal failure was defined as a GFR < 60 ml/min/1.73 m 2 using the MDRD method adapted to the African population. Continuous data were reported as mean ± standard deviation (SD). Comparisons used the χ2 test for categorical variables and Student’s t test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P Results: Among the 2440 subjects in this study the mean age was 44 ± 15.99, 692 (28%) were male. Among the 1080 participants who were aged less than 40 years old (mean: 31 ± 7.54), 296 (27.4%) were male. Body mass index higher than 25 was present in 32% of the studied population with a significant increase in women (38% vs 15%, p Conclusion: This community-based cross-sectional study showed a low prevalence of renal failure in younger participants in Northern Senegal. Further investigations are needed to assess chronic kidney failure and its determinants.

Background: Metabolic syndrome is known as a predictor of cardiovascular disease (CVD), a leading cause of death globally. The factors that comprise metabolic syndrome are on the rise in Sub-Saharan Africa, and data regarding the prevalence of metabolic syndrome in communities of aged less than 40 years old remain scarce. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency. Subjects aged between 18 and 80 years were recruited, however, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure (BP) and anthropometric measurements were performed in addition to a blood test measuring fasting triglycerides, high density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and plasma glucose. Metabolic syndrome was defined as fasting plasma glucose ≥110 mg/dl, serum triglycerides ≥150 mg/dl, serum HDL cholesterol 102 cm in males or >89 cm in females. Comparisons used the χ2 test for categorical variables and Student’s t test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P Results: Of the 2,440 subjects recruited, 1080 participants were less than 40 years old and included in the current analysis. The mean age of these participants was 31 ± 7.53I. There were 296 (27%) male participants in our study. . Overall, there were 41 participants (3.8%) with metabolic. For individual components of metabolic syndrome, body mass index of 25 or higher was present in 32% of the population with a significant increase among women (38 vs 15% vs 3,7%, p Conclusion: Our community-based cross-sectional study revealed a low prevalence of metabolic syndrome among younger participants in northern Senegal. However, the prevalence of dyslipidaemia was high.

Background: Diabetes is a major cardiovascular disease (CVD) risk factor. There has been a epidemiological shift and chronic CVD is increasing in Sub-Saharan Africa, however, the extent is unknown. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam etand Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency, we included subjects aged between 18 and 80 years old. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure and anthropometric measurements were measured in addition to blood tests including fasting plasma glucose. Diabetes was defined as fasting plasma glucose >= 1.26 g/L. Continuous data were reported as mean ± standard deviation (SD). Comparisons used the chi-squared test for categorical variables and Student’s t test for continuous variables. Multivariable adjusted logistic regression was used to identify factors associated with diabetes. Covariates with significant association (P Results: Among the 2440 subjects in this study (mean age: 44 years old, SD: 15.99), 692 (28%) were male. Nearly half of the sample never attended school (48%, 95%CI: 46-50%). Body mass index (BMI) higher than 25 was present in 43% of the sample (95%CI: 29-35%), with a significant increase in women (51% vs 22%, p Conclusion: This community-based study revealed a low prevalence of diabetes. However, the prevalence of additional CVD risk factors in this population was high. Preventive measures should be implemented to avoid increasing rates of diabetes in Sub-Saharan Africa.

Indoor air pollution is the underlying cause of 4 million deaths worldwide, of which 11% is directly attributable to obstructive pulmonary disease. This study made it possible to characterize indoor air pollution in the Medina (Dakar) and to estimate occurrence risk of obstructive pulmonary diseases associated to lack of ventilation in main living room. This is a cross-sectional study combining a socio-demographic survey, air quality metrology (CO, PM10, NO, CO2) and a Functional Respiratory Assessment (spirometry). Estimation of the risk was carried out by logistic regression by adjusting for a certain number of factors. Participants are distributed between 27 households using mainly gas (55.56%) and charcoal (29.63%) as cooking fuel and closed kitchens with window (66.67%). Obstructive pulmonary diseases are noted with an estimated prevalence of 33.06%. Regarding pollutants, levels are below WHO guidelines: CO (3.81 ppm), CO2 (531.5 ppm), PM10 (0.27 µg/m3) and NO (2.88 µg/m3). In addition, study reveals an occurrence risk (AOR [95%CI]) of obstructive pulmonary diseases multiplied by 2.54 [1.27–5.08] where ventilation of main living room is medium and for exposure to poor ventilation, risk is multiplied by 2.06 [1.02–4.17]. These results therefore suggest indoor air quality, in particular renewal of air in main living room, as a factor determining residents respiratory health.

Background: Type 2 diabetes mellitus, beyond its well-known cardiovascular and neurological complications, is now increasingly recognized as having deleterious effects on bone tissue. It’s thus presented as an independent risk factor for bone fragility with a considerable fracture risk relating to many more or less intricate parameters. The general objective of our study is to assess bone mass during type 2 diabetes in Senegalese women. Methodology: We had carried out a cross-sectional and descriptive study. Socio-demographic characteristics were collected on the basis of a questionnaire. Then each of the subjects had undergone a complete clinical examination followed by a blood sample for a biological assessment of certain cardiovascular risk factors. Bone mass was measured using a bio-impedancemeter. Results: We recruited 88 women with type 2 diabetes and 83 healthy control women. The mean age of diabetic subjects was 52.7 years ± 6.8 (with extremes of 39 and 74 years). In control, the mean age was 51.0 ± 8.5 years (with extremes of 35 and 72 years). Among the diabetic subjects, 22 subjects or 25% practiced a regular walk against 27 (32.5%) in the control. Forty-three among the diabetic subjects (48.8%) were known hypertensive and followed. According to the body mass index, 71 patients (80.7%) were overweight compared to 59 (71.1%) controls. According to the waist size, 80 (90.9%) diabetic subjects had an elevated waist size compared to 69 control women (83.1%). Among diabetic subjects, 41 patients (46.5%) were hyperglycemic imbalance according to fasting blood glucose and 59 patients (67%) according to glycated hemoglobin level. Thirty-seven diabetics (42%), had both high fasting blood glucose and elevated glycated hemoglobin. The mean duration of diabetes was 8.68 ± 7.18 years. We found significantly higher bone mass in type 2 diabetic subjects (p = 0.03). Among diabetics, 27.3% had low bone mass compared to 36.1% of control. It’s noted that the subjects of the “low bone mass” group among the control subjects also have a significant drop in other anthropometric parameters (weight, body mass index, waist size, muscle mass). It should also be noted that the fat mass is significantly higher in diabetic subjects with normal or even high bone mass. In control subjects, bone mass was positively correlated with weight (r = 0.36; p = 0.001), muscle mass (r = 0.93; p < 0.0001) and fasting blood glucose (r = 0.26; p = 0.02); and negatively correlate with age (r = 0.22; p = 0.04). On the other hand, in type 2 diabetic subjects, bone mass is positively correlated with age (r = 0.22; p = 0.04), muscle mass (r = 0.89; p < 0.0001) and the diabetes duration (r = 0.44; p = 0.001). Conclusion: Bone mass is higher in type 2 diabetics compared to healthy controls. Chronic hyperglycemia and the diabetes duration are believed to be responsible for the increase in bone mass. In addition, an increase in muscle mass would lead to an increase in bone mass.

In rapidly urbanising low-income towns and cities, there remains an absence of scientific evidence and regulatory structures to sustain the quality and quantity of groundwater used for low-cost water supplies and to reconcile this with continued use of the subsurface for low-cost sanitation. Here, we analyse the relationship between the density of on-site sanitation and shallow groundwater quality in the Thiaroye aquifer of Quaternary sands in Dakar, Senegal. On-site sanitation was mapped using object-oriented classification and visual interpretation of high-resolution, optical satellite images and ground-truthing surveys. Groundwater quality was assessed over a three-year period (2017–2019) from a network of 61 sources comprising boreholes, dug-wells, hand tubewells and piezometers. More than 253,000 on-site sanitation facilities are identified over an area of 520 km2 with densities ranging from 1 to 70 per hectare. A moderate, statistically significant linear relationship (r2 = 0.55, p « 0.01) is found between the density of on-site sanitation facilities and nitrate concentrations in sampled groundwater sources. Groundwater contamination beyond the WHO drinking-water guideline value (50 mg/L) occurs where densities of on-site sanitation facilities exceed 4 (±4) per hectare, a threshold commonly surpassed in peri-urban areas underlain by the Thiaroye aquifer of Dakar.

Introduction: Cases of restrictive and obstructive diseases have been reported in workers exposed to flour dust. In Senegal, studies on the lung function of bakery-pastry employees are rare. The purpose of our study was to evaluate the clinical respiratory manifestations and ventilatory disorders (VD) related to flour dust exposure among traditional bakers and pastry makers in the city of Thies, Senegal. Materials and Method: A descriptive cross-sectional study was conducted. Forty subjects were recruited. Subjects received a basic and post-bronchodilator spirometry. The targeted respiratory functional disorders were bronchial obstruction, functional restriction and mixed syndrome. Results: The average length of service at the workplace was 7±6,7 years. Smokers represented 17,5%. A respiratory symptoms were found in 65% of our subjects. Coughing, sneezing and rhinorrhea were more frequent with 50%, 24% and 17% respectively. The most common ventilatory disorders among exposed bakers were of the mixed type (22,5%). On the other hand, 12,5% had an isolated obstructive ventilatory disorder (OVD) and a restrictive functional disorder (RFD) was found in 10%. The obstructive ventilatory disorders were dominated by obstruction of the small airways (80%). The severity of ventilatory disorders was of a moderate deficit type (87% and 62% respectively). Respiratory function abnormalities were more common in the smokers with a prevalence of ventilatory disorders that increased with age of employment. However, the effect of exposure appears to be clear because among non-smokers, 12,13 % of the exposed patients had respiratory functional abnormalities with isolated restrictive functional disorder type. Conclusion: This study showed that bakery and pastry workers have various respiratory symptoms and ventilatory disorders. Smoking and job tenure remain factors that increase these flour dust-related risks.

Introduction: Petrol pump attendants are exposed to toxic substances in fuels. The release of petrol fumes during fuel refuelling is a repeated and often harmful source of exposure for petrol pump attendants. The purpose of our study was to evaluate the ventilatory disorders related to fuel exposure among petrol pump attendants. Materials and Method: Forty petrol pump attendants have been recruited. The study included a medical survey with a questionnaire that examined anthropometric characteristics, seniority, smoking habits and working conditions. The study included a medical survey with a questionnaire that examined anthropometric characteristics, seniority, smoking habits and working conditions. All our subjects received a basic and post-bronchodilator spirometry. The targeted respiratory functional disorders were bronchial obstruction, restrictive syndrome and mixed syndrome. Obstructive syndrome has been reported on the basis of: FEV1/ FVC and/or FEF25-75% less than 80%. Functional restriction was defined on the basis of a decrease in FVC

Introduction: Road traffic exposes bus drivers to the detrimental effects of air pollutants on respiratory health. This study determined the frequency of chronic respiratory illnesses and its related factors among bus drivers in Dakar, Senegal. Methods: This study had a cross-sectional design conducted in a total of 178 bus drivers in Dakar, Senegal. A questionnaire was used to inquire about socio-economic characteristics, occupational factors and respiratory symptoms of bus drivers. Lung function tests were used to determine the presence of asthma and Chronic Obstructive Pulmonary Disease (COPD). The relationship between our variables of interest and respiratory diseases was determined by logistic regression analysis. Results: The results of the study show that 57.9% of bus drivers had a chronic cough, and 65.7% had recurrent cold. Lung function tests showed that 38.8% of bus drivers had asthma and 30.3% COPD. Multivariate analysis found that recurrent cold increased the risk of asthma (OR = 6.3, 95% CI: 1.12 - 35.79) and COPD (OR = 7.7, 95% CI: 1.14 - 52.8). The respiratory health status of bus drivers depended on the work area (OR = 3.2, 95% CI: 1.13 - 9.31). Conclusion: The respiratory symptoms and illnesses observed among bus drivers are associated with their exposure to air pollutants from road traffic.

The aim of this study was to compare three correction methods of QT interval in African national level football players. QT interval was measured in D2 lead on resting electrocardiogram (ECG) in 216 Black male football players (age range 18 to 35 years). Corrected QT (QTc) was calculated using Bazett, Fridericia, and Framingham’s formulas. Means and percentages of long QT (QTc>440 ms and QTc≥470 ms) and short QT (QTc≤320 ms) were compared. Correlations and agreement criteria between correction methods were researched, and effects size were calculated. Heart rate was 59±9 beats/min (40 to 84) and measured QT (QTm) at 383.1±31.4 ms (320 to 480). QTc were 378.9±25.7, 380.1±23.8, and 383.1 ± 31.3 respectively with Bazett, Fridericia, and Framingham formulas; differences were not significant. According to the definition QTc>440 ms, no long QT was found using Fridericia formula whereas Bazett and Framingham showed 1.4% of long QT. Only Framingham’s formula showed long QT according to the definition QTc≥470 ms (0.9%). Framingham’s formula also showed significant difference with short QT as compared to the other methods (5.1 vs. 0.46%; p=0.008). The lower QTc value was 320 ms in all methods. Correlation and agreement were better between Bazett’s and Fridericia’s formula. Framingham’s formula showed higher proportions of long and short QT, while Fridericia’s one reduced them. Bazett's formula gave intermediate percentages. QTcE‚320 ms could be used to define short QT; 320 ms representing the lower limit in our study for the 3 formulas. Our data did not allow us to deduce a definition for the long QT. The limits of QTc ≥ 470 ms for men and QTc ≥ 480 ms for women, more adopted now in the literature, were suggested. Key words: QT interval, electrocardiogram, football player, Bazett, Fridericia, Framingham.

Background. Sub-Saharan Africa (SSA) including Senegal is faced with a significant and increasing burden of type 2 diabetes. However, little information is available about diabetes management among Senegalese diabetics. Purpose. The current study aims to describe the level of glycemic control among a convenience sample of diabetics who receive care at the M’Bour Hospital in M’Bour, Senegal. Methods. A total of 106 type 2 diabetic patients were recruited at the hospital complex of M’Bour, Senegal. Linear regression was employed to assess the relationship between clinical and sociodemographic factors and Hba1c. Results. Only 24.8% of the sample had glycemic control, according to an Hba1c test. Participants who were diagnosed earlier were less likely to have diabetes control (mean = 7.8 years) compared with those who were diagnosed more recently (mean = 6.5 years); p < .05. Conclusions. We found that glycemic control in our sample was suboptimal. Length of time with diabetes was one of the key factors related to glycemic control. Length of time with diabetes is negatively associated with glycemic control. Early diagnosis and early glycemic control are essential to long-term glycemic control screening, and early detection for diabetes is uncommon given the general lack of health insurance and most people paying out of pocket for medical care. In the absence of universal health insurance, public health programs that provide blood sugar screenings for high-risk individuals would provide preliminary indication of abnormal glucose; however, subsequent diagnostic testing and follow-up may still be cost prohibitive.

Background: The catholic lenten fasting is the period of 40 days of fasting that precedes Easter. It is one of religious fasting less documented in the scientific literature. Thus the aim of our study was to evaluate the evolution of anthropometric and body composition and biochemical profile during Catholic lenten fasting. Methods: We conducted a prospective study, which took place during the period between one week before at the end of lenten fasting. Eleven fasters (4 women and 7 men), aged between 18 and 59 years were included in present study. Anthropometric, body composition parameters and biochemical profile were evaluated one week before, at 15 th day and at the end of Lenten fasting. Results: Weight, body mass index (BMI) and visceral fat decreased significantly at the end of Lenten fasting. Lipid profile changed significantly during this fasting period. Total cholesterol (TC), low density lipoprotein – cholesterol (LDL-C) and triglycerides decreased significantly with fasting. High density lipoprotein – cholesterol (HDL-C) was remained unchanged during this fasting period while TC/HDL ratio was significantly decreased at the end of Lent. Conclusions: Present study showed that the fasting of Lent seems to have beneficial effects on reducing cardiovascular risk factors. Further studies are required to better understand the physiological mechanisms involved for a therapeutic use.

OBJECTIVE The prevalence of type 2 diabetes (T2D) is rapidly increasing in sub-Saharan Africa, where sickle cell trait (SCT) is also frequent. Although SCT is generally considered a benign condition, evidence suggests that SCT could exaggerate vascular dysfunction in T2D. However, it remains unclear whether SCT could increase the risk of the development of T2D complications. Therefore, this study was conducted to determine whether T2D complications were more prevalent among Senegalese individuals with SCT and T2D than among those with T2D only. RESEARCH DESIGN AND METHODS Rates of hypertension, retinopathy, peripheral neuropathy, peripheral artery disease, and impaired renal function as well as arterial stiffness, blood rheology, and concentrations of plasma advanced glycation end products (AGEs) and cytokines were compared between groups of Senegalese individuals with combined SCT and T2D (T2D-SCT) (n = 60), T2D (n = 52), SCT (n = 53), and neither T2D nor SCT (control) (n = 56). Human aortic endothelial cell (HAEC) expression of inflammatory and adhesion factors was measured after treatment with tumor necrosis factor-α and subjects’ plasma. Effects of AGE inhibition or tiron on HAEC expression of E-selectin were measured. RESULTS Retinopathy, hypertension, and reduced renal function were more prevalent, and arterial stiffness, blood viscosity at high shear rates, and thixotropic index were higher, in the T2D-SCT group compared with the other groups. Multivariable analysis showed that plasma AGE concentration was significantly associated with arterial stiffness. E-selectin expression was elevated in HAECs treated with T2D-SCT plasma compared with the other groups, but AGE inhibition reversed this. CONCLUSIONS SCT could potentially augment the risk of the development of T2D-related complications, including retinopathy, nephropathy, and hypertension.

IntroductionTraffic-related air pollution has been well documented to be associated with increased risks of airway diseases. Bus drivers are exposed to hazards resulting from the inhalation of poll...

Objective Type 2 diabetes (T2D)-related vascular dysfunction and hemorheological abnormalities could possibly be amplified by sickle cell trait (SCT). These alterations could potentially increase the risk of vascular complications in individuals with combined T2D and SCT. Therefore, this study used a mouse model to determine whether vascular function and blood rheology were more severely altered in combined T2D and SCT than in T2D or SCT alone. Methods Townes transgenic mice with or without SCT received a 12-week high fat high sucrose or standard diet to create models of combined T2D-SCT, T2D, SCT, and controls. Pressure-induced vasodilation (PIV) and sodium nitroprusside (SNP)-mediated vasodilation in-vivo, and hemorheological parameters were measured. Results No significant differences in blood viscosity, hematocrit, erythrocyte deformability, or PIV were observed between the control and T2D mice, or the control and SCT mice. However, blood viscosity, erythrocyte deformability, and PIV were significantly altered in the T2D-SCT mice compared to the control mice. There were no differences in SNP response between the groups. Conclusions Although neither T2D nor SCT alone had significant effects on blood rheology parameters or vascular function, combined T2D-SCT mice had significantly altered blood rheology and significantly impaired vascular function.

BACKGROUND Sickle cell trait (SCT) is a benign condition of sickle cell disease. Nevertheless, previous reports showed that SCT carriers have increased blood viscosity and decreased vascular reactivity compared to non-SCT carrier. The benefit of regular exercise on vascular function has been well documented in the general population but no study focused on the SCT population. PURPOSE The aim of our study was to compare arterial stiffness and blood viscosity between trained and untrained SCT carriers, as well as a group of untrained non-SCT. METHODS Arterial stiffness (finger-toe pulse wave velocity) and blood viscosity were evaluated in untrained non-SCT carriers (n = 10), untrained SCT carriers (n = 23) and trained SCT carriers (n = 17) who reported at least 10 hours of physical exercise per week. RESULTS Untrained SCT carriers had higher pulse wave velocity (p = 0.032) and blood viscosity (p

The pathophysiology of diabetic neuropathic pain is due to primarily metabolic and vascular fac- tors. There is an increase in sorbitol and fructose, glycated end products, reactive oxygen species and activation of protein kinase C in the diabetic state. All these factors lead to direct damage to the nerves. Taking effective clinical management of neuropathic pain is based on a pharmacologi- cal treatment that has shown their limits and many side effects. The hypothesis of central sensiti- zation inhibited by Clerodendrum formicarum, an African pharmacopoeia plant used to treat headaches, arthritis, epilepsy and chronic pain could act on astrocytes and microglial cells. The objective of this work is to study the effect of Clerodendrum formicarum (100, 150 and 200 mg/kg body weight) on astrocytes and microglial cells in a model of diabetic neuropathic pain induced by alloxan monohydrate (150 mg/kg). We noted a suppression of mechanical allodynia and me- chanical hyperalgesia respectively by the Von Frey filaments test and the pressure test on the paw by the Clerodendrum formicarum extracts (ECF) at different doses from 2 h at the first injection of the ECF. After 5 days of treatment, we expressed by Western Blot bands of different proteins and by quantitative RT-PCR, we determined inhibition of the expression of GFAP, CD11b and isoforms 1 and 2 of cyclooxygenase. These results suggest that ECF inhibits the activation of astrocytes, mi- croglial cells and cyclooxygenase signaling pathway.

Although most individuals with sickle cell disease (SCD) live in sub-Saharan Africa, the history of the disease in this continent remains largely unknown. SCD is characterized by chronic hemolytic anemia, acute-vaso occlusive events and progressive vascular organ damage. The CADRE study is a large cohort of SCD patients in five countries of West and Central Africa aiming at studying SCD-related vascular complications. The inclusion data of this study did not match the hyper-hemolysis paradigm (Dubert et al. Blood 2018), but several methodological limitations were raised, including probable mortality bias and questionable reliability of classical hemolysis markers in Africa. For the 5-year follow-up of the CADRE study, we designed a case-control study nested in the cohort, based on extreme phenotypes, to look for new markers of vasculopathy, including new markers of hemolysis. Patients and Methods SS adult patients of the CADRE cohort were selected in the centres of Dakar (Senegal) and Bamako (Mali), depending on the presence of none or at least one of the following complications at inclusion: tricuspid regurgitant jet velocity (TRJV)>2,5 m/s (which may indicate pulmonary hypertension), albuminuria/creatininuria>100 mg/g, leg ulcer, priapism, aseptic osteonecrosis and retinopathy. We chose the youngest patients with a vascular complication and the oldest without any complication. Overall, 6 groups of 40 SS patients with extreme phenotypes were constituted (20 in each centre). Patients were called for a specific visit and investigated at steady state. Besides clinical examination, usual laboratory blood tests and albuminuria measure, additional plasma and saliva samples were collected. A trained investigator isolated microparticles immediately after blood sampling by successive centrifugations, measured blood and plasma viscosities and assessed microcirculation function using peripheral arterial tonometry. A cardio-echography was performed by a trained cardiologist. Plasma samples were stored at -80 °C and shipped to Paris. High technology tests were performed in Paris, including blood cell derived microparticles, free hemoglobin, inflammatory cytokines, neutrophile extracellular trap (NETs). Using saliva DNA, we also genotyped the known SCD genetic modifiers and new candidate genes implicated in the catabolism of hemoglobin. Potential associations between those markers, usual hematological parameters, and the vascular complications were assessed statistically . Results We recalled 240 selected patients 5 years after their first visit: 38 could not be retrieved, 21 had deceased, 62 had at least one new complication, and only 15 still had no complication. Therefore, we selected 56 more patients to obtain at least 30 patients in each group. 237 SS adults were eventually investigated and the plasma samples of 232 SS patients were analyzable in Paris (106 from Bamako and 126 from Dakar). In these patients, at a mean age of 29 years (+/- 11), high TRJV was present in 58, macroalbuminuria in 33, leg ulcers in 36, priapism in 43, aseptic osteonecrosis in 45 and retinopathy in 31 whereas 28 had no vascular complication. A principal component analysis found no cluster of complications. Among patients with one "hyper-viscous" complication (retinopathy or osteonecrosis) or more, 78% also had at least one "hyper-haemolytic" complication (high TRJV, albuminuria, leg ulcer or priapism) and 49% of patients with a "hyper-haemolytic" complication also had a "hyper-viscous" complication. The microvascular function was not associated with any of the complications, whereas higher blood viscosity was associated with retinopathy. The results of the associations between the vascular complications and specific biological tests are presented in other publications. Conclusion This study illustrates the feasibility of high-technology experiments in SCD patients living in sub-Saharan Africa, but was particularly challenging because of the difficulty to prepare, store and transport frozen plasma samples. Moreover, in agreement with previously published data from the CADRE study, we found that the dichotomization of vascular complications into hyperhemolytic and hyperviscous subgroups is not clinically relevant in Africa. Other simple predictive markers of vascular complication are needed to optimize the follow-up of African patients with SCD. Disclosures No relevant conflicts of interest to declare.

Introduction Although most individuals with sickle cell disease (SCD) live in sub-Saharan Africa, the history of the disease on this continent remains largely unknown. SCD is characterized by the association of chronic hemolytic anemia with episodes of acute vaso-occlusive events and progressive vascular organ damage. Several pathophysiological pathways in SCD result in the activation of circulating blood cells and the release of microparticles (MPs). In the present study, we investigated cell-derived MPs in patients with SCD living in Africa and analyzed their relationship with clinical complications. Patients and Methods This cross-sectional case-control study is nested in the CADRE cohort (clinical trials.gov identifier NCTO3114137). We included 232 SS adults in two African centers: Bamako (Mali) and Dakar (Senegal). Patients were chosen depending on the absence or the presence of at least one of the following complications: tricuspid regurgitant jet velocity (TRJV) >3 m/s (which may indicate pulmonary hypertension), macroalbuminuria, leg ulcer, priapism, aseptic osteonecrosis, and retinopathy. Overall, 7 groups of 40 SS patients were constituted (20 in each center). Patients were investigated at steady state (i.e.,at least 15 days after a vaso-occlusive crisis, 8 days after fever or infectious disease, and 3 months after a transfusion). MPs were isolated in the African centers immediately after blood sampling by successive centrifugations at increasing speed: 2,500g x2 and 21,000g x2. MPs pellets were stored at -80 °C. The cellular origin of the MPs, erythrocyte, reticulocyte, endothelial, platelet, and leucocyte, was determined using antibodies directed against CD235a, CD71, CD106, CD41, and CD45, respectively, at the National Institute of Blood TransfusioninParis. To maintain the background at an acceptable level, events of 0.16 µm size were excluded (Fig 1A). Only MPs positive for Annexin V and the cell-type-specific labelling were retained. Potential associations between cell-derived MPs, hematological parameters, and vascular complications were assessed using logistic regression with adjustment for age, sex and country. Results The MP pellets of 106 SS patients from Bamako and 126 from Dakar were analyzed in Paris. In these patients, at a mean age of 29 years (+/- 11), high TRJV was present in 64, microalbuminuria in 84, leg ulcers in 33, priapism in 43, aseptic osteonecrosis in 45, and retinopathy in 31 patients whereas 28 patients had no complication at the time of sampling. As a typical result, Fig 1B shows erythrocyte-derived MPs labelled by Annexin V and CD235a (quarter Q2). The MPs distribution was as follows: erythroid 52% [reticulocytes (CD235a+CD71+) 14%, erythrocytes (CD235a+ CD71-) 38%], leukocyte 18%, platelet 21%, and endothelial 9%. Neither erythrocyte- nor reticulocyte-derived MPs significantly correlated with hemolysis markers (LDH, unconjugated bilirubin or reticulocytes) or hemoglobin levels. Erythrocyte- and reticulocyte-derived MPs were significantly lower in patients with retinopathy (OR=0.48, p=0.003 and OR=0.68, p=0.005, respectively). Reticulocyte-derived MPs were negatively associated with a history of priapism (OR=0.76, p=0.020) and positively associated with a history of leg ulcers (OR=1.23, p=0.040). No correlation was found between MPs of other cellular origin and chronic complications, except for a negative association between endothelial-derived MPs and priapism (OR=0.76, p=0.036). Conclusion In our African patients with SCD, erythroid-derived MPs, although recognized cellular products of hemolysis, were not associated with other markers of hemolysis. We hypothesize that erythroid MPs are not only derived from hemolysis but also probably from the sickling process in this population. They were negatively associated with retinopathy and priapism and positively associated with leg ulcers, but not with the other complications classically associated with the hyperhemolytic sub-phenotype. The search for pertinent biomarkers of SCD complications in Africa is an essential challenge. To our best knowledge, this report is the first illustrating the feasibility of high-technology experiments in an African context. Disclosures No relevant conflicts of interest to declare.

Background: Body composition plays a fundamental role in the occurrence of complications in rheumatoid arthritis. Authors conducted this study, which aimed to determine body composition and its effects on physiological status in African sub-Saharan polyarthritis women.Methods: The anthropometric parameters were measured after an interview and a complete physical examination. The body composition was evaluated using a Tanita® brand bioimpedance meter. Finally, all the patients had a dosage of certain biochemical parameters.Results: An excess of percent fat mass was noted in more than half of women (59.52%) without loss of muscle mass. At the same time, 30% of women had a significant decrease in the percentage of body water. The BMI did not appear to be an adequate proxy for these changes. Visceral fat level was elevated just in 16% of women, however it would be a determinant of physiological aging of subjects. Dual therapy methotrexate and corticosteroid would have varying effects depending on the duration and the dose of treatment. The basic metabolism in polyarthritic subjects would be dependent on two parameters namely muscle mass and inflammatory state.Conclusions: Evaluating changes in body composition quickly, non-invasively and inexpensively is possible. It could be useful in the follow-up of rheumatoid arthritis. Managing these changes can reduce cardiovascular morbidity and mortality in rheumatoid arthritis.

In the article cited above, the first sentence in the Results section of the abstract had the name of the group …

Diabetes is a steadily increasing threat in Sub-Saharan Africa (SSA). Factors such as urbanization, obesity, physical inactivity, and inadequate access to healthcare are believed to contribute to the increasing burden of diabetes. Interventions that optimize diabetes self-management are critically important since obtaining diabetes medications is challenging due to cost constraints and availability. Culture is a significant factor in shaping health behaviors such as diabetes self-management, where individual health behaviors operate in confluence with family, community, and social structures. This study examined experiences with diabetes self-management among clinic patients residing in M'bour, Senegal, using the PEN3 model as a cultural framework. Results indicate that financial challenges related to accessing medical care and adhering to the prescribed diabetic diet were the main barriers to diabetes management. Family dynamics serve as both supportive and inhibiting forces that influence the aforementioned barriers.

This study compared erythrocyte changes between a group of subjects with sickle cell trait (SCT) and controls (subjects without hemoglobinopathy) during a soccer game in two conditions: with and without hydration. Erythrocyte deformability of subjects was assessed by the coefficient of erythrocyte rigidity (Tk) which was calculated before and after football match. Our results showed a significant increase in erythrocyte rigidity (Tk) in SCT at the end of physical activities without hydration; however when water was provided ad libitum their Tk decreased significantly, reaching values of controls. And adequate hydration is recommended in subjects with sickle cell trait during and after exercise.

The present study compared the changes in blood viscosity, hydration status, body temperature and heart rate between a group of sickle cell trait (SCT) carriers and a control (Cont) group before and after a soccer game performed in two conditions: one with water offered ad libitum (hydration condition; Hyd) and the other one without water (dehydration condition; Dehyd). Blood viscosity and haematocrit per blood viscosity ratio (HVR; an index of red blood cell oxygen transport effectiveness) were measured before and at the end of each game. Resting blood viscosity was greater in the SCT carriers than in the Cont group. The increase of blood viscosity over baseline at the end of the game in the Cont group was similar in the two conditions. In contrast, the change in blood viscosity occurring in SCT carriers during soccer games was dependant on the experimental condition: (1) in Dehyd condition, blood viscosity rose over baseline; (2) in Hyd condition, blood viscosity decreased below resting level reaching Cont values. The Cont group had higher HVR than SCT carriers at rest. HVR remained unchanged in the Cont group at the end of the games, whatever the experimental condition. Although HVR of SCT carriers decreased below baseline at the end of the game performed in Dehyd condition, it increased over resting level in Hyd condition reaching the values of the Cont group. Our study demonstrated that ad libitum hydration in exercising SCT carriers normalises the blood hyperviscosity.

The levels and duration of physical activity that can be considered as completely safe in patients with sickle cell anaemia (SCA) is unknown. The present study compared the haemorheological and haematological profile, cell density distribution and basic biochemistry between a group of 17 patients with SCA and 21 healthy subjects before and after a 20 min duration submaximal cycling exercise at the same absolute workload. Blood was sampled at rest and 3 min after the end of exercise for measurement of biological parameters. Exercise did not affect the haematocrit and blood viscosity in the two groups. Plasma viscosity was not different between the two groups at rest and similarly increased with exercise. The proportion of intermediary dense cells (with density between 1·11 and 1·12 g/ml) decreased with exercise in the SCA group resulting in an increase in the proportion of red blood cells with a density >1·12 g/ml. No change was observed in the control group. The present study suggests that mild-moderate exercise is not very harmful for SCA patients. The haemorheological and haematological changes were very mild, except for the formation of dense cells but no clinically significant signs of medical complication were present in any of the patients.

International audience; This study compared the hemorheological responses of a group of sickle cell trait (SCT) carriers with those of a control (Cont) group in response to 40 min of submaximal exercise (exercise intensity, 55% aerobic peak power) performed in two conditions: one with water offered ad libitum, i.e., the hydration (Hyd) condition, and one without water, i.e., the dehydration (Dehyd) condition. Blood and plasma viscosities, as well as red blood cell rigidity, were determined at rest, at the end of exercise, and at 2 h recovery with a cone plate viscometer at high shear rate and 37°C. The SCT and Cont groups lost 1 ± 0.7 and 1.6 ± 0.6 kg of body weight, respectively, in the Dehyd condition, indicating a significant effect of water deprivation compared with the Hyd condition, in which body weight remained unchanged. Plasma viscosity increased with exercise and returned to baseline during recovery independently of the group and condition. As previously demonstrated, resting blood viscosity was greater in the SCT carriers than in the Cont group. Blood viscosity increased by the end of exercise and returned to baseline at 2 h recovery in the Cont group in both conditions. The blood viscosity of SCT carriers did not change in response to exercise in the Dehyd condition and remained elevated at 2 h recovery. This extended hyperviscosity, in association with other biological changes induced by exercise, could be considered as a risk factor for exercise-related events in SCT carriers, similar to vasoocclusive crises, notably during the recovery. In contrast, the Hyd condition normalized the hyperviscosity and red blood cell rigidity of the SCT carriers, with blood viscosity values reaching the same lower values as those found in the Cont group during the recovery. Adequate hydration of SCT carriers should be strongly promoted to reduce the clinical risk associated with potential hyperviscosity complications.

Background: Wood dust is produced at virtually all stages of the wood industry. The most important wood-related risks are chemical hazards with the use of toxic, allergenic, and carcinogenic products which may alter respiratory function. Prevalence rates of ventilatory disorders are heterogeneous and no data are available in Senegal. Aims and Objectives: The purpose of our study was to evaluate respiratory function in carpenters. Materials and Methods: A cross-sectional study was conducted from February to July 2017 in 70 male carpenters exclusively, from the city of Thies. Each carpenter received a questionnaire and a spirometry test as a way of establishing a baseline state of all the subjects. The spirometry was subjected to the standardized validation procedure according to the American Thoracic Society/ European Respiratory Society criteria. Results: The average age is 39 years old. Among these carpenters, 14% are active smokers and 17% are former smokers. Seniority ranged from 1 to 48 years. Spirometry revealed a pure obstructive respiratory disorder in 32.85% of cases. The obstruction is classified as mild in 17.14% and moderate in 7.14% of cases. A pure restrictive syndrome is present in 18.57% and a mixed syndrome in 7.14% of cases. Tobacco potentiates the effects of occupational airborne contaminants because smokers have more obstructive syndrome than ex-smokers 50% versus 33.33% (P = 0.02) and more restrictive syndrome than non-smokers 30% versus 14.58% (P = 0.01). Negative correlations between the duration of exposure and forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity, and MEF 25–75% had been found. Conclusion: Exposure to wood dust is implicated in the alteration of various respiratory function parameters.

Background: Chronic obstructive pulmonary disease (COPD) is characterized by high mortality. The latter is strongly attributed to cardiovascular events whose onset is endothelial dysfunction and vascular remodeling. Aims and Objectives: The aims were to evaluate the endothelial function during COPD and the factors involved with possible endothelial dysfunction in Senegalese Black men aged at least 18 years. Materials and Methods: This was a prospective and cross-sectional study. After a complete clinical examination and evaluation of the body composition by a bioimpedancemeter, the endothelial function was evaluated by EndoPAT2000®. Results: the mean age was 61.50 years ± 6.62. Of the subjects, 70% were smokers and 50% had limited chest enlargement. According to the body mass index and the percentage of body fat, underweight was 30% and 40%, respectively. The 75.5% of the meager could not be evaluated by bio-impedancemeter due to extreme thinness. Endothelial dysfunction involved 70% of subjects. In addition, 86% of subjects with endothelial dysfunction were smokers. The reactive hyperemia index was positively correlated with body mass index (P = 0.017 and r = 0.73), body fat percentage (P = 0.016 and r = 0.73) and visceral fat level (P = 0.008 and r = 0.78). Conclusion: The evolution of COPD would be laced with serious cardiovascular complications often fatal. The assessment of nutritional status and endothelial function is fundamental for better management of the disease.

Background: In rural Senegal, biomass fuels are the main and often the only source of domestic energy for cooking. Their combustion is a source of particles and many other chemical contaminants that could alter cardiovascular function. Aims and Objectives: The aim of our study was to assess the effects of exposure to biomass fumes on vascular function in non-smoking women in rural Senegal. Materials and Methods: We conducted a cross-sectional 8-month study of 64 women (32 exposed to biomass smoke and 32 unexposed controls) who were active or housewives and involved in cooking. The subjects were aged 33.56 ± 9.34 years and 30.22 ± 6 years, respectively. All the women received a questionnaire with questions on sociodemographic characteristics, habitat characteristics, cooking habits, and biomass exposure conditions. Flow-mediated brachial arterial vasodilation flow-mediated dilatation (FMD) expressed as a percentage of the diameter was measured basally at rest and post-compression at 5, 30, 60, 90, and 120 s and 10 min after deflation. Results: All participants were non-smokers. 12.5% of subjects used gas in addition to biomass. Seniority was 18. 90 ± 10 years, with a mean daily biomass exposure of 4 ± 1 h. The analysis of cardiovascular parameters and blood sugar found no significant difference between the two groups. Kinetic FMD comparisons between the two groups showed significant differences at points 60 and 90 s 10 min post-occlusion. A negative correlation was found between FMD at 90 s after deflation and the duration of exposure in exposed women (r = 0.44 P < 0.05). Conclusion: Our results showed that exposure to biomass is implicated in the appearance of vascular dysfunction in non-smoking women.

Tobacco consumption is a net increase in our areas. In Senegal, as in other African countries, sponsorship of cultural and sporting events in schools promote tobacco use among schoolchildren. Our objective was to assess the prevalence of tobacco in the French School of Jean Mermoz of Dakar by a survey completed by a measurement of carbon monoxide (CO) in expired air.seven hundred forty-one students (n = 402 girls and n = 339 boys), aged 11 to 18 years of French and African cultures, participated in the study. A questionnaire with several items of smoking has been distributed to them . Two weeks after the collection of questionnaires, the CO measuring for all students was conducted.The prevalence of smoking in High School was 23.1% and smoking was found more in boys according to the questionnaire and piCO+TM with 13.7% and 7.1% respectively. It affected over the upper age class or equal to fifteen years. The most mentioned reason for the initiation of smoking (45.4% of smokers) was curiosity with a need to be free, followed by the influence of the environment famial (44.4%) and friendly (20.5%). The measurement of carbon monoxide showed that 12.4% of our subjects had a smoking profile with 8% light smoking, 1% moderate smoking, and severe smoking was 3% of our students. A significant difference (p = 0.0021) between the two prevalences was found.The carbon monoxide intoxication by tobacco use is responsible for microcirculatory accidents such as tissue hypoxia, whereas smoking affects young students, in which the phenomenon is more precocious. Thus it is urgent to establish a policy of tobacco control in schools.

Aim: The sickle cell trait (SCT) is the heterozygous and benign form of the homozygous SC disease (SCD). Although SCT exhibits hemorheological disturbances and increased oxidative stress, its exact role in the development of cardiovascular disease in SCT remains to be determined. The present study sought to determine the arterial stiffness, an independent marker of sub-clinical atherosclerosis, between SCT and trained SCD. Materials and methods: Twelve SCT (43±11yrs, 6 males) were compared to 14 trained younger SCD (29±9yrs, 2 males) and 26 controls with normal hemoglobin (36±11rs, 13 males). Aortic (AoStiff-Physioflow) and peripheral arterial stiffness (pOpmetre-Axelife-France) assessed by foot-to-toe pulse wave velocity (ft-PWV), blood pressure (BP) and Framingham-Laurier cardiovascular risk score (CVR in %) were measured in each group. Results: SCT exhibited stiffer arteries (Aostiff: 5.8±0.71 m/s, ft-PWV: 10.9±6.2 m/s) than controls (Aostiff = 4.8±0.5 m/s, ft-PWV: 7.7±2.6 m/s) and SCD (Aostiff = 4.9±0.6 m/s, p=0.001, ft-PWV: 6.1±0.9 m/s p=0.003). SCT were older (p=0.001) than controls and SCD. The systolic and mean AP were lower in SCD than controls and SCT. In the whole group, the CVR score was the major contributor to PerStiff (r2=0.402, p

International audience; The aim of this study was to compare blood and plasma viscosities, as well as the hematocrit/blood viscosity ratio (HVR), between trained and sedentary SCT carriers. Thirty African male SCT carriers from the city of Dakar (Senegal) participated in the study: one group composed of 15 trained SCT carriers (TSCTc) and one group composed of 15 sedentary individuals (SSCTc). Blood was sampled in resting condition and blood and plasma viscosities were measured using a cone-plate viscometer. After the determination of hematocrit by microcentrifugation, HVR was determined for each subject. Blood and plasma viscosities, as well as hematocrit, were significantly reduced in TSCTc compared to SSCTc. As a consequence, HRV was greater in TSCTc. These findings provide evidence that SCT carriers should be encouraged to practice regular physical activity to limit the cardiovascular strain usually caused by their blood hyperviscosity.

OBJECTIVE It is predicted that Africa will have the greatest increase in the number of patients with type 2 diabetes mellitus (T2DM) within the next decade. T2DM patients are at risk for cardiovascular disorders. In Sub-Saharan African countries, sickle cell trait (SCT) is frequent. Despite the presence of modest abnormalities in hemorheology and oxidative stress, SCT is generally considered a benign condition. Little is known about vascular function in SCT, although recent studies demonstrated an increased risk of cardiovascular disorders, including venous thromboembolism, stroke, and chronic kidney disease. We hypothesized that SCT could accentuate the vascular dysfunction observed in T2DM. RESEARCH DESIGN AND METHODS The current study, conducted in Senegal, compared vascular function, hemorheological profile, and biomarkers of oxidative stress, inflammation, and nitric oxide metabolism in healthy individuals (CONT), subjects with T2DM or SCT, and patients with both T2DM and SCT (T2DM-SCT). RESULTS Flow-mediated dilation was blunted in individuals with T2DM, SCT, and T2DM-SCT compared with CONT, with vascular dysfunction being most pronounced in the latter group. Carotid-femoral pulse wave velocity measurements demonstrated increased arterial stiffness in T2DM-SCT. Oxidative stress, advanced glycation end products, and inflammation (interleukin-1β) were greater in patients with T2DM-SCT compared with the other groups. Blood viscosity was higher in individuals with TD2M, SCT carriers, and individuals with T2DM-SCT, and the values were further increased in the latter group. CONCLUSIONS Our results demonstrate severe biological abnormalities and marked vascular dysfunction in patients with both T2DM and SCT. SCT should be viewed as a risk factor for further cardiovascular disorders in individuals with T2DM.