Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?

eNeurologicalSci

卷:22

Seybou Diallo¹  Oumar Sangho²  Bernard Giumelli²  Fatoumata Konipo³  Cheick Oumar Guinto⁴  Yann Péréon⁴  Mohamed Albakaye⁴  Youssoufa Maiga⁴  Callixte Kuate-Tegueu⁴  Hamar A. Traoré⁴  Souleymane Dit Papa Coulibaly⁵  Awa Coulibaly⁵  Modibo Sangare⁵  Martin Sanou⁵  Robert Cowan⁵  Didier Bouhassira⁵  Zoumana Traoré⁶  Mariam Daou⁶  Salimata Diallo⁷  Madani Ouologem⁸  Julien Nizard⁸ 

[1] Corresponding author at: Gabriel Touré University Teaching Hospital, Bamako, BP: 267, Mali.;

[2] Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali;

[3] Laboratoire de Thérapeutique (EA3826), Faculté de Médecine de Nantes, Nantes, France;

[4] Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali;

[5] Faculté de Chirurgie Dentaire, Université de Nantes, France;

[6] Laboratoire d'Explorations Fonctionnelles, Centre de Référence Maladies Neuromusculaires Atlantique-Occitanie-Caraïbes, Hôtel-Dieu, CHU de Nantes, France;

[7] Service de Neurologie, Hôpital du, Mali, Bamako;

关键词: Chronic pain;    Neuropathic pain;    DN4 questionnaire;    Pain management;    Integrative medicine;    Mali;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction: According to the taxonomy of the International Association for the Study of Pain (IASP 2011), neuropathic pain (NeuP) is defined as “pain caused by a lesion or disease of the somatosensory nervous system”. NeuP is currently well-defined clinically, despite a high degree of etiological variation, and it has become a significant public health problem. This work aimed to study the situation regarding NeuP in current practice in Mali, as well as to analyze the therapeutic environment of the patients. Methodology: This was a retrospective and cross-sectional study, carried out in two phases: (1) compilation of the files of patients according to the ICD-11, over a period of 24 months (2) a second prospective phase regarding the Knowledge, Attitudes, and Practices (KAP) of general practitioners and neurologists in regard to NeuP. The focus of the first phase of the study was the files of the patients who had undergone a consultation at the Gabriel Touré UHC. The second phase of the study focused on the general practitioners (Community Health Centers (comHC) of Bamako) and neurologists (Malian or not). Results: Over the period of the study, 7840 patients were seen in consultation in the Department of Neurology, of whom 903 for NeuP, thus amounting to a NeuP frequency of 11.5%. Women accounted for 58.9% (532/903), with a sex ratio of 1.4. Using a comparative normal law, the difference in frequency was statistically significant between males and females (p < 10−7) and between two age groups (p 〈10−3). The 49–58 years of age group was represented the most. Diabetic NeuP (21%), lumbar radiculopathies (14%), HIV/AIDS NeuP (13%), and post-stroke NeuP (11%) were the most represented. The survey among the carers revealed: a need for training, a low level of compliance with the therapeutic guidelines, and the use of traditional medicine by the patients. Discussion/conclusion: This work confirms that NeuP is encountered frequently in current practice, and its optimal management will involve specific training of carers and improvement of access to the medications recommended in this indication. In light of this issue, we revisit the debate regarding the concept of essential medications and the relevance of taking into account effective medications for the treatment of NeuP.

【 授权许可】

Unknown