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

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...

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Autores principales: Maiga, Youssoufa, Sangho, Oumar, Konipo, Fatoumata, Diallo, Seybou, Coulibaly, Souleymane Dit Papa, Sangare, Modibo, Péréon, Yann, Giumelli, Bernard, Sanou, Martin, Coulibaly, Awa, Diallo, Salimata, Daou, Mariam, Traoré, Zoumana, Albakaye, Mohamed, Traoré, Hamar A., Guinto, Cheick Oumar, Ouologem, Madani, Kuate-Tegueu, Callixte, Bouhassira, Didier, Cowan, Robert, Nizard, Julien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841313/
https://www.ncbi.nlm.nih.gov/pubmed/33537467
http://dx.doi.org/10.1016/j.ensci.2021.100312
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author Maiga, Youssoufa
Sangho, Oumar
Konipo, Fatoumata
Diallo, Seybou
Coulibaly, Souleymane Dit Papa
Sangare, Modibo
Péréon, Yann
Giumelli, Bernard
Sanou, Martin
Coulibaly, Awa
Diallo, Salimata
Daou, Mariam
Traoré, Zoumana
Albakaye, Mohamed
Traoré, Hamar A.
Guinto, Cheick Oumar
Ouologem, Madani
Kuate-Tegueu, Callixte
Bouhassira, Didier
Cowan, Robert
Nizard, Julien
author_facet Maiga, Youssoufa
Sangho, Oumar
Konipo, Fatoumata
Diallo, Seybou
Coulibaly, Souleymane Dit Papa
Sangare, Modibo
Péréon, Yann
Giumelli, Bernard
Sanou, Martin
Coulibaly, Awa
Diallo, Salimata
Daou, Mariam
Traoré, Zoumana
Albakaye, Mohamed
Traoré, Hamar A.
Guinto, Cheick Oumar
Ouologem, Madani
Kuate-Tegueu, Callixte
Bouhassira, Didier
Cowan, Robert
Nizard, Julien
author_sort Maiga, Youssoufa
collection PubMed
description 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.
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spelling pubmed-78413132021-02-02 Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa? Maiga, Youssoufa Sangho, Oumar Konipo, Fatoumata Diallo, Seybou Coulibaly, Souleymane Dit Papa Sangare, Modibo Péréon, Yann Giumelli, Bernard Sanou, Martin Coulibaly, Awa Diallo, Salimata Daou, Mariam Traoré, Zoumana Albakaye, Mohamed Traoré, Hamar A. Guinto, Cheick Oumar Ouologem, Madani Kuate-Tegueu, Callixte Bouhassira, Didier Cowan, Robert Nizard, Julien eNeurologicalSci Review Article 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. Elsevier 2021-01-09 /pmc/articles/PMC7841313/ /pubmed/33537467 http://dx.doi.org/10.1016/j.ensci.2021.100312 Text en © 2021 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Maiga, Youssoufa
Sangho, Oumar
Konipo, Fatoumata
Diallo, Seybou
Coulibaly, Souleymane Dit Papa
Sangare, Modibo
Péréon, Yann
Giumelli, Bernard
Sanou, Martin
Coulibaly, Awa
Diallo, Salimata
Daou, Mariam
Traoré, Zoumana
Albakaye, Mohamed
Traoré, Hamar A.
Guinto, Cheick Oumar
Ouologem, Madani
Kuate-Tegueu, Callixte
Bouhassira, Didier
Cowan, Robert
Nizard, Julien
Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?
title Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?
title_full Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?
title_fullStr Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?
title_full_unstemmed Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?
title_short Neuropathic pain in Mali: The current situation, comprehensive hypothesis, which therapeutic strategy for Africa?
title_sort neuropathic pain in mali: the current situation, comprehensive hypothesis, which therapeutic strategy for africa?
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841313/
https://www.ncbi.nlm.nih.gov/pubmed/33537467
http://dx.doi.org/10.1016/j.ensci.2021.100312
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