Infectious spondylodiscitis in
the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis
issue, with long-term chronic disabling sequelae and significant social costs. Studyaim: To describe the epidemiological, clinical, paraclinical,
therapeutic and evolutionary aspects of infectious spondylodiscitis in the
elderly in a rheumatological setting in Togo. Patientsandmethods: This was a multicenter, cross-sectional
study conducted on the records of patients aged at least 65 years, suffering
from infectious spondylodiscitis and hospitalized in four rheumatology units
from their respective opening dates till December 31, 2020. Data collection
lasted three months (December 1, 2020 to February 29, 2021). The diagnosis of infectious spondylodiscitis was
radioclinical and laboratory-based. Results: 83 (49 women, 34
men) of the 1281 patients (6.48%) examined had infectious spondylodiscitis. The
mean age at consultation was 70.59 ± 5.09 years, and the mean duration of the
clinical course was 12 months. Spondylodiscitis was of tuberculous etiology
(89.20%). It was most often found in the lumbar (56.62%) and dorsal (21.69%)
segments. The location was multifocal in 12.05% of cases. It was associated
with pulmonary involvement in 22.64% of cases. A neurological complication was
identified in 48.19%. The main risk factors identified were promiscuity
(48.82%), chronic alcoholism (18.07%), HIV infection (8.43%), diabetes (6.03%)
and sickle cell disease (6.03%). The clinical
course under medical treatment was favorable in 57 patients (68.68%). Conclusion: Infectious spondylodiscitis remains a frequent reason for hospitalization,
tuberculosis being the most
References
[1]
OMS (Genève: Suisse) (2010) World Health Organization. Definition of an Elderly or Aged Person. [Google Scholar] http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html
[2]
World Bank. Population Aged 65 and Over. https://donnees.banquemondiale.org/indicator/SP.POP.65UP.TO.ZS
[3]
World Population Ageing 2019: Highlights—United Nations https://www.un.org/en/development/desa/population/
[4]
Kouame, A. (1990) Population Aging in Africa. IRDC, Hull.
[5]
Gabay, C. (2001) Polyarthritis and Late-Onset Connective Tissue Disease. Revue Médicale Suisse, 3, 212-223.
[6]
World Health Organization. Ageing and Health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
[7]
Wong, R., Davis, A., Badley, E., Grewal, R. and Mohammed, M. (2010) Prevalence of Arthritis and Rheumatic Diseases around the World: A Growing Burden and Implications for Health Care Needs. In: Models and Care, Arthritis Community Research Evaluation Unit, Toronto, 80-110.
[8]
Research Directorate, Evaluation Studies and Statistics. The Pathologies of Elderly People Living in Institutions. http://drees.socialsante.gouv.fr/IMG/pdf/er494.pdf
[9]
Ouedraogo, D.D., Bori-Bata, F. and Drabo, Y.J. (2011) Elderly and Rheumatological Diseases in Rheumatology Consultation in Burkina Faso (West Africa). Revue du Rhumatisme, 78, 1209-1210.
[10]
Diomandé, M., Eti, E., Ouali, B., Kouakou, E.S., Ouattara, M.Y., Kouassi, J.M.D., et al. (2015) Profile of Osteoarticular Diseases in Elderly Black Africans: 157 Cases Seen in Abidjan. La Tunisie medicale, 93, 312-315.
[11]
Kakpovi, K., Koffi-Tessio, V.E.S., Houzou, P., Agbevide, K., Fianyo, E., Tagbor, K.C., et al. (2018) Rheumatological Disorders of the Elderly in a Rheumatologic Consultation in Lome (Togo). La Revue de Gériatrie, 43, 31-33.
[12]
Kamissoko, A.B., Traoré, M., Oniankitan, S., Wann, T.A., Diallo, M.L., Dakeyo, H.C.M., et al. (2019) Profile of Rheumatic Diseases of the Elderly in Guinea. ESJ, 15, 42-53.
[13]
Grassa, R., Anoun, J.M., Thabet, D.E.H., Abid, F., Ben Fredj, I.A., Rezgui, C., et al. (2019) Does Infectious Spondylodiscitis in the Elderly Have the Same Profile as in the Young Subject? La Revue de Médecine Interne, 40, 111-112. https://doi.org/10.1016/j.revmed.2019.10.140
[14]
Gras, J., Zarrouk, V., Dubée, V., Lopes, A., Leflon, V., Guigui, P., et al. (2017) Clinical Characteristics and Prognosis of Pyogenic Spondylodiscitis in Subjects over 75 Years of Age. Médecine et Maladies Infectieuses, 47, 82-87. https://doi.org/10.1016/j.medmal.2017.03.212
[15]
Ponciano, A., Cruz, G., Ventura, C., Rabadão, E. and Saraiva da Cunha, J. (2018) Infectious Spondylodiscitis: 5-Year Analysis of a Tertiary Hospital in Portugal. Infectious Diseases, 50, 637-639. https://doi.org/10.1080/23744235.2017.1419374
[16]
Homagk, L., Marmelstein, D., Homagk, N. and Hofmann, G.O. (2019) SponDT (Spondylodiscitis Diagnosis and Treatment): Spondylodiscitis Scoring System. Journal of Orthopaedic Surgery and Research, 14, Article No. 100. https://doi.org/10.1186/s13018-019-1134-9
[17]
Zomalheto, Z., Kohossi, C., Dossou-Yovo, H. and Gounongbé, M. (2017) Aspects épidémiologiques et thérapeutiques du mal de Pott du sujet agé: étude comparative avec la forme du sujet jeune dans la population béninoise. Revue du Rhumatisme, 84, 154-155.
[18]
Grammatico Guillon, L., Baron, S., Desenclos, J., Rusch, E. and Besnier, J. (2007) Epidemiology of Infectious Spondylodiscitis in France: The Contribution of the Medical Information Systems Program (PMSI), 2002-2003. Bulletin épidémiologique Hebdomadaire, 43, 367-370.
[19]
Kodjo, K., Eyram, F., Komi, T.C., Kokouvi, E., Viwalé, K.E.S., Awaki-Esso, A., et al. (2021) Profile of Osteoarticular Infections among Rheumatology Inpatients in Lome, Togo: A Multicenter Experience. African Journal of Rheumatology, 9, 45-48.
[20]
Oniankitan, O., Bagayogo, Y., Fianyo, E., Koffi-Tessio, V., Kakpovi, K., Tagbor, K.C., et al. (2009) Spondylodiscitis at Hospital Outpatient Clinic in Lome (Togo). Medecine Tropicale, 69, 581-582.
[21]
Houzou, P., Atake, A.-E., Kakpovi, K., Koffi-Tessio, V.E., Tagbor, K.C., Fianyo, E., et al. (2021) Profile of Infectious Spondylodiscitis in Rheumatology Consultation at University Teaching Hospital of Kara, Togo. Open Journal of Rheumatology and Autoimmune Diseases, 11,160-168. https://doi.org/10.4236/ojra.2021.114017
[22]
Zohoun, A., Ngoh Akwa, E., El Ochi, M., Oragwu, N., Akhaddar, A., Albouzidi, A., et al. (2012) Bacteriological Features of Infectious Spondylodiscitis at Mohammed V Military Teaching Hospital of Rabat. Brazilian Journal of Microbiology, 43, 1327-1331. https://doi.org/10.1590/S1517-83822012000400013
[23]
Abla, H.B., Ben, M.I., Saidane, O., Ben Tekaya, A., Tekaya, R. and Abdelmoula, L. (2017) Neurological Complications of Infectious Spondylodiscitis. La Revue de Médecine Interne, 38, A247. https://doi.org/10.1016/j.revmed.2017.10.280
[24]
N’soundhat, N.E.., Moyikoua, R., Mpika, G.M., Ntsiba, H. and Bileckot, R. (2019) Morphological Aspects of Pott’s Disease in Adult Congolese Patients Living in Brazzaville. Health Sciences and Disease, 25, 64-67.
[25]
Houzou, P., Oniankitan, O., Koffi-Tessio, V.E.S., Fianyo, E., Kakpovi, K. and Mijyawa, M. (2014) Profile of Pott’s Disease in Rheumatologic Consultation in Lome (Togo). Journal de la Recherche Scientifique de l’Université de Lomé (Togo), 16, 495-499.
[26]
INAM: Institut National of Health Insurance of Togo. History of the Institut National of Health Insurance|INAM Togo. https://inamtogo.com/
[27]
Zomalheto, Z., Kobelembi, A., Agbodandé, A., Dossou-Yovo, H., Zossoungbo, F. and Avimadjé, M. (2015) Epidemiological, Clinical and Therapeutic Profile of Spondylodiscitis with Common Germs in Hospital Consultations in Cotonou (Benin). Medecine d’Afrique Noire, 62, 405-410.
[28]
Lemaignen, A., Buzelé, R., Druon, J., Bémer, P., Gras, G., Arvieux, C., et al. (2015) Osteoarticular Infections in Children and Adults. Rev Prat., 65, 1-11.
