Profile of osteoarticular infections among rheumatology inpatients in Lome, Togo: A multicenter experience

Abstract

Objective: To describe the epidemiological, clinical, therapeutic and evolutionary aspects of osteoarticular infections in rheumatology departments of several institutions in Lome, Togo.

Design: This was a multicenter crosssectional study.

Methods: The study was conducted from December 1, 2019 to February 29, 2020 on the records of patients suffering from osteoarticular infections hospitalized in the rheumatology departments of several institutions in Lome, Togo.

Results: Of the 1957 patients hospitalized in the rheumatology departments of Lome over a five-year period, 262 (13.38%) suffered from an osteoarticular infection. The mean age of the 262 patients (53.82% females and 46.18% males) was 42.06 ± 19.12 years and the mean duration of the disease was 4.28 months. The different clinical forms observed were: infectious spondylodiscitis (184 cases; 70.23%), infectious arthritis (81 cases; 30.92%) and bones infection (five cases; 1.90%). Infection was of probable tuberculous origin in 71.48% of patients, including 61.48% with Pott’s disease. A germ was isolated in 18 patients and was mostly Staphylococcus aureus in nine cases and Mycobacterium tuberculosis in five cases. The peripheral joints most affected by the infection were the knees (41 patients) and the hips (19 patients). The common risk factors identified were: poor hygiene (44.15%); alcohol abuse (22.73%) and HIV infection (33.73%). The evolution below 12 months of anti-tuberculosis treatment or below two months of triple broad-spectrum antibiotic therapy according to the  aetiology was favorable in 223 patients (85.11%). Eight patients (3.05%) succumbed.

Conclusion: Osteoarticular infections are one of the most common cases observed in hospitalization at the rheumatology departments in Lome. Infectious spondylodiscitis is the commonest clinical form.