[Epidemiologic aspects and medical-social impact of hemophilia at the University Hospital Center in Dakar].
The epidemiology and medico-social impact of hemophilia is poorly understood in Africa due to low incidence of the disease and lack of trained hematologists and adequate laboratory facilities. The purpose of this report is to describe our experience with the organization of regular follow-up for hemophilia patients at the University Hospital Center in Dakar, Senegal. A total of 54 patients with type A hemophilia were included in this three-year study. Moderate forms of hemophilia were the most common (55.6%) followed by severe (29.6%) and minor (14.8%) forms. There was no significant difference in mean patient age according to disease severity, i.e., 19.3 years for patients with severe forms, 13.4 years for patients with moderate forms and 15 years for patients with minor forms. Patients over 20 years of age accounted for 27.9% of the study population. The remaining patients were younger, i.e., between 10-19 years (33.3%) and between 1 and 9 years (38.8%). Eighty-seven percent of patients lived in Dakar and the remaining 13% were from various regions of the country. Among the 54 patients in this study, there were 38 (70.3%) with no hemophiliac brother in the family, 13 (24.1%) with one hemophiliac brother and three (5.6%) with two hemophiliac brothers. Osteoarticular damage was found in 28 patients (53.8%) involving the knee in 22, elbow in 18 and ankle in 9. Four patients were positive for HBs Ag (7.4%) and one patient for HIV. Professional or scholastic activity was possible in 69.2% of patients under 20 years old and 46.6% over 20 years old. Although results are still inadequate, a clear-cut improvement has been noted in the survival and quality of life of hemophiliacs in comparison with previous years. These findings show the value of regular surveillance for hemophilia patients in countries with limited resources.