Epidemiological and Clinical Studies of the Chronic Leuts of the Legs at the Friendship Hospital of Bangui, Central African Republic

Introduction: The purpose of this work was to describe the epidemiological and clinical aspects of leg ulcers in Bangui, Central African Republic Material and methods: This was a descriptive cross-sectional study from October 2014 to June 2016 including patients of both sexes, over 18 years old, treated for chronic ulcers in the Surgery Department of the Hospital of Friendship of Bangui. Results: Of a total of 1089 patients in the department, 41 were leg ulcers, with a hospital frequency of 3.8%. The average age was 50.2 years. The most affected age group was over 40 years old and over (78.0%). The male sex (58.5%) was more represented with a sex ratio equal to 1.4. Patients exercising an activity requiring prolonged standing were more likely to have ulcer in 53.7%. The circumstances of ulceration were infection (41.5%), trauma (34.1%), pruritus (12.2%), insect sting (7.3%) or burn (4.9%). The duration of clinical signs was less than 12 months (63.4%), 1-5 years (34.1%) and 6-10 years (2.5%). Among the favored conditions, HIV infection (17.1%), followed by diabetes (14.6), hypertension + diabetes (9.8%), under nutrition (7.3%), HIV + diabetes (2.4%), hypertension (2.4%). Leg ulcers were more localized on the right leg (36.6%). They were unique (73.2%) and multiple (26.8%). The diameter was 10 to 19 cm (36.5%); less than 10 cm (24.4%); greater than 30 cm (24.4%) and 20 to 30 cm (14.6%). The signs associated with the ulcer were edema (46.3%), pain (24.4%), absence of pedal pulse (7.3%), and ankylosis of the ankle (7.3%). Etiologies were established in 68.29% of cases, including infectious (28.57%), necrotic angiodermia (21.42%), arterial (21.42%), venous (17.85%) and pyoderma gangrenosum (10.4%). Conclusion: Ulcers are more common from age 40 years old and men are the most affected. Infectious and therefore avoidable causes dominate. It is essential to inform the patients, to sensitize the population and to train the nursing staff in order to reduce the prevalence and to improve care.