Hospital Stakeholders’ Perception on Environmental Effects Related to Biomedical Waste in Togo’s University Hospitals (UHC) in 2021

Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health care stakeholders on the environmental effects related to biomedical waste produced in Teaching Hospitals (CHU) in Togo in 2021. Methods: This was a cross-sectional study held from June 24 to August 28, 2021. It targeted three university hospitals, 340 health care providers and services selected by a probabilistic method with a simple random technique in 25 services, 72 directors, deputy directors, supervisors and heads of services, 27 collection and incineration agents selected by a non-probabilistic method with a reasoned choice technique, 44 patients and attendants and 36 householders of neighboring residents selected by a non-probabilistic method with an accidental choice technique. Variables such as the spreading of disease vectors, soil, air and water contamination, the presence of unpleasant odors and unsightly living conditions were assessed. Results: According to the respondents, biomedical waste causes the proliferation of vectors (55.3%), an unsightly environment inside the hospital (47.1%), and unpleasant odors (61.2%). Incineration operations disturb hospital residents (52.8%), according to the householders of the residents. During observation, we note deposits of waste that have not been destroyed and wastewater flowing in some places. Conclusion: Biomedical waste in Togo’s university hospitals generates environmental effects and therefore potentially high risks for human health. Improving their management should be a concern for all hospital actors.

Assessing Biomedical Solid and Liquid Waste Management in University Hospital Centers (CHU) in Togo, 2021

Introduction. Biomedical waste represents an environmental concern and a risk to healthcare workers, users of healthcare services, and the surrounding population. This study aimed to assess the management of solid and liquid biomedical waste in University Hospitals Centers (UHC) in Togo in 2021. Methods. This is a cross-sectional, evaluative and analytical study undertaken in 2021. It involved 3 UHCs, 25 departments, 340 care providers and departments randomly selected, 72 directors or deputies, supervisors and heads of departments, 27 collection and incineration agents selected by a reasoned choice technique, and 44 patients and attendants selected by an accidental choice technique. Data analysis was done using Pearson’s Chi2 statistical test for comparing proportions and logistic regression. Results. Solid and liquid waste management was “poor” due to non-use of waste management guidelines (ORa = 3.50;p = 0.0000), insufficient training of healthcare providers and collection agents (ORa = 6.55;p = 0.0000 and ORa = 6.08;p = 0.0000 respectively), insufficient user awareness sessions (ORa = 4.04;p = 0.0001), insufficient coordination of activities (ORa = 5.07;p = 0.0002), insufficient supervision of service providers and collection agents (ORa = 2.34;p = 0.0000), insufficient monitoring and follow-up of activities (ORa = 20.40;p = 0.0000). The sorting was not systematic (74.1%), and the Biochemical Oxygen Demand (BOD) and Chemical Oxygen Demand (COD) of the effluents were relatively high. Conclusion. Managing solid and liquid biomedical waste is insufficient in Togo’s university hospitals and represents a potential risk to human health and the environment.

Characterization of Four University Hospitals Wastewater in Cotonou, Benin

Introduction: Because of the specificity of their care activities, hospital wastewater contains various contaminants such as germs, disinfectants, metals, pharmaceuticals and chemical reagents, potentially infectious or toxic, which can be harmful to living organisms, or create ecological damage. This study aimed to analyze the quality of wastewaters produced by university hospitals of Cotonou in Benin. Methods: We conduct an analytical cross-sectional study including 30 wastewater samples from selected hospitals. An analysis of variance was performed at the significance level of 0.05. Results: Microbiological analysis showed the presence of germs such as total coliform types, faecal coliforms, fecal streptococcus, staphylococcus, yeasts and Clostridium perfringens in hospital wastewater samples. There was a significant difference (p < 0.05) in the microbial loads of various germs, except staphylococcus, between hospitals. With regard to the physicochemical parameters, only the conductivity complied with the standards for the discharge of wastewater into the environment. A significant difference was noted between hospitals, for the electrical conductivity of wastewater (p < 0.05). The average levels of metals detected in the wastewaters were in line with Benin’s standards. There was no difference between the average concentrations of metals except for copper (p < 0.05). Conclusion: The wastewater produced by the university hospitals of Cotonou is of poor quality and therefore requires adequate prior treatment before discharge into the environment.

Seroprevalence of Hepatitis B Virus Infection and Risk Factors among Adolescents and Youth in Secondary School in 2018, Commune of Covè, Benin

Background: Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus. The study aimed to determine the prevalence and associated factors of hepatitis B infection in adolescents and youth attending secondary school in Covè, urban area in Benin. Methods: From 4th to 10th February 2018, a cross-sectional survey was conducted among adolescents and youth aged 15 to 24 years old. Subjects were randomly selected. Hepatitis B surface antigenaemia (HBsAg) was assayed in blood using rapid enzyme-linked immunosorbent assay kits. Univariate and multivariate analyses were performed. Results: Two hundred adolescents and youth were recruited. The seroprevalence of hepatitis B virus infection was 18.50%. According to the multivariate logistic regression model, being infected by hepatitis B was 4.32 times higher in the age group of 15 - 19 years old than in 20 - 24 years age group (PR = 4.32 95% CI [1.51 - 12.34], p = 0.0063). Similarly, students who had not been aware of hepatitis B were more infected than those who were sensitized (PR = 14.60 [95% CI 4.98 - 4.27], p = 0.0001). With regard to lifestyle, individuals with tattoos or piercings were 8.60 times more likely to have been infected by HBV than those without tattoos or piercings, (PR = 8.60;95% CI [3.41 - 21.70], p < 0.0001). Conclusion: The seroprevalence of hepatitis B among adolescents and youth attending secondary school was high. Regular screening of HVB infection status should be included in school health services in Benin. Awareness campaigns and health education on HVB transmission and prevention should be promoted and strengthened.

Assessment of the Potential Contribution of the Ceramic Filter “Songhai” in the Treatment of Drinking Water in Benin (West Africa)

Contamination of domestic water sources by the biological and physico-chemical pollutants remains a public health issue in Benin. The household water purification devices such as ceramic filters may be a solution. “Filtre Songha?” is a ceramic filter, accessible and easy to use, marketed in Benin. The purpose of this study is to assess the contribution of the “Filtre Songha?” in the treatment of water for domestic use in a peri-urban area in Porto-Novo (Benin). Water samples have been taken, from a collective well and from the lagoon in the 5th district of Porto-Novo. The physico-chemical and bacteriological parameters were measured before and after filtration. The results showed that the use of filters has allowed for a reduction of 97.5% for total coliform in the well water and 99.05% for water from the lagoon. The reduction is 100% for Escherichia coli and fecal streptococci in both cases. Given the low cost and the lifetime use of “filtre Songhai”, this device can be recommended to households for drinking water, particularly for children below five years old the most vulnerable to water related diseases. Research is still necessary to improve the filtration time of this device.

Case-by-Case Surveillance for Bacterial Meningitis in Benin: Data Analysis, 2016 to 2018

Background: Bacterial meningitis is an inflammation of the meninges caused mainly by three bacterial species Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae that are transmitted by nasopharyngeal secretions emitted by carriers. Meningitis is a public health problem in Benin, like all countries in the African meningitis belt. This study aims to analyze the epidemiological surveillance data of meningitis in Benin from 2016 to 2018. Methods: Each suspect case of meningitis was recorded and Cerebrospinal Fluid (CSF) samples were collected. CSF collection was accompanied by the Integrated Disease Surveillance and Response form. This sheet provides information on the patient’s social-demographic and epidemiological data. CSF specimens were sent to the laboratory for analysis and identification (Gram stain, biochemical parameters, and latex agglutination test) of pathogens according to the WHO standards. Results: Of the 2992 patients with suspected meningitis, 2893 were hospitalized with a death rate of 9.4% (281/2992). The sex ratio of registered patients was 1.29 in favor of men. The median age was 4 years (min: 0;max: 90). Patients younger than five years were the most represented (44.8%). During the study period, there was a decrease in the incidence of meningitis per 100,000 inhabitants (6.3 to 3.2 from 2016 to 2018). Of 2928 CSF samples collected we were able to identify 899 pathogenic bacterial species. The most represented species are S. pneumoniae (63.4%), N. meningitidis (24.4%) and H. influenzae (12.2%). Conclusion: The burden of disease is disproportionate in the northern departments as in others. The frequency of bacterial meningitis in the northern region increased during the study period. However, deaths have been recorded in the departments of the South (“Atlantic”, “Plateau”). This suggests an improvement in epidemiological surveillance and case management throughout the national territory.

Microbiological Quality of the Effluents Produced by the University and Hospital Centres in the Department of Littoral, Republic of Benin

Introduction: The effluents generated by hospital activities pose a potential danger to health and the environment. This study aimed to study the microbiological quality of the effluents produced by the university and hospital centres of Littoral department. Methods: This was a descriptive cross-sectional study of 60 samples of hospital effluents from sewage treatment plants and septic tanks carried out during the period from April to June 2019. Samples at the station were made at the entrance and exit of the station. Samples for microbiological analysis were collected in pre-sterilized 500 mL glass bottles. Samples were kept between at 2&#176;C - 8&#176;C and in the dark to ensure satisfactory preservation. ANOVA one-way analysis of variance was performed for each microbiological parameter and principal component analysis (PCA) was also performed. Results: The bacteriological analyses carried out on the 60 samples taken showed a significant microbiological load. In fact, the bacteriological parameters measured and compared to the pollutant release standards in the environment show that the number of germs identified is above the recommended guideline values. The average values for total coliforms, faecal coliforms, faecal streptococci and staphylococci were: 3.91 × 105 UFC/100 mL, 0.52 × 105 UFC/100 mL, 3.92 × 105 UFC/100 mL and 1.36 × 105 UFC/100 mL, respectively. The most isolated bacteria were: Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, Enterococcus faecalis, Enterobacter cloacae, Pseudomonas horizyhabitans, Staphylococcus aureus and Staphylococcus saprophyticus. Most strains were resistant to at least 3 families of antibiotics (beta-lactams, aminoglycosides and fluoroquinolones). Conclusion: These effluents therefore present health and environmental risks. It is of utmost importance to develop methods for the treatment of these effluents before their release into the natural environment.