Effect of the Implementation of Emonc in the Reduction of Maternal Deaths in the Department of Collines from 2018 to 2022

Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.

Factors Associated with Acute Respiratory Infections in Children Aged 0 - 5 Years in the Yénawa District of Cotonou (Benin) in 2023

Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in children 0 to 5 years old in Yénawa, Cotonou in 2023. Subjects and Method: It was an analytical cross-sectional study of children aged 0 - 5 years and their mothers in Yénawa, selected by four-degree random sampling. The sampling size, calculated using the Schwartz formula, was 126 children and 126 mothers. The dependent variable was the occurrence of acute respiratory infections. The independent variables were classified into four groups: socio-demographic and economic characteristics, behavioral factors, child-related factors, and environmental factors. Data collected by observation and questionnaire survey were analyzed using STATA version 15 software. Associated factors were investigated by bivariate analysis and multiple logistic regression, at the 5% significance level. Results: A total of 126 children aged 0 - 5 years and 126 mothers were surveyed, aged 23.5 (11 - 36) months and 30 (18 - 48) years respectively. The prevalence of acute respiratory infections was 74.60% (CI95% = 66.89 to 82.30). The associated factors were the mother’s age between 18 and 28 (OR = 10.77;CI95% = 1.89 to 61.27;p = 0.007), the use of charcoal/wood for cooking (OR = 7.36;IC = 1.99 to 27.10;p = 0.003)), children's poor personal hygiene (OR = 8.87;IC = 2.92 to 26.97;p 0.001)), and cohabitation with domestic animals (OR = 7.27;IC = 1.67 to 31.71;p = 0.015). Conclusion: Communicating with mothers about the factors identified will help reduce the prevalence of acute respiratory infections in children aged 0 to 5.

Sociodemographic and Economic Factors Associated with Urinary Bilharzia in the Municipalities of Sô-Ava, Aguegues and N’Dali in Benin

Introduction: This research, conducted in the municipalities of Aguégués, Sô-Ava, and N’dali in Benin, focused on identifying socio-demographic and economic factors associated with urinary bilharzia in 415 school-aged children from 8 to 14 years. Using urine test strips and filtration techniques, the study found prevalences ranging from 11.88% to 34.53% across the municipalities. Method: Epidemiological data (urine) were collected and examined with test strips to assess the presence of terminal haematuria: the prevalence of infestation and parasite density was quantified using the filtration technique. Socio-demographic and economic factors were recorded using a questionnaire to assess the correlation with disease. Results: Prevalences of 34.53% (N = 48 out of 139), 13.53% (N = 18 out of 133) and 11.88% (N = 17 out of 143) respectively for the municipalities of Aguégués, N’dali and Sô Ava were calculated. The study showed that the variables “age”, “sex”, “religion” and “socio-professional” activity were not significantly correlated with bilharziasis (p > 0.05) and it appears that these factors are not related to bilharziasis in the surveyed households. While age, sex, religion, and socio-professional activity showed no significant correlation with bilharziasis, factors like agriculture, fishing, and place of residence were statistically significant in relation to the disease. Conclusion: The findings suggest that these socio-demographic and economic factors impede the elimination of schistosomiasis in the examined areas.

Contributions of the Measles Follow-Up Vaccination Campaign to Improving the Vaccination Coverage of Children Aged 6 - 59 Months in the Democratic Republic of the Congo in 2019

Background: In accordance with its measles elimination strategic plan 2012-2020, the Democratic Republic of the Congo (DRC) organized a follow-up vaccination campaign against measles from October to December 2019 in 26 provinces. This study aims to establish the contribution of this supplementary vaccination campaign to protecting children against measles. Methods: The survey was carried out in November 2020 among households of the DRC, according to the 2018 revised version of the World Health Organization’s stratified cluster sampling method, using multiple stage sampling. It targeted 280 children aged 6 - 59 months per stratum or province, with 10 children in each of the 28 selected clusters. Data collection using tablets with centralized and real-time data processing was preceded by enumeration to refine the household sampling frame. Clusters and households were selected by random draw. Data collected with CS Pro 7 software were analyzed with SPSS, Epi info 7 and Excel software to determine indicators and make before-after comparisons using the McNemar test, at a precision threshold of 5%. Results: Of the 8535 surveyed children, 89.5% were vaccinatedduring the follow-up campaign and 81.6% were vaccinated before. Only 3.7% had correctly completed campaign vaccination cards. Estimated vaccination coverage increased from 80.8% before the campaign to 92.6% after the campaign (p 0.001). Vaccination coverage after campaign against measles improved in all provinces (p < 0.001) except Bas-Uele and Maniema. Thirteen provinces reached the national coverage target of 95%, compared to five before the campaign. The proportion of zero-dose children dropped significantly after this campaign from 19.2% to 7.4% (p 0.001), and even fell below 1% in six provinces. Conclusion: This measles vaccination campaign improved overall vaccination coverage by 10% and reached more unvaccinated children. Efforts must continue to improve the retention of vaccination card, the adherence of unvaccinated children and the effectiveness of routine vaccination.

Is There an Association between the Type of Activities and Respiratory Disorders among e-Waste Workers? Case of Two Major Cities in West Africa

Background: Several studies have demonstrated that e-waste workers had a risk to develop the respiratory disorders but this was not specifically differentiated according to the type of the e-waste activities. The main aim of this study was to evaluate if the risk to develop respiratory disorders was different according to the type of activities carried out by the e-waste workers. Methods: A cross sectional study was conducted in Abidjan and Cotonou, two big cities in West Africa. The participants were randomly selected based on the list of e-waste workers provided by the census of different sites of e-waste. The spirometry was performed on all the study participants to assess whether they had respiratory disorders. A regression logistic model was performed to estimate the risk of developing respiratory disorders according to the type of activities carried out by the e-waste workers. Results: In total 308 e-waste workers including 149 at Abidjan and 159 at Cotonou were interviewed. Participants of this study ranged in age from 14 years to 69 years and the mean age was 33.71 ± 10.96. The main activities carried out by the study participants were respectively repairing (44.8%), buying or selling (40.3%), dismantling (31.8%). The prevalence of respiratory disorders was 20.1%. The multivariate analysis had not found a significant association between the type of activities and the presence of respiratory disorders. Conclusion: The effect of exposure to e-waste on respiratory health of workers was not different according to the type of activities. So, any policy that aims to reduce the risk of exposure on respiratory health must take into account all the e-waste workers regardless of the type of activities they perform in this sector.

Knowledge, Practices, and Environmental and Occupational Health Risks Associated with Electronic Waste Recycling in Cotonou, Benin

Objective: The e-waste recycling is increasing worldwide, yet there remain outstanding environmental and occupational health concerns. Most research conducted on e-waste recycling has focused on only few countries (e.g., China, Ghana), thus there is a need to increase understanding of e-waste workers’ (recyclers’) knowledge and practices in other locations, that is purpose of this study. Methods: In a cross-sectional study conducted in Cotonou, Benin, 45 e-waste recyclers were interviewed from September to November 2018. Survey data was collected concerning their demographics, professional practices, and knowledge of occupational and environmental risks associated with e-waste recycling. Results: Most participants reported the following methods of material recovery of electronic items in declining orders: dismantling (97.8%) > sorting (91.1%) > incinerating (88.9%). Only 44.2% of the recyclers reported wearing ≥ 1 piece of personal protective equipment (PPE). More than 90% of e-waste workers noted that they disposed the e-waste in natural sites. About half, 46.7% believed that e-waste can pollute water and 71.1% considered that it can pollute air and soil. Recyclers reported several diseases including respiratory (67.4%), heart (62.8%), eye (65.1%), kidney (41.9%) and cancers (30.2%) could be linked to their work, respectively. Interestingly, we also found associations between the number of electronic items dismantled per month and self-report symptoms from the e-waste recyclers such as finding blood in urine and stool, wounds, dizziness, and itchy skin. Our results also indicated associations between the number of hours worked per day and blood in urine, dizziness, itchy skin and airway obstruction. Conclusion: To our knowledge this is the first study to interview e-waste workers in Benin. Doing this increase understanding of their work practices and knowledge to help inform intervention and prevention activities.

Disability and Related Factors among Road Traffic Accident Victims in Benin: Study from Five Public and Faith-Based Hospitals in Urban and Suburban Areas

Introduction: Road traffic accidents (RTAs) are a major public health issue in developing countries, where roads tend to be built haphazardly and accidents take a heavy toll on victims—including leaving them disabled. This study seeks to identify those factors that cause RTA victims to become disabled as a result of their injuries. Methods: This retrospective community-based study looked at RTA victims treated in five public and faith-based hospitals in Benin. Disability was evaluated using the Washington Group on Disabilities Statistics questionnaire. The independent variables were related to the victim’s socio-demographic traits, the circumstances of the accident, and post-crash response mechanisms. The proportions were compared using the chi-squared test, with a threshold of 5%. Results: The prevalence of disability among road traffic accident victims is 9.59% (CI 95%: 6.86% - 13.20%). The occurrence of disability is associated with age (p = 0.002), occupational group (p = 0.0077), the mode of transport used to transfer the victim (p p = 0.0035). The study also found that people fail to make sufficient use of post-crash response mechanisms. Conclusion: Public policy-makers should therefore focus on stepping up interventions to get more people using both protective equipment and post-crash response services.