Theoretical Assessment of Environmental Factors and Untreated Infectious Individuals in the Transmission Dynamics of Buruli ulcer

Buruli ulcer is the third most common mycobacterial disease worldwide, posing a significant public health burden, especially in impoverished regions of West and Central Africa, such as Benin. The management of Buruli ulcer (BU) in Africa is often hindered by limited resources, delays in treatment, and inadequate medical facilities. Additionally, a portion of the population does not seek hospital care, which facilitates the continued presence of the pathogen in the environment. This paper aims to investigate the role of environmental factors in the transmission of Buruli ulcer. We develop a mathematical model to describe the dynamics of Buruli ulcer transmission, incorporating the presence of the bacterium in the environment. Theoretical results are presented to demonstrate that the model is well-posed. We compute the equilibria, including the disease-free equilibrium and the endemic equilibrium, and study their stability. To achieve this, we derive a threshold parameter called the basic reproduction number ℛ0, which determines whether the disease will persist in a human population. If ℛ0is less than one, the disease will eventually die out;if ℛ0is greater than one, the disease will persist. Sensitivity analysis is performed to understand the impact of various parameters on the dynamics of Buruli ulcer transmission and to identify the parameters that influence the basic reproduction number ℛ0. Finally, numerical simulations are conducted to validate the theoretical results obtained from the mathematical analysis.

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.

Effectiveness of Disinfection in Bacteriology Laboratories in Togo, 2021

Background: Laboratory personnel is at risk of biological contamination leading to laboratory-acquired infections (LAIs). The use of disinfection products is essential in the prevention of these infections. This work aimed to evaluate the effectiveness of antimicrobial agents used in disinfection in bacteriology laboratories in Togo. Methods: This was a cross-sectional study conducted from June to December 2021 in all bacteriology laboratories in Togo. Swabs taken before and after disinfection of surfaces and staff hands were immediately plated on agar media. Counting and identification of isolated colonies were done after 24 hours of incubation. The ANOVA test was used to compare calculated means, prevalence ratio (PR) and 95% confidence intervals (CI) to compare bacterial frequencies. Results: A total of 393 samples were taken, of which 41.2% were from hands. Before disinfection, surfaces were more contaminated than hands with respectively 40.4% and 29.6% (PR = 1.3;CI 95% = [0.9 - 1.9]). After surface disinfection with 0.5% of chlorine solution, bacterial elimination was total, but partial on hands washed with soap, with residual contamination of 3.7%. A total of 108 strains were isolated before disinfection of which Klebsiella spp. 38.9% and Staphylococcus spp. 25.0%;after disinfection 4 strains were isolated of which: Staphylococcus spp. 75.0% and Klebsiella spp. 25.0%. Conclusion: Surface disinfection was more effective than hand washing with soap and water. We recommend proper hand washing.

Scale and Associated Factors of Using Pyrethroid-Impregnated Mosquito Nets as Fishing Tools on Nokoué Lake within Sô-Ava Municipality in Benin, 2020

Background: In lacustrine communities, whether in Benin or elsewhere, populations use impregnated mosquito nets (IMNs) as fishing nets. This depletes the lake of its fishery resources, which in turn are contaminated by the pyrethroids impregnated in the nets. This study aims to determine the scale and factors associated with the use of pyrethroid-impregnated mosquito nets as fishing tools in the municipality of Sô-Ava in Benin. Methods: This is a cross-sectional and analytical study with two components. First, a quantitative component was made up of 280 volunteers who were interviewed in the seven districts of the city. Data collection was done in two phases: the first from September to October 2020, and the second in August 2022. Data were analyzed with Stata and logistic regression was used. Another qualitative component was made up of forty participants chosen by reasoned choice, of which 32 were split into four focus groups of eight members each, and the rest participated in semi-structured interviews. Triangulation of the different sources was used to analyze the data. Results: Around 67% of the population reported using impregnated mosquito nets as fishing tools and 33% exclusively for malaria. Seasonal fishermen (ORa = 2.03, CI = 1.35 - 4.97, P = 0.004) and years of professional experience (ORa = 1.53, CI = 1.00 - 2.05, P = 0.021) increase the risk of using these nets as fishing tools. The use of insecticide-treated mosquito nets against mosquitoes causes skin scratching and impairs breathing because of the impregnation products, as reported by respondents. Conclusion: A high prevalence of inappropriate use of impregnated mosquito nets in fishing practices is highlighted in this study. Interviews in the field revealed that nets are diverted for fishing purposes to increase the volume of catches. Consequently, it will be appropriate to assess the pyrethroid content in water and fishery products.

Microbiological Quality Assessment of Drinking Water in Lalo Commune, Benin (West Africa)

Although drinking water is readily available in Benin, its quality presents a public health concern. The district of Ahomadégbé in the commune of Lalo is characterized by several artesian wells. Unfortunately, anthropogenic factors negatively affect the drinking water quality in this area. The aim of this research was to study the microbiological quality of drinking water in the Ahomadégbé district, and to review household water treatment methods employed by the local population. Thirty-five water samples were taken—at water collection points, at selected points along the water transportation system and from water storage facilities, and microbiological parameters were measured. Qualitative data were collected via in-depth interviews with key informants regarding local household water treatment methods. Results reveal that there is a significant degree of microbiological pollution of drinking water in this district, particularly during the water transportation and storage stages where microbiological pollution exceeds levels approved by the World Health Organization. Local residents are familiar with several household water treatment methods. However, these methods are inconsistently applied, which limits their effectiveness. In addition to improving the quality of the drinking water resource itself, it is important to set up interventions relating to water treatment methods in local households.

Modifiable Behavioral Risk Factors Associated with Biological Risk Factors in Subjects at Risk of Type 2 Diabetes in Benin: PREDIBE Study

Introduction: Type 2 diabetes is a major public health problem worldwide. This study aimed at identifying modifiable behavioral risk factors associated with biological factors in people at risk of type 2 diabetes which could be targeted in the design and implementation of appropriate interventions to prevent the disease. Methods: 180 subjects at risk of type 2 diabetes (aged 15 - 60 years) were identified and selected at random during a preliminary survey conducted in two groups of villages in northeastern Benin. The study took part on August 2017. Questionnaires were administered to consenting subjects;anthropometric measurements taken and blood samples withdrawn. Blood samples were subjected to biochemical testing according to standard protocols. Results: Data was obtained from 180 subjects at risk of type 2 diabetes. The average age of the subjects was 42.76 ± 11.30 years. Multivariate analysis showed inadequate dietary intake score, low physical activity and tobacco use as behavioral factors significantly associated with high waist circumference, high blood sugar, low HDL cholesterol, high triglyceride levels and high body fat percentage. Conclusion: There is a possible association between biological and behavioral risk factors.

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.

Alcohol, Tobacco and Tramadol Daily Consumption and Road Traffic Crashes among Motorcycle Taxi Drivers in Cotonou (Benin)

Background: In Benin, motorcycle taxi drivers make up a significant portion of road transport. The use of psychoactive substances, a behavior recognized as being at risk of road crashes, is frequent in this group. This study aimed to analyze the association between the consumption of psychoactive substances and the occurrence of road crashes among motorcycle taxi drivers. Methods: This was a cross-sectional study involving 430 motorcycle taxi drivers selected from motorcycle taxi stands in Cotonou (Benin) using a two-stage cluster sampling technique. An interview with a structured questionnaire was used to collect data, which took place in March and April 2019. Alcohol, tramadol, and tobacco were the psychoactive substances considered in this study and their daily use was investigated. A binary logistic regression was used for the analysis. Results: Among the motorcycle taxi drivers surveyed, 27.79% (95% CI = 23.71 - 32.25) were involved in a road crash. The prevalence of psychoactive substances daily use was: 30.41% (95% CI = 26.17 - 35.00) for alcohol, 28.50% (95% CI = 24.37 - 33.02) for tramadol and 4.03% (95% CI = 2.51 - 6.42) for tobacco. Alcohol daily consumption (AOR = 2.09, 95% CI = 1.27 - 3.45, p = 0.004) was associated with a significant risk of road crashes. Conclusion: Interventions aiming to reduce psychoactive substances use should, therefore, be included in road safety policies, especially for this group.

Evaluation of the Effectiveness of the 2019 School-Based Awareness Campaign on Road Driving in the Municipalities of Cotonou and Abomey-Calavi in Benin

Being the leading death cause among young people in the world, road accidents are avoidable through the adoption of simple attitudes and behaviors. Handicap International Non-Governmental Organization (NGO) has launched an awareness campaign in secondary schools in the municipalities of Cotonou and Abomey-Calavito bring young Beninese users to adopt good attitudes and safe behavior while driving on the road. This study aims at assessing the effectiveness of this awareness campaign. It was an evaluative cross-sectional here-elsewhere type study, held in fourteen high schools in the cities of Cotonou and Abomey-Calavi, of which seven benefited from the campaign and seven did not. In each school, students were selected on the basis of two-stage random sampling. 656 students, 309 of whom were sensitized and 347 of whom were not, were included in this study. The campaign was quite effective. Students, teachers, and school officials’ perceptions of the campaign were positive. In addition, the sensitized students had a better level of knowledge (p = 0.001) and reported safer behaviors (p = 0.003) while driving on the road than those who were not aware. Although the effects are positive, they are still very small. Efforts must be continued and much remains to be done.

Evaluation of the Quality of Hospital-Based Management of Severe Acute Malnutrition in Children under 5 in Benin

Introduction: The aim of the study was to assess the quality of the management of severe acute malnutrition in the Mono Departmental Hospital Center (CHD) in Benin. Methods: This was a cross-sectional and evaluative study which took place from 03 February to 20 July 2016. The study was carried out in the mono departmental hospital of Lokossa. The non-probabilistic sampling method was used to select all our study materials and all our targets were systematically selected. Our study materials involved observation checklist, guidelines documents and questionnaires to collect data. The assessment of the quality of the hospital management of severe acute malnutrition was based on national and international standards like Benin’s national protocol of acute malnutrition management. Results: In our study, 27 cases of severe acute malnutrition (SAM) in children were considered. The median age of those children was 12 months. The rates of the components inputs, process and results were 25% (poor), 58.33% (acceptable) and 40% (poor), respectively. The sub components with respect to the norms were all related to the management of severe acute malnutrition like, availability of therapeutic foods ready for use, availability of management protocol, availability of trained and supervised staff in the management of the severe acute malnutrition and the proportion of dead and cured children. The study showed that the quality of the management of severe acute malnutrition at the mono departmental hospital of Lokossa was poor with a rate of 41.38%. Conclusion: The quality of the management of severe acute malnutrition at the mono departmental hospital of Lokossa was poor. The sub components that need to improve were the availability of therapeutic foods ready for use, availability of management protocol, along with the training and supervision of staff in charge of the management of severe acute malnutrition.

Buruli Ulcer: Epidemiological, Clinical and Biological Profile of Patients in the Centre de Depistage et de Traitement d’Allada (Benin) from 2010 to 2014

Introduction: The objective of our work was to describe the epidemiological, clinical and biological profile of Buruli ulcer in “Centre de Dépistage et de traitement de l’ulcère de Buruli” (CDTUB) in Allada. Methods: A descriptive and retrospective study focused on new cases of Buruli ulcer received in the CDTUB of Allada from 2010 to 2014. The diagnosis of Buruli ulcer was based on epidemiological, clinical and biological arguments. Results: Over 5 years, 274 new cases of Buruli ulcer have been diagnosed. The average age of the patients was 12 years and the sex ratio was 0.8. The average time to first consultation was 45 days. Clinically, 61% had a joint functional limitation. Lesions were ulcerated in 69% of cases, category I (26%), category II (53%), category III (21%) and were present on the lower limbs in 57% of cases. Microscopy was positive in 65.7% of cases and PCR in 78.1% of cases. Microscopy supplemented by PCR confirmed the diagnosis in 81% of cases. Conclusion: The epidemiological, clinical and biological profile of Buruli ulcer in Allada was characterized by a predominant disease in children, a predominance of ulcerated forms and a decisive contribution of PCR to the diagnosis.