Spontaneous Infection of Ascites Fluid at the National and University Hospital Hubert Koutoukou Maga in Cotonou: Prevalence and Associated Factors

Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated with it in the largest hospital in Cotonou. Methods: This was a retrospective descriptive and analytical study conducted from January 2013 to July 2019, at the National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) in Cotonou, Benin. All patients followed in the University Clinic of Hepato-Gastroenterology and diagnosed with SAFI were included. Results: Eighty-two patients were included, predominantly males (69.5%), with a mean age of 51.5 ± 14.5 years. Among them, 32 had SAFI, i.e., a prevalence of 39%. Of the 32 cases of SAFI, the culture of ascites fluid was positive in 6 cases (18.7%). The most frequent germ found in SAFI was Escherichia coli (5 patients, 83.3%). The factors associated with SAFI in this study were: abdominal pain (p = 0.004), increased bilirubinemia (p = 0.009), decreased prothrombin level 20 (p = 0.001). Conclusion: SAFI was common in cirrhotic patients in the department. Certain clinical and paraclinical factors were associated with it, as was the severity of cirrhosis. Early diagnosis and aetiological management of cirrhosis could reduce its frequency.

Prevalence and Causes of Neonatal Mortality at Chu-Mel, Cotonou in 2023

Introduction: Neonatal mortality represents a global health problem that has been at the core of programs developed by the World Health Organization (WHO) for more than 30 years. In our country, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. The goal of this study was to investigate the prevalence and causes of neonatal mortality at CHU-MEL of Cotonou in 2023. Material and Methods: This was a cross-sectional and descriptive study with retrospective data collection, carried out in the neonatology unit of the Mother and Child Teaching Hospital of Lagune (CHU-MEL) in Cotonou over a period of six months from January 1, 2023 to June 30, 2023. All neonates, premature or full-term, born alive and who died during hospitalization in the unit were included. Results: 211 cases of neonatal deaths were recorded among the 2884 neonates hospitalized in the unit during the study period, representing a hospital prevalence of 7.31%. Early neonatal mortality represented 81.5% of cases. The average age at admission was 4.6 days ± 5.3. The average weight of deceased neonates was 1609.08 ± 798.35 g. The most frequent reasons for hospitalization were represented by prematurity (60.66%) and respiratory distress (23.22%), respectively. Prematurity was the leading cause of neonatal mortality (41.7%), followed by neonatal infections (29.4%) and perinatal asphyxia (10.9%). Conclusion: The prevalence of neonatal mortality in the neonatology unit of CHU-MEL is high. Efforts to improve the quality of perinatal care departments must be intensified to reduce this prevalence.

Advanced Sheet Pile Curtain Design: Case Study of Cotonou East Corniche

This paper delves into the critical aspects of sheet pile walls in civil engineering, highlighting their versatility in soil protection, retention, and waterproofing, all while emphasizing sustainability and efficient construction practices. The paper explores two fundamental approaches to sheet pile design: limit equilibrium methods and numerical techniques, with a particular focus on finite element analysis. Utilizing the robust PLAXIS 2016 calculation code based on the finite element method and employing a simplified elastoplastic model (Mohr-Coulomb), this study meticulously models the interaction between sheet pile walls and surrounding soil. The research offers valuable insights into settlement and deformation patterns that adjacent buildings may experience during various construction phases. The central objective of this paper is to present the study’s findings and recommend potential mitigation measures for settlement effects on nearby structures. By unraveling the intricate interplay between sheet pile wall construction and neighboring buildings, the paper equips engineers and practitioners to make informed decisions that ensure the safety and integrity of the built environment. In the context of the Cotonou East Corniche development, the study addresses the limitations of existing software, such as RIDO, in predicting settlements and deformations affecting nearby buildings due to the substantial load supported by sheet pile walls. This information gap necessitates a comprehensive study to assess potential impacts on adjacent structures and propose suitable mitigation measures. The research underscores the intricate dynamics between sheet pile wall construction and its influence on the local environment. It emphasizes the critical importance of proactive engineering and vigilant monitoring in managing and mitigating potential hazards to nearby buildings. To mitigate these risks, the paper recommends measures such as deep foundations, ground improvement techniques, and retrofitting. The findings presented in this study contribute significantly to the field of civil engineering and offer invaluable insights into the multifaceted dynamics of construction-induced settlement. The study underscores the importance of continuous evaluation and coordination between construction teams and building owners to effectively manage the impacts of sheet pile wall construction on adjacent structures.

Distribution of 26 Metals in the Waters of the Aquatic Ecosystems of the Cotonou Channel and Lake Nokoué, Benin

Metallic elements have various origins: natural and anthropogenic sources as geochemical, marine and atmospheric sources resulting from the fallout of pollutants emitted or dust raised and which are transported by water and air currents. Thus marine, brackish and fresh continental waters may have high metal concentrations. In addition, some essential metals can become toxic above certain concentration values in aquatic environments. The aquatic ecosystems of Cotonou channel and lake Nokoué receive the pollutants charges from the town cities of Cotonou, Abomey-Calavi and town hall of So Ava. The aim of this study is to analyze waters from Eighteen (18) stations identified in the two ecosystems (nine by ecosystem). The concentrations of magnesium (Mg), calcium (Ca), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), cadmium (Cd), beryllium (Be), aluminum (Al), strontium (Sr), molybdenum (Mo), silver (Ag), tin (Sn), barium (Ba), platinum (Pt), mercury (Hg), thallium (Tl), lead (Pb), thorium (Th) and uranium (U) were measured after acid digestion of the water samples using the inductively coupled plasma source mass spectrometer (ICP-MS). The results of the analyses indicate an unequal distribution of metals in the different ecosystems. However, atypical concentrations were observed at some stations of the lake and the channel. Magnesium, calcium and manganese have very high values in Lake Nokoué respectively at Ganvié market station GAN_M (2990 ± 105 mg/L), Ganvié center, station GAN_C (4991 ± 177 mg/L) and Lake middle station MLak4 (10662 ± 17.03 μg/L). On the other hand, iron, aluminum and strontium have very high concentrations in the Cotonou Channel respectively at Agbato station AGB (5236 ± 103 and 8289 ± 519 μg/L) and at the estuary station EST (6118 ± 68 μg/L). The concentrations were compared to wells and cborehole waters in sixth neighborhood of Cotonou. We have used statistical analyzers such as MANOVA which have made it possible to classify the waters and metals in the ecosystems studied compared to groundwater and Well water waters. We use hierarchical clustering on principal components to identify similarities between stations based on metal concentration with R software packages “FactoMineR” and “factoextra”. In general, we can conclude that most of the metals have an anthropogenic source except strontium and major elements (Ca and Mg) which could respectively provide from marine waters and geochemical sources.

Higher Plasma Potassium Level Reduces 10-Year Cardiovascular Disease Risk Predicted by the Framingham Risk Score among Taxi-Motorbike Drivers Residing and Working in Cotonou, Benin

Hypertension, obesity, smoking, dyslipidemia, and type 2 diabetes (T2D) are the major risk factors for developing cardiovascular diseases (CVD). Recent studies revealed that taxi-motorbike drivers (TMDs) in Cotonou had higher rates of CVD risk factors, but their impacts on cardiovascular events have rarely been studied. The Framingham risk score (FRS) is an algorithm that considers CVD risk factors and estimates the risk of developing CVD in the next 10 years. Our objectives were to assess the 10-year CVD risk predicted by the FRS, and to examine the relationships of 10-year CVD risk with plasma iron and potassium levels among TMDs. We included 134 TMDs (22 - 59 years old) who had no prior diagnosis of CVD or T2D, and not taking medications affecting iron and potassium homeostasis. Conventional cardiovascular risk factors were used to calculate the 10-year CVD risk, which was categorized as low (20%). FRS > 2%, which corresponded to the 75th percentile of FRS distribution in our study population, was used as a cut-off value to classify participants into two groups. Plasma iron and potassium levels were segregated into tertiles and their associations with 10-year CVD risk were quantified by multivariate-adjusted logistic regression to calculate the odd ratios (ORs) to being above the 75th percentile of 10-year CVD risk with the corresponding 95% confidence intervals (CIs). We found that 62.0% of participants had at least one of cardiovascular risk factors. Approximately 97.8% of TMDs had 10-year CVD risk 4.8 mmol/L led to an 83% risk reduction of having 10-year CVD risk > 2% (OR = 0.17, 95% CI: 0.04 - 0.82, P = 0.027). In conclusion, our findings showed that high plasma potassium levels associate with reduced 10-year CVD risk among TMDs. Interventions focused on monitoring of plasma potassium, particularly in those with existing cardiovascular risk factors, may help prevent CVD.

Irritable Bowel Syndrome in General Population of Cotonou: Prevalence and Associated Factors

Introduction: Irritable bowel syndrome (IBS) is a known public health burden in western countries while only a few studies have been published on this disease in Africa. The objective of this study was to determine the prevalence of IBS in the general adult population of Cotonou (Benin), its associated risk factors and its impact on patients’ daily life. Method: This was a descriptive and analytical cross-sectional study conducted over one month. Data was collected via a questionnaire. IBS was defined by the Rome IV criteria. Results: A total of 768 participants were included, with a male predominance (sex ratio 1.8). The mean age of the participants was 30.6 years, with extremes of 15 to 76 years. The prevalence of IBS in our study was 4.2%. IBS-D was the most common subtype (34.4%). IBS symptoms were influenced by diet (46.9%), stress (31.3%) and lack of sleep (15.6%). In the univariate analysis, the risk factors associated with IBS were: Dendi and Otamari ethnicity (p = 0.015), low level of education (p = 0.047), family history of IBS (p = 0.026), smoking (p Conclusion: Despite IBS frequency, patients with IBS rarely seek medical attention. The public should therefore be informed about this condition to reduce its impact on their daily life.

Evaluation of Malaria Transmission and Vector Control Strategies in the Dry Season in the Cotonou V Health Zone, Benin, West Africa

The anarchic urbanization of certain African cities favors the multiplication of the malaria parasite. Thus, the urgent mobilization of African cities is essential to combat this health risk. It is, therefore, with the objective of contributing to the investigation of problem areas that the present study evaluates malaria transmission and vector control strategies in the Cotonou V health zone in particular. This is a cross-sectional study taking into account four neighborhoods, including Wologuèdè, Sainte Rita, Gbèdjromèdé and the area around Etoile Rouge. Two nocturnal captures on voluntary humans and the method of spray were carried out in the dry season from December 2021 to February 2022. On the captured Anopheles, the ELISA Circum-Sporozoite Protein test was performed to determine the infectivity and calculate some transmission parameters. Finally, we conducted a survey using the second stage sampling method with one step to ask selected households about their knowledge of vector control methods, their use and the physical integrity of LLINs. We collected 2386 culicidae of which the majority was Culex quinquefasciatus. After the ELISA test, the 29 Anopheles tested, showed no infectivity, i.e. an EIR of 0 pi/h/n. In addition, 99% of the populations in the Cotonou V area use LLINs to protect themselves. However, coils, door and window screens, aerosol sprays, skin and household repellents, and periodic indoor spraying were used. Finally, the majority of nets observed had T1 tears, but there were also T2, T3 and T4 nets (P-value = 0.0). This study confirms that malaria transmission during the dry season in the Cotonou V health zone is almost negligible but not non-existent. Also, populations are exposed to the nuisance of Culex quinquefasciatus mosquitoes continuously throughout the year.

Potential Risk of Transmission of Escherichia coli and Salmonella spp. Infections by the Musca domestica Fly and the Periplaneta americana Cockroach in the City of Cotonou (South Benin)

Background: The occurrence of bacterial infections sometimes involves synanthropic flies and cockroaches, as mechanical vectors of pathogenic microorganisms. The aim of this study was to identify the different species of flies and cockroaches that cohabit with humans in the city of Cotonou and determine the contribution of Musca domestica and Periplaneta americana in the transmission of bacteria responsible for infections in humans. Methods: Capture sessions during the day for flies and at night for cockroaches were carried out in 4 arrondissements of the city of Cotonou. The insects collected were transported to the Center of Research Entomological of Cotonou for identification, then sent to the Section Hygiene of Water and Food for microbiological analysis, enumeration and testing for human pathogenic bacteria. Results: A total of 351 flies and 26 cockroaches were collected at the sites, including two synanthropic species belonging to two families each. Musca domestica and Periplaneta americana were the most abundant species found after identification in the city of Cotonou. Thermo-tolerant coliforms and Escherichia coli were found on all specimens at varying concentrations. Salmonella spp. bacteria were identified in the fly population from the Dantokpa dump. Conclusion: Flies and cockroaches can transmit microorganisms to humans. The presence of Salmonella spp. among the specimens revealed that infections frequently caused by contaminated food or water are also transmitted to humans by flies. The presence of these germs on flies and cockroaches represents a potential risk of mechanical transmission to humans. It is, therefore, essential to continue investigations in order to assess the species of bacteria propagated, improve control strategies against these troublesome insects and adopt better hygiene conditions for better living.

Maternal Hospital Mortality in Cotonou: Incidence, Care-Associated Adverse Events and Causes

Introduction: Despite the many efforts made to combat preventable maternal deaths, these still remain high in Benin. It was therefore important to revisit the causes but especially the adverse events associated with care (EIS) in maternity. Objective: Determine the incidence, adverse events associated with care and causes of intra hospital maternal mortality in cotonou. Methods: This was a cross-sectional maternal mortality review study with retrospective data collection. It covered all cases of maternal death recorded between 2017 and 2021 in two (2) reference university maternities in Cotonou. Adverse events associated with care and the patient were analyzed using the maternal death audit grid validated for Benin. SPSS.26 software was used for data analysis. Results: The in-hospital maternal mortality ratio in Cotonou was 2028 maternal deaths per 100,000 live births in 2021. Only 7.2% (n = 36) of deaths were audited. The deceased mothers were 29.8 ± 7.4 years old, with no fixed monthly income in 82.7% (n = 420). Serious adverse events associated with care were: delay in decision to refer in 37% (n = 188), non-medical referral in 85.8% (n = 436) of cases, inadequate pre-referral treatment in 25.7% of cases. In receiving maternities, delay in diagnosis and inappropriate treatment at the receiving maternity were noted respectively in 22.9% and 28.6% of cases of maternal death. The direct causes of maternal death were dominated by serious obstetric hemorrhage in 43.9% (n = 223). As for the indirect causes, they were dominated by anemia excluding obstetric hemorrhages in 21.5% (n = 109). Conclusion: The in-hospital maternal mortality ratio was very high in Cotonou. The main cause was severe obstetric hemorrhage. There were several serious healthcare-associated adverse events whose correct management would significantly reduce the incidence of maternal deaths.

Epidemiology of Low Birth Weight in the Lake Areas of Cotonou (Benin Republic)

Introduction: Low birth weight is a significant public health problem worldwide, particularly in low-and-middle-income countries. This study aimed to investigate the epidemiology of low birth weight in the lake areas of Cotonou. Methods: A cross-sectional analytical study included 931 records of women who gave birth in 2022 in the Cotonou 1-4 health zone. Completed maternity records were included in this study, except for premature births and congenital malformations. Birth weight was the dependent variable. Sociodemographic, obstetrical, preventive care and child-related data were collected using a digitized form. These data were analyzed using SPSS software to determine the prevalence and factors associated with low birth weight using multiple logistic regression analysis. Results: The prevalence of low birth weight was 16.30%. Factors related to this prevalence were non-use of mosquito nets during pregnancy (OR = 2.72;CI: 1.275 - 5.805), twin pregnancy (OR = 9.97;CI: 3.869 - 25.696), previous abortion (OR = 1.61;CI: 1.034 - 2.515), low number of pregnancy (OR = 3.97;CI: 1.276 - 12.393), trimester of first antenatal visit (OR = 3.47;CI: 1.821 - 6.638) and birth size less than 45 cm (OR = 5.98;CI: 2.965 - 12.083). Conclusion: The prevalence obtained from this study justifies the need to support pregnant women in this health zone. It is, therefore, essential to strengthen communication and health promotion strategies for women before, during, and after pregnancy.

A Panorama of the Urological Diseases at the Former Military Teaching Hospital of Cotonou

Background: Urological care has been advancing quickly over the last ten years in Benin. In order to conveniently support that trend towards better urological care standards, decision-makers need sound data on urological diseases in the country. Objective: To determine the prevalence of urological diseases in the former Military Teaching Hospital of Cotonou. Patients and Method: We retrospectively collected the urological diseases that the institution had managed from January 2012 to December 2020. We used Excel© 2010 and SPSS© to analyze the collected data. Results: 4244 patients, i.e. 3717 males (87.58%) and 527 females (12.42%) were managed during the study period. The main diseases diagnosed were benign prostatic hyperplasia (32.61%, n = 1384), erectile dysfunction (10.44%, n = 443), chronic prostatitis (5.94%, n = 252), prostate cancer (4.03%, n = 171), and ejaculatory disorders (3.44%, n = 146). In patients ≤ 15 years, predominant diseases were peritoneal vaginal canal (15.9%, n = 43), circumcision (15.6%, n = 42), testicular dystopia (10.7%, n = 29), hydrocele (7.8%, n = 21), and hypospadias (5.6%, n = 15). Wilms tumor (1.9%, n = 5) was the first cancer, testicular (0.4%, n = 1) and para-testicular (0.4%, n = 1) tumors were the next. In patients > 15 and ≤40 years, the main diseases were infertility (14.1%, n = 189), chronic prostatitis (12.9%, n = 173), erectile dysfunction (10.1%, n = 135), ejaculatory disorders (6.2%, n = 83), genital infections (6.2%, n = 83) and urinary stone (4.9%, n = 66). The first cancer was kidney cancer (0.97%, n = 13) followed by bladder cancer (0.3%, n = 4) and testicular tumor (0.3%, n = 4). In patients >40 years, the most prevalent diseases were BPH (52.0%, n = 1370), erectile dysfunction (11.7%, n = 308), prostate cancer (6.5%, n = 171), inguinal hernia (5.1%, n = 134), and urinary stone (3.9%, n = 102). Prostate cancer is the first cancer;the next were bladder (0.95%, n = 25) and kidney (0.68%, n = 18) cancers. Conclusion: Benign prostatic hyperplasia and urological cancers (prostate, bladder and kidney cancers) were the main urological diseases at the former Military Teaching Hospital of Cotonou. Urological malformations and Wilms tumor were the main diseases in the children.

Epidemiology of Low Birth Weight in the Lake Areas of Cotonou (Benin Republic)

Introduction: Low birth weight is a significant public health problem worldwide, particularly in low-and-middle-income countries. This study aimed to investigate the epidemiology of low birth weight in the lake areas of Cotonou. Methods: A cross-sectional analytical study included 931 records of women who gave birth in 2022 in the Cotonou 1-4 health zone. Completed maternity records were included in this study, except for premature births and congenital malformations. Birth weight was the dependent variable. Sociodemographic, obstetrical, preventive care and child-related data were collected using a digitized form. These data were analyzed using SPSS software to determine the prevalence and factors associated with low birth weight using multiple logistic regression analysis. Results: The prevalence of low birth weight was 16.30%. Factors related to this prevalence were non-use of mosquito nets during pregnancy (OR = 2.72;CI: 1.275 - 5.805), twin pregnancy (OR = 9.97;CI: 3.869 - 25.696), previous abortion (OR = 1.61;CI: 1.034 - 2.515), low number of pregnancy (OR = 3.97;CI: 1.276 - 12.393), trimester of first antenatal visit (OR = 3.47;CI: 1.821 - 6.638) and birth size less than 45 cm (OR = 5.98;CI: 2.965 - 12.083). Conclusion: The prevalence obtained from this study justifies the need to support pregnant women in this health zone. It is, therefore, essential to strengthen communication and health promotion strategies for women before, during, and after pregnancy.

Hand Hygiene Compliance in the Prevention of Nosocomial Infections in the Neonatal Unit of the National University Teaching Hospital of Cotonou

Objective: Despite the presence of hand washing material and the training given to medical staff regarding hygiene measures and health care procedures in October 2015, the prevalence of nosocomial infections in the neonatal unit of the National University Teaching Hospital of Cotonou (CNHU-Cotonou) was estimated at 8% in January 2016. To determine the factors that contribute to these infections, this study assessed medical staff compliance with hand hygiene measures and procedures. Method: This research was a cross-sectional and observational study conducted from February 15 to March 31, 2016 through direct and cautious observation of 47 members of the medical and paramedical staff. The study variables were hand washing before entering the neonatal unit and before entering each treatment room, hand washing before and after seeing each patient, compliance with hand washing steps, the use of hydroalcoholic solutions and adhering to the ban on mobile phone use inside the treatment room. Results: Only 15% of the medical staff followed all of the rules and measures governing hand hygiene. The result showed that 76.6% of them did not wash their hands before entering the unit;32% washed their hands before each care session;95.7% washed their hands after each care session;and 85% did not comply with the hand washing steps. Only 21.3% of the personnel used hydroalcoholic solution, and only 85% of the personnel adhered to the ban on mobile phone use within the treatment room. Conclusion: Compliance with hand hygiene measures is insufficient. These low compliance rates facilitate the occurrence of nosocomial infections. Nosocomial infections could be prevented by identifying the reasons that medical personnel do not wash their hands and by implementing a program for education/awareness on hygiene measures based on an analysis of errors and care procedures and sustained by regular evaluations.

Non-Traumatic Chronic Nasosinusitis Disorders: Clinical and Computed Tomodensitometric Aspects in Cotonou in Benin, West Africa

Introduction: Damage to the nasal cavities and sinuses of the face concern many disciplines, especially the specialist in Otorhinolaryngology and Cervi-cal-Facial Surgery (ENT-CFS), since most symptoms have little value to direct the patient towards a precise diagnosis, radiological exploration, including three-dimensional imaging, provides diagnostic, therapeutic and follow-up support. The aim is to study the clinical and computed tomography scan as-pects of non-traumatic chronic nasosinusitis disorders at the Teaching Univer-sity Hospital of Hubert Koutoukou Maga (CNHU/HKM) in Cotonou. Materi-al and Method: It was a descriptive and analytical study with retrospective collection, carried out over a period of 36 months from January 1st, 2014 to December 31st, 2016;on 261 files of patients seen in Otorhinolaryngology (ENT) and Cervico Facial Surgery (CFS) consultating for a chronic nasosinusi-tis disorder with no trauma notion and having performed a CT scan. Results: Chronic lesions of the nasal sinus cavities accounted for 13.42% of ENT con-sultations. There was female predominance with a sex ratio of 0.85. The clinic varied, the most common signs were rhinorrhea (74%), headache (73.6%) and sneezing (38.3%). On computed tomography scan, 225 results were pathologi-cal. Sinus backfilling was in the lead with 66.7% followed by mucous thicken-ing with 60.44%, and by bone involvement in 28%. Inflammatory pathologies (82.22%) were on top of the list, followed by pseudo-tumoral pathologies (20.9%). The anterior sinus complex was the most affected (56%) with predominance of the maxillary sinuses. Conclusion: chronic nasosinusitis dis-orders are frequent in daily practice, with a varied clinic. Computed tomogra-phy scan is a major diagnostic tool that should be favored.

Phytochemical Screening, Nutritional and Toxicological Analyses of Leaves and Fruits of <i>Solanum macrocarpon</i>Linn (Solanaceae) in Cotonou (Benin)

Vegetables are very important sources of protein and minerals. Some of them even have medicinal properties recognized traditionally. Despite the large number of studies carried out on various vegetables and vegetable crops, very few have scientifically explored the usefulness of S. macrocarpon. This study identified the main groups of chemicals and mineral elements to explain any medicinal or nutritional value. It has also identified some toxic elements contained in this vegetable. Phytochemical screening was carried out on the leaves and fruits of S. macrocarpon. Some mineral elements were determined by Atomic Absorption Spectrophotometry (sodium, potassium, calcium, magnesium) while protein, phosphorous, iron, copper, zinc and toxic metals (lead, cadmium) were determined by Molecular Absorption Spectrophotometry. Fat, ash, moisture and vitamins were sought. The study showed that the leaves of S. macrocarpon were more nutritious than fruits (P macrocarpon require that the consumption of vegetables should be as varied as possible and that the fruit may be consumed with caution. In addition, constraints about vegetable cultivation in Cotonou could lead to research findings that could help provide techniques for producing healthy vegetables.Vitamins A and K1 were found in both parts of this vegetable very rich in water while vitamin E has not been detected. S. macrocarpon also contains lipids at various levels.

Urologic Complications after Gynaecologic and Obstetric Surgery at the Urology-Andrology Teaching Clinic of Teaching Hospital of Cotonou

Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre- dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.

Effectiveness and Safety of Tenofovir Disoproxil Fumarate in Patients Treated for Hepatitis B in the National University Hospital of Cotonou

Introduction: Viral hepatitis B (VHB) is a serious and global public health issue, particularly in sub-Saharan Africa where it is endemic. The objective of this work was to evaluate the effectiveness and safety of tenofovir disoproxil fumarate (TDF) in the treatment of chronic VHB in Cotonou. Methods: This was a descriptive cross-sectional study with a retrospective collection of data from January 1st, 2015 to December 31st, 2016 (24 months) and prospective from May to August 2017 (4 months). Chronic VHB patients treated with TDF for at least 6 months were included. The non-detectability of HBV DNA and the normalization of aminotransferases defined the virological and biochemical responses, respectively. The evaluation of the treatment response on liver fibrosis was done by using APRI score. Renal impairment was assessed by a reduction in glomerular filtration rate according to MDRD (Modifications of the Diet in Renal Disease) formula below 90 mL/min/1.73 m2. Results: In all, 42 patients treated with TDF were included. The average age was 46.7 ± 13.8 years. The study population was predominantly male with a sex ratio of 2.5. Among the 42 patients treated with TDF for an average of 60 weeks (24 to 96 weeks), 36 patients (85.7%) had a virological response;21 patients (50%) had a biochemical response. Virologic response was 70% at week 24 (W24), 92.6% at W48, 87.5% at W72 and 100% at W96 without significant difference between W24 and W48;between W48 and W72 then between W72 and W96. There was a regression of fibrosis and cirrhosis but not significantly. Renal involvement occurred in 3 out of 19 cases (15.8%) including a case of chronic end stage renal failure and 2 cases of mild chronic renal failure. Conclusion: The treatment with TDF is effective and globally safe in our patients with chronic viral hepatitis B in Cotonou.

Functional Constipation in the General Population in Cotonou:Prevalence and Associated Socio-Demographic Factors

Background: Constipation is considered rare in sub-Saharan Africa because of the high fiber content of the local diet. However, certain factors could intervene in this pathology. The purpose of this study was to assess the prevalence of constipation in the general population in Cotonou and to determine the associated socio-demographic factors. Methods: This was a cross-sectional descriptive and analytical study conducted from July to August 2017 in 7 districts of the township of Cotonou, according to a cluster sampling. We included anyone over the age of 15 living in the city of Cotonou for at least 6 months. Constipation was either self-reported or functional (meeting the Rome IV criteria). Results: A total of 1058 participants were included: 574 men (sex ratio of 1.2), mean age of 29 years [range 15 - 92]. Self-reported constipation was noted in 512 patients (48.5%). It was functional in 256 cases (24.2%). In the latter category, there was a predominance of women (138, 53.9%), of secondary education (46.5%), of self-employed professionals (50.4%), from the Ouémé-Plateau (41.8%). Were associated with the occurrence of functional constipation (univariate analysis), age ≥ 60 years (p = 0.049), female gender (p = 0.003), and subjects living alone (166, 64.8%) vs. those living in a relationship (90, 35.2%, p = 0.001). Conclusion: Constipation was not as rare in Cotonou. It was more common in women, subjects over 60 years old or living alone.

Prevalence of Dementia and Its Associated Factors in Cotonou Teaching Hospital, Benin

Introduction: Dementia constitutes a public health hazard in developing countries. There is little data in the sub-Saharan region of African especially in Benin. Objective: Determining dementia hospitalization prevalence and identifying its associated factors in CNHU-HKM, Cotonou. Method: It was a cross-sectional, prospective, descriptive and analytical research conducted from October 2012 to July 2013 in the neurology department;it involved 251 patients aged 50 and above. Dementia screening was conducted using a modified and adapted Mini Mental Scale Examination (MMSE). Dementia clinical and etiological diagnoses were respectively conducted based on DMS-IV and HACHINSKI criteria. Results: Patients were averagely aged 60.9 ± 8.1. Sex ratio (Male/Female) was 1.07. Dementia prevalence was 8.8%. This rate increased proportionally with age, from 5.3% with patients aged below 60 to 12.7% with patients aged above 60. Degenerative dementia was the most predominant type (50%). Following multi-varied analysis, smoking (RC = 6.05 [IC 95% = 1.26 - 29.38] p = 0.0001) and stroke past records (RC = 6.05 [IC 95% = 1.26 - 29.38] p = 0.001) revealed to be the factors associated with dementia. Conclusion: This research showed that dementia affects a significant part of the aging population in CNHU-HKM. It is imperative to combat its associated factors so as to defuse its prevalence.

Elevated White Blood Cell Count Is Associated with an Increased Risk of Insulin Resistance among Non-Diabetic Taxi-Motorbike Drivers Working in Cotonou, Benin

High white blood cell count (WBC) and insulin resistance (IR) are interrelated events that contribute to non-communicable diseases (NCDs), including type-2 diabetes (T2D). However, associations between IR and hematological parameters have never been explored in populations of Benin. The aims of this study were to determine the prevalence of IR and associated hematological parameters in taxi-motorbike drivers (TMDs) working in Cotonou. A total of 133 participants were analyzed in this cross-sectional study. Complete blood count, including WBC and platelet, as well as fasting plasma glucose and insulin, were performed by standard procedures. IR was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Factors associated with IR, their odds ratios (ORs) and 95% confidence intervals (CIs) were determined by logistic regression analysis. The mean age of the study participants was 39.3 years. The HOMA-IR cut-off (75th percentile) for IR was 5.9. The overall prevalence of IR was 24.1%. IR increased with the increase of exposure duration and WBC levels. Logistic regression analysis revealed that the risk of IR increased significantly with higher total WBC, with adjusted ORs (95% CI) for the second and third tertiles of 3.56 (1.10 - 11.58) and 4.01 (1.21 - 13.31), respectively. Similar patterns of associations were observed in an analysis restricted to non-drinkers, although these estimates lacked statistical significance. BMI > 24.2 kg/m2 was independently associated with an increased risk of IR (OR = 3.82, 95% CI: 1.33 - 11.03, P = 0.013). In conclusion, the prevalence of IR in TMDs was 24.1%. IR was significantly associated with elevated WBC count and BMI. WBC may serve as a biomarker to identify individuals at the greatest IR risk.