Profile of Patients Infected with SARS-CoV-2 and Presenting at Least One Comorbidity in the Epidemic Treatment Centers (CTE) of Benin: Epidemiological, Clinical, and Therapeutic Aspects

Introduction: 2019 coronavirus disease, also known as COVID-19, is a highly contagious respiratory disease, rapidly expanding, caused by a new human coronavirus (SARS-COV-2). COVID-19, the main public health problem in Benin since March 2020, is marked by its impact on morbidity and mortality, and its significant socio-economic consequences worldwide. When associated with comorbidity, it can be fatal for the patient. The aim of this work is to study the profile of patients infected with the new coronavirus and presenting one or more associated comorbidities in Benin’s CTEs. Method: This study was carried out in the three (03) CTEs of Benin. It was a retrospective and descriptive study on patients infected with the new coronavirus and presenting at least one associated comorbidity over 11-month period from August 2020 to June 2021. We carried out a thorough recruitment of all patients who tested positive by PCR and were admitted to these centers, presenting at least one comorbidity and whose records were more or less complete during the study period. Results: Out of 819 hospitalized patients during the study period, 516 patients had at least one comorbidity. The hospital prevalence of COVID cases associated with comorbidities in the care centers was 63%. The male gender predominated (57.75%), with a sex ratio (M/F) of 1.37. The over-60 age group was the most represented (49.80%). Comorbidities were dominated respectively by arterial hypertension (68.60%), diabetes (40.31%), obesity (11.05%) and chronic renal failure (7.75%). The symptomatology was polymorphous, but respectively dominated by asthenia (57.56%), fever (51.55%), dyspnea (45.93%) and cough (45.16%). Patient treatment was based on two protocols: one using chloroquine and the other using antiretrovirals (ARVs). The progression was favorable for 76.74% of patients. Conclusion: It is therefore important to reinforce the means of combating comorbidities, in particular hypertension, diabetes, obesity, HIV and chronic renal failure. A particular attention must be paid to the old individuals.

Rabies by Dog Bites in Benin: Determinants of Good Knowledge of the Rabies Risk among Subjects Exposed in the Plateau Department in 2023

Rabies, a viral zoonosis, is one of the neglected tropical diseases (NTDs) that mainly affects poor and vulnerable populations. Human rabies is endemic in Benin. Although listed among the notifiable diseases, it nevertheless remains a neglected and under-reported disease. The objective of this study was to investigate the determinants of knowledge of rabies risk among subjects exposed to human rabies by dog bites in the Plateau department of Benin. Methods: This was a cross-sectional study with an analytical aim which involved a sample of 900 people aged at least 18 years old chosen randomly and residing in the Plateau department for at least six months. A pre-tested and validated digital questionnaire served as a data collection tool. Data analysis was done with R 3.4.1 software. The prevalence ratio was used as a measure of association. The confidence threshold was set at 5%. We carried out a multiple logistic regression using the likelihood ratio (top-down approach) in order to identify the main factors which influenced the good knowledge of human rabies in the population of Plateau. Results: In the study population, 80.89% of the subjects surveyed lived in a rural area. The sex ratio (Male/Female) was 1.11. The average age of the subjects was 40.24 ± 14.52 years. The prevalence of dog bites was 4.11% (95% CI = [3.00;5.63]) or 37 subjects bitten. After evaluation of knowledge of rabies risk in the study population, the main factors which positively influenced good knowledge of human rabies were age (p linear trend 0.01), residence of the subject in the municipality of Pobè (ORa = 8.34;95% CI = 0.83 - 1.23;p < 0.01), individual dwelling (ORa = 17.95;95% CI = 13.12 - 49.58;p < 0. 01), educational level of at least secondary (ORa = 5.53;CI 95 = 3.06 - 10.15;p = 0.01), the existence of a veterinary center (ORa = 3.66;CI 95 = 1.07 - 12.43 p = 0.01) and knowledge of a dog bites victim (ORa = 6.55;95% CI = 2.73 - 8.25;p < 0.01). Conclusion: This population study confirms that human rabies remains a public health problem with a need to raise awareness among populations on good prevention practices against human rabies after a dog bite in the Plateau department. This could help to improve strategies surveillance for the control and eradication of human rabies through the implementation of the One Health approach.

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.

Monitoring Adverse Events during Seasonal Malaria Chemoprevention Campaigns for Children Aged 3 - 59 Months in Benin in 2023

Background: Seasonal malaria chemoprevention (SMC) is crucial for reducing the burden of malaria in children. However, adverse events (AEs) can affect treatment adherence and efficacy. This study assesses the prevalence of AEs associated with SMC and identifies factors associated with treatment discontinuation. Methods: A cross-sectional study of 3115 children receiving SMC was conducted. The study was conducted in two departments in northern Benin. The prevalence of AEs and factors associated with discontinuation of treatment were analyzed. Results: Among the children, 578 (18.6%, 95% CI: 17.2 - 19.9) reported AEs, mainly vomiting (63.5%), fever (43.8%) and diarrhea (23.0%). Boys (51.9%) had slightly more AEs than girls (48.1%). The prevalence of AEs was higher in rural areas (64.0%) than in urban areas (36.0%). Only 2.8% of children stopped taking SMC because of AEs. There was no significant association between AEs and discontinuation of SMC (p = 0.608). Children referred to health centers for management of AEs were less likely to discontinue treatment (p = 0.015). Conclusion: AEs were common, but the rate of discontinuation of SMC due to AEs was low, indicating good treatment tolerance. Effective management of AEs in health centers reduces treatment interruptions.

Factors Associated with High Blood Pressure and Diabetes Cormobidity in Littoral Department of Benin, in 2023

Introduction: The number of people suffering from diabetes and hypertension (HBP) is increasing worldwide and particularly in sub-Saharan Africa, despite the fact that they are preventable. The aim of our study is to determine the factors associated with hypertension and diabetes comorbidity in the Department of Littoral in 2023. Study Setting and Methods: Our study took place in the Department of Littoral in Benin. It was a cross-sectional general population study conducted over a three-month period from April 10 to July 10, 2023. It included subjects aged 18 and over with or without a history of hypertension and/or diabetes. The sampling method was probabilistic and the technique used was a WHO three-stage cluster survey. The dependent variable is comorbidity of hypertension and diabetes. A logistic regression model was used to identify factors associated with hypertension-diabetes comorbidity. Results: The study population was predominantly female (59.9%). The mean age was 44 ± 17. A total of 48 (8.8%) of the subjects in the study suffered from both diabetes and hypertension. Factors associated with comorbidity of hypertension and diabetes were age ≥ 50 years (OR: 5.48;95% CI: 2.69 - 12.20;p = 0.001);male sex (OR: 2.98;95% CI: 1.39 - 6.46;p = 0.005);too much salt or salty sauce consumed (OR: 6.06;95% CI: 1.56 - 22.20;p = 0.034);abdominal obesity (OR: 6.12;95% CI: 2.79 - 14.3;p = 0.001). Conclusion: Hypertension and diabetes are emerging as major public health problems in Benin. The main associated factors were age, gender, the amount of salt or salty sauce consumed and abdominal obesity. A response is urgently needed to act on the factors identified in order to avoid possible complications and an increase in prevalence.

Factors Associated with Overweight among Workers of the Ministry of Labor and Public Service in Benin in 2023

Introduction: The problem of excess weight is pandemic and affects the majority of nations, regardless of their level of development. However, the prevalence of overweight among workers in Benin is very poorly documented. To fill this gap, the present study aimed to determine the prevalence and factors associated with overweight among workers of the Ministry of Labor and Public Service (MTFP) in 2023 in Benin. Materials and Methods: This is a descriptive cross-sectional study with analytical purposes carried out from August 16 to December 17, 2023, among MINISTRY OF LABOR AND PUBLIC SERVICE staff. The variables studied were overweight, sociodemographic, occupational and dietary characteristics, lifestyle, anthropometric factors and family history of obesity. An exhaustive recruitment of workers meeting our inclusion criteria and a questionnaire survey was carried out. Data were analyzed using R 4.0.4 software. A bivariate analysis followed by a multivariable analysis made it possible to identify the factors associated with overweight at the p Results: In total, 379 workers were included in our study. The average age of the surveyed workers was 44.86 years ± 7.67 years, with 202 (53.30%) workers at least 45 years old. Men predominated with a number of 228 (60.16%). The prevalence of overweight was 63.32% (95% CI: [58.23 - 68.15]) and the associated factors after multivariate analysis were: female sex (ORa = 4.00;95% CI [2.11 - 7.76];p Conclusion: The prevalence of overweight is high among ministry of labor and public service workers. Education and awareness in the professional environment on the prevention and management of risk factors are essential for a long-term impact on a notable regression of this public health phenomenon.

Mother-to-Child Transmission of HIV/AIDS during Pregnancy and Delivery and Associated Factors in the Region of Couffo in Benin

Evaluation of the effectiveness of the mother-to-child HIV Prevention Program, in Benin in 2016 reported a national rate of 6.7%. The Region of Couffo, within 12 Regions (departments) in the country, had the highest rate of transmission, which was 16.1%. The study aimed to determine transmission rate during pregnancy and delivery as well as the factors associated with it. This is a retrospective and analytical study based on a sample of seventy (70) babies born to HIV-infected mothers in 2016 in Couffo. Key findings showed, there is a perinatal transmission of five percent (5%) and the factors associated with this transmission are: delay in carrying out first antenatal visits at the health facility, low frequency of visits performed versus number requested and appropriate time, poor health condition of mothers during pregnancy, absence or late start of antiretroviral care and treatment during pregnancy, irregular intake of intermittent presumptive treatment at sulfadoxine-pyrimethamine to prevent malaria, a short antiretroviral therapy (less than three months) for mothers before delivery and the default in cleaning mother’s genital tract with betadine after the woman’s water broke.

Human Habitats and Malaria Vector Control in Benin: Current Situation and Implications for Effective Control

Long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) are the main indoor malaria vector tools control tools. The study examined housing characteristics and investigated the relationship between the total volume of household possessions, the volume of the sleeping room, and the hanging of LLINs. A total of 831 bedrooms were randomly selected in Benin in 2015. The findings showed that mud walls were predominant in rural areas (more than 75%), while metal roofs were common (77.3% - 97.9%). Battery-powered lighting was prevalent in rural areas in Northern (97%), while open-flame oil lamps were commonly used in rural areas in Southern (86%). The availability of correct bedding was low, ranging from 1% to 10% in all households. 20% of the bedrooms had at least 50% of their volume occupied by household possessions in urban areas. In rural areas, bedrooms without LLINs had a lower mean rate ratio of the volume occupied by possessions per the total volume of the room compared to bedrooms with at least one LLIN installed (p < 0.0001). The characteristics of human habitats are not favourable to the correct use of vector control intervention indoors. It is therefore important to improve people’s living conditions as the next step for malaria elimination.

Prevalence and Associated Factors of Occupational Stress in the Mining Sector: The Case Study of the Youga Mine at Zabre in Burkina Faso

Introduction: Occupational stress (OS) is a public health issue;it affects all sectors of activity in Burkina Faso. General objective: Assess the situation of professional stress and its associated factors among workers at the Youga mine in the municipality of Zabré. Material and Methods: This was a descriptive and analytical cross-sectional study. Data collection took place August 15, 2020 to October 10, 2020 from 324 mine workers who met the inclusion criteria using an anonymous questionnaire. Data analysis was done with EpiDATA3.1 software. The Fisher and Chi-squared tests were used to compare the proportions. A binary logistic regression was performed by the stepwise top-down method. The significance level chosen for the tests was p ≤ 0.05. Results: In our study, 324 workers were included. The average age was 35.84 ± 6.56 years with extremes of 23 years and 58 years. The sex ratio was 8. The prevalence of OS was 26.23% and that of iso strain and lack of rewards were 24.38% and 45.06%, respectively. Factors associated with OS were marital status p = 0.010;higher education level p = 0.032, lack of recognition p = 0.001, intention to change jobs p = 0.009, job security p = 0.035;job satisfaction p = 0.046 and the stress felt by the worker at his job p = 0.003. Conclusion: Occupational stress is a reality in the mining sector in Burkina Faso, our study consisted of evaluating the extent and determining the factors of OS in order to propose preventive measures for the good health of workers.

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.

Socio-Medical and Demographic Factors Associated with Perinatal Mortality in a Southern Benin Health Zone Hospital in 2020: A Case-Control Study

Background: Perinatal mortality remains a major public health concern in developing countries such as Benin. To better steer response interventions, this study was carried out in southern Benin with the aim of identifying the demographic and socio-medical factors linked to perinatal mortality. Methods: The case-control study, held from January 1 to December 31, 2020, covered 154 targets, including 77 cases of neonates deceased within the perinatal period and 77 live-born control neonates selected on a one-for-one basis. Univariate analysis using the McNemar test and logistic regression were used to identify risk factors for perinatal mortality, at a 5% threshold of significance. Results: Sahoué/mina ethnicities, only associated socio-demographic characteristic, increased the risk of perinatal death by 2.47 times (p = 0.008). Mother’s age, education, occupation, marital status, and household size were not associated (p > 0.05). Risk of death was increased 2.5 times when the mother was referred (p = 0.007), 3.3 times when she came from a hard-to-reach locality (p Conclusion: Although attention must also be paid to referral and access to care, this study identifies antenatal consultation as the main target of any intervention to reduce perinatal mortality.

Risk Factors for Surgical Site Infections in Patients Operated at the University Clinic of Traumatology-Orthopedics and Restorative Surgery of the National Hospital and University Center Hubert Koutoukou Maga in Cotonou

Background: Operative site infections (ISO) are typically nosocomial. According to the WHO the incidence of ISO varies from 0.5% to 15% and exceeds 25% in developing countries. They result from the combined action of several factors and represent a concern for public health. To study the contributing factors of surgical site infections in patients operated at the University Clinic of Orthopedic Traumatology of CNHU-HKM of Cotonou. Method: This was an analytical cross-sectional study that involved 35 operated patients and ten nurses. Were included in our study: 1) All patients, without distinction of sex or age, having been operated on in the university clinic of orthopedic traumatology, during the survey period;2) Patients hospitalized for post-operative care during the survey period;3) The nursing staff on duty during our study period. The usual statistical measures were used according to the type of variables: means, standard deviations, percentages. Data analysis first involved calculating percentages for the qualitative variables and means followed by their standard deviations for the quantitative variables. Next, the Pearson Chi-square test was used to test the association between the dependent variable and the independent variables of interest. The significance level is set at p Results: The prevalence of surgical site infections was 28.58%. The main factors contributing to the occurrence of SSIs that were found were the patient’s level of education (p = 0.003) and the reuse of bandages used for dressing (p = 0.004). Other potential factors such as the economic status of the patient, the poor quality of technical dressings, and the preoperative stay were also highlighted. Conclusion: Surgical site infections remain a global concern. Risk factors were found on both the patient and nurse sides. It is urgent to address these various factors to minimize the occurrence of surgical site infections.

Factors Associated with Non-Compliance among Patients with Chronic Kidney Disease at the Departmental University Hospital of Borgou and Alibori in Parakou (Benin)

Introduction: Therapeutic compliance in chronic kidney disease (CKD) represents a major challenge for the prevention of this condition, which is both a non-communicable disease (NCD) and a complication of other NCDs. Non-adherence to treatment (NOT) is a factor in the poor prognosis of CKD in developing countries, particularly in Benin. The aim of this study was to evaluate therapeutic compliance (TC) and determine the factors associated with non-compliance in patients with chronic kidney disease undergoing treatment at the Departmental University Hospital of Borgou and Alibori in Parakou (CHUD/B-A). Patients and Methods: This study was carried out in the Nephrology Department of CHUD/B-A. It was a cross-sectional, descriptive study with analytical aims that ran from December 25, 2022 to March 15, 2023 and covered data from 2017 to 2022. It involved 345 patient records meeting the diagnosis of CKD according to the KDIGO 2012 criteria. NOT was defined by a Girerd score evaluation greater than or equal to 3. Data processing and analysis were performed with R software version 4.3.0. Results: The mean age (SD) of patients was 50 years (±14.9). The prevalence of NOT was 57.1%. Potential predictors of non-adherence were: monthly revenue (p = 0.009), mode of admission (p = 0.001), phytotherapy (p = 0.040), traditional treatment (p = 0.049) and quantity of drugs (p = 0.042). Conclusion: Therapeutic compliance among chronic kidney patients still needs to be improved through awareness-raising sessions.

Prevalence and Factors Associated with HIV Serodiscordance among Infected Couples in the City of Parakou (Benin)

Introduction: Achieving the goal of “zero new human immunodeficiency virus (HIV) infections by 2030” requires the elimination of HIV transmission within serodiscordant couples. In Benin, the phenomenon of HIV serodiscordance remains poorly documented. Objective: the aim of this study was to determine the prevalence of HIV serodiscordance and its associated factors among infected couples in the city of Parakou. Study Framework and Method: This was a descriptive cross-sectional study with an analytical focusing on qualitative and quantitative plans. It was carried out on thirty approved sites in the city of Parakou between July and December 2022. We used a non-exhaustive convenience sample of people living with HIV (PLHIV) whose partner’s status was known. Data collection took place in two phases: an interview phase during which sociodemographic, economic, behavioral and marital/social data were collected. The second phase focused on clinical and therapeutic data which were collected from the patients’ personal records. Results: A total of 417 study subjects were recruited. The average age (SD) of the subjects was 38.17 (±10.25) years [37.19 - 39.16]. Females accounted for the largest proportion (79.62%). Most respondents (74.11%) were married. Monogamous unions were the most frequent, involving 67.87% of participants, most of whom (44.60%) had been infected for between 1 and 5 years. Couples in union for less than 10 years were the most numerous (218 people or 52.28%). The respondent was head of household among only 140 respondents (33.57%) of which 84 men (60.00%) and 56 women (40.00%). Female heads of household were mainly divorcees and widows. Around 75% of PLHIV had monthly incomes of less than 50,000F CFA (81.16 USD). Prevalence of HIV serodiscordance was 71.70%. It was 70.91% [65.54% - 76.28%] at care sites and 73.24% [65.95% - 80.52%] at sites involved in preventing mother-to-child transmission (PMTCT sites). Potential predictors of HIV serodiscordance were: household head status;serostatus of last child;duration of relationship;multiple and occasional sexual partners;sharing serostatus with spouse;duration of couple relationship;spouse’s extramarital relationships and strained relations with children. Conclusion: Response strategies against the HIV pandemic need to be reshaped to better supervise the follow-up of HIV serodiscordant couples in the city of Parakou specifically and in Benin in general.