Lower Limb Arteriopathy in Diabetics at the Oueme-Plateau Provincial Hospital in Porto-Novo: Frequency and Associated Factors

Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patients in treatment at the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a cross-sectional, descriptive, and analytical study from July 12 to October 10, 2021, at the Oueme-Plateau Provincial Teaching Hospital in Porto-Novo. ALL was screened by performing systolic pressure index (SPI) in all diabetic patients aged at least 18 years, seen in consultation or hospitalization during the study period and who had given their consent. Results: The study registered 165 diabetics and 98.2% of them were type 2. Subjects aged between 55 and 65 years were the most represented (33.9%), with an average age of 59.4 years. Women were in the majority (61.2%), with a sex ratio of 0.6. High blood pressure was associated with diabetes in 61.2% of patients. The prevalence of ALL was 48.5% (80 patients). Obliterative arteriopathy of the lower limbs (OALL) was observed in 70 patients (42.4%), mediacalcosis in 8 patients (4.8%), and mixed arteriopathy in 2 patients (1.2%). In 88.5% of patients, the pathology was symptomless. Factors significantly associated with ALL included advanced age (p = 0.01), the age of the glycemic imbalance (p = 0.03), lack of regular physical activity (p = 0.001) and dyslipidemia (p = 0.008). Conclusion: Pelvic limb arteriopathy is usual among diabetics at Oueme-Plateau Provincial Teaching Hospital. The use of SPI, which enables diagnosis, requires simple, low-cost means, and should be encouraged.

Diabetes in Borgou Department in Benin: Prevalence and Associated Factors

An epidemic trend is observed in the evolution the epidemiology of diabetes mellitus worldwide. In a nationwide survey conducted in 2008, prevalence of diabetes was estimated to 2.6% in the hole Beninese population and to 4.6% in Borgou department representing the highest in the country. Aim: To determine the prevalence of diabetes mellitus in the adult population and investigate associated factors in Borgou department. Method: A survey was conducted from September 30th to November 20th 2011. In a random sampling using the STEP wise approach of surveillance of chronic diseases recommended by the World Health Organization, 4597 subjects over 18 years old (1935 men and 2662 women) were selected. After informed consent, every subject was submitted to the STEP questionnaire and anthropometric measures. Capillary blood was drawn in fast condition to determine glycaemia. Diabetes was defined by fasting glycaemia above 1.26 g/l. Chi square test was used for statistical analysis and difference was considered significant with p < 0.05. Results: Prevalence of diabetes was 12.4%. There was not a significant difference between men (8.5%) and women (9.4%), p = 0.33. Prevalence of previously known diabetes was 1.2% suggesting a large proportion of undiagnosed diabetes. Prevalence of diabetes increased significantly with age (p < 0.0001). There was no association with instruction level (p = 0.21). Other factors significantly associated with diabetes were place of residency (p < 0.0001), ethnicity (p = 0.002), marital status (p < 0.0001), obesity (p = 0.017) and high blood pressure (p < 0.0004). Conclusion: There is a rapid increase in diabetes prevalence in Borgou department in Benin confirming the epidemic trend of the disease. A large proportion of these diabetic subjects remained undiagnosed, so untreated and then, exposed to precocious chronic complications and precocious mortality. These results strongly support need for active intervention program with objectives of primary, secondary and tertiary prevention of diabetes mellitus and associated factors.

Determinants of High Blood Pressure and Quality of Management in Three Regions of Benin

Objective: The aim of this work was to determine the prevalence, associated factors and quality of high blood pressure (HBP) management in three regions of Benin in 2015. Methodology: This was a cross-sectional study, with two components. The first component included adults aged from 18 to 69 years, selected using a three-stage random sampling within the households. Data were collected thanks to the French version of the WHO STEPS instrument. Anthropometric data, including blood pressure, capillary fasting glucose and total cholesterol were measured according to standard procedures. The second component included Public Health Centers (PHC) selected by a random stratified multi-stage sampling. Data were collected on the structures and the processes of HBP management using the standardized tool for assessing the capacities of management of non-communicable diseases in peripheral health centers provided by the World Health Organization. Results: A total of 4816 participants were included in the first component. The mean age was 35.8 ± 12.7 years. The weighted prevalence of HBP was 27.9% (95% Confidence Interval (CI) [25.6 - 30.2]). It was higher in the 60 - 69 years compared to the lower age groups (Adjusted Odd-ratio (ORa) = 5;95% CI [3.9 - 6.5)]). HBP was positively associated with urban residence (ORa = 1.26;95% CI [1.24 - 1.28]), obesity (ORa = 1.46;95% CI [1.43 - 1.50]), hyperglycemia (ORa = 1.13;95% CI [1.10 - 1.15)]) and hypercholesterolemia (ORa = 1.64;95% CI [1.59 - 1.70)]). A total of 27 PHC were included in the second component. Taking blood pressure and other anthropometric measurements was not routine in PHC. Several essential medicines were not available in the PHC. A low level of community involvement in the management of HBP was noted. Conclusion: This study confirms the high prevalence of HBP and shows inadequacies in its management in the targeted PHC. More appropriate prevention and control measures for HBP should be implemented.

Diabetes and Its Treatment Quality in Benin (West Africa): Analysis of Data from the STEPS Survey 2015

Aims: Diabetes is a major public health problem in low and middle-income countries. This study 1) estimated prevalence and factors associated with hyperglycemia in Benin, and 2) assessed the treatment quality of diabetes. Methodology: A cross-sectional research was conducted with two components. The First component has included 4954 subjects aged (18 - 69) randomly selected in Mono/Couffo and Donga regions. Data were collected according to WHO’s STEPS approach. Capillary blood glucose was measured using the automat Cardiocheck&#174;PA. The Second component considered Public Health Centers (PHCs) within the study regions. Health system established for diabetes control, healthcare practices and the level of involvement of the Public Healthcare Providers and community actors in the management of diabetes have been explored. Findings: A total of 4775 subjects participated in the first component with a predominance of women (56.8%), rural residence and aged (Conclusion: Diabetes prevalence goes increasingly in Benin when its management is inadequate in PHCs. Prevention and control actions should be strengthened.