Epidemiological, Clinical and Etiological Aspects of Sciatica in Hospital Setting, CNHU-HKM Cotonou

Sciatica, mostly clinical-based diagnosis, is a potentially debilitating condition as a result of disco-radicular conflict between L4 and L5 or L5 and S1. This study aims at describing the epidemiological, clinical and etiological aspects of sciatica in Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) of Cotonou. It was a prospective, descriptive and analytical study conducted in CNHU-HKM Cotonou neurology department from 1st January to 30th June 2016. The study population comprised 115 low back pain patients seen in consultation. Data collection was carried out through a standard information sheet with socio-demographic, clinical, para-clinical, etiological and therapeutic data. Epi data 3.1 was used for data entry and Stata11 for processing. Frequency of sciatica was 18.6%, with 95% CI [11.5% - 25.7%]. The study population age ranged from 29 to 73 years, with 52 ± 16 as mean value, while sex ratio was estimated at 0.6. Bilateral sciatica representing 53% was present in L5 and S1 nerve roots in 44.4% of cases. It was exacerbated in prolonged standing (24.4%) and relieved in supine position (44.3%), with paresthesia (59.1%) and intermittent radicular claudication (40.9%). Spinal osteoarthritis was the most prevalent etiology (47%). Sciatica is becoming increasing prevalent and should be regarded as problem of health concern.

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.

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.

Clinical Presentation and Evolution of Systemic Lupus at the CNHU-HKM of Cotonou (Benin)

Introduction: Systemic lupus erythematosus (SLE) is a non-organ-specific autoimmune disease with an unknown origin. The unchanged trend of premature mortality in systemic lupus erythematosus shows the critical unmet need for improved and optimized management of systemic lupus erythematosus. Objectives: To analyze the clinical features and the prognostic factors of death in SLE at the CNHU-HKM of Cotonou. Patients and Methods: This was a retrospective cohort study. It was conducted over the period from January 1st 2010 to December 31st 2021. The study population consisted of all patients followed for SLE in the internal medicine, rheumatology, nephrology and dermatology wards at the CNHU-HKM of Cotonou. Results: 88 cases were recorded in 12 years, i.e. an incidence of 7 cases per year. There were 80 women and 8 men with a mean age of 36.4 ± 13.1 years. The clinical picture was dominated by mucocutaneous (86.3%) and osteoarticular (71.5%) disorders. The biological abnormalities observed were anemia (78.8%), lymphopenia (43.1%) and thrombocytopenia (17.7%). 39 patients had renal damage (44.3%). The incidence of death was 17%. Factors associated with death were renal involvement, infectious complications, high initial SLEDAI score, flare, thrombocytopenia and lymphopenia. Conclusion: Mortality related to SLE remains high at the CNHU-HKM of Cotonou. Renal involvement, infectious complications, high initial SLEDAI score, flare, lymphopenia and thrombocytopenia were the factors associated with death. The presence of these factors should lead to an evaluation of the treatment.

Therapeutic Itinerary of Patients Followed for Connectivitis in the Internal Medicine Department of the CNHU-HKM of Cotonou (Benin)

Introduction: In black Africa, connectivites have been for a long time a source of diagnostic erraticity because of their clinical polymorphism. This study aims to determine the therapeutic itinerary of patients followed for connectivitis in the Internal Medicine Department of the CNHU HKM of Cotonou. Methodology: This is a cross-sectional study that included patients followed for connectivitis in the HKM-Cotonou Internal Medicine Department from January 2010 to October 2018. Results: Out of 3600 patients hospitalized in the study period, 21 had connectivitis, i.e. a hospital frequency of 0.58%. Of the 21 patients collected, 18 met the inclusion criteria. The mean age was 40 (±11) years old and the youngest was of 21 and the oldest 58. The sex ratio was 17.9. The “Fon” ethnic group was the most represented (33.3%) and 15 (83.3%) subjects were Christians. Systemic lupus erythematosus was the most frequent connectivitis (55.6%). The average time of consultation was 38 months. Witchcraft was the most incriminating cause (78%). Ten (55.5%) patients had resorted to self-medication as their first choice of treatment, 5 (27.8%) to traditional medicine treatment and 3 (16.7%) to prayer for healing. The reasons for the first choice of treatment were satisfaction (44.4%), financial problems (27.8%), trivialization of the disease (16.7%), and advice from family and friends (11.1%). The consultation at the CNHU followed a referral from a first contact health structure (61%) or an initiative of the patient (27.8%). Conclusion: Connectivitis is a source of diagnostic error in our context. Awareness must be raised among patients for an early consultation at the first symptoms.

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.

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.

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.

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.

Sanitary Quality of the Meals Served in the Canteens and Vicinity of the Lagoon Mother and Child University Hospital Centre and National Hospital and University Centre Hubert Koutoukou Maga of Cotonou (Benin)

Background: Food safety is an integral part of food security. It refers to the protection of the food supply against risks of microbial, chemical and physical origin at every stage of the food chain. The study aimed to investigate the sanitary quality of meals served in the canteens and vicinity of the Lagoon Mother and Child University Hospital Centre (CHU-MEL) and National Hospital and University Centre Hubert Koutoukou Maga (CNHU-HKM) of Cotonou. Methods: It was a cross-sectional with a data collection period from 16 March to 22 April 2021. There were 32 vendors surveyed and 40 meals sampled for microbiological examination. We collected data on the vendors’ socio-demographic characteristics, working environment, health status, knowledge and food hygiene practices. Results: About 83% of the meals contained pathogenic microorganisms. All meals had a temperature from 4°C to 60°C called the “danger zone”. The level of knowledge about food hygiene was low in 65.7% of the vendors. About 47% had poor personal and clothing hygiene, food storage and service practices. Conclusion: These results show that the meals sold in the CHU-MEL and CNHU-HKM could present a health risk for the consumer. There is a need for improvement of the sanitary quality of the meals delivered in the canteens and vicinity of these hospitals.

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.

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.

Immunization against Hepatitis B Virus: Serological Status of West African Populations Residing in Cotonou (Benin) and Dakar (Senegal)

Background: According to WHO estimates, by 2022 over 296 million people are living with chronic hepatitis B virus (HBV) infection, and over 820,000 have died from complications. In sub-Saharan African countries such as Benin and Senegal, few research studies have addressed the issue of HBV immunization. Objective: The main objective of this study was to evaluate immunization against the hepatitis B virus in populations residing in Cotonou and Dakar by titrating anti-HBs antibodies (Ab) and detecting total anti-HBc immunoglobulins (Ig). Materials and Methods: This was a prospective, descriptive, analytical study of two West African populations recruited in Dakar at the Laboratory of Medical Biology (LBM) of the General Hospital Idrissa Pouye (HOGIP) and in Cotonou at the LBMs of the health centres of the Cotonou archdiocese. HBsAg-negative patients constituted our study population. The study took place in November-December 2019 for Dakar and February-March 2020 for Cotonou. Anti-HBs antibodies were tested and titrated. In the event of anti-HBs positivity, total anti-HBc was determined. A microparticle chemiluminescence immunoassay was used for marker determination. The detection threshold was 2.50 IU/L for anti-HBs. Excel and IBM SPSS Statistics software were used for data analysis. Subjects’ sociodemographic characteristics were collected using a questionnaire, as was knowledge of their vaccination status. The study was approved by the ethics committees in Benin and Senegal. Results: A total of 394 HBs antigen-negative participants were recruited: 205 in Cotonou and 189 in Dakar. The population was predominantly female, with 65.36% (N = 134) and 57.14% (N = 108) women in Cotonou and Dakar respectively. The median age of participants was 29 years in Cotonou, with extremes of 10 and 65 years, versus 39 years in Dakar, with extremes of 6 and 93 years. Some participants claimed to be unaware of their vaccination status: 33.17% in Cotonou and 56.61% in Dakar. The total prevalence of anti-HBs-positive subjects was 88.78% (N = 182) in Cotonou and 98.41% (N = 186) in Dakar. In Cotonou (N = 205), 35.61% (N = 73) of subjects had protective anti-HBs levels between 11.60 IU/L and 10,000 IU/L. In Dakar, 61.38% (N = 116) of subjects had protective HBV immunity, with anti-HBs titres ranging from 10.30 IU/L to 11357 IU/L. In Cotonou, 80.82% (N = 59) of immunized subjects (N = 73) had anti-HBC antibodies, compared with 84.48% (N = 98) of immunized individuals (N = 116) in the population recruited in Dakar, indicating immunization following HBV infection. Conclusion: Our study involved a predominantly female population, many of whom were unaware of their serological status. Vaccination policies and knowledge of the viral hepatitis B epidemic need to be strengthened.

Stroke after Hospitalization: Assessment of Functional Prognosis through Disability and Dependency in CNHU-HKM, Cotonou, Benin

Introduction: Stroke results in severe disability, with impacts that are sometimes socially, emotionally or professionally dramatic and also dramatic for the cost involved in care and treatment. Objective: Assessing the functional prognosis after hospitalization and identifying associated factors. Method: It consisted in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved 100 patients who have known stroke for at least 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Disability and dependency were then measured respectively with the Rankin score and Barthel index. The STATA/IC11.0 statistical software was used as the basis for data analysis. Unvaried and multi-varied analyzes helped to identify associated factors. Results: The overall disability and dependency rates were respectively 69% and 57.7%. And the highest rate of disability (38.8%) was observed between 50 and 60 years old. However, dependency prevalence was higher in subjects above 70 years old (37.3%). Regarding gender, the prevalence of disability was 59.2% in men and rather 41.5% in women. Predictors of disability and dependency were paralysis on admission (IC95% = 0.26 [0.77 - 0.92];p = 0.036), obesity (IC95% = 0.26 [0.77 - 0.92];p = 0.012) and monthly income lower than 70$US (IC95% = 0.05 [0.01 - 0.56];p = 0.015). Conclusion: This study enabled us to assess the functional outcome of patients once discharged. The significance of motor deficit on stroke occurrence, obesity and the low monthly income were factors of poor functional prognosis.

Satisfaction of Patients Treated in Physical Medicine and Rehabilitation Department in CNHU-HKM of Cotonou

Satisfaction of patients is an important dimension of the hospital management and the evaluation of the quality of care and services offered to patients. Objective: To estimate the degree of satisfaction of patients admitted in Physical Medicine and Rehabilitation Department in the National Hospital and University Center (CNHU-HKM) in Cotonou. Method: Cross-sectional study with descriptive and analytical aim. It was led from June 15th to October 15th 2013, on 158 patients or guides of children or not communicating patients having ambulatory care in the Department of Physical Medicine and Rehabilitation and who agree to participate to the study. The level of global satisfaction of the subjects was estimated with a digital scale from 0 to 10. It was secondarily transformed into a discreet qualitative variable. Result: Rate of participation was 63.2%. Patients had deficiencies of rheumatilogical origine (41.1%), neurological (27.2%), traumatological (24.1%). Their pathologies were evolving since 1 month to 10 years. It was about their first attendance of the Rehabilitation Department of CNHU-HKM in 72.2%. Patients’ degree of satisfaction was good for the deadliness of expectation, reception (80%), cleanliness of the building, respect of patients’ intimacy. Global satisfaction of patients was good in 72%. It was influenced by the deadline of evolution of the pathologies. Discussion-Conclusion: The level of satisfaction of patients admitted in the Rehabilitation Department in CNHU-HKM was acceptable. However, they are parameters that remain to be improved.

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.

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.