Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (Mo...Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.展开更多
Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of t...Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of the people who suffer them and are the source of various complications. We report a case of FGM complications in the form of total coalescence of the labia majora with a small hole from which urine flows permanently. The management was a disinfubilation with suturing of the edges and urethral reimplantation and the evolution was favorable with complete healing after two (2) weeks.展开更多
Purpose:.To investigate the stereopsis after single focus intraocular lens (SIOL) implantation in patients aged < 40 years with unilateral cataract. Methods: In total, 36 patients (36 eyes) were divided into emmetr...Purpose:.To investigate the stereopsis after single focus intraocular lens (SIOL) implantation in patients aged < 40 years with unilateral cataract. Methods: In total, 36 patients (36 eyes) were divided into emmetropia and myopia groups. Twenty seven subjects with good uncorrected distance visual acuity (UCDVA) after surgery were enrolled in the emmetropia group..The myopia group consisted of 9 subjects whose one eye had mild myopia postoperatively and the other was emmetropic or myopic. Visual acuity,.distance and near stereoacuity were measured post-operatively. Results:.In the emmetropia group,.uncorrected near visual acuity (UCNVA) did not differ significantly between eyes (t=1.87,P>0.05)..The LogMAR UCNVA of the operated and fellow eyes were (0.71±0.12) and (-0.05±0.07, t=28.4,P< 0.001) respectively..Distance stereoacuity was 60";.the near stereoacuity with uncorrected visual acuity and BCNVA in the operated eyes were 200" and 30" respectively (Z=-4.121,P< 0.001). In the myopia group,.the BCDVA did not differ significantly between the operated and fellow eyes (t=-0.636,P > 0.05)..The UCNVA of the operated eyes (0.18±0.12) was significantly better compared with that of the fellow eyes(-0.04±0.10,.t=4.2252,.P<0.001)..The distance stereoacuity with uncorrected visual acuity and BCDVA in the operated eyes were 200" and 60" respectively (Z =-2.371,P<0.05). The near stereoacuity with uncorrected visual acuity was 50". Conclusion:For patients with unilateral cataract aged<40 years, stereopsis is closely associated with refractive status after IOL implantation..Near stereoacuity in emmetropic eyes can be improved with refraction,.and that in mildly myopic eyes can be enhanced by leaving myopia uncorrected.展开更多
Background: With the recent aging of society, the need for medical treatment of elderly patients with head and neck cancer seems to have been increasing. Method: The present study analyzed all 103 patients with head a...Background: With the recent aging of society, the need for medical treatment of elderly patients with head and neck cancer seems to have been increasing. Method: The present study analyzed all 103 patients with head and neck cancer ≥80 years, and we compared results with those of the previous generation (Group P;range: 75 - 79 years) comprising 104 patients treated in the same period. Results: We provided treatment just as wanted and could not choose it often. The reasons were oncological factors such as unresectable tumor or distant metastasis, refusal of treatment, and physical factors such as poor PS or number of comorbidities. Conclusion: Treatment choices should be based on the wishes and motivations of the patient and the medical assessment of physical function. When a patient ≥80 years old is treated, the high incidence of complications and severity of the disease should be considered.展开更多
文摘Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.
文摘Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of the people who suffer them and are the source of various complications. We report a case of FGM complications in the form of total coalescence of the labia majora with a small hole from which urine flows permanently. The management was a disinfubilation with suturing of the edges and urethral reimplantation and the evolution was favorable with complete healing after two (2) weeks.
文摘Purpose:.To investigate the stereopsis after single focus intraocular lens (SIOL) implantation in patients aged < 40 years with unilateral cataract. Methods: In total, 36 patients (36 eyes) were divided into emmetropia and myopia groups. Twenty seven subjects with good uncorrected distance visual acuity (UCDVA) after surgery were enrolled in the emmetropia group..The myopia group consisted of 9 subjects whose one eye had mild myopia postoperatively and the other was emmetropic or myopic. Visual acuity,.distance and near stereoacuity were measured post-operatively. Results:.In the emmetropia group,.uncorrected near visual acuity (UCNVA) did not differ significantly between eyes (t=1.87,P>0.05)..The LogMAR UCNVA of the operated and fellow eyes were (0.71±0.12) and (-0.05±0.07, t=28.4,P< 0.001) respectively..Distance stereoacuity was 60";.the near stereoacuity with uncorrected visual acuity and BCNVA in the operated eyes were 200" and 30" respectively (Z=-4.121,P< 0.001). In the myopia group,.the BCDVA did not differ significantly between the operated and fellow eyes (t=-0.636,P > 0.05)..The UCNVA of the operated eyes (0.18±0.12) was significantly better compared with that of the fellow eyes(-0.04±0.10,.t=4.2252,.P<0.001)..The distance stereoacuity with uncorrected visual acuity and BCDVA in the operated eyes were 200" and 60" respectively (Z =-2.371,P<0.05). The near stereoacuity with uncorrected visual acuity was 50". Conclusion:For patients with unilateral cataract aged<40 years, stereopsis is closely associated with refractive status after IOL implantation..Near stereoacuity in emmetropic eyes can be improved with refraction,.and that in mildly myopic eyes can be enhanced by leaving myopia uncorrected.
文摘Background: With the recent aging of society, the need for medical treatment of elderly patients with head and neck cancer seems to have been increasing. Method: The present study analyzed all 103 patients with head and neck cancer ≥80 years, and we compared results with those of the previous generation (Group P;range: 75 - 79 years) comprising 104 patients treated in the same period. Results: We provided treatment just as wanted and could not choose it often. The reasons were oncological factors such as unresectable tumor or distant metastasis, refusal of treatment, and physical factors such as poor PS or number of comorbidities. Conclusion: Treatment choices should be based on the wishes and motivations of the patient and the medical assessment of physical function. When a patient ≥80 years old is treated, the high incidence of complications and severity of the disease should be considered.
