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.

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.

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.