Surveillance of Surgical Site Infections: A Public Health Emergency in a Regional Hospital of Northern Benin. A Prospective Observational Pilot Study

Background: Surgical site infections (SSIs) are considered as result of the healthcare quality in hospitals. Objective: to study SSI at Saint Jean de Dieu Hospital Tanguieta (SJDHT), prior to the implementation of a permanent monitoring system. Method: transversal, and descriptive study with prospective data collection was performed from 1 July to 31 janvier 2017 in the department of general surgery of SJDHT. The hospital lacks in a microbiology unit. All patients who underwent surgery during this period were included and the monitoring lasted one month. SSIs diagnostic was carried out according to WHO criteria as described in the Practical Guide for the Prevention of Nosocomial Infections published in 2002. Statistical tests (χ-square and Student’s t-test) were applied and p 0.05 were statistically significant. Results: Of 343 patients recorded, 105 (30.6%) had SSI. Their age averaged 40.3 years and the sex-ratio (men/women) was 2.8. The emergency surgery resulted in a 50.0% rate of SSI (p = 0.00). The SSI rate for clean and clean-contaminated surgery was 6.3% against 94.6% for infected surgery (p = 0.00). The SSI rates were 100% and 66.7% for NNISS = 2 and NNISS = 1 (p = 0.00), respectively. Superficial SSI rate was 13.3%, while deep SSI and organ/space SSI were 46.7% and 40%, respectively. The hospital stay of patients with SSI was three times longer than the length of patients without SSI (p = 0.00). Conclusion: SSIs are real burden at SJDHT. Appropriate measures must be adopted to reduce its prevalence.

Influence of Antiretroviral Therapy on the Metabolic Profile of People Living with HIV Followed at University Hospital, Cotonou, Benin

Introduction: Since the advent of antiretroviral therapy, the vital prognosis of people living with HIV (PLWHA) has improved significantly. However, the risk of metabolic complications is high, thus making the bed of cardiovascular disease. Our objective was to compare the prevalence of metabolic abnormalities among PLWHA receiving ARVs to that observed in those who are not treated. Methods: We conducted a cross-sectional study (January to April 2010) at the PLWHA ambulatory care center of national university hospital (CNHU-Hubert K. Maga) in Cotonou, Bénin. We recruited 420 PLWHA (210 treated for at least 6 months and 210 untreated). We determined the prevalence of metabolic syndrome (MS) defined by the criteria of NCEP-ATP III, and the prevalence of abnormal glucose and lipid, and lipodystrophy. Association between metabolic syndrome and ARVs used was analyzed by binomial regression. Confidence intervals were calculated at 95% and 5% alpha level. Results: The prevalence of MS was 16% (18% of patients treated vs. 13% of non-treated, p = 0.18). That of hyperglycemia was 18% (30% of patients treated vs. 6% of untreated;p < 0.001) and of diabetes 7% (12% of patients treated vs 2% of untreated;p < 0.0001). The total cholesterol prevalence was 29% (44% of treated vs 13% of untreated;p <0.02). That of lipodystrophy in 210 patients was 29% (lipoatrophy16%, lipohypertrophy 8%, mixed form 6%). Factors associated with metabolic syndrome were age, hypertension, diabetes (personal or family), BMI, exposure to stavudine (OR = 1.59 [1.02 to 2.47], p = 0.04) and indinavir booted with ritonavir (OR = 2.23 [1.11 to 4 46], p = 0.02). Conclusion: The metabolic abnormalities are more common in PLWHA treated with ARVs. Preventing these anomalies should be made to the initiation of antiretroviral therapy and during the therapeutic monitoring.

Prognosis of Patients with Pregnancy Hypertensive Disorders Followed in University Hospital to Parzakou in 2020

Introduction: Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. Methods: The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values < 5% were considered statistically significant. Results: During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%;eclampsia: 3.6%;puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases;it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013);family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013);history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p < 0.012). Conclusion: The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.

Helicobacter Pylori Infection: Epidemiological, Clinical and Pathological Aspects in a Digestive Endoscopy Unit and the Pathological Anatomy Service of Parakou in Benin Republic

Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to study the epidemiological, clinical and pathological aspects of Helicobacter pylori infection among adults in a digestive endoscopy unit and the pathological anatomy service of Parakou. Patients and Methods: This was a descriptive and analytical cross-sectional study conducted from January 2020 to September 2020 in the digestive endoscopy unit and pathological anatomy service at the Departmental University Hospital Center of Borgou. Patients aged 18 years and older, who had undergone a gastroscopy with biopsies and who gave their oral consent were included. Three antral biopsies and two fundic biopsies were performed. The search for Hp was done under an optical microscope after staining with hematoxylin eosin. Results: A total of 151 patients were included and 51.66% were infected with Hp. Their average age was 40.63 ± 15.32 years and the sex ratio was 0.9. Epigastric pain was the most reported symptom (71.01%). Endoscopically, the prevalence of erythematous gastropathy was 98.72%. The study of chronic Hp gastritis according to Sydney system had shown signs of activity in 100% of patients with Hp and glandular atrophy in 83.33% of them. Intestinal metaplasia and dysplasia accounted for 24.35% and 29.48% of cases, respectively. Factors associated with Hp infection were: absence of proton pump inhibitor intake prior to examination, absence of handwashing with soap and water before eating, erythematous aspect of gastritis on gastroscopy, absence of intestinal metaplasia of the fundus, active and chronic aspects of gastritis on histology. Conclusion: The frequency of Hp infection in hospitals among adults admitted to the Digestive Endoscopy Unit of Parakou is high. To reduce this prevalence, it will be necessary to act on the factors identified.

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.

Factors Associated with Voluntary Cosmetic Depigmentation in Schools in the Collines Department (Benin)

Skin depigmentation is a worrying practice that is gaining popularity, particularly among young girls. However, this practice poses health risks. It also reflects a negative view of black skin color. This was a cross-sectional study carried out between April and May 2023 which involved 1039 female students from schools and universities in the Collines department selected by stratified sampling. Data was collected during a face-to-face interview using a questionnaire providing information on the demographic, socio-cultural, and economic characteristics of the girls. The depigmentation products used were identified as well as the complications caused by the use of these products. Statistical analysis made it possible to calculate the frequencies and logistic regression made it possible to identify the factors associated with depigmentation. The prevalence of depigmentation among the girls surveyed was 78.2%. The main products used were soaps based on mercurial derivative and hydroquinone (21.6%) and lotions based on hydroquinone and corticosteroids (75.7%). The factors associated with the practice of depigmentation were the ethnicity of the respondents (OR = 2.52;95% CI = [0.47 - 13.33], p = 0.001);the average monthly income of the parents (OR = 3.26;95% CI = [1.71 - 6.09], p = 0.003);the opinion of the respondents on depigmentation (OR = 2.48;95% CI = [0.84 - 7.3], p < 0.001) and the value given to light skin versus black skin (OR = 3.41;95% CI = [2.32 - 5.01], p < 0.001). In conclusion, the prevalence of depigmentation among the girls surveyed is high. Consequently, reinforced awareness measures and stricter control of bleaching products are imperative to address this high prevalence of the phenomenon.

Incidental Discovery of Sphenoid Sinuses Agenesis: A Report of Two Cases in Benin, West Africa

Sphenoid sinuses are carved into the body of the sphenoid bone. They are probably the most variably pneumatized structures of the skull. They begin their pneumatization at the age of three and finished at adolescence. Several anatomic variants of sphenoid sinuses have been described in the literature. The agenesis of sphenoid sinuses in adults is very rarely found. We report two incidental cases of sphenoid sinuses agenesis discovered on CT scan in Benin, West Africa.

Anatomic Variants of Sphenoid Sinuses and Adjacent Structures: A Study of 225 Skull CT Scans at CNHU-HKM in Benin, West Africa

Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM), of Cotonou in Benin from November 1st to December 31st. A review of CT scans skull was done for the subjects aged at least 16 years old. Anatomic variants of the sphenoid sinuses and adjacent structures have been investigated. Results: 225 CT scans of skull were analyzed. The sellar type was the most common type of pneumatization of sphenoid sinuses (74.7%). Pneumatization of anterior clinoid processes of greater and lesser wings of the sphenoid and of pterygoid processes was observed in 7.1%;4.6%;3.3% and 7.3%;respectively. Protrusion of carotid canals and optic canals, maxillary and vidian nerves were observed in 48.3%;13.1%;18% and 9.5%;respectively. Conclusion: Risky anatomic variants of the sphenoid sinuses and adjacent structures are also described by CT-scan among Beninese. Before any surgery and to avoid bad outcome, a precise approach of these risky anatomic variants must be carried out by using CT-scan.

Diabetic Ketosis Decompensations at the National Hospital in Benin (West Africa), What Did We Learn about the Precipitating Factors?

We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.

Sphenoid Sinuses Pneumatization and Association with the Protrusion of Surrounding Neurovascular Structures amongst Beninese

Goal: The aim of this work is to study the relationship between the pneumatization of the adjacent structures of sphenoid sinuses and the protrusion of the neurovascular structures in the sinuses. Methods: A review of 225 CT scans skull was done for subjects aged at least 16 years old from November 1st to December 31st 2017. The pneumatization of adjacent structures of sphenoid sinuses and its relation with the protrusion of neurovascular structures surround the sinuses have been investigated. We used Fischer Exact test for comparison. The p value Results: Statistically significant associations were found between anterior clinoid process bilateral pneumatization and bilateral protrusion of carotid canal (p Conclusion: Compared to the literature, the prevalence of pneumatization of the adjacent structures of sphenoid sinuses was lower on Beninese than Caucasian and Asian. But there were the same correlations with the protrusion of neurovascular structures. In case of endonasal surgery of the sphenoid sinuses, surgeon should be aware of the high possibility the injury of optic nerves and internal carotid artery.

Factors Associated with Hypertensive Disorders of Pregnancy in Public Maternities of the City of Parakou In 2019

The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had the hypertensive disorders of pregnancy. The Gestational HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;p = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;p = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;p = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;p = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;p = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;p < 0.05). Conclusion: HDP are common in Parakou. Some factors previously described in the literature are associated with them.

Prevalence of Obesity in Black Subjects with Type 2 Diabetes in Benin

Background: Abdominal obesity is often associated with type 2 diabetes, especially in the context of metabolic syndrome. The objective of this study was to determine the prevalence of corpuscular and abdominal obesity in type 2 diabetes in the two major cities in southern Benin. Methods: It was a multicentric, prospective, descriptive and analytical study that had as framework the center for screening and monitoring of diabetes “Banque d’insuline” of Cotonou, the Polyclinic Atinkanmey of Cotonou and the Internal Medicine Department of the Departmental University Hospital of Ouémé-Plateau in Porto-Novo. The study was a six-month period (March-August 2014). Results: We included a total of 400 type 2 diabetics. Women represented 66% of the study population with a sex ratio of 0.52. The mean age of patients was 55.6 ± 10.3 years with extremes of 28 and 87 years. The prevalence of corpuscular obesity (BMI ≥ 30 Kg/m2) was 38.5% in our study population. For the gender, it was 48.5% in women and 19.1% in men with a statistically significant difference (p = 0.0001). The overall prevalence of abdominal obesity in our study population was 87.8%. Almost all of our diabetic women (99.2%) had abdominal obesity versus 65.4% in men (p = 0.0001). All the patients with type 2 diabetes having corpuscular obesity had also abdominal obesity. This abdominal obesity was observed in 80.1% of non-obese diabetic (p = 0.0001). On the contrary, the majority of patients with abdominal obesity (56.12%) had a BMI below 30 kg/m2. Conclusion: This study shows a high prevalence of abdominal obesity (87.8%) in our study population compared with the corpuscular obesity (38.5%). Hence, the importance of measuring waist circumference is more than BMI in diabetic patients.

Non-Traumatic Chronic Nasosinusitis Disorders: Clinical and Computed Tomodensitometric Aspects in Cotonou in Benin, West Africa

Introduction: Damage to the nasal cavities and sinuses of the face concern many disciplines, especially the specialist in Otorhinolaryngology and Cervi-cal-Facial Surgery (ENT-CFS), since most symptoms have little value to direct the patient towards a precise diagnosis, radiological exploration, including three-dimensional imaging, provides diagnostic, therapeutic and follow-up support. The aim is to study the clinical and computed tomography scan as-pects of non-traumatic chronic nasosinusitis disorders at the Teaching Univer-sity Hospital of Hubert Koutoukou Maga (CNHU/HKM) in Cotonou. Materi-al and Method: It was a descriptive and analytical study with retrospective collection, carried out over a period of 36 months from January 1st, 2014 to December 31st, 2016;on 261 files of patients seen in Otorhinolaryngology (ENT) and Cervico Facial Surgery (CFS) consultating for a chronic nasosinusi-tis disorder with no trauma notion and having performed a CT scan. Results: Chronic lesions of the nasal sinus cavities accounted for 13.42% of ENT con-sultations. There was female predominance with a sex ratio of 0.85. The clinic varied, the most common signs were rhinorrhea (74%), headache (73.6%) and sneezing (38.3%). On computed tomography scan, 225 results were pathologi-cal. Sinus backfilling was in the lead with 66.7% followed by mucous thicken-ing with 60.44%, and by bone involvement in 28%. Inflammatory pathologies (82.22%) were on top of the list, followed by pseudo-tumoral pathologies (20.9%). The anterior sinus complex was the most affected (56%) with predominance of the maxillary sinuses. Conclusion: chronic nasosinusitis dis-orders are frequent in daily practice, with a varied clinic. Computed tomogra-phy scan is a major diagnostic tool that should be favored.