Background: Human African trypanosomiasis (HAT) occurs in three historical foci in the Central African Republic. Objective: To describe the morbi-mortality of childhood HAT in rural Central African Republic with the a...Background: Human African trypanosomiasis (HAT) occurs in three historical foci in the Central African Republic. Objective: To describe the morbi-mortality of childhood HAT in rural Central African Republic with the aim of early management. Methods: Descriptive and analytic cross-sectional study conducted from January 1, 2017 to March 30, 2018 at Nola prefectural hospital. This study was included all children seen as outpatients and/or hospitalized in the pediatric wards, in whom the diagnosis of HAT was confirmed. Statistical analysis was performed using Epi-info software. Results: Forty children were included from Bilolo (60%), Nola (30%) and Salo (10%). The sex ratio was 0.66 with a median age of 8.65 ± 12.48 years. Fever (82.5%), nocturnal insomnia (75%), daytime somnolence (67.5%), headache (65%), polyarthralgia (62.5%), convulsions 52.5% (n = 21), tremor (27.5%), trypanidism (7.5%) and delirium (2.5%) were the main functional signs. Examination signs were adenopathy (52.5%), paresthesia (30%), decreased cutaneous-abdominal reflexes (25%) and osteoarticular reflexes (17.5%), hyperesthesia (20%), extrapyramidal hypertonia (15%) and depression (2.5%). The children were in the lymphatic-blood phase in 65% of cases, and meningoencephalitis in 35%. Pentamidine was administered in 65% of cases. Four children died and 6 had neurological sequelae. There was an association between age under 5, Bilolo’s focus, the children’s history and the severity of the disease. Age under 5, gender, household, children’s activity, history and occurrence of sequelae were also associated. Conclusion: HAT remains a permanent threat to Central African children. Any clinical presentation combining long-term infectious signs and unexplained neurological or neuropsychological disorders must be treated with caution.展开更多
Introduction: Work-related accidents constitute are a public health concern worldwide. The aim of our study was to assess a series of work-related accidents that occurred in a cardboard packaging manufacturing company...Introduction: Work-related accidents constitute are a public health concern worldwide. The aim of our study was to assess a series of work-related accidents that occurred in a cardboard packaging manufacturing company in Abidjan from 2012 to 2019 and to determine the consequences for the victims and the company. We’ve carried out a retrospective study of all work-related injuries reported to the National Social Insurance Fund of Cote d’Ivoire from 2012 to 2019 using the company’s work-related accidents’ register and investigation reports. Results: The prevalence of work-related injuries among the workers was 84% for the manual workers and 16% for the supervisors. The trends in the prevalence of work-related injuries were upwards, with a slow and almost linear progression over the period of study. Most of the accidents (53%) occurred in the process area. The upper limbs were the most common location of injuries (46%) and almost all the cases were declared cured. The cumulative direct costs of the TAs over the 8 years were 46,185,533 FCFA, or 70409.39 euros. The average direct annual cost was 624,129 CFA francs, or 951.47 euros. The average annual indirect cost was 41,265,576 CFA francs. The cumulative amount of indirect costs was 330,124,611 CFA francs over the 8 years. The indirect costs accumulated over the 8 years represented 98.17% of the cumulative economic cost of work accidents. Discussion: The assessment of the socioeconomic impact of these work-related injuries revealed that indirect costs which are usually ignored nor underestimated by the employers represent a minimum direct/indirect ratio of 1/27. Conclusion: Prevention is the best option to anticipate or mitigate the impact of work-related accidents among the victims.展开更多
Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods:...Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.展开更多
Purpose: Bacterial resistance to antibiotics has become a global public health problem. Enterobacteriaceae ESBL is among the most incriminated in this emergence which reduces the therapeutic possibilities. Thus, the o...Purpose: Bacterial resistance to antibiotics has become a global public health problem. Enterobacteriaceae ESBL is among the most incriminated in this emergence which reduces the therapeutic possibilities. Thus, the objective of this study is to determine the prevalence of the extended-spectrum beta- lactamase (ESBL) producing Enterobacteriaceae at ZNH and their antibiotic susceptibility profile. Materials and Methods: This is a prospective study carried out over 5 months in all hospitalized and non-hospitalized patients in whom a culture was taken for the diagnosis of an infection. The search for ESBL is done by the double disc diffusion method. Results: In total, 21 out of 45 of our strains are ESBL-producing, i.e. a frequency of 46.7%. The mean age is 41.62 (±22.90) with extremes of 2.6 - 78 years. The distribution of ESBL producing species showed a predominance of E. coli with 66.7% followed by K. pneumoniae and K. oxytoca each 9.5%. All ESBL strains were resistant to Amoxicillin, Cefalotin, Pipiracillin, Piperacillin + tazobactam, Ticarcillin, Ticarcillin + clavulanic acid. Resistance to C3G and Aztreonam was each 95.5%, to Amoxicillin/clavulanic acid 9.1%. All strains were sensitive to imipenem. E. coli strains showed resistance: 85.7% to ciprofloxacin, 50% to Amikacin, 57.1% to Gentamicin. For K. pneumoniae, it is 66.7% for Gentamicin and Ciprofloxacin. Conclusion: Our study reports a high prevalence of ESBL at the HNZ. This must be taken into account in order to monitor this phenomenon which constitutes a public health problem. The study also reports sensitivity to Amoxicillin/clavulanic acid and Aminoside which can be an alternative.展开更多
Background: In Benin, little is known about the influence of both gender and HIV-status on diagnostic patterns and treatment outcomes of Tuber-culosis (TB) patients. Objective: To assess whether differences in gender ...Background: In Benin, little is known about the influence of both gender and HIV-status on diagnostic patterns and treatment outcomes of Tuber-culosis (TB) patients. Objective: To assess whether differences in gender and HIV status affect diagnostic patterns and treatment outcomes of TB patients. Methods: Retrospective cohort study of patients registered in 2013 and 2014 in the three largest TB Basic Management Units in south Benin. Results: Of 2694 registered TB patients, 1700 (63.1%) were male. Case notification rates were higher in males compared with females (96 vs 53/100,000 inhabitants). The male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV negative cases. In HIV-positive patients, there were no differences in TB types between men and women. In HIV-negative patients, there were significantly higher proportions of females with clinically diagnosed pulmonary TB (p = 0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times higher amongst males compared with females. For New bacteriologically confirmed pulmonary TB, no differences were observed in treatment outcomes between genders in the HIV positive group;but significantly more unfavorable outcomes were reported among HIV negative males, with higher rates of failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study has shown that overall TB notification rates were higher in males than in females in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.展开更多
Background: In most societies, homicide or murder is a crime that often leads to imprisonment. Studies around the world have sometimes found cases of mental illness (schizophrenia spectrum disorders) as an explanation...Background: In most societies, homicide or murder is a crime that often leads to imprisonment. Studies around the world have sometimes found cases of mental illness (schizophrenia spectrum disorders) as an explanation for some homicides. The aim of this study was to determine the factors associated with homicide in the Togolese context. Methods: This was a descriptive and analytical cross-sectional study of pre-trial psychiatric expertise reports from January 31<sup>st</sup>, 2019 to January 30<sup>th</sup>, 2022. Results: Out of 704 defendants appraised, 206 (29.3%) had committed homicide. Males accounted for 91.7% of Homicide defendants (HD). Their average age was 31.6 ± 12.2 years, with extremes of 16 and 74 years. Factors associated with homicide were female gender, age between 30 and 45 years, married or cohabiting status and occupation as a farmer/fisherman/breeder. Psychoactive substance use (PAS), mental illness and psychiatric history were not associated with homicide. Conclusion: Preventing delinquency and interpersonal conflict, and promoting social cohesion, could significantly reduce homicides in Togo.展开更多
A case of a 12-month-old male infant, who presented a painless swelling of the right anterolateral edge of the mobile tongue, is reported. The treatment consisted of a partial glossectomy with total surgical excision ...A case of a 12-month-old male infant, who presented a painless swelling of the right anterolateral edge of the mobile tongue, is reported. The treatment consisted of a partial glossectomy with total surgical excision of the tumor. The diagnosis of low grade myofibroblastic sarcoma on the histological arguments (tumor architecture, cytology, mitotic index) and immunohistochemistry was retained.展开更多
Nowadays, the circulation of poor quality medicines is becoming an alarming worldwide phenomenon with serious public health and socio-economic concerns. The situation is particularly critical in developing countries w...Nowadays, the circulation of poor quality medicines is becoming an alarming worldwide phenomenon with serious public health and socio-economic concerns. The situation is particularly critical in developing countries where drug quality assurance and regulatory systems for drug manufacturing, importation, distribution and sales are weak. A sustained vigilance on poor quality medicines that regroup counterfeit/falsified, substandard and degraded medicines is therefore required to ensure patient safety and genuine medicines integrity. A case situation is illustrated including a strategic approach and analytical tools that were found useful to detect poor quality medicines, identify unknown components, and timely alerts for appropriate measures against the spread of those harmful products. Several suspected medicines randomly sampled in several strategic Rwandan areas were firstly check-controlled by means of visual inspection and then applying several analytical techniques from simple to more complex ones. The following medicines were studied: quinine sulfate tablets, artemisinin-based combination tablets, and artesunate powders for injection. Taking into account the pharmaceutical forms and the chemical characteristics, the following tests were applied: uniformity of mass, friability, disintegration, fluorescence, identification and assay. They were followed by more complex analytical techniques that allowed more comprehension of abnormal findings among which the presence of a wrong active pharmaceutical ingredient in quinine sulfate tablets which is mainly discussed in this paper to illustrate a strategic approach and various analytical tools that can be used in detecting and identifying unknown component in poor quality medicines.展开更多
Introduction: Attention deficit hyperactivity disorder (ADHD) is a little-studied psychiatric pathology in our countries, and particularly here in Benin. Objectives: To calculate the prevalence and identify the factor...Introduction: Attention deficit hyperactivity disorder (ADHD) is a little-studied psychiatric pathology in our countries, and particularly here in Benin. Objectives: To calculate the prevalence and identify the factors associated with attention deficit hyperactivity disorder among adults in the commune of Parakou in 2022. Methods: Cross-sectional, descriptive, analytical study including subjects aged 18 and over. ADHD was assessed with the Adult ADHD Self Report Scale (ARSR-v1.1) and consequences with the Weiss functional impairment rating scale (WFIRS-S). Results: A total of 456 people were included in the study. The mean age of those surveyed was 25.9 ± 11.6 years. The prevalence of ADHD symptoms among the adults surveyed was 6.8%. The clinical form of ADHD with a predominance of inattention had a prevalence of 3.3%. After multivariate analysis, the factor associated with the presence of ADHD symptoms in adults in the commune of Parakou was: a poor relationship with the subject’s partner (p = 0.031, ORa = 6.5 [1.18-35.68]). Conclusion: ADHD is present in the community of Parakou and needs further attention.展开更多
The widespread use of long-lasting insecticidal nets (LLINs) is a major intervention method for malaria control. While coverage of LLINs has increased, there is a need for information on the operational effectiveness ...The widespread use of long-lasting insecticidal nets (LLINs) is a major intervention method for malaria control. While coverage of LLINs has increased, there is a need for information on the operational effectiveness of nets deployed in the field in the context of malaria vector resistance to insecticides used for impregnation. The development of specific anti-malarial biomarkers to assess exposure to mosquito bites is an important development in evaluations. The aim of this study was to characterize the human IgG antibody response to Anopheles gSG6-P1 saliva, a salivary peptide antigen previously shown to be a relevant biomarker of human exposure to Anopheles bites, in order to assess the LLINs under field conditions in areas of low and high vector resistance to insecticides. We analyzed data from 240 randomly selected children ( 0.05). Furthermore, the same finding was observed for antibody expression in children whether or not they used LLINs on the day before the survey (p = 0.7724). Similarly, gender and especially age, major factors of variation in the adaptive immune response, did not have a significant effect on IgG expression.展开更多
Context: The resistance to pyrethroids in malaria vectors continues to grow in Africa and could therefore compromise or reduce substantially the effectiveness of LLINs in preventing malaria. It is therefore of paramou...Context: The resistance to pyrethroids in malaria vectors continues to grow in Africa and could therefore compromise or reduce substantially the effectiveness of LLINs in preventing malaria. It is therefore of paramount importance to evaluate the protective efficacy of LLINs in children sleeping in areas of vector resistance to insecticides in order to draw lessons for future interventions. This study assesses the effect of the use of LLINs on malaria morbidity in clusters of low and high resistance of vectors to pyrethroids. Methods: This is a cross-sectional case-control study with one control for one case that was conducted in the communes of Kétou, Ifangni, Kétou, and Pobè in the Plateau department of southern Benin. The use of LLINs and malaria morbidity was measured and compared in children from clusters of low and high vector resistance to insecticides. In each commune, 30 cases and 30 controls were recruited for a total of 240 children under 5 years of age from villages with low and high insecticide resistance. Results: According to the localities of origin of the children, of all parents of children surveyed, 169 (70.4%) asserted the children slept under an LLIN the day before they arrived at the health center. This rate represents 70.8% (85 children) among the cases and 70.0% (84 children) among the controls without significant difference (p = 0.8). The use of LLINs the day before the survey, the frequency of their use during the two weeks preceding the day of the survey, their availability at the household level, the use of other tools for protection against mosquito bites are the same in the two groups of children (cases and controls) (p > 0.05) as well in low and high resistance villages. On the other hand, the parasite prevalence, the splenomegaly and the geometric means of the parasite densities, are significantly higher in the cases than in the controls (p Conclusion: The evaluation of epidemiological indicators in children under five years old at the level of health centers did not enable demonstrating the impact of resistance on the operational effectiveness of the LLINs. The information collected within the four health facilities only reflects the situation that should normally be seen in the population under the real conditions of use of LLINs in high and low resistance areas.展开更多
Introduction: The objective of our work was to describe the epidemiological, clinical and biological profile of Buruli ulcer in “Centre de Dépistage et de traitement de l’ulcère de Buruli” (CDTUB) in Alla...Introduction: The objective of our work was to describe the epidemiological, clinical and biological profile of Buruli ulcer in “Centre de Dépistage et de traitement de l’ulcère de Buruli” (CDTUB) in Allada. Methods: A descriptive and retrospective study focused on new cases of Buruli ulcer received in the CDTUB of Allada from 2010 to 2014. The diagnosis of Buruli ulcer was based on epidemiological, clinical and biological arguments. Results: Over 5 years, 274 new cases of Buruli ulcer have been diagnosed. The average age of the patients was 12 years and the sex ratio was 0.8. The average time to first consultation was 45 days. Clinically, 61% had a joint functional limitation. Lesions were ulcerated in 69% of cases, category I (26%), category II (53%), category III (21%) and were present on the lower limbs in 57% of cases. Microscopy was positive in 65.7% of cases and PCR in 78.1% of cases. Microscopy supplemented by PCR confirmed the diagnosis in 81% of cases. Conclusion: The epidemiological, clinical and biological profile of Buruli ulcer in Allada was characterized by a predominant disease in children, a predominance of ulcerated forms and a decisive contribution of PCR to the diagnosis.展开更多
According to WHO, the rates of smear-negative and extra-pulmonary pulmonary tuberculosis are increasing in high prevalence HIV epidemic areas. Delays in diagnosis of tuberculosis can lead to large excess of mortality....According to WHO, the rates of smear-negative and extra-pulmonary pulmonary tuberculosis are increasing in high prevalence HIV epidemic areas. Delays in diagnosis of tuberculosis can lead to large excess of mortality. It is extremely important to provide a strong diagnosis tool of tuberculosis if we want to reduce mortality due particularly to TB co-infection in HIV infected people in low-income countries such as Togo. This study aims to assess the performance of Determine? TB LAM Antigen, a rapid diagnostic test (RDT) for tuberculosis. It was an evaluation study, conducted at the National Reference Laboratory for Mycobacteria located at the Sylvanus Olympio University Teaching Hospital in Lomé, Togo from 01 July to 15 November 2017. We performed the assessment onto 100 urine specimens collected from 100 subjects (HIV-infected or not). The test allows qualitative detection of the Lipo Arabinno Mannan (LAM) antigen of Mycobacteria in the urine. Bacilloscopy was chosen as gold standard. Overall, the test Determine? TB LAM presented a sensitivity of 31.25% and a specificity of 95%. In contrast, the sensitivity and specificity of the test were respectively 82.35% and 66.67% in the group of HIV-infected subjects. In HIV non-infected subjects, the sensitivity was 17.46% and the specificity was 100%. Determine? TB LAM Antigen test can help detect TB in HIV-infected people unable to expectorate in our settings.展开更多
Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection amon...Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.展开更多
Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex wor...Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.展开更多
Introduction: Neonatal pathology remains a real public health problem in developing countries. In Burkina Faso, this mortality has declined over the last ten years but remains below compared to the Sustainable Develop...Introduction: Neonatal pathology remains a real public health problem in developing countries. In Burkina Faso, this mortality has declined over the last ten years but remains below compared to the Sustainable Development Goals, which is 12 per 1000 living births at most by 2030. This study aims to identify specific causes of neonatal morbidity and mortality and will contribute to the implementation of preventive and curative measures aimed at reducing neonatal mortality at HOSCO. Method: This was a retrospective study using the records and database of newborns hospitalized from January 1<sup>srt</sup>, 2017 to December 31<sup>srt</sup>, 2020. Using logistic regression, the factors associated with mortality were determined. Results: During the study period, 3020 newborns were hospitalized. Most newborns (83.71%) were referred by a peripheral health facility. The average age at admission was 0.3 days ± 0.9 and the sex ratio was 1.2. Prematurity was the leading cause of hospitalization (61.13%) followed by neonatal infection (38.34%) and neonatal suffering (23.88%). The mortality rate was 40.6% with 82.71% cases of death in the early neonatal period. The main causes of death were low birth weight (47.39%), respiratory distress (18.76%), neonatal suffering (17.37%) and neonatal infection (13.87%). Home delivery, gestational age 36 weeks, number of PNC 4, concept of resuscitation, Apgar at the 5th minute 7, birth weight 2000 g and >4000 g, respiratory distress, hypothermia, neurological disorders were factors associated with deaths. Conclusion: Neonatal mortality is influenced by both maternal and fetal factors and many of them are preventable.展开更多
Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 ...Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023 among all students at the University of Parakou. The sampling technique was stratified non-proportional at two levels. The dependent variable was self-reported sexual assault. The psychopathological repercussions linked to sexual assault and explored in these students were: post-traumatic stress disorder assessed with the Post Traumatic Stress Disorder Checklist-5 (PCL-5) scale;and current depression screened with the Patient Health Questionnaire-9 (PHQ-9) scale. Results: A total of 376 female students from the University of Parakou meeting the inclusion criteria were surveyed. The average age of the subjects surveyed was 20.56 ± 2.46 years, with extremes of 16 and 32 years. A predominance of subjects under 25 was observed. The prevalence of sexual assault among female students at the University of Parakou was 10.63%. The types of aggression suffered were mostly rape (18 people;45%) and sexual touching (16 people;40%), and the aggressors were mainly friends/boyfriends (13;32.5%), family members (12;30.0%) and people from the house/neighborhood (9;22.5%). Psychological repercussions included depression in 72.5% (29) of cases, with mild depression in 30% (12), moderate depression in 37.5% (15) and severe depression in 5% (2). Anxiety disorders were present in 27.50% (11) of victims. The risk factors associated with sexual assault in these students were gravidity (p = 0.014;OR = 15.32), unhappy life events (p = 0.01;OR = 17.24), and age of first sexual intercourse (p = 0.016;OR = 4.608). Conclusion: One in ten female students in Parakou has been sexually assaulted. Once again, preventive action through effective sex education is a means of fighting the problem that should be prioritized for every girl and boy from an early age. Psychological support by specialists should be offered to any victim discovered without delay. Communication on the subject should be multiplied in all family and academic educational environments, from the lowest to the highest levels.展开更多
Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse env...Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse environmental conditions (low or high temperatures, high pH, and high salinity). The global Enterococcus faecalis-Enterococcus faecium ratio is currently shifting towards Enterococcus faecium. Enterococci present variable levels of resistance to certain families of antibiotics. This is the case for aminoglycosides, beta-lactams and cephalosporins. In 2017, WHO ranked Enterococci among priority pathogens for research and development of new antibiotics. The objective of our study was to determine the antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolates from urine and pleural fluid in two hospitals in Cameroon. This cross-sectional and analytic study was carried out between June to August 2023 on hospitalized and day patients in which a cytobacteriological test of urine and pleural fluid was done. The samples were inoculated on CLED Agar for urine and on Chocolate + polyvitex and blood agar (prepared from Columbia agar) for pleural fluid samples and incubated at 37℃ for 18 to 24 hours. Identification of isolates was carried out using the API 20 STREP micro gallery (Biomerieux, France) and tested for antimicrobial susceptibility. The data on socio-demographical and potential risk factors were recorded using self-administered questionnaires and data from laboratory analyses of the specimen were collected in a data capture sheet. Potential risk factors associated with the presence of Enterococci, were evaluated using the logistic regression in univariate and multivariate analysis. P value < 0.05 was considered as significant. A total of 511 patients were recruited who were predominantly females. Enterococcus spp were isolated in 27.79% of our samples with Enterococcus faecalis mostly encountered. Enterococcus spp showed a high level of resistance to penicilline (99.3% to Ampicilline), macrolides (66.2% to Erythromycin) and cyclines (85.2% to Doxycycline). Hospitalisation, access to health facilities, contact with urine specimen and hand hygiene practices were risk factors related to infection with Enterococcus spp while hospitalisation, health facility and hand hygiene were related to glycopeptide resistant Enterococcus. Strict compliance with hygiene rules and appropriate antibiotic consumption could help in the fight against these infections.展开更多
Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way a...Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.展开更多
Introduction: Post-traumatic stress disorder (PTSD) is defined as “actual exposure to death or the threat of death, serious injury or sexual violence”, either directly or indirectly, resulting in a symptomatic proce...Introduction: Post-traumatic stress disorder (PTSD) is defined as “actual exposure to death or the threat of death, serious injury or sexual violence”, either directly or indirectly, resulting in a symptomatic procession of repetition, avoidance, neurovegetative hyperactivity and individualized symptoms, with or without negative cognitive and mood changes. It therefore goes without saying that the defence and security forces constitute a high-risk population in need of attention. Objective: To study post-traumatic stress disorder in defence and security forces in the city of Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023. The study population consisted of active military, republican police and firefighters in the city of Parakou in 2023. Non-proportional stratified sampling was used, given the inaccessibility of the source population size for national security reasons. Post-traumatic stress disorder was assessed using the “post-traumatic stress disorder checklist-5 (PCLS-5) scale. Results: A total of 305 subjects participated in the survey. Males dominated 90.2%. The most represented corps was the Republican Police (41.6%), most of whom were non-commissioned officers (46.6%). The majority count between 11 and 20 years of service (48.9%), with 2 to 5 missions completed (67.5%). The calculated prevalence of post-traumatic stress disorder was 11.8%, based on the post-traumatic stress disorder checklist-5 (PCL-5). Of the 36 respondents with post-traumatic stress disorder, 20 (55.6%) had experienced an armed attack, 25 (69.4%) had witnessed a violent death, 18 (50.0%) had witnessed the agony of a colleague, 15 (41.7%) had been exposed to a fire or explosion, while 26 (72.2%) had been traumatized by physical and/or verbal aggression. 5 (13.9%) had consulted a specialist psychiatrist, while 6 (16.7%) were on medication and 26 (72.2%) used sport as a means of maintaining physical and mental health. Respectively 22 (61.1%) and 21 (58.3%) had definite symptoms of anxiety and depression. Multivariate analysis revealed a significant association between post-traumatic stress disorder and the following variables: total number of children ≤ 2 (p = 0.015), comorbidities such as arterial hypertension (p = 0.007), history of hepatitis (p = 0.017), work accidents (p = 0.016), alcohol dependence (p = 0.004), domestic violence (p = 0.004), psychological violence (p = 0.017) and anxiety disorders (p Conclusion: Defence and security personnel can also be prey to post-traumatic stress disorder (PTSD), which needs to be systematically taken into account when they are subjected to trauma in the course of their duties. Mental health should be an integral part of the periodic medical check-up objectives for defence and security forces throughout the country.展开更多
文摘Background: Human African trypanosomiasis (HAT) occurs in three historical foci in the Central African Republic. Objective: To describe the morbi-mortality of childhood HAT in rural Central African Republic with the aim of early management. Methods: Descriptive and analytic cross-sectional study conducted from January 1, 2017 to March 30, 2018 at Nola prefectural hospital. This study was included all children seen as outpatients and/or hospitalized in the pediatric wards, in whom the diagnosis of HAT was confirmed. Statistical analysis was performed using Epi-info software. Results: Forty children were included from Bilolo (60%), Nola (30%) and Salo (10%). The sex ratio was 0.66 with a median age of 8.65 ± 12.48 years. Fever (82.5%), nocturnal insomnia (75%), daytime somnolence (67.5%), headache (65%), polyarthralgia (62.5%), convulsions 52.5% (n = 21), tremor (27.5%), trypanidism (7.5%) and delirium (2.5%) were the main functional signs. Examination signs were adenopathy (52.5%), paresthesia (30%), decreased cutaneous-abdominal reflexes (25%) and osteoarticular reflexes (17.5%), hyperesthesia (20%), extrapyramidal hypertonia (15%) and depression (2.5%). The children were in the lymphatic-blood phase in 65% of cases, and meningoencephalitis in 35%. Pentamidine was administered in 65% of cases. Four children died and 6 had neurological sequelae. There was an association between age under 5, Bilolo’s focus, the children’s history and the severity of the disease. Age under 5, gender, household, children’s activity, history and occurrence of sequelae were also associated. Conclusion: HAT remains a permanent threat to Central African children. Any clinical presentation combining long-term infectious signs and unexplained neurological or neuropsychological disorders must be treated with caution.
文摘Introduction: Work-related accidents constitute are a public health concern worldwide. The aim of our study was to assess a series of work-related accidents that occurred in a cardboard packaging manufacturing company in Abidjan from 2012 to 2019 and to determine the consequences for the victims and the company. We’ve carried out a retrospective study of all work-related injuries reported to the National Social Insurance Fund of Cote d’Ivoire from 2012 to 2019 using the company’s work-related accidents’ register and investigation reports. Results: The prevalence of work-related injuries among the workers was 84% for the manual workers and 16% for the supervisors. The trends in the prevalence of work-related injuries were upwards, with a slow and almost linear progression over the period of study. Most of the accidents (53%) occurred in the process area. The upper limbs were the most common location of injuries (46%) and almost all the cases were declared cured. The cumulative direct costs of the TAs over the 8 years were 46,185,533 FCFA, or 70409.39 euros. The average direct annual cost was 624,129 CFA francs, or 951.47 euros. The average annual indirect cost was 41,265,576 CFA francs. The cumulative amount of indirect costs was 330,124,611 CFA francs over the 8 years. The indirect costs accumulated over the 8 years represented 98.17% of the cumulative economic cost of work accidents. Discussion: The assessment of the socioeconomic impact of these work-related injuries revealed that indirect costs which are usually ignored nor underestimated by the employers represent a minimum direct/indirect ratio of 1/27. Conclusion: Prevention is the best option to anticipate or mitigate the impact of work-related accidents among the victims.
文摘Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.
文摘Purpose: Bacterial resistance to antibiotics has become a global public health problem. Enterobacteriaceae ESBL is among the most incriminated in this emergence which reduces the therapeutic possibilities. Thus, the objective of this study is to determine the prevalence of the extended-spectrum beta- lactamase (ESBL) producing Enterobacteriaceae at ZNH and their antibiotic susceptibility profile. Materials and Methods: This is a prospective study carried out over 5 months in all hospitalized and non-hospitalized patients in whom a culture was taken for the diagnosis of an infection. The search for ESBL is done by the double disc diffusion method. Results: In total, 21 out of 45 of our strains are ESBL-producing, i.e. a frequency of 46.7%. The mean age is 41.62 (±22.90) with extremes of 2.6 - 78 years. The distribution of ESBL producing species showed a predominance of E. coli with 66.7% followed by K. pneumoniae and K. oxytoca each 9.5%. All ESBL strains were resistant to Amoxicillin, Cefalotin, Pipiracillin, Piperacillin + tazobactam, Ticarcillin, Ticarcillin + clavulanic acid. Resistance to C3G and Aztreonam was each 95.5%, to Amoxicillin/clavulanic acid 9.1%. All strains were sensitive to imipenem. E. coli strains showed resistance: 85.7% to ciprofloxacin, 50% to Amikacin, 57.1% to Gentamicin. For K. pneumoniae, it is 66.7% for Gentamicin and Ciprofloxacin. Conclusion: Our study reports a high prevalence of ESBL at the HNZ. This must be taken into account in order to monitor this phenomenon which constitutes a public health problem. The study also reports sensitivity to Amoxicillin/clavulanic acid and Aminoside which can be an alternative.
文摘Background: In Benin, little is known about the influence of both gender and HIV-status on diagnostic patterns and treatment outcomes of Tuber-culosis (TB) patients. Objective: To assess whether differences in gender and HIV status affect diagnostic patterns and treatment outcomes of TB patients. Methods: Retrospective cohort study of patients registered in 2013 and 2014 in the three largest TB Basic Management Units in south Benin. Results: Of 2694 registered TB patients, 1700 (63.1%) were male. Case notification rates were higher in males compared with females (96 vs 53/100,000 inhabitants). The male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV negative cases. In HIV-positive patients, there were no differences in TB types between men and women. In HIV-negative patients, there were significantly higher proportions of females with clinically diagnosed pulmonary TB (p = 0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times higher amongst males compared with females. For New bacteriologically confirmed pulmonary TB, no differences were observed in treatment outcomes between genders in the HIV positive group;but significantly more unfavorable outcomes were reported among HIV negative males, with higher rates of failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study has shown that overall TB notification rates were higher in males than in females in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
文摘Background: In most societies, homicide or murder is a crime that often leads to imprisonment. Studies around the world have sometimes found cases of mental illness (schizophrenia spectrum disorders) as an explanation for some homicides. The aim of this study was to determine the factors associated with homicide in the Togolese context. Methods: This was a descriptive and analytical cross-sectional study of pre-trial psychiatric expertise reports from January 31<sup>st</sup>, 2019 to January 30<sup>th</sup>, 2022. Results: Out of 704 defendants appraised, 206 (29.3%) had committed homicide. Males accounted for 91.7% of Homicide defendants (HD). Their average age was 31.6 ± 12.2 years, with extremes of 16 and 74 years. Factors associated with homicide were female gender, age between 30 and 45 years, married or cohabiting status and occupation as a farmer/fisherman/breeder. Psychoactive substance use (PAS), mental illness and psychiatric history were not associated with homicide. Conclusion: Preventing delinquency and interpersonal conflict, and promoting social cohesion, could significantly reduce homicides in Togo.
文摘A case of a 12-month-old male infant, who presented a painless swelling of the right anterolateral edge of the mobile tongue, is reported. The treatment consisted of a partial glossectomy with total surgical excision of the tumor. The diagnosis of low grade myofibroblastic sarcoma on the histological arguments (tumor architecture, cytology, mitotic index) and immunohistochemistry was retained.
文摘Nowadays, the circulation of poor quality medicines is becoming an alarming worldwide phenomenon with serious public health and socio-economic concerns. The situation is particularly critical in developing countries where drug quality assurance and regulatory systems for drug manufacturing, importation, distribution and sales are weak. A sustained vigilance on poor quality medicines that regroup counterfeit/falsified, substandard and degraded medicines is therefore required to ensure patient safety and genuine medicines integrity. A case situation is illustrated including a strategic approach and analytical tools that were found useful to detect poor quality medicines, identify unknown components, and timely alerts for appropriate measures against the spread of those harmful products. Several suspected medicines randomly sampled in several strategic Rwandan areas were firstly check-controlled by means of visual inspection and then applying several analytical techniques from simple to more complex ones. The following medicines were studied: quinine sulfate tablets, artemisinin-based combination tablets, and artesunate powders for injection. Taking into account the pharmaceutical forms and the chemical characteristics, the following tests were applied: uniformity of mass, friability, disintegration, fluorescence, identification and assay. They were followed by more complex analytical techniques that allowed more comprehension of abnormal findings among which the presence of a wrong active pharmaceutical ingredient in quinine sulfate tablets which is mainly discussed in this paper to illustrate a strategic approach and various analytical tools that can be used in detecting and identifying unknown component in poor quality medicines.
文摘Introduction: Attention deficit hyperactivity disorder (ADHD) is a little-studied psychiatric pathology in our countries, and particularly here in Benin. Objectives: To calculate the prevalence and identify the factors associated with attention deficit hyperactivity disorder among adults in the commune of Parakou in 2022. Methods: Cross-sectional, descriptive, analytical study including subjects aged 18 and over. ADHD was assessed with the Adult ADHD Self Report Scale (ARSR-v1.1) and consequences with the Weiss functional impairment rating scale (WFIRS-S). Results: A total of 456 people were included in the study. The mean age of those surveyed was 25.9 ± 11.6 years. The prevalence of ADHD symptoms among the adults surveyed was 6.8%. The clinical form of ADHD with a predominance of inattention had a prevalence of 3.3%. After multivariate analysis, the factor associated with the presence of ADHD symptoms in adults in the commune of Parakou was: a poor relationship with the subject’s partner (p = 0.031, ORa = 6.5 [1.18-35.68]). Conclusion: ADHD is present in the community of Parakou and needs further attention.
文摘The widespread use of long-lasting insecticidal nets (LLINs) is a major intervention method for malaria control. While coverage of LLINs has increased, there is a need for information on the operational effectiveness of nets deployed in the field in the context of malaria vector resistance to insecticides used for impregnation. The development of specific anti-malarial biomarkers to assess exposure to mosquito bites is an important development in evaluations. The aim of this study was to characterize the human IgG antibody response to Anopheles gSG6-P1 saliva, a salivary peptide antigen previously shown to be a relevant biomarker of human exposure to Anopheles bites, in order to assess the LLINs under field conditions in areas of low and high vector resistance to insecticides. We analyzed data from 240 randomly selected children ( 0.05). Furthermore, the same finding was observed for antibody expression in children whether or not they used LLINs on the day before the survey (p = 0.7724). Similarly, gender and especially age, major factors of variation in the adaptive immune response, did not have a significant effect on IgG expression.
文摘Context: The resistance to pyrethroids in malaria vectors continues to grow in Africa and could therefore compromise or reduce substantially the effectiveness of LLINs in preventing malaria. It is therefore of paramount importance to evaluate the protective efficacy of LLINs in children sleeping in areas of vector resistance to insecticides in order to draw lessons for future interventions. This study assesses the effect of the use of LLINs on malaria morbidity in clusters of low and high resistance of vectors to pyrethroids. Methods: This is a cross-sectional case-control study with one control for one case that was conducted in the communes of Kétou, Ifangni, Kétou, and Pobè in the Plateau department of southern Benin. The use of LLINs and malaria morbidity was measured and compared in children from clusters of low and high vector resistance to insecticides. In each commune, 30 cases and 30 controls were recruited for a total of 240 children under 5 years of age from villages with low and high insecticide resistance. Results: According to the localities of origin of the children, of all parents of children surveyed, 169 (70.4%) asserted the children slept under an LLIN the day before they arrived at the health center. This rate represents 70.8% (85 children) among the cases and 70.0% (84 children) among the controls without significant difference (p = 0.8). The use of LLINs the day before the survey, the frequency of their use during the two weeks preceding the day of the survey, their availability at the household level, the use of other tools for protection against mosquito bites are the same in the two groups of children (cases and controls) (p > 0.05) as well in low and high resistance villages. On the other hand, the parasite prevalence, the splenomegaly and the geometric means of the parasite densities, are significantly higher in the cases than in the controls (p Conclusion: The evaluation of epidemiological indicators in children under five years old at the level of health centers did not enable demonstrating the impact of resistance on the operational effectiveness of the LLINs. The information collected within the four health facilities only reflects the situation that should normally be seen in the population under the real conditions of use of LLINs in high and low resistance areas.
文摘Introduction: The objective of our work was to describe the epidemiological, clinical and biological profile of Buruli ulcer in “Centre de Dépistage et de traitement de l’ulcère de Buruli” (CDTUB) in Allada. Methods: A descriptive and retrospective study focused on new cases of Buruli ulcer received in the CDTUB of Allada from 2010 to 2014. The diagnosis of Buruli ulcer was based on epidemiological, clinical and biological arguments. Results: Over 5 years, 274 new cases of Buruli ulcer have been diagnosed. The average age of the patients was 12 years and the sex ratio was 0.8. The average time to first consultation was 45 days. Clinically, 61% had a joint functional limitation. Lesions were ulcerated in 69% of cases, category I (26%), category II (53%), category III (21%) and were present on the lower limbs in 57% of cases. Microscopy was positive in 65.7% of cases and PCR in 78.1% of cases. Microscopy supplemented by PCR confirmed the diagnosis in 81% of cases. Conclusion: The epidemiological, clinical and biological profile of Buruli ulcer in Allada was characterized by a predominant disease in children, a predominance of ulcerated forms and a decisive contribution of PCR to the diagnosis.
文摘According to WHO, the rates of smear-negative and extra-pulmonary pulmonary tuberculosis are increasing in high prevalence HIV epidemic areas. Delays in diagnosis of tuberculosis can lead to large excess of mortality. It is extremely important to provide a strong diagnosis tool of tuberculosis if we want to reduce mortality due particularly to TB co-infection in HIV infected people in low-income countries such as Togo. This study aims to assess the performance of Determine? TB LAM Antigen, a rapid diagnostic test (RDT) for tuberculosis. It was an evaluation study, conducted at the National Reference Laboratory for Mycobacteria located at the Sylvanus Olympio University Teaching Hospital in Lomé, Togo from 01 July to 15 November 2017. We performed the assessment onto 100 urine specimens collected from 100 subjects (HIV-infected or not). The test allows qualitative detection of the Lipo Arabinno Mannan (LAM) antigen of Mycobacteria in the urine. Bacilloscopy was chosen as gold standard. Overall, the test Determine? TB LAM presented a sensitivity of 31.25% and a specificity of 95%. In contrast, the sensitivity and specificity of the test were respectively 82.35% and 66.67% in the group of HIV-infected subjects. In HIV non-infected subjects, the sensitivity was 17.46% and the specificity was 100%. Determine? TB LAM Antigen test can help detect TB in HIV-infected people unable to expectorate in our settings.
文摘Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.
文摘Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.
文摘Introduction: Neonatal pathology remains a real public health problem in developing countries. In Burkina Faso, this mortality has declined over the last ten years but remains below compared to the Sustainable Development Goals, which is 12 per 1000 living births at most by 2030. This study aims to identify specific causes of neonatal morbidity and mortality and will contribute to the implementation of preventive and curative measures aimed at reducing neonatal mortality at HOSCO. Method: This was a retrospective study using the records and database of newborns hospitalized from January 1<sup>srt</sup>, 2017 to December 31<sup>srt</sup>, 2020. Using logistic regression, the factors associated with mortality were determined. Results: During the study period, 3020 newborns were hospitalized. Most newborns (83.71%) were referred by a peripheral health facility. The average age at admission was 0.3 days ± 0.9 and the sex ratio was 1.2. Prematurity was the leading cause of hospitalization (61.13%) followed by neonatal infection (38.34%) and neonatal suffering (23.88%). The mortality rate was 40.6% with 82.71% cases of death in the early neonatal period. The main causes of death were low birth weight (47.39%), respiratory distress (18.76%), neonatal suffering (17.37%) and neonatal infection (13.87%). Home delivery, gestational age 36 weeks, number of PNC 4, concept of resuscitation, Apgar at the 5th minute 7, birth weight 2000 g and >4000 g, respiratory distress, hypothermia, neurological disorders were factors associated with deaths. Conclusion: Neonatal mortality is influenced by both maternal and fetal factors and many of them are preventable.
文摘Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023 among all students at the University of Parakou. The sampling technique was stratified non-proportional at two levels. The dependent variable was self-reported sexual assault. The psychopathological repercussions linked to sexual assault and explored in these students were: post-traumatic stress disorder assessed with the Post Traumatic Stress Disorder Checklist-5 (PCL-5) scale;and current depression screened with the Patient Health Questionnaire-9 (PHQ-9) scale. Results: A total of 376 female students from the University of Parakou meeting the inclusion criteria were surveyed. The average age of the subjects surveyed was 20.56 ± 2.46 years, with extremes of 16 and 32 years. A predominance of subjects under 25 was observed. The prevalence of sexual assault among female students at the University of Parakou was 10.63%. The types of aggression suffered were mostly rape (18 people;45%) and sexual touching (16 people;40%), and the aggressors were mainly friends/boyfriends (13;32.5%), family members (12;30.0%) and people from the house/neighborhood (9;22.5%). Psychological repercussions included depression in 72.5% (29) of cases, with mild depression in 30% (12), moderate depression in 37.5% (15) and severe depression in 5% (2). Anxiety disorders were present in 27.50% (11) of victims. The risk factors associated with sexual assault in these students were gravidity (p = 0.014;OR = 15.32), unhappy life events (p = 0.01;OR = 17.24), and age of first sexual intercourse (p = 0.016;OR = 4.608). Conclusion: One in ten female students in Parakou has been sexually assaulted. Once again, preventive action through effective sex education is a means of fighting the problem that should be prioritized for every girl and boy from an early age. Psychological support by specialists should be offered to any victim discovered without delay. Communication on the subject should be multiplied in all family and academic educational environments, from the lowest to the highest levels.
文摘Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse environmental conditions (low or high temperatures, high pH, and high salinity). The global Enterococcus faecalis-Enterococcus faecium ratio is currently shifting towards Enterococcus faecium. Enterococci present variable levels of resistance to certain families of antibiotics. This is the case for aminoglycosides, beta-lactams and cephalosporins. In 2017, WHO ranked Enterococci among priority pathogens for research and development of new antibiotics. The objective of our study was to determine the antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolates from urine and pleural fluid in two hospitals in Cameroon. This cross-sectional and analytic study was carried out between June to August 2023 on hospitalized and day patients in which a cytobacteriological test of urine and pleural fluid was done. The samples were inoculated on CLED Agar for urine and on Chocolate + polyvitex and blood agar (prepared from Columbia agar) for pleural fluid samples and incubated at 37℃ for 18 to 24 hours. Identification of isolates was carried out using the API 20 STREP micro gallery (Biomerieux, France) and tested for antimicrobial susceptibility. The data on socio-demographical and potential risk factors were recorded using self-administered questionnaires and data from laboratory analyses of the specimen were collected in a data capture sheet. Potential risk factors associated with the presence of Enterococci, were evaluated using the logistic regression in univariate and multivariate analysis. P value < 0.05 was considered as significant. A total of 511 patients were recruited who were predominantly females. Enterococcus spp were isolated in 27.79% of our samples with Enterococcus faecalis mostly encountered. Enterococcus spp showed a high level of resistance to penicilline (99.3% to Ampicilline), macrolides (66.2% to Erythromycin) and cyclines (85.2% to Doxycycline). Hospitalisation, access to health facilities, contact with urine specimen and hand hygiene practices were risk factors related to infection with Enterococcus spp while hospitalisation, health facility and hand hygiene were related to glycopeptide resistant Enterococcus. Strict compliance with hygiene rules and appropriate antibiotic consumption could help in the fight against these infections.
文摘Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.
文摘Introduction: Post-traumatic stress disorder (PTSD) is defined as “actual exposure to death or the threat of death, serious injury or sexual violence”, either directly or indirectly, resulting in a symptomatic procession of repetition, avoidance, neurovegetative hyperactivity and individualized symptoms, with or without negative cognitive and mood changes. It therefore goes without saying that the defence and security forces constitute a high-risk population in need of attention. Objective: To study post-traumatic stress disorder in defence and security forces in the city of Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023. The study population consisted of active military, republican police and firefighters in the city of Parakou in 2023. Non-proportional stratified sampling was used, given the inaccessibility of the source population size for national security reasons. Post-traumatic stress disorder was assessed using the “post-traumatic stress disorder checklist-5 (PCLS-5) scale. Results: A total of 305 subjects participated in the survey. Males dominated 90.2%. The most represented corps was the Republican Police (41.6%), most of whom were non-commissioned officers (46.6%). The majority count between 11 and 20 years of service (48.9%), with 2 to 5 missions completed (67.5%). The calculated prevalence of post-traumatic stress disorder was 11.8%, based on the post-traumatic stress disorder checklist-5 (PCL-5). Of the 36 respondents with post-traumatic stress disorder, 20 (55.6%) had experienced an armed attack, 25 (69.4%) had witnessed a violent death, 18 (50.0%) had witnessed the agony of a colleague, 15 (41.7%) had been exposed to a fire or explosion, while 26 (72.2%) had been traumatized by physical and/or verbal aggression. 5 (13.9%) had consulted a specialist psychiatrist, while 6 (16.7%) were on medication and 26 (72.2%) used sport as a means of maintaining physical and mental health. Respectively 22 (61.1%) and 21 (58.3%) had definite symptoms of anxiety and depression. Multivariate analysis revealed a significant association between post-traumatic stress disorder and the following variables: total number of children ≤ 2 (p = 0.015), comorbidities such as arterial hypertension (p = 0.007), history of hepatitis (p = 0.017), work accidents (p = 0.016), alcohol dependence (p = 0.004), domestic violence (p = 0.004), psychological violence (p = 0.017) and anxiety disorders (p Conclusion: Defence and security personnel can also be prey to post-traumatic stress disorder (PTSD), which needs to be systematically taken into account when they are subjected to trauma in the course of their duties. Mental health should be an integral part of the periodic medical check-up objectives for defence and security forces throughout the country.
