[Use of dried blood spots in early diagnosis of HIV-1 infection in children born to HIV-infected mothers as part of the prevention of mother-to-child transmission in Benin]. / Utilisation des prélèvements capillaires sur buvard dans le diagnostic précoce de l'infection à VIH-1 chez des enfants nés de mères infectées dans le cadre de la prévention de la transmission mère-enfant au Bénin.

The goal of this study was to evaluate using the molecular diagnosis, infection transmission rate of HIV in children born to HIV-1 positive mothers as part of the prevention of mother-to-child transmission (PMTCT) in Benin. The sample consisted of 524 dried blood spots (DBS) of children born to HIV-1 positive mothers, from 30 sites (PMTCT) taken between October 2009 and June 2010. The diagnosis of HIV-1 was performed by the qualitative detection of viral nucleic acids (RNA and DNA) in DBS on filter paper using the Abbott RealTime(®) HIV-1 Qualitative assay. We found that 51 DBS were positive (9.7%) and 473 were negative (90.3%). The failure rate of PMTCT among 420 mothers who received antiretroviral prophylaxis was 6.7% (28/420). This failure rate was significantly higher among children born to infected mothers on antiretroviral monotherapy than on triple therapy (HAART). The results of our study enrich the data in the literature on highly active antiretroviral chemoprophylaxis to reduce the transmission of HIV-1 from mother to child.

[Mucocutaneous manifestations of human immunodeficiency virus infection in Cotonou, Benin]. / Manifestations cutanéo-muqueuses des personnes vivant avec le virus de l'immunodéficience humaine à Cotonou, Bénin.

The purpose of this study was to describe mucocutaneous manifestations observed in persons living with human immunodeficiency virus (PLHIV) in Cotonou, Benin. A transverse retrospective study was carried out on the records of PLHIV who underwent follow-up at the Military Teaching Hospital in Cotonou from February 2002 to September 2005. The files of all eligible adult patients examined by dermatologists prior to initiation of antiretroviral treatment were reviewed. Dermatologic manifestations were defined as any cutaneous or cicatricial lesion of the skin. Data was analyzed using the EPI INFO software package. (version 6.0). A total of 152 patient files were included. The sex ratio was 1.10 with a female predominance. Mean age was 37.8 years. HIV1 was predominant (98%). Two-thirds of patients were as stage 3 according to the WHO classification. A total of 276 dermatologic manifestations were identified. The most common manifestations were buccopharyngeal candidiasis (24.6%), prurigo (20.6%), shingles (11.6%), and dermatophytosis (10.5%). The mean CD4 lymphocyte level was 106 cells/mm3. The CD4 level was below 100 cells/mm3 in 52% of cases involving candidiasis and 60% of cases involving prurigo. Dermatologic findings in this study were identical to those described in most studies from Africa and Asia. However the low prevalence of Koposi's sarcoma and seborrheic dermitits was surprising given the advanced stage of immunodepression in our patients. The most frequent mucocutaneous manifestations of HIV infection in Benin are infectious disease and prurigo.

[Survey on the illicit drug market in Cotonou, Benin in March 2003]. / Enquete sur le marché illicite des médicaments à Cotonou (Bénin) en mars 2003.

Illicit sale of medicines is a serious public health problem in Africa. In Benin, an informational program was undertaken to fight this threat. A three-day survey on consumption of medicines was conducted in various areas in Cotonou. The purpose was to evaluate purchasing practices so that related concerns and beliefs could be used to craft messages for the next campaign to curb illicit medicines. In addition to being a tool for message development, this survey will be used as an evaluation tool to measure message impact during and after the information campaign. A questionnaire designed to evaluate several aspects of drug purchasing behavior was administered by investigators in 600 randomly selected households. The main findings were as follows. Repressive measures to reduce the sale of counterfeit medicines on the illicit market are necessary but inadequate. New campaign messages for targeted groups are necessary since 86% of people interviewed thought that medicines acquired from street vendors were of good quality. More importantly it will be necessary to make legitimate medicines more accessible and affordable (generic drugs) and to simplify dispensation procedures allowing prescriptions to be filled followed by appropriate professional counsel.

[Evaluation of public awareness campaigns on counterfeit medicines in Cotonou, Benin]. / Evaluation des campagnes de sensibilisation sur les pratiques d'achat de médicaments dans la ville de Cotonou.

A public awareness campaign mainly TV and radio announcements to promote public awareness of the dangers of counterfeit medicines was developed based on survey data collected in 2003. The survey was designed to evaluate the purchasing practices of consumers in Cotonou, Benin with regard to medicines. Based on findings, several recommendations were made for crafting new messages about generic drugs and the dangers of the illicit medicines market. Evaluation of the results of the new campaign that lasted 9 months showed that: most respondents stated that the campaign announcements were effective in increasing their awareness; nine out of 10 persons understood the messages on the dangers of the illicit market; a net decrease in buying on the illicit market was observed among respondents that increased their awareness; the frequency of house calls by illicit vendors decreased. Most respondents stated that they requested generic drugs spontaneously. The preferred sources for procurement of generic medicines were public health facilities and pharmacies.

[Clinical and immunological profile of HIV infected patients in Cotonou, Benin]. / Profil clinique et immunologique des patients infectés par le VIH dépistés à Cotonou, Bénin.

OBJECTIVES: This study had for aim to identify the clinical status and the level of immuno-deficiency of HIV-infected patients on their first visit. METHODS: One hundred and thirty-six HIV+ patients were prospectively evaluated from November 1, 2001 to May 31, 2002. RESULTS: One hundred and thirty-four were infected with HIV1 and two with HIV2. The mean age on the first consultation was 37 +/- 2 years. The m/w sex ratio was 0.9. 46.3% were stage C. The main clinical symptoms were: weight loss (88%), fever (80%), cough (71%), diarrhea (51%). BMI was normal in 70% and KI > or =80% in 57% of the cases but immuno-deficiency was severe with CD4 cells count <200 per mm3 in 69%. The main diseases were digestive candidiasis (53%), pneumonia (18%), tuberculosis (12%), non-determined pneumonia (29%), prurigo (20%), zona (16%), cryptosporidiosis (4%), cerebral toxoplasmosis (3%), and Kaposi's sarcoma (1%).