[ATTITUDES AND PRACTICES OF HEALTH PROFESSIONALS REGARDING BLOOD EXPOSURE ACCIDENTS (BSE) IN PARAKOU IN 2022]. / Attitude et Pratique des Professionnels de la santé sur les Accidents d'Exposition au Sang (AES) à Parakou en 2022.

Introduction: Les professionnels de la santé sont souvent victimes d'AES au cours des activités de soin. Objectif: Étudier les attitudes et pratiques des soignants sur les AES dans la commune de Parakou en 2022. Méthodes: Il s'est agi d'une étude transversale descriptive à visée analytique avec recueil prospectif des données réalisée du 1eravril au 30 juin 2022. Étaient inclus dans l'étude, les professionnels de la santé des établissements sanitaires publics et privés ainsi que les étudiants en médecine. Les données ont été saisies grâce au logiciel Epi-Data 3.1 puis apurées et vérifiées dans le logiciel STATA MP 14. Le seuil de significativité était de 0,05. Résultats: Au total 791 professionnels de la santé avaient participé à l'étude dont 465 (58,8 %) de travailleurs et 326 (41,2 %) étudiants. L'âge moyen était de 32,2 ans ± 8,9 avec des extrêmes de 19 ans et 62 ans. Il y avait plus de femmes 60,4 % pour 39,6 % d'hommes, la sex-ratio étant de 0,7. La prévalence des AES du personnel soignant était de 116 (25 %) et celle des étudiants de 79 (24,2 %) (p=0,819). La piqûre était la principale cause d'AES (79,3 %) du personnel soignant et (72,2 %) des étudiants. Les gestes incriminés étaient les injections (98,7 %), les prélèvements sanguins (40,5 %) et le recapuchonnage d'aiguille (25,3 %). Pour la prise en charge, le rinçage à l'eau (54,3 %), le lavage au savon (50,9 %) et la désinfection à l'eau de javel (48,3 %) étaient les principaux gestes adoptés. La déclaration d'AES avait été effective pour 50 (43,1 %) du personnel soignant et pour 22 (27,9 %) d'étudiants. Le patientsource était connu dans 80,0 % des cas. La catégorie professionnelle (p = 0,000), l'âge (p= 0,005) et le corps du personnel soignant (p = 0,008) étaient associés de façon significative à l'attitude et pratique sur les AES. Conclusion: Les AES constituent une menace réelle pour les professionnels de la santé. Une bonne attitude et pratique est gage d'une prise en charge adéquate.

Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries.

BACKGROUND: The End TB Strategy calls for global scale-up of preventive treatment for latent tuberculosis infection (LTBI), but little information is available about the associated human resource requirements. Our study aimed to quantify the healthcare worker (HCW) time needed to perform the tasks associated with each step along the LTBI cascade of care for household contacts of TB patients. METHODS: We conducted a time and motion (TAM) study between January 2018 and March 2019, in which consenting HCWs were observed throughout a typical workday. The precise time spent was recorded in pre-specified categories of work activities for each step along the cascade. A linear mixed model was fit to estimate the time at each step. RESULTS: A total of 173 HCWs in Benin, Canada, Ghana, Indonesia, and Vietnam participated. The greatest amount of time was spent for the medical evaluation (median: 11 min; IQR: 6-16), while the least time was spent on reading a tuberculin skin test (TST) (median: 4 min; IQR: 2-9). The greatest variability was seen in the time spent for each medical evaluation, while TST placement and reading showed the least variability. The total time required to complete all steps along the LTBI cascade, from identification of household contacts (HHC) through to treatment initiation ranged from 1.8 h per index TB patient in Vietnam to 5.2 h in Ghana. CONCLUSIONS: Our findings suggest that the time requirements are very modest to perform each step in the latent TB cascade of care, but to achieve full identification and management of all household contacts will require additional human resources in many settings.

Tuberculosis contact investigation and short-course preventive therapy among young children in Africa.

SETTING: The largest cities in Benin, Burkina Faso, Cameroon and Central African Republic.OBJECTIVE: To demonstrate the feasibility and document the effectiveness of household contact investigation and preventive therapy in resource-limited settings.DESIGN: Children under 5 years living at home with adults with bacteriologically confirmed pulmonary tuberculosis (TB) were screened using questionnaire, clinical examination, tuberculin skin test and chest X-ray. Children free of active TB were offered preventive treatment with a 3-month rifampicin-isoniazid (3RH) or 6-month isoniazid (6H) regimen in Benin. Children were followed-up monthly during treatment, then quarterly over 1 year. Costs of transportation, phone contacts and chest X-rays were covered.RESULTS: A total of 1965 children were enrolled, of whom 56 (2.8%) had prevalent TB at inclusion. Among the 1909 children free of TB, 1745 (91%) started preventive therapy, 1642 (94%) of whom completed treatment. Mild adverse reactions, mostly gastrointestinal, were reported in 2% of children. One case of incident TB, possibly due to a late TB infection, was reported after completing the 3RH regimen.CONCLUSION: Contact investigation and preventive therapy were successfully implemented in these resource-limited urban settings in programmatic conditions with few additional resources. The 3RH regimen is a valuable alternative to 6H for preventing TB.

[Prevalence and control of asthma among medical students at Parakou, Benin]. / Prévalence et contrôle de l'asthme chez les étudiants en médecine à Parakou, Bénin.

INTRODUCTION: The objective of this study was to determine the prevalence and to assess the control of asthma among students at the faculty of medicine of the university of Parakou in Benin. METHODS: This cross-sectional study was carried out between January and November 2017. The Asthma Screening Questionnaire (ASQ) was filled out by medical students, followed by the Asthma Control Test questionnaire for those who were suspected of having clinical asthma (ASQ≥4). All students with clinical asthma or with a history of asthma were invited to perform a spirometry test. RESULTS: Overall, 837 (73.7%) students out of 1136 were included. The prevalence was 9.1% for ever diagnosed asthma, 14% for clinical asthma and 5.3% for confirmed asthma. Among 761 students, without a previous asthma diagnosis, 10.4% had clinical asthma and 3.3% a confirmed asthma. Female sex (aOR=2.1; 95%CI =1.0-4.1), a previous diagnosis of asthma (aOR=7; 95% CI=3.2-15.2) and allergic rhinitis (aOR=3.9; 95% CI=1.9-7.8) were associated with confirmed asthma. Asthma symptoms were controlled in 92 (78.6%) students, partly controlled in 20 (17.1%), and not controlled in 5 (4.3%). CONCLUSION: Clinical manifestations of asthma are frequent among medical students at Parakou. Some are not well controlled, suggesting a need for greater awareness and an improvement in clinical follow-up.

Implementation of isoniazid preventive therapy in children aged under 5 years exposed to tuberculosis in Benin.

SETTINGS: Two large tuberculosis (TB) centres under a well-functioning National TB Programme (NTP) in Benin, West Africa. OBJECTIVE: To assess the feasibility and results of integrating a programme of isoniazid preventive therapy (IPT) in children aged <5 years exposed to TB as part of the existing routine activities of the NTP. METHOD: All children aged <5 years living in the household of a patient with smear-positive pulmonary TB were examined by a doctor and received IPT if no evidence of TB was detected. The children were followed clinically by a nurse for 6 months. RESULTS: From January 2013 to June 2014, 496 children were examined and prescribed IPT among 499 notified contacts; 86% adhered to IPT for at least 6 months. There were six deaths and three cases of active TB among the children, all during the first 3 months of follow-up. CONCLUSIONS: In an African country with moderate TB incidence and a well-functioning NTP, the integration of IPT into the NTP for children aged <5 years exposed to TB in the family was feasible based on simple tools associated with the follow-up of index cases. The rate of adherence to IPT was high.

[Air pollution and respiratory disease in a tropical urban setting in Cotonou, Benin]. / Pollution atmosphérique et pathologie respiratoire en milieu urbain et tropical a Cotonou, Bénin.

PURPOSE: To assess the impact of air pollution inside and outside housing on respiratory function in people living around traffic intersections. METHODS: A descriptive analytical study was carried out from February 5 to July 5, 2006. Carbon monoxide (CO), sulfur dioxide (SO2), and nitric dioxide (NO2) were measured over an 8-hour period inside and outside 60 houses near intersections during periods of heavy and light traffic. Spirometry was performed on residents of the same houses. RESULTS: CO levels were higher during heavy than light traffic both inside houses: 65 ppm vs. 43.2 ppm and outside houses: 160 ppm vs. 115 ppm. Similar results were observed for SO2, i.e., 2.8 ppm vs. 0.49 ppm inside houses and 4.3 ppm vs. 0.83 ppm outside houses. Measurements for NO2 were consistently nil. Respiratory symptoms were more frequent during heavy than light traffic: p = 0.0001; odds ratio (OR), 4.73; confidence interval (CI), 2.13-10.51. The frequency of spirometric abnormalities was higher in heavy than light traffic: p = 0.004; OR, 5.78; CI, 1.43-27.10. CONCLUSION: Indoor pollution level is higher during heavy traffic than light traffic. Respiratory symptoms were greater during heavy than light traffic.