Knowledge, attitudes and practices of general practitioners on peripheral neuropathies in Benin in 2021.

PURPOSE: First healthcare actors in neurological diseases management, General Practitioners (GPs) still limited in the assessment of Peripheral Neuropathies (PN). This study assesses the knowledge, attitudes, practices (KAP) of GPs on PN in Benin in 2021 and identifying associated factors to low KAP. MATERIALS AND METHODS: It was a cross-sectional study conducted from 20 November 2020 to 30 June 2021 which included GPs registered in the National Order of Physicians in Benin and interns in last year of medical studies (MS). An overall KAP score of 24 points was derived. KAP levels were low (score < 17), medium (17 to 19) and high (score ≥ 20). Multivariable regression models were performed to identify factors associated with low KAP. RESULTS: 645/1,066 participants (60.5%) were included in the study with median age 28 years [Interquartile range IQR: 26-30 years], and 442 (68.5%) were male. The KAP level was low in 70.1%. 16.7% had a low knowledge of polyneuropathy manifestations, 35% perceived PN as an incurable disease. Lack of knowledge on PN before MS (adjusted Odds-ratio aOR = 1.6 [95% confidence interval CI: 1.1-2.3]), and no postgraduate training on PN (aOR = 1.8 [95% CI: 1.--3.0]) were associated with low overall KAP level. Working in rural area (aOR = 0.4 [95%CI: 0.2-0.7]), and being an intern (aOR = 0.6 [95%CI: 0.4-0.9]) were associated with better overall KAP level. CONCLUSION: This study highlights the need for better training with strong emphasis on PN during the MS and the organization of postgraduate training for GPs; the cornerstone for improving the management of PN in Benin.

Prevalence and associated factors with peripheral neuropathies in the general population in the rural area of Adjohoun in Benin.

BACKGROUND: Peripheral neuropathies (PN) are a group of neurological conditions related to damage to the peripheral nervous system. Due to their wide diversity, few studies in sub-Saharan Africa have explored their epidemiology in general population. Our objective was to study the prevalence and associated factors with PN in general population in Adjohoun in Benin. METHODS: A cross-sectional study has been conducted from February to March 2019 and included people aged ≥ 18 years old living in Adjohoun, Benin. Following a screening phase for PN (using World Health Organization questionnaire for major neurological diseases), a neurologist made a diagnosis after in-depth clinical examinations completed in some cases by electroneuromyography. The EFNS (European Federation of Neurological Societies) 2010 criteria was used for chronic inflammatory demyelinating polyneuropathy diagnosis. Data such as age, occupation, consanguinity, alcohol consumption, diabetes, hypertension were collected. Association between independent variables and PN were investigated using multivariable logistic regression models. RESULTS: In total, 1 655 participants were included, mean age 41.4 ± 16.7 years; 64.8 % are female. The overall prevalence of PN was 6.9 % (95 %CI: 5.7 %-8.2 %). The main types of PN were: polyneuropathies 4.8 % (95 %CI: 3.8 %-5.9 %); polyradiculoneuropathies 1.6 % (95 %CI: 1.0 %-2.2 %). Factors independently associated with PN were age ≥ 40 years (adjusted Odds Ratio aOR = 19.6; 95 %CI: 8.2-46.3), diabetes (aOR = 1.8; 95 %CI: 1.08-2.99) and hypertension (aOR = 1.6; 95 %CI: 1.02-2.5). CONCLUSION: The prevalence of PN was high in the rural commune of Adjohoun in Benin. Actions on its modifiable associated factors such as diabetes and hypertension could help reduce the proportion of PN and their potential harmful consequences.

Stroke care and outcomes in the Department of Neurology in Parakou, Benin: Retrospective cohort study.

INTRODUCTION: Stroke is one of the most common causes of high mortality rates in Africa with many unknown aspects around its prognosis. In this study we aim to describe stroke characteristics and in-hospital mortality of stroke in Parakou. METHODS: This is a retrospective cohort study including all stroke patients admitted to the Department of Neurology at Parakou Teaching Hospital from January 1, 2013 through to December 31, 2019. Clinical data, vascular risk factors, stroke subtype and outcome data were recorded. The in-hospital case-fatality and its associated factors were determined. The study was approved by the Local Ethics Committee of Biomedical research and has been registered under the unique indentifying number researchregistry5687 and is available at https://www.researchregistry.com/browse-the-registry#home/. RESULTS: Stroke cases represented 51.5% of all patients. There were 372 patients included in the study with a mean age of 58.2 ± 14.2 years. The sex ratio was 1:3. Ischemic stroke accounted for 40.3%, intracerebral hemorrhage 30.4%, and unknown 29.3%. The main vascular risk factors were hypertension (69.1%), alcoholism (23.9%) and diabetes mellitus (16.9%). The mean NIHSS at admission was 9.4 ± 5.7 and the length of hospital stay was 9.0 ± 7.3. The most common complications recorded during the acute phase were swallowing disorders (10.2%), pneumonia (9.1%) and urinary tract infections (8.3%). The in-hospital case fatality was 6.2% and was associated with loss of consciousness (p = 0.0001), high NIHSS on admission (p = 0.001), fever (p = 0.0001), swallowing disorders (p = 0.001) and leukocytosis (p = 0.021). On discharge, 27.6% were independent and 97.8% were on antihypertensive drugs. CONCLUSION: The in-hospital stroke mortality was close to that reported by other studies in Africa.

Ischemic stroke due to embolic heart diseases and associated factors in Benin hospital setting.

INTRODUCTION: Poor access to cardiovascular checkups is a major cause of ignorance of embolic heart diseases as the etiology for ischemic stroke. OBJECTIVE: Study ischemic strokes due to embolic heart diseases and their associated factors. METHOD: It was a cross-sectional, prospective, descriptive and analytical study conducted from November 1, 2014 to August 31, 2015 on 104 patients with ischemic stroke confirmed through brain imaging. Embolic heart diseases included arrhythmia due to atrial fibrillation (AF), atrial flutter, myocardial infarction (MI), heart valve diseases and atrial septal aneurysm (ASA). The dependent variable was embolic heart disease while independent variables encompassed socio-demographic factors, patients' history, and lifestyle. Data analysis was carried out through SAS 9.3. RESULTS: The rate of embolic heart diseases (EHD) as etiology for ischemic stroke was 26% (28/104). AF accounted for 69% of embolic heart diseases and 22.8% of etiologies for ischemic stroke. Ischemic strokes prevalence was 3.5%, 2.5% and 1.2% respectively for heart valve diseases, MI and ASA. The associated factor was age (p=0.000). CONCLUSION: The diagnosis of a potential cardiac source of embolism is essential because of therapeutic and prognostic implications. Wherefore, there is need for cardiovascular examination particularly Holter ECG and cardiac ultrasound examination which are not always accessible to our populations.