Trends in the utilisation of skilled birth attendance among pregnant women in Benin, from 2001 to 2017-2018, and projections to 2030.

BACKGROUND: Skilled birth attendance during childbirth is known to promote better pregnancy outcomes as well as contribute to maternal and newborn survival. The study aimed to analyse the progress in the use of skilled birth attendance by pregnant women over the last two decades (2001 to 2017-2018) in Benin, and then to make projections to 2030. METHODS: A secondary analysis was made using Benin's Demographic and Health Survey (DHS) databases. The study population were i) women of 15-49 years of age who were successfully surveyed and usually resided in the households visited during DHS-II, DHS-III, DHS-IV and DHS-V, ii) and had had at least one live birth in the five years preceding each of these surveys. For each DHS, the corresponding proportion of births attended by skilled health personnel was determined. The study then generated the Annual Percent Change (APC) between each survey and globally, and projections were made to 2030. RESULTS: Nationally, the percentage of women who gave birth attended by skilled health personnel was 67.39% in 2001, 76.10% in 2006, 80.87% in 2011-2012, and 79.12% in 2017-2018; this represents an APC = 0.98% between 2001 and 2017-2018. If the historical rate of progression is maintained, it is expected that by 2030, 89.35% of pregnant women will be using skilled birth attendance services. CONCLUSION: Efforts are needed to understand the drivers of skilled birth attendance among pregnant women to adopt appropriate strategies.

Quality of maternal care in the hospital pyramid in Benin: Challenges and prospects / La qualité des soins maternels de la pyramide hospitalière au Bénin : défis et perspectives

Introduction: The quality of health care in general and that of maternal health in particular is an issue that concerns all countries, especially developing countries like Benin. Purpose of research: To assess the quality of care offered to mothers within the hospital pyramid in Benin. Results: Out of a total of 36 hospitals surveyed, nine (25%) did not have a neonatal unit. This study showed an overall fair quality in the area of maternal care with an average score of 3.6. Thus, the differences in the quality of this care obtained need significant improvement. Providers' satisfaction was acceptable unlike beneficiaries who expressed dissatisfaction. Conclusions: Most hospitals in Benin do not yet provide quality maternal care, which is effective, efficient, continuous, accessible, and safe. Evidence-based interventions that focus on the identified shortcomings will improve the quality of maternal health care in Benin's hospital pyramid.

Introduction: La qualité des soins de santé en général, et de la santé maternelle en particulier, est une question qui interpelle tous les pays, en l'occurrence ceux en voie de développement comme le Bénin. But de l'étude: Évaluer la qualité des soins offerts aux mères au niveau de la pyramide hospitalière au Bénin. Résultats: Sur un total de 36 hôpitaux enquêtés, neuf (25 %) ne disposaient pas d'une unité de néonatologie. Cette étude a montré globalement une qualité passable dans le domaine des soins maternels avec un score moyen de 3,6. Ainsi, les écarts de qualité de ces soins obtenus nécessitent des améliorations importantes. La satisfaction des prestataires était acceptable contrairement aux bénéficiaires qui ont manifesté une insatisfaction. Conclusions: La plupart des hôpitaux du Bénin n'assurent pas encore des soins maternels de qualité, c'est-à-dire des soins efficaces, efficients, continus, accessibles et garantissant la sécurité des patients. Des interventions probantes focalisées sur les dysfonctionnements identifiés permettront d'améliorer la qualité de la santé maternelle au niveau de la pyramide hospitalière du Bénin.

Effect of living conditions on genital mutilation practices among adolescent girls in West Africa: A pooled analysis from demographic and health surveys.

Despite commitments and interventions, Female Genital Mutilations (FGM) practice persists in West African countries. This research analyzes the effect of living conditions on FGM practice. Data were sourced from thirty-four demographic and health surveys conducted between 1995 and 2020 in 12 countries. The study sample consisted of 69,971 adolescent girls aged 15-19 years. Meta-regression analysis and binary logistic regression analyses showed the effect and relative contribution of study covariates on the phenomenon. The overall average prevalence of FGM is 40.7%, with a mixed effect of living conditions on FGM practice. The factors associated with FGM practice are, in order of importance, religion, level of education, ethnicity and place of residence. All factors have a direct effect on the studied phenomenon, and the level of education acts as an inhibiter of the effect of living conditions. The study suggests the need to strengthen the involvement of religious, traditional and community leaders in the definition and implementation of actions to combat FGM, as well as girl's education, especially by maintaining them in school till completion of at least secondary school.

[Coexistence of maternal overweight or obesity and stunted children in south-western Benin households]. / Coexistence du surpoids ou obésité et retard de croissance dans les ménages du Sud-ouest Bénin.

INTRODUCTION: To determine the prevalence and determinants of coexistence of maternal overweight or obesity and stunted children (DBM / SCOM) in south-western Benin households. METHODS: This cross-sectional study was carried out in June 2015 on 357 mother-child pairs randomly selected by a two-stage sampling technique in the city of Comè and its surroundings. Data on socio-economic factors, family, health care, dietary quality were collected by questionnaires, observation and documentary review. Anthropometric measurements were performed in mothers and children. A logistic regression analysis model was used to search for determinants of the coexistence of the two aspects of malnutrition. RESULTS: 19.3% of mothers were overweight and 5.7% were obese. 46% of children were stunted. The prevalence of DBM / SCOM was 11.5%. The main factors associated with DBM/SCOM were the child's age, the mother's occupation, ethnicity, social status and educational level, and the size, economic level, transportation means and food insecurity of the household. CONCLUSION: A high frequency of the coexistence of maternal overweight or obesity and stunting was observed in Comè households. Interventions based on the identified determinants are needed to act simultaneously on the double burden of malnutrition in Comè.

[Poliomyelitis case surveillance data management in Burkina Faso]. / Gestion de l’'information au cours de la surveillance des Paralysies Flasques Aiguës au Burkina Faso.

INTRODUCTION: The global initiative for poliomyelitis eradication can only remain relevant if survey systems are regularly assessed. In order to identify shortcomings and to propose improvement, the data collection and transmission during case investigation were assessed in the Banfora health district in Burkina Faso. METHODS: The survey targeted six (6) primary health centres, the district laboratory and the national laboratory, all involved in the poliomyelitis surveillance system. Data from registers, forms documenting suspected cases, stool sample forms and weekly reports were collected by means of a data grid. Data from actors involved in the poliomyelitis case investigation system were collected by means of an individual questionnaire. RESULTS: The reactivity of investigating suspected cases was satisfactory with a median alert questionnaire notification time of 18 hours. The completeness of the reporting system was satisfactory. Nevertheless, the promptness of data management by primary heath centres and the national laboratory remained unsatisfactory. Evaluation of data management revealed logistic and organization shortcomings. CONCLUSION: The overall efficacy of the poliomyelitis surveillance could be improved by using management tools for laboratory supplies, collecting data related to the homes of suspected cases and implementing a cold chain maintenance plan.

[Factors associated with psychoactive substance use among Beninese adolescents]. / Facteurs associés à l’'usage de substances psychoactives chez les adolescents au Bénin.

INTRODUCTION: Psychoactive substances use among adolescents is a serious public health problem, as it exposes them to risks and health hazards and can ultimately lead to dependence. The present study investigated the prevalence and factors associated with substance use in the Kpomassè Ouidah Tori-Bossito health area in Benin. METHODS: This was a cross-sectional study conducted from 1st May to 15 July 2014 in 451 adolescents aged 10 to 19 years selected by the cluster sampling technique. Data were collected using a questionnaire about the adolescents' individual, family and socio-environmental factors. Associated factors were investigated by backward stepwise logistic regression. RESULTS: Alcohol was the substance most commonly abused with a prevalence of 30.1%, followed by tobacco, with a prevalence of 21.7% and finally cannabis, cocaine or amphetamine with a prevalence of 13.9%. More than one in ten teenagers (16.6%) consumed two or three substances. Factors associated with alcohol misuse were male gender, the area of urban residence, being married, depression, search for pleasure, conflictual family relationships and having neighbours who drink alcohol. Significant risk factors for smoking were male gender, having a single parent or being an orphan, poor parental involvement in the child's education, smoking friends and neighbours. Cannabis, cocaine and amphetamine use was mostly associated with an urban residential environment, depression, conflictual family relationships and poor parental involvement in the child's education, drug use by the parents and illicit drug use by friends. CONCLUSION: These results show that psychoactive substance use is a public health problem in the Tori-Bossito Kpomassè Ouidah health area. Communication interventions for behaviour change, advocacy, and a better public understanding of the legislation on psychoactive substances should be conducted.

[Health workers' involvement for data quality improvement in Benin]. / Implication des agents de santé dans la conception des outils de collecte de données au Bénin.

OBJECTIVE: In developing countries, the poor quality of data derived from Health Information Systems constitutes a problem that limits use of these data and contributes to the recurrent difficulties of health system management. The low level of involvement of health workers directly responsible for data may contribute to this poor quality. This study documents a Health Information System collection tool design experience by health workers and assesses its effect on data quality. METHODS: Eighty health workers responsible for clinical statistics in public health centres participated in this study. The two tools used for clinical data collection were modified by a group of 6 volunteer health workers. Monitoring indicators, data entry time, percentage exhaustiveness and quality of data were assessed before and after using the new tools. Data were compared by Wilcoxon's test for paired data and Mc Nemar's chi-square test. RESULTS: Between the two assessments, the data entry time increased from 28.7 to 22.5 seconds by reported case (p=0.153), the exhaustiveness of the reports increased from 16% to 89% (p<0.001) and the proportion of reports with sufficient data quality increased from 18.8% to 45.8% (p=0.002). CONCLUSION: The positive course of the indicators shows that increased involvement of health workers in key stages such as the design of data collection tools can help improve data quality.

[Factors associated with the poor coverage of Intermittent Preventive Treatment in pregnant women in the Pobè-Adja-Ouèrè-Kétou health zone in Benin]. / Facteurs associés à la faible couverture du Traitement Préventif Intermittent chez les femmes enceintes de la zone sanitaire béninoise de Pobè-Adja-Ouèrè-Kétou.

World Health Organization estimates indicate 216 million malaria episodes in 2010, including 81% in the African region. One of the recommended means of prevention in pregnant women is intermittent preventive treatment, until 2012, two doses of sulfadoxine/pyrimethamine or three doesfor a woman living with HIV In the Pobè-Adja-Ouèrè-Kétou health zone of Benin, coverage ofintermittent preventive treatment remains low (49% against a forecast of 80%) several years after implementation of this strategy. We conducted a cross-sectional study in June and July 2012 to identify factors associated with low intermittent preventive treatment coverage in this area. A total of 339 women were interviewed and 48% ofthem received less than two doses of sulfadoxine pyrimethamine during their prenatal consultations. The variables associated with low intermittent preventive treatment coverage were low antenatal care coverage (p < 0.001) and a prenatal consultation in the private sector (p = 0.039). In the light of our results, actions must be taken by this health zone to encourage women to complete the four visits during pregnancy.

[Quality assessment of refocused antenatal care services at the district hospital of Suru-Léré in Benin]. / Evaluation de la qualité des services de consultation prénatale recentrée à l'hôpital de district de suru-Léré au Bénin.

INTRODUCTION: Antenatal care service, one of the interventions of public health, has been recognized as one of the pillars for the reduction of maternal and neonatal mortality. It has been revised in recent years and a new model of its contents has been submitted by WHO. Considering the complexity of its implementation, it is useful to periodically assess the performance of antenatal services with the view of their improvement. METHODS: An evaluative study was thus carried out in one health district hospital in Benin; the care staff attitudes and practices were analyzed on 80 pregnant women admitted in the antenatal care as well as services organization, care environment and satisfaction of these women. The performance was appreciated on the basis of hundred criteria. RESULTS: The overall performance of antenatal services through the inputs, procedures and satisfaction of the pregnant women, was considered to be satisfactory. The services organization, health care environment, patient reception and interpersonal communication were the elements which showed deficiencies. CONCLUSION: Improvement will have to be carried out based on shortcomings identified, by the planners, organizers and staff in order to reinforce the hospital's performance on antenatal services.

[Malaria prevention practices in peri-urban zones of two health districts of Burkina Faso]. / Pratiques de prévention antipaludique dans les zones périurbaines de deux districts sanitaires du Burkina Faso.

INTRODUCTION: Malaria prevention constitutes a key strategy to control this disease in Burkina Faso. METHODS: A cross-sectional study conducted in July and August 2011, assessed malaria prevention practices of populations of peri-urban zones of the Bogodogo and Boulmiougou health districts of the city of Ouagadougou. RESULTS: A total of 180 household heads, 192 mothers of children under the age of 5 years and 30 pregnant women were surveyed. For 86.7% household heads, 92% of mothers of children under the age of five years and 96.5% of pregnant women, mosquito bites represented the main mode of transmission of malaria. The majority of survey subjects reported a preference for mosquito coils rather than mosquito nets on the night preceding the survey. DISCUSSION: The content of malaria prevention communication must take into account sociodemographic realities and lifestyles of population groups, such as those living in peri-urban regions.

Unraveling the quality of implementation of sexual and reproductive health projects among adolescents and youths in low-income regions: a case study of the JADES 2 project in Niger in 2021.

Introduction: many young people globally grapple with early pregnancies and sexually transmitted diseases (STD), especially in regions like Africa and particularly Niger due to high poverty rates. Various sexual and reproductive health (SRH) projects aim to address these challenges. This study evaluated the JADES 2 project's implementation of SRH services provided focusing on the quality of these services in Niger in 2021. Methods: a cross-sectional evaluative study was conducted based on Donabedian and Bruce's theory from March 10 to August 15, 2021, in Niger. The evaluation was carried out through the analysis of supervision data, administration of questionnaires, and semi-structured interviews in 9 Integrated Health Centers and Youth-Friendly Centers. Across these sites, 203 adolescents and young people, as well as 9 healthcare workers involved in providing SRH services, were interviewed. The composite indicator in the field developed by the World Health Organization (WHO) in 2000 was used. Results: the quality score estimated for the project was 67% indicating that the services provided was of good quality. The majority (56%) of surveyed people were very satisfied with the services received, and 65% were aware of at least two methods of preventing Sexually transmitted infections (STIs) and three methods of preventing early pregnancies. Conclusion: the SRH services implemented are of acceptable quality. The study identified gaps in the process of service provision, particularly regarding confidentiality and the availability of inputs and medications.

[Evaluation of free cesarean sections in Benin]. / Evaluation de la mise en oeuvre de la gratuité de la césarienne au Béenin.

INTRODUCTION: The Benin Government introduced free caesarean section in public hospitals in 2009 and a national agency was created to manage free caesarean section. METHODS: Three years after introduction of free caesarean section, we evaluated this measure in the Ouidah hospital area (HZO) by analysing the hospital structure, the implementation process and the results. RESULTS: This study showed the efficacy of free caesarean section, which has helped to increase the caesarean rate from 2.38% in 2009 to 3.48% in 2012, a caesarean section mortality rate of 0.99%, insufficient information for beneficiaries, some drugs are not covered by this measure, and additional costs must be paid by beneficiaries. DISCUSSION: These results indicate the need for a detailed cost analysis to adjust the unit cost for caesarean section. This type of evaluation should be performed in all public hospitals in the country to more clearly identify malfunctions.

Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin.

BACKGROUND: Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries. We introduced such reviews in five district, regional and national hospitals in Benin, West Africa. In a cross-sectional study we analysed the extent to which the hospital audit teams were able to identify case management problems (CMPs), analyse their causes, agree on solutions and put these solutions into practice. METHODS: We analysed case summaries, women's interview transcripts and audit minutes produced by the audit teams for 67 meetings concerning one woman with near-miss complications each. We compared the proportion of CMPs identified by an external assessment team to the number found by the audit teams. For the latter, we described the CMP causes identified, solutions proposed and implemented by the audit teams. RESULTS: Audit meetings were conducted regularly and were well attended. Audit teams identified half of the 714 CMPs; they were more likely to find managerial ones (71%) than the ones relating to treatment (30%). Most identified CMPs were valid. Almost all causes of CMPs were plausible, but often too superficial to be of great value for directing remedial action. Audit teams suggested solutions, most of them promising ones, for 38% of the CMPs they had identified, but recorded their implementation only for a minority (8.5%). CONCLUSIONS: The importance of following-up and documenting the implementation of solutions should be stressed in future audit interventions. Tools facilitating the follow-up should be made available. Near-miss case reviews hold promise, but their effectiveness to improve the quality of care sustainably and on a large scale still needs to be established.

Prevalence of dementia among elderly people living in Cotonou, an urban area of Benin (West Africa).

BACKGROUND/AIMS: The population of Benin is, like those of most developing countries, aging; dementia is therefore a major concern. Our goal was to estimate the prevalence of dementia in an elderly population living in urban Benin. METHODS: In a cross-sectional community-based study, people aged 65 years and above were screened using the Community Screening Interview for Dementia and the Five-Word Test. RESULTS: The prevalence of dementia was 3.7% (95% CI 2.6-4.8) overall. The figure increased with age and was higher among women than men. CONCLUSION: Dementia was slightly more prevalent than previously reported in a rural area of Benin, but the rate was similar to that recorded in other cities in developing countries.

[Audit of the quality of treatment of "near miss" patients in referral maternities in Southern Benin]. / Audit de la qualité de prise en charge des << échappées belle >> (near miss) dans les maternités de référence du Sud Bénin.

OBJECTIVES: Maternal mortality is highly associated with the provision of obstetric care. The provision of safe and timely emergency obstetric care (EOC) for women with severe obstetric complications is one of the main components of safe motherhood programs. In this research the objective was to determine the quality of EOC by examining its availability and its provision in a timely fashion. DESIGN: prospective observational study in qualified facilities providing EOC. SETTING: two teaching, two regional and three district hospitals in the southern part of Benin, West Africa. METHOD: The study was conducted from July to October 2003. Data collection tools used were based on the World Health organisation Guidelines for monitoring EOC. The midwives in charge of the survey started observation from the admission room and followed the provision of the care offered to the women admitted with near miss complications until they were discharged from hospital. The information about EOC, its availability, timeliness and patients' follow-up were recorded. RESULTS: The study sample included 557 women; immediate emergency care was given within 30 minutes for 61% of the patients. Surgical care (caesarean section and ectopic pregnancies surgery) was started within 60 minutes for 42% and 45 % of the women. In the near miss cases suffering anaemia, blood was not available for 12% of patients and blood transfusions were started within 60 minutes in 10% of cases. In the case of uterine rupture or pre-rupture, the time for starting caesarean section was 60 minutes for 58% of women. As to haemorrhagic near-miss cases, blood was not available in 44% of cases and if caesarean section was indicated, it was done within 60 minutes in 47% of the cases. Half of the patients with hypertension received treatment within 60 minutes after the decision to do so was taken. In infection cases, 53% of the patients received antibiotics treatment within 60 minutes. Generally, the quality of providing EOC in the facilities of the study was good in only 16.4% of cases. The quality of care was good in 31.4% of the cases with dystocia, 19% of the cases with hypertension, in 18% of the cases with haemorrhage, in 13.4% of the cases with infection, and in 6.4% of the cases with anaemia. CONCLUSION: Our study has shown that, often, EOC was not provided in a timely fashion. A reflection with all the health providers involved should lead to a better understanding of better ways to improve the quality of EOC.

Factors associated with post-cesarean stillbirth in 12 hospitals in Benin: a cross-sectional.

INTRODUCTION: In spite of free caesarean section applied in Benin since 2009, high rates of stillborn babies continue to be recorded. This study aimed to determine the factors associated with post-caesarean stillborn in Benin. METHODS: Cross-sectional study that covered all women who have delivered by caesarean from December 2013 to February 2014 in twelve hospitals chosen by simple random selection in each of the twelve departments of Benin. Data collected by chart review have been analyzed using the statistical software Epi info 3.5.1. Univariate analysis and multivariable logistic regression were used to identify factors associated with post-caesarean stillbirth at the significance threshold of 5%. RESULTS: There were 66 stillborn per 1,000 births of which 58% died before admission to hospital. The risk factors identified were the reference (p = 0.0011), general anesthesia (p = 0.0371), the low birth weight (p = 0.0001), the retro-placental hematoma (p = 0.0083), and the umbilical cord prolapse (p = 0.0229). Acute fetal distress (p = 0.0308) and anesthesia administered by an anesthetist nurse or midwife (p = 0.0337) were protective factors. CONCLUSION: The majority of cases, in utero death occurred before admission to hospital. Strengthening antenatal refocused consultation, a better access to quality obstetric care and the grant of all obstetric care could reduce stillbirths from caesarean sections in Benin.

Characterization of swarming and mating behaviour between Anopheles coluzzii and Anopheles melas in a sympatry area of Benin.

The swarm structure of two sibling species, Anopheles gambiae coluzzii and Anopheles melas, was characterize to explore the ecological and environmental parameters associated with the formation of swarms and their spatial distribution. Swarms and breeding sites were searched and sampled between January and December 2010, and larval and adult samples were identified by PCR. During the dry season, 456 swarms of An. gambiae s.l. were sampled from 38 swarm sites yielding a total of 23,274 males and 76 females. Of these 38 swarming sites, 18 were composed exclusively of An. gambiae coluzzii and 20 exclusively of An. melas, presenting clear evidence of reproductive swarm segregation. The species makeup of couples sampled from swarms also demonstrated assortative mating. The swarm site localization was close to human dwellings in the case of the An. gambiae coluzzii and on salt production sites for An. melas. At the peak of the rainy season, swarms of An. melas were absent. These findings offer evidence that the ecological speciation of these two sibling species of mosquitoes is associated with spatial swarm segregation and assortative mating, providing strong support for the hypothesis that mate recognition is currently maintaining adaptive differentiation and promoting ecological speciation. Further studies on the swarming and mating systems of An. gambiae, with the prospect of producing a predictive model of swarm distribution, are needed to inform any future efforts to implement strategies based on the use of GMM or SIT.

Effect of three larval diets on larval development and male sexual performance of Anopheles gambiae s.s.

Population replacement/elimination strategies based on mass-release of sterile or otherwise genetically modified (male) mosquitoes are being considered in order to expand the malaria vector control arsenal on the way to eradication. A challenge in this context, is to produce male mosquitoes that will be able to compete and mate with wild females more efficiently than their wild counterparts, i.e. high fitness males. This study explored the effect of three larval food diets developed by the International Atomic Energy Agency on the overall fitness and mating performance of male Anopheles gambiae s.s. mosquitoes (Kisumu strain). Larval development (pupation and emergence rate, development time) was monitored, and adult wing length and energy reserves at emergence (i.e. lipids, sugars, glycogen and proteins) were measured. Male sexual performance was assessed through an insemination test whereby one male and 10 virgin females were maintained together in the same cage in order to record the number of inseminated females per 24h. Our results show that males reared on Diets 2 and 3 performed best during larval development. Males provided with treatment 2.2 had a shorter development time and performed best in insemination tests. However, these males had the lowest overall lifespan, suggesting a trade-off between longevity and sexual performances which needs to be taken into consideration when planning release. The results from this work were discussed in the context of sterile insect techniques or genetic control methods which is today one of the strategy in the overall mosquito control and elimination efforts.

Phenotypic effects of concomitant insensitive acetylcholinesterase (ace-1(R)) and knockdown resistance (kdr(R)) in Anopheles gambiae: a hindrance for insecticide resistance management for malaria vector control.

BACKGROUND: Malaria is endemic in sub-Saharan Africa with considerable burden for human health. Major insecticide resistance mechanisms such as kdr(R) and ace-1(R) alleles constitute a hindrance to malaria vector control programs. Anopheles gambiae bearing both kdr and ace-1 resistant alleles are increasingly recorded in wild populations. In order to maintain the efficacy of vector control strategies, the characterization of concomitant kdr and ace-1 resistance, and their pleiotropic effects on malaria vector phenotype on insecticide efficacy are important. METHODS: Larval and adult bioassays were performed with different insecticide classes used in public health following WHO standard guidelines on four laboratory Anopheles gambiae strains, sharing the same genetic background but harboring distinct resistance status: KISUMU with no resistance allele; ACERKIS with ace-1(R) allele; KISKDR with kdr(R) allele and ACERKDRKIS with both resistance alleles' ace-1(R) and kdr(R) . RESULTS: Larval bioassays indicate that the homozygote resistant strain harboring both alleles (ACERKDRKIS) displayed slightly but significantly higher resistance level to various insecticides like carbamates (bendiocarb, p < 0.001; propoxur, p = 0.02) and organophosphates (chlorpyriphos-methyl, p = 0.002; fenitrothion, p < 0.001) when compared to ACERKIS strain. However, no differences were recorded between ACERKDRKIS and KISKDR resistance level against permethrin (Pyrethroid, p = 0.7) and DDT (Organochlorine, p = 0.24). For adult bioassays, the percentages of mosquitoes knocked down were significantly lower for ACERKDRKIS than for KISKDR with permethrin (p = 0.003) but not with deltamethrin. The percentage of mortality from adult bioassays was similar between ACERKDRKIS and ACERKIS with carbamates and organophosphates, or between ACERKDRKIS and KISKDR with pyrethroid and DDT. Concerning acetylcholinesterase enzyme, ACERKDRKIS strain showed similarAChE1 activity than that of ACERKIS. CONCLUSION: The presence of both kdr(R) and ace-1(R) alleles seems to increase the resistance levels to both carbamate and organophosphate insecticides and at operational level, may represent an important threat to malaria vector control programs in West Africa.