Épidemiologie de l'obésité et profil lipidique chez les professionnels de la santé à Parakou (Bénin) en 2015

L'objectif de l'étude est de déterminer la prévalence de l'obésité et le profil lipidique chez le personnel administratif et soignant des hôpitaux de Parakou en 2015. Elle était descriptive transversale étalée sur deux mois. Les données ont été collectées sur la base d'un questionnaire, du calcul l'IMC, et de dosages des lipides sanguins. Le taux de participation était 63,33% et la sex-ratio à 0,86. La prévalence du surpoids était 31,82% et celle de l'obésité 22,42%. Le surpoids et l'obésité étaient surtout observés chez les femmes. La dyslipidémie globale est notée chez 151(45,76%) sujets. La prise de poids a été significativement associé au sexe (p=0,00). L'obésité est un problème de santé publique en milieu hospitalier à Parakou. Les femmes sont les plus à risque. Le taux de dyslipidémie déterminée n'est pas négligeable

Troubles musculosquelettiques chez les employés au tri de billets d'une l'agence camerounaise de la Banque des Etats de L'Afrique Centrale (BEAC) au Cameroun en 2016

Objectif : Certains secteurs d'activités, à l'instar du secteur bancaire peuvent sembler exempts de risque pour la santé des travailleurs. Nous avons effectué une étude en vue d'évaluer les troubles musculosquelettiques chez les trieuses dans l'agence de la Banque des États de l'Afrique Centrale à Nkongsamba (Cameroun). Méthode d'étude : Il s'agissait d'une étude transversale descriptive et analytique qui s'est déroulée sur quatre mois de Juin à Octobre 2016, portant sur les employés impliqués dans les activités de tri bancaire. La collecte des données est faite grâce à un questionnaire inspiré du questionnaire standard de l'INRS et une grille d'observation des opérations selon la checklist OSHA. Les données recueillies par le questionnaire ont été traitées par les logiciels Epi-info 7.2.0.1. Résultats : Tous les participants à l'étude sont de sexe féminin. La moyenne d'âge est 40,1 ans. La tranche d'âge 35-40 ans était prépondérante. L'ancienneté moyenne est de 10,4 ans ; avec des extrêmes de 2 ans et 30 ans. Elles sont à 90,6% droitières. La fréquence des troubles musculosquelettiques était 81,2%. Le siège prédominant était le bas du dos, suivi du poignet et du cou. Les moins de 35 ans n'éprouvaient de troubles musculosquelettiques. Les TMS croissaient avec l'ancienneté dans l'activité ; au-delà de 10 années dans l'activité, la présence de TMS est quasiconstante. Conclusion : Les TMS sont importants dans l'activité de tri de billets de banque. Des mesures relativement simples et facilement applicables sont à mettre en oeuvre pour y remédier

Change in peak expiratory flow over time among workers exposed to polyvinyl chloride dust.

OBJECTIVE: To evaluate the variation of peak expiratory flow (PEF) over a working week among non-smoking workers without previous asthma who have been exposed to polyvinyl chloride (PVC) dust. DESIGN: We conducted a cross-sectional study among 42 operators with exposure to PVC dust (filling hoppers to feed extrusion machines) and 23 employees without exposure to PVC dust in a plant producing PVC pipes in West Africa. A pre-tested questionnaire was administered and PEF was measured using a portable peak flow meter after a day off (day 1), on day 3 and at the end of the week (day 6). RESULTS: The two groups did not differ by age or body mass index. Dyspnoea was more prevalent in exposed workers than controls (52% vs. 13%, P = 0.002). PEF decreased more significantly in exposed workers than controls (-8% vs. -3% on day 3 and -10% vs. -5% on day 6, both P = 0.004). The duration of exposure did not affect PEF variability in the exposed groups. CONCLUSION: The decrease of PEF over the working week in workers exposed to PVC dust is consistent with occupational asthma, although standard measures to diagnose occupational asthma were not used. This result reinforces the need to prevent excessive exposure to PVC dust.

[Assessment of nurses' workload in a hospital in Benin]. / Evaluation de la charge de travail des infirmiers dans un hopital au Benin.

The importance of nursing work is well established in the treatment of patients. But the weakness of the nurse-patient ratio and lack of proper equipment create a workload for these nurses and can impact on the quality of care. The objective of this study was to assess the nursing workload during night shifts in a hospital in Benin. A prospective observational study of the work of nurses in the general medical service of this hospital was conducted. A comprehensive and systematic analysis of this work was done and resulted in the identification of the tasks performed, the analysis of postures and the evaluation of the average distance walked by nurses. Performing care tasks occupy more than one third of the working time and approximately 3 minutes were spent per tasks. The postures in static muscular work and standing / walking posture represent more than half of the working time. The brightness measured is about 110 Lux and nurses walked more than 2.5 km during their night shift. In conclusion, the nursing work combines several tasks that create a considerable workload. The improvement of the work conditions will decrease the workload and will contribute to better care for patients.

L'importance du travail infirmier n'est plus à démontrer dans la prise en charge des patients. Mais la faiblesse du ratio infirmier-patient et le manque de matériel adéquat créent une charge de travail à ces infirmiers et peut altérer la qualité des soins. L'objectif de ce travail a été d'évaluer la charge de travail infirmier au cours d'un travail de nuit dans un hôpital au Bénin. Une étude prospective observationnelle du travail des infirmiers dans le service de médecine générale de cet hôpital a été réalisée. Une analyse globale et systématisée de ce travail a permis de répertorier les différentes tâches réalisées, d'analyser les postures adoptées et d'évaluer la distance moyenne parcourue par les infirmiers. La réalisation des soins occupe plus du 1/3 du temps de travail et environ 3 minutes sont passées par tâches. Le travail musculaire statique et la posture debout/marche représentent plus de la moitié du temps de travail. L'éclairage mesuré est de 110 Lux et les infirmiers parcourent en moyenne plus de 2,5 Km. En conclusion le travail infirmier associe plusieurs tâches qui créent une certaine charge de travail dans un environnement physique peu éclairé. L'amélioration des conditions de travail contribuerait à une préservation de la santé des infirmiers et une meilleure qualité de soins.

[Sensitisation profile to airborne allergens of patients followed for asthma in Cotonou, Benin. A cross-sectional study using prick-tests]. / Profil de sensibilisation aux pneumallergènes des patients suivis pour asthme à Cotonou, Bénin : étude transversale par prick-tests.

RATIONALE: The sensitisation profile to airborne allergens of asthma patients followed in Benin is not known. PATIENTS AND METHODS: A descriptive cross-sectional study was conducted from April to June 2013 at the hospital reference centre. A prick-test was performed in all adults with asthma consulting during this period. The standardized allergenic extracts tested were: mites (Dermatophagoides pteronyssinus [DP], Dermatophagoides farinae [DF] and Blomia tropicalis [BT]), cockroaches, 5 different grasses, Alternaria, dogs and cats. The test was positive when the diameter of the wheal was more than half that of the positive control and/or when the diameter of the wheal was ≥3mm than the negative control. RESULTS: Of the 253 asthmatics tested, 247 (97.6%) had at least one positive skin reaction. The average age was 44 years, the sex ratio was 0.81. Sensitization to mites was the most frequent (99.6%), followed by cockroaches (71.3%), 5 grasses (71.3%), Alternaria (71%), dog (68%) and cat (63.6%). The average number of sensitivities was 5±2. CONCLUSION: Asthmatics monitored in Cotonou have multiple sensitisations dominated by mites.

The prevalence of byssinosis among cotton workers in the north of Benin.

BACKGROUND: Cotton is the main agricultural export product in Benin. Cotton dust is thus present in the air during the handling and processing of cotton. This dust contains a mixture of substances including ground up plant matter, fibres, bacteria, fungi, soil, pesticides, noncotton matter, and other contaminants. While cotton processing is decreasing in industrialized countries, it is increasing in developing countries. Cotton processing, particularly in the early processes of spinning, can cause byssinosis. OBJECTIVE: To determine the respiratory effects of cotton dust exposure among cotton mill workers in Benin. METHODS: In a cross-sectional study, 109 workers exposed to cotton dust and 107 unexposed workers were studied. The International Commission on Occupational Health (ICOH) questionnaire was used for data collection on respiratory symptoms. For each worker, crossshift pulmonary function was performed with a dry spirometer. Based on the severity of respiratory symptoms and spirometry byssinosis was defined and classified according to the criteria of Schilling, et al. RESULTS: The mean ± SD age of the exposed and unexposed workers was 46.3 ± 7.8 and 37.0 ± 8.3 years, respectively (p<0.001). The mean FEV1 predicted value for the exposed and unexposed workers was 76.3% and 77.3%, respectively. The prevalence of grade 3 byssinosis was 21.1% (95% CI: 13.4-28.9) in exposed workers and 8.4% (95% CI: 3.1-13.7) in unexposed workers (p=0.006). On Mondays, the exposed workers had more respiratory symptoms than unexposed workers; for grade 3 byssinosis, the prevalence was 13.8% in exposed and 4.7% in unexposed workers (p=0.011). CONCLUSION: The prevalence of respiratory symptoms and byssinosis among cotton mill workers in Benin is high and needs prompt attention of health care workers and policymakers.

Seroprevalence et facteurs associes au statut serologique des enfants nes de meres seropositives au VIH dans les sites de prevention de Cotonou au Benin

L'objectif de l'etude etait de determiner les facteurs qui sont associes au statut serologique des enfants nes de meres seropositives dans quatre sites de Prevention de la Transmission Mere-Enfant (PTME) de Cotonou. Une etude transversale et retrospective; a double volet quantitatif et qualitatif a porte sur 114 dossiers d'enfants nes de meres seropositives ainsi que leurs meres en 2010; 60 meres seropositives ayant frequente ces sites et 29 agents de sante assurant leur prise en charge en 2011. Elle a ete basee sur le depouillement des dossiers medicaux; des entretiens individuels et des observations du cadre de travail. Des analyses bi-variees ont ete realisees pour rechercher les facteurs associes au statut serologique de l'enfant dans Epi Info 3.5.3. L'etude a montre que le traitement aux ARV; le type du VIH; le sexe de l'enfant; la prophylaxie au Cotrimoxazole ont ete associes significativement au statut serologique de l'enfant. Le cadre de travail inadequat; les ruptures de stock des ARV; Cotrimoxazole et reactifs et leur gestion insuffisante; les difficultes pour faire face aux depenses supplementaires liees aux soins ont ete releves. En conclusion; l'acces aux ARV et au Cotrimoxazole et leur gestion adequate; l'observance rigoureuse des traitements et le soutien financier aux meres seropositives contribueront a la baisse considerable du taux de transmission de la mere a l'enfant du VIH dans les sites PTME de Cotonou

Facteurs de risques des accidents d'exposition au sang chez les professionnels de la sante de la zone sanitaire Parakou-N'dali (nord Benin)

Les accidents d'exposition au sang font partie des nombreux risques auxquels le personnel soignant est expose au cours de leur carriere. Nous avons entrepris une etude transversale descriptive du 1er mars au 31 juillet 2011 au sein du personnel de sante de la zone sanitaire Parakou-N'dali dans le but d'evaluer l'etat de connaissances et les attitudes de ces agents de sante face aux accidents d'exposition au sang (AES).Nous avons collige les dossiers de 350 travailleurs professionnels de la sante dont 104 ont ete victimes une fois au moins d'un AES soit 29;7. Nous avons observe une nette predominance feminine avec un sexe ratio egal a 2; 6. Les infirmiers et infirmieres sont les plus touches du personnel soignant soit 38;5. Le centre de sante confessionnel est la structure ou nous avons rencontre moins de victimes d'AES (8;7). Les services de gyneco-obstetrique arrivent en tete des services ou sont enregistres le plus de travailleurs victimes (31;4). Les injections representent a elles seules 40;4 des activites de soins au cours desquelles les agents ont ete exposes.Les AES constituent un important risque professionnel pour les agents de sante en exercice dans le nord du Benin. Une politique d'education et de communication pour un changement de comportements a l'endroit des soignants est necessaire en vue de l'adoption de comportements qui leur reduiront les risques d'AES

[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.

[Prevalence of respiratory disorders in women exposed to the smoke from smoking fish in the municipality of Cotonou, Benin]. / Prevalence Des Troubles Respiratoires Chez Les Femmes Exercant Sur Un Site Artisanal De Fumage De Poisson A Cotonou Au Benin.

INTRODUCTION: Women are constantly exposed to fumes and gases produced by burning wood, however they are poorly studied. The aim of this study was to assess the prevalence of respiratory disorders among women most at risk. SUBJECTS AND METHODS: We conducted a descriptive, transversal and prospective women engaged with the site of artisanal smoked fish Hwlacodji in Cotonou. The survey included a questionnaire exploring the medical history and pathological respiratory events occurred during the last 12 months. All had received spirometry testing. RESULTS: 84 women were included. The average age was 37 ± 12 years, with extremes of 18 and 70 years. More than half of respondents had a tenure of more than 20 years and 61/84 (73%) practiced this profession full time. 70 (83%) had at least one respiratory symptom. The reported symptoms were: rhinitis 77%, 70% cough, dyspnea 65% and 19% have gone out of business last year due to lung disease. Ventilatory abnormalities are found in 49% of respondents. Abnormalities relate to FEV / FVC <0.8: 3 (3.5%), PEF <0, 8: 10 (11.90%), FEV <0.8: 10 (11.90%). CONCLUSION: The respiratory symptoms is quite expressive contrasts with spirometric results. Monitoring over a long period of mostly young women will help lead to meaningful conclusions.

Dietary patterns of urban adults in Benin: relationship with overall diet quality and socio-demographic characteristics.

OBJECTIVES: To identify dietary patterns of urban Beninese adults and explore their links with overall diet quality and socio-demographics. SUBJECTS AND METHODS: A sample of 200 men and women aged 25-60 years was randomly selected in 10 neighbourhoods. Food intake was assessed through three non-consecutive 24 h food recalls. Dietary patterns were examined using cluster analysis. Diet quality was assessed based on diversity, a micronutrient adequacy score (MAS) and a healthfulness score (HS). Socio-demographics were documented using a questionnaire. RESULTS: Two distinct dietary patterns emerged: a 'traditional' type (66% of the subjects) and a 'transitional' type (34%). Subjects with a 'transitional diet' were predominantly from the upper socioeconomic status or born in the city. Compared with the traditional type, the 'transitional diet' had a significantly higher percentage of energy from fat (17.6 vs 15.5%), saturated fat (5.9 vs 5.2%) and sugar (6.3 vs 5.0%). It was also significantly higher in cholesterol and lower in fibre. The 'transitional diet' was more diversified, but it also showed a lower HS than the 'traditional diet'. Mean intake of fruit was low in both clusters (<16 g day(-1)). A higher intake of vegetables was associated with both a higher MAS (P<0.001) and a higher HS (P<0.001). CONCLUSIONS: The dietary transition is evidenced in this study, although both dietary patterns were still low in fat and sugar. Programmes focusing on the prevention of diet-related chronic diseases in this population should encourage the maintenance of the healthful elements of the diets, while emphasizing consumption of fruits and vegetables.

[Epidemiological data on snake bite cases reported in Benin from 1994 to 2000]. / Données épidémiologiques sur les cas de morsures de serpent déclarés au Bénin de 1994 à 2000.

Snake bites constitute a frequent occupational injury, mainly occuRring during agricultural activities in Benin as in the majority of tropical countries. The present study was performed within the scope of a periodic epidemiological analysis of occupational injuries over the past 15 years. It is a retrospective study based on the snake bites reported by the Ministry of Public Health from 1994 to 2000. The data collected through the medical centre registers showed that, with a total of 30,273 cases declared during these 7 years, snakebites represent less than 1% of the whole causes of admission. Although the prevalence was weak, the lethality was very high (15%). Envenomations involved more deaths than malaria and acute respiratory infections together. One third of cases occurred in adults and teenagers. Lethality in infants was not negligible. The two departments of northern Benin accounted for 314 of the envenomations. Lethality does not appear to be decreasing. The routine management of cases should be improved by appropriate training for health care workers and the introduction of a therapeutic strategy at every level of the medical system.

[Student nurses' and nurse midwives' behavior concerning sexuality and prevention of sexually transmitted diseases in Cotonou (Benin)]. / Comportement des étudiants infirmiers et sages-femmes vis-à-vis de la sexualité et de la prévention des maladies sexuellement transmissibles à Cotonou (Bénin).

Sexually-transmitted diseases (STDs) remain a public health problem in Benin. However, few studies have focused on the future educators, the student nurses. We studied a cross-section of the population of student nurses at the Institut National Médico-Social at Cotonou in December, 1995. The aim of the study was to describe nurses' sexual behavior and their views on STD transmission and prevention. Information was obtained from 141 students by means of an anonymous questionnaire. We found that first sexual relationships often occurred at a young age (12 years old). Sexual relations generally began between 0.25 and 60 months after meeting the partner for the first time. Men were more likely to have multiple partners than women (P < 0.05). The students' views on STD transmission and the use of condoms indicated that they lacked information. About half the students said that they use condoms during sexual intercourse. We identified four groups of students, based on condom-use. This may make more effective student education possible in the future. We suggest improved education of student nurses, greater emphasis in the school curriculum on sexually-transmitted diseases and the creation of a counseling service at the Institute.

[A case of acute pyrimethamine poisoning]. / A propos d'un cas d'intoxication aiguë à la pyriméthamine.

Intoxication by pyrimethamine is rare compare to these of patients who ingest a massive dose of amino-4-quinoleine. Clinic manifestations can be delayed and they are specially based on haematologic disorder as shown by literature data. Others organs can be concerned. The authors would like to present the case of a patient with a severe pancytopenia accompanied with: ocular blow like hyperhaemia of conjunctiva then iris siderosis. skin attack as Gunther's disease. Etiologic treatment by folinic acid is the only deduction. Recovery is complete.

Etude comparée de la numération formule sanguine chez les techniciens de radiologie et un groupe de personnes non exposées

L'analyse des resultats de la numeration formule sanguine realisee chez des techniciens de radiologie et des personnes non exposees aux irradiations a permis de montrer qu'il n'y a pas de modification significative de l'hemogramme entre les deux groupes. Les auteurs insistent neanmoins sur la necessite d'une surveillance hematologique reguliere afin de de prevenir les risques d'irradiation

[Experimental study of poisoning of goats with Pergularia tomentosa L]. / Etude expérimentale de l'intoxication des caprins par Pergularia tomentosa L.

A large number of ruminants are often lost in Niger due to poisoning caused by Pergularia tomentosa L. This plant traditionally used to tan skin was experienced in goats. The symptoms observed, the post-mortem findings and the search for toxic compounds suggest that P. tomentosa contains tannins. In addition, this plant most likely also includes substances with cardiac effects.

[Serological study of toxoplasmosis and echinococcosis in cattle breeders and abattoir personnel in Benin]. / Etude sérologique de la toxoplasmose et de l'hydatidose chez les éleveurs de bovins et le personnel des abattoirs au Bénin.

In Benin, a serological study of toxoplasmosis and hydatid disease has been effected among bovine stock-breeders and the staff of the slaughter-houses in comparison with a sample of blood donors. Our results reveal the highest rate of toxoplasmosis infection (87%) among the staff of the slaughter-houses, whereas the bovine stock-breeders are the most exposed population to hydatid disease with a 9% prevalence. There is no mention of similar works in Benin in medical literature.

[Human brucellosis in Benin: results of a serological survey among exposed workers]. / La brucellose humaine au Bénin: résultats d'une enquête sérologique chez des travailleurs exposés.

A serological survey was carried out in Bénin in order to assess the rate of brucellosis infection among exposed workers (workers in slaughtering-houses and breeders). 221 sera were tested with rose Bengale test, Wright sero-agglutination test, indirect immunofluorescence test and counter-immuno electrophoresis (brucelline). The percentage of positive sera among exposed workers is 17,7%. The rose Bengale and immunofluorescence tests combination permits complete detection of positive sera. These results suggest the existence of human brucellosis in Bénin and shows the necessity of a national control programme adapted to the socio-economic problems of this country.