Role of Seaports and Imported Rats in Seoul Hantavirus Circulation, Africa.

Seoul orthohantavirus (SEOV) is not considered a major public health threat on the continent of Africa. However, Africa is exposed to rodentborne SEOV introduction events through maritime traffic after exponential growth of trade with the rest of the world. Serologic studies have already detected hantavirus antibodies in human populations, and recent investigations have confirmed circulation of hantavirus, including SEOV, in rat populations. Thus, SEOV is a possible emerging zoonotic risk in Africa. Moreover, the range of SEOV could rapidly expand, and transmission to humans could increase because of host switching from the usual brown rat (Rattus norvegicus) species, which is currently invading Africa, to the more widely installed black rat (R. rattus) species. Because of rapid economic development, environmental and climatic changes, and increased international trade, strengthened surveillance is urgently needed to prevent SEOV dissemination among humans in Africa.

[Peripheral neuropathies and factors associated in chronic hemodialysis patients in Benin]. / Neuropathies périphériques et facteurs associés chez les hémodialysés chroniques du Bénin.

INTRODUCTION: Peripheral neuropathies, in hemodialysis patients, are frequent. OBJECTIVE: To study peripheral neuropathies in the population of chronic hemodialysis patients in Benin. METHODS: This was a descriptive and analytical cross-sectional study conducted from April 1st to July 31st, 2017 in the hemodialysis units of the two public dialysis centers in Benin. Recruitment was exhaustive with inclusion of all patients with hemodialysis for more than 3months, aged at least 18years and consenting. The diagnosis of peripheral neuropathy was based on the presence of sensory-motor and/or vegetative disorders associated with amyotrophy, abolition or reduction of osteotendinous reflexes and absence of central signs. RESULTS: A total of 189 hemodialysis patients were included in the two public hemodialysis centers of Benin, 180 at the CNHU-HKM and 9 at the CHUD/BA. The mean age was 50.23±13.31years with extremes from 20 to 85 years and a sex ratio of 1.59. The overall frequency of peripheral neuropathy was 59.26%, including polyneuropathies (72.32%), unifocal mononeuropathies (10.71%), polyradiculoneuropathies (9.82%), and multiple mononeuropathies (7.14%). The associated factor in multivariate analysis was socioeconomic level (P=0.001; OR 39.41; 95% CI 4.81-322.64). CONCLUSION: Peripheral neuropathy is frequent in chronic hemodialysis patients in Benin, requiring early detection and management.

[Red blood cell alloimmunization among polytransfused patients in the National Hospital and University Center of Cotonou: about 51 cases]. / Allo-immunisation anti-érythrocytaire chez les polytransfusés au Centre National Hospitalier Universitaire de Cotonou: à propos de 51 cas.

Blood transfusion is a medical procedure used to treat patients with labile blood product. Each transfusion of globular concentrate exposes recipients to the risk of red blood cell alloimmunization. The test for red cell antibodies (RCA) ensures the immunohaematological safety of transfused patients. In Benin, this test is not performed in a systematic way or included either in the pre-transfusion or in the post-transfusion tests. The purpose of this study is to determine the presence of red cell antibodies among polytransfused patients. RCA was performed using indirect antiglobulin test on gel-filtration in 51 polytransfused patients including 26 selected in the Department of Hematology and 25 in the Department of Nephrology at the National Hospital and University Center of Cotonou. After phenotyping alloimmunized patients, tests for detecting signs of hemolysis were performed. Clinical data as well as those on transfusion were collected from transfusion registries and medical records. The prevalence of alloimmunization in our study population was 13.73%. The antibodies identified had the following characteristics: association of anti-RH1 and anti-RH3, anti LE1, association of anti-RH3 and anti-FY1. Alloantibodies were more frequent in patients who had received more than 15 packed red blood cells. Laboratory tests showed signs of hemolysis in one alloimmunized patient. There was no correlation between age, sex, clinical diagnosis and the occurrence of red blood cell alloimmunization. The test for red cell antibodies should be systematically performed in polytransfused patients in order to ensure better transfusion recipient safety in Benin.

Prevalence of abnormal kidney function in a rural population of Benin and associated risk factors.

BACKGROUND: The global burden of kidney disease has increased in recent years worldwide. Risk factors for kidney disease are common in Africa, but data on their prevalence are lacking. This study aims to determine the prevalence of abnormal kidney function and associated factors among participants included in the TAnve HEalth Study (TAHES) cohort in Benin. METHODS: This was a cross-sectional study nested within the TAHES cohort. It was carried out in 2019, among TAHES participants aged 25 years and above, living in Tanvè and Dékanmè, two villages located in southwestern Benin. Data on risk factors were collected using the World Health Organization's STEPS questionnaire. Anthropometric measurements and capillary creatinine measurements were performed. Abnormal kidney function was defined as a low glomerular filtration rate (< 60 mL/min/1.73 m2). RESULTS: Creatinine was measured among 1360 out of the 1583 participants in the cohort in 2019. The median age was 39 [32-53]. The prevalence of abnormal kidney function was 16.10%; 95%CI = [14.15-18.05]. The results of the multivariate logistic regression showed that the probability of abnormal kidney function increased significantly with age (adjusted OR (aOR) = 2.75; 95%CI = [1.83-4.14]), female gender (aOR = 2; 95%CI = [1.37-2.91]), hypertension (aOR = 1.54; 95%CI = [1.12-2.13]), high body mass index (aOR = 1, 56; 95%CI = [1.12-2.17]) and hyperglycemia (aOR = 2.86; 95%CI = [1.68-4.88]). CONCLUSION: The prevalence of abnormal kidney function was high. These data should guide national authorities and help to raise community awareness of the benefits of early detection of this condition.

Epidemiological and Clinical Profile of Dermatoses Observed in Chronic Hemodialysis Patients at the National Teaching Hospital (NTH-HKM) of Cotonou, Benin.

Introduction. Dermatological damage in chronic hemodialysis patients is not uncommon. In Benin, to date, no study on the dermatological manifestations of chronic hemodialysis patients has been carried out. However, the presence of cutaneous signs is evident in these patients, and the need for dermatological care is not negligible. The objective of this study was to identify the epidemiological and clinical profile of the main dermatological manifestations presented by chronic hemodialysis patients at the NTH-HKM of Cotonou (Benin). METHODS: This was a descriptive cross-sectional study conducted in chronic hemodialysis patients from May 15th to September 15th, 2018. Included were all patients seen during the study period who had been on hemodialysis for at least three months, had at least one dermatological manifestation, and gave verbal or written consent. Chronic hemodialysis patients who did not wish to participate in the survey were excluded. RESULTS: 87 patients were included in the study for a hospital frequency of 33.8%. The sex ratio (male to female) was 2. The median age was 49 years (IQ [40.75-59]). Median age in hemodialysis was 36 months with two weekly sessions. The main dermatological manifestations were xerosis (48.3%), pruritus (34.5%), alopecia (14%), nail dystrophy (9.2%), equisegmented nails (8%), and melanoderma (8%). Pruritus was associated with a longer duration of hemodialysis sessions (p=0.01), while xerosis, alopecia, and melanoderma were associated with seniority in hemodialysis. CONCLUSION: Cutaneous manifestations in hemodialysis patients were frequent and dominated by xerosis, pruritus, and alopecia. Factors associated with some of these dermatologic manifestations were seniority in hemodialysis, long duration of the hemodialysis session, and female gender.

[Left ventricular hypertrophy in chronic hemodialysis patients at CNHU-HKM of Cotonou]. / Hypertrophie ventriculaire gauche chez les hémodialysés chroniques du CNHU-HKM de Cotonou.

INTRODUCTION: Left ventricular hypertrophy (LVH) is a predictor of mortality in hemodialysis. It takes a very high proportion among cardiovascular complications. OBJECTIVE: It was to determine the frequency of LVH and identify its associated factors among chronic hemodialysis patients of CNHU-HKM. METHODS: This is a cross-sectional, descriptive and analytical, which took place 1st February to 31st October 2014. The sample consisted of patients aged over 15 years, chronic hemodialysis for at least 3 months. LVH is defined by a Left Ventricular Mass Index (LVMI)>115 g/m2 for men and >95 g/m2 in women. Doppler ultrasound was performed during 15 to 20 hours after the last hemodialysis session. Factors associated as sociodemographic characteristics, history, biological data, dialysis parameters were sought by logistic regression univariate analysis. The significance level was less than 0.05. RéSULTS: The sample size was 141 patients, 39% of women with a sex-ratio of 1.6. The average age was 50.1±12.3 years. The frequency of hypertension was 67.4%; diabetes: 14.9%; smoking: 9.2%; the rise of the pre-dialysis blood pression: 46.8%. The frequency of LVH was 54.6% and the associated factors were: the elevation of the predialysis blood pression (P=0.04), obesity (P=0.01), central catheter (P=0.03), anemia (P=0.02) and cardiomegaly (P<0.001). CONCLUSION: LVH is frequent in hemodialysis of CNHU-HKM. It is necessary to optimize the hemodialysis sessions and to achieve better management of associated factors.

[Hepatitis B and renal failure: prevalence and associated factors in National University Hospital Center of Cotonou]. / Hépatite virale B et insuffisance rénale: prévalence et facteurs associés au Centre National Hospitalier et Universitaire de Cotonou.

INTRODUCTION: the association between the kidneys and hepatitis B is complex. This study aims to determine the prevalence and factors associated with renal disease in people living with hepatitis B virus (PLHBV) in Cotonou. METHODS: we conducted a cross-sectional, descriptive and analytical study in the Hepatogastroenterology Department at the National University Hospital Center in Cotonou over the period May -August 2017. All the patients with positive hepatitis B surface antigen (HBS Ag) test hospitalized in the study period were included. The diagnosis of renal failure was retained in patients with glomerular filtration rate less than 90 mL/min/1.73 m2 (estimated with MDRD Equation). RESULTS: the study involved 105 patients with positive hepatitis B surface antigen (HBS Ag) test Among them, 65 (61.9%) were under anti-HBV treatment ( 62 of them were under tenofovir ); 41 patients had renal failure (39%) with tubular involvement (2 cases) and glomerular involvement (4 cases). Renal function had got progressively worse over time in 22 patients (21%) and had improved in 6 patients (5.7%). Univariate analysis showed that factors associated with the occurrence of renal failure were: age greater than 50 years (p = 0.0125), high blood pressure (p = 0.0037), initially abnormal renal function (p < 0.0003) and co-medications (p = 0.0007). Anti-HBV treatment wasn't associated with the occurrence of renal failure (p = 0.2887). CONCLUSION: the prevalence of renal failure in PLHBV was high (39%). Age, arterial hypertension, pre-existing renal failure and co-medications were identified as factors associated with decline in renal function in PLHBV.

Evaluation du statut martial des hémodialyses suivis au CNHU-HKM de Cotonou

Introduction : Le but de ce travail est d'évaluer l'état martial des hémodialysés du CNHU-HKM de Cotonou. Patient et Méthodes : Il s'agit d'une étude transversale à visée descriptive et analytique, réalisée en janvier 2017 dans l'Unité d'Hémodialyse du Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA (CNHU-HKM). Ont été inclus, les patients hémodialysés chroniques, en dialyse de plus de 3 mois et âgés d'au moins 18 ans, sans pathologie intercurrente et non hospitalisés dans les 4 dernières semaines. L'évaluation de l'anémie a porté sur l'hémoglobine (g/dl), la ferritinémie (ng/ml) et le coefficient de saturation de la transferrine (CST). L'analyse des données a été faite au moyen des logiciels Excel 2013 et SPSS ver 8.0. Résultats : Au total, 190 hémodialysés ont été retenus, l'âge moyen était de 48,81±12.7 avec un sex-ratio de 1,71 et une ancienneté en dialyse de 68,25± 59,5 mois. Le taux moyen d'hémoglobine était de 8,6 ± 1,8 g/dl avec une ferritinemie moyenne de 1056,60± 1388,60 µg/l. La prévalence de l'anémie était de 91,6%. Parmi les patients, 23,7% avaient une ferritinemie entre 300 et 500 ng/dl et 66,8% avaient une ferritinemie élevée. Le CST était bas chez 69 patients soit 36,3% .Tous nos patients étaient sous EPO 4000 ui/semaine et la pluspart ont une supplémentation en fer. Discussion et Conclusion: Le pourcentage de nos patients répondant aux recommandations concernant l'anémie chez les hémodialysés est strictement inferieur aux données de la littérature. La ferritinemie de la moyenne de nos patients est supérieur aux normes, ce qui pourrait les exposer aux complications d'une surcharge ferrique

Profil épidemiologique de la maladie rénale chronique dans le service de néphrologie du CNHU-HKM de Cotonou

Introduction : La maladie rénale chronique (MRC) constitue un problème majeur de santé publique. Le but de ce travail est d'étudier le profil épidémiologique de la maladie rénale chronique dans la clinique universitaire de néphrologie et d'hémodialyse du CNHU-HKM de Cotonou. Méthodes : Il s'agissait d'une étude rétrospective descriptive qui porte sur tous les patients hospitalisés ou suivis en consultation externe sur une période allant du 1er janvier 2010 au 31 décembre 2014 soit 5 ans. Etaient inclus dans l'étude, les patients des deux sexes âgés de plus de quinze (15) et présentant une MRC définie par un débit de filtration glomérulaire inferieur à 60ml/min/1,73m2 sur trois (3) mois et/ou un des marqueurs d'atteinte rénale persistant au-delà de trois (3) mois. La collecte des données a été faite par un dépouillement des dossiers à l'aide d'un questionnaire établi. Résultats : Au total 820 cas de MRC ont été retenus. La moyenne d'âge des patients était de 47 ± 15 ans. La sex-ratio était de 1,8, la profession artisanale représentait 41,2% suivis de commerçants à 29%. La MRC représentait 91% des admissions. Le stade 5 de l'insuffisance rénale chronique terminale était observé chez 78% des patients. Les principales étiologies étaient dominées par HTA 75%, diabète sucré 15% et glomérulonéphrite chronique (GNC) 4%. Conclusion : La prévalence de la MRC est très élevée dans le service. Le diagnostic précoce et la prise en charge adéquate de HTA, diabète et GNC sont nécessaires

Quality of life of hemodialysis patients in Togo: A single-center study on 64 hemodialysis patients at the Sylvanus Olympio University Hospital in Lomé, Togo.

This study aims at assessing patients' quality of life during hemodialysis (HD) and determining influencing factors. This prospective study was conducted over a three-month period (December 1, 2012-February 28, 2013) at the Sylvanus Olympio University Hospital (CHU-SO) HD unit, the only center to provide such services in Togo. Respondents used the standard Medical Outcome Survey-Short Form 36 questionnaire. This study was conducted on 64 patients (44 males and 20 females = M/F ratio 2.2). Mean patient age was 45.51 ± 14.00 years old with the vast majority in the 16-44-year-old group (90.82%), and mean dialysis vintage was 2.84 ± 2.37 years (1 month to 9.5 years). The mean global quality of life score was 35.58 (standard deviation ± 15). Quality of life physical score and mental score were, respectively, 31.84 and 40.64. Physical limitation scores were 15.23, followed by general ill-health score 37.38 and poor physical function score 47.37. Mental limitation score was 30.20 and vitality score was 43.75. The quality of life was inversely proportional to patient age and the dialysis vintage, with female quality of life scores worse than male in all questionnaire parameters. Togolese dialysis patients suffer from poor quality of life. Factors underlying such poor quality of life include advanced age, female gender, long-standing history of dialysis, and patient profession.

Polykystose renale autosomique dominante (PKAD) au CNHU-HKM de Cotonou: profil épidémiologique, clinique, biologique et intérêt du dépistage familial

Introduction: Étudier le profil épidémiologique, clinique et paraclinique de la PKAD chez des patients diagnostiqués au CNHU de Cotonou et évaluer l'intérêt d'un dépistage chez les patients à risque. Méthodes: Il s'agit d'une étude transversale comportant une revue de dossiers des patients cliniquement diagnostiqués PKAD à la clinique universitaire de néphrologie et d'hémodialyse du 1er janvier 2000 au 31 janvier 2011, et une enquête familiale chez les patients où le diagnostic de PKAD a été confirmé entre le 1er février et le 31 Août 2011.Un séquençage à la recherche de mutations dans les gènes de la Polycystine 1 et 2 a été réalisé chez les cas index. Résultats: L'incidence hospitalière de la PKAD était de 7,8 cas par an. Le dépistage familial avait permis d'examiner 99 membres de 22 familles et de confirmer 14 cas de PKAD. L'âge moyen des patients était de 45,6±12,8ans. Le signe physique le plus fréquent était l'hypertension artérielle (HTA (83%). Une insuffisance rénale chronique était observée dans 75% des cas. Le séquençage direct avait permis de mettre en évidence 7 nouvelles mutations dont 02 mutations dans les gènes PKD2 et 5 dans PKD1. Conclusion: La PKAD relativement fréquente, présente de nouvelles mutations chez les patients diagnostiqués au CNHU de Cotonou. Le conseil génétique est particulièrement indiqué dans les familles où la maladie rénale a débuté précocement

[Means of communication for an early detection of diabetic nephropathy among the diabetics followed in the academic hospital of Cotonou]. / Moyens de communication en vue du dépistage précoce de la néphropathie diabétique chez les diabétiques suivis à l'hôpital universitaire de Cotonou.

The purpose of this study is to determine the level of knowledge and the means of communication for early detection of diabetic nephropathy. This is a prospective study which took place from 6 February to 31 May 2012, in the Academic Clinics of Nephrology-Hemodialysis and the Endocrinology and Metabolic Diseases. Included all patients with diabetes mellitus in two sexes, older than fifteen years and hospitalized in one of these two clinicals or received in consultation during the study period. A questionnaire is used for data collection. Statistical analysis was performed by STATA 11(®) in its English version. One hundred and sixty patients were enrolled. More than 4 out of 5 patients had reported knowledge of diabetes mellitus while only 26.67% had acknowledged that manifests itself by high glycemia. More than half of the patients (57.50%) had said that diabetes mellitus can be complicated by renal impairment. Three out of four diabetics (75.63%) didn't know that it is possible to make an early diagnosis of diabetic nephropathy. The radio and television broadcasts, and sensitizations during medical consultations represented the best means of communication for early detection of diabetic nephropathy. The combination of several means of communication will raise awareness on early detection of diabetic nephropathy.