Poly sensibilisation dans le cadre d'un eczéma de contact des mains chez une aide-ménagère dans le nord du Bénin / Poly sensitization in the context of hand contact eczema in a household helper in northern Benin

L'eczéma des mains est fréquent. Son étiologie est souvent multifactorielle comprenant les facteurs environnementaux et des facteurs individuels prédisposants. Il pose des problèmes de diagnostic étiologique en particulier dans un contexte de poly sensibilisation. Observation Il s'est agi d'une employée de maison âgée de 17 ans sans antécédents allergiques connus. Elle a développé un eczéma bilatéral des mains six mois après embauche. Le patch test avec la batterie standard européenne a montré une poly sensibilisation à plusieurs allergènes contenus dans les détergents et désinfectants. Le patch test aux gants est revenu négatif mais n'exclut pas son implication dans la survenue des lésions devant le caractère bilatéral et symétrique des lésions. Une réorientation professionnelle a été proposée devant le jeune âge de la travailleuse Conclusion La connaissance des allergènes en cause au cours d'un eczéma est un atout pour une meilleure prise en charge du patient mais leur identification n'est pas toujours aisée. La réorientation professionnelle lorsqu'elle est possible assure la guérison.

Introduction: Hand eczema is common. Its etiology is often multifactorial, including environmental factors and individual predisposing factors. It poses problems of etiological diagnosis, particularly in the context of poly sensitization. Observation: This case involved a 17-year-old domestic worker with no known allergic history. She developed bilateral hand eczema six months after hiring. The patch test with the standard European battery showed poly-sensitization to several allergens contained in detergents and disinfectants. The glove patch test came back negative, but did not rule out its involvement in the lesions, given the bilateral and symmetrical nature of the lesions. In view of the young age of the worker, a vocational reorientation was carried out. Conclusion: Knowledge of the allergens involved in eczema is an asset for better patient management, but identifying them is not always easy. When possible, professional reorientation ensures recovery

[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.

Dépistage des affections oculaires chez des travailleurs d'une entreprise de télécommunication, Lomé, Togo / NA

Les yeux constituent un organe important dans la mise en oeuvre des activités professionnelles et extraprofessionnelles. Dans le cadre d'une entreprise de télécommunication, il a été constaté une augmentation croissante des problèmes oculaires d'années en années.L'objectif de l'étudeétaitde décrire l'épidémiologiedes affections oculaires en fonction de l'exposition à l'écranchez lestravailleurs d'une entreprise de Télécommunication au Togo. Il s'agissait d'une étude transversale. Une analyse descriptive a été faite en fonction de l'exposition au travail sur écran.Sur les 766 participants inclus, 599 étaient des hommes (78,20%).La prévalence des affections oculaires était très élevée indépendamment de l'exposition au travail sur écran en dehors des conjonctivites.Les principales affections oculaires étaient représentées par: une proportion significativement faible de cas d'amétropie (81% vs 97%) et de cataracte (6% vs 13%) chez les travailleurs exposés par rapport à ceux non exposés à l'exception des conjonctivites (32% vs 23%) qui étaient significativement plus fréquentes chez les exposés au travail sur écran de visualisation que les non exposés. L'âge influençait significativement la survenue de ces pathologies à l'exception des conjonctivites.Les facteurs tels que l'âge et les antécédents médicaux et professionnels des travailleurs devront être pris en compte dans le suivi de l'état oculaire des travailleurs.

The eyes are an important organ in the performance of professional and extra-professional activities. In the context of a telecommunications company, eye problems increase from year to year. The objective of this study was to describe the epidemiology of eye diseases as a function of screen exposure among workers in a telecommunications company in Togo. This was a cross- sectional study. A descriptive analysis was done based on the exposure to screen-based work. Of the 766 participants included, 599 were male (78.20%). The prevalence of eye diseases was very high regardless of exposure to screen-based work outside conjunctivitis. The main ocular disorders were represented by: a significantly low proportion of cases of ametropia (81% vs 97%) and cataracts (6% vs 13%) in exposed workers compared to unexposed workers, with the exception of conjunctivitis (32% vs 23%) which were significantly more frequent in occupational exposures on visual display screens than unexposed workers. Age significantly influenced the occurrence of these pathologies with the exception of conjunctivitis. Factors such as the age and medical and occupational history of workers should be taken into account when monitoring the ocular status of workers.

Statut de travailleur tuberculeux et environnement professionnel, Cotonou, Bénin / NA

Le partage du statut de tuberculose (TB) peut être pour le patient une source de conflit en milieu professionnel en raison de la stigmatisation liée à la maladie. L'objectif de la présente étude était d'évaluer les raisons et les réactions de partage ou non du statut de patient TB en milieu professionnel.Il s'agissait d'une étude transversale descriptive ayant inclus lestravailleurs TB du Centre National Hospitalier de Pneumo-Phtisiologie de Cotonou. Sur les 107 travailleurs inclus, 50% provenaient des petites entreprises privées et 30% du secteur informel. Parmi ceux qui avaient des supérieurs (43/107) ou des collègues (68/107) de service, respectivement 65,1% et 41,2% n'ont pas informé leur supérieur hiérarchique ou au moins un collègue. Les raisons évoquées étaient : crainte d'une perte de l'emploi (40%), peur du rejet (68%).La majorité de ceux qui avait partagé leur statut avaiteu en retour une réaction d'acceptation de la part de leur employeur (86,7 %) et collègues (85%).

Sharing tuberculosis status can be a source of conflict for the patient in the workplace due to the stigma associated with the disease. The objective of this study was to assess the reasons and reactions for and against sharing TB patient status in the workplace. This was a descriptive cross-sectional study that included tuberculosis workers at the National Tuberculosis Center at Cotonou. Of the 107 workers included, 50% came from small private companies and 30% from the informal sector. Of those who had supervisors (43/107) or colleagues (68/107) on duty, 65.1% and 41.2% respectively did not inform their supervisor or at least one colleague. The reasons given were: fear of job loss (40%), fear of rejection (68%). The majority of those who had shared their status had in turn received an acceptance reaction from their employer (86.7%) and colleagues (85%).

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.