[Assessment of antibiotics prescribing for outpatients in Cotonou, Benin]. / Evaluation de la prescription des antibiotiques en médecine ambulatoire à Cotonou, Bénin.

The objective was to study antibiotics prescribing in Cotonou health care centres. This prospective study was conducted in two phases. The first consisted in collecting antibiotics prescriptions. In a second phase, the prescriptions were submitted to 4 experts who assessed the correctness of the prescribing. Out of the 588 prescriptions that could be analysed, 173 (29.4%) were correct The quality of the prescribing seems to depend only on the pathology but not on the nature of the basic training of the prescriber

Bulk staining of smears: no demonstrated risk of bacilli transfer from a positive to a negative smear.

Despite a theoretical risk of transfer of bacilli from a positive to a negative smear, bulk staining is routinely performed in many laboratories. To assess this risk in our laboratory, two smears were made from each sputum specimen and stained with auramine: one smear was stained on a rack and the second using the bulk method. Smears were read blind using a fluorescence microscope. A total of 811 sputum specimens were analysed. No acid-fast bacilli transfer was observed even when staining solution jars had not been renewed for 3 days. Bulk staining is rapid and cheap, and could be used in laboratories with a high workload in low-resource settings.

Anti-tuberculosis drug resistance among new and previously treated pulmonary tuberculosis patients in Cotonou, Benin.

OBJECTIVES: To assess the current anti-tuberculosis drug resistance situation in Cotonou, at the largest anti-tuberculosis centre of Benin. METHODS: A total of 470 isolates of Mycobacterium tuberculosis complex from pulmonary tuberculosis (TB) patients were analysed: 244 from new cases and 226 from previously treated cases. Drug susceptibility testing of isolates against first-line drugs was performed using the proportion method. RESULTS: Primary multidrug resistance (MDR) depends on the patients' origin: MDR in new cases is relatively high (1.6%) when all patients are considered, but low (0.5%) and comparable to 1994 national survey results when only patients residing in Benin are considered. MDR in previously treated patients (11.1%) remains comparable to the study performed in Benin in 1994. No relation was found between human immunodeficiency virus co-infection and anti-tuberculosis drug resistance. CONCLUSION: This study shows the great importance of correct patient identification in epidemiological surveys, where results may vary according to the population(s) studied.

[Clinical and immunological profile of HIV infected patients in Cotonou, Benin]. / Profil clinique et immunologique des patients infectés par le VIH dépistés à Cotonou, Bénin.

OBJECTIVES: This study had for aim to identify the clinical status and the level of immuno-deficiency of HIV-infected patients on their first visit. METHODS: One hundred and thirty-six HIV+ patients were prospectively evaluated from November 1, 2001 to May 31, 2002. RESULTS: One hundred and thirty-four were infected with HIV1 and two with HIV2. The mean age on the first consultation was 37 +/- 2 years. The m/w sex ratio was 0.9. 46.3% were stage C. The main clinical symptoms were: weight loss (88%), fever (80%), cough (71%), diarrhea (51%). BMI was normal in 70% and KI > or =80% in 57% of the cases but immuno-deficiency was severe with CD4 cells count <200 per mm3 in 69%. The main diseases were digestive candidiasis (53%), pneumonia (18%), tuberculosis (12%), non-determined pneumonia (29%), prurigo (20%), zona (16%), cryptosporidiosis (4%), cerebral toxoplasmosis (3%), and Kaposi's sarcoma (1%).

[Epidemiological observations on the first case of human paragonimiasis and potential intermediate hosts of Paragonimus sp. in Benin]. / Observations épidémiologiques sur le premier cas de paragonimose humaine et les hôtes intermédiaires potentiels de Paragonimus sp. au Bénin.

Parasitological investigations were carried out for four months in 1998 in two Beninese centres of pneumo-phtisiology (Akpakpa, at Cotonou, and Akron, at Porto-Novo) to detect the patients harbouring eggs of Paragonimus sp. amongst the persons consulting for tuberculosis and showing a broncho-pneumopathy without mycobacteria. Eggs of Paragonimus sp. were detected in the sputum of a single patient out of 369 persons examined (prevalence, 0.2%). This patient had eaten crabs in the months preceding the date of diagnosis. A treatment using praziquantel has improved clinical symptomatology and biological signs found in this patient. These studies have been completed by visiting markets located in the coastal plain of Benin to identify the crabs that were sold and to find metacercariae of Paragonimus sp. Negative results were obtained when 126 Cardisoma armatum ("hole crab") were dissected. In contrast, the dissection of 176 Callinectes marginatus ("swimming crab") was successful, with 5% of crabs harbouring metacercariae of probably Paragonimus sp. Further studies are necessary to confirm these first results and to determine the global prevalence of Paragonimus infection in these definitive and intermediary hosts.

[Antibiotic sensitivity of gram negative bacilli isolated from urinary tract infections at NUHC of Cotonou (Benin) from March to December 1992]. / Sensibilité aux antibiotiques de bacilles a gram négatif isolés d'infections urinaires au CHNU de Cotonou (Bénin) de mars à Décembre 1992.

Eleven antibiotics were tested against 1,194 Gram negative bacilli isolated from urinary tract infections at the National University Hospital Center at Cotonou. Among the betalactams tested, only cefotaxime remained active against most of the bacteria tested: 90% of the strains of Escherichia coli and 75% of the strains of Enterobacter cloacae were sensitive. Ampicilline, on the other hand, had lost its activity even on strains which are usually the most susceptible. Thirteen percent of the E. coli strains were sensitive. This reduction in antibiotic activity against bacterial strains in Cotonou, which concerned to various degrees the tetracyclines, chloramphenicol, cotrimoxazole, is less pronounced for the amino-sides (gentamicine and netilmicine), and the quinolones of which nalidixique acid was active against 83.9% of the strains of E. coli. The low frequency of isolation of wild type strains (sensitive to betalactams) is probably the consequence of strong selection pressure due to a massive, and uncontrolled use of antibiotics in Cotonou.

[Bacteriological aspects of cholera in Benin (epidemic of 1991)]. / Aspects bactériologiques du choléra au Bénin (épidémie de 1991).

This study showed that the strains of Vibrio cholerae El Tor, Ogawa serotype, isolated during the last cholera outbreak in Benin (1991) are widely sensitive to tetracyclin (84%), sulfamid (96%), ampicillin (98%).

[Seroprevalence of treponematosis among pregnant women in Cotonou (Benin)]. / Séroprévalence des tréponématoses chez des femmes enceintes à Cotonou (Bénin).

A study of frequency of treponematosis among pregnant women in Mother Hood of Zogbo (Cotonou) shows 5.1 +/- 2.8% of positivity with risk of 5% by TPHA and VDRL. The low level of endemicity, associated with the absence of cutaneous lesions of treponematosis in Cotonou may correspond to a syphilis infection. This study points out the necessity to strengthen the struggle against the all other sexually transmitted diseases (MST) in the same way that the HIV infection in Benin.

[Initial resistance to streptomycin, isoniazid, rifampicin and ethambutol in bacillus-laden tuberculosis patients at the National Center of Pneumo-physiology at Cotonou (Benin)]. / Résistance initiale à la streptomycine, l'isoniazide, la rifampicine et l'éthambutol chez des malades tuberculeux bacillifères au Centre national de pneumo-phtisiologie à Cotonou (Bénin).

The authors are reporting results from a study about BK sensitivity among principal antituberculosis drugs in Benin Republic: 81.5% of them are susceptible for all specific antibiotics, 8.5% are offering resistance to INH and Streptomycin together. In this preliminary study no primitive resistance for RMP has been found.

[Rotavirus gastroenteritis in a pediatric service at the National University Hospital Center of Cotonou (Benin)]. / Gastro-entérites à rotavirus en pédiatrie hospitalière au Centre National Hospitalier et Universitaire de Cotonou (Bénin).

The authors are reporting results from rotavirus research in diarrhoeal stools among 220 children under 5 years of age in Cotonou C.N.H.U. (Bénin). Among them, 64 (29%) are rotavirus carriers.

[Mycobacterium fortuitum in a patient with human immunodeficiency syndrome (AIDS) in Benin)]. / Infection pulmonaire à Mycobactérium fortuitum chez un malade atteint du syndrome d'immunodéficience acquise humaine (SIDA) au Bénin.

The authors report a case of Mycobacterium Fortuitum infection in one AIDS patient. This case underlines the interest for the clinicians to investigate systematically a possible infection by Mycobacterium fortuitum in all AIDS patients with pulmonary tuberculosis.