Evaluation de la satisfaction des accouchées du service de gynécologie obstétrique du Centre Hospitalier Départemental du Borgou de Parakou (Bénin)

Introduction : La satisfaction des patients est une composante essentielle de la qualité des soins. Cependant, l'évaluation de la satisfaction est une pratique presque inexistante dans les établissements de santé au Bénin. L'objectif de cette étude était de mesurer la satisfaction des bénéficiaires de l'offre de soins lié à l'accouchement au Centre Hospitalier Départemental du Borgou (CHD-B).Patientes et méthodes : nous avons réalisé une étude transversale à visée descriptive et analytique du 2 juin au 15 septembre 2014. Elle a concerné 180 accouchées, recrutées de façon systématique avec un pas de sondage égale à 2. Les données ont été collectées grâce à des entrevues individuelles associées à l'exploitation des dossiers des patientes. Résultats : Le taux de satisfaction pour l'accouchement en général a été de 73,89%. Ce taux était plus élevé en cas d'accouchement par césarienne (78,05%) que par voie basse (68,37%). Les patientes ont été satisfaites de l'accueil (78%), du délai d'attente aux urgences (87,83%) et de la régularité des soins (74%). Par contre elles ont été insatisfaites des conditions de séjour (47,32%), de la restauration (53,09%) et de la prise en charge de la douleur (35,9%). Les accouchées disent n'avoir pas été informées sur leur état de santé (66,67%) ni sur celui de leur enfant (68,33%). Les facteurs associés à la satisfaction des accouchées ont été la parité, le niveau intellectuel et socio-économique et les interventions par voie basse. Conclusion : Les patientes étaient satisfaites des soins liés à l'accouchement au CHD-B. Il a été possible d'identifier certains facteurs qui influencent la satisfaction des accouchées

[Study of factors influencing hepatitis B immunization coverage in 1 to 8-years-old children in the Ouidah health district in Benin in 2007]. / Etude des facteurs influençant la couverture vaccinale contre l'hépatite B chez les enfants de 1 à 8 ans dans la zone sanitaire de Ouidah au Bénin en 2007.

Hepatitis B is a major public health problem in Africa. The estimated prevalence in Benin is between 5.2% and 8.3%. Since 1992, the WHO has recommended immunization of all children between 0 and 12-months-old all around the world. Benin has been vaccinating children from 0 to 11 months since 1999. The purpose of this study was to identify factors influencing hepatitis B immunization coverage in children from 1 to 8-years-old in the Ouidah health district. This descriptive and analytical cross sectional study was carried out from October 25 to 31, 2007. The primary study targets were children from 1 to 8 years. Secondary targets were mothers and healthcare workers. A three-degree cluster sampling technique was used. Hepatitis immunization coverage was 72.2% (95%CI, 65.4 - 78.3). The negative factor influencing coverage in children was age over 5 years reflecting the absence of catch-up sessions for untargeted children overlooked for hepatitis B immunization. The negative factor in mothers was age over 30 years pending multivariate analysis that was not performed in this study. Regarding healthcare workers, understaffing was noted at this level of the health system. Hepatitis B immunization coverage in untargeted children was lower than in children between 0 and 11 months. In 2007, hepatitis B immunization coverage in the Ouidah health district was lower in untargeted children than children of 0 to 11 months. This study showed that immunization coverage decreased with age, thus underlining the need for catch-up sessions to ensure hepatitis B immunization in high prevalence areas.

[Surveillance system for Buruli ulcer in Benin: results after four years]. / Mise en place d'un système de surveillance de l'ulcère de Buruli au Bénin: point de 4 années de surveillance.

Infection by Mycobacterium ulcerans, commonly known as Buruli ulcer (BU), is an emerging infectious disease in some African countries, including Benin. A national BU control program has been organised since 1997. One of its main objectives is to organise a system of BU surveillance, based on the BU02 data collection form developed by the World Health Organization. This surveillance system has allowed the National BU program to collect suitable data for more than 3,793 patients. This article assesses data collection in Benin and demonstrates its suitability and high quality.

[Air pollution in urban area in Cotonou and Lokossa, Benin]. / Pollution atmosphérique en milieu urbain a cotonou et a Lokossa, Bénin.

In some African countries, time of clean environment with no air pollution belongs to the past. From now on, pollution is a problem of public heath in addition to malnutrition and infectious diseases still badly controlled. The sanitary consequences induced by pollution is now a cause for concern in the population. Yet, very few data are available to develop awareness of the population and convince the authorities to implement urgent policy in order to put a brake on the phenomenon. The objective of this document aims at describing the atmospheric pollution recorded in Cotonou and Lokossa as well as possible symptoms linked to exposure of pollutants of the population. Therefore we carried out a transversal study in the city of Cotonou and Lokossa (125 kilometers from Cotonou). Air samples were taken at crossroads levels and motorbikes to measure the different chemical components, 400 taxi drivers were questioned on symptoms affecting them. The toxicological analysis of air and blood sample is carried out at the laboratory of the Université Libre in Brussels. The data analysis revealed a high pollution in Cotonou. The carbon monoxide concentration varies from 26 ppm to 38,6 ppm in the morning and increases in the afternoon (58 to 78,6 ppm). Benzene is found with an average of 7,2 micro/m3 in Cotonou. These concentrations are not so high in the town of Lokossa (carbon monoxide from 45 to 51ppm). In Cotonou motorbike taxis account for 90% of the cases with intoxication symptoms 1,5 time higher than in the non-drivers of these motorbikes. The symptoms recorded on statement are intoxication disorders such as conjunctival hyperemia (18%) among which 12% of lacrimation, respiratory disorders (23%). On the other hand, registered disorders were not so important in Lokossa: conjunctival hyperemia (5,6%), nausea (32%) and other signs as sight disorders (4%). The disorders frequency in non drivers is not so high in Cotonou and Lokossa. In the blood test, the Hbco rate is abnormal in more than 66% of the drivers. The authors suggest the regular checking of imported secondhand cars, measures to reduce exhaust emissions and the reinforcement of the law on air pollution as well as a proper management of crossroads.

[Epidemiological aspects of snakebites in Benin]. / Aspects épidémiologiques des morsures de serpent au Bénin.

Among rural environmental health emergencies, snakebite was common in villages community and agriculture activities. Their frequency and fatal complication depend on the venomous character of the species and the lack of early treatment. The aim of this work was to describe some epidemiological aspects of the snakebites and to suggest preventive strategies to avoid complication. So, we conducted a retrospective survey using health centre data of the statistic office of MOH from 2000 to 2002. During the three years, 10,954 cases were notified with an annual total average of 3,651 bites with 158 for kid's average. The wounded distribution indicated more wounded male than female (sex-ratio = 2:1), with a yearly rising trend in adults. Fatality rate was 0.94% in 2001 and rose to 1.57% in 2002. Fatality rate was higher in kids (1.67%) than in adults (1.08%). According to the ecological environment northern provinces were more exposed (71.6%) than central and south areas. But in central area, fatality rate was higher (1.05%) than in others (0.80%). Based on these findings, authors suggested the training of caregivers in rural health centre on earlier treatment, community training on snakebite primary health care and implementation of snakebite register

[Diagnostic value of tegument pallor in anemia in pregnant women in Benin]. / Valeur diagnostique de la pâleur des téguments dans l'anémie chez les femmes enceintes au Bénin.

Anemia in pregnant women is a common and severe public health problem encountered in developing countries. Its detection is most often based upon clinical examination and observation of conjunctive pallor; however, little is known or documented on the performance indicators of this clinical method in Africa. This work aims assess the value of performance indicators in detecting moderate and severe anemia by means of tegument pallor examination in a maternity ward in rural Benin. To this end, 480 pregnant women were recruited at random during their prenatal visits to a rural maternity clinic. Two independent observers had noted conjunctive or other forms of teguments in all of the women selected, and a concentration of hemoglobin was confirmed by a blood test. An analysis of the results indicated that 67.4% of pregnant women were biologically anemic (Hb < 11.0 g/dl) while only 49% among them were clinically anemic. The sensitivity of the clinical observation method for conjunctive pallor is 87.5% for severe anemia and 74% for moderate anemia. Its positive predictive value is 62.5% for moderate anemia and very weak for light cases of anemia, at only 3%. The accuracy of this clinical method varies from 51-71%, when the likelihood is determined as 1.8 to 2.3. Its reproducibility appears equally weak and clinical observer variability seems to be poor to fair agreement at k = 0.34 (p = 0.00). For practical reasons, the authors suggest the strengthening of the teaching of this method to obstetrics' care providers and medical students in training in order to improve its more effective use and practice in rural maternity units without laboratories.

[Utilization of health services by mothers of children with fever in the south of Benin]. / Utilisation des services de santé par les mères des enfants fébriles au sud du Bénin.

In spite of preventives activities, malaria remained the most murderess tropical disease at less 5 years old child in Benin. However, few mothers in rural middle used modern cares services when their child are feverish. This paper aims to selected risk factors associated to the under-utilization of care services in child fever situation in Benin. We conducted a cross sectional study including 360 mothers recruited randomly in villages. From 76% of feverish child counted two last weeks preceding the survey, 6% of them used, in first intention, health centers. Relatives of the others child preferred self-medication (leaves infusion or drogues bought without medical prescription) despite their perception of child malaria fever severity. Multivariate analysis selected: expensively cares (OR = 1.47 IC = 0.95-2.25), mothers's perception (OR = 1.22 IC = 0.72-2.07), husband decision (OR = 1.59 IC = 1.36-1.91), inappropriateness of work schedules of the health services (OR = 3.19 IC = 1.41-7.02) and traditional relatives practices (OR = 1.31 IC = 1.00-1.68). After discussion of methodological limits, authors suggested reinforcement of the awareness of relatives on advantages of precocious modern cares, appropriate work schedules for rural population and promotion of the insecticide-impregnated bed nets for child.

Recovery time of independent poststroke life habits: Part II.

The purposes of this study were to determine the time of the recovery of poststroke life habits and to identify prognostic indicators associated with recovery time among stroke patients in a rehabilitation program. A sample of 421 stroke patients who were admitted to a rehabilitation center was recruited from medical records available from January 1987 to December 1992. The relation between the achievement of independent life habits including bed mobility, transfers and ambulation, bathing activities, dressing activities, eating activities, home activities, sphincter control, and sleep with the potential covariates associated with recovery time was assessed through the analysis of survival data using the Cox maximum-likelihood proportional hazard models. The poststroke life habits obtained generated mean recovery times ranging from 5.51 to 57.60 days from admission to rehabilitation. The survival analysis revealed that the recovery time of the selected poststroke abilities was significantly influenced (p <.05) by one or several indicators; these included physical ability and neuropsychological and life habit characteristics. With this precious information, stroke rehabilitation specialists may be able to reduce the length of time required to recover independent poststroke life habits by treating the specific neuropsychological, physical, and life habit characteristics identified in this study. A faster poststroke recovery would reduce the socioeconomic impact generated by stroke disability and would also ensure a better quality of life to the stroke survivor.

Recovery time of independent poststroke abilities: Part I.

The purposes of this study were to determine the time of the recovery of poststroke abilities and to identify prognostic indicators associated with recovery time among stroke patients undergoing a rehabilitation program. A sample of 421 stroke participants admitted to a rehabilitation center was recruited from medical records that were available from January 1987 to December 1992. The mean age was 61.8 years (range, 17-89 years). The relationship between the achievement of independent poststroke abilities and the potential covariates associated with recovery time was assessed through the analysis of survival data. Cox maximum-likelihood proportional hazard models were used for the analysis. Independent poststroke abilities included behavior, cognitive, perceptual, communication, visual, and motor status. The time from rehabilitation admission to complete independence was introduced to the model in relation to the covariates. The mean time of recovery of poststroke abilities ranged from 18.70 to 32.40 days from the rehabilitation admission. The survival analysis revealed that the time of recovery of the selected poststroke abilities was significantly influenced (p <.05) by one or several factors, among these were neuropsychological, physical, and life habits. With this precious information, stroke rehabilitation specialists may be able to reduce the length of time required to recover independent poststroke abilities by treating the specific neuropsychological, physical, and life habit characteristics identified in this study. A faster poststroke recovery will reduce the socioeconomic impact generated by stroke disability and will ensure a better quality of life to the stroke survivor.

[Factors associated with low birth weight: a multivariate analysis]. / Facteurs associés à la naissance des enfants de faible poids: une analyse multivariée.

The low birth weight of infants is a major public health problem of unknown cause in Benin. We recruited 4,213 pregnant women from a maternity ward in Cotonou for a prospective study. The women were interviewed and further information was obtained from their maternity records. The women were followed until delivery. We found that 6.9% of the births occurred pre-term and there was intrauterine growth retardation in 10.9% of cases. Multiple regression analysis showed that the risks of giving birth to underweight infants were highest for women who were themselves underweight, who had complications due to bleeding or malaria or had social and psychological risk factors. For these particular women, unwanted pregnancy (ORa = 1.60; CI = 1.30-2.00) and lifting heavy loads (ORa = 1.30; CI = 1.10-1.60) were high risk factors. However, adequate prenatal care (ORa = 0.85; CI = 0.69-0.99) and having given birth before were protective factors, reducing the likelihood of a low birth weight. These results have implications for preventive care, in terms of nutrition during pregnancy and psychosociological factors.

[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.

[Prevalence of induced abortions and family planning in Benin]. / Prévalence des interruptions de grossesse et de la régulation des naissances au Bénin.

OBJECTIVE: Our purpose was to determine the extent of induced abortion as a practice of family planning. STUDY DESIGN: Benin regional public and private records from 1990 to 1994 were used to examine frequencies of induced abortion and contraceptive utilization and describe trends. Descriptive statistics such as variation coefficient and chi 2 were use to compare inter-regional prevalence. RESULTS: Prevalence of induced abortion was 1.5/1000 delivery and that of contraceptive use 11.4/1000. From 1990 to 1994 prevalence of induced abortion and of contraceptive use increased significantly (p < 0.05). Similar trends were observed for inter-regional contraceptive use. CONCLUSION: Findings suggest that increasing use of contraceptives did not lead to decreased induced abortion prevalence in Benin. They may help decision makers to reinforce sensibilization about the danger of induced abortion.

[Epidemiological portrait of acquired immunodeficiency syndrome and its implications in Benin]. / Portrait épidémiologique du syndrome d'immunodéficience acquise et ses implications au Bénin.

The HIV/AIDS threat continues in African countries, including the Republic of Benin, during this period of economic crisis which is accentuated by the devaluation of the currency. National statistics from the Ministry of Health indicate a progression of the number of cases seropositive for HIV and the number of cases developing AIDS. Concomitantly, we observe a decrease of the number of teenagers fearing HIV infection and a spread or risky sexual behavior, such as unprotected sex. Despite the weak prevalence of HIV infection in Benin, the increase of the number of cases with AIDS remains a serious social problem. This paper describes the epidemiological pattern of AIDS and its social, demographic and economical implications as they affect the current national program to increase the awareness of the problem. We obtained scientific information on the epidemiological chain of AIDS morbidity from prior research results, data from the disease control centers and interviews with the parents of some patients. Quantitative data was collected from twenty selected disease control centers of the national program against AIDS from 1986 to 1995. We compared these data with data obtained by the WHO from 1986 to 1992 from the neighboring countries of Benin. We observed an exponential growth of the cumulative number of AIDS cases, from one declared case in 1985 to 1,280 cases in 1995, including twenty thousand cases seropositive for HIV in 1991. The majority of cases were people between 20 and 49 years old and were predominantly males. Heterosexual (73%), homosexual (0.8%), and mother to child vertical transmission were the principal modes of transmission registered for carriers of HIV-1, HIV-2, or both. The qualitative study revealed a social situation dominated by verbal violence against infected women, absenteeism at work of the patients' family and, friends and a psychological impact on the children of the patients. An evaluation of the direct costs of AIDS was estimated to be $217,600 (US $) for the 1,280 reported cases. We suggest further reinforcement of the program to raise the awareness of the young people in the urban and rural areas of the country.

[Birth intervals and birth of low weight infants in Benin]. / Intervalles inter-grossesses et naissance des enfants de faible poids au Bénin.

Low birthweight is a public health problem in Benin but its etiology remains unclear. Studies in industrial countries suggest several risk factors including the interval between pregnancies or child spacing. The purpose of this cohort study was to assess the relationship between pregnancy interval and low birthweight in Benin. Data were collected from a total of 2,862 multiparous pregnant women randomly recruited in 1991 at the time of their first prenatal care visit to maternity units in Cotonou, Benin. Sociodemographic information and obstetrical history were obtained by interviewing the mother and reviewing delivery records. About 15% of the women recruited delivered low birthweight children. The relative risks of preterm birthweight and intrauterine growth retardation was calculated in function of three pregnancy intervals: less than 12 months, 12 to 23 months, and 24 to 34 months. It was 1.31 (1.00-1.75), 1.00 (0.70-1.02)) and 0.77 (0.60-0.87) respectively for preterm birthweight and 1.27 (1.03-1.64), 1.17 (0.79-1.39) and 0.79 5 (0.57-0.87) respectively for intrauterine growth retardation. Logistic regression analysis taking into account sociodemographic factors and previous obstetrical history did not show a significant correlation between pregnancy interval and preterm low birthweight or between pregnancy interval and intrauterine growth retardation. Maternal nutritional status, maternal age, number of previous births, and education level were correlated with low birthweight.

[Is there a relationship between a history of spontaneous abortion and low birthweight in Cotonou (West Africa)?]. / Existe-t-il une relation entre l'antécédent de fausse couche spontanée et les naissances de petit poids à Cotonou (Afrique de l'Ouest)?

In Benin, as in other African countries, low birthweight infants is a major health problem with poorly understood causes. In a case-control study of 2114 mothers recruited before discharge from the "Lagune" maternity ward at Cotonou, we examined the relationship between spontaneous abortion and low birthweight infants in women who delivered between 15 June 1990 and 20 July 1991. Information was obtained by interview then on the basis of hospital files. The results indicated that there was no association between spontaneous abortion and premature birth: OR = 1.00 (95% CI = 0.61-1.56). Likewise, the relationship between a past history of spontaneous abortion and intrauterine growth retardation was not significant: OR = 1.19 (95% CI = 0.83-1.71). Adjustment with characteristics of the mothers did not improve the correlations. It is concluded that there is no relationship between a past history of spontaneous abortion and low birthweight.

PIP: Researchers analyzed data on 2114 mothers who delivered at Lagune Maternity Hospital in Cotonou, Benin, to examine the relationship between premature birth, intrauterine growth retardation (IUGR), and history of spontaneous abortion. There was no statistically significant correlation between premature birth and history of spontaneous abortion (odds ratio [OR] = 1). Initiation of prenatal care after the first trimester was significantly associated with an increased risk of premature birth (OR = 1.27). There was no statistically significant correlation between term IUGR births and history of spontaneous abortion (OR = 1.19), even if a woman had a history of habitual abortion (OR = 1.22). Maternal weight less than 50 kg and initiation of prenatal care beyond the first trimester were associated with an increased risk of a term IUGR birth (OR = 1.75 and 1.27, respectively). These results indicate that a history of spontaneous abortion does not increase the risk of low birth weight whether it be caused by premature birth or IUGR.

[Pregnancies complicated by hemorrhage and birth of low birth weight infants in Cotonou (Benin)]. / Grossesses compliquées d'hémorragie et naissances d'enfants de faible poids à Cotonou (Bénin).

The effect of bleeding during pregnancy on the outcome remains unclear. Nevertheless, some of these pregnancies go to term, raising the question of the effects on the new-born infant. The data concerning a possible correlation with low birth weight are ambiguous. Furthermore, there are few studies of this issue in developing countries. We studied 2168 women giving birth to single children chosen at random in two maternity services in Cotonou (Benin) in 1990. Data was collected by two trained midwives interviewing the women and from the medical files 24 hours after delivery. One hundred and thirty seven mothers (6.2%) reported bleeding during pregnancy. Multivariate statistical analysis indicated that this was associated with preterm birth of low birth weight infants: OR = 4.09 (2.2-7.6) for bleeding during the first trimester, OR = 2.29 (1.1-6.9) during the second and OR = 4.79 (2.1-11.9) during the third. Only bleeding during the third trimester correlated with a significant retardation of intrauterine growth [OR = 2.33 (1.4-7.3)] according to model fitting. Thus, despite possible bias in this retrospective study, bleeding during pregnancy appears to be a predictor of low birth weight in Cotonou (West Africa).

[Incidence of and factors associated with primary cesarean section in Benin (Africa)]. / Incidence et facteurs associés à la césarienne primaire au Bénin (Afrique).

Among 3225 deliveries in two Cotonou public maternity units, 244 primary cesarean section were observed during July 1988 to December 1989. Primary cesarean section incidence varied according to indications, maternal parity and maternity care units. Foetal distress (65.9%), malpresentation and cephalopelvic disproportion (22.1%) were the dominant organic risk factors for the primary cesarean section. Multivariate stepwise logistic regression technique indicated that the most important indications for the practice in Cotonou were mainly organic risk factors, maternal height and parity as well as repeating stillborn history. Practician experiences (OR = 6.6) and foetal distress (OR = 9.3) in the decision making process were highly associated to cesarean section and differed between maternity units. Authors provided some suggestion for improving the practice of cesarean section in Cotonou and in Bénin.

[Acquired immunodeficiency syndrome (AIDS): knowledge and fear of contagion in nursing students during their hospital training]. / Syndrome d'immunodéficience acquise (SIDA): connaissances et peur de contagion des élèves infirmiers lors des stages hospitaliers.

The authors report the transversal investigation results of 115 male and nurse students of Cotonou on their AIDS knowledge, AIDS prevention, and their attitudes toward HIV infected patients. 98% have a good knowledge of AIDS. 55% utilize condom. 77% give to their fear of contagion during their in Service training for the care of HIV infected patients. The authors conclude for AIDS education reinforcement in school of nursing.

PIP: In July 1991 in Benin, a survey was conducted among 115 female and male nursing students aged 20-38 during their in-service training at the university hospital in Cotonou to determine their knowledge of HIV infection and prevention, their attitude toward HIV/AIDS, and their behavior. 98% knew actual routes of HIV transmission. 67.8% knew that HIV is sensitive to heat outside of the body and that it is not sensitive to fever in HIV positive individuals. 23.4% thought that HIV positive persons should be quarantined. 62.6% knew that HIV positive persons would develop AIDS. More than 80% asserted that they were strongly exposed to HIV infection at the AIDS Patient Care Services. Age at first intercourse ranged from 10 to 34 years (mean, 18.07 years). Men were more likely to have multiple partners than women (35% vs. 5%). 55.7% of nursing students regularly used condoms, especially among male students (p 0.05). 68.7% of nursing students wanted to undergo HIV testing. The remaining students did not want an HIV test for fear of a positive test inciting a suicidal attempt. 77.4% were afraid that they would find themselves infected during their practical training. The multivariate analysis showed that fear of becoming infected with HIV increased as the knowledge level fell. Lack of confidence to ask one's partner to use a condom had the most effect on fear of HIV infection (odds ratio [OR] = 7.47). Another strong factor was insufficient information on HIV infection (OR = 5.63). These findings suggest that the sexual behavior of the nursing students put them at higher risk of HIV infection than working with AIDS patients. They highlight the need to include HIV/AIDS education in the nursing curriculum.

[Evaluation survey of the acceptability of the condom in Benin (Come district)]. / Enquete d'evaluation de l'acceptabilite du preservatif masculin au Benin (district de Come).

PIP: 250 males aged 15-50 years in the district of Come, Benin, were surveyed in March 1989 for this study of the acceptability of condoms. The survey was part of a program to improve AIDS-prevention strategies. The district of Come is located on an important international highway near the border with Togo. The adolescent population is large and sexually active. The questionnaire was self-administered by respondents literate in French and was administered by interviews for illiterate respondents. The sample was systematically selected from electoral and secondary school lists. Among the 246 respondents completing the survey, 54.4% were married, 43.9% were single, and 1.63% were divorced. 255 of subjects reported having had acute urethritis of venereal origin at least once during the 2 years preceding the survey. 100 reported using some means of protection during intercourse and 146 (59.3%) did not. Only 6 of the 246 had not been informed of the protective benefits of the condom. Among the 146 not using any protection, 24 cited as the reason decrease of pleasure, 20 difficulty of acquisition, 6 lack of knowledge of condoms, 10 belief that the partner was healthy, 4 fear of condom failure, and 82 no reason. 88 of the 100 reporting they used protection used condoms alone or with spermicide. The others used spermicidal creams such as Neo-Sampoon. Among the 88 using condoms, 22 did so regularly, 20 from time to time, and 46 rarely. 14 of 46 single men and 8 of 40 married men reported using condoms regularly. 77.2% of the condom users had secondary educations and 15.9% had university educations. 76 of the 88 experienced annoyances during condom use, with 23 citing lack of contact with the partner, 17 decreased experienced tearing of a condom, 4 developed infections despite condom use, and 2 complained of the frustration of their partners because of delayed ejaculation. 30% obtained their condoms in pharmacies and 70% did so at family planning or health centers.^ieng