Internet addiction, new contemporary reality in Benin: exploratory analysis of associated factors among medical and paramedical students in 2022 / L'addiction à internet, une réalité contemporaine au Bénin : analyse exploratoire des facteurs associés chez des étudiants du secteur médical et paramédical en 2022.

INTRODUCTION: Nowadays, Internet addiction is a major concern due to the growing number of Internet users and the consequences associated with this addiction. PURPOSE OF THE RESEARCH: In this study, we aimed to determine the prevalence of and factors associated with Internet addiction among health sciences students at the University of Abomey-Calavi. METHODS: A cross-sectional study was conducted among 346 students from the Faculty of Health Sciences and the National Institute of Medical and Health Sciences at the University of Abomey-Calavi. Participants were selected using simple random sampling. Internet addiction was assessed using K. Young's "Internet Addiction Test." Logistic regression modeling was employed to explore factors associated with Internet addiction. The strength of the association was assessed using odds ratios; the confidence interval (CI) was 95%; and a p-value < 0.05 in the final model was considered significant. RESULTS: The prevalence of Internet addiction was 31.8% (95% CI: [23.26% - 41.38%]). Factors associated with Internet addiction were the participant's field of study, poor relationships with friends and family, communication difficulties, depression, and psychoactive substance consumption. CONCLUSIONS: Evidence of Internet addiction exists among students in health sciences institutions in Benin. These findings can support the development of prevention and intervention strategies centered on addressing a public health issue that is still insufficiently recognized.

Introduction: De nos jours, l'addiction à Internet est une préoccupation majeure en raison de l'évolution croissante du nombre d'internautes mais aussi de ses conséquences. But de l'étude: Dans cette étude, nous avons déterminé la prévalence et les facteurs associés à l'addiction à Internet chez les étudiants des sciences de la santé de l'Université d'Abomey-Calavi. Méthodes: Il s'agit d'une étude transversale menée auprès de 346 étudiants de la Faculté des sciences de la santé et de l'Institut national médico-sanitaire de l'Université d'Abomey-Calavi. Ces derniers ont été sélectionnés par échantillonnage aléatoire simple. L'addiction à Internet a été mesurée grâce à l'outil « Internet addiction test de Young ¼. Une modélisation par régression logistique a été utilisée pour explorer les facteurs associés à l'addiction à Internet. La force de l'association a été évaluée avec un rapport de cotes et son intervalle de confiance (IC) à 95 % ; une valeur p <0,05 dans le modèle final a été considérée comme significative. Résultats: La prévalence de l'addiction à Internet était de 31,8 % (IC95 % : [23,26 % - 41,38 %]). La filière d'études, les mauvaises relations avec les proches, les difficultés de communication, la dépression et la consommation de substances psychoactives étaient associées à l'addiction à Internet. Conclusions: Il existe des évidences qui montrent l'addiction à Internet des étudiants des institutions universitaires de santé au Benin. Ces évidences peuvent soutenir la mise en place de stratégies de prévention et de prise en charge axées sur la communication autour d'un phénomène encore insuffisamment perçu comme le problème de santé publique qu'il constitue.

Understanding Households' Willingness to Pay for Improved Sanitation Services in Benin: A Study Protocol.

Nowadays, in Benin, latrine construction by households highly depends on their financial contributions. However, empirical evidence shows that many households are unwilling to invest in adequate sanitation services. The study aims to determine the household's willingness to pay for improved sanitation services and the associated factors. The study population will include households lacking unimproved sanitation facilities. The household heads will be eligible for survey participation. We will perform a contingent valuation to determine households' willingness to pay for a Ventilated Improved Pit (VIP) latrine. Following a description of the surveyed population, we will assess willingness to pay using the 'doubleb' command in Stata. Subsequently, we will conduct multivariate logistic regression to determine the factors associated with willingness to pay. The expected results will be: a description of the basic characteristics of households without improved sanitation services, an estimation of household willingness to pay for VIP latrines using the contingent valuation, and factors associated with household willingness to pay for VIP latrines. This study will contribute to the literature on household demand for improved sanitation services in Benin.

Corrigendum: Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa.

[This corrects the article DOI: 10.3389/fpubh.2023.1136299.].

Exploring the association between household access to water, sanitation and hygiene (WASH) services and common childhood diseases using data from the 2017-2018 Demographic and Health Survey in Benin: focus on diarrhoea and acute respiratory infection.

OBJECTIVE: The paper aimed to study the association between household access to water, sanitation and hygiene (WASH) services and the occurrence of diarrhoea and acute respiratory infection among children under 5 years in Benin. DESIGN: We performed secondary analyses using Benin's Fifth Demographic and Health Survey datasets. The dependent variables were diarrhoea and acute respiratory infection (yes=1, no=0). Among the independent variables were the household access to individual WASH services, grouped as follows: 'basic', 'limited', 'unimproved' and 'no service'. Multivariate logistic regression was used to determine the association between household access to WASH services and the occurrence of diarrhoea and acute respiratory infection. Results from the multivariate logistic regression were presented using adjusted Odds Ratios (aORs) with 95% Confidence Intervals (95% CIs). SETTING: Benin. PARTICIPANTS: Children under 5 years successfully surveyed during Benin's Fifth Demographic and Health Survey. OUTCOME MEASURES: Diarrhoea and acute respiratory infection. RESULTS: In the current study, 12 034 children under 5 years met the selection criteria and were included in the analyses. The prevalence of diarrhoea and acute respiratory infection was 10.5% (95% CI=9.8% to 11.3%) and 2.9% (95% CI=2.5% to 3.4%), respectively. Children living in households without sanitation service, that is, practising open defecation (aOR=1.9, 95% CI=1.4 to 2.6), and with unimproved (aOR=1.9, 95% CI=1.3 to 2.7) and limited (aOR=1.5, 95% CI=1.1 to 2.2) services were more likely to have diarrhoea compared with children with basic sanitation services. Household access to WASH services was not associated with acute respiratory infection. CONCLUSION: We suggest reinforcing household access to basic sanitation services to combat diarrhoea in children under 5 years. Further research is needed on the effects of WASH interventions on diarrhoea and acute respiratory infection in children under 5 years.

Understanding the factors of road crash severity in Benin: a matched case-control study.

Background: In Benin, due to the unavailability of comprehensive data on road crashes, road safety policies are mainly based on partial statistics provided by the police. These remain unreliable in terms of injury severity and risk factors. This study aims to determine the factors influencing the severity of injuries after a road crash in Benin. Methods: The present nested case-control study, matched for age and sex, was based on a hospital cohort of road crash victims set up in five hospitals in Benin between July 2019 and January 2020. A sample of severely injured patients according to the Abbreviated Injury Scale (cases) was compared to non-severely injured patients (controls). Results: The severe crash occurred mainly during the night between 8 p.m. and midnight (36.2% of cases vs. 24.4% of controls) and on main roads (57.8% of cases vs. 34.7% of controls). Factors associated with injury severity were the time of the crash: night between 8 p.m. and midnight [Adjusted Odd Ratio (AOR): 2.1; CI 95%: 1.4-3.2], major roads (national interstate roads and national roads) (AOR: 2.8; CI 95%: 2.0-4.0) and non-work-related travel (AOR: 1.8; CI 95%: 1.2-2.7). Conclusions: Factors associated with road crash severity in Benin were night-time, main roads, and non-work related travel. Raising user awareness about compliance with traffic rules and improving public lighting, especially along main roads could help reduce the number of serious injuries.

Effects of the level of household access to water, sanitation and hygiene on the nutritional status of children under five, Benin.

BACKGROUND: Whether or not the Water, Sanitation and Hygiene (WASH) conditions in which children under five live determine their nutritional status is still under discussion. The work aimed to study the effects of household WASH conditions to which children under five are exposed on their nutritional status in Benin. METHODS: The study utilized a cross-sectional design and consisted of secondary analyses using datasets from the fifth Demographic and Health Survey (DHS-V) conducted in Benin. Stunting, wasting and underweight were the dependent variables. The WASH conditions in which children live were evaluated in the immediate environment, i.e., at the level of their households. After describing the study variables, the relationships between the dependent variables and the exposures were checked using multivariate logistic regression. Data analysis was performed with Stata 15 and took into account the survey's sampling design. RESULTS: The prevalence of stunting, wasting and underweight was 31.15% (95% CI = 29.90-32.42), 4.79% (95% CI = 4.33-5.31) and 15.82% (95% CI = 14.92-16.76), respectively. The stunting odds were 1.35 (95% CI = 1.15-1.59) and 1.27 (95% CI = 1.01-1.59) times higher for children from households with no water and sanitation services, respectively, compared to children living in households with basic water and sanitation services. Children under five from households with no hygiene facilities and using limited hygiene services had 1.31 (95% CI = 1.05-1.63) and 1.35 (95% CI = 1.10-1.67) times the odds of being stunted, respectively, compared to children covered by basic hygiene facilities. There is no evidence of a significant relationship between household access to WASH and wasting in children under five. The odds of being underweight were 1.33 (95% CI = 1.02-1.72) times higher among children under five from households with limited hygiene facilities than among children from households with basic hygiene facilities. CONCLUSION: Interventions to fight malnutrition in children under five should include a WASH dimension.

Trends in the utilisation of skilled birth attendance among pregnant women in Benin, from 2001 to 2017-2018, and projections to 2030.

BACKGROUND: Skilled birth attendance during childbirth is known to promote better pregnancy outcomes as well as contribute to maternal and newborn survival. The study aimed to analyse the progress in the use of skilled birth attendance by pregnant women over the last two decades (2001 to 2017-2018) in Benin, and then to make projections to 2030. METHODS: A secondary analysis was made using Benin's Demographic and Health Survey (DHS) databases. The study population were i) women of 15-49 years of age who were successfully surveyed and usually resided in the households visited during DHS-II, DHS-III, DHS-IV and DHS-V, ii) and had had at least one live birth in the five years preceding each of these surveys. For each DHS, the corresponding proportion of births attended by skilled health personnel was determined. The study then generated the Annual Percent Change (APC) between each survey and globally, and projections were made to 2030. RESULTS: Nationally, the percentage of women who gave birth attended by skilled health personnel was 67.39% in 2001, 76.10% in 2006, 80.87% in 2011-2012, and 79.12% in 2017-2018; this represents an APC = 0.98% between 2001 and 2017-2018. If the historical rate of progression is maintained, it is expected that by 2030, 89.35% of pregnant women will be using skilled birth attendance services. CONCLUSION: Efforts are needed to understand the drivers of skilled birth attendance among pregnant women to adopt appropriate strategies.

Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa.

Introduction: Sub-Saharan Africa has the highest under-five mortality rate and is among the regions where people have the least access to adequate Water, Sanitation, and Hygiene (WASH) services. The work aimed to investigate the effects of WASH conditions faced by children on under-five mortality in Sub-Saharan Africa. Methods: We carried out secondary analyses using the Demographic and Health Survey datasets of 30 countries in Sub-Saharan Africa. The study population consisted of children born within 5 years preceding the selected surveys. The dependent variable was the child's status (1 = deceased versus 0 = alive) on the survey day. The individual WASH conditions in which children live were assessed in their immediate environment, i.e., at the level of their households of residence. The other explanatory variables were related to the child, mother, household, and environment. Following a description of the study variables, we identified the predictors of under-five mortality using a mixed logistic regression. Results: The analyses involved 303,985 children. Overall, 6.36% (95% CI = 6.24-6.49) of children died before their fifth birthday. The percentage of children living in households with access to individual basic WASH services was 58.15% (95% CI = 57.51-58.78), 28.18% (95% CI = 27.74-28.63), and 17.06% (95% CI = 16.71-17.41), respectively. Children living in households using unimproved water facilities (aOR = 1.10; 95% CI = 1.04-1.16) or surface water (aOR = 1.11; 95% CI = 1.03-1.20) were more likely to die before five than those coming from households with basic water facilities. The risk of under-five mortality was 11% higher for children living in households with limited sanitation facilities (aOR = 1.11; 95% CI = 1.04-1.18) than for those with basic sanitation services. We found no evidence to support a relationship between household access to hygiene services and under-five mortality. Conclusion: Interventions to reduce under-five mortality should focus on strengthening access to basic water and sanitation services. Further studies are needed to investigate the contribution of access to basic hygiene services on under-five mortality.

Is Benin on track to reach universal household coverage of basic water, sanitation and hygiene services by 2030?

INTRODUCTION: With the end of the Millennium Agenda, the United Nations Member States adopted the Sustainable Development Agenda in 2015. This new agenda identifies 17 Sustainable Development Goals (SDGs) and 169 targets for 2030, including Water, Sanitation and Hygiene (WASH). OBJECTIVE: To study the evolution of household access to WASH services over the last two decades in Benin and make projections for 2030. METHODS: In this study, secondary analyses were performed using the datasets of the Demographic and Health Surveys in Benin from 2001 to 2017-2018. The statistical unit was the household. The achievement of the WASH SDGs targets was monitored through the proportion of households using individual basic WASH services, the proportion of households using surface water for drinking, and the proportion of households practising open defecation. The study generated Annual Percentage Changes (APCs) for outcome variables. Based on the APCs between 2001 and 2017-2018, projections were made for 2030. RESULTS: From 2001 to 2017-2018, household access to individual basic WASH services increased from 50.54% to 63.98% (APC = +1.44%), 5.39% to 13.29% (APC = +5.62%), and 2.12% to 10.11% (APC = +9.92%), respectively. At the same time, the prevalence of surface water consumption and open defecation among households decreased from 10.54% to 5.84% (APC = -3.52%) and 67.03% to 53.91% (APC = -1.31%), respectively. If the trend observed between 2001 and 2017-2018 remains unchanged, the national coverage of households with basic individual WASH services would be 76.50%, 26.33% and 10.51%, respectively, by 2030. The prevalence of surface water consumption and open defecation among households would be 3.73% and 45.71%, respectively, by 2030. CONCLUSION: Benin achieved significant progress in household coverage of adequate WASH services over the last two decades. However, progress appears insufficient to achieve universal coverage of households with basic WASH services, and eliminate surface water consumption and open defecation by 2030. There is a need to strengthen research into the drivers of household access to adequate WASH services.

Prevalence of fatigue while driving among two-wheeled vehicle drivers and associated factors: Exploratory approach from secondary analysis based on hospital data, Benin.

Fatigue while driving is one of the risk factors of road crashes. It's still poorly considered in interventions because of insufficient literature. In addition, the literature on this issue doesn't focus on two-wheelers, the most frequent users in the Benin context. The study examined the prevalence of fatigue while driving among two-wheeled vehicle drivers and the related factors. It's a secondary baseline data analysis from a cohort of road crash victims recruited from five hospitals in Benin. Data were collected from July 2019 to January 2020. Patients who identified themselves as drivers during the accident were included. Data on individual characteristics, including fatigue status in the moments preceding the collision, and other risk factors and environmental settings, were extracted. We used multivariate logistic regression. Among the respondents, 12.20% (95% CI=10.20-14.53) reported fatigue in the moments preceding the collision. The odds of fatigue while driving were significantly higher in male drivers (aOR=3.60; 95% CI=1.08-11.98), during professional trips (aOR=2.09; 95% CI=1.30-3.37), in non-helmet wearers (aOR=1.85; 95% CI=1.09-3.13), in users of stimulants (aOR=3.13; 95% CI=1.50-6.54), in those with a history of chronic diseases (aOR=1.95; 95% CI=1.16-3.27), at dusk (aOR=4.22; 95% CI=2.22-8.02), at night (aOR=6.90; 95% CI=3.95-12.05), and on Inter-State National Roads (aOR=2.01; 95% CI=1.18-3.43). Fatigue is a risk factor for road crashes in Benin, associated with other risk factors that highlight particularly vulnerable profiles and groups. Integrating prevention policies based on these cumulative risk factors will result in efficiency improvements.

Tends of "Zero-dose" children aged 12-23 months in Togo from 2000 to 2017 and predictions for 2030

Guided by the principle of leaving no one behind by improving equitable access and use of new and existing vaccines, the Immunization Agenda 2030 aims, among other things, to halve the incidence of "zero-dose" at the national level. This study aimed at studying the tends of the prevalence of "zerodose" children from 2000 to 2017 and making predictions for 2030. The study consisted of secondary data analyses from the Multiple Indicator Cluster Surveys (MICS) conducted in Togo. The study population consisted of children aged 12-23 months surveyed during MICS2 in 2000, MICS3 in 2006, MICS4 in 2010 and MICS6 in 2017. The dependent variable was the "zero-dose" vaccination status (1=Yes vs 0=No). The explanatory variables were related to the child, mother, household and environment. The study generated the overall annual percentage changes (APC) and by the independent variables. As a result, the prevalence of children with "zero-dose" expected for 2030 was estimated using Excel 2013 and Stata 16.0 software. In total, 636, 864, 916 and 952 children aged 12-23 months were included for MICS2, MICS3, MICS4 and MICS7, respectively. The prevalence of "zerodose" children decreased from 37.15% in 2000 to 31.72% in 2006, then 30.10% in 2010 and 26.86% in 2017, with an overall APC= - 1.89%. The highest relative annual decrease was from 2000 to 2006. If the historical rate of decrease remains unchanged, we predict that percentage of "zero-dose" children aged 12-23 months will be 20.96% in 2030, with a decrease of 22% compared to 2017, against a target of 50%. We suggest that strengthening strategies to increase full immunization coverage of children will contribute to reducing the percentage of zero dose children. A prerequisite will be a better understanding of the predictors of the "zero-dose" phenomenon in children

Helmet Use Among Two-Wheeler Riders' Road Accident Victims in Benin.

BACKGROUND: In Benin, some riders of two-wheeled vehicles still do not wear helmets, the main protection against head injuries in road accidents. The objective of this study is to describe the characteristics of two-wheeled users, and to determine the factors influencing helmet use among this group. METHODS: This is a prospective cross-sectional study of 977 two-wheeled road accident victims from a cohort. Proportions or means were calculated for the different variables. Statistical comparisons were made to test the association with helmet use. Logistic regression modelling was performed to identify factors associated with helmet use. RESULTS: Among all subjects, 81.1% [CI95% (78.5; 83.4)] wore a helmet. Factors explaining helmet use were female gender (OR = 2.8 [1.3-6.1]), purpose of trip (OR = 1.7 [1.1-2.6]), possession of health insurance (OR = 3.7 [1.3-10, 5]), having been driving for 15-20 years (OR = 2.6 [1.4-4.7]) or more than 20 years (OR = 3.4 [2.0-5.8]), good road conditions (OR = 3.1 [2.0-4.8]), and good visibility (OR = 1.9 [1.3-3.1]). CONCLUSION: The factors influencing helmet use are gender, reason for travel, length of time as a driver, possession of health insurance, conditions, and visibility of the road on which the subject are driving. These factors are related to experience and appropriation of the notion of risk, but also related to the environment. To increase helmet use among two-wheelers, helmet awareness should take into account the individual factors found in this study. Enforcement actions should be strengthened, and the quality of the roads improved.

Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin.

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8-29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Household access to basic drinking water, sanitation and hygiene facilities: secondary analysis of data from the demographic and health survey V, 2017-2018.

BACKGROUND: In Benin, access to water, sanitation and hygiene (WASH) remains an issue. This study aims to provide an overview of household access to basic WASH services based on nationally representative data. METHOD: Secondary analyses were run using the 'HOUSEHOLD' dataset of the fifth Demographic and Health Survey 2017-2018. The dependent variables were household access to individual and combined basic WASH services. The characteristics of the household head and those related to the composition, wealth and environment of the household were independent variables. After a descriptive analysis of all study variables, multivariate logistic regression was performed to identify predictors of outcome variables. RESULTS: The study included 14,156 households. Of these, 63.98% (95% CI = 61.63-66.26), 13.28% (95% CI = 12.10-14.57) and 10.11% (95% CI = 9.19-11.11) had access to individual basic water, sanitation and hygiene facilities, respectively. Also, 3% (95% CI = 2.53-3.56) of households had access to combined basic WASH services. Overall, the richest households and few, and those headed by people aged 30 and over, female and with higher levels of education, were the most likely to have access to individual and combined basic WASH services. In addition, disparities based on the department of residence were observed. CONCLUSION: The authors suggest a multifactorial approach that addresses the identified determinants.

Implementation of a model of awareness-raising for taxi motorcyclists in Benin in relation to helmet use: a quasi-experimental study.

BACKGROUND: This study aims to test the effectiveness of an awareness-raising model designed based on the theory of planned behaviour regarding helmet use for motorcycle taxi drivers. METHODS: This quasi-experimental study took place in the cities of Parakou (intervention group) and Porto Novo (control group). Over a three-month period, a package of awareness-raising activities, based on the theory of planned behaviour, have been implemented in the intervention area. Data relate to knowledge, attitudes and practices regarding helmet use was collected prospectively before the intervention, at the end, and 6 months later. Stata 15 was used for data analysis. Chi-square or Fisher, Student's or Kruskal-Wallis tests was carried out. The difference-in-difference method was used to determine the specific effect of the awareness activities. RESULTS: After the intervention, there was an improvement in the total score in both groups compared to baseline. The total score increased by 0.2 (0.06-0.3) in the experimental group when the number of sessions attended increased by one (p = 0.005). The difference-in-difference estimator measured among subjects who attended at least one awareness session, controlling for socio-demographic variables, showed a significantly higher difference in the total score of subjects in the experimental group compared to those in the control group both at the end of the interactive sessions and 6 months later. CONCLUSION: This model improves the helmet-wearing behaviour of motorbike taxi drivers in the experimental area. It could be adapted and applied to other socio-professional groups and other types of users.

Évaluation de la mise en œuvre de la sécurité routière au Bénin en 2019.

OBJECTIVE: The study aims to assess the level of implementation of road safety interventions in Benin. METHOD: The research is based on an evaluative study of road safety aimed to analyze the implementation and logic of road safety interventions, conducted in Benin in 2019. It combined a review of the gray literature and a qualitative component. The data were collected through documents and interviews in structures involved in road safety management. RESULTS: Road safety was a national priority with one lead institution and several structures involved. There was a lack of consensus among stakeholders, insufficient framework documents, resources, legislative texts, and study data. Few roads were in good condition and very few allowed the separation of two-wheeled vehicles. The vehicle fleet was outdated. Various activities were carried out to raise awareness, to educate the population and to enforce the texts but they were insufficient and poorly coordinated. Reference hospitals had the minimum service to deal with trauma cases. The interventions had not yet resulted in a reduction in the number of injuries and fatalities by accidents, which was increasing. CONCLUSION: Benin has made great efforts in the area of road safety. However, there are still some shortcomings to take into account.

Prevalence and Risk Factors of Post-Traumatic Stress Disorder in Survivors of a Cohort of Road Accident Victims in Benin: Results of a 12-Month Cross-Sectional Study.

Purpose: Post-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals. Materials and Methods: An institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05. Results: Out of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36-29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38-3.33), hospitalization (AOR = 1.87, 95% CI 1.21-2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16-8.25), and no return to work (AOR = 3.17, 95% CI: 1.99-5.06). Conclusion: The prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin's hospitals.

Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Effect of wearing a helmet on the occurrence of head injuries in motorcycle riders in Benin: a case-control study.

BACKGROUND: In Benin, motorcycles are the main means of transport for road users and are involved in more than half of crashes. This study aims to determine the effect of wearing a helmet on reducing head injuries in road crashes in Benin. METHODS: This case-control study took place in 2020 and focused on road trauma victims. The sample, consisting of 242 cases (trauma victims with head injuries) for 484 controls (without head injuries), was drawn from a database of traffic crash victims recruited from five hospitals across the country from July 2019 to January 2020. Four groups of independent variables were studied: socio-demographic and economic variables, history, behavioural variables including helmet use and road-related and environmental variables. To assess the shape of the association between the independent variables and the dependent variable, a descending step-by-step binary logistic regression model was performed using an explanatory approach. RESULTS: Fewer of the subjects with a head injury were wearing a helmet at the time of the crash 69.8% (95% CI = 63.6-75.6) compared to those without a head injury 90.3% (95% CI = 87.3-92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5-5.7)); the head injury rating was 1.9 (95% CI = 1.2-3.3) times higher in subjects who were fatigued during the crash than among those who were not and 2.0 (95% CI = 1.2-3.3) times higher in subjects with no medical history. CONCLUSION: Failure to wear a helmet exposes motorcyclists to the risk of head injuries during crashes. It is important to increase awareness and better target such initiatives at the subjects most at risk.

Prevalence and Factors Associated With Surgical Site Infections in the University Clinics of Traumatology and Urology of the National University Hospital Centre Hubert Koutoukou Maga in Cotonou.

Objectives: Study the prevalence and factors associated with the occurrence of surgical site infections in University Clinics of Trauma-Orthopedics, Reconstructive Surgery and Urology in a developing country. Methods: This was a retrospective descriptive and analytical study of 384 people operated on during the period of 2019. Logistic regression was used to study the factors associated with surgical site infections. The associations between the dependent variable and the other variables were assessed by the odds ratio (OR) followed by their 95% confidence interval. Results: The prevalence of surgical site infections was 7.81% CI 95% = (5.12-10.51). The factors linked to the surgical site infections in the studied population were the patient's admission method [OR = 2.74; 95% CI = (1.08-6.95)] and the length of the postoperative stay [OR = 8.75; 95% CI = (2.83-26.98)]. The interview and direct observation identified health care system dysfunctions, medical errors, patient monitoring and financial unavailability as factors that could favor the onset of surgical site infections. Conclusion: Interventions should be focused on the factors identified for the effective management of operated patients.