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1.
Geneva; World Health Organization; 2020-03-17.
em Inglês | WHO IRIS | ID: who-331481
2.
Int J Equity Health ; 18(1): 195, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31847877

RESUMO

BACKGROUND: Equity seems inherent to the pursuance of universal health coverage (UHC), but it is not a natural consequence of it. We explore how the multidimensional concept of equity has been approached in key global UHC policy documents, as well as in country-level UHC policies. METHODS: We analysed a purposeful sample of UHC reports and policy documents both at global level and in two Western African countries (Benin and Senegal). We manually searched each document for its use and discussion of equity and related terms. The content was summarised and thematically analysed, in order to comprehend how these concepts were understood in the documents. We distinguished between the level at which inequity takes place and the origin or types of inequities. RESULTS: Most of the documents analysed do not define equity in the first place, and speak about "health inequities" in the broad sense, without mentioning the dimension or type of inequity considered. Some dimensions of equity are ambiguous - especially coverage and financing. Many documents assimilate equity to an overall objective or guiding principle closely associated to UHC. The concept of equity is also often linked to other concepts and values (social justice, inclusion, solidarity, human rights - but also to efficiency and sustainability). Regarding the levels of equity most often considered, access (availability, coverage, provision) is the most often quoted dimension, followed by financial protection. Regarding the types of equity considered, those most referred to are socio-economic, geographic, and gender-based disparities. In Benin and Senegal, geographic inequities are mostly pinpointed by UHC policy documents, but concrete interventions mostly target the poor. Overall, the UHC policy of both countries are quite similar in terms of their approach to equity. CONCLUSIONS: While equity is widely referred to in global and country-specific UHC policy documents, its multiple dimensions results in a rather rhetorical utilisation of the concept. Whereas equity covers various levels and types, many global UHC documents fail to define it properly and to comprehend the breadth of the concept. Consequently, perhaps, country-specific policy documents also use equity as a rhetoric principle, without sufficient consideration for concrete ways for implementation.


Assuntos
Equidade em Saúde , Política de Saúde , Cobertura Universal do Seguro de Saúde , Benin , Saúde Global , Humanos , Senegal
3.
Pan Afr Med J ; 33: 226, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692755

RESUMO

The purpose of this study is to determine the seroprevalence and the factors associated with viral hepatitis B among pregnant women at the Departmental University Hospital of Borgou (CHUD-B).We conducted a cross-sectional descriptive and analytical study with prospective collection of data. It focused on pregnant women treated and/or having given birth at the CHUD-B from 1 April 2017 to 30 June 2017. The study included patients who gave their consent to participate in the study. The variables studied were the sociodemographic data of pregnant women and the result of HBsAg test. The detectionof HBsAg in blood sampling of pregnant women was performed using a biological test for rapid diagnosis. Positive results were confirmed by ELISA technique. Two hundred and fourteen (214) pregnant women were included in the study. The average age of patients was 26.73±5.68 years. The mean gestation age was 31 weeks of amenorrhea (WA) ranging from 4 WA and 42 WA. Among them, 30 women were positive for HBsAg, reflecting a prevalence of 14.02%. The factors associated with this colonization were the practice of scarification, a personal history of jaundice and family history of viral hepatitis B. The seroprevalence of viral hepatitis B among pregnant women at the CHUD-B is high. This best reflect this major public health problem due to Hepatitis B virus.


Assuntos
Antígenos de Superfície da Hepatite B/sangue , Hepatite B/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Benin/epidemiologia , Estudos Transversais , Feminino , Hepatite B/diagnóstico , Humanos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/virologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
4.
Hum Genet ; 138(11-12): 1341-1357, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31667592

RESUMO

Recent research efforts to identify genes involved in malaria susceptibility using genome-wide approaches have focused on severe malaria. Here, we present the first GWAS on non-severe malaria designed to identify genetic variants involved in innate immunity or innate resistance mechanisms. Our study was performed on two cohorts of infants from southern Benin (525 and 250 individuals used as discovery and replication cohorts, respectively) closely followed from birth to 18-24 months of age, with an assessment of a space- and time-dependent environmental risk of exposure. Both the recurrence of mild malaria attacks and the recurrence of malaria infections as a whole (symptomatic and asymptomatic) were considered. Post-GWAS functional analyses were performed using positional, eQTL, and chromatin interaction mapping to identify the genes underlying association signals. Our study highlights a role of PTPRT, a tyrosine phosphatase receptor involved in STAT3 pathway, in the protection against both mild malaria attacks and malaria infections (p = 9.70 × 10-8 and p = 1.78 × 10-7, respectively, in the discovery cohort). Strong statistical support was also found for a role of MYLK4 (meta-analysis, p = 5.29 × 10-8 with malaria attacks), and for several other genes, whose biological functions are relevant in malaria infection. Results shows that GWAS on non-severe malaria can successfully identify new candidate genes and inform physiological mechanisms underlying natural protection against malaria.


Assuntos
Proteínas de Transporte/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Malária/epidemiologia , Malária/genética , Locos de Características Quantitativas , Benin/epidemiologia , Pré-Escolar , Estudos de Coortes , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Malária/parasitologia , Masculino
5.
Pan Afr Med J ; 34: 30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762898

RESUMO

Introduction: Placental malaria (PM) is an important predictor of infant morbidity and mortality in sub-Saharan Africa. Although placental histology is the gold standard test to diagnose PM, the placenta impression smears remains widely used in epidemiological studies. This study is set to evaluate the performance of placental impression smears to detect PM in pregnant women in southern Benin. Methods: A cross-sectional analysis was performed on data collected in the framework a multicenter randomized clinical trial (Malaria in Pregnancy Preventive and Alternative Drugs). Samples from 491 pregnant women were examined in the district of Allada, Southern Benin. Plasmodium falciparum infections have been assessed in placental blood and placental biopsy. Results: Placental malaria detected by placenta impression smears and histology were prevalent in 11.4% and 10.8%, respectively. Sensitivity and specificity of placental impression smears were 90.6% and 98.4%. Among 55 pregnant women tested positive by placenta impression smears, 48 were positive by the histology, while 7 were negative (positive predictive value: 87.3%). Four hundred and twenty four (424) of the 429 tested negative by the placenta impression smears, were also negative according to histology whereas the rest (5 of 429) of the women were positive (negative predictive value: 98.8%). Conclusion: Placenta impression smear is an accurate and easy method for the diagnosis of placental malaria.


Assuntos
Malária Falciparum/diagnóstico , Doenças Placentárias/diagnóstico , Plasmodium falciparum/isolamento & purificação , Complicações Parasitárias na Gravidez/diagnóstico , Adulto , Benin , Biópsia , Estudos Transversais , Feminino , Humanos , Doenças Placentárias/parasitologia , Valor Preditivo dos Testes , Gravidez , Sensibilidade e Especificidade , Adulto Jovem
6.
Zootaxa ; 4576(2): zootaxa.4576.2.1, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-31715759

RESUMO

The Indo-Pacific portunid, Charybdis hellerii (A. Milne-Edwards, 1867), is a crab species native to the Indian and Western Pacific Oceans and has previously colonized the Eastern Mediterranean and the Western Atlantic. It is now recorded in the Eastern Atlantic, on the coast of Benin, where a thriving population has established. This invasive and widely distributed species exhibits morphological variations within and between populations, which are discussed in detail. Its current distribution is presented, and its future expansion along the West African coast and future impact on coastal ecosystems and local fisheries are the object of tentative forecasts. Illustrations of sexually mature specimens from different sizes and regions are presented, and their allometric, individual and geographical variations are discussed. A new synonymy and a new account on the taxonomy and the biology of the species are presented. Illustrations of the lectotype and the paralectotype of C. hellerii are also provided for the first time. Charybdis spinifera (Miers, 1884), C. merguiensis (De Man, 1887) and C. vannamei Ward, 1941 are here treated as subjective junior synonyms of C. hellerii. The holotype of C. spinifera and two syntypes of C. merguiensis are illustrated.


Assuntos
Braquiúros , Espécies Introduzidas , Animais , Benin , Ecossistema , Oceano Pacífico
7.
PLoS Negl Trop Dis ; 13(10): e0007866, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31658295

RESUMO

BACKGROUND: Antibiotic treatment proved itself as the mainstay of treatment for Buruli ulcer disease. This neglected tropical disease is caused by Mycobacterium ulcerans. Surgery persists as an adjunct therapy intended to reduce the mycobacterial load. In an earlier clinical trial, patients benefited from delaying the decision to operate. Nevertheless, the rate of surgical interventions differs highly per clinic. METHODS: A retrospective study was conducted in six different Buruli ulcer (BU) treatment centers in Benin and Ghana. BU patients clinically diagnosed between January 2012 and December 2016 were included and surgical interventions during the follow-up period, at least one year after diagnosis, were recorded. Logistic regression analysis was carried out to estimate the effect of the treatment center on the decision to perform surgery, while controlling for interaction and confounders. RESULTS: A total of 1193 patients, 612 from Benin and 581 from Ghana, were included. In Benin, lesions were most frequently (42%) categorized as the most severe lesions (WHO criteria, category III), whereas in Ghana lesions were most frequently (44%) categorized as small lesions (WHO criteria, category I). In total 344 (29%) patients received surgical intervention. The percentage of patients receiving surgical intervention varied between hospitals from 1.5% to 72%. Patients treated in one of the centers in Benin were much more likely to have surgery compared to the clinic in Ghana with the lowest rate of surgical intervention (RR = 46.7 CI 95% [17.5-124.8]). Even after adjusting for confounders (severity of disease, age, sex, limitation of movement at joint at time of diagnosis, ulcer and critical sites), rates of surgical interventions varied highly. CONCLUSION: The decision to perform surgery to reduce the mycobacterial load in BU varies highly per clinic. Evidence based guidelines are needed to guide the role of surgery in the treatment of BU.


Assuntos
Úlcera de Buruli/tratamento farmacológico , Úlcera de Buruli/epidemiologia , Úlcera de Buruli/cirurgia , Adolescente , Adulto , Antibacterianos/uso terapêutico , Benin/epidemiologia , Úlcera de Buruli/microbiologia , Criança , Feminino , Gana/epidemiologia , Humanos , Modelos Logísticos , Masculino , Mycobacterium ulcerans , Razão de Chances , Análise de Regressão , Estudos Retrospectivos , Adulto Jovem
10.
Bull Soc Pathol Exot ; 112(2): 79-89, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31478622

RESUMO

To assess the seroprevalence of toxoplasmosis among pregnant women in Benin, we conducted a meta-analysis using the PRISMA criteria. Al research published between 1990 and 2018 on toxoplasmosis among pregnant women Benin were eligible. A total of five databases were investigated, and the extracted data were subjected to a meta-analysis under R 3.1 using both random effect model and fixed effect model. The overall prevalence of toxoplasma-specific IgG among pregnant women was 47% (CI 95%: 40-53) and that of specific IgM was 2% (CI 95%: 1-3). The infection rate in urban areas (52%) was significantly higher than in rural areas (33%). The two main risk factors identified by the various eligible studies were the age of the pregnant women and the consumption of raw vegetables. We show that toxoplasmosis is endemic in pregnant women in Benin, implying that primary prevention measures must be put in place by the competent authorities to control this infection.


Assuntos
Complicações Parasitárias na Gravidez/epidemiologia , Toxoplasmose/epidemiologia , Adulto , Benin/epidemiologia , Estudos Transversais , Feminino , Humanos , Gravidez , Prevalência , Análise de Regressão , Estudos Soroepidemiológicos , Adulto Jovem
11.
Bull World Health Organ ; 97(9): 620-630, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31474775

RESUMO

Increasing overall fiscal space is important for the health sector due to the centrality of public financing to make progress towards universal health coverage. One strategy is to mobilize additional government revenues through new taxes or increased tax rates on goods and services. We illustrate how countries can assess the feasibility and quantitative potential of different revenue-raising mechanisms. We review and synthesize the processes and results from country assessments in Benin, Mali, Mozambique and Togo. The studies analysed new taxes or increased taxes on airplane tickets, phone calls, alcoholic drinks, tourism services, financial transactions, lottery tickets, vehicles and the extractive industries. Study teams in each country assessed the feasibility of new revenue-raising mechanisms using six qualitative criteria. The quantitative potential of these mechanisms was estimated by defining different scenarios and setting assumptions. Consultations with stakeholders at the start of the process served to select the revenue-raising mechanisms to study and later to discuss findings and options. Exploring feasibility was essential, as this helped rule out options that appeared promising from the quantitative assessment. Stakeholders rated stability and sustainability positive for most mechanisms, but political feasibility was a key issue throughout. The estimated additional revenues through new revenue-raising mechanisms ranged from 0.47-1.62% as a share of general government expenditure in the four countries. Overall, the revenue raised through these mechanisms was small. Countries are advised to consider multiple strategies to expand fiscal space for health.


Assuntos
Financiamento da Assistência à Saúde , Impostos/economia , Cobertura Universal do Seguro de Saúde/economia , Benin , Comércio/economia , Gastos em Saúde , Política de Saúde , Humanos , Mali , Moçambique , Participação dos Interessados , Togo
12.
J Ethnobiol Ethnomed ; 15(1): 38, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412939

RESUMO

BACKGROUND: Atacora Chain of Mountains (ACM) is the Benin part of a range of mountains lying from Benin to Ghana through Togo. It provides goods and services to people and is dominated by rural communities with heavy reliance on natural resources. The ACM may be threatened by the increasing resource needs and the possible shift in people's livelihood priorities brought about by challenges and opportunities ushered in by modernization. This study sought to understand local people's perception of the services derived from the ACM and the socio-demographic factors (age, gender, and level of urbanization of the place people live in) accounting for these perceptions. METHODS: Face to face interviews with 12 focus groups in 3 municipalities were carried out to obtain a list of ecosystem services cited by the participants. At the individual level, 144 people (men, women, young, adult, and old people from either rural or urbanized areas) equally distributed in the 3 municipalities were asked whether they acknowledge each of the services cited by the focus groups. Logistic regressions were then used with generalized linear models (GLM) function in R to analyze the relationships between the probability of acknowledgement of a service by the respondents and their socio-demographic characteristics. RESULTS: Local people perceived the ACM as a provider of provisioning, supporting, and cultural services but cited more provisioning services than the others. The factors considered in this study (gender, location, and age) were all predictors of ecosystem services perception in the ACM. Location influenced people's perception of provisioning and supporting services such that respondents from rural municipalities were more likely to perceive provisioning and supporting services. This is because people in rural areas have a heavier reliance on natural resources. Gender was associated with respondents' perception of supporting, provisioning, and cultural services. Women were more likely to perceive provisioning services and less likely supporting and cultural services. People in each category of gender have a perception of ES linked to their livelihood activities. Young people were less likely to perceive supporting services than adults and old people due to their less involvement in farming activities. CONCLUSIONS: This study showed that gender, location, and age predict local people's perception of ecosystem services in the ACM and livelihood orientation is determinant. The omission of regulation and many of the supporting services questions the future of this mountain chain if its exploitation continues without any awareness and conservation measures.


Assuntos
Agricultura/métodos , Biodiversidade , Conservação dos Recursos Naturais/métodos , Ecossistema , Recursos Naturais/provisão & distribução , Adolescente , Adulto , Agricultura/estatística & dados numéricos , Benin , Conservação dos Recursos Naturais/economia , Países em Desenvolvimento , Feminino , Humanos , Masculino , Percepção , População Rural , Fatores Socioeconômicos , Adulto Jovem
13.
Pan Afr Med J ; 33: 51, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448014

RESUMO

Typhoid fever and tuberculosis, considered rare diseases in western countries, is still considered a notable problem of health issue in developing countries. The gastrointestinal manifestations of typhoid fever are the most common and the typhoid intestinal perforation (TIP) is considered the most dangerous complication. Abdominal localization of tuberculosis is the 6th most frequent site for extra pulmonary involvement, it can involve any part of the digestive system, including peritoneum, causing miliary peritoneal tuberculosis (MPT). This is the case report of a 4 years old girl with multiple jejunal perforations in a setting of contemporary miliary peritoneal tuberculosis and typhoid fever occurred in "Hopital Saint Jean de Dieu" in Tanguietà, north of Benin. The patient was admitted in the emergency department with an acute abdomen and suspect of intestinal perforation, in very bad clinical conditions, underwent emergency laparotomy. The finding was a multiple perforations of the jejunum in a setting of combined abdominal typhoid fever and miliary peritoneal tuberculosis. Typhoid intestinal perforations and peritoneal tuberculosis are a very rare cause of non-traumatic peritonitis in western country, but still common in developing country. Considering the modern migratory flux and the diffusion of volunteer missions all around the world, the western surgeon should know this pathological entities, and the best treatments available, well known by surgeons with experience of working in developing countries. The combination of both TIP and MPT in the same patient, is a very rare finding which can worsen the outcome of the patient itself.


Assuntos
Perfuração Intestinal/diagnóstico , Peritonite Tuberculosa/diagnóstico , Tuberculose Miliar/diagnóstico , Febre Tifoide/diagnóstico , Abdome Agudo/etiologia , Benin , Pré-Escolar , Feminino , Humanos , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Jejuno/patologia , Laparotomia/métodos , Peritonite Tuberculosa/complicações , Tuberculose Miliar/complicações , Febre Tifoide/complicações
14.
Pan Afr Med J ; 33: 72, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448034

RESUMO

Introduction: This study aims to determine the prevalence and the factors associated with the use of products for voluntary depigmentation among women aged 15-49 years in Comè health zone in Benin. Methods: We conducted a cross-sectional study of 511 women aged 15-49 years selected using a cluster survey in 2016. Data were collected using a questionnaire seeking to explore the demographic, socio-cultural and economic characteristics of women. Depigmentation ingredients have been identified looking at the composition of regularly used body lotions. We performed a multiple logistic regression analysis. The statistical significance level was set at 5%. Results: The prevalence of use for voluntary depigmentation products among women aged 15-49 years in Comè health zone was 79,22% 95%; CI=[75,72-82,78] and 84,23% of women knew at least one of the adverse health effects associated with the use of skin depigmentation products. The products used were hydroquinone based (98.24%) and dermocorticoid based (1.76%). Factors associated with the use of voluntary depigmentation products included marital status (single, widowed, separated or divorced) (OR=3.1; 95% CI=[1.29-7.44]), the search for a husband or a partner (OR=4.92; 95% CI=[1.20-20.09]), the presence of hyperpigmented spots (OR=10.32; 95% CI=[2.87-37,01]). Conclusion: These results show that the use of skin depigmentation products among women is a serious and huge public health problem in Comè health zone. Integrated communication campaign which can produce positive changes should be implemented.


Assuntos
Hidroquinonas/administração & dosagem , Preparações Clareadoras de Pele/administração & dosagem , Pigmentação da Pele/efeitos dos fármacos , Adolescente , Adulto , Benin , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Prevalência , Preparações Clareadoras de Pele/efeitos adversos , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
15.
Wilderness Environ Med ; 30(3): 295-301, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31229367

RESUMO

The West African carpet viper (Echis ocellatus) causes more deaths than any other snake in sub-Saharan Africa. Carpet viper envenomations are characterized by a venom-induced consumption coagulopathy and systemic bleeding syndrome, in addition to local symptoms of painful progressive swelling and tissue destruction. The highest mortality rate is seen in the final stages of the syndrome, which typically ends with fatal internal bleeding or hemorrhagic shock. We present 2 cases of E ocellatus envenomation with intracranial hemorrhage seen at a rural hospital in Bembèrèkè, Benin, and describe the successful management of these patients in a limited-resource setting. In one case the patient was treated with an ineffective Indian-made antivenom before evaluation by the authors and continued to deteriorate until she was treated with effective antivenom 10 d after the bite. In both cases lumbar puncture was performed for diagnostic or therapeutic purposes with good effect, and both patients made full recoveries without sequelae. These cases demonstrate the remarkable ability of high-quality antivenoms to reverse life-threatening envenomations even in the final stages of the hemorrhagic syndrome and illustrate the dangers posed by low-quality antivenoms that have flooded the market in the developing world.


Assuntos
Antivenenos/uso terapêutico , Fatores Imunológicos/uso terapêutico , Hemorragias Intracranianas/terapia , Mordeduras de Serpentes/terapia , Venenos de Víboras/antagonistas & inibidores , Viperidae , Animais , Benin , Criança , Feminino , Humanos , Hemorragias Intracranianas/etiologia , Masculino , Resultado do Tratamento
16.
Rev Mal Respir ; 36(6): 664-671, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31204234

RESUMO

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.


Assuntos
Asma/epidemiologia , Asma/prevenção & controle , Estudantes de Medicina , Adolescente , Benin/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Adulto Jovem
17.
Pan Afr Med J ; 32: 69, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31231452

RESUMO

Introduction: Cerebrovascular accidents (strokes) are one of the main acquired causes of epilepsy in adults, but little data are available on the incidence of epilepsy after a stroke in Africa. This study aims to estimate the impact of epilepsy in stroke patients in Parakou. Methods: We conducted a dynamic cohort study including 203 stroke patients hospitalized in the Department of Neurology at the University Hospital of Parakou. Patients with a history of epilepsy were excluded from the follow-up. Patients were monitored over a 21-month period from 1 January 2013 to 30 September 2014. Epilepsy was defined according to the International League Against Epilepsy criteria. Results: Patients were aged 18-99 years, with an average age of 58.4 ± 14.2 years. The median of consultation time after symptoms was 54,3 h (+/-112,9h). Ischemic strokes accounted for 45.8%, haemorrhagic strokes 31% and indeterminate strokes 23.2%. The cumulative impact of epilepsy was 17. The incidence density rate of epilepsy was 9.8 per 100 person-years. Factors associated with the occurrence of epilepsy were the educational level, the duration of hospitalization and Barthel score. Conclusion: The incidence of epilepsy is very high; hence, taking into consideration the factors associated with it during the implementation of a treatment strategy may reduce its overall load.


Assuntos
Isquemia Encefálica/complicações , Epilepsia/epidemiologia , Hospitalização/estatística & dados numéricos , Acidente Vascular Cerebral/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Benin/epidemiologia , Isquemia Encefálica/epidemiologia , Estudos de Coortes , Epilepsia/etiologia , Feminino , Seguimentos , Hospitais Universitários , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Adulto Jovem
18.
Pan Afr Med J ; 32: 107, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31223397

RESUMO

Introduction: low back pain is a major health problem in the workplace. Some populations of workers appear to be much more exposed than others. The aim of this study is to determine the prevalence and the factors associated with the occurrence of low back pain among motorcycle drivers in Porto-Novo. Methods: we conducted a cross-sectional descriptive and analytical study of 270 consenting motorcycle drivers with at least one year of seniority. Patients were asked to complete the Nordic Questionnaire adapted to our context and physical examination of the spine was performed. Data were analyzed using Epidata 3.1. Software and STATA/IC 11.0. The threshold significance level was 5% and the confidence intervals were 95%. Results: the prevalence of low back pain was 68.89%. The average age of motorcycle drivers was 42.43 ±11.25 [25-64]years. The majority of them had been driving for more than 5 years (93.33%). Drivers spent an average of more than 8 hours (93.34%) driving per day and 68.52% of them drove over 160km per day. Low back pain was mechanical in 91.39% of cases. It was characterized by sudden onset in 81.73% of cases. Pain was moderate in 55.91% of drivers, evolving in acute pain in 46.24% of drivers and without radiation in 62.36% of cases. Age, education level, stress, posture, condition of motorcycle shock absorbers were associated with low back pain in these motorcycle drivers (p < 0.001). By contrast, distance travelled, job duration, seniority and road conditions were not associated with the occurrence of low back pain. Conclusion: low back pain is a serious public health problem in particular among motorcycle drivers in our country where riding a motorcycle is becoming more and more a work to bring assistance to the population facing growing unemployment. Hence the need to address factors associated with effective prevention.


Assuntos
Dor Aguda/epidemiologia , Dor Lombar/epidemiologia , Motocicletas , Doenças Profissionais/epidemiologia , Adulto , Benin/epidemiologia , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo
19.
PLoS One ; 14(6): e0218012, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31251748

RESUMO

BACKGROUND: PfEMP1 is the major protein from parasitic origin involved in the pathophysiology of severe malaria, and PfEMP1 domain subtypes are associated with the infection outcome. In addition, PfEMP1 variability is endless and current publicly available protein repositories do not reflect the high diversity of the sequences of PfEMP1 proteins. The identification of PfEMP1 protein sequences expressed with samples remains challenging. The aim of our study is to identify the different PfEMP1 proteins variants expressed within patient samples, and therefore identify PfEMP1 proteins domains expressed by patients presenting uncomplicated malaria or severe malaria in malaria endemic setting in Cotonou, Benin. METHODS: We performed a multi-omic approach to decipher PfEMP1 expression at the patient's level in different clinical settings. Using a combination of whole genome sequencing approach and RNA sequencing, we were able to identify new PfEMP1 sequences and created a new custom protein database. This database was used for protein identification in mass spectrometry analysis. RESULTS: The differential expression analysis of RNAsequencing data shows an increased expression of the var domains transcripts DBLα1.7, DBLα1.1, DBLα2 and DBLß12 in samples from patients suffering from Cerebral Malaria compared to Uncomplicated Malaria. Our approach allowed us to attribute PfEMP1 sequences to each sample and identify new peptides associated to PfEMP1 proteins in mass spectrometry. CONCLUSION: We highlighted the diversity of the PfEMP1 sequences from field sample compared to reference sequences repositories and confirmed the validity of our approach. These findings should contribute to further vaccine development strategies based on PfEMP1 proteins.


Assuntos
Genômica , Malária Falciparum/metabolismo , Plasmodium falciparum/metabolismo , Proteínas de Protozoários/metabolismo , Espectrometria de Massas em Tandem , Benin , Cromatografia Líquida , Humanos , Peptídeos/metabolismo , Proteogenômica , Proteoma/metabolismo , Proteínas de Protozoários/genética
20.
Malar J ; 18(1): 194, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185998

RESUMO

BACKGROUND: Substantial evidence indicates that cytophilic IgG responses to Plasmodium falciparum merozoite antigens play a role in protection from malaria. The specific targets mediating immunity remain unclear. Evaluating antibody responses in infants naturally-exposed to malaria will allow to better understand the establishment of anti-malarial immunity and to contribute to a vaccine development by identifying the most appropriate merozoite candidate antigens. METHODS: The study was based on parasitological and clinical active follow-up of infants from birth to 18 months of age conducted in the Tori Bossito area of southern Benin. For 399 infants, plasma levels of cytophilic IgG antibodies with specificity for five asexual stage malaria vaccine candidate antigens were determined by ELISA in infants' peripheral blood at 6, 9, 12 and 15 months of age. Multivariate mixed logistic model was used to investigate the association between antibody levels and anti-malarial protection in the trimester following the IgG quantification. Moreover, the concentrations of merozoite antigen-specific IgG were compared between a group of infants apparently able to control asymptomatic malaria infection (CAIG) and a group of infants with no control of malaria infection (Control group (NCIG)). Protective effect of antibodies was also assessed after 15 months of malaria exposure with a Cox regression model adjusted on environmental risk. RESULTS: Cytophilic IgG responses to AMA1, MSP1, MSP2-3D7, MSP2-FC27, MSP3 and GLURP R2 were associated with increasing malarial infection risk in univariate analysis. The multivariate mixed model showed that IgG1 and IgG3 to AMA1 were associated with an increased risk of malarial infection. However infants from CAIG (n = 53) had significantly higher AMA1-, MSP2-FC27-, MSP3-specific IgG1 and AMA1-, MSP1-, MSP2-FC27-, MSP3 and GLURP-R2-specific IgG3 than those from NCIG (n = 183). The latter IgG responses were not associated with protection against clinical malaria in the whole cohort when protective effect is assessed after 15 months of malaria exposition. CONCLUSION: In this cohort, merozoite antigen-specific cytophilic IgG levels represent a marker of malaria exposure in infants from 6 to 18 months of age. However, infants with resolution of asymptomatic infection (CAIG) seem to have acquired naturally immunity against P. falciparum. This observation is encouraging in the context of the development of multitarget P. falciparum vaccines.


Assuntos
Anticorpos Antiprotozoários/sangue , Antígenos de Protozoários/imunologia , Imunoglobulina G/sangue , Malária Falciparum/imunologia , Plasmodium falciparum/imunologia , Proteínas de Protozoários/imunologia , Benin , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Gravidez , Inquéritos e Questionários
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