Antioxidant status in alcohol-related diabetes mellitus in Beninese subjects.

In the present study, we investigated the antioxidant status in diabetes mellitus, related or not to alcohol consumption. A total of 38 type 1, 48 type 2 and 42 alcohol-related diabetic patients were selected. Total antioxidant status was assessed through the oxygen radical absorbance capacity of the plasma and the determination of enzymatic and non-enzymatic antioxidant molecules. Serum triglycerides, total cholesterol and HDL-cholesterol concentrations were determined and the lipid peroxydation was evaluated by measuring thiobarbituric acid reactive substances (TBARS) assay. Plasma total antioxidant capacity was more decreased in alcohol-related diabetes than that in type 1 and type 2 diabetes, regardless of the complications (retinopathy and renal failure). Plasma vitamin E concentrations were significantly decreased whereas those of vitamin C increased in all of the diabetic patients compared to the controls, irrespective to the complications. In addition, superoxide dismutase and glutathione peroxidase activities were reduced in all the patients (type 1, type 2 and alcohol-related), irrespective to the complications. Glutathione reductase activity was diminished in type 1 and alcohol-related, but not in type 2, diabetic patients. Glutathione (GSH) concentrations significantly decreased in all diabetic patients with a significant decrease in alcohol-related diabetic patients. Excessive alcohol consumption appears as an oxidative aggravating factor in diabetes mellitus. Besides, alcohol-related diabetes highly resembles to type 1 diabetes as far as the antioxidant parameters are concerned.

Estimation of the prevalence of epilepsy in the Benin region of Zinvié using the capture-recapture method.

BACKGROUND: The prevalence of epilepsy was estimated in two villages of 3134 inhabitants, in Benin, in April and May 1997 using the capture-recapture method. METHODS: Information was obtained from (i) a door-to-door cross-sectional study, (ii) a non-medical source consisting of key informants (traditional practitioners, teachers, village leaders, and religious representatives) and (iii) a medical source through evaluation of medical records in health centres. In all the three situations, the diagnosis of epilepsy was confirmed by a neurologist. RESULTS: The door-to-door survey found 50 epileptics, i.e. a prevalence of 15.9 per 1000. The non-medical source found 26 patients. The medical source found only four patients. In total, 66 epileptics were found by combining the three sources, giving a prevalence of 21.1 per 1000. After application of the capture-recapture method, the estimated number of cases from the door-to-door survey and non-medical source was 105, and 110 cases when the medical source was considered as well. The respective prevalences were 33.5 per 1000, and 35.1 per 1000. CONCLUSIONS: The door-to-door survey has been usefully improved by using key informants. The epilepsy prevalence estimate found by capture-recapture is clearly higher than that found by traditional cross-sectional methods, and could better depict the frequency of epilepsy in Africa.

Intrafamilial clustering and 4-year follow-up of asymptomatic human T-cell leukaemia virus type I (HTLV-I) infection in Benin (West Africa).

BACKGROUND: Few data exist concerning familial human T-cell leukaemia virus type I (HTLV-I) carrier states and transmission in African countries. Two previous surveys performed in Benin in 1989 and 1990 using a three-level cluster sampling method allowed us to identify HTLV-I positive subjects. The evolution of HTLV-I within the families of these subjects is described over a 4-year period, 1991-1995. METHODS: Since 1991, 37 HTLV-I seropositive subjects, six subjects with indeterminate Western-Blot pattern, and their relatives have been followed up once a year clinically and biologically. RESULTS: Twenty-three mothers in the study group gave birth to 27 children between 1991 and 1995. Among the 13 infants born to the 12 seropositive mothers, two seroconverted before their second birthday. One adult woman whose husband was seropositive developed seropositivity 4 years after marriage. In March 1992, a family case-control study (proband study) was conducted. A seroprevalence of 27.5% was found among 138 relatives of 32 infected subjects and 1.4% among 142 relatives of 32 control subjects. CONCLUSIONS: There is clearly an intrafamilial clustering of HTLV-I in Benin. The annual incidence density of HTLV-I in this cohort is estimated at 6 per thousand.

Seroprevalence of cysticercosis in Bénin.

We report the results of a seroepidemiological study on the prevalence of cysticercosis in Bénin. Cluster sampling at 3 levels was performed in the 6 départements (Atacora, Borgou, Zou, Mono, Atlantique and Oueme) and 2625 serum samples, from 1329 adult females and 1296 adult males, were collected. Antibodies against Taenia solium cysticerci were first searched for by enzyme-linked immunosorbent assay and the 41 seropositive samples were then examined by enzyme-linked electroimmunotransfer blot assay (EITB). Thirty-five samples gave positive results in the EITB. The overall seroprevalence of cysticercosis was therefore 1.3% (95% confidence interval [95% CI] 0.9-1.9). The seroprevalence was 1.9% in males (95% CI 1.2-2.7) and 0.8% (95% CI 0.4-1.5) in females (P < 0.05). A progressive increase in seroprevalence with increasing age was found. The highest seroprevalences were observed in Atacora and Atlantique, 2 non-Muslim départements (3.3% and 3.0%, respectively). This study demonstrated the public health importance of cysticercosis in Bénin.

[Intra-family transmission of human T-cell lymphotropic virus-1 (HTLV-1) in a cohort of HTLV-1-positive patients (Bénin)]. / Transmission intra-familiale du virus lymphotrope pour les cellules T humaines type 1 (HTLV-1) dans une cohorte de sujets HTLV-1 positifs (Bénin).

We are reporting the results of a familial study carried out in Benin in March 1994 within a cohort of HTLV-1 positive subjects. This study aims at appraising the different modes of intra-familial transmission of this retrovirus. The study has included 212 persons: 33 seropositive subjects (identified during two previous seroprevalence surveys and followed up since 1991), and 179 members of their families. Blood specimens have been taken from each of these subjects. Sera have been screened for HTLV-1 antibodies by ELISA test and positive results confirmed by Western blot test. Out of 18 children born during the follow up period, 2 cases of seroconversion have been observed. One case of seroconversion has also been noted among the 17 couples in which either of the spouses is seropositive. Among the 136 children of the cohort: 17.8% of them are HTLV-1 positive when both parents are seropositive 26.1% if the mother only is seropositive and 0% if the father only is seropositive. The incidence rate in this cohort is estimated to be 0.43%. These data relative to the intra-familial transmission of HTLV-1 in Benin appear to be consistent with those previously reported in Japan.

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

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

[Anxiety and depression among the epileptics in general population in Benin (Western Africa)]. / Anxiété et dépression chez les épileptiques en population générale au Bénin (Afrique de l'Ouest).

In order to assess prevalence of depression and anxiety among epileptic patients and to compare it to a control population, a matched case-control survey was performed in 196 persons above 18 Year old (98 epileptics and 98 controls matched according to sex, age 10 and social environment) in Republic of Benin (West Africa), using Goldberg's Depression and Anxiety scale. Two main investigators helped by 5 sociology students were trained on a questionnaire by a psychiatrist skilled with public health matters. People taking part in the survey are epileptic patients who already used health services. Inclusions took place within 17 communes of four departments (Mono, Zou, Ouémé, Atlantique) located in Southern part of Benin. The questionnaire used an Identity sheet and the Goldberg Depression Scale. Results are shown as mean standard deviations, for quantitative values, and percents for qualitative ones. Comparisons of proportions in qualitative variables are carried out using c2 test or Fisher's exact test. Comparisons of means rates between subject's groups are carried out with a Student t test or variance analysis. The correlations between two quantitative variables were assessed by linear correlation coefficient. Significance threshold chosen for the whole set of statistics analysis is 0.05. The majority of interviewed epileptic patients is young (average 32.6 11.5 Years old). A male predominance exists (sex ratio 1.28). 93% of interviewed persons live within their family, are married or cohabit (controls: 98.2%; cases: 87.9%); 57.4% are married (controls: 70%; cases: 44%). The most represented professional categories are craftsmen and shopkeepers (29.2%) as well as farmers (19.5%). Most of recruited patients live in an urban setting (55.4%) and 63.6% of interviewed persons had been living in the area of survey for over 10 Years. The most represented religion within the sample is Christian religion (67.7%), Animists (23.3%) and Muslims (5.8%). 97% of epileptic patients reported they had one fit during the two Years before the survey; roughly one half (48%) had 2 to 5 fits and 41.5% of them had more than 10 fits; only 14% say they have had an EEG. Presence of an Anti Epileptic Drug (77.5%) reduces anxiety and depression. Considering a severity threshold of 5 for anxiety and 2 for depression (8), proportions of epileptic patients displaying a severe anxiety (79.8%) or a severe depression (89.6%) are significantly higher (p<0.0001) than in control subjects (12.3% and 46.9%). Comparison of average scores confirms the difference (p<0.0001) between cases (5.8 2.0 and 2.3 1.9) and controls (4.7 2.4 and 2.0 2.1) regarding anxiety and depression. Neither the sex, nor age, nor life environment (urban/rural), nor frequency of fits hold significant influence over an-xiety and depression. However, results in this survey include higher average rates of anxiety and depression for women (6.3 1.8) than men (5.5 1.8), though such statement is only nearly significant (p=0.06). Results of the survey confirm the other works on this topic about characteristics of depression for epileptic patients, though results here are higher than usual. Anxiety and depression are common troubles found in epileptic patient, both often occurring at the same time. Two distinct theories about this fact are opposed, first explain the connection of anxiety and depression with epilepsy because of the social and cultural burden upon an epileptic patient in those countries, the second theory is about depression and epilepsy sharing some neuroaminergical dysfunctions; these facts were not considered in this survey. When taking into account the thresholds of seriousness on Goldberg's scale, proportion of controls displaying a probably deeper depression is high (46.9%) compared to usual hospital prevalence rates (4 to 25%) found in Western Africa where survey in general population are scarce. It could either be a bias in the selection or the confirmation that family and relatives of an epileptic patient are enduring a great psychic pain too; finally, this high rate o, this high rate of severe depression within controls may suggest a need to adapt thresholds of Goldberg's scale to match African populations. This hypothesis is interesting regarding the results of some Authors who validated this scale in population of aged people; they highlighted the fewer precision of two items (lost of interest, focus difficulties) and also a slight discriminatory weight for other few items. However the psychometric characteristics of Goldberg's scale are accurate (for depression subscale, a sensitivity of 88% and a specificity of 68%; for the whole scale, a sensitivity of 84% and a specificity of 68%). It would be pertinent to carry out a study to validate Goldberg's scale within some African populations. This study also highlights the importance of psychological factors in epilepsy and suggests a specific global care of the disease.

[Comparison of sociocultural attitudes towards epilepsy in Limousin (France), in Togo and in Benin (Africa)]. / Comparaison des représentations socioculturelles des épilepsies en Limousin (France), au Togo et au Bénin (Afrique).

Sociocultural attitudes continue to have a negative impact on management of epilepsy in many African countries and in a few advanced countries. The purpose of this study was to compare attitudes toward epilepsy in France and two African nations: Togo and Benin. A total of 305 epileptic patients over 18 years of age were interviewed using the same quantitative questionnaire about their beliefs, knowledge attitudes and practices regarding their disease. There were 77 patients from the Limousin region in France, 129 from the rural canton of Nadoba in Togo and 99 from the coastal province in Benin. The frequency of epileptic seizure during the last two years prior to the study was lower in France than in Togo and Benin. The number of people who believed in supernatural causes of epilepsy was higher in Togo and Benin whereas the number of people attributing the disease to social causes (e.g. death and stress) was higher in France. Few epileptic patients in France thought that the disease was contagious whereas many patients in both Togo and Benin still believed that the disease was contagious and that some foods were forbidden. More patients in France than in Togo and Benin were aware of the relationship of epilepsy with alcohol, drug abuse and cerebral injury. Epileptic patients in France were more likely to consult a physician and use medical drugs for the treatment of epilepsy than their counterparts in Togo and Benin. Epileptic patients in Togo often complained of social exclusion. Although sometimes contradictory, these findings support the idea that sociocultural attitudes should be taken into account in the management of the disease.

[Types of hypertension in pregnant women of Benin admitted to the National University Hospital of Cotonou]. / Les différents types d'hypertension artérielle chez les femmes enceintes béninoises admises au CNHU de Cotonou.

We carried out a retrospective and prospective study between January 1995 and August 1996, of pregnant women with high blood pressure. The aim of this work was to determine the prevalence of each type of hypertension according to the classification of the American College of Obstetricians and Gynecologists (ACOG) and to evaluate the prognosis for the mother and child. The prevalence of hypertension in pregnancy was found to be 7.65%. A family history of hypertension, obesity and a personal history of hypertension in pregnancy were all risk factors. Severe hypertension (diastolic blood pressure (DBP) > 110 mm Hg) affected 59.4% of the women. Chronic hypertension occurred in 41.51% of cases, preeclampsia in 26.41% of cases, associated preeclampsia in 18.87% of cases and isolated hypertension in 13.21% of cases. Eclampsia (70.6%) was the principal maternal complication in this study population. Fifty-four of the women gave birth to normal babies, 21 to hypotrophic babies, 15 gave birth prematurely and 3 had miscarriages. Six of the seven deaths involved women with DBP above 110 mm Hg.

[Human African trypanosomiasis in the north of Benin. A preliminary serologic survey]. / La trypanosomiase humaine africaine dans le nord du Bénin. Enquête sérologique préliminaire.

Atacora Province has been for a long time a focus of human trypanosomiasis in the People's Republic of Benin. If the prevalence has appreciably decreased in the 1960s on account of the experienced methods of tracking down and a sustained supervision, it is easy to establish and to fear today the waking and even the extension of the historic focus formerly called "Foyer Atacora". Since 1974, new patients in second period of the infection are tracked down each year; they particularly come from the localities of Tanguieta and Materi. This suggests that sleeping sickness still persists in the North Country; that is the reason why it appears interesting to evaluate the present state of African human trypanosomiasis in this region of Benin; this appraisal has been tried from a clinic and serologic survey during May 1986 in the the population of four localities of this province: N'Dahonta, Porga Forêt, Porga Village and Dassari.

Psychosocial issues in people with epilepsy in Togo and Benin (West Africa) I. Anxiety and depression measured using Goldberg's scale.

PURPOSE: This study in Togo and Benin, West Africa, was aimed at measuring depression and anxiety among people with epilepsy (PWE). METHODS: This cross-sectional study of 281 adult PWE in Togo and 215 in Benin matched with the same number of controls without epilepsy used Goldberg's anxiety and depression scale. The statistical tests used for comparisons were chi(2) tests, Fisher's exact test, analysis of variance, and Fisher's PLSD test when necessary. RESULTS: PWE in Togo and Benin had significantly higher (P<0.0001) average depression scores (4.4+/-2.1, 4.7+/-2.7) than controls (0.5+/-0.9, 1.4+/-2.4). They also had significantly higher (P<0.0001) average anxiety scores (5.3+/-2.0, 6.2+/-2.1) than controls (2.5+/-1.6, 1.6+/-2.0). In consideration of the thresholds of the scale, the prevalence of possible major anxiety and depression among PWE was also very high compared with controls (P<0.0001). High anxiety and depression scores were, in general, positively correlated with a higher frequency of seizures and lack of treatment. CONCLUSION: Results confirmed the existence of anxiety and depression among PWE in Togo and Benin.

Psychosocial issues in people with epilepsy in Togo and Benin (West Africa) II: quality of life measured using the QOLIE-31 scale.

PURPOSE: This study in Togo and Benin, West Africa, was aimed at measuring health-related quality of life (HRQOL) of people with epilepsy (PWE). METHODS: It was a cross-sectional study among 281 adult PWE in Togo and 215 in Benin matched with the same number of controls without epilepsy, using the Quality Of Life in Epilepsy Scale-31 (QOLIE-31). RESULTS: In Togo and Benin, controls had significantly better HRQOL (80.3+/-7.4, 72.2+/-12.7) than PWE (49.5+/-14.4, 52.1+/-33.4) according to the QOLIE-31 Overall score (P<0.0001). HRQOL was, in general, negatively correlated with a higher frequency of seizures and lack of treatment. CONCLUSION: Results call for specific management of epilepsy in PWE in Togo and Benin to improve their HRQOL.

Pathologie aigue et fonction renale : a propos de 322 observations au C.H.N.U. de Cotonou

Pendant une periode de 5 ans; les deux unites qui constituent le Service Polyvalent de Reanimation du CHNU de Cotonou ont admis 4937 patients dont 680 ont presente une insuffisance renale aigue soit une prevalence de 13;57 pour cent. Analysant 322 dossiers les auteurs ont tire plusieurs conclusions. L'insuffisance renale aigue est plus frequente dans le secteur chirurgical que dans le secteur medical. Elle frappe des sujets jeunes avec un sex-ratio de 2 hommes pour une femme. Les principales etiologies sont: abdomen chirurgical aigu (peritonites et occlusion en tete); traumatologie; urologie; obstetrique et dans le secteur medical: l'insuffisance renale aigue; les intoxications medicamenteuses; le paludisme complique et le choc septique. L'hypercreatinemie varie de 139 a 3161 mmoles/litres. L'hyperkaliemie n'est pas exceptionelle (29 cas) comme l'hyponatremie (81 cas) et l'hypocalcemie (26 cas). L'insuffisance renale aigue est le type le plus frequent en milieu chirugical (95 pour cent des cas) alors que la forme organique est dominante dans le secteur medical. Le traitement symptomatique utilise le remplissage vasculaire (199 fois); le Furosemide (206 fois); la Dopamine a dose dopaminergique (77 fois); l'alcalinisation (112 fois) et l'hemodialyse (39 fois). Le traitement etiologique est base sur la chirurgie; la malariatherapie; l'antibiotherapie; la prise en charge des intoxications aigues. La mortalite globale a ete tres elevee (40;06 pour cent) plus forte dans le secteur medical (45;79 pour cent) qu'en milieu chirurgical

Valeurs de reference de 11 proteines seriques dans une population apparemment en bonne sante

"Les auteurs rapportent les valeurs normales de 11 proteines seriques dans une population de sujets adultes. Les proteines etudiees comprennent: les proteines de la reaction immunitaire (IgG; IgM; IgA); celles de la reaction inflammatoire et celles du statut nutritionnel. Le dosage a ete realise sur un immunonephelemetre ""ICS"" de la firme Beckman avec des immunerums dont la plupart a ete prepare a Cotonou. L'examen des resultats montre que par rapport au sujet de race blanche; le profil proteique du Beninois se caracterise par une hypergammaglobulinemie de type IgG et IgM et une hypogammaglobulinemie de type IgA; une augmentation du taux de certaines proteines de la reaction inflammatoire comme les orosomucoides; 1 antitrypsine; et de ceux des composants C3 et C4 du complement"

Apport de l'ELISA et du Test Immunoblot deuxieme generation dans le diagnostic des hepatopathies virales C : a propos de 13 cas colliges au C.N.H.U. de Cotonou

Treize patients presentant une hepathopathie ont ete soumis au depistage des marqueurs seriques du virus de l'hepatite C (VHC) par la methode ELISA suivie de la confirmation par un test immunoblot de deuxieme generation. Cinq patients sur les treize etaient porteurs d'anticorps specifiques anti-VHC. Ce resultat preliminaire suggere que le VHC jouerait un role non negligeable dans le developpement des hepatopathies au Benin

Prevalence des anticorps anti-VHC chez les malades drepanocytaires polytransfuses a Cotonou (Benin)

Dans une etude prospective; trente malades drepanocytaires polytransfuses ont ete soumis au depistage des marqueurs seriques du Virus de l'Hepatite C (VHC) par la methode ELISA suivie de la confirmation par le test Immunoblot 2eme generation. Ce groupe a ete compare a 30 autres malades porteurs de la meme tare mais n'ayant jamais ete soumis a une hemotherapie. La prevalence des anti-VHC etait respectivement de 20 pour cent et 0 pour cent dans les 2 groupes. La difference observee etait significative. Au Benin; la transfusion sanguine constitue donc pour le receveur; un risque non negligeable d'exposition au VHC