Influence du système de logement sur quelques performances zootechniques et économiques des poules pondeuses au Sud-Bénin

Les effets de deux systèmes de logement (batterie de cages et sol sur litière) sur les performances zootechniques et économiques des poules pondeuses ont été évalués en zone tropicale humide, au sud du Benin. Un total de 180 poules pondeuses (Isa Brown) de 26 semaines d'âge était réparti en deux groupes de 108 et 72 poules installées, respectivement, au sol sur litière de copeaux de bois et en batterie de cages californiennes. Toutes les poules ont été soumises à la même alimentation durant l'expérimentation pendant 15 semaines. L'ingestion d'aliment (111,5 vs 115,0 g/poule/j), le pourcentage d'oeufs fêlés (0,189 et 2,24 %) et le poids moyen des oeufs (55,2 vs 57,0 g) étaient significativement plus faibles en cages que sur litière. Par contre, le taux de ponte (74,9 et 68,8 %), l'indice de consommation alimentaire (3,04 vs 3,28g aliment/g oeuf) et le coût alimentaire (36,3 vs 35,7 FCFA/oeuf), respectivement, en cage et sur litière, étaient similaires. L'indice d'efficience alimentaire était significativement plus élevé sur litière (2,24 F CFA oeuf/F CFA aliment) qu'en cages (1,533 FCFA oeuf/FCFA aliment). Ainsi, l'élevage des poules pondeuses en batterie de cages permet d'améliorer certaines de leurs performances zoo-économiques tels que l'indice d'efficience alimentaire, l'ingestion d'aliment, et de réduire la proportion d'oeufs fêlés.Mot Clés : Taux de ponte, Ingestion alimentaire, Indice d'efficience alimentaire, Cage, Bénin

Detection of antibiotics residues in meat of reformed and marketed laying hens in southern Benin

The presence in meat products of antibiotic residues is of toxicological risks for the consumer. In order to protect consumers through the safety of meat from reformed and marketed laying hens, a qualitative study was conducted in southern Benin. The study was conducted in twenty laying hen farms in Abomey-Calavi, Ouidah and Porto Novo towns. The survey identified antibiotics used by farmers. In each farm, five reformed chickens ready to be marketed were randomly selected. On each bird, the sternum and right thigh were collected and analyzed by the microbiological method of four plates at the Laboratory. Results showed that farmers use eight families of antibiotics: aminoglycosides, diaminopyridines, macrolides, polypeptides, quinolones second and third generation, sulfonamides and tetracyclines. Residues of tetracyclines and aminoglycosides were found only in Abomey-Calavi town with respective proportions of 25.71 ± 10.14% and 21.41± 9.93% while residues of macrolides were observed in three localities which are Abomey-Calavi, Ouidah and Porto Novo, with respective rates of 65.71 ± 9.92%, 46 ± 15.5% and 20 ± 8.36%. From the above results, we recommend to veterinarians the efficient use of antibiotics and to poultry farmers the respect of withdrawal period.Keywords: Antibiotics residues, laying hens, sternum, thigh, Beni

Zootechnical study of breeding modes of Somba cattle in Benin

The Somba cattle (Bos Taurus brachyceros sp), located in Benin and Togo, has a severe reduction of its livestock in recent decades. The aim of this study was to determine the causes of this phenomenon, in order to propose new approaches of conservation. The study consisted of surveys with targeted farmers and cattle. The results indicate that Somba cattle are not cared for both in terms of food and health, justifying its low performance and high mortality rate. The parameters covered by the study vary from one mode of farming to another. For individual parameters, entrusted farming is more interesting. In more than 80% of the farms of this mode, age at first calving is around 36 months, whereas it is of 42 months in the home farming, and have an inter calving period of 14 months which is also less than 24 months in the second case. Demographic parameters seem more interesting than home farming. Then, the mortality rate is 13.46% in home farming against 16.61% in entrusted farming. Regarding to external factors, health monitoring is lax in both modes. Food is a great concern especially during the dry season. The absorption by zebu was often mentioned as the main cause of the decrease of Somba cattle livestock. The present study shows that high mortality due to an absence of health monitoring is the basis of the sharp decline in the number of Somba cattle. The influence of zebu is currently marginal because 96.22% of cattle at the farm level respondents are Somba breed.Keywords: Parameters, individuals, demographic, livestock, conservation, mortalit

Activity-Based Funding of Hospitals and Its Impact on Mortality, Readmission, Discharge Destination, Severity of Illness, and Volume of Care: A Systematic Review and Meta-Analysis

Background: Activity-based funding (ABF) of hospitals is a policy intervention intended to re-shape incentives across health systems through the use of diagnosis-related groups. Many countries are adopting or actively promoting ABF. We assessed the effect of ABF on key measures potentially affecting patients and health care systems: mortality (acute and post-acute care); readmission rates; discharge rate to post-acute care following hospitalization; severity of illness; volume of care.     Methods: We undertook a systematic review and meta-analysis of the worldwide evidence produced since 1980. We included all studies reporting original quantitative data comparing the impact of ABF versus alternative funding systems in acute care settings, regardless of language. We searched 9 electronic databases (OVID MEDLINE, EMBASE, OVID Healthstar, CINAHL, Cochrane CENTRAL, Health Technology Assessment, NHS Economic Evaluation Database, Cochrane Database of Systematic Reviews, and Business Source), hand-searched reference lists, and consulted with experts. Paired reviewers independently screened for eligibility, abstracted data, and assessed study credibility according to a pre-defined scoring system, resolving conflicts by discussion or adjudication.     Results: Of 16,565 unique citations, 50 US studies and 15 studies from 9 other countries proved eligible (i.e. Australia, Austria, England, Germany, Israel, Italy, Scotland, Sweden, Switzerland). We found consistent and robust differences between ABF and no-ABF in discharge to post-acute care, showing a 24% increase with ABF (pooled relative risk = 1.24, 95% CI 1.18–1.31). Results also suggested a possible increase in readmission with ABF, and an apparent increase in severity of illness, perhaps reflecting differences in diagnostic coding. Although we found no consistent, systematic differences in mortality rates and volume of care, results varied widely across studies, some suggesting appreciable benefits from ABF, and others suggesting deleterious consequences.     Conclusions: Transitioning to ABF is associated with important policy- and clinically-relevant changes. Evidence suggests substantial increases in admissions to post-acute care following hospitalization, with implications for system capacity and equitable access to care. High variability in results of other outcomes leaves the impact in particular settings uncertain, and may not allow a jurisdiction to predict if ABF would be harmless. Decision-makers considering ABF should plan for likely increases in post-acute care admissions, and be aware of the large uncertainty around impacts on other critical outcomes

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Fiscal federalism and equity in the state joint local governments’ account: Oyo state in focus

The introduction of state joint local governments’ account implies that the revenues allocated to the Local Government Areas (LGAs) of a state from the Federation Account should be pooled together and shared among the LGAs. But some deductions are usually made before the balances of the pooled revenues are distributed to the 33 LGAs in Oyo State using the principles and formula approved by the state’s House of Assembly. This resulted in allocating revenues to some LGAs more than they were allocated from the Federation Account at the expense of others. This paper examined the issue of equity in the operation of joint account in Nigeria with particular reference to Oyo State. Data for this study were collected through secondary sources and descriptive and inferential statistical methods of analysis tools such as ratios, percentages, bar charts and t-test were used. Results showed that there are discrepancies between theproportions of direct and indirect allocations made to the LGAs during the periods 2003-2007. The comparison of per capita allocations to the LGAs with equal proportions of direct and indirect allocations further showed that the principle of equity was played down upon. The t-test also showed that there is significant difference between the means of per capita directallocations (PCDA) and per capita indirect allocations (PCIA). It was therefore concluded that the 33 LGAs in Oyo State were not fairly treated because majority (54%) of them were made worse off by the joint account. The paper recommended that the principles and formula used inoperating the joint account in Oyo State should be reviewed such that the treatment that can be received by individuals living in the 33 LGAs will almost be the same