Assessment of serum cystatin C in the early detection of type 2 diabetic nephropathy in Cotonou, Benin

Introduction: Diabetic nephropathy is a frequent and dreaded complication of diabetes mellitus. The purpose of this work was to study the role of serum cystatin C in the early detection of diabetic nephropathy among type 2 diabetic patients.Methods: This was a cross-sectional study conducted in Cotonou over a period of six months. Blood samples were tested at the regional food safety testing analysis laboratory. Type 2 diabetic patients older than 15 years, who gave their informed consent, were included in the study. Patients with proven proteinuria, acute kidney injury, haematuria, a positive urine test for nitrite, or reduced glomerular filtration rate <60 mL/min/1.73 m2 were excluded from the study. All patients were subjected to serum cystatin C and microalbuminuria assays.Results: Eighty-eight patients were included in the study. Their average age was 50.7 ± 9.6 years and the male to female ratio was 1.4:1. Twenty-four-hour microalbuminuria was positive in 53 (60%) cases whereas serum cystatin C tested positive in only 2 cases. Sensitivity and specificity tests applied to cystatin C showed very low sensitivity (4%) with a positive predictive value of 100% and high specificity (100%) with a negative predictive value of 41%.Conclusions: When compared with 24-hour microalbuminuria, serum cystatin C assay was not sensitive enough to prove suitable for screening for diabetic nephropathy. Serum cystatin C would therefore not be useful for the early detection of nephropathy among type 2 diabetic patients

Prévalence, facteurs associés et prédisposant au syndrome métabolique chez les personnes vivants avec le VIH sous traitement antirétroviral à Porto-Novo en 2014

Introduction: Le syndrome métabolique est associé aux maladies cardiovasculaires. L'infection au VIH est devenue aujourd'hui une maladie chronique. L'objectif de cette étude est de déterminer la prévalence, les facteurs associés et prédisposant au syndrome métabolique chez les patients infectés par le VIH sous traitement antirétroviral. Méthodes: Il s'est agi d'une étude transversale, descriptive et analytique. La population d'étude est  constituée des patients vivant avec le VIH sous antirétroviral suivis au Centre Hospitalier Universitaire de l'Ouémé-Plateau. Le syndrome métabolique a été défini selon les critères de la Fédération Internationale du Diabète. Résultats: La population était constituée de 244 patients. La prévalence du syndrome métabolique était  de 18,03% avec une prédominance féminine (74,6%). La moyenne d'âge était de 40,7 ± 9,71 ans. Les facteurs associés au syndrome métabolique étaient le sexe féminin, la sédentarité, l'antécédent d'HTA, le surpoids, l'apport énergétique élevé, l'apport lipidique élevé, la consommation d'alcool, la consommation de tabac et l'hypercholestérolémie. Les facteurs prédisposant au syndrome métabolique étaient la présence de l'HTA, le tour de taille élevé, l'hyperglycémie, l'hypocholestérolémie HDL et l'hypertriglycéridémie. Conclusion: Le syndrome métabolique est fréquent chez les patients infectés par le VIH sous traitement antirétroviral. Une prévention prenant en compte les facteurs associés et prédisposant s'avère  nécessaire.Key words: Syndrome métabolique, VIH, Porto-Novo, Béni

Epidemiological, Clinical, and Diagnostic Aspects of Urinary Tract Infection in Newborns at the Departmental Teaching Hospital of Borgou-Alibori (DTH-B/A) in Benin

To study epidemiological and diagnostic aspects of urinary tract infection (UTI) in newborns at the Departmental Teaching Hospital of Borgou-Alibori (DTH-B/A). This was a cross-sectional study conducted from April 1, 2019 to September 30, 2019 and concerned all newborns admitted to the neonatal unit of DTH-B/A. According to the National Agency for Health Accreditation and Evaluation (NAHAE)recommendations of 2002, all symptomatic newborns who did not have a visible malformation outside the genitourinary system and whose parents gave their consent were included in the study. The census was exhaustive despite the calculated minimum size of 109 newborns. Urine sedimentation and cytobacteriological examination of urine samples, taken in adhesive bags after local disinfection, demonstrated presence of pathogenic microbes. Sensitivity of detected microbes was studied to different antibiotics. Interpretive reading of antibiograms was established according to the Standards of the French Society of Microbiology (FEMS), edition 2012. If UTI was confirmed, an abdominopelvic ultrasound was performed in search for a malformative uropathy as a contributing factor in newborns. A standardized survey was developed for data collection. The data entered were analyzed using the Epi info software, version 3.5.4. In all, 124 newborns were included in the study. UTI accounted for 8.06% of all neonatal infections and 2.15% of admissions. The average age of onset was 7.8 days, with a gender ratio of 1:1. The main clinical manifestations were jaundice and respiratory distress. Microbes involved were Staphylococcus aureus (6/10), Escherichia coli (2/10), and Klebsiella oxytoca (2/10). The resistance of microbes to antibiotics was generally high. No abnormalities were revealed in the ultrasound. Although neonatal UTI is not a rare infection, bacterial resistance is of concern

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Acute Kidney Damage during Severe Malaria in Children at the Borgou Departmental Teaching Hospital (Benin)

Malaria is an endemic pathology with several complications, including kidney damage. The objective of this work was to study kidney damage during severe malaria in children at the pediatrics department of the Borgou Departmental Teaching Hospital (Borgou DTH), Benin in 2021. This was a longitudinal study carried out over 4 months from June 1, 2021 to September 30, 2021 (with 1 month of recruitment from June 1 to July 1, 2021) at the pediatric department of the Borgou DTH. The study included children aged 1 month–15 years, hospitalized for Plasmodium falciparum malaria with at least one clinical manifestation of malaria severity established by the World Health Organization in 2000 and whose parents had given their informed consent. The damage was established by urinary sedimentation using urine dipstick and urinary cap and serum creatinine. Acute kidney injury (AKI) was intended and classified according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The dependent variable was the presence of at least one clinical, biological, and functional impairment. Follow-up was regular for up to 3 months. Lost to follow-up were excluded. Predictors of occurrence were identified. Statistical difference was considered significant at P < 0.05. Of the 164 children hospitalized for severe malaria during the study period, 72 had at least one renal impairment, with a frequency of 43.90%. The average age of the children was 44.93 months. On urine dipstick, 76.39% of the patients had hemoglobinuria and 55.56% had albuminuria. Urinary cap revealed 44% granular cylindruria and 32% crystalluria. AKI was detected in 4.54% patients. Recovery was complete in all follow-up cases. The predictors of kidney damage were coma ( P = 0.017), jaundice ( P = 0.007), thrombocytopenia ( P = 0.021), and long hospital stay ( P = 0.008). Kidney damage in severe malaria is frequent. Early diagnosis and prompt treatment are fundamentals of rapid and complete recovery of kidney functions

Kidney Injury in Children Infected with HIV, Followed at the Teaching Hospital of Borgou (Benin): Epidemiological and Clinical Aspects

The history of kidney disease associated with HIV infection dates back to the years of HIV breakthrough. The objective was to study kidney damage in children infected with HIV at the Teaching Hospital of Borgou (Benin) in 2019. This was a cross-sectional, descriptive, analytical, matching-type study carried out from June 1, 2019 to September 30, 2019 at the pediatrics department of Teaching Hospital of Borgou (Benin). The study included HIV-positive children, followed in consultations, and whose parents gave their consent. The biological markers were demonstrated with urine dipstick. Glomerular filtration rate was calculated using the Schwartz test and classified according to stages. The dependent variable was the presence of at least one impairment (biological or functional). Sample size was determined by Schwartz’s method on the basis of one case for two controls. Sociodemographic, clinical, biological, and therapeutic data were collected. Comparisons were made using the Chi- square test or Fisher’s exact test. The identification of associated factors was possible using a multiple logistic regression model at 5% threshold. In total, we included 117 children, including 39 HIV-positive children. The average age was 8 ± 4.81 years and the gender ratio was 1:17. The frequency of kidney damage was 76.5%. Permanent proteinuria and at least two crosses on urine dipstick were present in 20.5%, leukocyturia in 2.6%, and proximal tubular dysfunction in 5.1%. Glomerular hyperfiltration was found in 38.5%, acute kidney injury in 38.5%, and chronic kidney injury in 5.1%. Associated factors were age (P = 0.004), presence of opportunistic infections (P = 0.00), and treatment adherence (P = 0.004). Kidney damage is common in HIV-positive children. Careful follow-up is necessary to avoid complications

Insuffisance Rénale Aigue Post-Opératoire Au Centre Hospitalier Universitaire Et Départemental Du Borgou : Fréquence Et Facteurs De Risques Associés

Introduction: Acute renal failure (ARF) post-operative is a specific form of acute deficiencies causing multiple declining factors. Objective: This survey aims to study the incidence and risk factors associated with acute renal failure (ARF) in post-operative surgical intensive care units to University Hospital of Borgou (UH-B): during 2015. Patients and Methods this study is a cross sectional, descriptive and analytical ones with the prospective data collection from March 1st to August 31th, 2015. The research has involved all patients admitted to the operating room for surgery and motherhood whatever reason and then transferred respectively to the intensive care areas at UH-B. The postoperative ARF has been investigated inner patients following inclusion criteria and classification according to RIFLE score. The socio-demographic, clinical and biological variables monitoring, even support and evolution are experimented. A questionnaire is designed for data collection. Data are analyzed by Epi-Info means with 5% of significance level. Results: 130 patients are registered. The mean age is 27.68 ± 12.87 years. The sex ratio is 0.66. The frequency of post-operative ARF reaches 12.31%. The associated risk factors are: hypertension (p = 0.0018), diabetes (p = 0.002), heart failure (p = 0.0104), severe sepsis (p = 0.006) hypovolemic shock (p = 0.002), ASA class ≥ 3 (p = 0.0014), preeclampsia-eclampsia (p = 0.012), the Altémier class classification ≥ 3 (p = 0.0164), a pathological urinary sediment like a proteinuria (p=0.006), haematuria (p= 0.001) and nitrituria (p=0.007). Consequently, three (03) subjects out of sixteen (16) have died (18.75%). Conclusion: The post-operative ARF is a reality in University Hospital Borgou , with a higher mortality rate. Thus, the prevention strategy is the best treatment through the screening and monitoring promotion towards risk factors

Mortalité des Patients Hémodialysés Chroniques au Bénin : Une Etude Rétrospective sur 6 Ans

Introduction: La dialyse est l’une des dernières alternatives dans l’arsenal thérapeutique, capable de maintenir en vie un patient insuffisant rénale chronique terminale. Avant la mise en place de la dialyse au Benin l’insuffisance rénale chronique terminale était systématiquement mortelle. Cette étude avait pour objectif de mettre à jour les données épidémiologiques sur les hémodialysés, la mortalité due à l’insuffisance rénale chronique terminale au CHUD du Borgou Alibori et les facteurs associés à la mortalité due hémodialysés. Cadre et méthodes d’étude : Elle a été réalisée dans le service de néphrologie dudit hôpital. Il s’agissait d’une étude transversale, descriptive à visée analytique qui s’est déroulé du 25 décembre 2022 au 15 mars 2023 et a porté sur les données de 2017 à 2022. Elle a concerné 95 dossiers de patients hémodialysés recruté par commodité et répondant aux critères d’inclusion. Le traitement et l’analyse des données a été faite avec le logiciel SPSS 26. Résultats: Le taux de mortalité était de 80% des hémodialysés. L’âge médian des patients était de 44 ans. Les prédicteurs potentiel de la mortalité des hémodialysés du service de néphrologie du CHUD/B-A étaient le travail en indépendant et secteur informel (p=0,004), le faible revenu mensuel (p=0,017), l’hypoglycémie (p=0,011), un nombre élevé de médicament (p=0,004), la mauvaise observance thérapeutique (p=0,003) et un court séjour en dialyse (p<0,000). Conclusión: Le projet d’assurance pour le renforcement du capital humain est une porte de sortie pour diminuer la mortalité de l’hémodialyse ainsi que le renforcement de la lutte contre les MNT.   Introduction: Dialysis is one of the last alternatives in the therapeutic arsenal, capable of keeping a patient with chronic end-stage renal disease alive. Before the introduction of dialysis in Benin, end-stage renal disease was systematically fatal. The aim of this study was to update epidemiological data on hemodialysis patients, mortality due to end-stage renal failure at the CHUD du Borgou Alibori, and factors associated with mortality due to hemodialysis. Study setting and methods: The study was carried out in the hospital's nephrology department. It was a cross-sectional, descriptive study with analytical aims that ran from December 25, 2022 to March 15, 2023 and covered data from 2017 to 2022. It involved 95 hemodialysis patient records recruited by convenience and meeting the inclusion criteria. Data processing and analysis was performed using SPSS 26 software. Results: The mortality rate was 80% for hemodialysis patients. The median age of patients was 44 years. Potential predictors of mortality in hemodialysis patients at the CHUD/B-A nephrology department were self-employment and informal sector (p=0.004), low monthly income (p=0.017), hypoglycemia (p=0.011), high number of medications (p=0.004), poor compliance (p=0.003) and short dialysis stay (p<0.000). Conclusion: The insurance project for strengthening human capital is a way out to reduce hemodialysis mortality and strengthen the fight against NCDs

Prevalence De L’insuffisance Cardiaque Au Cours De La Grossesse Et Dans Les Suites De Couches En Milieu Hospitalier A Parakou En 2015

Introduction: Heart failure is one of peripartum complications which contribute to maternal mortality. But the epidemiological features of this disease are not well known in Benin. This paper aims at studying the prevalence and associated factors of heart failure during pregnancy and the postpartum in Parakou in 2015. Methods: It was a descriptive and analytic cross sectional study scheduled from March to July 2015. We recruited systematically all pregnant or parturient women, met in Parakou’s hospitals. The inclusion criteria were the presence of at least one cardiovascular symptom. Diagnosis of heart failure was made by using the guidelines of the European Society of Cardiology and of the American Society of Echocardiography. Results: During the survey, 2503 pregnant or parturient women were admitted and 25 (0,99%) were diagnosed with heart failure. Dyspnea was the main symptom (96%). Heart failure was caused by peripartum cardiomyopathy(84%), hypertensive cardiomyopathy (12%) and rheumatic heart disease (4%). Heart failure was more prevalent in patients with the following conditions: age≥30years (p=0,001), low socioeconomic level (p=0,02), multigestational status (p=0,002) and multiparity (p<0,001). The management of heart failure was classic. The main difficulty noted was financial problems with 36% of patients unable to afford the treatment. No case of death was counted during the study. Conclusion: In Parakou, heart failure occurs mostly during the post partum period. Dyspnea was the main symptom. The main etiology was peripartum cardiomyopathy. The associated conditions were age≥30years, low socioeconomic level, multigestational status and multiparity

Mortalité des Patients Hémodialysés Chroniques au Bénin : Une Étude Rétrospective sur 6 Ans

Introduction: Au Bénin, la dialyse est la dernière alternative dans l’arsenal thérapeutique, pour maintenir en vie un patient insuffisant rénal chronique terminal. Avant la mise en place de la dialyse, l’insuffisance rénale chronique terminale était systématiquement mortelle. Cette étude a pour objectif d’identifier les facteurs associés à la mortalité deshémodialysés au CHUD/B-A. Cadre et méthodes d’étude: Cette recherche a été réalisée dans le service de néphrologie du CHUD/B-A. Il s’agissait d’une étude transversale, descriptive et analytique qui s’est déroulée du 25 décembre 2022 au 15 mars 2023 et a porté sur les données de 2017 à 2022. Elle a concerné 95 dossiers de patients hémodialysés, collectés de façon exhaustive et répondant aux critères d’inclusion. L‘analyse des données a été  faite avec le logiciel SPSS 26. Résultats: Le taux brut de mortalité était de 80%. L’âge médian des patients était de 44 ans. Les facteurs de risque associés à la mortalité des hémodialysés du service de néphrologie du CHUD/B-A étaient: les travailleurs en indépendant et secteur informel (HRa=2,7, p=0,009), le faible revenu mensuel (HRa=4,4, p=0,009), l’hypoglycémie (HRa=3,3, p=0,003), le nombre élevé de médicament (HRa=2,2, p=0,004), la mauvaise observance thérapeutique (HRa=2,2, p=0,003) et le court séjour en hémodialyse (HRa=31,7, p<0,001). Conclusion: La réduction de la mortalité des hémodialysés chroniques passe par l’amélioration de l’accessibilité financière à la l’hémodialyse. Introduction: In Benin, dialysis is the last alternative in the therapeutic arsenal to keep a patient with chronic end-stage renal failure alive. Before the introduction of dialysis, end-stage renal failure was systematically fatal. The aim of this study is to identify the factors associated with mortality in hemodialysis patients at CHUD/B-A. Study setting and methods: This research was carried out in the nephrology department of CHUD/B-A. It was a cross-sectional, descriptive and analytical study that ran from December 25, 2022 to March 15, 2023, and covered data from 2017 to 2022. It involved 95 hemodialysis patient records, collected exhaustively and meeting the inclusion criteria. Data analysis was performed using SPSS 26 software. Results: The crude mortality rate was 80%. The median age of patients was 44 years. Risk factors associated with mortality among hemodialysis patients in the CHUD/B-A nephrology department were: self-employed and informal sector (HRa=2.7, p=0.009), low monthly income (HRa=4.4, p=0.009), hypoglycemia (HRa=3.3, p=0.003), high number of medications (HRa=2.2, p=0.004), poor therapeutic compliance (HRa=2.2, p=0.003) and short stay in hemodialysis (HRa=31.7, p<0.001). Conclusion: Reducing mortality among chronic haemodialysis patients means improving the affordability of haemodialysis