LES URGENCES OBSTÉTRICALES À L’HÔPITAL UNIVERSITAIRE DE PARAKOU AU BÉNIN : ASPECTS CLINIQUES, THÉRAPEUTIQUES ET ÉVOLUTIFS

Objective: To describe the clinical, therapeutic and outcome aspects of emergency obstetric care at the University Hospital of Parakou in Benin. Patients and methods: This was a descriptive and analytical cross-sectional study with prospective data collection. It covered a period of 6 months (14 January to 14 July 2013) and involved 507 patients. Results: The intake frequency of obstetrics emergencies was 31.8%. The mean age of patients was 26.7 ± 6.2 years, ranging from 15 to 45 years. The admission average time was 32 ± 27.8 hours. The mean gravidity was 3.21 ± 2.16 and the mean parity was 2.00 ± 2.13. The major identified emergency obstetrics groups were: dystocia (32.1%), hemorrhagic emergencies (21.7%), hypertensive emergencies (16.4%), fetal hypoxia (15.2%), the infectious emergencies (12.4%) and anemia on pregnancy (2.2%). The average hospital stay was 4.0 ± 3.4 days with a range of 1 to 23 days. Maternal mortality was 0.4%. Fetal mortality was 9.2% and was related to the occurrence of antepartum hemorrhage (p = 0.001), poor monitoring of antenatal care (p = 0.001) in obstructed labor (p = 0.001), and the presence meconium in the amniotic fluid (p = 0.001). Conclusion: Obstetrics emergencies are common in the maternity of the University Hospital of Parakou. Reducing the morbidity and mortality associated with obstetric emergencies happen by improving the quality of care for the education of patients to consult early to improving the technical platform and the introduction of insurance universal health

LES URGENCES OBSTÉTRICALES À L’HÔPITAL UNIVERSITAIRE DE PARAKOU AU BÉNIN : ASPECTS CLINIQUES, THÉRAPEUTIQUES ET ÉVOLUTIFS

Objective: To describe the clinical, therapeutic and outcome aspects of emergency obstetric care at the University Hospital of Parakou in Benin. Patients and methods: This was a descriptive and analytical cross-sectional study with prospective data collection. It covered a period of 6 months (14 January to 14 July 2013) and involved 507 patients. Results: The intake frequency of obstetrics emergencies was 31.8%. The mean age of patients was 26.7 ± 6.2 years, ranging from 15 to 45 years. The admission average time was 32 ± 27.8 hours. The mean gravidity was 3.21 ± 2.16 and the mean parity was 2.00 ± 2.13. The major identified emergency obstetrics groups were: dystocia (32.1%), hemorrhagic emergencies (21.7%), hypertensive emergencies (16.4%), fetal hypoxia (15.2%), the infectious emergencies (12.4%) and anemia on pregnancy (2.2%). The average hospital stay was 4.0 ± 3.4 days with a range of 1 to 23 days. Maternal mortality was 0.4%. Fetal mortality was 9.2% and was related to the occurrence of antepartum hemorrhage (p = 0.001), poor monitoring of antenatal care (p = 0.001) in obstructed labor (p = 0.001), and the presence meconium in the amniotic fluid (p = 0.001). Conclusion: Obstetrics emergencies are common in the maternity of the University Hospital of Parakou. Reducing the morbidity and mortality associated with obstetric emergencies happen by improving the quality of care for the education of patients to consult early to improving the technical platform and the introduction of insurance universal health

Burn-Out Chez Le Personnel Soignant Des Unités De Soins Intensifs De L’hôpital Universitaire De Parakou Au Bénin

The aim of the study was to identify Burn-out factors among caregivers in intensive care units in University Hospital of Parakou. We used a descriptive, analytical and correlational study with prospective data collection carried out over four months (March 1 to June 30, 2015) and 123 caregivers concerned consenting to the study. The Maslach Burn-out Inventory (MBI) was used for the assessment of burnout of the respondents. Among the 143 agents identified, 123of them (86%) consented to the survey. The average age of caregivers was 34.4 ± 9.3 years with a male predominance (56.9%). Seventy-six caregivers lived with a partner (61.8%) and 90.8% of them were monogamous. Seventy-one caregivers (57.7%) were not satisfied with their socio-economic situations and 88.7% of them associate secondary activities. Eighty eight caregivers (71.5%) were identified in their industry stressful conditions. The frequency of Burn-out was 68.3%. The occurrence of burn out was associated with sex (p = 0.001), type of family (p = 0.001), vocational qualification (p = 0.001) in the industry (p = 0 001), socio-economic conditions (p = 0.01), disease appeared in the exercise of the profession (p = 0.02), organizational factors (p = 0.001) and stressful conditions (p = 0.04). In conclusion we observe that the function nurse in the intensive care unit of the University Hospital of Parakou has a physical and mental hardship among caregivers inducing a high score of Burn-out, implementing an adapted prevention program is therefore necessary to lowering it

Prise en Charge des Brûlures Graves de l’enfant en Réanimation à l’hôpital Universitaire de Parakou au Bénin

Objectif : Décrire les aspects sociodémographiques, cliniques, paracliniques, thérapeutiques et évolutifs des brûlures graves de l’enfant en réanimation polyvalente à l’hôpital universitaire de Parakou au Bénin. Patients et méthodes : C’est une étude longitudinale à visée descriptive et analytique avec recueil rétrospectif des données laquelle a été réalisée du 1 er janvier 2012 au 31 décembre 2016. Dans le recueil des données étaient inclus les patients âgés de moins de 16 ans présentant une brûlure grave et admis en réanimation. Résultats : Durant la période d’étude, 2966 patients ont été hospitalisés en réanimation, parmi lesquels nous avons dénombré 122 cas de brûlures (4,52%) et de façon spécifique nous avons colligé 49 cas de brûlures graves de l’enfant représentant 40,16% de l’ensemble des brûlés et 1,65% des admissions. L’âge moyen était de 3,5 ±2,7 ans (2 mois et 12 ans) et une prédominance masculine a été notée (57,1%). Le délai médian d’admission était de 2 heures. L’ensemble des brûlures étaient accidentelles et 93,9% d’entre elles étaient domestiques. Le mécanisme de survenue était thermique dans 100% des cas. L’ébouillantement constituait 67,3% et les flammes 32,7% des cas. La surface corporelle brûlée (SCB) moyenne était de 30,0 ± 19,2%et les brûlures du 2 ème degré représentaient 95,9%. Le traitement comprenait un pansement occlusif avec une pommade à base de Trolamine (Biafine® ), un remplissage vasculaire, l’administration d’antalgique, d’antibiotique et d’antianémique voire la transfusion. La durée moyenne d’hospitalisation était de 7 ± 5 jours avec des extrêmes de un et 20 jours. Des complications étaient survenues chez 73,5% des patients : anémie (75,0%), choc hypovolémique (33,3%) et infection locale (22,2%). La mortalité était de 40,8% et était liée à l’anémie, au choc hypovolémique et au sepsis. Conclusion : La brûlure grave met en jeu le pronostic vital de l’enfant, raison pour laquelle la prévention primaire doit être de mise.Objective: To describe the socio-demographic, clinical, paraclinical, therapeutic, and evolutionary aspects of children with severe burns in the general purpose intensive care units at Parakou Teaching Hospital in Benin. Patients and Methods: A longitudinal study with descriptive and analytical purposes and a retrospective data collection was conducted from January 1st 2012 to December 31st 2016. The patients were under 16 years of age, with a severe burn, and were admitted to the intensive care units. Results: During the study period, 2966 patients have been hospitalized in the intensive care units including 122 burns cases (4.52%). Specifically, we recruited 49 children with severe burns representing 40.16% of all the burn victims and 1.65% of those that were admitted. The mean age was 3.5 ± 2.7 years (2 months and 12 years) with a male predominance (57.1%). The median time for admission was 2 hours. All the burns were unintentional and 93.9% of them were domestic. The mechanism leading to their onset was thermal in 100% of cases. Scalding represented 67.3% and flame 32.7% of the cases. The average body surface burned (BSB) was 30.0 ± 19.2% and 95.9% which represented 2nd degree burn. The treatment constituted an occlusive dressing using Trolamine (Biafine®), a vascular filling, analgesic, antibiotic and anti-anaemic administration or even a blood transfusion. The mean duration of hospitalization was 7 ± 5 days with the extremes of 1 and 20 days. Complications occurred in 73.5% of patients: anaemia (75.0%), hypovolemic shock (33.3%), and local infection (22.2%). The mortality was 40.8% and was related to anaemia, hypovolemic shock, and sepsis. Conclusion: The severe burn is life-threatening for the children. Hence, primary prevention must be the rule

LES RUPTURES UTERINES A L’HOPITAL DE REFERENCE DE PARAKOU AU BENIN : ASPECTS EPIDEMIOLOGIQUES, THERAPEUTIQUES ET PRONOSTIQUES

Objective: To describe the epidemiological, therapeutic and prognostic of uterine rupture in a second-level referral hospital in Parakou in Benin. Patients and methods: This was a descriptive cross-sectional study from a comprehensive sampling. It covered a period of 14 years (1 January 2001 to 31 December 2014) and involved 203 patients. Results: The frequency of uterine rupture in service was 0.7%, a uterine rupture for 135 deliveries. These were the patients referred in 77.3% of cases. The average age of these patients was 28 ± 5.4 years, ranging from 13 to 44 years. The etiologic factors were often associated. It was basically multiparity (42.4%), obstructed labor (32%) and uterine scars (26.1%). Treatment was conservative in 85.7%. The average time of surgical management was 01h38min ± 42min. In 69.8% of cases, patients were transfused and 72, 3% of the patients had received intravenous fluids. The prognosis is characterized by high perinatal mortality (80.2%) and maternal morbidity is dominated by anemia (79.7%) and abscesses (9.7%) and fistulas (2.4%). Conclusion: The epidemiological aspects of uterine ruptures in the gynecology and obstetrics department of CHD B encourage us to family planning, screening of dystocia and management deliveries on uterus scar

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

Short Term (3 Months) Prognosis of Stroke in Parakou

International audienceBackground: The burden of stroke is very high in sub-Saharan Africa. The identification of the factors influencing poor outcome can help to reduce this burden. Objective: To study factors influencing the prognosis of stroke at Parakou. Methods: It was a prospective study conducted over two periods: inclusion period between 1st January and 30 June 2013; monitoring period of survivors between 1st July and 30 September. All consecutive patients admitted in the hospitals for stroke in the study period were included. The functional outcomes were assessed by the RANKIN scale (RANKIN > 2). Epi-info version 7 and SPSS version 16 were used for the statistical analyses. Results: We recruited 85 patients; mean age was 52 ± 15 years. The housewives and the unschooled represented respectively 33% and 65%. The mortality rates at 1 and 3 month were respectively 27% and 32%. Factors associated with mortality were female gender, stroke severity, disorders of consciousness, hyperthermia and hyperglycemia at admission, overweight, pneumonia, anemia, hyperleucocytosis, higher total and LDL serum cholesterol levels at 1 month; housewife status and pneumonia were associated at 3 month. 47% of survivors were independent at 1 month. Stroke severity and length of hospital stay were associatedwith disability at 1 month whereas previous stroke and disability history, stroke severity, weight and length of hospital stay were related with 3month poor functional outcome. Conclusion: This study showed the poor outcome of stroke patients in Parakou which were influenced by many factors. Taking account of these factors in the strategies of care in the acute phase may improve the prognosis of stroke patients

Vécu psychologique préopératoire et croyances chez les patients adultes programmés pour une intervention chirurgicale à l'hôpital universitaire de Parakou au Bénin

Objectif : Étudier le vécu psychologique préopératoire et les croyances chez les patients adultes programmés pour une intervention chirurgicale à l’hôpital universitaire de Parakou. Patients et méthodes : Étude descriptive et analytique avec recueil prospectif des données réalisées sur trois mois (1er juin au 30 août 2012) et a concerné 75 patients. Résultats : Sur les 108 patients programmés pour une intervention chirurgicale, 75 patients (69,4 %) avaient été retenus. L’âge moyen était de 44,11 ± 16,24 ans avec une prédominance masculine (56 %). Cinquante-cinq patients (73,3 %) étaient anxieux et 32 patients (46,7 %) avaient peur de mourir. Quarante-cinq patients (60 %) n’avaient pas reçu d’informations sur l’intervention qu’ils devaient subir et 60 patients (80 %) n’étaient pas informés des complications possibles de la chirurgie. Cinquante-huit patients (77,3 %) ont été informés de la technique d’anesthésie et 5,2 % des patients étaient informés des éventuelles complications de l’anesthésie. Pour 56 patients (74,7 %), la maladie était d’origine naturelle, dans 18,6 % des cas, il s’agissait d’un envoutement et pour 5 patients (6,7 %) la maladie serait due à une divinité. Dans le cadre de la prise en charge spirituelle, 15 patients (20 %) avaient consulté un marabout, 11 patients (14,7 %) un guérisseur et 10 patients (13,3 %) un féticheur. Conclusion : La période préopératoire induit une charge importante d’anxiété chez les patients et leur entourage. Au Bénin, l’annonce d’une intervention chirurgicale est l’occasion d’une confrontation du patient à une obsession de la mort dont il ne parvient à se soustraire malgré les innombrables sacrifices traditionnels conjuratoires

Prévalence de l’hépatite B chronique selon le statut sérologique VIH à Parakou au Bénin

International audienceThe prevalence of hepatitis B is very variable across geographic areas and seems to be influenced by HIV infection. This study aims to evaluate the impact of serologic HIV status on the overall prevalence of hepatitis B in a Hospital in Parakou, Benin