Can treatment of malaria be restricted to parasitologically confirmed malaria? A school-based study in Benin in children with and without fever

<p>Abstract</p> <p>Background</p> <p>Applying the switch from presumptive treatment of malaria to new policies of anti-malarial prescriptions restricted to parasitologically-confirmed cases is a still unsolved challenge. Pragmatic studies can provide data on consequences of such a switch. In order to assess whether restricting anti-malarials to rapid diagnostic test (RDT)-confirmed cases in children of between five and 15 years of age is consistent with an adequate management of fevers, a school-based study was performed in Allada, Benin.</p> <p>Methods</p> <p>Children in the index group (with fever and a negative RDT) and the matched control group (without fever and a negative RDT) were not prescribed anti-malarials and actively followed-up during 14 days. Blood smears were collected at each assessment. Self-medication with chloroquine and quinine was assessed with blood spots. Malaria attacks during the follow-up were defined by persistent or recurrent fever concomitant to a positive malaria test.</p> <p>Results</p> <p>484 children were followed-up (242 in each group). At day 3, fever had disappeared in 94% of children from the index group. The incidence of malaria was similar (five cases in the index group and seven cases in the control group) between groups. Self-medication with chloroquine and quinine in this cohort was uncommon.</p> <p>Conclusions</p> <p>Applying a policy of restricting anti-malarials to RDT-confirmed cases is consistent with an adequate management of fevers in this population. Further studies on the management of fever in younger children are of upmost importance.</p

What would PCR assessment change in the management of fevers in a malaria endemic area? A school-based study in Benin in children with and without fever

<p>Abstract</p> <p>Background</p> <p>A recent school-based study in Benin showed that applying a policy of anti-malarial prescriptions restricted to parasitologically-confirmed cases on the management of fever is safe and feasible. Additional PCR data were analysed in order to touch patho-physiological issues, such as the usefulness of PCR in the management of malaria in an endemic area or the triggering of a malaria attack in children with submicroscopic malaria.</p> <p>Methods</p> <p>PCR data were prospectively collected in the setting of an exposed (with fever)/non exposed (without fever) study design. All children had a negative malaria rapid diagnostic test (RDT) at baseline, were followed up to day 14 and did not receive drugs with anti-malarial activity. The index group was defined by children with fever at baseline and the control group by children without fever at baseline. Children with submicroscopic malaria in these two groups were defined by a positive PCR at baseline.</p> <p>Results</p> <p>PCR was positive in 66 (27%) children of the index group and in 104 (44%) children of the control group respectively. The only significant factor positively related to PCR positivity at baseline was the clinical status (control group). When definition of malaria attacks included PCR results, no difference of malaria incidence was observed between the index and control groups, neither in the whole cohort, nor in children with submicroscopic malaria. The rate of undiagnosed malaria at baseline was estimated to 3.7% at baseline in the index group.</p> <p>Conclusions</p> <p>Treating all children with fever and a positive PCR would have led to a significant increase of anti-malarial consumption, with few benefits in terms of clinical events. Non malarial fevers do not or do not frequently trigger malaria attacks in children with submicroscopic malaria.</p

Determinants of Adherence to Recommendations of the Dietary Approach to Stop Hypertension in Adults with Hypertension Treated in a Hospital in Benin

Abstract The dietary approach to stop hypertension (DASH) is an effective nutritional strategy to prevent and treat cardiovascular disease. Optimal benefit from dietary recommendations in management of hypertension depends on the compliance. This analytic cross sectional study aimed at establishing determinants of DASH among adults with hypertension treated at hospital in Benin. The study included 150 hypertensive adults selected during medical visit for blood pressure monitoring at hospital Saint-Luc in Cotonou from June 3 rd to July 1 st , 2014. Data on consumption of sodium, fruits and vegetables, alcohol, saturated and trans fat rich products were collected by questionnaire. A score of adherence to DASH was built. Determinants of adherence to DASH were identified using logistic regression model. Only 20% of subjects showed adherence to DASH. Better knowledge on hypertension OR=5.18 (95%IC 1.98-13.22) and healthy dietary habits and lifestyle prior to diagnosis of hypertension OR=4.26 (95%IC 1.67-13.18) increased the likelihood of adherence to dietary recommendations for hypertension management. Nutrition education and information of patients on hypertension and its complications during medical consultations may increase their adherence to dietary recommendations for management of the disease

Genetic Variation in Autophagy-Related Genes Influences the Risk and Phenotype of Buruli Ulcer

Abstract Introductio

Infections postopératoires de plaies: cas du centre national hospitalier et universitaire de Cotonou (Bénin)

Doctorat en Sciences de la santé publiqueinfo:eu-repo/semantics/nonPublishe

Health problems are also linked to endemic profile.

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Pollution physico-chimique et microbiologique de l'eau des puits dans la commune d'Abomey-Calavi au Bénin en 2009

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Analyse multivariable des facteurs influençant la qualité de prise en charge des "Echappées Belles" dans les maternités de référence au sud du Bénin.

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Healthcare access in Benin: poverty and community aid networks

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Accès aux soins de santé au Bénin: indigence et réseaux d'aide communautaire.

The objective of this study was to evaluate the capacity of poor and non-poor households to pay for health care and to show how existing community assistance (or solidarity) networks (CAN) may compensate for this inability. Sixteen (16) study sites were randomly selected after stratification of Benin into four groups. All 1,312 households in our sample (668 poor and 664 non-poor) were interviewed, and 48 focus group were held with opinion leaders, women, healthcare workers, social workers, and persons responsible for these networks. The survey showed that only 27% of the heads of households have permanent financial access to health care and health services. This financial access is lower for the poor (9%) than for others (46%). However, the capacity of heads of households to pay reached 84% (87% for the non-poor and 81% for the poor, with P<0.01). Capacity to pay differs between strata (P<0.001) and is higher in the urban strata. For 25% of the families, intervention of the CAN made payment possible, preferentially for the poor. In 90% of cases, this community support came from the family network. Health centre management committees contributed in only 0.8% of cases. In general, help covered only a small percentage of those in need. The health policy of African countries must ensure that health care is accessible to the population, especially the poor.Comparative StudyEnglish AbstractEvaluation StudiesJournal Articleinfo:eu-repo/semantics/publishe