Performances comparées du HDL-cholestérol et du ratio cholestérol total/HDL pour le dépistage du syndrome métabolique chez des adultes du Sud-Bénin (Afrique de l’Ouest)

Les critères de définition du Syndrome métabolique (SMet) n’identifient pas convenablement les sujets d’origine africaine à risque. L’objectif était de déterminer lequel du ratio cholestérol total/HDL-cholestérol (CT/HDL-C) et du HDL-Cholestérol est le meilleur prédicteur du SMet chez les adultes béninois. L’étude de type transversal, issue d’une enquête longitudinale sur le risque cardiométabolique a inclu 416 sujets âgés de 29 à 69 ans. Les composantes du SMet considérées sont : l’obésité abdominale, la tension artérielle élevée, la glycémie élevée, le HDL-C bas et les triglycérides élevés. La comparaison des aires sous les courbes (AUC) de la « fonction d’efficacité du récepteur » (ROC) de prédiction de l’existence deux composantes du SMet autre que l’obésité abdominale, a permis de déterminer le meilleur prédicteur. Les prévalences du SMet étaient de 13,9% selon la définition harmonisée, 12,3% lorsque le HDL-C bas est remplacée par CT/HDL-C élevé. Les prévalences du HDL-bas et du CT/HDL-C élevé sont de 37,7% et 22,6%, respectivement. Pour le dépistage du SMet, l’AUC du CT/HDL-C est de 0,69 (IC 95% 0,61-0,77) chez les femmes et 0,68 (IC 95% 0,59-0,77) chez les hommes. L’AUC du HDL-C est de 0,45 (IC 95% 0,37-0,53) chez les femmes et 0,40 (IC 95% 0,30-0,44) chez les hommes. Le HDL-C et le CT/HDL-C ont une faible capacité prédictive pour le SMet, mais la composante CT/HDL-C prédit mieux le SMet que le HDL-C isolé. Toutefois, l’utilisation de l’un ou l’autre des deux paramètres ne modifie pas substantiellement la prévalence du SMet dans la population d’étude.© 2016 International Formulae Group. All rights reserved.Mots clés: Syndrome métabolique, lipoprotéines, ratio CT/HDL-C, Sud-BéninEnglish Title: Comparative performance of HDL-cholesterol and total cholesterol / HDL ratio for screening of metabolic syndrome in Southern Benin adults (West Africa)English AbstractCurrent definition criteria of the metabolic syndrome (MetS) do not adequately identify at risk African origin subjects. The objective was to determine which of total cholesterol/HDL-cholesterol (TC/HDL-C) and HDL-cholesterol is the best predictor of metabolic syndrome (SMet) in Benin adults. This cross-sectional study was nested in a four-year follow-up study on cardiometabolic risk factors and included 416 adults aged 29-69 years. Components of MetS considered were abdominal obesity, high blood pressure (BP), high fasting glucose, low HDL-C and high triglycerides. Areas under the "Receiver operator characteristic" curves (AUC)for CT/HDL-C and HDL-C in predicting the presence of at least two other components of SMet were compared in order to determine the best predictor of SMet. The prevalence of SMet was 13.9%, when replacing low HDL-C by high TC/HDL-C and 15.3% when both dyslipidemia indicators are combined. The prevalence of low HDL-C and high TC/HDL-C was 37.7% and 22.6%, respectively (p<0.001). Screening for SMet, the AUC of TC/HDL-C were 0.69 (95% CI 0.61-0.77) for women and 0.68 (95% CI 0.59-0.77) in men. The AUC of HDL-C were 0.45 (95% CI 0.37-0.53) for women and 0.40 (95% CI 0.30-0.44) for men. Both TC/HDL-C and HDL-C showed some weak predictive values for SMet, but TC/HDL-C ratio predicted SMet better than HDL-C.© 2016 International Formulae Group. All rights reserved.Keywords: Metabolic syndrome, lipoprotein, ratio CT/HDL-C, Southern Beni

Factors associated with early sexual intercourse among teenagers and young adults in rural south of Benin

Early initiation to sexual intercourse increases the risk of sexually transmitted infections including HIV/AIDS and early or unwanted pregnancies. This study aimed identifying the factors associated with the early initiation to sexual intercourse among teenagers and young adults aged 10-24, in the south of Benin. A cross-sectional study was conducted in the south of Benin where 360 respondents were selected by random cluster sampling. Multiple logistic regressions was used to find related factors to early sexual intercourse. The significance level for the tests was of 5%. The average reported age of initiation to sexual intercourse was 14.75±2.18. Among the male teenagers and young adults, 41.11% had an early sexual intercourse against 20.24% for the female gender (P<10-3). The lack of communication between parents-teenagers (P=0.003), level of education of the father (P=0.021), exposure to pornographic movies (P=0.025), an adverse opinion on premarital sexual abstinence (P=0.026) were significantly associated with early sexual intercourse. Communication about health promotion for behavioural change may contribute to delay the age of sexual initiation

BMC Womens Health

BACKGROUND: Violence against women remains an important issue of inequality in African societies, with several consequences to health, social and economic status. This study aims to identify the factors related to the perception of intimate partner violence in Benin. METHODS: Data on intimate partner violence was collected by conducting live interviews, and from the Benin Demographic and Health Survey 2012. The dependent variable was acceptance of intimate partner violence. The independent variables were socio-demographic features such as age, level of education, matrimonial status, ethnicity, religion, place of residence and the index of economic well-being. Logistic regressions were performed and odds ratios (OR) with a confidence interval of 95% (CI95%) were estimated. RESULTS: Among the 21,574 people who answered the questions relating to violence against women by an intimate partner, the prevalence of acceptance of intimate partner violence was 15.77%. Ethnicity, level of education, administrative department of residence, religion, and socio-economic quintile were factors associated with the respondents' acceptance of violence against women by an intimate partner. CONCLUSION: Acceptance of intimate partner violence could be a major obstacle to the success of some health programs. There is a need to break the norms that support the vulnerability of women in Beninese society

Accessibilité à la césarienne au Bénin

Introduction: To be used effectively, emergency obstetric and neonatal care must be available and accessible. This study sought to measure the accessibility of cesarean deliveries in Benin. Method: Cross-sectional study of randomly selected women in each of the 12 obstetrics departments in Benin. Geographical accessibility was measured by estimating the distance between the parturientes residence and the hospital. Financial accessibility was the average direct cost of the cesarean delivery —the sum of medical and nonmedical costs. The functionality of the referral system was assessed according to the conditions of referral of women referred for cesareans. Results: The mean distance between women’s homes and the hospital was 20.2 ± 22.3 kilometers. Of the 579 women, 63.0% were referred from a peripheral health center to a hospital; the referral conditions were completed in the obstetric record for only half of them. The data sheet for the referral was completed for only 34.4%; venous access had been placed in 28.5%, and the patient was accompanied by medical personnel in only 1.7% of cases. The average direct cost of the cesarean to families was 36,782 ± 30,859 FCFA. Conclusion: Cesarean deliveries are now more accessible financially due to the policy of free access, but they remains geographically inaccessible, because of the long distances to be covered and the poor organization of referrals to ensure continuity of care.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Management of information within emergencies departments in developing countries: Analysis at the National Emergency Department in Benin

Introduction: The management of health information is a key pillar in both emergencies reception and handling facilities, given the strategic position and the potential of these facilities within hospitals, and in the monitoring of public health and epidemiology. With the technological revolution, computerization made the information systems evolve in emergency departments, especially in developed countries, with improved performance in terms of care quality, productivity and patient satisfaction. This study analyses the situation of Benin in this field, through the case of the Academic Clinic of Emergency Department of the National University Teaching Hospital of Cotonou, the national reference hospital. Methods: The study is cross-sectional and evaluative. Collection techniques are literature review and structured interviews. The components rated are resources, indicators, data sources, data management and the use-dissemination of the information through a model adapted from Health Metrics Network framework. We used quantitative and qualitative analysis. Results: The absence of a regulatory framework restricts the operation of the system in all components and accounts for the lack and inadequacy of the dedicated resources. Conclusion: Dedication of more resources for this system for crucial needs such as computerization requires sensitization and greater awareness of the administrative authorities about the fact that an effective health information management system is of prime importance in this type of facility.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

"My right to walk, my right to live": pedestrian fatalities, roads and environmental features in Benin.

The implementation of road safety interventions in many developing countries usually focuses on the behavior of users. In order to draw more attention on the role of road infrastructure and physical environment in road safety interventions, this study aims to analyze the environmental and road factors associated with the pedestrians involved in traffic crashes in Benin.info:eu-repo/semantics/publishe