Prévalence de l’hépatite B chez les personnes infectées par le VIH à Parakou au Bénin

Introduction: la co-infection avec l'hépatite B est l'un des défis majeurs de la prise en charge du VIH depuis l'amélioration de l'accès aux  antirétroviraux en Afrique. La présente étude visait à estimer la prévalence de l'hépatite B chez les personnes séropositives au VIH à Parakou et décrire les facteurs associés. Méthodes: il s'agit d'une étude transversale menée de Mai 2011 à Juin 2012 dans le service de Médecine du CHU de Parakou. Ont été inclus tous les adultes séropositifs au VIH vus en  consultation ou hospitalisés. Les données ont été collectées par interviews et dépouillement de dossiers médicaux. L'antigène HBs a été recherché par un test rapide et l'ALAT a été dosé. L'analyse des données a été faite avec le logiciel EpiInfo 3.5.1. Les proportions ont été comparées grâce au test de Chi-deux ou au test de Fisher au seuil de significativité de 5%. Un modèle de régression logistique multivariable a permis d'expliquer la prévalence de l'hépatite B.Résultats: sur les 744 sujets inclus on a dénombré 555 femmes. L'âge moyen était de 35,5 + 10,1 ans. La  prévalence de l'hépatite B a été estimée à 16,9% (IC95 : 14,3%-19,9%). Cette prévalence était plus élevée chez les sujets originaires du  Borgou/Alibori et ceux au stade 4 de l'OMS. Conclusion: la prévalence de la co-infection VIH/VHB au CHU Parakou est élevée. Le dispositif national de prise en charge et de prévention de l'hépatite B chez les personnes  séropositives au VIH doit être renforcé

Etude Des Facteurs De Risque De L’obésité Chez Le Personnel Du CHUD/Borgou à Parakou (Bénin) en 2013

The objective of this study was to determine the prevalence of obesity among employees CHUD in Parakou and risk factors in 2013. Methods: This was a cross sectional study, descriptive analytical referred to place from 05 August to 05 September 2013. The study population consists of employees of CHUD in Parakou. Data were collected using a questionnaire and by anthropometric measures. Results: The overall prevalence of overweight and obesity was 55.9%. The sex ratio was 0.8. The mean age of subjects was 37.2 ± 9.0 years. Factors associated with obesity were: female gender (p = 10-11), those aged 30-49 years (p = 0.04), subjects with a level of secondary education limited (p = 0.01), subjects with a daily consumption and accidental alcohol (p = 10-9), snacking (p = 0.00012). Conclusion: Obesity prevention should involve the establishment and maintenance during the lifetime of healthy eating habits and regular physical activity

Positive Impact of Increases in Condom Use among Female Sex Workers and Clients in a Medium HIV Prevalence Epidemic: Modelling Results from Project SIDA1/2/3 in Cotonou, Benin

Background A comprehensive, HIV prevention programme (Projet Sida1/2/3) was implemented among female sex workers (FSWs) in Cotonou, Benin, in 1993 following which condom use among FSWs increased threefold between 1993 and 2008 while FSW HIV prevalence declined from 53.3% to 30.4%. Objective Estimate the potential impact of the intervention on HIV prevalence/incidence in FSWs, clients and the general population in Cotonou, Benin. Methods and Findings A transmission dynamics model parameterised with setting-specific bio-behavioural data was used within a Bayesian framework to fit the model and simulate HIV transmission in the high and low-risk population of Cotonou and to estimate HIV incidence and infections averted by SIDA1/2/3. Our model results suggest that prior to SIDA1/2/3 commercial sex had contributed directly or indirectly to 93% (84–98%) of all cumulative infections and that the observed decline in FSWs HIV prevalence was more consistent with the self-reported post-intervention increase in condom use by FSWs than a counterfactual assuming no change in condom use after 1993 (CF-1). Compared to the counterfactual (CF-1), the increase in condom use may have prevented 62% (52–71%) of new HIV infections among FSWs between 1993 and 2008 and 33% (20–46%) in the overall population. Conclusions Our analysis provides plausible evidence that the post-intervention increase in condom use during commercial sex significantly reduced HIV prevalence and incidence among FSWs and general population. Sex worker interventions can be effective even in medium HIV prevalence epidemics and need to be sustained over the long-term

Issue Thérapeutique Des Patients Tuberculeux Pulmonaires Biologiquement Confirmés Dans La Zone Sanitaire De Parakou-N’Dali De 2011 À 2015

Objective: The objective of this study is to describe the therapeutic outcome and factors associated with treatment failure in laboratory confirmed pulmonary tuberculosis patients. Methods: He acted in a descriptive and analytical study referred to prospective data collection. The study population consisted of laboratory confirmed pulmonary tuberculosis patients in the health zone Parakou-N'Dali from 2011 to 2015. Results: A total of 313 TB patients were enrolled. The average age of patients was 37.4 ± 14.3 years. The sex ratio was 2.1. Two hundred sixtyfive (265) patients were cured, a cure rate of 84.66%; 5 patients had completed treatment. Therapeutic success was observed in 270 patients (86.26%); the rate of treatment failure was 2.24%. Twenty-nine (29) patients died (9.26%); 6 patients were lost to follow and only 1 was transferred. Factors associated with treatment failure were the BMI screening to the lower than 18.5 kg/m2 (p = 0.000) and hospitalization (p = 0.002).Conclusion: The therapeutic outcome of patients with pulmonary tuberculosis in the health zone Parakou-N'Dali was characterized by a low rate process complete, lost sight and transfers

Prevalence of human papillomavirus infection in women in Benin, West Africa

<p>Abstract</p> <p>Background</p> <p>Cervical cancer ranks as the first most frequent cancer among women in Benin. The major cause of cervical cancer now recognized is persistent infection of Human Papillomavirus (HPV). In Benin there is a lack of screening programs for prevention of cervical cancer and little information exists regarding HPV genotype distribution.</p> <p>Methods</p> <p>Cervical cells from 725 women were examined for the presence of viral DNA by means of a polymerase chain reaction (PCR) multiplex-based assay with the amplification of a fragment of L1 region and of E6/E7 region of the HPV genome, and of abnormal cytology by Papanicolaou method. The association between HPV status and Pap test reports was evaluated. Socio-demographic and reproductive characteristics were also related.</p> <p>Results</p> <p>A total of 18 different HPV types were identified, with a prevalence of 33.2% overall, and 52% and 26.7% among women with and without cervical lesions, respectively. Multiple HPV infections were observed in 40.2% of HPV-infected women. In the HPV-testing group, the odds ratio for the detection of abnormal cytology was 2.98 (95% CI, 1.83-4.84) for HPV positive in comparison to HPV negative women. High risk types were involved in 88% of infections, most notably HPV-59, HPV-35, HPV-16, HPV-18, HPV-58 and HPV-45. In multiple infections of women with cytological abnormalities HPV-45 predominated.</p> <p>Conclusions</p> <p>This study provides the first estimates of the prevalence of HPV and type-specific distribution among women from Benin and demonstrates that the epidemiology of HPV infection in Benin is different from that of other world regions. Specific area vaccinations may be needed to prevent cervical cancer and the other HPV-related diseases.</p

Prevalence of metabolic syndrome among HIV-positive and HIV-negative populations in sub-Saharan Africa-a systematic review and meta-analysis

BACKGROUND: Metabolic syndrome (MetS) is a constellation of conditions that increase the risk of cardiovascular diseases. It is an emerging concern in sub-Saharan African (SSA) countries, particularly because of an increasingly aging population and lifestyle changes. There is an increased risk of MetS and its components among people living with Human immune deficiency syndrome (HIV) individuals; however, the prevalence of metabolic syndrome in the SSA population and its differential contribution by HIV status is not yet established. This systematic review and meta-analysis were conducted to estimate the pooled prevalence of metabolic syndrome in people living with HIV and uninfected populations, its variation by sub-components. METHODS: We performed a comprehensive search on major databases-MEDLINE (PubMed), EBSCOhost, and Cochrane Database of Systematic Reviews and Web of sciences for original epidemiological research articles that compared proportions of the MetS and its subcomponents between people living with HIV and uninfected patients and published between January 1990-December 2017. The inclusion criteria were adults aged ≥ 18 years, with confirmed HIV status. We assessed the risk of bias using a prevalence studies tool, and random effect meta-analyses were used to compute the pooled overall prevalence. RESULTS: A total of four cross-sectional studies comprising 496 HIV uninfected and 731 infected participants were included in the meta-analysis. The overall prevalence of MetS among people living with HIV was 21.5% (95% CI 15.09-26.86) versus uninfected 12.0% (95% CI 5.00-21.00%), with substantial heterogeneity. The reported relative risk estimate for MetS among the two groups was twofold (RR 1.83, 95% CI 0.98-3.41), with an estimated predictive interval of 0.15 to 22.43 and P = 0.055 higher for the infected population. Hypertension was the most prevalent MetS sub-components, with diverse proportions of people living with HIV (5.2-50.0%) and uninfected (10.0-59.0%) populations. CONCLUSIONS: The high range of MetS prevalence in the HIV-infected population compared to the uninfected population highlights the possible presence of HIV related drivers of MetS. Also, the reported high rate of MetS, irrespective of HIV status, indicates a major metabolic disorder epidemic that requires urgent prevention and management programs in SSA. Similarly, in the era of universal test and treat strategy among people living with HIV cohorts, routine check-up of MetS sub-components is required in HIV management as biomarkers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016045727