Epidemiological aspects of surgical site infections in an income country. The case of regional hospital center, Borgou (Benin)

ABSTRACT Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013), each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and 70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days. The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli (64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional Hospital Centre of Borgou.Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013), each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and 70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days. The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli (64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional Hospital Centre of Borgou

In Silico Modeling and Immunoinformatics Probing Disclose the Epitope Based PeptideVaccine Against Zika Virus Envelope Glycoprotein

Zika virus (ZIKV) is an aedes mosquito borne pathogen belonging to the member of flaviviridae subgroup is the causative agent of an emerging disease called Zika fever, known as a benign infection usually presenting as influenza like illness with cutaneous rash. Due to recent epidemic outbreaks it is realized as a major health risk which need enhanced surveillance, but no attempt has been made to design an epitope based peptide vaccine against Zika virus. Viral envelope proteins are derived from host cell membrane proteins with some viral glycoproteins and are used to cover their protective protein capsid, help the viruses to enter host cells and help them to avoid the host immune response. In this study, amino acid sequence of ZIKV envelope glycoprotein was obtained from a protein database and examined with in silico approaches to determine the most immunogenic epitopes for B cell and T cell which could induce humoral as well as cell mediated immune response. Both the linear and conformational epitopes for B cell were predicted by immunoinformatics tools housed in IEDB resources. The peptide sequence DAHAKRQTVVVLGSQEGAV from position 121 and peptide sequence from 117-137 amino acids were predicted as most potential B cell linear and conformational epitopes respectively. Epitopes for CD4+ and CD8+ T cell were also predicted by using tools within IEDB resource and peptide sequence MMLELDPPF from position 250-258 amino acids was predicted as most immunogenic CD8+ T cell epitope with immune response evoking ability prediction score (I pMHC) of 0.09139 and conservancy of 52.17%. The innate immune response for ZIKV envelope glycoprotein was determined by interferon (IFN)-gamma effectuation and mimicking capacity by immunoinformatics and molecular docking study respectively. However, this is an introductory approach to design an epitope based peptide vaccine against Zika virus; we hope this model will be very much helpful in designing and predicting novel vaccine candidate

Tropical field stations yield high conservation return on investment

Conservation funding is currently limited; cost-effective conservation solutions are essential. We suggest that the thousands of field stations worldwide can play key roles at the frontline of biodiversity conservation and have high intrinsic value. We assessed field stations’ conservation return on investment and explored the impact of COVID-19. We surveyed leaders of field stations across tropical regions that host primate research; 157 field stations in 56 countries responded. Respondents reported improved habitat quality and reduced hunting rates at over 80% of field stations and lower operational costs per km2 than protected areas, yet half of those surveyed have less funding now than in 2019. Spatial analyses support field station presence as reducing deforestation. These “earth observatories” provide a high return on investment; we advocate for increased support of field station programs and for governments to support their vital conservation efforts by investing accordingly

Tropical field stations yield high conservation return on investment

Conservation funding is currently limited; cost-effective conservation solutions are essential. We suggest that the thousands of field stations worldwide can play key roles at the frontline of biodiversity conservation and have high intrinsic value. We assessed field stations’ conservation return on investment and explored the impact of COVID-19. We surveyed leaders of field stations across tropical regions that host primate research; 157 field stations in 56 countries responded. Respondents reported improved habitat quality and reduced hunting rates at over 80% of field stations and lower operational costs per km2 than protected areas, yet half of those surveyed have less funding now than in 2019. Spatial analyses support field station presence as reducing deforestation. These “earth observatories” provide a high return on investment; we advocate for increased support of field station programs and for governments to support their vital conservation efforts by investing accordingly

Health insurance coverage and antenatal care services utilization in West Africa.

BACKGROUND: In recent decades, there has been a significant focus towards the improvement of maternal mortality indicators in low-and middle-income countries. Though progress has been made around the world, West Africa has maintained an elevated burden of diseases. One proposed solution to increasing access to primary care services is health insurance coverage. As limited evidence exists, we sought to understand the relationship between health insurance coverage and at least four antenatal care (ANC) visits in West Africa. METHODS: Demographic and Health Survey data from 10 West African countries were weighted, cleaned, and analysed. The total sample was 79,794 women aged 15 to 49 years old were considered for the analysis. Health insurance coverage was the explanatory variable, and the outcome variable was number of ANC visits. The data were analysed using binary logistic regression. The results were presented using crude and adjusted odds ratio (aOR) at 95% confidence interval. RESULTS: Approximately 86.73% of women who were covered by health insurance had four or more ANC visits, compared to 55.15% for women without insurance. In total, 56.91% of the total sample attended a minimum of four ANC visits. Women with health insurance coverage were more likely to make the minimum recommended number of ANC visits than their non-insured-peers (aOR [95% CI] =1.55 [1.37-1.73]). CONCLUSION: Health insurance is a significant determinant in accessing primary care services for pregnant women. Yet, very few in the region are covered by an insurance scheme. In the wake of the COVID-19 pandemic, policy makers should prioritize rapid solutions to provide primary care while setting the infrastructure for long-term and sustainable options such as publicly run health insurance schemes

Health insurance coverage and access to child and maternal health services in West Africa: a study protocol for a systematic review

BackgroundThough many studies have discussed the impact of health insurance on access to medical services, few have considered Western Africa. Despite decades of targeted efforts, West Africa has the most elevated maternal mortality rates (MMR) and under-five mortality rates in the world. The solution to this issue is widely believed to be the implementation of universal health coverage (UHC) as most causes of death could be effectively dealt with through primary health care providers. It is possible that UHC without additional efforts to tackle important determinants of health such as education and poverty is insufficient. The objective of this study is to examine the link between being covered by health insurance and access to health services for mothers and children in West Africa.MethodsA systematic literature review will be conducted. We will search the online databases MEDLINE complete, Embase, CINAHL complete, and Global Health from inception onwards. The focus will be on primary research studies and grey literature that examined health insurance in relation to access to maternal and child health services. Two reviewers will independently screen all citations, full-text articles, and abstract data. The primary outcome will be maternal and child access to health insurance and access to primary and secondary services such as attending the minimum number of prenatal visits and accessing services in emergency circumstances where catastrophic expenditures may have been an obstacle. A standardized data extraction form by the Cochrane library will be used. A narrative synthesis will be conducted with a summary of findings tables to be produced.DiscussionThe systematic review will present findings on the impact of access to health insurance on access to maternal and child health care. The findings will inform discussion around the pursuit of UHC as a key health systems policy. The final manuscript will be disseminated through peer-reviewed journal and scientific conferences

Qualite de vie au travail des personnes vivant avec le VIH sous traitement antiretroviral au Togo en 2019 : Quality of life at work in people living with HIV on antiretroviral treatment in Togo, in 2019

Introduction : Les personnes vivant avec le VIH (PVVIH) sont confrontées aux effets indésirables du traitement antirétroviral et aux troubles psychosociaux qui impactent leur qualité de vie. L’objectif de cette étude était d’évaluer la qualité de vie au travail des PVVIH sous traitement antirétroviral suivies au centre hospitalier universitaire (CHU) - Campus de Lomé.Méthode : Une étude transversale a été menée du 15 juillet au 15 septembre 2019 chez les PVVIH âgées d’au moins 18 ans sous traitement antirétroviral et suivies dans l’unité de prise en charge des PVVIH du CHU-Campus. Les données ont été collectées à l’aide d’un questionnaire standardisé : Medical outcome study short form-36 item health survey (MOS SF-36).Résultats : Au total, 245 PVVIH ont été enquêtées. L’âge moyen était de 44,10 ± 10,67 ans et le sex-ratio (H/F) de 0,29. La durée moyenne de séropositivité et du traitement antirétroviral était respectivement de 5,96 ± 4,33 ans et 5,42 ± 3,97 ans. Les PVVIH étaient sous Ténofovir-Lamivudine-Efavirenz dans 86,12% des cas. La « vitalité » était la dimension la plus altérée (55,43). La « composante psychique » était plus altérée que la « composante physique » (43,62 vs 49,69 ; p ˂ 0,001). La dimension « limitations due à l’état psychique » a été impactée par les affections opportunistes (p = 0,043). La dimension « santé psychique » a été impactée par le type de traitement antirétroviral (p = 0,025).Conclusion : Les PVVIH sous traitement antirétroviral avaient une bonne qualité de vie globale hormis la vitalité. Leur état de santé mentale était plus altéré d’où la nécessité d’une prise en charge psychologique plus renforcée. Introduction: People living with HIV (PLWHIV) are confronted with adverse effects of antiretroviral drugs and other psychosocial disorders that impact their quality of life. The objective of this study was to evaluate the quality of life at work of PLWHIV on antiretroviral treatment followed at Campus - university hospital in Lomé.Method: A cross-sectional study was conducted from July 15 to September 15, 2019, among PLWHIV at least 18-years-old on antiretroviral treatment and followed in the unity that took care of PLWHIV at Campus - university hospital. The data were collected using a standardised questionnaire: Medical Outcome Study Short Form-36 Item Health Survey (MOS SF-36).Results: A total of 245 PLWHIV were interviewed. The mean age was 44.10 ± 10.67 years. The sex-ratio (M/F) was 0.29. The mean duration of the fact of being seropositive and antiretroviral treatment was respectively 5.96 ± 4.33 years and 5.42 ± 3.97 years. PLWHIV were on Ténofovir-Lamivudine-Efavirenz in 86.12% of case. The “Vitality” was the most altered dimension (55.43). The “psychic component” was more altered than the “physical component” (43.62 vs. 49.69; p ˂ 0.001). The "limitations due to mental state" was impacted by opportunist infections (p = 0.043). The ‘‘mental health’’ dimension was impacted by the type of antiretroviral treatment (p = 0.025).Conclusion: PLWHIV on antiretroviral treatment had a good global quality of life except of vitality. Their mental health state was more altered so psychological care should grow stronger

Diabete chez le sujet age au Togo

Objectif: Il s’agit de faire ressortir les aspects épidémio-cliniques, les complications et l’évolution du diabète chez le sujet âgé au Togo.Méthode: Il s’est agi d’une étude rétrospective réalisée sur 18 mois allant du 1er Octobre 2012 au 31 Mars 2014. Elle a concerné 22 patients diabétiques âgés de plus de 65 ans hospitalisés dans le service de médecine interne du CHU Sylvanus Olympio de Lomé.Résultats: La fréquence du diabète chez le sujet âgé était de 25,88%. La tranche d’âge la plus représentée était celle de 65 à 69 ans. La moyenne d’âge était de 71,13 ans avec des extrêmes de 65 et 85 ans. La sex-ratio (H/F) était de 2,14. Le Diabète de type II a été représenté dans tous les cas. L’hypertension artérielle étaient associée au diabète dans 50% des cas. Les complications métaboliques aiguës étaient représentées par l’acidocétose (10 cas) et l’hypoglycémie (2 cas). Concernant les complications chroniques, les plus fréquentes étaient des rétinopathies diabétiques (5 cas), la neuropathie périphérique (5cas) et le pied diabétique (4 cas). L’évolution a été défavorable (décès) chez 4 patients.Conclusion: Les complications du diabète chez le sujet âgé sont les mêmes que celles retrouvées dans la population diabétique jeune mais avec une prédominance des complications dégénératives.Mots clés: Diabète, sujet âgé, complications, Lomé (Togo)English Title: Diabetes in old person in TogoEnglish AbstractGoal: Our concern is to bring out the clinical and epideomological aspects, complications diabetes progression with the old subject in TogoMethod: It concerned a retrospective 18 months study carried out from the period of October 1, 2012 to March 31, 2014. It involved 22 diabetics patients of 65 of age admitted in the internal medecine unit of Sylvanus Olympio Teaching Hospital of Lome.Results: The frequency of diabetes with the old subject was 25.88%. The most represented age bracket was that of 65 and 69 of age. The average age was 71, 13 with extrem of 65 and 85 of age. The sex-ratio (M/W) was 2.14. Type II diabetes was represented in all cases. Arterial high blood pressure was associated with diabetes in 50% of cases. Acute metabolic complications were ketoacidosis (10 cases) and hypoglycaemi (2 cas). Regarding chronic complications, the most frequents were diabetic retinopathies (5 cas), peripheral neuropathy (5cas) and diabetic foot (4 cases). The progression was unfavourable (death) 4 patients.Conclusion: Diabetes complications with old subject are the same as those found in the young diabetic people but with a predominance of degenerative complications.Keywords: Diabetes, old subject, complications, Lomé (Togo