Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Facteurs associes a l'asthme severe chez les patients asthmatiques suivis au Centre National Hospitalier de Pneumo-phtisiologie de Cotonou (Benin) en 2014

Introduction: la presente etude vise a determiner la frequence de l'asthme severe chez les patients asthmatiques suivis au Centre National Hospitalier de Pneumo-Phtisiologie (CNHPP) de Cotonou et identifier les facteurs de risque qui lui sont associes. Methodes: l'etude transversale; descriptive et analytique a porte sur 213 patients asthmatiques de la file active 2013 du CNHPP. Les donnees ont ete collectees par l'exploitation des dossiers et l'entretien individuel avec les patients. Elles ont ete traitees et analysees a l'aide des logiciels EPIINFO7 et STATA11. Le test Chi2 de Pearson; la regression logistique uni variee et multi variee ont ete utilises au seuil de signification de 0;05. Resultats: au total; 154 patients asthmatiques soit 72;7% ont repondu au questionnaire. Parmi eux 20;8% (IC95% :(14;67 ; 28;05)) souffraient d'asthme severe. L'age des patients s'etendait de 10 a 76 ans avec une mediane de 41 ans; 51;3% etaient de sexe feminin; 79;9% avaient des antecedents d'allergie; 61;7% ont commence leur asthme apres l'age de 12 ans et seuls 11% ont consomme ou consommaient du tabac. Les facteurs associes a la survenue de l'asthme severe etaient : l'age de 46 a 55 ans (p = 0;04) ; les troisieme et quatrieme quintiles du bien-etre economique (p = 0;01) et le debut de l'asthme apres l'age de 12 ans (p 0;001). Conclusion: l'etude a montre une frequence elevee de l'asthme severe au Benin et permettra d'ameliorer sa prise en charge au CNHPP