Situation analysis of urogenital bilharzia in West Africa (2010-2021) and control strategies and prospects: systematic review and meta-analysis.

Schistosomes are parasitic diseases caused by flatworms (schistosomes or bilharzia), transmitted in the urine or in the faeces, and involving intermediate hosts (freshwater molluscs). Their recrudescence in endemic areas is no longer in question and remains a crucial public health problem in the world in general and in West Africa in particular. In order to eradicate bilharzia, many control strategies and policies have been implemented on both sides. The objective of this systematic literature review is to synthesize the existing evidence on control strategies implemented by West African countries. To achieve this, data were collected from PubMed, Direct Science, Web of Sciences, Google Scholar, PloS and Banque de Données de Santé Publique (BDSP), using appropriate keywords. Academic articles and theses written in French or English that evaluated the analysis of a bilharzia situation in West Africa were selected. Sixteen scientific papers were selected for the study, ten of which were used for a meta-analysis. The systematic review revealed that bilharzia is still an endemic disease in West Africa. Clearly, it continues to wreak havoc on the population, especially among school children. Rural areas are the most affected by the disease. Strategies to control bilharzia are based on preventive and curative treatment of the infection with chemotherapy and vector control of soil molluscs (host and vector of bilharzia eggs). Praziquantel is the main known antibilharzian. Also, the species most frequently found in analyses are S. haematobiumand S. mansonii. This review has allowed to evaluate the control strategies carried out and to deduce the strengths and weaknesses, in order to define the perspectives for the efficiency of the anti-bilharzia control for the eradication of bilharzia in the endemic zones of West Africa.

["Getting clear skin and why not?": voluntary depigmentation among women in a southwest region of Benin]. / "Avoir la peau claire et pourquoi pas? ": dépigmentation volontaire chez les femmes dans une région du sud-ouest du Bénin.

INTRODUCTION: This study aims to determine the prevalence and the factors associated with the use of products for voluntary depigmentation among women aged 15-49 years in Comè health zone in Benin. METHODS: We conducted a cross-sectional study of 511 women aged 15-49 years selected using a cluster survey in 2016. Data were collected using a questionnaire seeking to explore the demographic, socio-cultural and economic characteristics of women. Depigmentation ingredients have been identified looking at the composition of regularly used body lotions. We performed a multiple logistic regression analysis. The statistical significance level was set at 5%. RESULTS: The prevalence of use for voluntary depigmentation products among women aged 15-49 years in Comè health zone was 79,22% 95%; CI=[75,72-82,78] and 84,23% of women knew at least one of the adverse health effects associated with the use of skin depigmentation products. The products used were hydroquinone based (98.24%) and dermocorticoid based (1.76%). Factors associated with the use of voluntary depigmentation products included marital status (single, widowed, separated or divorced) (OR=3.1; 95% CI=[1.29-7.44]), the search for a husband or a partner (OR=4.92; 95% CI=[1.20-20.09]), the presence of hyperpigmented spots (OR=10.32; 95% CI=[2.87-37,01]). CONCLUSION: These results show that the use of skin depigmentation products among women is a serious and huge public health problem in Comè health zone. Integrated communication campaign which can produce positive changes should be implemented.

Factors associated with post-cesarean stillbirth in 12 hospitals in Benin: a cross-sectional.

INTRODUCTION: In spite of free caesarean section applied in Benin since 2009, high rates of stillborn babies continue to be recorded. This study aimed to determine the factors associated with post-caesarean stillborn in Benin. METHODS: Cross-sectional study that covered all women who have delivered by caesarean from December 2013 to February 2014 in twelve hospitals chosen by simple random selection in each of the twelve departments of Benin. Data collected by chart review have been analyzed using the statistical software Epi info 3.5.1. Univariate analysis and multivariable logistic regression were used to identify factors associated with post-caesarean stillbirth at the significance threshold of 5%. RESULTS: There were 66 stillborn per 1,000 births of which 58% died before admission to hospital. The risk factors identified were the reference (p = 0.0011), general anesthesia (p = 0.0371), the low birth weight (p = 0.0001), the retro-placental hematoma (p = 0.0083), and the umbilical cord prolapse (p = 0.0229). Acute fetal distress (p = 0.0308) and anesthesia administered by an anesthetist nurse or midwife (p = 0.0337) were protective factors. CONCLUSION: The majority of cases, in utero death occurred before admission to hospital. Strengthening antenatal refocused consultation, a better access to quality obstetric care and the grant of all obstetric care could reduce stillbirths from caesarean sections in Benin.

[The determinants of the low case fatality rate of the cholera epidemic in the Littoral department of Benin in 2008]. / Les déterminants de la faible létalité de l'épidémie de choléra dans le Littoral au Bénin en 2008.

The 2008 cholera outbreak in Benin was characterized by a low case fatality rate (0.39 p.100) in the Littoral department, where 502 cases were recorded between July and December. The aim of this study was to identify the key factors associated with the low case fatality rate within the department. The cross-sectional, descriptive and analytical study conducted as part of this research used 404 patient records, focus group discussions with ten former patients, in-depth interviews with 8 health authorities involved in the response and structured face-to-face interviews with 12 health personnel involved in the treatment of patients. The data were analyzed using qualitative and quantitative content analysis based on EPIINFO 3.3.2 and EXCEL 2007 software. The results from several sources were cross-checked through triangulation. The mean age of patients was 23.72 ± 14.8 years. 39.35% patients were admitted with severe dehydration. Oral rehydration, intravenous rehydration and antibiotic therapy were given to 99.5%, 85% and 97.77% of patients, respectively. Only one hospital death was noted. The low case fatality rate was mainly due to the following factors: the high quality of care provided in a center with qualified personnel and available and free of charge treatment kits, protocols based on massive rehydration and appropriate hygiene measures, and patient compliance with the treatment plan. The response was also characterized by good coordination, wide mass and local health promotion, and selective antibiotic prophylaxis, which contributed significantly to reducing the spread of the infection.

[Assessment of the quality of response to the 2008 cholera outbreak in Contonou (Benin)]. / La riposte à l'épidémie de choléra de 2008 à Cotonou (Bénin).

To assess the quality of the response to the 2008 outbreak of cholera in Cotonou (Benin), this retrospective study focused on the health professionals managing the response, community leaders, cases of cholera found in homes and health service documents. The terms of reference used for the purposes of this assessment included the WHO recommendations and the rules set out in the national plan for the fight against epidemics. The resources and method used in this study complied with the norms specified in the plan, as did the epidemiologic follow-up. Community and family interventions concerned only a limited number of households in comparison with the total number of cases. Of the 402 cases diagnosed between July 28th and October 16th 2008, 384 cases were given treatment complying with the specified protocols, and just one death was recorded (hospital lethality 0.25%). The mean length of hospitalization was 2.43 days ± 1.16. Compliance with standard response procedures resulted in good quality care and very low lethality. The national plan of response to epidemics is therefore validated. An improved management of outbreaks requires national multi-sector coordination. Authorities in the following areas need to be involved: healthcare, environment, education, public administration and local communities.