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INTRODUCTION: The sterilization of surgical drapes plays an important role in preventing infections associated with treatments. At the CNHU-HKM, sterilization procedure for drapes encounters problems. The purpose of this study was to examine the factors associated with the quality of sterilization of surgical drapes at the CNHU-HKM. METHODS: We conducted a cross-sectional, descriptive and analytical study focusing on 20 sterile surgical drapes, 41 agents were involved in the management of drapes and 55 members of the surgical team. The probabilistic method was used for sterile surgical drapes, the non-probabilistic method for the others. Pearson's Chi-square Test and logistic regression were used to find the association, with a significant threshold and a p<0.05. RESULTS: Eighty six point forty six percent of subjects were males with an average age of 42 years. The quality of the process of sterilization of the operative drapes was not good in the two departments responsible for processing the drapes. Bacteriological analysis showed that, out of 20 sterile surgical drapes, 9 had Acinetobacter spp. a multidrug-resistant germ causing nosocomial infections. Multivariate analysis showed that professional experience (p=0.015) and quality control of the procedure (p=0.034) were statistically associated with the quality of sterilization. CONCLUSION: The presence of Acinetobacter spp. on the sterilized drapes demonstrates that sterilization of drapes at the CNHU-HKM is of poor quality. Measures strengthening the skills of providers are necessary to improve the quality of sterilization procedures.
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Garantía de la Calidad de Atención de Salud , Esterilización/normas , Paños Quirúrgicos/microbiología , Adulto , Benin/epidemiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Estudios Transversales , Femenino , Higiene de las Manos/normas , Higiene de las Manos/estadística & datos numéricos , Hospitales Universitarios , Humanos , Masculino , Técnicas Microbiológicas , Quirófanos/normas , Quirófanos/estadística & datos numéricos , Garantía de la Calidad de Atención de Salud/normas , Garantía de la Calidad de Atención de Salud/estadística & datos numéricos , Calidad de la Atención de Salud , Medición de Riesgo , Factores de Riesgo , Esterilización/estadística & datos numéricos , Paños Quirúrgicos/normas , Paños Quirúrgicos/estadística & datos numéricos , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
INTRODUCTION: At the international level, further reflection on the role of community health workers is in progress. The objective of this work is to develop a model of the integration of community health workers in the National Health System. METHOD: The study was conducted in Benin and Togo. It was a cluster survey that involved 385 Community Health Workers (CHW), 238 village heads, 92 health care managers selected responsibly, and 6150 households selected in a probabilistic manner. The analysis of the strengths, weaknesses, opportunities and threats of interventions under Community directives has contributed to the development of the model.Results : In both countries, community health reference materials existed, and 98.4% community health workers were trained before the beginning of the activities, and all have an intrinsic motivation for the work they do. Only 31.3% of households participated in the selection of community health workers in their locality. The absence of laws recognizing the work of the CHW is a threat to their integration into the healthcare system. The main elements proposed in the model are, the development of the status of community health workers, their remuneration on a budget managed by the health district and fed by several sources. CONCLUSION: Community Health Workers should not be a health care alternative, but an integral part of the national health system.
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Agentes Comunitarios de Salud , Medicina Estatal , Benin , Atención a la Salud , Humanos , Motivación , Investigación Cualitativa , TogoRESUMEN
INTRODUCTION: Organizational culture, a frequently ignored concept, affects job satisfaction and productivity in organizations. OBJECTIVE: To determine the factors associated with the strength of organizational culture (OC) in Mono / Couffo regional hospital in Lokossa in Benin. METHODS: This cross-sectional and analytical study involved 121 workers of Mono/Couffo hospital in March 2015. Data on the strength of OC was collected using a questionnaire based on the validated tool proposed by Cameron and Quinn (2006). Logistic regression was performed to explore the nature of the relationship between the independent variables and OC using Odds ratios. RESULTS: 62% of the surveyed subjects had a positive perception of organizational culture. This perception was statistically associated with managerial factors (moral support of workers and type of relationship with the executive staff). The risk of perceiving a low strength of OC was sixfold higher OR = 3.78, 95% CI (1.08 - 13.22) among subjects who felt they did not have moral support from executive staff than in those who perceived this moral support. The risk of perceiving a weak OC was higher among subjects who considered relations with the staff to be uncordial [OR = 14.32, 95% CI (4.35 - 47.11)] compared to those who considered these relations to be cordial. CONCLUSION: Human resource management factors were more closely associated with the strength of organizational culture. Hospital managers should pay more attention to these factors in their hospitals to promote better institutional performance.
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Actitud del Personal de Salud , Cultura Organizacional , Adulto , Benin , Estudios Transversales , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: In Intertropical Africa hospitalized patients are exposed to a risk of nosocomial infections. The dearth of published data on this subject limits the descriptive analysis of the situation. This study aimed to determine the incidence, the germs responsible for these infections and the risk factors of nosocomial infections in the Maternity Ward at the General Referral Hospital in Katuba, Lubumbashi, Democratic Republic of the Congo. METHODS: We conducted a descriptive, longitudinal study from 1 October 2014 to 1 January 2015. Our study population consisted of 207 women who had been hospitalized in the Maternity Ward at the General Referral Hospital in Katuba. We carried out a comprehensive data collection. RESULTS: Nosocomial infection rate accounted for 15.5%. Parturient women who had been hospitalized for more than three days were three times more likely to develop a nosocomial infection (p=0.003), while those who had had a complicated delivery were four times more likely to be at risk of developing nosocomial infection (p = 0.000). Escherichia coli was the most isolated causative agent (38.1%), followed by Citrobacter freundi (23.8%), Acinobacter baumani (.18, 2%), Staphylococcus aureus (18.2%), Enterococcus aureus (14.3%) and Pseudomonas aeroginosa (9.1%). Ampicillin was the most prescribed antibiotic, to which isolated microbes were resistant. CONCLUSION: It is necessary to improve hospital hygiene and to conduct further study to examine the similarity between germs strains in the environment and those in biological fluids.
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Bacterias/aislamiento & purificación , Infección Hospitalaria/epidemiología , Infección de la Herida Quirúrgica/epidemiología , Infecciones Urinarias/epidemiología , Adolescente , Adulto , Antibacterianos/uso terapéutico , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/microbiología , República Democrática del Congo , Farmacorresistencia Bacteriana , Femenino , Hospitales Generales , Humanos , Incidencia , Estudios Longitudinales , Persona de Mediana Edad , Embarazo , Factores de Riesgo , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/microbiología , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/microbiología , Adulto JovenRESUMEN
INTRODUCTION: Buruli ulcer (BU) is a severe necrotizing human skin disease caused by Mycobacterium ulcerans. Clinically, presentation is a sum of these diverse pathogenic hits subjected to critical immune-regulatory mechanisms. Among them, autophagy has been demonstrated as a cellular process of critical importance. Since microtubules and dynein are affected by mycolactone, the critical pathogenic exotoxin produced by M. ulcerans, cytoskeleton-related changes might potentially impair the autophagic process and impact the risk and progression of infection. OBJECTIVE: Genetic variants in the autophagy-related genes NOD2, PARK2 and ATG16L1 has been associated with susceptibility to mycobacterial diseases. Here, we investigated their association with BU risk, its severe phenotypes and its progression to an ulcerative form. METHODS: Genetic variants were genotyped using KASPar chemistry in 208 BU patients (70.2% with an ulcerative form and 28% in severe WHO category 3 phenotype) and 300 healthy endemic controls. RESULTS: The rs1333955 SNP in PARK2 was significantly associated with increased susceptibility to BU [odds ratio (OR), 1.43; P = 0.05]. In addition, both the rs9302752 and rs2066842 SNPs in NOD2 gee significantly increased the predisposition of patients to develop category 3 (OR, 2.23; P = 0.02; and OR 12.7; P = 0.03, respectively, whereas the rs2241880 SNP in ATG16L1 was found to significantly protect patients from presenting the ulcer phenotype (OR, 0.35; P = 0.02). CONCLUSION: Our findings indicate that specific genetic variants in autophagy-related genes influence susceptibility to the development of BU and its progression to severe phenotypes.
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Autofagia , Úlcera de Buruli/genética , Úlcera de Buruli/patología , Predisposición Genética a la Enfermedad , Interacciones Huésped-Patógeno , Mycobacterium ulcerans/inmunología , Polimorfismo de Nucleótido Simple , Adolescente , Adulto , Proteínas Relacionadas con la Autofagia , Úlcera de Buruli/epidemiología , Proteínas Portadoras/genética , Niño , Femenino , Técnicas de Genotipaje , Humanos , Masculino , Proteína Adaptadora de Señalización NOD2/genética , Medición de Riesgo , Ubiquitina-Proteína Ligasas/genética , Adulto JovenRESUMEN
BACKGROUND: Identification of variation in Ace-1 copy number and G119S mutation genotype from samples of Anopheles gambiae and Anopheles coluzzii across West Africa are important diagnostics of carbamate and organophosphate resistance at population and individual levels. The most widespread and economical method, PCR-RFLP, suffers from an inability to discriminate true heterozygotes from heterozygotes with duplication. METHODS: In addition to PCR-RFLP, in this study three different molecular techniques were applied on the same mosquito specimens: TaqMan qPCR, qRTPCR and ddPCR. To group heterozygous individuals recorded from the PCR-RFLP analysis into different assumptive genotypes K-means clustering was applied on the Z-scores of data obtained from both the TaqMan and ddPCR methods. The qRTPCR analysis was used for absolute quantification of copy number variation. RESULTS: The results indicate that most heterozygotes are duplicated and that G119S mutation must now be regarded as a complex genotype ranging from primarily single-copy susceptible Glycine homozygotes to balanced and imbalanced heterozygotes, and multiply-amplified resistant Serine allele homozygotes. Whilst qRTPCR-based gene copy analysis suffers from some imprecision, it clearly illustrates differences in copy number among genotype groups identified by TaqMan or ddPCR. Based on TaqMan method properties, and by coupling TaqMan and ddPCR methods simultaneously on the same type of mosquito specimens, it demonstrated that the TaqMan genotype assays associated with the K-means clustering algorithm could provide a useful semi-quantitative estimate method to investigate the level of allele-specific duplication in mosquito populations. CONCLUSIONS: Ace-1 gene duplication is evidently far more complex in An. gambiae and An. coluzzii than the better-studied mosquito Culex quinquefasciatus, which consequently can no longer be considered an appropriate model for prediction of phenotypic consequences. These require urgent further evaluation in Anopheles. To maintain the sustained effectiveness carbamates and organophosphates as alternative products to pyrethroids for malaria vector control, monitoring of duplicated resistant alleles in natural populations is essential to guide the rational use of these insecticides.
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Acetilcolinesterasa/genética , Anopheles/efectos de los fármacos , Anopheles/genética , Duplicación de Gen , Técnicas de Genotipaje/métodos , Resistencia a los Insecticidas , Insecticidas/farmacología , África Occidental , Animales , Carbamatos/farmacología , Estudios Transversales , Femenino , Estudios Longitudinales , Organofosfatos/farmacología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodosRESUMEN
Widespread resistance to pyrethroids threatens malaria control in Africa. Consequently, several countries switched to carbamates and organophophates insecticides for indoor residual spraying. However, a mutation in the ace-1 gene conferring resistance to these compounds (ace-1(R) allele), is already present. Furthermore, a duplicated allele (ace-1(D)) recently appeared; characterizing its selective advantage is mandatory to evaluate the threat. Our data revealed that a unique duplication event, pairing a susceptible and a resistant copy of the ace-1 gene spread through West Africa. Further investigations revealed that, while ace-1(D) confers less resistance than ace-1(R), the high fitness cost associated with ace-1(R) is almost completely suppressed by the duplication for all traits studied. ace-1 duplication thus represents a permanent heterozygote phenotype, selected, and thus spreading, due to the mosaic nature of mosquito control. It provides malaria mosquito with a new evolutionary path that could hamper resistance management.
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Acetilcolinesterasa/genética , Anopheles/genética , Proteínas de Insectos/genética , Insectos Vectores/genética , Animales , Anopheles/enzimología , Resistencia a Medicamentos , Evolución Molecular , Femenino , Aptitud Genética , Insectos Vectores/enzimología , Insecticidas/farmacología , Dosificación Letal Mediana , Masculino , Control de Mosquitos , Piretrinas/farmacologíaRESUMEN
OBJECTIVE: In developing countries, the poor quality of data derived from Health Information Systems constitutes a problem that limits use of these data and contributes to the recurrent difficulties of health system management. The low level of involvement of health workers directly responsible for data may contribute to this poor quality. This study documents a Health Information System collection tool design experience by health workers and assesses its effect on data quality. METHODS: Eighty health workers responsible for clinical statistics in public health centres participated in this study. The two tools used for clinical data collection were modified by a group of 6 volunteer health workers. Monitoring indicators, data entry time, percentage exhaustiveness and quality of data were assessed before and after using the new tools. Data were compared by Wilcoxon's test for paired data and Mc Nemar's chi-square test. RESULTS: Between the two assessments, the data entry time increased from 28.7 to 22.5 seconds by reported case (p=0.153), the exhaustiveness of the reports increased from 16% to 89% (p<0.001) and the proportion of reports with sufficient data quality increased from 18.8% to 45.8% (p=0.002). CONCLUSION: The positive course of the indicators shows that increased involvement of health workers in key stages such as the design of data collection tools can help improve data quality.
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Recolección de Datos/normas , Personal de Salud/organización & administración , Mejoramiento de la Calidad , Benin , Países en Desarrollo , Humanos , Salud Pública , Indicadores de Calidad de la Atención de Salud , Factores de TiempoRESUMEN
World Health Organization estimates indicate 216 million malaria episodes in 2010, including 81% in the African region. One of the recommended means of prevention in pregnant women is intermittent preventive treatment, until 2012, two doses of sulfadoxine/pyrimethamine or three doesfor a woman living with HIV In the Pobè-Adja-Ouèrè-Kétou health zone of Benin, coverage ofintermittent preventive treatment remains low (49% against a forecast of 80%) several years after implementation of this strategy. We conducted a cross-sectional study in June and July 2012 to identify factors associated with low intermittent preventive treatment coverage in this area. A total of 339 women were interviewed and 48% ofthem received less than two doses of sulfadoxine pyrimethamine during their prenatal consultations. The variables associated with low intermittent preventive treatment coverage were low antenatal care coverage (p < 0.001) and a prenatal consultation in the private sector (p = 0.039). In the light of our results, actions must be taken by this health zone to encourage women to complete the four visits during pregnancy.
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Antimaláricos/uso terapéutico , Malaria/prevención & control , Atención Prenatal , Adulto , Benin/epidemiología , Estudios Transversales , Combinación de Medicamentos , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Malaria/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Atención Prenatal/métodos , Atención Prenatal/estadística & datos numéricos , Medicina Preventiva/normas , Pirimetamina/uso terapéutico , Factores Socioeconómicos , Sulfadoxina/uso terapéutico , Adulto JovenRESUMEN
INTRODUCTION: Psychoactive substances use among adolescents is a serious public health problem, as it exposes them to risks and health hazards and can ultimately lead to dependence. The present study investigated the prevalence and factors associated with substance use in the Kpomassè Ouidah Tori-Bossito health area in Benin. METHODS: This was a cross-sectional study conducted from 1st May to 15 July 2014 in 451 adolescents aged 10 to 19 years selected by the cluster sampling technique. Data were collected using a questionnaire about the adolescents' individual, family and socio-environmental factors. Associated factors were investigated by backward stepwise logistic regression. RESULTS: Alcohol was the substance most commonly abused with a prevalence of 30.1%, followed by tobacco, with a prevalence of 21.7% and finally cannabis, cocaine or amphetamine with a prevalence of 13.9%. More than one in ten teenagers (16.6%) consumed two or three substances. Factors associated with alcohol misuse were male gender, the area of urban residence, being married, depression, search for pleasure, conflictual family relationships and having neighbours who drink alcohol. Significant risk factors for smoking were male gender, having a single parent or being an orphan, poor parental involvement in the child's education, smoking friends and neighbours. Cannabis, cocaine and amphetamine use was mostly associated with an urban residential environment, depression, conflictual family relationships and poor parental involvement in the child's education, drug use by the parents and illicit drug use by friends. CONCLUSION: These results show that psychoactive substance use is a public health problem in the Tori-Bossito Kpomassè Ouidah health area. Communication interventions for behaviour change, advocacy, and a better public understanding of the legislation on psychoactive substances should be conducted.
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Consumo de Bebidas Alcohólicas/epidemiología , Fumar/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Conducta del Adolescente , Benin/epidemiología , Niño , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Health information systems in developing countries are often faulted for the poor quality of the data generated and for the insufficient means implemented to improve system performance. This study examined data quality in the Routine Health Information System in Benin in 2012 and carried out a cross-sectional evaluation of the quality of the data using the Lot Quality Assurance Sampling method. The results confirm the insufficient quality of the data based on three criteria: completeness, reliability and accuracy. However, differences can be seen as the shortcomings are less significant for financial data and for immunization data. The method is simple, fast and can be proposed for current use at operational level as a data quality control tool during the production stage.
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Exactitud de los Datos , Atención a la Salud , Mejoramiento de la Calidad , BeninRESUMEN
BACKGROUND: Malaria is endemic in sub-Saharan Africa with considerable burden for human health. Major insecticide resistance mechanisms such as kdr(R) and ace-1(R) alleles constitute a hindrance to malaria vector control programs. Anopheles gambiae bearing both kdr and ace-1 resistant alleles are increasingly recorded in wild populations. In order to maintain the efficacy of vector control strategies, the characterization of concomitant kdr and ace-1 resistance, and their pleiotropic effects on malaria vector phenotype on insecticide efficacy are important. METHODS: Larval and adult bioassays were performed with different insecticide classes used in public health following WHO standard guidelines on four laboratory Anopheles gambiae strains, sharing the same genetic background but harboring distinct resistance status: KISUMU with no resistance allele; ACERKIS with ace-1(R) allele; KISKDR with kdr(R) allele and ACERKDRKIS with both resistance alleles' ace-1(R) and kdr(R) . RESULTS: Larval bioassays indicate that the homozygote resistant strain harboring both alleles (ACERKDRKIS) displayed slightly but significantly higher resistance level to various insecticides like carbamates (bendiocarb, p < 0.001; propoxur, p = 0.02) and organophosphates (chlorpyriphos-methyl, p = 0.002; fenitrothion, p < 0.001) when compared to ACERKIS strain. However, no differences were recorded between ACERKDRKIS and KISKDR resistance level against permethrin (Pyrethroid, p = 0.7) and DDT (Organochlorine, p = 0.24). For adult bioassays, the percentages of mosquitoes knocked down were significantly lower for ACERKDRKIS than for KISKDR with permethrin (p = 0.003) but not with deltamethrin. The percentage of mortality from adult bioassays was similar between ACERKDRKIS and ACERKIS with carbamates and organophosphates, or between ACERKDRKIS and KISKDR with pyrethroid and DDT. Concerning acetylcholinesterase enzyme, ACERKDRKIS strain showed similarAChE1 activity than that of ACERKIS. CONCLUSION: The presence of both kdr(R) and ace-1(R) alleles seems to increase the resistance levels to both carbamate and organophosphate insecticides and at operational level, may represent an important threat to malaria vector control programs in West Africa.
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Acetilcolinesterasa/metabolismo , Anopheles/efectos de los fármacos , Anopheles/genética , Resistencia a los Insecticidas/genética , Insecticidas/farmacología , Acetilcolinesterasa/genética , Animales , Bioensayo , Regulación Enzimológica de la Expresión Génica , Larva/efectos de los fármacosRESUMEN
INTRODUCTION: Buruli ulcer (BU) is an infectious disease caused by Mycobacterium ulcerans. Benin, one of the most severely affected countries, notified 365 cases in 2012. This article presents the results of a psychosocial and behavioural survey conducted in the context of a health promotion (HP) project with community participation. This paper describes the diagnosis, prevention, behaviours, as well as perceptions and experiences related to BU. METHODS: A cross-sectional study was conducted in two villages (Azonme, Houedota) of Benin Atlantic department. From 15 May to 19 June 2011, a volunteer survey was conducted with 15 former patients and 15 new patients, selected by purposive sampling and 30 randomly selected healthy individuals. Encoding and data analysis were performed with SPSS and Excel. RESULTS: Respondents were aged 11 to 100 years with a mean age of 36.63 years and 55% were men. More than 96% of respondents were aware of BU (symptoms, mode of transmission, prevention and treatment). % were familiar with the mode of transmission, but were not aware of preventive measures. Twenty-none of the 30 patients or former patients were treated in hospital. The attributed and perceived (including non-medical) causes of the disease were water (52), bacteria (17), bad luck (5). 92% of respondents were satisfied with the services of health professionals but proposed changes (46) concerning hospital accessibility and cost of care. DISCUSSION: These results show similarities and differences compared to those reported in the literature on the subject. These surveys were the basis for health promotion interventions with the participation of two communities.
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Úlcera de Buruli/prevención & control , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Adolescente , Adulto , Anciano , Benin/epidemiología , Úlcera de Buruli/diagnóstico , Úlcera de Buruli/epidemiología , Niño , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium ulcerans/aislamiento & purificación , Satisfacción del Paciente/estadística & datos numéricos , Adulto JovenRESUMEN
INTRODUCTION: Work engagement, an emerging concept in the field of positive psychology in the workplace is not well known in developing countries. Defined as a positive and and fulfilling mindset related to work, it recalls a positive attitude incentive of performance and need to be investigated. In the context of the socioeconomic crisis of health workers, and with the chronic issue of poor quality of data, this study was designed to identify the factors associated with work engagement among health workers. in charge of data collection in the Benin Routine Health Information System. METHODS: This study was a cross-sectional and analytical study targeting health workers in charge of data collection in public and private health centres. The dependent variable was work engagement and independent variables were sociodemographic and professional features, personal and professional resources and perception of technical factors. Logistic regression was used. The adequacy of the model was tested with the Hosmer-Lemeshow goodness of fit test. RESULTS: The results indicate that the level of work engagement is similar with that observed in previous studies. Predictors identified in logistic regression are perception of technical factors, location of the job, and personal resources, such as level of effort and overcommitment. DISCUSSION: This study identified factors associated with work engagement in a developing country, and adds to the knowledge concerning this new concept in Benin. The findings can contribute to research for improvement of human resources management in the health sector to achieve real performance and development.
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Actitud del Personal de Salud , Personal de Salud , Satisfacción en el Trabajo , Trabajo/psicología , Adulto , Benin , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
BACKGROUND: Routine health information systems (RHIS) are crucial to the acquisition of data for health sector planning. In developing countries, the insufficient quality of the data produced by these systems limits their usefulness in regards to decision-making. The aim of this study was to identify the factors associated with poor data quality in the RHIS in Benin. METHODS: This cross-sectional descriptive and analytical study included health workers who were responsible for data collection in public and private health centers. The technique and tools used were an interview with a self-administered questionnaire. The dependent variable was the quality of the data. The independent variables were socio-demographic and work-related characteristics, personal and work-related resources, and the perception of the technical factors. The quality of the data was assessed using the Lot Quality Assurance Sampling method. We used survival analysis with univariate proportional hazards (PH) Cox models to derive hazards ratios (HR) and their 95% confidence intervals (95% CI). Focus group data were evaluated with a content analysis. RESULTS: A significant link was found between data quality and level of responsibility (p = 0.011), sector of employment (p = 0.007), RHIS training (p = 0.026), level of work engagement (p < 0.001), and the level of perceived self-efficacy (p = 0.03). The focus groups confirmed a positive relationship with organizational factors such as the availability of resources, supervision, and the perceived complexity of the technical factors. CONCLUSION: This exploratory study identified several factors associated with the quality of the data in the RHIS in Benin. The results could provide strategic decision support in improving the system's performance.
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INTRODUCTION: Antenatal care service, one of the interventions of public health, has been recognized as one of the pillars for the reduction of maternal and neonatal mortality. It has been revised in recent years and a new model of its contents has been submitted by WHO. Considering the complexity of its implementation, it is useful to periodically assess the performance of antenatal services with the view of their improvement. METHODS: An evaluative study was thus carried out in one health district hospital in Benin; the care staff attitudes and practices were analyzed on 80 pregnant women admitted in the antenatal care as well as services organization, care environment and satisfaction of these women. The performance was appreciated on the basis of hundred criteria. RESULTS: The overall performance of antenatal services through the inputs, procedures and satisfaction of the pregnant women, was considered to be satisfactory. The services organization, health care environment, patient reception and interpersonal communication were the elements which showed deficiencies. CONCLUSION: Improvement will have to be carried out based on shortcomings identified, by the planners, organizers and staff in order to reinforce the hospital's performance on antenatal services.
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Hospitales de Distrito/normas , Atención Prenatal/normas , Garantía de la Calidad de Atención de Salud , Benin , Femenino , Humanos , EmbarazoRESUMEN
INTRODUCTION: With the growing shortage of qualified healthcare professionals and the challenge of achieving the Millennium Development Goals, community participation has become an essential reality. In the Avrankou Adjarra Akpro-Missérété (3A) health zone of the Ouémé department, community volunteers are supported by UNICEF and the NGO Africare. The objective of this study was to assess the quality of the contribution of community volunteers to implementation of community-based integrated management of childhood illness (IMCI). METHODS: This cross-sectional, descriptive and analytical study was conducted in health zone 3A among 38 community volunteers and 331 mothers or carers of children under the age of five years, recruited exhaustively and randomly, respectively. Tools used for data collection were questionnaires, interview guides and survey sheets. RESULTS: 81.6% of community volunteers demonstrated appropriate behaviour in relation to the various professionals of community-based IMCI, with good motivation in 71.1% of cases and acceptable motivation in 28.9% of cases. Motivation was significantly correlated with the quality of the contribution of community volunteers to implementation of community IMCI (P = 0.0012). DISCUSSION: Motivation contributes to the quality of community volunteer input to COMMUNITY IMCI. This situation must be maintained by the combined efforts of all stakeholders involved in this strategy.
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Servicios de Salud del Niño/normas , Servicios de Salud Comunitaria/normas , Calidad de la Atención de Salud , Voluntarios , Benin , Niño , Estudios Transversales , HumanosRESUMEN
Population replacement/elimination strategies based on mass-release of sterile or otherwise genetically modified (male) mosquitoes are being considered in order to expand the malaria vector control arsenal on the way to eradication. A challenge in this context, is to produce male mosquitoes that will be able to compete and mate with wild females more efficiently than their wild counterparts, i.e. high fitness males. This study explored the effect of three larval food diets developed by the International Atomic Energy Agency on the overall fitness and mating performance of male Anopheles gambiae s.s. mosquitoes (Kisumu strain). Larval development (pupation and emergence rate, development time) was monitored, and adult wing length and energy reserves at emergence (i.e. lipids, sugars, glycogen and proteins) were measured. Male sexual performance was assessed through an insemination test whereby one male and 10 virgin females were maintained together in the same cage in order to record the number of inseminated females per 24h. Our results show that males reared on Diets 2 and 3 performed best during larval development. Males provided with treatment 2.2 had a shorter development time and performed best in insemination tests. However, these males had the lowest overall lifespan, suggesting a trade-off between longevity and sexual performances which needs to be taken into consideration when planning release. The results from this work were discussed in the context of sterile insect techniques or genetic control methods which is today one of the strategy in the overall mosquito control and elimination efforts.
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Anopheles/fisiología , Dieta/métodos , Conducta Sexual Animal , Animales , Anopheles/crecimiento & desarrollo , Larva/crecimiento & desarrollo , Larva/fisiología , Longevidad , MasculinoRESUMEN
The swarm structure of two sibling species, Anopheles gambiae coluzzii and Anopheles melas, was characterize to explore the ecological and environmental parameters associated with the formation of swarms and their spatial distribution. Swarms and breeding sites were searched and sampled between January and December 2010, and larval and adult samples were identified by PCR. During the dry season, 456 swarms of An. gambiae s.l. were sampled from 38 swarm sites yielding a total of 23,274 males and 76 females. Of these 38 swarming sites, 18 were composed exclusively of An. gambiae coluzzii and 20 exclusively of An. melas, presenting clear evidence of reproductive swarm segregation. The species makeup of couples sampled from swarms also demonstrated assortative mating. The swarm site localization was close to human dwellings in the case of the An. gambiae coluzzii and on salt production sites for An. melas. At the peak of the rainy season, swarms of An. melas were absent. These findings offer evidence that the ecological speciation of these two sibling species of mosquitoes is associated with spatial swarm segregation and assortative mating, providing strong support for the hypothesis that mate recognition is currently maintaining adaptive differentiation and promoting ecological speciation. Further studies on the swarming and mating systems of An. gambiae, with the prospect of producing a predictive model of swarm distribution, are needed to inform any future efforts to implement strategies based on the use of GMM or SIT.
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Anopheles/fisiología , Conducta Sexual Animal , Animales , Benin , Femenino , Masculino , Estaciones del Año , SimpatríaRESUMEN
BACKGROUND: The periodontium is the supporting tissues surrounding the teeth. Periodontal disease is of infectious and inflammatory nature. The goal of our study was to act on the factors associated with the periodontal disease in pregnant women at the Mother-Child Lagune Hospital (MCLH) in Cotonou in 2007. METHODS: We conducted a cross-sectional descriptive and analytical study of the prevalence of periodontal disease in pregnant women, non-pregnant women, and associated factors in pregnant women at the MCLH. The study sample consists of 316 women aged 14 to 49 years, 50% were pregnant (158) and 50% were not pregnant (158). RESULTS: The prevalence of periodontal disease in pregnant women was 51.27% with 95% CI= [43, 47; 59, 07]. Amongst non-pregnant women, it is 39, 87% with 95% CI= [32, 27; 47, 47]. We found no significant difference between the prevalence of periodontal disease in pregnant women and non-pregnant women in contrast to literature data. The unvaried and multivariate analyses with logistic model were made between explanatory variables and the dependent variable (periodontal disease) in pregnant women to identify factors that promote the occurrence of periodontal disease. These analyzes revealed that dental cavity and simultaneous use of standard or vegetal toothbrushes have a statistically significant relationship with periodontal disease. These two variables are predictors of periodontal disease in pregnant women at the MCLH. CONCLUSION: Our study showed that the dental cavities and the simultaneous use of either the standard or vegetal toothbrushes have a statistically significant relationship with periodontal disease occurence.
INTRODUCTION: Le parodonte est l'ensemble des tissus de soutien de la dent. Les parodontopathies sont des maladies infectieuses et de nature essentiellement inflammatoire. Le but de notre étude était d'agir sur les facteurs associés aux parodontopathies chez la femme enceinte à l'Hôpital de la Mère et de l'Enfant-Lagune de Cotonou en 2007 (HOMEL). MATÉRIEL ET MÉTHODES: Nous avons mené une étude transversale descriptive et analytique pour étudier la prévalence des parodontopathies chez les femmes enceintes et les femmes non enceintes, et les facteurs associés chez la femme enceinte à l'Hôpital de la Mère et de l'Enfant-Lagune de Cotonou (HOMEL). L'échantillon de l'étude était composé de 316 femmes âgées de 14 à 49 ans dont 50% sont enceintes (158) et 50% ne sont pas enceintes (158). RÉSULTATS: La prévalence des parodontopathies chez les femmes enceintes est de 51,27 % avec IC95 %= [43,47; 59,07]. Elle est de 39,87 % avec IC95 %= [32,27; 47,47] chez les femmes non enceintes. Nous n'avons pas trouvé de différence significative entre les prévalences des parodontopathies chez les femmes enceintes et chez les femmes non enceintes contrairement aux données de la littérature. L'analyse uni variée et multi variée avec le modèle logistique ont été effectuées entre les variables explicatives et la variable dépendante (parodontopathies) chez la femme enceinte pour identifier les facteurs qui favorisent la survenue des parodontopathies. Ces analyses ont révélé que la carie dentaire et l'utilisation simultanée des brosses à dents moderne et végétale ont une relation statistiquement significative avec les parodontopathies. Ces deux variables sont les facteurs prédictifs des parodontopathies chez la femme enceinte à l'Hôpital de la Mère et de l'Enfant lagune de Cotonou. CONCLUSION: Notre étude a montré que la carie dentaire et l'utilisation simultanée des brosses à dents moderne et végétale ont une relation statistiquement significative avec la survenue des parodontopathies.