[Prevalence and complications of gestational diabetes in women followed in Parakou maternities]. / Prévalence et complications du diabète gestationnel chez les femmes suivies dans les maternités de Parakou.

INTRODUCTION: The study was initiated to determine the prevalence and the complications of gestational diabetes in women attending Parakou maternities clinics in 2015. METHODS: This study was longitudinal, descriptive and analytical. The study population consists of women with gestational diabetes in Parakou maternities wards. The gestational diabetes was screened by the oral glucose tolerance test. The outcome of pregnancy was appreciated by the search for complications during pregnancy. Glycemic control was achieved in women 6 weeks after delivery. The data were analyzed using EPI-INFO 3.1 Fr. RESULTS: Of the 151 pregnant women who did the screening, 19 had a gestational diabetes; a prevalence of 12.6%. Pregnant women with gestational diabetes were at increased fetal macrosomia, hydramnios, macrosomia at birth, high birth weight of newborns compared to women without gestational diabetes (p<0,01). The maternal complications did not observed. The postprandial delivery blood glucose of women with gestational diabetes was normal. CONCLUSION: The gestational diabetes is associated with complications of pregnancy. Routine screening of women at risk for adequate management is necessary.

INTRODUCTION: L'étude a été initiée afin de déterminer la prévalence et les complications du diabète gestationnel (DG) chez les femmes suivies dans les maternités de Parakou en 2015. MÉTHODES: L'étude a été longitudinale, descriptive et analytique. La population d'étude est constituée des femmes souffrant de diabète gestationnel (DG) dans les maternités de Parakou. Le DG a été dépisté par l'épreuve d'hyperglycémie provoquée par voie orale. L'issue de la grossesse a été appréciée par la recherche de complications au cours de la grossesse. Un contrôle glycémique a été réalisé chez les femmes 6 semaines après l'accouchement. L'analyse des données a été faite par le logiciel EPI Data 3.1fr. RÉSULTATS: Parmi les 151 gestantes qui ont réalisé le dépistage, 19 ont un DG soit une prévalence de 12,6%. Les gestantes ayant un DG avaient plus de risque de macrosomie fœtale suspectée à l'échographie, d'hydramnios, de macrosomie à la naissance, de poids de naissance élevé des nouveaux-nés comparativement aux femmes n'ayant pas un diabète gestationnel (p<0,01). Il n'y avait pas de complications maternelles. La glycémie post prandiale du post partum des femmes ayant un DG était normale. CONCLUSION: Le DG est associé à des complications de la grossesse. Un dépistage systématique chez les femmes à risque en vue d'une prise en charge adéquate est nécessaire.

Sleep-related disorders and sleep quality among adults living in Parakou, a sub-Saharan African city.

PURPOSE: To determine the prevalence of sleep-related disorders, poor sleeping, and factors associated with poor sleep quality among inhabitants of Parakou, Benin. METHODS: This was a cross-sectional study conducted from April-August 2018 on 930 randomly selected adults (age ≥ 18 years). Using the Pittsburg Sleep Quality Index, the Insomnia Severity Index, and the Epworth Sleepiness Scale, subjects were questioned on their sleep, on parasomnias, and on movement-related sleep disorders. RESULTS: Overall, the prevalence of insomnia was 22% (95% CI, 19.1-24.4) and severe insomnia was 0.8%. The prevalence of excessive daytime sleepiness was 15% (95% CI, 12.5-17.0). Daily nightmares (2%) and rhythmic movements (6%) were those most commonly reported among parasomnias and movement-related sleep disorders. No major differences were found between men and women. The prevalence of poor sleeping (PSQI > 5) was 39% (95%CI, 36.3-42.5). Adjusted analyses showed a higher risk of poor sleeping in those aged 45-54 years (aOR = 1.78, p = 0.032) or ≥ 55 years (aOR = 3.61, p < 0.001), those overweight or obese (aOR = 1.53, p = 0.007), those underweight (aOR = 2.90, p = 0.030), and among females (aOR = 1.84, p < 0.001). Being divorced was associated with a lower risk of poor sleeping (aOR = 0.18, p = 0.036). Poor sleepers were more commonly found among those who had excessive daytime sleepiness (65% versus 36%, p < 0.001) and insomnia (86% versus 27%, p < 0.001). CONCLUSION: Sleep-related disorders were common in Parakou city, Benin, with four out of ten persons having poor sleep quality. There is a need to improve the management of sleep-related disorders and promote better sleep practices for the community.

Risk of obstructive sleep apnea and quality of sleep among adults with type 2 diabetes mellitus in a sub-Saharan Africa city.

INTRODUCTION: diabetes mellitus (DM) and Obstructive Sleep Apnea (OSA) are two major and interconnected non-communicable diseases. Both negatively impact on sleep quality. This study aimed to determine among persons with type 2 DM, the proportions at high risk of OSA and of self-reported poor sleep quality along with their associated-factors in Parakou city, Benin. METHODS: this was a cross-sectional prospective study of 100% (n=383) outpatient adults with type 2 DM, conducted between April and August 2019 in the three top centres managing diabetic persons in Parakou city. They were interviewed, examined and investigated using capillary fasting blood glucose tests. The STOP-Bang Questionnaire (SBQ) was used to determine the risk of OSA. RESULTS: overall, their mean age was 57.37 (11.45) years. They were 61.62% (n=236) females and 38.38% (n=147) males. Sleep duration was insufficient in 26.89% (n=103). Nocturia was reported in 49.35% (n=189). The risk of OSA was high in 14.10% (n=54), intermediate in 24.80% (n=95) and low in 61.10% (n=234). Friedman Position Tongue Grade 3 (Adjusted Odds Ratio, aOR=2.48; 95%CI=1.11 - 5.55; p=0.025) and 4 (aOR=4.65; 95%CI=1.26 - 15.90; p=0.015) were independently associated with a high risk of OSA. The prevalence of reported poor sleep quality was 27.42% (n=105). Female gender (aOR=2.08; 95%CI=1.18-3.83; p=0.014), diabetic foot (aOR=5.07; 95%CI=1.15-23.63; p=0.031), nocturia (aOR=1.96; 95%CI=1.18-3.29; p=0.010), tiredness (aOR=2.77; 95%CI=1.26-6.23; p=0.012) and a high risk of OSA (aOR=3.31; 95%CI=1.28-8.93; p=0.015) were independently associated with a greater risk of reported poor sleep quality. CONCLUSION: in Parakou, the proportions of patients with type 2 DM at increased risk of OSA and with poor quality of sleep are relatively high. There is need for better systematic screening of OSA in persons with DM.

Report of a fatal case of Lassa fever in Parakou in 2018: clinical, therapeutic and diagnostic aspects.

BACKGROUND: Lassa fever is one of the most lethal neglected tropical diseases in West Africa. It is a serious public health problem in this region of Africa where it is endemic in several countries. However, it remains a very little known disease by healthcare workers. The lack of specificity of its clinical manifestations makes its diagnosis difficult even in an epidemic context. CASE PRESENTATION: We report here a confirmed case of Lassa fever whose diagnosis could not be suspected until 11 days after the symptomatology began. This case was recognized as a suspected case of Lassa fever in the Internal Medicine Department of the Regional and Teaching Hospital of Borgou due to the persistence of the fever and the worsening of the patient's clinical condition despite triple antibiotic therapy in general and especially due to the appearance of hemorrhages. Confirmation of the presence of Lassa fever virus by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) assay on blood sample was obtained after his death despite late initiation of Ribavirin treatment. CONCLUSION: This case challenges Benin's health authorities on the need to facilitate access to diagnosis of viral hemorrhagic fevers and to train caregivers at all levels of the health system for better management of these diseases.

Fréquence et déterminants de la dénutrition post-opératoire en chirurgie viscérale au Centre National Hospitalier et Universitaire Koutoucou Hubert Maga, Cotonou: Frequency and determinants of post-operative undernutrition in patients undergoing visceral surgery at the University Hospital Centre Koutoucou Hubert Maga, Cotonou.

This study aims to determine the frequency and identify the factors associated with undernutrition among patients undergoing visceral surgery in 2014. We conducted a cross-sectional, descriptive and analytical study over the period September 11, 2014-December 11, 2014. The study population comprised patients who had undergone visceral surgery at the National University Hospital Centre Koutoucou Hubert MAGA, Cotonou. Undernutrition is defined as a body mass index less than 18.5 kg/m2. A total of 90 patients were included in the study, 57,78% (52 patients) were male. The average age of patients was 55±6,32 years. Undernutrition was found in 42 patients (46.67%). The factors associated with undernutrition in postoperative patients were: age greater than or equal to 50 years, low level of protein, water and energy intake, diarrhea, cancer, digestive system surgery, emergency surgery, significant weight loss and hyperleukocytosis. Undernutrition is common in postoperative patients. Hence the importance of nutritional screening and of early treatment.

Management of arterial hypertension in Cotonou city, Benin: general practitioners' knowledge, attitudes and practice.

OBJECTIVE: We aimed to assess the management of hypertensive patients by general practitioners in Cotonou city. METHODS: This was a cross-sectional study based on a multicentre survey conducted from 1 May to 31 July 2011. We recruited all consenting general practitioners who worked in public and private centres in Cotonou city. We used the 7th report of the Joint National Committee to assess the management of hypertension by general practitioners. A tested and validated self-questionnaire was used to collect the data on hypertension management by general practitioners. RESULTS: In eight centres that approved the study, 41 general practitioners were included. The definition of hypertension was known by 20 (48.8%) practitioners. Only 25 (61.0%) could describe the conditions for blood pressure measurement. Ten of them were unable to list half of the minimum recommended tests for hypertension, and the majority (92.7%) did not have any idea of global cardiovascular risk. The blood pressure goal was known by only 18 (43.9%) practitioners. Lifestyle (82.9%) and monotherapy (70.7%) were the therapeutic modalities most prescribed. Antihypertensive agents commonly used by practitioners were calcium channel blockers (82.9%), angiotensin converting enzyme inhibitors (53.7%) and diuretics (36.6%). The general practitioners referred their patients to cardiologists mainly for uncontrolled hypertension (63.4%) and the onset of acute complications (56.1%). CONCLUSION: The general practitioners' knowledge of hypertension was insufficient and their management did not reflect international guidelines.