RESUMO
Background: Vaccination is a protective measure against infectious diseases and remains one of the best investments in public health. Some African countries are still struggling to reach the required child immunization coverage. Several factors are responsible for limiting immunization coverage. Most of the factors considered to limit immunization coverage are related to the health system. In addition, inaccessibility to care, especially during the critical period of the Covid-19 pandemic, greatly reduced vaccination coverage rates. In Benin, several vaccines are included in the Expanded Programme on Immunization or are administered as part of routine immunization. However, cases of non-compliance with the vaccine and persistent flaccid paralysis are still recorded in the commune of Ouidah in southern Benin. The aim of this study was to investigate the coverage and factors associated with full immunization for age in children aged 0-5 years. Methods: A cross-sectional survey was conducted from August to October 2021 in two villages (Adjara-Hounvè and Ahouicodji) in southern Benin. All the households were included. The survey regarded children under 5 for whom a vaccination record was presented. A couple child/mother was recruited after informed consent of the mother and her child. An univariate analysis followed by a multivariate analysis was performed by using a logistic regression model to identify the variables that influence vaccine completeness. Spatial description of vaccine completeness was performed using the kriging method using ArcGIS 10.8 mapping software. Results. Of the 414 mothers surveyed, 57.49% had an immunization card, from which information was collected. Of the 238 children recruited, 141 were in Adjara-Hounvè and 97 in Ahouicodji. Of the 238 children with an immunization card, 20.6% were fully immunized for their age. All children received Baccille Calmette Guérin vaccine at birth. Since poliomyelitis, pentavalent, pneumococcal conjugate, and rotavirus are three-dose vaccines, the percentage of children who received these vaccines decreased as the number of doses increased: 96.6%, 88.2%, 78.1% and 72.3% for the four doses of polio respectively. According to 53.4% of the respondents the reception at the vaccination site was poor, and according to 70.3% of them waiting time for vaccination sessions was long. Several reasons justified the absence of complete vaccination for the age of the children: vaccination site too far from the place of residence (59.54%), lack of financial means (29.78%) and the mother's ignorance (12.76%). Education level "primary" vs "none" (ORa = 3.32; CI95% 1.07-10.25), occupation "health staff" vs "housewife" (ORa = 21.18; CI95% 3.07-145.94), mothers' knowledge of Expanded Programme on Immunization diseases (ORa = 2, 20; CI95% 1.03-4.68) and children's age 0-2 months vs ≥ 16 months (ORa = 8.53; CI95% 2.52-28.85) and 9-15 months vs ≥ 16 months (ORa = 2.99; CI95% 1.24-7.23) increased complete immunization status for age. The homogeneity of behaviour related to age-complete immunization coverage in children under 5 years was evident at mapping. Conclusion: Age-complete immunization coverage in children under 5 years of age is very low, with a spatial homogeneity in community immunization uptake behaviour. Age-complete immunization coverage is an innovative indicator that can contribute to achieving age-specific immunization targets.
Assuntos
Cobertura Vacinal , Vacinação , Humanos , Benin , Lactente , Cobertura Vacinal/estatística & dados numéricos , Pré-Escolar , Feminino , Masculino , Estudos Transversais , Vacinação/estatística & dados numéricos , Recém-Nascido , COVID-19/prevenção & controle , COVID-19/epidemiologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Programas de ImunizaçãoRESUMO
BACKGROUND: Despite a global decrease in malaria burden worldwide, malaria remains a major public health concern, especially in Benin children, the most vulnerable group. A better understanding of malaria's spatial and age-dependent characteristics can help provide durable disease control and elimination. This study aimed to analyze the spatial distribution of Plasmodium falciparum malaria infection and disease among children under five years of age in Benin, West Africa. METHODS: A cross-sectional epidemiological and clinical survey was conducted using parasitological examination and rapid diagnostic tests (RDT) in Benin. Interviews were done with 10,367 children from 72 villages across two health districts in Benin. The prevalence of infection and clinical cases was estimated according to age. A Bayesian spatial binomial model was used to estimate the prevalence of malaria infection, and clinical cases were adjusted for environmental and demographic covariates. It was implemented in R using Integrated Nested Laplace Approximations (INLA) and Stochastic Partial Differentiation Equations (SPDE) techniques. RESULTS: The prevalence of P. falciparum infection was moderate in the south (34.6%) of Benin and high in the northern region (77.5%). In the south, the prevalence of P. falciparum infection and clinical malaria cases were similar according to age. In northern Benin children under six months of age were less frequently infected than children aged 6-11, 12-23, 24-60 months, (p < 0.0001) and had the lowest risk of malaria cases compared to the other age groups (6-12), (13-23) and (24-60): OR = 3.66 [2.21-6.05], OR = 3.66 [2.21-6.04], and OR = 2.83 [1.77-4.54] respectively (p < 0.0001). Spatial model prediction showed more heterogeneity in the south than in the north but a higher risk of malaria infection and clinical cases in the north than in the south. CONCLUSION: Integrated and periodic risk mapping of Plasmodium falciparum infection and clinical cases will make interventions more evidence-based by showing progress or a lack in malaria control.
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Malária Falciparum , Malária , África Ocidental , Teorema de Bayes , Benin/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Fácies , Humanos , Malária/epidemiologia , Malária Falciparum/diagnóstico , Malária Falciparum/epidemiologiaRESUMO
BACKGROUND: In Benin, malaria clinical cases, including the larger popular entity called "Palu" are evoked when people get fever. "Palu" is often self-diagnosed and self-medicated at home. This study aimed to describe the use of herbal medicine, and/or pharmaceutical medicines for prevention and treatment of malaria at home and the factors associated with this usage. METHODS: A cross-sectional survey was conducted in Benin in an urban and in a rural area in 2016. Around 600 households in each place were selected by using a random sampling of houses GPS coordinates of the families. The association between socio demographic characteristics and the use of herbal medicine was tested by using logistic regression models. RESULTS: In Cotonou (urban), 43.64% of households reported using herbal or pharmaceutical medicine to prevent "Palu", while they were 53.1% in Lobogo (rural). To treat "Palu" in Cotonou, 5.34% of households reported using herbal medicine exclusively, 33.70% pharmaceutical medicine exclusively and 60.96% reported using both. In Lobogo, 4% reported using herbal medicine exclusively, 6.78% pharmaceutical medicine exclusively and 89.22% reported using both. In Cotonou, the factors "age of respondent", "participation to a traditional form of savings" and "low socioeconomic level of the household" were associated with the use of herbal medicine. CONCLUSIONS: This study shows the strong use of herbal medicine to prevent "Palu" or even treat it, and in this case it is mostly associated with the use of pharmaceutical medicine. It also highlights the fact that malaria control and care seeking behaviour with herbal medicine remain closely linked to household low-income status but also to cultural behaviour. The interest of this study is mostly educational, with regards to community practices concerning "Palu", and to the design of adapted behaviour change communication strategies. Finally, there is a need to take into account the traditional habits of populations in malaria control and define a rational and risk-free use of herbal medicine as WHO-recommended.
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Malária , Preparações Farmacêuticas , África Ocidental , Benin/epidemiologia , Estudos Transversais , Humanos , Malária/tratamento farmacológico , Malária/prevenção & controleRESUMO
INTRODUCTION: Several studies around the world have shown a significant increase in student mistreatments in the Faculty of Medicine. The purpose of our study was to analyze student mistreatments and associated factors in the Faculty of Medicine of the University of Parakou (FM/UP) in 2018. METHODS: We conducted a cross-sectional, descriptive and analytical survey among the students of the Faculty of Medicine of the University of Parakou from 1st to 28 February 2018. Participants were second-year medical students (PCEM2), fourth-year medical students (DCEM2) and sixth-year medical students (DCEM4) attending the academic year 2017-2018 and who had freely given their informed consent to participate in the study. RESULTS: One hundred percent of students of the FM/UP had experienced mistreatment at least once. Students had frequently experienced mistreatment in 34.34% of cases. Humiliation, verbal violence and instigation to personal services were the most common types of violence. However, approximately 10% of students had experienced sexual harassment. Perpetrators of mistreatments were doctors/teachers, nurses and interns. Female students were three times more sexually harassed than their colleagues of the opposite sex (p=0.0069). The older the students were and enrolled in the second-year of the Faculty of Medicine, the more they experienced humiliation (p=0.0001 for age and p<0.0001 for education) and verbal violence (p=0.0007 for age and p<0.0001 for education). CONCLUSION: This study highlights that all the students of the FM/UP have experienced mistreatment at least once after enrolment in the university. Based on this study, university officials should implement communication strategies to change the abusive behavior of teachers and supervisors. A register of complaints would also be useful in reducing this phenomenon.
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Docentes de Medicina/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Violência/estatística & dados numéricos , Adolescente , Adulto , Benin , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Masculino , Inquéritos e Questionários , Adulto JovemRESUMO
Objectif : Prévenir les allergies respiratoires professionnelles chez les travailleurs exposés à la poussière de farine de blé dans les boulangeries de la ville de Porto-Novo. Méthode : Il s'est agi d'une étude transversale descriptive conduite d'Octobre à Décembre 2014 dans 5 boulangeries de la ville de Porto-Novo. A travers un échantillonnage à deux degrés, nous avons sélectionné d'une part de façon aléatoire 5 boulangeries des 32 de la ville et d'autre part de façon exhaustive recruter 51 travailleurs des 5 boulangeries. Il a été procédé à un examen physique (auscultation pulmonaire et examen oto-rhinolaryngologique) systématique de tous les travailleurs interviewés. Analyse des données : Les données ont été enregistrées et analysées avec le logiciel EPI info version 3.5.3. Les résultats obtenus ont été compilés dans des tableaux de fréquence simple. Résultats : La grande majorité des travailleurs sont de sexe masculin (90,2%). La plupart des travailleurs ont un âge compris dans la tranche de 31 et 50 ans (47,1%) et une ancienneté comprise entre 1 à 9 ans (47,2%). Les travailleurs sont concentrés au niveau des postes de : façonnage (68,7%), pétrissage (49,1%) et enfournage (39,2%). Les procédés et pratiques générateurs d'importantes poussières selon les travailleurs sont : le fleurage (88%), la vidange des sacs à farine dans le pétrin (80%), l'usage du balai pour le nettoyage (41,2%) et le pétrissage (19,6).. Les symptômes respiratoires dont se plaignent souvent les travailleurs sont : éternuement (82,4%), rhume/écoulement nasal (58,8%), toux (37%) et bronchorrhée (27,5%). Ces symptômes apparaissent chez les travailleurs le plus souvent après un délai d'exposition compris entre 1 et 9 ans et plus de la moitié des cas (57,1%) dans la tranche d'âge de 31-50ans. 2/3 des cas d'asthme sont survenus chez les travailleurs dans cette fourchette d'âge. Conclusion : La farine est désormais reconnue comme étant le premier allergène professionnel. Il s'avère important d'adopter une démarche de prévention adéquate du risque qu'elle constitue afin de garantir la santé et la sécurité aux travailleurs
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Alergia e Imunologia , Benin , Doenças Profissionais , Exposição Ocupacional , Hipersensibilidade RespiratóriaRESUMO
Contexte : Les cardiopathies congénitales constituent un problème majeur de santé publique et leur correction, un défi dans les pays en développement. Devant l'impossibilité d'accès local à une cure chirurgicale, le transfert à l'étranger reste le seul recours avec un retard à la prise en charge et un taux de récusation élevée. Objectifs : Décrire le devenir des enfants porteurs de cardiopathies congénitales récusées. Méthodes : Etude transversale descriptive et analytique, ayant inclus les enfants de moins de 15 ans, récusés pour correction de cardiopathies congénitales entre 2006 et 2016. Les données cliniques, paracliniques et évolutives ont été recueillies à partir des dossiers médicaux. Une réévaluation clinique et échocardiographique a été faite sur convocation des enfants. Résultats : Sur 376 dossiers soumis, 48 dossiers ont été récusés soit 12,76%. 44 patients ont été inclus dans l'étude. L'âge moyen des enfants au diagnostic de la cardiopathie et le sex-ratio étaient respectivement de 2,47±3,98 ans et 1,3. La soumission des dossiers a été faite en moyenne à 0,82± 0,5 mois après le diagnostic. La récusation est faite en moyenne à 1,42±2,13 mois après soumission. Les motifs étaient : cardiopathies complexes (40,91%), l'HTAP sévère ou syndrome d'Eisenmenger (25%) et les comorbidités (34,09%). Après récusation, 72,73% des patients n'avaient plus aucun suivi médical. La mortalité après récusation était de 25% chez les récusés (31,25% des patients non suivis versus 8,33% des patients suivis, p= 0,24). A la réévaluation réalisée chez 31 patients, 93,55% étaient hypotrophes, 67,74% dyspnéiques et 32,26% cyanosés. Le diagnostic échographique était concordant à l'initial chez 58,06%. Les porteurs de syndrome d'Eisenmenger représentaient 71%. Trois patients initialement récusés pour hypotrophie sévère sont devenus opérables. Conclusion: Le pronostic des cardiopathies récusées est péjoratif en l'absence de suivi. La correction locale des cardiopathies et le suivi médical permettra d'améliorer le pronostic des cardiopathies congénitales