[Socio-cultural aspects of epilepsy in a rural community in northern Benin in 2011]. / Aspects socioculturels de l'épilepsie dans une communauté rurale au nord Bénin en 2011.

Despite the development of knowledge in diagnosis and therapeutic of epilepsy it remains to be cause of rejection and stigma. We aimed to study the knowledge, attitude and practice toward epilepsy and the stigma in a rural community. The cross-sectional study was carried out from 1st to 31st March 2011 in a rural community (Tourou) at Parakou in the northern Benin. It was a door-to-door survey and included 1 031 adults older than 15 years. The diagnosis of epilepsy was based on International League Against Epilepsy. The specific questionnaire was used and comprised 16 items which explored knowledge, attitude and practice toward epilepsy. Another questionnaire was developed to study stigma among epileptics. The associated factors to the misconception toward epilepsy have been studied. All adults have heard about epilepsy and knew the generalized tonic-clonic form of epilepsy and knew someone with epilepsy. Hereditary (98%) and witchcraft (97.9%) and social problems (65.9%) were mentioned as the most cause of epilepsy. Epilepsy was cited as contagious disease by 90.6% of respondents and the associated factors were the sex (p=0.005) and occupational status (0.024). The saliva (98.1%) and witness of the place of seizure (97.8%) were the frequently mentioned modes of transmission. 65% of all mentioned that epileptics can not get marriage and the main associated factors to this belief were the advanced age (p=0.008) and occupational status (0.004). 64.4% believed that children with epilepsy shouldn't be attend to school, age (0.004), ethnicity (0.047) and occupational status were the associated factors with this misconception. Despite 99.4% considered epilepsy as treatable disease only 12.7% would have referred epileptics to the hospital. All the seven epileptics considered themselves as victims of stigma and rejected by their family and the community. The misconceptions associated to the epilepsy can explain the stigma and the therapeutic gap in this rural community.

[Preoperative psychological experience and beliefs in adult patients scheduled for surgery at the University Hospital of Parakou in Benin]. / Vécu psychologique préopératoire et croyances chez les patients adultes programmés pour une intervention chirurgicale à l'hôpital universitaire de Parakou au Bénin.

OBJECTIVE: To study the preoperative psychological experience and beliefs in adult patients scheduled for surgery at the University Hospital of Parakou. PATIENTS AND METHODS: A descriptive and analytical study with prospective data collection conducted over three months (June 1st to August 30, 2012) and involved 75 patients. RESULTS: Of the 108 patients scheduled for surgery, 75 patients (69.44%) had been chosen. The average age was 44.11±16.24 years with a male predominance (56%). Fifty-five patients (73.3%) were anxious and 32 patients (46.7%) were afraid of dying. Forty-five patients (60%) had not received any information about the procedure they should undergo and 60 patients (80%) were not informed of the possible complications of surgery. Fifty-eight patients (77.3%) were aware of the anesthetic technique and 5.2% of patients were aware of the possible complications of anesthesia. In 56 patients (74.7%), the disease was of natural origin, in 18.6% of cases there was an enchantment and 5 patients (6.7%) the disease is due to a deity. In the context of spiritual care, 15 patients (20%) had consulted a marabout, 11 patients (14.7%) a healer and 10 patients (13.3) a fetish. CONCLUSION: The preoperative period induces a significant burden of anxiety among patients and their families. In Benin, the announcement of surgery is an opportunity for confrontation of the patient to an obsession with death which he manages to escape despite the countless sacrifices of traditional conjuring.

[Major salmonellosis in Benin]. / Salmonelloses majeures au Bénin.

Although salmonellosis is a common endemo-epidemic disease in Benin, there is a paucity of data about it. The purpose of this cross-sectional study was to determine the incidence of major salmonellosis requiring hospitalizaton and to describe its epidemiological, clinical, and serologic features as well as treatment and outcome. Consecutive cases observed at the Medical Department of Parakou University Hospital in Benin between January 1, 2005 and December 31 2007 were included. Salmonellosis was defined on the basis of clinical and serological criteria. Among the 2,520 patients hospitalized during the study period, salmonellosis was diagnosed in 135 (5.4% [95% CI 4.5%-6.3%]). Highest incidences were observed in January, July, October and November. The main symptoms were headache, fever, fatigue and abdominal pain. The Salmonella typhi serotype was identified in 94.8% of patients. Two patients presented co-infection, i.e., Salmonella typhi with paratyphi A in one case and Salmonella typhi with paratyphi B in the other. Fluoroquinolones were used for treatment in 79.3% of patients. Outcome was favorable in 62.2%. The main complications were,typhoid digestive perforation in 11.1%, and gastrointestinal bleeding in 8.1%. The mortality rate was 4.4% (n=6). These data are consistent with previous reports in the literature and confirm the frequency and severity of salmonellosis in Benin.

[Effective management of hospital services in Benin]. / Une gestion managériale des structures hospitalières du Bénin.

Hospital services remain poorly managed in African countries and in particular in Benin. Effective management must promote strategic planning and implementation of resources to achieve desired goals. The purpose of this article is to describe elements contributing to the poor performance of health care facilities in Benin and more particularly the response of hospital management within the framework of ongoing reforms. Analysis also focuses on strategic priorities and the central role of the human factor in any action to organize management. Implementation of participative management in the Beninese hospitals still requires great improvement in numerous areas including integration of health facilities into an open system, reinforcement of continuous education programs for personnel, recruitment of qualified technical personnel, and creation of training modules in hospital management.

Une gestion manageriale des structures hospitalieres du Benin

La gestion des services hospitaliers reste un probleme dans les etats africains et plus particulierement au Benin. Elle doit etre un instrument d'aide a la definition des orientations strategiques et des dispositions a mettre en oeuvre pour les realiser. Cet article presente des elements de dysfonctionnement des etablissements de soins au Benin et plus particulierement la gestion hospitaliere au regard des reformes en cours. L'analyse aborde aussi les strategies prioritaires et l'importance du role central de l'element humain dans toute action d'organisation manageriale. Cette organisation de management participatif demande encore beaucoup d'efforts pour son application dans les hopitaux beninois; dont entre autres : la prise en compte de l'environnement des structures de sante dans un systeme ouvert; le renforcement de la formation continue des personnels; la dotation de personnel technique competent; la creation de modules de formation en gestion hospitaliere

[Epilepsy caused by cysticercosis. Apropos of a sociological and cultural investigation conducted at Savalou in Benin]. / Epilepsie provoquée par la cysticercose. A propos d'une enquête sociologique et culturelle réalisée à Savalou au Bénin.

Neurocysticercosis has been detected at Savalou, place situated in the center of Bénin. The prevalence of epilepsy was 1.52% (22 out of 1443) and of cysticercosis, 3.95% (57 out of 1443). It was then necessary to appreciate the socio-cultural and environmental dimension which could explain the propagation of the disease and to look for contingent durable and adapted solutions for its eradication. The collect of information has been done through observation of the environment, interviews and group-discussions. A sample of 104 persons has been obtained through a probation at three degrees. At the end of the survey, the characteristics of the population and the ecosystem of the investigated region has been studied, as well as the impact of professionals in traditional medicine and the difficulties of the epileptic man in his socio-cultural environment. The development of an appropriate ethnomedicine is suggested in the setting of a sanitary education on neurocysticercosis.