Introduction: Le port de charge cephalique par les enfants est une methode de manutention courante au Benin. Peu d'etude ont investigue sur le port de charge cephalique chez les enfants. Methodes: Cette etude transversale vise a faire l'etat des lieux et a identifier les facteurs associes au port de charge cephalique chez des enfants au Benin. Au total,300 enfants âges de 13,7 ± 2,6 ans ont participe a l'etude dans les 12 departements du Benin. La methode non probabiliste et la technique accidentelle ont ete utilisees pour determiner la taille de l'echantillon. La masse portee par les enfants constitue la variable dependante. L'âge, la taille, les sites corporels des douleurs, l'anciennete dans le port de charge et la frequence hebdomadaire du port cephalique de charge constituent les variables independantes. Resultats: Le rapport de la masse portee sur le poids corporel est evalue en moyenne a 66%. Pendant et apres le port de charge, les douleurs ressenties sont localisees essentiellement au cou, au dos et au bas du dos. Le test de correlation entre charge portee et la taille indique r = 0,58 (p < 0,001). Conclusion: Cette etude indique que les enfants surchargent leur rachis lors du port de charge cephalique. Pan African Medical Journal 2016; 23
Material and methods All presentations made during scientific meetings from June 2011 to December 2013 were reviewed and their domains of study (research) were identified. Scientific meetings at a Military Teaching Hospital were organized, in order to promote research within Benin Armed Forces Health Services, through monthly meetings. Semester and annual planning was done for presentations as each department was asked to propose 2 research conclusions per year. Research conclusions were programmed and presented as well as their perspectives.
There is a risk of anaemia among HIV-infected children on antiretroviral therapy (ART) containing zidovudine (ZDV) recommended in first-line regimens in the WHO guidelines. We estimated the risk of severe anaemia after initiation of a ZDV-containing regimen in HIV-infected children included in the IeDEA West African database.Standardized collection of data from HIV-infected children (positive PCR<18 months or positive serology ≥ 18 months) followed up in HIV programmes was included in the regional IeDEA West Africa collaboration. Ten clinical centres from seven countries contributed (Benin, Burkina Faso, Côte d'Ivoire, Gambia, Ghana, Mali and Senegal) to this collection. Inclusion criteria were age <16 years and starting ART. We explored the data quality of haemoglobin documentation over time and the incidence and predictors of severe anaemia (Hb<7 g/dL) per 100 child-years of follow-up over the duration of first-line antiretroviral therapy.As of December 2009, among the 2933 children included in the collaboration, 45% were girls, median age was five years; median CD4 cell percentage was 13%; median weight-for-age z-score was-2.7; and 1772 (60.4%) had a first-line ZDV-containing regimen. At baseline, 70% of the children with a first-line ZDV-containing regimen had a haemoglobin measure available versus 76% in those not on ZDV (p ≤ 0.01): the prevalence of severe anaemia was 3.0% (n=38) in the ZDV group versus 10.2% (n=89) in those without (p<0. 01). Over the first-line follow-up, 58.9% of the children had ≥ 1 measure of haemoglobin available in those exposed to ZDV versus 60.4% of those not (p=0.45). Severe anaemia occurred in 92 children with an incidence of 2.47 per 100 child-years of follow-up in those on a ZDV-containing regimen versus 4.25 in those not (p ≤ 0.01). Adjusted for age at ART initiation and first-line regimen, a weight-for-age z-score ≤-3 was a strong predictor associated with a 5.59 times risk of severe anaemia (p<0.01).Severe anaemia is frequent at baseline and guides the first-line ART prescription, but its incidence seems rare among children on ART. Severe malnutrition at baseline is a strong predictor for development of severe anaemia, and interventions to address this should form an integral component of clinical care.
Understanding family dynamics and relationship is an important facet of care, therapeutic education and psychosocial support. As part of a therapeutic education program organized within a pediatric service in Cotonou, Benin, we have experimented with the genogram at the time of diagnosis and tested it as an educational tool. This study evaluates the usefulness of the genogram for therapeutic patient education, and its capacity to serve as an aid to better understand family structure and dynamics. The study was conducted in 2007 with 29 parents of children living with HIV / AIDS. Six professionals observed the conditions for the development and application of the genograms their effects on the production of information of an educational nature. The results indicate that it can provide families and caregivers benchmarks essential for understanding the role of the family and community in which the child-patient is situated and how they function. It facilitates the identification of key resource persons for the child and selfcare to be mobilized and fostered within the family.
The purpose of this study was to describe mucocutaneous manifestations observed in persons living with human immunodeficiency virus (PLHIV) in Cotonou Benin. A transverse retrospective study was carried out on the records of PLHIV who underwent follow-up at the Military Teaching Hospital in Cotonou from February 2002 to September 2005. The files of all eligible adult patients examined by dermatologists prior to initiation of antiretroviral treatment were reviewed. Dermatologic manifestations were defined as any cutaneous or cicatricial lesion of the skin. Data was analyzed using the EPI INFO software package. (version 6.0). A total of 152 patient files were included. The sex ratio was 1.10 with a female predominance. Mean age was 37.8 years. HIV1 was predominant (98%). Two-thirds of patients were as stage 3 according to the WHO classification. A total of 276 dermatologic manifestations were identified. The most common manifestations were buccopharyngeal candidiasis (24.6%) prurigo (20.6%) shingles (11.6%) and dermatophytosis (10.5%). The mean CD4 lymphocyte level was 106 cells/mm3. The CD4 level was below 100 cells/mm3 in 52% of cases involving candidiasis and 60% of cases involving prurigo. Dermatologic findings in this study were identical to those described in most studies from Africa and Asia. However the low prevalence of Koposis sarcoma and seborrheic dermitits was surprising given the advanced stage of immunodepression in our patients. The most frequent mucocutaneous manifestations of HIV infection in Benin are infectious disease and prurigo.
The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge.We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study.Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children.Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected children.
Objective To investigate the factors associated with HIV1 RNA plasma viral load (pVL) below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT) in Benin. Design Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. Methods HIV-infected women were enrolled in the second trimester of pregnancy. Socio-economic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART) for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. Results Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area), regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. Conclusions This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control.
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