<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Gastroesophageal Reflux Disease (GERD) is a common benign condition w...<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Gastroesophageal Reflux Disease (GERD) is a common benign condition with a worldwide prevalence of between 5</span><span style="font-family:Verdana;">%</span><span style="font-family:""><span style="font-family:Verdana;"> and 45% in the adult population. Its prevalence in the general population is little known in Africa. The aim of this work was to study the prevalence of typical GERD in the general adult population of a large city and the associated socio-demographic factors.</span><b><span style="font-family:Verdana;"> Patients and Methods:</span></b><span style="font-family:Verdana;"> This was a prospectively collected, descriptive and analytical cross-sectional study that was conducted over a one-month period (June 2018). We included any person residing in the city of Cotonou for at least 6 months, aged 15 years or older, who had given consent for the study. The two-stage cluster sampling technique was used. The dependent variable was the typical gastroesophageal reflux defined by the heatburn-regurgitation association. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We had included 728 su</span></span><span style="font-family:Verdana;">b</span><span style="font-family:""><span style="font-family:Verdana;">jects. Of these, 255 had a typical GERD, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> a prevalence of 35%. The mean age of the respondents was 31.9 ± 13.2 years with extremes of 15 and 88 years. There were 379 men (52.1%) with a sex ratio of 1.08. The study population was represented respectively by artisans (29.3%), students (26.6%) and traders/dealers (20.3%). In terms of marital status, there were as many married and single subjects (48.2%). In addition, 47% of the study population had a body mass index of less than 25 kg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;">. In univariate analysis, the sociodemo</span><span style="font-family:Verdana;">graphic factors associated with typical GERD were: age (60 years and older)</span><span style="font-family:Verdana;">: OR: 0.220 [95% CI 07</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.63], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">005</span><span style="font-family:""> </span><span style="font-family:Verdana;">and marital status divorced/separated/widowed: OR: 0.32 [0.11</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.97], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.</span><span style="font-family:""><span style="font-family:Verdana;">04. Older age and divorced/separated/widowed status appear to be protective of the occurrence of GERD.</span><b><span style="font-family:Verdana;"> Conclusion:</span></b><span style="font-family:Verdana;"> Typical GERD was common in the adult population of Cotonou. It readily affected young (under 60 years of age), single or married subjects</span></span><span style="font-family:Verdana;">.展开更多
Objective: The aim of this study conducted in Benin was to compare HIV-1 infected female sex workers (FSW) and patients from the general population (GP) to see whether there was a difference in adherence level, mortal...Objective: The aim of this study conducted in Benin was to compare HIV-1 infected female sex workers (FSW) and patients from the general population (GP) to see whether there was a difference in adherence level, mortality rate and immuno-virologic response to antiretroviral therapy (ART). Methods: Fifty-tree FSW and 318 patients from the GP were recruited and followed for at least one year. We compared both cohorts according to poor-adherence (taking <95% of the pills), CD4 count increase, undetectable viral load (VL;≤50 copies/mL) and crude mortality rate. We constructed a multivariate regression model to assess factors associated with undetectable VL. Results: During the first year, the proportion of FSW with poor-adherence was significantly higher than that of the GP patients (19.3% versus 7.5%;p < 0.0001) and median gain in CD4 count among FSW was slightly lower (103/mm3 versus 129/mm3;p = 0.085). In the multivariate model (including CD4 at ART initiation and the sub-cohort i.e. FSW vs GP patients), duration under ART (p = 0.003) as well as CD4 count at enrolment in the study (p < 0.0001) and good-adherence (0.057) were independently associated with undetectable VL. When adherence was withdrawn from this model, there was a borderline significant association between detectable VL and being a FSW (p = 0.074). The crude mortality rate was 1.11 per 100 persons-years among the GP patients and 4.65 per 100 persons-years among FSW. Conclusion: Response to ART was lower among FSW compared to GP patients, as a result of poorer adherence. Specific behavioural interventions are needed to improve adherence and response to ART among FSW.展开更多
Introduction: Healthcare-associated infections are involved in hospital long-stay and in the increase in inherent costs to patients care. Objectives: Objective was to describe the characteristics of healthcare-associa...Introduction: Healthcare-associated infections are involved in hospital long-stay and in the increase in inherent costs to patients care. Objectives: Objective was to describe the characteristics of healthcare-associated bacteremia and urinary tract infections in medical wards of CNHU-HKM of Cotonou, describe the distribution of germs identified according to admission wards and identify factors associated with onset of healthcare-associated infections. Materials and Methods: It was a cohort study conducted from 4th April to 16th September 2016. The study population included patients admitted in wards A and B of CNHU-HKM Medicine department for at least the past 48 hours, or readmitted in one of the medical wards less than 14 days after their discharge from hospital. Results: The study included 825 patients in total. Prevalence of healthcare-associated infections was 9.8%. Bacteremia was the most represented group (65.4%). The most often identified germs regardless of the site were respectively: K. pneumonia (38.5%), S. aureus (23.1%) and E. coli (20.0%). HIV+ status, internal medicine department, nephrology and endocrinology, duration of admission and the use of urinary catheter represent factors statistically associated with the onset of healthcare-associated infections. Conclusion: Healthcare-associated infections are a real public health issue in CNHU-HKM Medicine Department. There is pressing need to conduct a study on clinical hygiene so as to assess healthcare staff in practice.展开更多
Background: Late presentation to care is associated with increased morbidity, mortality and healthcare cost. Objectives: To determine the prevalence of late presentation to care in Benin, describe its trends and ident...Background: Late presentation to care is associated with increased morbidity, mortality and healthcare cost. Objectives: To determine the prevalence of late presentation to care in Benin, describe its trends and identify risk factors associated. Methods: We conducted a retrospective analysis from 2003 to 2014 at the National HIV Referral Centre in Benin. The definition of the European Late Presentation Consensus Group (ELPCG) for late presentation to care was used. Late Presenters (LP) were defined as patients presenting to care with CD4 count below 350 cells/mm3 or with an AIDS defining event, and patients with advanced HIV disease (AHD) were defined as persons with a CD4 count below 200 cells/mm3. Results: 5018 patients were included. Women accounted for 62.9%. Patients ranged in age from 18 to 62 years. 4233 patients (84.4%) were late presenters (LP) and 3126 (62.3%) were in Advanced HIV Disease (AHD). Late presentation decreased from 97.7% in 2003 to 78.7% in 2009. Between 2009 and 2014, there was no substantial decrease. Older age [Odds Ratio (OR) = 3.17;95% Confidence Interval (CI) = [2.52 - 4.00], p Conclusions: The prevalence of late presentation to care in Cotonou is alarming. This prevalence has been on a declining trend, but it remains extremely high. In order to reach the first 90 of the 90-90-90 targets, policymakers should promote the Provider-initiated HIV Testing and Counselling in all health facilities, modeled on the existing PMTCT of HIV screening during pregnancy.展开更多
文摘<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Gastroesophageal Reflux Disease (GERD) is a common benign condition with a worldwide prevalence of between 5</span><span style="font-family:Verdana;">%</span><span style="font-family:""><span style="font-family:Verdana;"> and 45% in the adult population. Its prevalence in the general population is little known in Africa. The aim of this work was to study the prevalence of typical GERD in the general adult population of a large city and the associated socio-demographic factors.</span><b><span style="font-family:Verdana;"> Patients and Methods:</span></b><span style="font-family:Verdana;"> This was a prospectively collected, descriptive and analytical cross-sectional study that was conducted over a one-month period (June 2018). We included any person residing in the city of Cotonou for at least 6 months, aged 15 years or older, who had given consent for the study. The two-stage cluster sampling technique was used. The dependent variable was the typical gastroesophageal reflux defined by the heatburn-regurgitation association. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We had included 728 su</span></span><span style="font-family:Verdana;">b</span><span style="font-family:""><span style="font-family:Verdana;">jects. Of these, 255 had a typical GERD, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> a prevalence of 35%. The mean age of the respondents was 31.9 ± 13.2 years with extremes of 15 and 88 years. There were 379 men (52.1%) with a sex ratio of 1.08. The study population was represented respectively by artisans (29.3%), students (26.6%) and traders/dealers (20.3%). In terms of marital status, there were as many married and single subjects (48.2%). In addition, 47% of the study population had a body mass index of less than 25 kg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;">. In univariate analysis, the sociodemo</span><span style="font-family:Verdana;">graphic factors associated with typical GERD were: age (60 years and older)</span><span style="font-family:Verdana;">: OR: 0.220 [95% CI 07</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.63], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">005</span><span style="font-family:""> </span><span style="font-family:Verdana;">and marital status divorced/separated/widowed: OR: 0.32 [0.11</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.97], p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.</span><span style="font-family:""><span style="font-family:Verdana;">04. Older age and divorced/separated/widowed status appear to be protective of the occurrence of GERD.</span><b><span style="font-family:Verdana;"> Conclusion:</span></b><span style="font-family:Verdana;"> Typical GERD was common in the adult population of Cotonou. It readily affected young (under 60 years of age), single or married subjects</span></span><span style="font-family:Verdana;">.
文摘Objective: The aim of this study conducted in Benin was to compare HIV-1 infected female sex workers (FSW) and patients from the general population (GP) to see whether there was a difference in adherence level, mortality rate and immuno-virologic response to antiretroviral therapy (ART). Methods: Fifty-tree FSW and 318 patients from the GP were recruited and followed for at least one year. We compared both cohorts according to poor-adherence (taking <95% of the pills), CD4 count increase, undetectable viral load (VL;≤50 copies/mL) and crude mortality rate. We constructed a multivariate regression model to assess factors associated with undetectable VL. Results: During the first year, the proportion of FSW with poor-adherence was significantly higher than that of the GP patients (19.3% versus 7.5%;p < 0.0001) and median gain in CD4 count among FSW was slightly lower (103/mm3 versus 129/mm3;p = 0.085). In the multivariate model (including CD4 at ART initiation and the sub-cohort i.e. FSW vs GP patients), duration under ART (p = 0.003) as well as CD4 count at enrolment in the study (p < 0.0001) and good-adherence (0.057) were independently associated with undetectable VL. When adherence was withdrawn from this model, there was a borderline significant association between detectable VL and being a FSW (p = 0.074). The crude mortality rate was 1.11 per 100 persons-years among the GP patients and 4.65 per 100 persons-years among FSW. Conclusion: Response to ART was lower among FSW compared to GP patients, as a result of poorer adherence. Specific behavioural interventions are needed to improve adherence and response to ART among FSW.
文摘Introduction: Healthcare-associated infections are involved in hospital long-stay and in the increase in inherent costs to patients care. Objectives: Objective was to describe the characteristics of healthcare-associated bacteremia and urinary tract infections in medical wards of CNHU-HKM of Cotonou, describe the distribution of germs identified according to admission wards and identify factors associated with onset of healthcare-associated infections. Materials and Methods: It was a cohort study conducted from 4th April to 16th September 2016. The study population included patients admitted in wards A and B of CNHU-HKM Medicine department for at least the past 48 hours, or readmitted in one of the medical wards less than 14 days after their discharge from hospital. Results: The study included 825 patients in total. Prevalence of healthcare-associated infections was 9.8%. Bacteremia was the most represented group (65.4%). The most often identified germs regardless of the site were respectively: K. pneumonia (38.5%), S. aureus (23.1%) and E. coli (20.0%). HIV+ status, internal medicine department, nephrology and endocrinology, duration of admission and the use of urinary catheter represent factors statistically associated with the onset of healthcare-associated infections. Conclusion: Healthcare-associated infections are a real public health issue in CNHU-HKM Medicine Department. There is pressing need to conduct a study on clinical hygiene so as to assess healthcare staff in practice.
文摘Background: Late presentation to care is associated with increased morbidity, mortality and healthcare cost. Objectives: To determine the prevalence of late presentation to care in Benin, describe its trends and identify risk factors associated. Methods: We conducted a retrospective analysis from 2003 to 2014 at the National HIV Referral Centre in Benin. The definition of the European Late Presentation Consensus Group (ELPCG) for late presentation to care was used. Late Presenters (LP) were defined as patients presenting to care with CD4 count below 350 cells/mm3 or with an AIDS defining event, and patients with advanced HIV disease (AHD) were defined as persons with a CD4 count below 200 cells/mm3. Results: 5018 patients were included. Women accounted for 62.9%. Patients ranged in age from 18 to 62 years. 4233 patients (84.4%) were late presenters (LP) and 3126 (62.3%) were in Advanced HIV Disease (AHD). Late presentation decreased from 97.7% in 2003 to 78.7% in 2009. Between 2009 and 2014, there was no substantial decrease. Older age [Odds Ratio (OR) = 3.17;95% Confidence Interval (CI) = [2.52 - 4.00], p Conclusions: The prevalence of late presentation to care in Cotonou is alarming. This prevalence has been on a declining trend, but it remains extremely high. In order to reach the first 90 of the 90-90-90 targets, policymakers should promote the Provider-initiated HIV Testing and Counselling in all health facilities, modeled on the existing PMTCT of HIV screening during pregnancy.
