Gilbert Avode

Link between Epilepsy and Malnutrition in a Rural Area of Benin

Summary:  Purpose: Epilepsy and malnutrition are both important public health problems in sub‐Saharan Africa. A relationship between epilepsy and malnutrition has been suspected for many years. Our objective was to investigate the association between epilepsy and malnutrition in Djidja, Benin.

Epidemiology of epilepsy in rural Benin: prevalence, incidence, mortality, and follow-up.

Epilepsy is a major clinical and social issue in Africa. This study was conducted to estimate the prevalence, incidence, mortality, and therapeutic outcome in rural Djidja in Benin.

Anxiété et dépression chez les épileptiques en population générale au Bénin (Afrique de l’Ouest)

Resume Afin d’evaluer la prevalence de la depression et de l’anxiete parmi les epileptiques et de les comparer a une population temoin, une enquete cas-temoin transversale utilisant l’echelle d’anxiete et de depression de Goldberg a ete conduite au Benin (Afrique de l’Ouest) aupres de 98 epileptiques âges de 18 ans et plus, ainsi que 98 temoins apparies selon le sexe, l’âge (± 10 ans) et le milieu de vie. L’âge moyen est de 32,6 ans ± 11,5 et le sex-ratio 1,28. 93 % des personnes interrogees vivent en famille, sont mariees ou vivent maritalement (temoins : 98,2 % ; cas : 87,9 %) ; 57,4 % sont maries (temoins : 70 % ; cas : 44 %) ; 97 % des epileptiques affirment avoir eu une crise dans les deux annees precedant l’enquete ; 48 % en ont eu 2 a 5 et 41,5 %, plus de 10. Il n’y a pas de correlation significative entre la frequence des crises et le niveau d’anxiete et de depression, en revanche la presence d’un traitement antiepileptique (77,5 %) diminue l’anxiete et la depression. Les epileptiques presentent plus souvent une anxiete severe (79,8 %) ou une depression severe (89,6 %) que les temoins (12,3 % et 46,9 %) (p

Interest of LQAS method in a survey of HTLV-I infection in Benin (West Africa)

HTLV-I is heterogeneously distributed in Sub-Saharan Africa. Traditional survey methods as cluster sampling could provide information for a country or region of interest. However, they cannot identify small areas with higher prevalences of infection to help in the health policy planning. Identification of such areas could be done by a Lot Quality Assurance Sampling (LQAS) method, which is currently used in industry to identify a poor performance in assembly lines. The LQAS method was used in Atacora (Northern Benin) between March and May 1998 to identify areas with a HTLV-I seroprevalence higher than 4%. Sixty-five subjects were randomly selected in each of 36 communes (lots) of this department. Lots were classified as unacceptable when the sample contained at least one positive subject. The LQAS method identified 25 (69.4 %) communes with a prevalence higher than 4%. Using stratified sampling theory, the overall HTLV-I seroprevalence was 4.5% (95% CI: 3.6-5.4%). These data show the interest of LQAS method application under field conditions to detect clusters of infection.

Prevention of venous thromboembolism among inpatients at Cotonou teaching hospital, Benin.

AIM The aim of this retrospective study was to evaluate the use and appropriateness of preventive measures for venous thrombosis among adult inpatients in a Benin teaching hospital. PATIENTS AND METHODS All patients were systematically enrolled. The risk of venous thrombosis was estimated according to international guidelines. Thromboembolic events were diagnosed using the Wells score and, when possible, by paraclinical investigations. The following variables were studied: the risk of venous thrombosis, the use and appropriateness of preventive measures, and the frequency of thromboembolic events. The data were analyzed with Epiinfo 6.04.fr and SPSS software, and significance was assumed at p=0.05. RESULTS The study population consisted of 487 patients recruited in four surgical wards, four general wards and one obstetric-gynecology ward. Mean age was 38.7+/-11.3 years and the sex ratio 0.51. The risk of thrombosis was considered low in 15% of patients, moderate in 60.8%, high in 21.1% and very high in 3.1%. Prophylactic measures were prescribed to 33.9% of the patients overall, 53.6% in the obstetric gynecology ward, 28.5% in the surgical wards and 12.9% in the general wards. The frequency of preventive measures rose with the level of risk (p<0.0001). Preventive measures consisted of passive mobilization, aspirin, enoxaparin and acenocoumarol. The prescriptions were appropriate in only 6% of cases. Among 198 patients who were monitored for two months after hospital discharge, 8% had a venous thromboembolic event. Such events were more frequent in the absence of prophylaxis (12% vs 3.3%, p=0.02). CONCLUSION The risk of venous thromboembolic is recognized but poorly managed in this Bénin teaching hospital.