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La fixation d’un ose, fréquemment le glucose, sur les protéines est une réaction biochimique courante entraînant la formation des produits avancés de la glycation (en anglais Advanced Glycation Endproducts, AGEs). L’hyperglycémie permanente observée pendant le diabète, provoque une élévation du taux de glycation des protéines, avec pour conséquence une altération de leurs fonctions. Plusieurs auteurs ont montré le lien entre l’accumulation des AGEs dans différents organes et les complications microvasculaires et macrovasculaires observées lors du diabète. D’autres travaux ont montré que ces complications diabétiques et plusieurs autres maladies métaboliques découlent d’une série de processus délétères initiée par les AGEs. Il s’agit de l’inflammation par le biais des récepteurs, les modifications conformationnelles des macromolécules aboutissant à des accumulations d’agrégats et à une réponse immunitaire médiée par l’immunogénicité des AGEs. Les principales approches thérapeutiques pour le traitement du diabète impliquent l’administration d'insuline, l'inhibition des enzymes de digestion des polysaccharides (alpha-amylase et alpha-glucosidase) et les inhibiteurs de la glycation. Plusieurs travaux ont prouvé qu’un nombre important de plantes, herbes aromatiques et épices possèdent des propriétés antiglycatives très intéressantes et pourront être envisagées pour élargir la gamme des molécules thérapeutiques. The binding of a monosaccharide, frequently glucose, to proteins is a common biochemical reaction leading to the formation of advanced glycation end products (AGEs). The permanent hyperglycaemia observed during diabetes induces an increase in the glycation rate of proteins, with the consequent alteration of their functions. Several authors have demonstrated the link between the accumulation of AGEs in different organs and the microvascular and macrovascular complications observed in diabetes. Other work has shown that these diabetic complications and several other metabolic diseases stem from a series of deleterious processes initiated by AGEs. This is inflammation through receptors, conformational changes of macromolecules leading to accumulations of aggregates and an immune response mediated by the immunogenicity of AGEs. The main therapeutic approaches for the treatment of diabetes involve insulin administration, inhibition of polysaccharide digestion enzymes (alpha-amylase and alpha-glucosidase) and glycation inhibitors. Several works have proven that a large number of plants, aromatic herbs and spices have very interesting antiglycative properties and could be considered to expand the range of therapeutic molecules.

Background/Purpose: Esophageal atresia (EA) is a congenital defect in the thoracic esophagus associated or not with a tracheoesophageal fistula (TEF). It is associated with high mortality in low-income countries such as Burkina Faso, Madagascar and Ghana. The purpose of this study was to present the recent management of newborns with EA/TEF in Benin and to identify the needs of families whose children have survived. Method: Over a period of 10 years, 54 newborns with EA/TEF operated on in the 2 largest university hospitals in Benin were included. Two groups were identified. Group A (n=33) included newborns in whom a primary repair had been performed. Group B (n=21) involved newborns who underwent staged repair. Staged repair involved cervical oesophagostomy + gastrostomy (n= 7) or upper oesophageal pouch suction + gastrostomy (n=2) or cervical esophagostomy + stoma of the lower esophageal pouch (n=12). Ten parents from group B were interviewed for the needs survey. The significance level was defined as p < 0.05. Results: There were 31 male newborns. The median for gestational age was 37 gestational weeks (range: 35 - 38). Polyhydramnios was observed in 4 cases. The mean birth weight was 2365 g. (range: 1000 g - 3500 g). The mean age at diagnosis was 3.48 days (range: 24 hours - 19 days). Surgery was performed at day 5 on average with extremes from day 2 to day 17. The surgery lasted an average of 2h12 min and the overall mortality rate was 74.07%. Mortality rate in group A was 100% and 33.33% in group B. There was a strong statistically significant difference in survival between the two groups. (p=19.10-8). Sepsis was the most common cause of death. Stress, fear and anxiety of losing the child were the difficulties frequently encountered at bedtime and every day. Four parents had to stop their activities to be available to take care of their child. All the parents had expressed the need for psychological support. Conclusion: Pending an improvement of the technical platform, staged repair remains an essential option for the survival of patients. The creation of a framework for discussion with families authorizing social actions and quality medical support is desired.

Paradoxical reactions (PR) during tuberculosis treatment are rare in HIV negative subjects and result in polymorphic clinical presentations which could sometimes lead to confusion. We report the case of a postpartum mother, HIV negative who was placed on treatment for pulmonary tuberculosis. She experienced transient clinical improvement and developed PR which mimicked lung malignancy. This is a rare phenomenon and may result in diagnostic and therapeutic dilemma in resource poor settings.

La Sardinelle plate est l’un des petits pélagiques côtiers béninois soumis à une forte pression de pêche. Cette étude présente la caractérisation morphologique, le mode de croissance et l’embonpoint de l’espèce. Pendant douze mois, 1026 spécimens de Sardinella maderensis ont été échantillonnés aléatoirement dans les débarquements au port de pêche artisanale de Cotonou. Parmi les différents paramètres biométriques et méristiques relevés sur chaque spécimen, seules la longueur totale et la grande hauteur ont montré une différence significative suivant le sexe (p

The present study aimed to assess the physico-chemical quality of wastewater(s) in order to better control the flow of various pollutants generated by the industries from the industrial zone of Cotonou. Water samples were collected in triplicate in each collector and analyzed for their nutrient and metal content (Cu2+, Fe2+, Cd2+, Al3+ and Pb2+) and chemical oxygen demand (COD) and a five-day biochemical oxygen demand (BOD5) were carried out by spectrophotometry. The results revealed highly mineralized waters, indicated by average pH (6.97± 0.34), dissolved oxygen (5.16 ± 0.29 mg/L), electrical conductivity (2280.58 ± 263.97 µS/cm) and total dissolved solids (1076.04 ± 51.01 mg/L). The values of COD (482.05± 1.18 mg/L) and BOD5 (291.67 ±2.19 mg/L) were very high, exceeding the standard for industrial wastewater discharge in Benin respectively by 5 and 11 which is indicative of the presence of very poor biodegradable materials coming essentially from industrial discharge in the study area. The concentration of Cd2+, Pb2+ and nutrient salts indicative of eutrophication were relatively low in the collectors. However, the concentration of Al3+ (2.65±0.03 mg/L) and Cu2+ (10.20 ± 0.14 mg/L) were very high with the later cation being four times higher than the wastewater standard in Benin (2.5 mg/L) for the most heavily loaded collectors. In conclusion, the results of this study provide useful insights for implementation of purification system and efficient management of wastewater from industries.

The Joint Aeolus Tropical Atlantic Campaign (JATAC) for the Calibration and Validation (Cal/Val) of the ESA’s Aeolus mission was held on summer and September 2021 and 2022 at the remote tropical islands of Cabo Verde. The JATAC campaign comprises airborne and ground-based instrumentation delivering reference measurements of wind profiles and aerosol/cloud optical properties for the validation of the Aeolus products, as well as supporting related research activities. The ground-based component of JATAC, ASKOS (https://askos.space.noa.gr/) was stationed at the Ocean Science Center in Mindelo (OSCM), São Vicente Island, where measurements from active and passive remote sensing sensors have been deployed for the validation of the Aeolus Level 2 aerosol and wind products.The eVe lidar, which is the ESA’s ground reference lidar system, was deployed in ASKOS for the validation of the Aeolus Level 2A aerosol products. eVe lidar is a scanning system that can perform combined linear/circular polarization and Raman measurements that operates at 355 nm and retrieves the particle backscatter coefficient, the particle extinction coefficient, the lidar ratio, and the linear and circular depolarization ratios. The lidar is implemented in a dual-laser/dual-telescope configuration that allows eVe to simultaneously reproduce the operation of the ALADIN lidar onboard Aeolus, i.e. circularly polarized emission, as well as the operation of a traditional lidar system, i.e. with linearly polarized emission. Targeted measurements of eVe lidar for the Aeolus validation were performed every Friday evening during the nearest Aeolus overpass from Mindelo resulting to a dataset of fourteen collocations for the intensive ASKOS operation periods in 2021 and 2022. In this study, we present the results from the comparison of the particle backscatter and extinction coefficients, and the lidar ratio between eVe and Aeolus profiles. Acknowledgements:This research was supported by the European Space Agency project ASKOS (Grant agreement 4000131861/20/NL/IA) and the PANGEA4CalVal project (Grant Agreement 101079201) funded by European Union’s Horizon Widera 2021 Access program.

Due to costs of setting up and operating electrical stirring systems to keep algae in suspension and exposed to light, cultivation of monospecific algae is poorly expanded in developing countries. However, some algal species, such as Arthrospira platensis, are equipped with gaseous vesicles that allow them to stay afloat and increase their exposure to light. In this study, we investigated in an unstirred outdoor environment, its growth kinetic and purifying performance in a brewery effluent-based media. Batch cultures were carried out in three experimental treatments and evolution of physicochemical and growth parameters were monitored. Then its contribution to depollution was determined. Results show that optimal conditions for producing A. platensis include the culture tank transparency, the effluent dilution (i.e. 10%), and the culture media amendment with sodium bicarbonate and sodium nitrate. The average productivity recorded reached 0.55 g DW·L−1·d−1 during the exponential growth phase, while preserving culture from contamination. COD and total nitrogen concentrations were reduced to 32.5 and 64.91%. Such results open up prospects for low-cost production of certain algae, in transparent and relatively high barrels, thus breaking the classic barriers related to shallow basin depth and mechanical agitation traditionally considered as critical to the success of algal production.

The silver catfish Schilbe intermedius (Ruppell, 1832) is single-spawning species spread in Africa and may reach 50 cm in length. Since there are no studies on the artificial reproduction of S. intermedius, the aim of the present study was to induce for the first time spawning by hormonal injection and to determine the reproductive parameters for this species. Artificial induction was carried out by the injection of Ovaprim (0.5 ml kg− 1) to males and females. Different eggs measurements were carried out by micrometer. Egg stripping was carried out ten hours after hormone injection at 27.17 ± 0.22 °C (mean ± standard deviation) with mean spawning rate 58.15 ± 2.88 %. Relative fecundity was 613.25 ± 71.83 oocytes/g with mean diameters 0.94 ± 0.10 mm and 1.11 ± 0.06 mm, respectively, before and after eggs fertilization. Fecundity and hatching rates ranged, respectively, from 60.30 to 68.02 % and 56.11–60.96 %. Egg hatching occurred about 22 or 28 h after fertilization at 26.02 °C, and the larvae average length was 1.24 ± 0.14 mm. Yolk sac resorption occurred 48 h after hatching and larvae acquired their morphological structures in about 72 h after hatching. This information will be important in improving the artificial reproduction protocols of S. intermedius in controlled breeding programs.

Background There are no comparative study between guided growth and tibial osteotomy in early stage of Blount disease (BD) to our knowledge. The aim of this work was to compare the results of patients treated by these two techniques. Method This was a retrospective, descriptive, and analytical study over a period of 5 years in including 17 children (24 Knees) with an early stage of infantile BD in two centers. Patient were classified in two groups: group 1(treated by guided growth), group 2 (treated by Tibial Osteotomy). Preoperative alignment analysis using the tibial femoral angle (HKA) and the proximal medial tibial mechanical angle (mMPTA) were compared with three measurements taken postoperatively in each of the groups. The mean variations of the angles were compared between the two groups. Results Socio-demographic characteristics were similar for the two groups. Median age at surgery was 6.5 ± 2.5 [3–9 years] in group 1 and 6.8 ± 2.9 years [3–9 years]. At a follow-up of 24 ± 3.5 months, the limb alignment was significantly corrected (1,03°/month) in group 1 (median HKA 144°–171°; p = 0,001; median MMPTA 78°–87°, p = 0,018), and in group 2 we observed at a follow-up of 23 ± 15 months a progressive loss (0,52°/month) of the correction obtained immediately postoperatively (median HKA 160°–176°(immediate post operative) to 165,5°; p = 0,31; median MMPTA = 78°–86° (immediate post operative) to 80,5°; p = 0,37). There was a statistically significant difference between the mean variation in HKA between the two groups (group 1 = 22,5; group 2 = 4,5, p = 0.00), as well as for MMPTA; (group 1 = 7; group 2 = 2,5, p = 0,023). The rate of correction was 78% in group 1 with no rebound at a median follow-up after removal of the material of 10 ± 2.4 months. Within group 2, the rate of correction was 10% with a recurrence rate of 60%. Conclusion Guided growth appears to be the best treatment for early stage of BD in squelletically immature patients.

Background The fetu in fetu (FIF) is an extremely rare congenital condition characterized by a 2nd fetus that grows into the body of the healthy twin. Its thoracic location is more exceptional. Case presentation We report a case of intrathoracic mass in a 5-month-old female infant, diagnosed after an assessment for respiratory distress. She underwent an emergency left thoracotomy which allowed for the removal of a large thoraco-mediastinal mass inside a membranous sac containing a clear liquid mixed with vernix caseosa. The mass was completely covered with normal skin, three lobes similar to rudimentary outline of the head and limb. It was attached to a single large vascular pedicle. The pathological examination concluded that there was a high possibility of FIF. The postoperative follow-up was uncomplicated, and the child is still in good clinical condition after the 5-month follow-up. Conclusion The assessment of the respiratory distress in an infant with a mass centered by an axial skeleton on the chest x-ray and thoracic CT scan may suggest a diagnosis of intrathoracic FIF.

Introduction: OEIS syndrome, the most severe form of exstrophy-epispadias complex, is characterized by the existence of an omphalocele, a bladder exstrophy, an anal imperforation and a spina bifida. Case Presentation: Two clinical cases admitted at the first day of life in neonatology department are reported; one was born by caesarean section, weighing 2500 g and the other one vaginally with a weight at 1890 g. The first child’s mother was a primigravid, primiparous and the second mother was multiparous. Prenatal ultrasound was performed in one case. The clinical examination found two exstrophied hemi-bladders with two productive ureteral meatus, separated by a double intestinal orifice, a manifestation of anal imperforation, omphalocele, spina bifida and lumbar vertebral malformations; which corresponds to a typical form of OEIS syndrome. One of the babies had an associated clubfoot. The karyotype could not be performed. Both were dead; the first in the early postoperative period, the second one at 16 days of life without surgery. Conclusion: OEIS syndrome is a rare condition and represents a therapeutic challenge in developing countries. Promoting prenatal diagnosis is essential.

AimsImmunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here, we assessed the predictive power of immune cells correlated with biochemical parameters in gestational diabetes mellitus (GDM).Materials and MethodsImmune cells and serum biochemical parameters were determined in women with GDM and pregnant controls. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of ratios of immune cells to biochemical parameters for predicting GDM.ResultsBlood glucose, total cholesterol, LDL-cholesterol and triglycerides were significantly increased whereas HDL-cholesterol decreased in women with GDM compared to pregnant controls. Glycated hemoglobin, creatinine, transaminase activities did not significantly differ between both groups. Total leukocyte, lymphocyte and platelet numbers were significantly high in women with GDM. Correlation tests showed that ratios of lymphocyte/HDL-C, monocyte/HDL-C and granulocyte/HDL-C were significantly higher in women with GDM than in pregnant controls (p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte/HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p=0.041).ConclusionOur study showed that ratios of lymphocyte, monocyte and granulocyte to HDL-C might represent valuable biomarkers for GDM and in particular, lymphocyte/HDL-C ratio exhibited a strong predictive power for GDM risk.

Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality—over one and a half million children and adolescents develop TB each year. A history of the global public health perspective on child and adolescent TB is followed by 12 narratives detailing challenges and progress in 19 TB endemic low and middle-income countries. Overarching challenges include: under-detection and under-reporting of child and adolescent TB; poor implementation and reporting of contact investigation and TB preventive treatment services; the need for health systems strengthening to deliver effective, decentralized services; and lack of integration between TB programs and child health services. The COVID-19 pandemic has had a significant negative impact on case detection and treatment outcomes. Child and adolescent TB working groups can address country-specific challenges to close the policy–practice gaps by developing and supporting decentral ized models of care, strengthening clinical and laboratory diagnosis, including of multidrug-resistant TB, providing recommended options for treatment of disease and infection, and forging strong collaborations across relevant health sectors.

Background Esophageal perforation is a rare surgical pathology in children. Thoracic esophageal perforation is more severe than cervical esophageal perforation. Iatrogenic cause, mainly by endoscopy, is the most common in esophageal perforation. However, perforation induced by “Magill forceps” is exceptional. Case presentation A systematic physical examination revealed pyrexia severe respiratory distress and right-sided pleural effusion. We report the success of non-operative treatment applied to thoracic esophageal perforation due to Magill forceps in a 24-month-old male infant. The immediate and short-term outcomes were excellent. Conclusions Non-operative treatment is possible in iatrogenic perforation of thoracic esophageal in infants. This treatment delivers excellent outcome in carefully selected patients.

Data on the prevalence of sleep-disordered breathing (SDB) in the African general population are scarce, and a better understanding is urgently needed. Our study aimed to objectively determine the prevalence of, and factors associated with, SDB in a large sample in Benin, west Africa.In the Benin Society and Sleep (BeSAS) cross-sectional study, participants aged 25 years and older were recruited from both urban and rural areas. Rural participants were recruited from Tanve, a village located 200 km north of Cotonou, and urban participants were recruited from Cotonou. The participants underwent respiratory polygraphy at home using a type-3 device that measures airflow through a nasal pressure sensor, respiratory effort (thoracic movement), and pulse oximetry. Clinical and morphometric data were also collected. SDB severity categories were defined according to the apnoea-hypopnoea index (AHI), with mild-to-severe SDB (AHI ≥5/h), moderate-to-severe SDB (AHI ≥15/h), and severe SDB (AHI ≥30/h).The study was completed from April 4, 2018 to Jan 15, 2021. Of 2909 participants recruited in the BeSAS study, 2168 (74·5%) underwent respiratory polygraphy. For the 1810 participants with complete polygraphic data (mean age 46 years, SD 15; 1163 [64·2%] women), the prevalence of mild-to-severe SDB (AHI ≥5/h) was 43·2% (95% CI 40·9-45·5), of moderate-to-severe SDB (AHI ≥15/h) was 11·6% (10·2-13·1), and of severe SDB (AHI ≥30/h) was 2·7% (2·0-3·5). Factors independently associated with SDB were advanced age, male sex, large neck circumference, abdominal obesity, overweight or obesity, and snoring. After multivariable adjustment, severe SDB was independently associated with hypertension in women (odds ratio 3·99, 95% CI 1·04-15·33; pThe BeSAS study provides the first large-scale objective evaluation of SDB prevalence and associated factors in Africa. The high prevalence of SDB identified should stimulate the development of public health policies to prevent and treat this condition in African countries.Ligue Pulmonaire Vaudoise, Switzerland.

This study aimed to describe real-life microbiological testing of adults hospitalised with community-acquired pneumonia (CAP) and to assess concordance with the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) and 2011 European Respiratory Society (ERS) CAP guidelines. This was a cohort study based on the Global Initiative for Methicillin-resistant Staphylococcus aureus Pneumonia (GLIMP) database, which contains point-prevalence data on adults hospitalised with CAP across 54 countries during 2015. In total, 3702 patients were included. Testing was performed in 3217 patients, and included blood culture (71.1%), sputum culture (61.8%), Legionella urinary antigen test (30.1%), pneumococcal urinary antigen test (30.0%), viral testing (14.9%), acute-phase serology (8.8%), bronchoalveolar lavage culture (8.4%) and pleural fluid culture (3.2%). A pathogen was detected in 1173 (36.5%) patients. Testing attitudes varied significantly according to geography and disease severity. Testing was concordant with IDSA/ATS and ERS guidelines in 16.7% and 23.9% of patients, respectively. IDSA/ATS concordance was higher in Europe than in North America (21.5% versus 9.8%; p, Testing practices vary based on geography and disease severity, and IDSA/ATS/ERS testing recommendations are rarely followed http://ow.ly/80Iy30lxo1c

Background: Gastroschisis often has a fatal outcome in developing countries. Its outcome is taken as an indicator of the level of healthcare in a particular healthcare facility. The aim was to study the outcome of the management of gastroschisis and to identify the main challenges of its treatment in a country with limited resources. Methods: This is a prospective and descriptive study conducted over a period of 4 years (2016-2020). It included all the neonates admitted to the two referral hospitals of our country with the diagnosis of gastroschisis. Each of the university hospitals had a neonatology unit. Parenteral nutrition and assisted ventilation were not available. Results: Twenty patients were admitted to our hospitals with an annual frequency of five cases. The sex ratio (M:F) was 1.5. Only one of the 20 mothers (5%) of the patients had an antenatal diagnosis and was the only one born in a university hospital. The remaining (19-95%) were referred to a university hospital after their birth. None of the 20 patients had received parenteral nutrition. Surgically, seven babies (35%) had benefited from the placement of a silo with progressive reduction of the bowels. The mortality of gastroschisis was 100% and the average life span of the patients was 4.5 days [1-20 days]. Conclusion: It is important to act appropriately on the whole chain of management of gastroschisis from antenatal diagnosis to treatment so that this pathology is no longer fatal for newborns in countries with limited resources.

Bowel malrotation is an abnormality in the rotation of the primary intestinal loop during embryonic life. It is a severe abnormality exposing the patient to fatal complications. We report here a series of five patients presenting digestive malrotation with various malformative associations. The first three cases are multiple intestinal atresia on incomplete common mesentery. They underwent an intestinal anastomosis: end-lateral duodeno-ileal for one and end-to-end jejuno-jejunal for the other two with Ladd procedure. In the latter two cases, the omphalocele was the associated malformation; complications such as rupture of the omphalocele with intestinal perforation for one and occlusion by strangulation at the level of the neck for the other were recorded. Ileal resection removing the perforation with end-to-end ileo-ileal anastomosis was performed for the first, while reduction of strangulation at the origin of the occlusion was sufficient for the second. The LADD procedure was the complementary gesture in all cases. The outcome was favorable in 3 cases; two of the newborns who had jejunal atresia died, one on day 5 in a picture of acute respiratory distress, the other on day 6 in a picture of disseminated intravascular coagulation.

Summary Background Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This study aimed to test both interventions in low-income and middle-income countries. Methods FALCON was a 2 × 2 factorial, randomised controlled trial stratified by whether surgery was clean-contaminated, or contaminated or dirty, including patients undergoing abdominal surgery with a skin incision of 5 cm or greater. This trial was undertaken in 54 hospitals in seven countries (Benin, Ghana, India, Mexico, Nigeria, Rwanda, and South Africa). Patients were computer randomised 1:1:1:1 to: (1) 2% alcoholic chlorhexidine and non-coated suture, (2) 2% alcoholic chlorhexidine and triclosan-coated suture, (3) 10% aqueous povidone–iodine and non-coated suture, or (4) 10% aqueous povidone–iodine and triclosan-coated suture. Patients and outcome assessors were masked to intervention allocation. The primary outcome was SSI, reported by trained outcome assessors, and presented using adjusted relative risks and 95% CIs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT03700749. Findings Between Dec 10, 2018, and Sept 7, 2020, 5788 patients (3091 in clean-contaminated stratum, 2697 in contaminated or dirty stratum) were randomised (1446 to alcoholic chlorhexidine and non-coated suture, 1446 to alcoholic chlorhexidine and triclosan-coated suture, 1447 to aqueous povidone–iodine and non-coated suture, and 1449 to aqueous povidone–iodine and triclosan-coated suture). 14·0% (810/5788) of patients were children and 66·9% (3873/5788) had emergency surgery. The overall SSI rate was 22·0% (1163/5284; clean-contaminated stratum 15·5% [454/2923], contaminated or dirty stratum 30·0% [709/2361]). For both strata, there was no evidence of a difference in the risk of SSI with alcoholic chlorhexidine versus povidone–iodine (clean-contaminated stratum 15·3% [223/1455] vs 15·7% [231/1468], relative risk 0·97 [95% CI 0·82–1·14]; contaminated or dirty stratum 28·3% [338/1194] vs 31·8% [371/1167], relative risk 0·91 [95% CI 0·81–1·02]), or with triclosan-coated sutures versus non-coated sutures (clean-contaminated stratum 14·7% [215/1459] vs 16·3% [239/1464], relative risk 0·90 [95% CI 0·77–1·06]; contaminated or dirty stratum 29·4% [347/1181] vs 30·7% [362/1180], relative risk 0·98 [95% CI 0·87–1·10]). With both strata combined, there were no differences using alcoholic chlorhexidine or triclosan-coated sutures. Interpretation This trial did not show benefit from 2% alcoholic chlorhexidine skin preparation compared with povidone–iodine, or with triclosan-coated sutures compared with non-coated sutures, in preventing SSI in clean-contaminated or contaminated or dirty surgical wounds. Both interventions are more expensive than alternatives, and these findings do not support recommendations for routine use. Funding National Institute for Health Research (NIHR) Global Health Research Unit Grant, BD.

BACKGROUND: There are no comparative study between guided growth and tibial osteotomy in early stage of Blount disease (BD) to our knowledge. The aim of this work was to compare the results of patients treated by these two techniques. METHOD: This was a retrospective, descriptive, and analytical study over a period of 5 years in including 17 children (24 Knees) with an early stage of infantile BD in two centers. Patient were classified in two groups: group 1(treated by guided growth), group 2 (treated by Tibial Osteotomy). Preoperative alignment analysis using the tibial femoral angle (HKA) and the proximal medial tibial mechanical angle (mMPTA) were compared with three measurements taken postoperatively in each of the groups. The mean variations of the angles were compared between the two groups. RESULTS: Socio-demographic characteristics were similar for the two groups. Median age at surgery was 6.5 ± 2.5 [3–9 years] in group 1 and 6.8 ± 2.9 years [3–9 years]. At a follow-up of 24 ± 3.5 months, the limb alignment was significantly corrected (1,03°/month) in group 1 (median HKA 144°–171°; p = 0,001; median MMPTA 78°–87°, p = 0,018), and in group 2 we observed at a follow-up of 23 ± 15 months a progressive loss (0,52°/month) of the correction obtained immediately postoperatively (median HKA 160°–176°(immediate post operative) to 165,5°; p = 0,31; median MMPTA = 78°–86° (immediate post operative) to 80,5°; p = 0,37). There was a statistically significant difference between the mean variation in HKA between the two groups (group 1 = 22,5; group 2 = 4,5, p = 0.00), as well as for MMPTA; (group 1 = 7; group 2 = 2,5, p = 0,023). The rate of correction was 78% in group 1 with no rebound at a median follow-up after removal of the material of 10 ± 2.4 months. Within group 2, the rate of correction was 10% with a recurrence rate of 60%. CONCLUSION: Guided growth appears to be the best treatment for early stage of BD in squelletically immature patients.

Background Abdominal trauma are a common cause of infant morbidity and mortality. Aim To assess the relevance of computed tomography scan for the management of abdominal trauma in children in countries with limited resources. Patients and method: It was a retrospective and descriptive study over 5 years in patients aged 0 to 15 years. Results Twenty four cases of abdominal trauma were collected. There were 14 boys and 10 girls with a sex ratio of 1.4. The average age was 8.7 years with extremes of 18 months and 15 years. The causes found were: road accidents (14 cases), home accident (6 cases), gambling accidents (3 cases) and one aggression. Traumas were divided into 83.3% (20 cases) of abdominal blunt and 16.7% (4 cases) of abdominal wound. Polytrauma accounted for 41.7% (10 cases). No computed tomography scan was ordered. The spleen was the most injured organ (11 cases) followed by the intestines (6 cases). The average length of hospital stay was 12.3 days with extremes of 3 and 15 days. The treatment was non-operative in 13 patients (54.2%) and surgical in 11 ones (45.8%). No deaths were noted in our series. Conclusion Abdominal trauma in children are potentially serious injuries. The treatment depends on the damaged organ and the patient's hemodynamic status. Computed tomography scan does not appear to be indispensable in the management of traumatized children in countries with limited resources.

Background: There are no real comparative study between guided growth and tibial osteotomy in early stage of Blount disease. The aim of this work was to compare the results of patients treated by these two techniques. Method: We had performed a multicenter retrospective, descriptive and analytical study over a period of 05 years. All children admitted for Blount disease without medial proximal tibial epiphysiodesis and treated by one of these techniques were included. Age, sex, existence of tibial torsion, radiological stage based on Catonne's classification were studied. We also evaluated preoperatively, immediately postoperatively, and at latest follow-up tibiofemoral angle, mechanical medial proximal tibial angle, mechanical lateral distal femoral angle, and the tibial metaphyso-diaphyseal angle. Results: Seventeen (17) patients for 24 knees were included. The sex ratio was 0.54. All patients had tibial torsion. Fourteen knees (64%) were treated by guided growth at a mean age of 5.5±2.5 (range, 3-9 years). With a mean follow-up of 12 ± 3.5 months (range 6-15month); tibiofemoral, mechanical medial proximal tibial, and tibial metaphyso-diaphyseal angles were significantly corrected with normalization of the mechanical axis in 8 patients (60%). Ten patients (36%) were treated by revisited Rab osteotomy at a mean age of 7.7±4.9 years (range, 4-12 years). At a mean follow-up of 23±15 months (range, 10-48 months), only tibial metaphyso-diaphyseal angle was significantly corrected. The recurrence rate was 60%. Despite perfect correction of tibiofemoral, and mechanical medial proximal tibial angles in immediate postoperative follow-up, they gradually decrease in patients treated by Rab osteotomy, whereas they gradually increased in case of guided growth. Conclusion: Guided growth appears to be the best treatment for early stage of Blount disease. Trial registration: Retrospectively registered

Additional file 2. Map showing the geographical distribution of survey respondents.Map was created with MapChart.net; the created map is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License: https://creativecommons.org/licenses/by-sa/4.0/

Additional file 1. Google survey form with the fields used for the subsequent extraction of quantitative and qualitative data.

Background: There are currently no data on the prevalence of sleep-disordered breathing (SDB) in the African general population. This study aimed to objectively determine the prevalence of, and factors associated with, SDB in a large population-based sample in Benin, West Africa. Methods: The Benin Society and Sleep (BeSAS) population-based study was conducted from April 2018 to January 2021. Participants were recruited from both urban and rural areas. Subjects underwent polygraphy at home using a type III device. Clinical and morphometric data were also collected. SBD severity categories were defined according to apnoea-hypopnoea index (AHI): mild-to-severe (AHI ≥5/h, moderate-to-severe (AHI ≥15/h) or severe (AHI ≥30/h). Findings: For the 1810 participants with complete polygraphic data (age 46±15 years, 64·2% women), the prevalence (95% confidence interval [CI]) of mild-to-severe SDB (AHI ≥5/h) was 43·2% (40·9–45·5), of moderate-to-severe SDB (AHI ≥15/h) was 11·6% (10·2–13·1), and of severe SDB (AHI ≥30/h) was 2·7% (2·0-3·5). Factors independently associated with SBD were advanced age, large neck circumference, and snoring in both sexes. After multivariable adjustment, severe SDB was independently associated with hypertension (odds ratio 3·99 [95% CI 1·04–15·33]; p trend =0·044) in women but not in men. Interpretation: The BeSAS study provides the first objective evaluation of SDB prevalence and associated factors in Africa. The high prevalence of SDB identified should stimulate the development of public health policies to prevent and treat this condition in African countries. Funding Information: Ligue Pulmonaire Vaudoise, Switzerland. Declaration of Interests: RH is member of the medical advisory board of Dreem and Nightbalance (Philips) and received honorariums, grants or speakers’ fees from ResMed, Jazz, Inspire, Philips and Dreem. All the other authors have no conflict of interest to disclose. Ethics Approval Statement: The study was approved by the National Ethics Committee of Benin (reference No. 45, 25 October 2017) with regular annual approval renewal throughout the course of the research project. Participants were enrolled on a voluntary basis and provided written informed consent. If a subject was unable to read or write, a family member able to read was asked to assist with providing information.

L´agénésie sternale comme l´ectopia cordis sont des malformations congénitales extrêmement rares. Nous rapportons l´unique cas pris en charge dans un service de chirurgie pédiatrique au Bénin. Il s´agissait d´une fillette de 3 ans ayant présenté depuis sa naissance une agénésie sternale avec ectopia cordis. Elle avait bénéficié initialement d´une cicatrisation dirigée puis secondairement d´une thoracoplastie avec succès. Les résultats à long terme sont bons. Elle est aujourd´hui âgée de 13 ans, scolarisée et présente un état clinique satisfaisant. Il s´agit d´un des rares cas rapportés dans la littérature et maintenu en vie par une gestion thérapeutique optimale dans un contexte ouest africain.

Additional file 3. Thematic analysis of the responses to open-ended questions by survey respondents according to country category.

Background : Immunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here we assessed the predictive power of immunological parameters correlated with biochemical ones in gestational diabetes mellitus (GDM). Material and Methods : 217 pregnant women were screened for GDM between the 2 nd and the 3 rd trimester of gestation, based on IAGDP methods in this cross-sectional descriptive study. Immunological and biochemical parameters were determined using appropriate methods. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of immunological to biochemical parameter ratios for predicting GDM. Results : 11.90% of pregnant women were diagnosed GDM positive. Serum glucose levels, total cholesterol, LDL-cholesterol, triglycerides and total proteins were significantly increased while HDL-cholesterol decreased in women with GDM compared to controls. The levels of glycosylated hemoglobin and creatinine, as well as transaminase (AST and ALT) activities did not significantly differ between GDM and pregnant controls. Total leucocytes (white blood cell), lymphocyte and platelet numbers were significantly higher in women with GDM than in pregnant controls. We also found that the lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios were significantly higher in women with GDM than in pregnant controls ( p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte:HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p =0.041). Conclusion : The lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios may represent valuable makers, and the lymphocyte:HDL-C ratio in particular may have strong predictive power for GDM. This ratio can be easily assessed in patients.

Background and importance According to the WHO, care associated infections (CAIs) affect at least 2 million patients worldwide annually. In this African country, common CAIs are surgery site infections (SSI; 24.7% among inpatients in the south of the country). To prevent SSIs, appropriate use of antibiotics is essential. Aim and objectives To audit compliance with international recommendations of antibioprophylaxis practices in visceral surgery. Material and methods Data were prospectively collected in visceral surgery wards of five hospitals. Compliance with the antibiotic indication (administered when needed and not administered when not required), choice of molecule, dosage, timing of administration and duration were assessed in patients admitted for class 1 or 2 surgery according to Altemeier’s classification over 4 months. The international recommendation on antibiotic prophylaxis described by the SFAR (Societe Francaise d’ Anesthesie et Reanimation)1 was considered as a reference. Statistical analysis was performed using SPSS software. Results A total of 71 interventions were included the study. In 50 cases (70.4%), the administration conformed to the indication criteria (ie, 48 administrations when actually indicated and 2 abstentions when antibioprophylaxis was not required). None (0%) of the 48 patients who received the indicated antibioprophylaxis were administered the recommended molecule. Ceftriaxone was the most widely used molecule (31%). In addition, the initial dose, timing and duration of antibiotic treatment were in accordance with SFAR standards in 35%, 14% and 21% of cases, respectively. Conclusion and relevance This study highlights a problem of compliance with recommendations. This can be partly explained by the unavailability of half of the recommended molecules in the local market, the urgent character of the surgery and the lack of knowledge and training of health staff. The overuse of broad spectrum antibiotics reported in other studies may reveal a fear of SSIs by healthcare providers. These data underline the need for implementing an appropriate antibioguide based on local epidemiology and drug availability. References and/or acknowledgements 1. SFAR. Antibioprophylaxie en chirurgie et medecine interventionnelle. Reactualisation 2018;2018:1–31 [En ligne] www.cpias.fr/nosobase/.../Antibioprophylaxie-RFE-mise-a-jour-2018.pdf We thank the Academie de Recherche et d’Enseignement Superieur (ARES) for funding this work. No conflict of interest.

The pneumoperitoneum is the abnormal presence of free air in the peritoneal cavity. In most cases it is related to the perforation of hollow organs. Nevertheless there are cases of pneumoperitoneum without obvious causes called idiopathic. We report a case of massive pneumoperitoneum of radiological discovery in a patient of 16 years old boy, sickle-cell of type SS, during the exploration of an angiocholitis. It was medically treated successfully. No obvious etiology had been found. This particular situation is a dogma which runs up against the classic interventionist spirit; therefore each of pneumoperitoneum needs to be studied case by case. The presence of signs of peritoneal irritation allows surgical exploration. Otherwise, laparoscopy seems to be a minimally invasive surgical method and allows a visual diagnosis by eliminating a hollow organ perforation.

Congenital diaphragmatic hernia is the outcome of the abdominal contents in the thorax by a breach caused by a failure to close the pleuroperitoneal canal. It is a rare and serious disease. Our teaching hospital had registered these seven last years five cases of congenital diaphragmatic hernia, operated, but never published. We report the most recent one, a case of a newborn baby seen at the 5th hour of life for respiratory distress. Initial examination revealed: an asymmetric thorax, respiratory distress with 88% oxygen saturation at ambient air, tachycardia and abolition of vesicular murmur in the left lung field. L-abdomen was flat and soft. Thoraco-abdominal radiography revealed a clear left intra-thoracic image with mass effect on the left lung parenchyma. He has benefited from a reduction of the herniated visceras and a successful closing of the breach. The operation had few after-effects after five months follow-up with a very good recovery of the cardio-pulmonary function.

Congenital diaphragmatic hernia is a common cause of neonatal respiratory distress. The right or left diaphragmatic cupola hernia is most often involved. Rarely, a retro-costo-xiphoidian or Larrey or Morgagni hernia is diagnosed as part of respiratory distress. We present a case of congenital retro-costo-xiphoid diaphragmatic hernia in a midline situation, involving the sternal portion and extending to the diaphragmatic domes on each side. The discovery was made antenatal by obstetric ultrasound from 21 weeks. At birth, there was minor respiratory distress. The management consisted of a reduction and placement of a polypropylene plate in the natal post by abdominal approach.

Rising demand of fish generates various pressures on aquatic ecosystems, causing its deterioration and the loss of its biodiversity. With the aim of a better management and fish production in a salubrious environment, this study proposes the utilization of organic fertilizers from rabbit manure. The treatments consisted of manure of rabbits fed with: manufactured diet (T1), improved diet with Ipomea aquatic (T2), improved diet with Elaeis guineensis (T3), and improved diet with Panicum maximum (T4). Indeed, experimental design was a completely randomized block design with three replications. 6 g in 10 L of water from the different manures from each diet was followed during 50 days. Various nutrients were measured. After the mineralization process, the best manure which released more nutrients was T4 with measured proportions of N-NO2 −, N-NO3 −, N-NH3, P-PO4 3−, Ca2+, Mg2+, K+, and suspended matter being 0.06 ± 0.0, 0.38 ± 0.1, 0.85 ± 0.1, 8.27 ± 0.9, 12.11 ± 0.8, 4.47 ± 0.3, 3.02 ± 0.2, and 140.78 ± 18.6 mg/L, respectively. The highest content of phosphorus and nitrogen was recorded in T4 and T2, respectively. The principal component analysis showed a positive correlation between P-PO4 3−, Ca2+, Mg2+, MES, conductivity, and salinity during mineralization. Manure from rabbits fed by an improved diet with P. maximum (T4) was recommended for agro-piscicultural production system.

Chloroscombrus chrysurus (Linnaeus 1766) is one of the most abundant species of Carangidae family occurring in the nearshore waters of Benin. To ascertain the exploitation level of this fishery resource, some demographic parameters of the species were studied for management and conservation measures. 605 specimens were collected randomly from commercial catches from August to November 2014. Morphometric, meristic and weight data were analyzed using SPSS software and the ELEFAN I routine from FiSAT. The population of C. chrysurus was not heterogeneous with a sex-ratio of 1.4:1 (p < 0.05; χ² = 312.485) and masculinity and femininity rates were 58.31% and 41.69% respectively. Length frequencies showed low percentage of small sized individuals and independent distribution of sex (r = 0.16, p < 0.05). The monthly variations of the gonad-somatic index (GSI) and the condition factor (Kc) showed a decreasing trend over the review period and corresponding probably to the period of gametes emission. von Bertalanffy growth parameters estimated were L ∞ = 28.35 cm, K = 0.49 year -1 , t 0 = -0.33 year and φ’ = 2.59. Total mortality, natural mortality and fishing mortality are 1.39, 1.17 and 0.22 respectively. The exploitation rate (E = 0.16) showed that the resource was underexploited implying that the purse seine is not a danger for this species.

West African Ilisha was the third most abundant species of Clupeidae off Benin coastal waters after Sardinella spp and Ethmalosa frimbriata. The fishing effort of these fisheries increased with a dominance of small-sized specimens in the catches. This paper allowed updating some demographic parameters and the exploitation rate of Ilisha africana collected between July 2013 and June 2014 from the coastal waters of Benin for management and conservation of these fisheries. The growth pattern showed a negative allometric growth with an abundance of small-sized specimens. The von Bertalanffy growth function (VBGF) estimations were: L∞= 21.31 cm standard length; K = 1.20 year-1; and t0 = -0.138 year. The total mortality rate (Z), natural mortality rate (M) and fishing mortality rate (F) were 4.040 year-1, 2.27 year-1 and 1.77 year-1 respectively. The Z/K ratio was 3.667 and the exploitation rate (E = F/Z) was 0.44 showing an under exploitation of this species. The estimated potential longevity (tmax) was 2.5 years. In addition, the fisheries management should be devolved from the state to the local level to compel fishermen to take greater responsibility for the sustainability and conservation of the fisheries such as size-limit regulation by gradually increasing fishing gears mesh size.

Introduction L’usage de la chicha constitue un mode de consommation du tabac de plus en plus prise chez les jeunes en Afrique au sud du Sahara. Le but cette etude etait de determiner la prevalence et les facteurs associes a la consommation du tabac par la chicha chez les etudiants a Cotonou en 2018. Methodes Il s’agit d’une etude transversale descriptive et analytique qui a eu lieu de juin a novembre 2018 aupres des etudiants de Cotonou. La taille de l’echantillon etait de 678. L’echantillonnage a ete realise par sondage aleatoire a trois degres. Un questionnaire anonyme auto-administre a servi a collecter les donnees. La difference etait statistiquement significative pour une valeur de p Resultats L’âge moyen des enquetes etait de 20,20 ± 2,50 ans. La prevalence de la consommation de tabac par la chicha en milieu estudiantin a Cotonou en 2018 etait de 13,86 % (IC95 % : 11,47 ; 16,67). Les facteurs associes etaient : la consommation de tabac par un parent proche (frere, sœur, cousin, cousine), p Conclusion La consommation de la chicha constitue un phenomene frequent chez les etudiants a Cotonou. Ce nouveau mode de consommation du tabac s’inscrit le plus souvent dans un contexte de polytoxicomanie. Ceci doit donc etre pris en compte pour l’implementation et le renforcement des interventions de la lutte antitabac en Afrique.

Tethered cord syndrome is a spectrum of neurological symptoms due to a constant or intermittent axial traction of the terminal cone of the spinal cord, fixed in abnormal caudal position. It is a rare congenital lesion whose symptoms can be observed only in adulthood. We report the case of a 10-year-old boy with tethered cord syndrome discovered due to bladder and anal incontinence and confirmed by lumbosacral magnetic resonance imaging. He underwent neurosurgical release of the terminal cone by posterior approach. Evolution was marked by improvement of sphincteric disorders. This case study has been followed by a literature review on this subject. This case study highlights the role of magnetic resonance imaging (MRI) in the diagnosis of this disorder.

Setting National teaching hospital for the management of respiratory diseases, Cotonou, Benin. Objective 1) To estimate the prevalence of lung function impairment (LFI) and associated factors in patients cured of pulmonary tuberculosis (PTB); and 2) to determine the link between human immunodeficiency virus (HIV) infection and LFI occurrence. Design We performed a cross-sectional study in cured patients with smear-positive TB (PTB+) treated between 2012 and 2015. We recruited two control groups of 70 HIV-infected (HIV+/TB-) and 70 HIV-negative participants without TB (HIV-/TB-). We performed spirometry in all participants to identify LFI (obstructive, restrictive or mixed) and the 6-min walk test (6-MWT) in PTB+ participants. We assessed the factors associated with LFI using logistic regression. Results Of 4711 subjects with PTB, 241 were contacted and 189 were included. The median age was 37 years; 128 (68.0%) were male. Overall, 85 cured PTB+ patients had LFI (45.0%). Extent of initial radiological lesions, time between symptom onset and treatment, and female sex were independently associated with LFI. Fifty-five (29.1%) cured PTB+ patients had an abnormal 6-MWT; those with LFI had a higher risk of poor exercise tolerance (OR 2.23; interquartile range 1.16-4.30). We did not find any association between HIV infection and LFI. Conclusion LFI is very common in cured PTB+ patients from Benin and significantly impacts exercise tolerance.