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Contingency measures taken by governments with movement restrictions during the COVID-19 pandemic may create difficulties in conducting some field activities for TB control especially the supervision of Basic Management Units (BMUs). We described in this paper an innovative initiative to conduct remote supervision (Esupervision) using Information and Communication Technology tools.This initiative was conducted in Benin Republic. To carry out the activity, we used smartphone, WhatsApp® for messaging, CamScanner for scanning (both free applications); and internet connection. BMUs were asked to scan their reports and all necessary documents and sent them by WhatsApp® after scanning. On the day planned for the supervision, the supervisors of each section (clinic, laboratory, food delivery supervision) calls the BMUs health professionals via WhatsApp® video to conduct the activity according to the National Tuberculosis Programme guidelines.Overall, all the main objectives of a supervision were achieved despite some difficulties mainly related to the quality of internet connection. The reports from the different sections were validated for each BMU. For the laboratory activities, general aspects as well as the stock of reagents were evaluated; microcopy fields with an ordinary microscope were visualized. The management of tuberculosis patients was assessed by visualizing the results of bacteriological exams, treatment records, and stocks of medicines.Even though, this activity will probably not replace the traditional face-to-face supervision, it could be used in settings where movements are restricted for several reasons including COVID-19 pandemic, conflicts and natural disasters.Les mesures d'urgence prises par les gouvernements avec des restrictions de mouvements dans le cadre de la pandémie du COVID-19 peuvent créer des difficultés dans la conduite de certaines activités de terrain pour le contrôle de la tuberculose, en particulier la supervision des centres de dépistage et de traitement de la tuberculose (CDT). Nous avons décrit dans cet article, une initiative novatrice pour effectuer la supervision à distance (E-supervision) en utilisant les outils des Technologies de l'Information et de la Communication au Bénin.Cette initiative a été conduite en République du Bénin. Pour mener à bien cette activité, nous avons utilisé : smartphone, WhatsApp pour la messagerie et CamScanner ® pour le scannage (deux applications gratuites) ; et la connexion internet. Les agents des CDT ont été invités à envoyer tous les documents aux équipes de supervision via WhatsApp ® après les avoir scannés. Le jour prévu pour la supervision, les superviseurs de chaque section (clinique, laboratoire, gestion des vivres) ont appelé par WhatsApp ® video les acteurs des CDT pour dérouler les différentes séquences de la supervision selon les recommandations du Programme.Dans l'ensemble, tous les principaux objectifs d'une supervision ont été atteints malgré quelques difficultés liées principalement à la qualité de la connexion internet. Les rapports des différentes sections (clinique, laboratoire et gestion des aliments) ont été validés pour chaque CDT. Pour les activités de laboratoire, l'aspect général ainsi que le stock de réactifs ont été évalués ; les champs de microcopie avec un microscope ordinaire ont été visualisés. La gestion des patients tuberculeux a été évaluée en visualisant les résultats des examens bactériologiques, les dossiers de traitement, les stocks de médicaments.Bien que cette activité ne remplacera probablement pas la supervision traditionnelle en face à face, elle pourrait être utilisée dans des contextes où les mouvements sont limités pour plusieurs raisons, notamment la pandémie COVID-19, les conflits, les catastrophes naturelles.Lutte contre la tuberculose, COVID-19, supervision, centres antituberculeux.

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.

The objective of this study was to determine the prevalence and to assess the control of asthma among students at the faculty of medicine of the university of Parakou in Benin.This cross-sectional study was carried out between January and November 2017. The Asthma Screening Questionnaire (ASQ) was filled out by medical students, followed by the Asthma Control Test questionnaire for those who were suspected of having clinical asthma (ASQ≥4). All students with clinical asthma or with a history of asthma were invited to perform a spirometry test.Overall, 837 (73.7%) students out of 1136 were included. The prevalence was 9.1% for ever diagnosed asthma, 14% for clinical asthma and 5.3% for confirmed asthma. Among 761 students, without a previous asthma diagnosis, 10.4% had clinical asthma and 3.3% a confirmed asthma. Female sex (aOR=2.1; 95%CI =1.0-4.1), a previous diagnosis of asthma (aOR=7; 95% CI=3.2-15.2) and allergic rhinitis (aOR=3.9; 95% CI=1.9-7.8) were associated with confirmed asthma. Asthma symptoms were controlled in 92 (78.6%) students, partly controlled in 20 (17.1%), and not controlled in 5 (4.3%).Clinical manifestations of asthma are frequent among medical students at Parakou. Some are not well controlled, suggesting a need for greater awareness and an improvement in clinical follow-up.

To determine the epidemiological, diagnostic and evolutives features of tuberculosis (TB) in older subjects in Benin.This was a retrospective cohort study of adults TB patients (age≥15 years) who were notified at all the Basic Management Units (BMU) in Benin from January 1st, 2013 to December 31st. Older subjects (age≥60 years) were compared to those less than 60 years named young subjects. The threshold of significance was set at 5%.The analysis was carried out on 6531 cases adults cases notified during the period. 601 (9.2%) were 60 years old or above. The case notification rate (CNR) in elders was more than twice the CNR in young people (68 cases vs. 31 cases per 100,000 population). Older subjects were less often infected with HIV (9.3%) than young's (16.7%), P0.0001. In new bacteriologically confirmed pulmonary TB negative for HIV, unfavorable treatment outcomes were more frequent in older subjects than in young subjects with more deaths (7.5% vs. 3.0%). On the other hand, in bacteriological confirmed TB seropositive for HIV and all the other cases, treatment outcomes were comparable between the two groups.The high CNR and the high death rate in older subjects should plead for a specific care for an adapted management of TB case in this group.

The objective of this work was to describe the profile of routinely managed tuberculosis patients whose sputum smear did not become negative after the initial phase of anti-tuberculous treatment and to analyze the factors associated with this. With this aim a cross-sectional, retrospective, descriptive and analytical study was carried out in a population of adults with pulmonary tuberculosis (PTB) between 2013 and 2014 in three cities in southern Benin (Cotonou, Porto-Novo and Abomey). The data of the patients who did not convert (PTB +) were compared with those who did (PTB-). A multivariate logistic regression analysis was performed. In 1989 (94%) of the cases, 305 (15.3%) were TPB+ with significant differences between the cities. The mean age was 38±13 years vs 34±12 years, respectively, for PTB+and PTB -, P=0.091. At the end of the multivariate analysis, the factors associated with non-conversion were: high bacillary load (≥10 AFB/microscopic field) at diagnosis, HIV+status, and adverse outcome at the end of anti-tuberculous treatment. These patients should be monitored carefully.

The authors had for aim to assess the management of tuberculosis and HIV co-infection in Cotonou, Benin.We made a cross-sectional, retrospective, and descriptive study comparing the clinical presentation and outcome of patients with tuberculosis and HIV co-infection versus patients with tuberculosis alone, all managed at the National Pneumophtisiology Center in Cotonou, Benin, in 2009.The rate of HIV screening in TB patients was 99%. One thousand and eighty-six TB patients were included and 259 were HIV positive. The mean age of co-infected patients was 36 years, versus 34 for TB mono-infected patients. The sex ratio among co-infected was 1.15 versus 2.25 among TB patients. Positive pulmonary sputum was less frequent with co-infection. Two hundred and fifty-seven over 259 patients were treated with cotrimoxazole. One hundred and eighty-five over 234 (79.05%) had CD4 counts350. Eighty-five (46%) of the 185 patients with CD4350, were given antiretroviral therapy. Treatment success rate was lower for co-infected (75%) than for patients with TB alone (86%), and death rates were higher in co-infected patients (10% vs. 3%).High death rate and high rate of lost to follow-up are arguments for systematic antiretroviral treatment of co-infected patients. Early screening for TB and HIV, and reviewing the current national recommendations, as well as an increased governmental effort to provide medicines to all patients in need of ARV are mandatory.

Background: Cotton is the main agricultural export product in Benin. Cotton dust is thus present in the air during the handling and processing of cotton. This dust contains a mixture of substances including ground up plant matter, fibres, bacteria, fungi, soil, pesticides, noncotton matter, and other contaminants. While cotton processing is decreasing in industrialized countries, it is increasing in developing countries. Cotton processing, particularly in the early processes of spinning, can cause byssinosis. Objective: To determine the respiratory effects of cotton dust exposure among cotton mill workers in Benin. Methods: In a cross-sectional study, 109 workers exposed to cotton dust and 107 unexposed workers were studied. The International Commission on Occupational Health (ICOH) questionnaire was used for data collection on respiratory symptoms. For each worker, crossshift pulmonary function was performed with a dry spirometer. Based on the severity of respiratory symptoms and spirometry byssinosis was defined and classified according to the criteria of Schilling, et al. Results: The mean±SD age of the exposed and unexposed workers was 46.3±7.8 and 37.0±8.3 years, respectively (p

The sensitisation profile to airborne allergens of asthma patients followed in Benin is not known.A descriptive cross-sectional study was conducted from April to June 2013 at the hospital reference centre. A prick-test was performed in all adults with asthma consulting during this period. The standardized allergenic extracts tested were: mites (Dermatophagoides pteronyssinus [DP], Dermatophagoides farinae [DF] and Blomia tropicalis [BT]), cockroaches, 5 different grasses, Alternaria, dogs and cats. The test was positive when the diameter of the wheal was more than half that of the positive control and/or when the diameter of the wheal was ≥3mm than the negative control.Of the 253 asthmatics tested, 247 (97.6%) had at least one positive skin reaction. The average age was 44 years, the sex ratio was 0.81. Sensitization to mites was the most frequent (99.6%), followed by cockroaches (71.3%), 5 grasses (71.3%), Alternaria (71%), dog (68%) and cat (63.6%). The average number of sensitivities was 5±2.Asthmatics monitored in Cotonou have multiple sensitisations dominated by mites.

Women are constantly exposed to fumes and gases produced by burning wood, however they are poorly studied. The aim of this study was to assess the prevalence of respiratory disorders among women most at risk.We conducted a descriptive, transversal and prospective women engaged with the site of artisanal smoked fish Hwlacodji in Cotonou. The survey included a questionnaire exploring the medical history and pathological respiratory events occurred during the last 12 months. All had received spirometry testing.84 women were included. The average age was 37 ± 12 years, with extremes of 18 and 70 years. More than half of respondents had a tenure of more than 20 years and 61/84 (73%) practiced this profession full time. 70 (83%) had at least one respiratory symptom. The reported symptoms were: rhinitis 77%, 70% cough, dyspnea 65% and 19% have gone out of business last year due to lung disease. Ventilatory abnormalities are found in 49% of respondents. Abnormalities relate to FEV / FVC0.8: 3 (3.5%), PEF0, 8: 10 (11.90%), FEV0.8: 10 (11.90%).The respiratory symptoms is quite expressive contrasts with spirometric results. Monitoring over a long period of mostly young women will help lead to meaningful conclusions.

The bronchoconstriction induced by exercise (BIE) in urban black Africans is poorly known. The warm moist air would be a mitigating factor for its occurrence. The objective of this study was to measure the prevalence and determine the associated factors.A prospective descriptive and analytical involving 40 student-athletes was conducted from September 12 to 24, 2010. The test was considered positive when the percentage fall in FEV from baseline in pre-test and the smallest value in post-test exceeded 10%.The prevalence of bronchoconstriction induced by exercise was 40% CI (26.3-55.4). The presence of symptoms of atopy was higher in athletes with an BIE than in those without (66% vs. 33.33% p NS).The proportion of the BIE in the middle of the black African athlete is as important as that observed in other countries, highlighting the weak influence of climate on its occurrence.

Retreatment of tuberculosis is the leading risk factor for drug resistance if the management is not adequate and complete. The objective of this study was to evaluate the management of cases of retreatment in Cotonou. This was a retrospective, descriptive cross type which covered a period of 5 years. Outcomes of retreatment cases were compared against those for new cases that were registered during the same period. We analyzed the cases of 389 retreatment patients and 4542 new cases. The success rates of treatment were generally satisfactory (80% vs. 86%, P=0.0001). Of adverse outcomes, the rate of loss of sight of was 12% versus 7%, P=0.26, the rate was 23% for cases of occasions. The failure rate was low and similar in both populations (2%). The retreatment regimen for patients with TB in Cotonou appears to give generally satisfactory results. The high loss to follow-up in case of retreatment means that a personalized therapeutic approach for such patients is needed in general and in particular in the case of defaulters.

To assess the impact of air pollution inside and outside housing on respiratory function in people living around traffic intersections.A descriptive analytical study was carried out from February 5 to July 5, 2006. Carbon monoxide (CO), sulfur dioxide (SO2), and nitric dioxide (NO2) were measured over an 8-hour period inside and outside 60 houses near intersections during periods of heavy and light traffic. Spirometry was performed on residents of the same houses.CO levels were higher during heavy than light traffic both inside houses: 65 ppm vs. 43.2 ppm and outside houses: 160 ppm vs. 115 ppm. Similar results were observed for SO2, i.e., 2.8 ppm vs. 0.49 ppm inside houses and 4.3 ppm vs. 0.83 ppm outside houses. Measurements for NO2 were consistently nil. Respiratory symptoms were more frequent during heavy than light traffic: p = 0.0001; odds ratio (OR), 4.73; confidence interval (CI), 2.13-10.51. The frequency of spirometric abnormalities was higher in heavy than light traffic: p = 0.004; OR, 5.78; CI, 1.43-27.10.Indoor pollution level is higher during heavy traffic than light traffic. Respiratory symptoms were greater during heavy than light traffic.