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Introduction: Because of the specificity of their care activities, hospital wastewater contains various contaminants such as germs, disinfectants, metals, pharmaceuticals and chemical reagents, potentially infectious or toxic, which can be harmful to living organisms, or create ecological damage. This study aimed to analyze the quality of wastewaters produced by university hospitals of Cotonou in Benin. Methods: We conduct an analytical cross-sectional study including 30 wastewater samples from selected hospitals. An analysis of variance was performed at the significance level of 0.05. Results: Microbiological analysis showed the presence of germs such as total coliform types, faecal coliforms, fecal streptococcus, staphylococcus, yeasts and Clostridium perfringens in hospital wastewater samples. There was a significant difference (p < 0.05) in the microbial loads of various germs, except staphylococcus, between hospitals. With regard to the physicochemical parameters, only the conductivity complied with the standards for the discharge of wastewater into the environment. A significant difference was noted between hospitals, for the electrical conductivity of wastewater (p < 0.05). The average levels of metals detected in the wastewaters were in line with Benin’s standards. There was no difference between the average concentrations of metals except for copper (p < 0.05). Conclusion: The wastewater produced by the university hospitals of Cotonou is of poor quality and therefore requires adequate prior treatment before discharge into the environment.

Background: Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus. The study aimed to determine the prevalence and associated factors of hepatitis B infection in adolescents and youth attending secondary school in Cove, urban area in Benin. Methods: From 4th to 10th February 2018, a cross-sectional survey was conducted among adolescents and youth aged 15 to 24 years old. Subjects were randomly selected. Hepatitis B surface antigenaemia (HBsAg) was assayed in blood using rapid enzyme-linked immunosorbent assay kits. Univariate and multivariate analyses were performed. Results: Two hundred adolescents and youth were recruited. The seroprevalence of hepatitis B virus infection was 18.50%. According to the multivariate logistic regression model, being infected by hepatitis B was 4.32 times higher in the age group of 15 - 19 years old than in 20 - 24 years age group (PR = 4.32 95% CI [1.51 - 12.34], p = 0.0063). Similarly, students who had not been aware of hepatitis B were more infected than those who were sensitized (PR = 14.60 [95% CI 4.98 - 4.27], p = 0.0001). With regard to lifestyle, individuals with tattoos or piercings were 8.60 times more likely to have been infected by HBV than those without tattoos or piercings, (PR = 8.60; 95% CI [3.41 - 21.70], p < 0.0001). Conclusion: The seroprevalence of hepatitis B among adolescents and youth attending secondary school was high. Regular screening of HVB infection status should be included in school health services in Benin. Awareness campaigns and health education on HVB transmission and prevention should be promoted and strengthened.

Introduction: The effluents generated by hospital activities pose a potential danger to health and the environment. This study aimed to study the microbiological quality of the effluents produced by the university and hospital centres of Littoral department. Methods: This was a descriptive cross-sectional study of 60 samples of hospital effluents from sewage treatment plants and septic tanks carried out during the period from April to June 2019. Samples at the station were made at the entrance and exit of the station. Samples for microbiological analysis were collected in pre-sterilized 500 mL glass bottles. Samples were kept between at 2°C - 8°C and in the dark to ensure satisfactory preservation. ANOVA one-way analysis of variance was performed for each microbiological parameter and principal component analysis (PCA) was also performed. Results: The bacteriological analyses carried out on the 60 samples taken showed a significant microbiological load. In fact, the bacteriological parameters measured and compared to the pollutant release standards in the environment show that the number of germs identified is above the recommended guideline values. The average values for total coliforms, faecal coliforms, faecal streptococci and staphylococci were: 3.91 × 105 UFC/100 mL, 0.52 × 105 UFC/100 mL, 3.92 × 105 UFC/100 mL and 1.36 × 105 UFC/100 mL, respectively. The most isolated bacteria were: Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, Enterococcus faecalis, Enterobacter cloacae, Pseudomonas horizyhabitans, Staphylococcus aureus and Staphylococcus saprophyticus. Most strains were resistant to at least 3 families of antibiotics (beta-lactams, aminoglycosides and fluoroquinolones). Conclusion: These effluents therefore present health and environmental risks. It is of utmost importance to develop methods for the treatment of these effluents before their release into the natural environment.

Background: Bacterial meningitis is an inflammation of the meninges caused mainly by three bacterial species Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae that are transmitted by nasopharyngeal secretions emitted by carriers. Meningitis is a public health problem in Benin, like all countries in the African meningitis belt. This study aims to analyze the epidemiological surveillance data of meningitis in Benin from 2016 to 2018. Methods: Each suspect case of meningitis was recorded and Cerebrospinal Fluid (CSF) samples were collected. CSF collection was accompanied by the Integrated Disease Surveillance and Response form. This sheet provides information on the patient’s social-demographic and epidemiological data. CSF specimens were sent to the laboratory for analysis and identification (Gram stain, biochemical parameters, and latex agglutination test) of pathogens according to the WHO standards. Results: Of the 2992 patients with suspected meningitis, 2893 were hospitalized with a death rate of 9.4% (281/2992). The sex ratio of registered patients was 1.29 in favor of men. The median age was 4 years (min: 0; max: 90). Patients younger than five years were the most represented (44.8%). During the study period, there was a decrease in the incidence of meningitis per 100,000 inhabitants (6.3 to 3.2 from 2016 to 2018). Of 2928 CSF samples collected we were able to identify 899 pathogenic bacterial species. The most represented species are S. pneumoniae (63.4%), N. meningitidis (24.4%) and H. influenzae (12.2%). Conclusion: The burden of disease is disproportionate in the northern departments as in others. The frequency of bacterial meningitis in the northern region increased during the study period. However, deaths have been recorded in the departments of the South (“Atlantic”, “Plateau”). This suggests an improvement in epidemiological surveillance and case management throughout the national territory.

Aims: The aim of our work was, on the one hand, to evaluate the risk factors for infectious contamination in hospital environments and, on the other hand, to carry out a microbiological control of surfaces at the Abomey-Calavi / So-Ava hospital in Benin. Methodology: The risk factors were evaluated using structured interviews based on the questionnaire. Fifty-five health care workers were surveyed and the questionnaire focused on: i) knowledge of care-associated infections and risk factors, ii) services most affected by care-associated infections and iii) origin of care-associated infections. For the microbial quality control of medical surfaces and materials, samples were collected by the dry swab method and the microbial isolation was carried out on Chapman and EMB agar plates. The biochemical analyses were carried out for the confirmations. Results: Out of 55 respondents, the 93% think that bacterial germs are often involved in care-associated infections. In addition, 80% of respondents believe that the healthcare environment may be the source of care-associated infections. Regarding the microbiological quality of the surfaces, out of 96 samples collected, 77% were contaminated with Staphylococcus spp and 30% with Enterobacteria. Concerning units’ contamination, the highest prevalence was observed in paediatrics with 92% of samples contaminated with Staphylococcus spp followed by the operating theatre (87%). Conclusion: It is clear from our work that hygiene managers must carry out preventive and corrective actions for the respect of the principles of hygiene. It would also be important to conduct regular microbiological monitoring of surfaces to identify any contamination.

BackgroundLiquid discharges from hospitals (effluents) threaten the environment and are now a central concern of all stakeholders in the health system and those in the protection of the environment. The management of effluents is a major problem in developing countries. The objective of this study was to assess the quality of effluent management at the level of university hospital centers (CHU) in the Littoral region in Benin.MethodsIt was a cross-sectional, descriptive, evaluative study that took place in 2020 to assess the “structure”, “process” and “results” components according to standard thresholds (Bad: ResultsIn all the CHUs, all the components, as well as the overall quality of the management of hospital effluents, had a score between 0 and 60%, with an assessment deemed bad. The poor quality of the process highlighted the non-compliance with standards relating to the management of hospital liquid discharges. Several factors linked to the “structure”, “process” and “results” components at the same time explain this poor management of university hospitals effluents.ConclusionThese effluents discharged without prior treatment into wastewater could constitute a source of dissemination of potentially pathogenic microorganisms. It is therefore important to develop methods for treating these effluents before they are released into the natural environment.

Introduction The sterilization of surgical drapes plays an important role in preventing infections associated with treatments. At the CNHU-HKM, sterilization procedure for drapes encounters problems. The purpose of this study was to examine the factors associated with the quality of sterilization of surgical drapes at the CNHU-HKM. Methods We conducted a cross-sectional, descriptive and analytical study focusing on 20 sterile surgical drapes, 41 agents were involved in the management of drapes and 55 members of the surgical team. The probabilistic method was used for sterile surgical drapes, the non-probabilistic method for the others. Pearson's Chi-square Test and logistic regression were used to find the association, with a significant threshold and a p Results Eighty six point forty six percent of subjects were males with an average age of 42 years. The quality of the process of sterilization of the operative drapes was not good in the two departments responsible for processing the drapes. Bacteriological analysis showed that, out of 20 sterile surgical drapes, 9 had Acinetobacter spp. a multidrug-resistant germ causing nosocomial infections. Multivariate analysis showed that professional experience (p=0.015) and quality control of the procedure (p=0.034) were statistically associated with the quality of sterilization. Conclusion The presence of Acinetobacter spp. on the sterilized drapes demonstrates that sterilization of drapes at the CNHU-HKM is of poor quality. Measures strengthening the skills of providers are necessary to improve the quality of sterilization procedures.

Background Hand Hygiene (HH) has been described as the cornerstone and starting point in all infection control. Compliance to HH is a fundamental quality indicator. The aim of this study was to investigate the HH compliance among Health-care Workers (HCWs) in Benin surgical care units. Methods A multicenter prospective observational study was conducted for two months. The World Health Organization (WHO) Hand Hygiene Observation Tool was used in obstetric and gastrointestinal surgery through six public hospitals in Benin. HH compliance was calculated by dividing the number of times HH was performed by the total number of opportunities. HH technique and duration were also observed. Results A total of 1315 HH opportunities were identified during observation period. Overall, the compliance rate was 33.3% (438/1315), without significant difference between professional categories (nurses =34.2%; auxiliaries =32.7%; and physicians =32.4%; p = 0.705). However, compliance rates differed (p HCWs were more likely to use soap and water (72.1%) compared to the alcohol based hand rub solution (27.9%). For all of the WHO five moments, hand washing was the most preferred action. For instance, hand rub only was observed 3.9% after body fluid exposure and 16.3% before aseptic action compared to hand washing at 50.6 and 16.7% respectively. Duration of HH performance was not correctly adhered to 94% of alcohol hand rub cases (mean duration 9 ± 6 s instead of 20 to 30 s) and 99.5% of hand washing cases (10 ± 7 s instead of the recommended 40 to 60 s). Of the 432 HCWs observed, 77.3% followed HH prerequisites (i.e. no artificial fingernails, no jewellery). We also noted a lack of permanent hand hygiene infrastructures such as sink, soap, towels and clean water. Conclusion Compliance in surgery was found to be low in Benin hospitals. They missed two opportunities out of three to apply HH and when HH was applied, technique and duration were not appropriate. HH practices should be a priority to improve patient safety in Benin.

Nowadays, infections linked to health care and services constitute a great issue of public health. Such a challenge has, not only, contributed to the implementation of structure and, but also, to the increase of the culture of quality and security in health centers. In Niger, this aspect is less explored and documented. The present study aimed at evaluating the quality of hospital hygiene at the hospital of Gaweye district (Niamey) in 2018. This is a cross-sectional, descriptive, and evaluative study of the quality assessment of hospital hygiene at the Gaweye District Hospital. The components under study were: "structure", "Process", and "results". These consist of subcomponents which, in turn, are filled with variables. Ratings were based on standard thresholds (insufficient