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Hepatitis B is a major public health problem in Africa. The estimated prevalence in Benin is between 5.2% and 8.3%. Since 1992, the WHO has recommended immunization of all children between 0 and 12-months-old all around the world. Benin has been vaccinating children from 0 to 11 months since 1999. The purpose of this study was to identify factors influencing hepatitis B immunization coverage in children from 1 to 8-years-old in the Ouidah health district. This descriptive and analytical cross sectional study was carried out from October 25 to 31, 2007. The primary study targets were children from 1 to 8 years. Secondary targets were mothers and healthcare workers. A three-degree cluster sampling technique was used. Hepatitis immunization coverage was 72.2% (95%CI, 65.4 - 78.3). The negative factor influencing coverage in children was age over 5 years reflecting the absence of catch-up sessions for untargeted children overlooked for hepatitis B immunization. The negative factor in mothers was age over 30 years pending multivariate analysis that was not performed in this study. Regarding healthcare workers, understaffing was noted at this level of the health system. Hepatitis B immunization coverage in untargeted children was lower than in children between 0 and 11 months. In 2007, hepatitis B immunization coverage in the Ouidah health district was lower in untargeted children than children of 0 to 11 months. This study showed that immunization coverage decreased with age, thus underlining the need for catch-up sessions to ensure hepatitis B immunization in high prevalence areas.

In Africa persons seeking medical advice rarely see a physician first. The goal of initial contact is to ensure seamless interfacing with the other services of the healthcare system. The community physician in Africa is either a physician paid by contributions from people living in the region or, in most cases, a civil servant practicing at an outlying health center. Because community physicians often work in isolated locations, their colleagues at major hospital centers and in the academic world are rarely aware of their activity. As a result community physicians in Africa have little impact on the healthcare system. In fact their role should be to relieve overloading of hospitals that have become large dispensaries crowded with patients that have not received proper care in outlying facilities. In this article the authors call for community physicians in Africa to be brought out of isolation and given their true function as "clinicians with aptitudes in public health capable of assisting actions to restore and promote health and to prevent disease".

We report the first congolese case of intestinal cystic pneumatosis diagnosis at a patient of 64 years who was hospitalized for a glairo-sanguinolent diarrhea, of diffuse abdominal pains and meteorism. Diagnosis was confirmed by the coloscopy which showed polypoïdes formings to fine, translucent walls, depressibles, and for intestinal opacification which showed parietales incomplete images of the left colonist. Evolution was favorable under metronidazol and ciprofloxacin. The coloscopy of control did not find a recurrence.