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The objective of this research is to assess the effects of the use of insect nets in vegetable production. To achieve this goal, data were collected in four departments of southern Benin (Mono, Couffo, Oueme and Plateau) using an interview guide and a structured questionnaire. A total of 223 producers chosen at random from these areas where the CRSP Horticulture Project is located were surveyed. The results of the study show that growers using insect nets have not given up using chemical pesticides. However, a significant reduction in treatment frequencies was recorded in the nursery and after transplanting for most of the pesticides identified. Similarly, a significant reduction (more than 60.0%) in pest attacks (Helicoverpa armigera, Hellula undalis, Plutella xylostella, Bemisia tabaci and cochineals) was recorded among producers using anti-insect nets at 5%. These results involve that it is necessary to sensitize farmers to the use of nets to protect plants. This will significantly reduce pest attacks and reduce the use of pesticides in production. Key words: Anti-insect nets, effects, pests, market gardening, Benin.

We evaluated, in a laboratory experiment, the susceptibility of 10 tomato cultivars to the attack by the tomato red spider mite Tetranychus evansi, an invasive pest of this crop in Benin. Among the 10 cultivars tested, six were imported (i.e. Roma VF, Tima, Rio Grande, Buffalo, Petomech, and TLCV15) and four local (i.e. Akikon, Tounvi, TomL4, and Kekefo). Leaf disks (2.5 cm diameter) excised from leaves of tested cultivars, and placed upper side down on top of water-soaked cotton wool laying in 9.5 cm diameter Petri dishes (6 leaf disks per Petri dish), served both as experimental units and feeding source for the mites. Mites were individually placed on leaf disks of each cultivar and several biological parameters – development, reproductive parameters and longevity – were assessed. The experiments were performed at 27 ± 1 °C, 65–70% RH, and 12:12 h (L: D) photoperiod. Our results revealed significant effects of tomato cultivars on several biological parameters of T. evansi, especially the developmental time of the egg stage (P ˂ 0.0001), and the larval stage (P = 0.0113), as well as female oviposition period (P = 0.0002). Likewise, female longevity (P = 0.0095) and fecundity (i.e. egg/♀, P = 0.0055) were significantly affected. The sex-ratio of the progeny was generally similar for all the cultivars except for Buffalo and Tounvi on which most juveniles did not develop beyond the larval stage. These two cultivars appeared as potential tomato cultivars for implementation of IPM strategies for the control of T. evansi.

IntroductionAt the end of the treatment, many young breast cancer (BC) survivors face difficulties related to fertility and sexuality, mainly due to the side effects of treatment. Integrating patient needs into medical decisions is becoming increasingly essential for high quality care. To this end, there is a compelling need to elicit patients’ perspectives through qualitative studies, to understand their experiences and needs in the aftermath of cancer. We aim to: (1) identify clinical, social and economic determinants of sexuality and fertility, and describe other living conditions of young BC survivors in France; and (2) explore young women’s experience after BC in relation to clinical and information needs about fertility preservation and sexual health.Methods and analysisThis is a mixed-methods, cross-sectional, population-based study. In the quantitative component, women diagnosed with non-metastatic BC between 2009 and 2016 and aged 40 years or younger at diagnosis will be identified through the French network of cancer registries (FRANCIM). Participants will complete self-report questionnaires including standardised measures of sexuality, health-related quality of life (HRQoL), anxiety, depression, social deprivation and social support. Fertility and professional reintegration issues will also be assessed. Sexuality profiles will be identified by ascending hierarchical classification and fertility profiles will be identified by latent class models. Determinants of sexuality, fertility and HRQoL will be identified using a mixed regression model. Subsequently, semistructured interviews will be performed with a sample of 30 women who participated in the quantitative study. Interviews will be recorded, transcribed synthetically and content analysis will be performed, with the aid of NVivo software.Ethics and disseminationThis study will be performed in accordance with the declaration of Helsinki. The protocol was approved in October 2020 by the Committee for the Protection of Persons North-West III (20.07.16.44445) and by the French national data protection authority (CNIL-MR003 No1989764-v0).The results of this project will be communicated to the scientific community through publications in international scientific peer-reviewed journals and communications to national and international congresses. Popularised results will also be provided to patient associations. The results of Candy project will also be published on the website of the sponsor, www.cgfl.fr.

Corchorus olitorius L. which belongs to Tiliaceae family is a cultivated herbaceous plant highly consumed as traditional leafy vegetables in Benin. Extracts from samples of different morphotypes leaves of this species were analysed for their phytochemical compositions, antioxidant and cytotoxicity activities. On each sample extract, qualitative phytochemical tests were used to detect the presence of bioactive molecules and evaluate their cytotoxicity using brine shrimp lethality bioassay. Antioxidant activity was assessed using the 2,2-diphenyl-1-picryl-hydrazyl assay. Phytochemical screening revealed the presence of several phytochemical compounds in all samples of morphotypes studied but these have not a similar profile. Morphotypes with shiny rounded leaves have more phytochemicals (58% of phytochemicals compounds) than the other samples. Analysis of the potential antioxidant reveals a first category of morphotypes with high potential antioxidant capacity ranged from 27,859 to 32,985 mM EAA/g followed by second class of morphotype which ranged from 17,527 to 23,098 mM EAA/g . Regular consumption of C. olitorius such as varieties with rounded and non-shiny leaves, varieties with elongated and shiny leaves, varieties with red stems, varieties with elongated and non-shiny leaves with lateral lobes, would be useful for the treatment of various diseases induced by free radicals. The LC50 of morphotypes C. olitorius varies between 0.78 and 3.125 mg/ml indicating non toxicity. From this study, results justify the use of some morphotypes of C. olitorius in traditional medicine. Hence, these morphotypes are nutraceuticals leafy vegetables that must be promoted through development of food based products. Key words: Phytochemical analysis, antioxidant activity, cytotoxic activity, Corchorus olitorius, morphotypes, Benin.

Background: In Africa, primary hip osteoarthritis seems to be less frequent than in Europe. Sickle cell disease is responsible for aseptic osteonecrosis of the femoral head associated with secondary hip osteoarthritis. Very little evidence is available on the influence of aetiology (primary and secondary) and radiographic status on pain and disability in a Beninese population with hip osteoarthritis. Objectives: The aim of this study was to compare the impacts of aetiology and radiographic status on pain, disability and quality of life in a Beninese population with hip osteoarthritis. Method: This was a descriptive cross-sectional study, including participants recruited in the Clinic of Physical Medicine and Rehabilitation at the National Teaching Hospital in Cotonou. Assessment was based on the International Classification of Functioning, Disability and Health model. The main outcomes were severity of osteoarthritis, pain, range of motion, muscle strength, gait speed and quality of life. Statistical comparisons between the aetiologies were performed using a t -test or rank sum test. One-way analysis of variance was used to test the effect of radiographic status. Results: Forty-nine participants (26 women and 23 men; mean age [standard deviation] 40.5 [17.9] years) were recruited. According to the aetiology (59.2% and 40.8% of primary and secondary osteoarthritis, respectively), there were no significant differences for any of the outcomes. Grades I, II, III and IV osteoarthritis were observed in 22.4%, 14.3%, 26.5% and 36.7% of the participants, respectively. Participants with grade IV osteoarthritis were more affected than those with grades I, II and III based on the Kellgren and Lawrence classification. Conclusion: Aetiology did not influence pain, gait speed or quality of life. Participants with grade IV osteoarthritis had more pain, were more limited in walking and had a more impaired quality of life.

Constraints related to the technical and socioeconomic aspects of adopting tomato varieties are well documented. However, preferences relating to the demand for this fruit are rarely studied. In fa...

Background The impacts of Leg Length Discrepancy (LLD) on the kinematic and dynamic parameters of walking have been widely discussed. But little is known on total mechanical work and energy cost. These two variables are more representative of the functional impairment undergone by the LLD patients. Aim To assess the changes of the mechanical work and energy cost of walking in subjects with real LLD and to compare their results with healthy subjects in whom the LLD has been simulated. Method The mechanical work and energy cost data of 60 healthy subjects (speed: 4 km/h) with artificial LLD induced by soles (2 and 4 cm), 20 patients (speed: 3.75 ± 0.5 km/h) with real LLD and 20 matched subjects (speed: 3.75 ± 0.5 km/h) were collected. Statistical comparisons between the groups were performed using a t-paired test and ANOVA. Results Patients with a real LLD showed a significant decrease in mechanical work and energy cost when compared to norms. Patients with real LLD provide a better recovery when compared to subjects with artificial LLD of 2 cm, and a decrease of energy cost and higher muscular efficiency (mechanical work/energy cost) when compared to subjects with artificial LLD of 4 cm. Conclusions Our results showed that patients with a real LLD develop compensatory strategies during gait, probably to minimize the displacement of the body center of mass and consequently reduce the amount of energy expenditure useful for their displacement. Moreover, they adopt a better gait strategy compared to the subjects in whom LLD was simulated.

Continuous coverage of vegetables with nets under different climate conditions in Benin and Kenya proved effective in prot ecting vegetable nurseries and main fields against key lepidopteran and dipteran pests. However, netting did not effectively protect the vegetables against small insects such as aphids and whiteflies, although a visual barrier could delay outbreaks. Hence, opening the nets during the day could be an alternative option to conserve the natu ral enemies for small insects. Moreover, the efficacy of the visual barrier may be complemented by a repellent compound impregnated in the net. The small-holder growers adopting the nets in Benin and Kenya have reduced the number of pesticid e applications required by 70-100%. They have also increased the yield in quality and quantity of production due to microclimate modification. Cost-benefit anal yses of the technology showed that with insect proof nets profitability rates of up to three times could be achieved when compared to the farmers' practices observed in the real environment. Hence, this technology could be a promising way to develop an agro-ecological approach for sustainable management of key horticultural crop pests. (Resume d'auteur)

This chapter provides a set of indicators related to Renal Transplantation access in France. It describes patient outcomes and reports on cumulative incidence rates of wait-listing and renal transplantation according to main patient of characteristics and regions. The REIN registry integrates kidney transplant and dialysis data. It provides a comprehensive view on waiting list and renal transplantation access to the patients, nephrologists, and national or regional health authorities. Access to the waiting list is evaluated on a cohort of 51,845 new patients who started dialysis between 2002 and 2011 in 25 regions. The probability of first wait-listing was of 3.7% at the start of dialysis (pre-emptive registrations), 15% at 12, 22% at 36 and 24% to 60 months. The probability of being registered was strongly related to age, diabetes and region. Patient older than 60 had a very poor access to the waiting list, whatever their diabetes status was. Probability of first wait-listing was much lower (36.5% at 60 months) in type 2 diabetic-40 to 59 years old patients. Among 13,653 patients less than 60 years old, the probability of being registered was 11% at the start of dialysis, 43% to 12 months, 62% to 36 months and 66% to 60 months (median dialysis duration: 16 months). Seventeen regions with up to 5 years follow-up show an increase of 8 to 15% in pre-emptive registrations between 2007 and 2001, without change at 1 year. Access to kidney transplant is evaluated on a cohort of 53,301 new patients who started a renal replacement therapy (dialysis or pre-emptive renal transplant) between 2002 and 2011 in 25 regions. The probability of first kidney transplant was of 7% at 12, 17% at 36 and 21% at 60 months. 8,633 patients (16,2%) had received a first renal transplant within 14.7 month median time; 1,455 (2.7%) had received a pre-emptive graft [male: 58%, median age: 48.7y]. Among the 14,770 new patients less than 60 years old, the probability of being transplanted was of 21% at 12, 46% at 36 and 58% at 60 months (median dialysis duration: 42 months). When pre-emptive graft were excluded, the probability of being transplanted was of 5% at 12, 15% to 36 and 19% to 60 months Insofar as kidney transplant is regarded as the most efficient treatment, access to the waiting list and renal transplant are sensitive issues.

In Africa, synthetic pesticide applications are overly frequent and above labelled rates. We assessed the efficacy of an insect net physical control system on field cabbage (Brassica oleracea var. capitata) production in France and Benin. Various mesh sizes and netting removal frequencies were compared under contrasting climatic conditions. Studies under Mediterranean climatic conditions (spring season) compared two mesh sizes (0.73 mm and 1.6 mm). Studies under subequatorial climatic conditions (cool and hot seasons) tested nets of mesh size 0.4 mm and 0.9 mm used either as permanent cover, removed daily, or 3 days per week. The results showed that a fine mesh did not improve the netting efficacy against pests but had a major impact on the microclimate. In Mediterranean climatic conditions, the netting efficacy and beneficial microclimate improved crop yields. In subequatorial conditions, crop yields were lowest with permanent net protection due to high temperatures under the nets and poor aphid and Spodoptera littoralis control. Removing the nets 3 days per week was a good technical/economic trade-off, ensuring acceptable efficacy with minimal effects on the microclimate.

This chapter provides a set of indicators related to Renal Transplantation access in France. It describes patient outcomes and reports on cumulative incidence rates of wait-listing and renal transplantation according to main patient of characteristics and regions. The REIN registry integrates kidney transplant and dialysis data. It provides a comprehensive view on waiting list and renal transplantation access to the patients, nephrologists, and national or regional health authorities. Access to the waiting list is evaluated on a cohort of 51,845 new patients who started dialysis between 2002 and 2011 in 25 regions. The probability of first wait-listing was of 3.7% at the start of dialysis (pre-emptive registrations), 15% at 12, 22% at 36 and 24% to 60 months. The probability of being registered was strongly related to age, diabetes and region. Patient older than 60 had a very poor access to the waiting list, whatever their diabetes status was. Probability of first wait-listing was much lower (36.5% at 60 months) in type 2 diabetic-40 to 59 years old patients. Among 13,653 patients less than 60 years old, the probability of being registered was 11% at the start of dialysis, 43% to 12 months, 62% to 36 months and 66% to 60 months (median dialysis duration: 16 months). Seventeen regions with up to 5 years follow-up show an increase of 8 to 15% in pre-emptive registrations between 2007 and 2001, without change at 1 year. Access to kidney transplant is evaluated on a cohort of 53,301 new patients who started a renal replacement therapy (dialysis or pre-emptive renal transplant) between 2002 and 2011 in 25 regions. The probability of first kidney transplant was of 7% at 12, 17% at 36 and 21% at 60 months. 8,633 patients (16,2%) had received a first renal transplant within 14.7 month median time; 1,455 (2.7%) had received a pre-emptive graft [male: 58%, median age: 48.7y]. Among the 14,770 new patients less than 60 years old, the probability of being transplanted was of 21% at 12, 46% at 36 and 58% at 60 months (median dialysis duration: 42 months). When pre-emptive graft were excluded, the probability of being transplanted was of 5% at 12, 15% to 36 and 19% to 60 months Insofar as kidney transplant is regarded as the most efficient treatment, access to the waiting list and renal transplant are sensitive issues.

Anaemia is a serious public health problem especially in developing countries as Benin. Cocos nucifera is one of medicinal plants used in Benin to treat anemia. This study aimed to test its therapeutic efficacy in anemia treatment. Method: Five groups of five Wistar rats each were formed. The rats of four groups were rendered anemic by injection of phenylhydrazine (hemolysis) in the first two days D0 and D1. From the second to the fifteenth day (D2 to D15), anemic groups were gavaged either by the aqueous extract of Cocos nucifera at 200 or 300 mg / kg body weight/day, or by vitafer, a reference drug against anemia. The last anemic group was not treated. The group of non-anemic rats served as a control. Blood samples were collected for all rats on days D0, D2, D7, D10 and D15 to assess blood count and osmotic resistance of red blood cells. Results: The phytochemical analysis revealed the presence of tannins, flavonoids, leucoanthocyanes, steroids, quinone derivatives, reducing compounds and mucilage. The extract like the vitafer corrected completely anemia before two weeks by stimulating hemoglobin synthesis, production and early release of immature red cells in the blood stream. Its effect was dose dependent, quite specific and did not affect platelet lineage. Conclusion: Cocos nucifera has a good therapeutic efficacy and may be considered for transformation into improved traditional medicines (ITM) after study of its biological tolerance and appropriate clinical trials.

Introduction L’ulcere de Buruli est une affection cutanee due a Mycobacterium ulcerans . L’objectif etait d’evaluer le delai de cicatrisation des lesions de l’ulcere de Buruli de diametre ≤ 10 cm. Patients et methodes Il s’agissait d’une etude retrospective, descriptive et analytique, realisee de 2010 a 2012 a Pobe (Benin). Ont ete inclus, les patients ayant eu une PCR positive au M. ulcerans , des lesions de diametre ≤ 10 cm et traites suivant les recommandations de l’OMS. Les donnees etaient enregistrees et analysees avec le logiciel EPIINFO, version 3.5.1. Resultats Au total, 104 patients etaient inclus. Les plaques ulcerees representaient la forme clinique la plus frequente (57 %). Le delai moyen de consultation etait de 16,6 ± 19,6 semaines. Les patients presentant une lesion ulceree et ayant consulte moins de 5 semaines apres le debut de la maladie, avaient un delai moyen de cicatrisation de 85,1 ± 33,7 jours vs 146,1 ± 80,2 jours pour ceux ayant consulte 27 semaines apres le debut de la maladie ( p p = 0,04). Conclusion Le retard a la consultation allonge le delai de cicatrisation des lesions. Les lesions non ulcerees quelles que soient leur taille ont un delai de cicatrisation plus long que celui des lesions ulcerees. Les resultats de ce travail devraient susciter d’autres etudes pour de nouvelles perspectives therapeutiques de cette affection.

Sesamum radiatum and Justicia tenella are two traditional leafy vegetables highly consumed in Benin. In spite of their importance in food security, nutrition, and income generation, they still remain very little known to the scientific communities. In order to document their diversity and the various traditional cultural practices associated with their production and identity as well as their domestication levels across zones, a survey was conducted in 10 villages randomly selected from different agroecological and ethnic zones of both northern and central Benin. Data were collected in the different sites through application of Participatory Research Appraisal tools and techniques and analysed using both simple descriptive statistics (means, frequencies, etc.) and multivariate analysis (ANOVA, cluster analysis). The study revealed the existence of clear intraspecific diversity within J. tenella contrarily to S. radiatum for which no apparent diversity was noted. In most of the households surveyed, J. tenella and S. radiatum were found respectively at steps 3 and 4 in the domestication process. The production of these vegetable species is still traditional and biologic (no fertilisers, no pesticides). The cultural practices used are not the same for the two species and vary between households and between ethnic groups. The multivariate analyses (Cluster analysis, PCA) conducted based on the various traditional farming practices to examine the relationship between farmers revealed respectively 4 and 5 categories of producers of J. tenella and S. radiatum corresponding to the same numbers of applied traditional technological packages. Further domestication trials were recommended to develop the best technical packages required to master mass production of the species in the future for the benefit of both producers and consumers. Agromorphological and genetic characterisation were also recommended in order to establish the scientific basis for their varietal improvement. Key words: Sesamum radiatum, Justicia tenella, leafy vegetables, traditional production, domestication, Benin.

Aim This study aimed to characterize the sociodemographic data, health status, quality of care and 6-year trends in elderly people with type 2 diabetes. Methods This study used two French cross-sectional representative surveys of adults of all ages with all types of diabetes (Entred 2001 and 2007), which combined medical claims, and patient and medical provider questionnaires. The 2007 data in patients with type 2 diabetes aged 65years or over ( n =1766) were described and compared with the 2001 data ( n =1801). Results Since 2001, obesity has increased (35% in 2007; +7 points since 2001) while written nutritional advice was less often provided (59%; −6 points). Mean HbA 1c (7.1%; −0.2%), blood pressure (135/76mmHg; −4/−3mmHg) and LDL cholesterol (1.04g/L; −0.21g/L) declined, while the use of medication increased: at least two OHAs, 34% (+4 points); OHA(s) and insulin combined, 10% (+4 points); antihypertensive treatment, 83% (+4 points); and statins 48% (+26 points). Severe hypoglycaemia remained frequent (10% had an event at least once a year). The overall prevalence of complications increased. Renal complications were not monitored carefully enough (missing value for albuminuria: 42%; −4.5 points), and 46% of those with a glomerular filtration rate less than 60mL/min/1.73m 2 were taking metformin. Conclusion Elderly people with type 2 diabetes are receiving better quality of care and have better control of cardiovascular risk factors than before. However, improvement is still required, in particular by performing better screening for complications. In this patient population, it is important to carefully monitor the risks for hypoglycaemia, hypotension, malnutrition and contraindications related to renal function.

Objectif Decrire les sejours hospitaliers et les caracteristiques des personnes diabetiques hospitalisees. Patients et methodes En 2007, 8926 adultes diabetiques rembourses d’au moins 3 antidiabetiques au cours des 12 derniers mois ont ete tires au sort. Les consommations medicales etaient disponibles pour tous, un questionnaire pour 48 % des patients et 28 % des medecins en 2008. Les sejours hospitaliers ont ete extraits du PMSI de 2006 a 2009 (N = 7534, 84 %) et reconstitues sur trois annees (annee N 08/2006-07/2007, N+1, N+2) pour 7534 personnes (84 %) n’ayant pas refuse de participer a l’etude Entred. Resultats Durant les 3 annees, 61 % des personnes diabetiques ont ete hospitalisees au moins une fois (type 1–72 %, type 2–62 %, autres types-75 %, inconnu-58 %). Durant N+2, 34 % ont ete hospitalisees (type 1–40 %, type 2–35 %) : 15 % en hospitalisation de jour (type 1–18 %, type 2–16 %), 26 % en hospitalisation complete (type 1–28 %, type 2–26 %). Les personnes diabetiques hospitalisees ont eu en moyenne 2,6 sejours, soit 10 jours d’hospitalisation cumules par personne dans l’annee; 4 % ont ete hospitalisees durant plus de 15 jours consecutifs. Cardiopathies (taux d’hospitalisation 35‰ de l’ensemble des personnes diabetiques dont insuffisance cardiaque 16‰, cardiopathie ischemique 22‰), insuffisance renale chronique (27‰) et cancer (27‰) representaient les motifs les plus frequents. Le diabete etait mentionne en diagnostic (principal/relie/associe) pour 47 % des sejours. Comparees aux personnes diabetiques non hospitalisees, celles hospitalisees sur une annee etait plus agees (66 ans); plus sou vent en ALD (88 %); declaraient plus souvent des difficultes financieres (56 %), un diabete ancien (diagnostic ≥ 10 ans : 53 %) et une complication. Elles avaient un recours aux soins plus frequent et etaient plus souvent traitees par insuline (29 %). Conclusion Les hospitalisations restent frequentes chez les personnes diabetiques, et souvent en lien avec des complications du diabete. Toutefois, le diagnostic de diabete n’est pas mentionne dans plus de la moitie des sejours.

Objectif Evaluer l'impact de la dyslipidemie atherogene (DA) sur les taux d'hospitalisation pour complications cardiovasculaires des patients diabetiques de type 2 (DT2) ayant un LDL-cholesterol controle. Patients et methodes Pour l'enquete Entred 2007, 8 926 adultes diabetiques (definis par le remboursement d'au moins 3 antidiabetiques entre aout 2006 et juillet 2007) ont ete tires au sort dans les bases de donnees de l'assurance maladie. Pour 48 %, un questionnaire patient et pour 28 % un questionnaire medecin ont ete recueillis. Les sejours hospitaliers ont ete extraits du PMSI pour 84 % sur la periode aout 2008-juillet 2009. Selon le type de complications, les diagnostics ont ete recherches dans les diagnostics principaux et/ou associes. La DA etait definie par HDL-C Resultats Nous avons inclus dans l'etude 1299 DT2 ayant un LDL-C ‰ personnes DT2, superieur a celui des DT2 sans DA (20 ‰ , p=0,02). Conclusion Chez les personnes DT2 ayant un LDL-C controle, les hospitalisations pour cardiopathie ischemique sont plus frequentes chez ceux ayant une DA. La DA pourrait jouer un role dans le developpement de la cardiopathie ischemique.

Titre : ADELF-EMOIS 2012 – Utilisation des donnees du programme de medicalisation des systemes d’information (PMSI) pour la surveillance des complications du diabete en France. Entred 2007. Auteurs : AGF Assogba (Institut de Veille Sanitaire, Departement des Maladies Chroniques et Traumatismes, Saint-Maurice, France) F. Penfornis (Service d’endocrinologie, Hopital Jean Minoz, Besancon, France) B. Detournay (CEMKA-EVAL, Bourg-la-Reine, France) C. Druet (Institut de Veille Sanitaire, Departement des Maladies Chroniques et Traumatismes, Saint-Maurice, France) A. Fagot-Campagna (Institut de Veille Sanitaire, Departement des Maladies Chroniques et Traumatismes, Saint Maurice, France) S. Fosse (Institut de Veille Sanitaire, Departement des Maladies Chroniques et Traumatismes, Saint-Maurice, France) Resume : Introduction Ce travail vise a etudier la qualite du reperage du diagnostic du diabete au cours des sejours hospitaliers lies a ses complications, par croisement du PMSI avec des donnees d’enquete en population diabetique traitee. Methodes Pour l’enquete Entred 2007, 8926 adultes diabetiques rembourses d'au moins 3 antidiabetiques entre aout 2006-juillet 2007 ont ete tires au sort dans les bases de l’assurance maladie. Les sejours hospitaliers ont ete extraits du PMSI pour 7534 personnes (84%) n’ayant pas refuse de participer a Entred et reconstitues sur aout 2006-juillet 2007. Selon le type de complications, les diagnostics ont ete recherches dans les diagnostics principaux, relies et/ou associes, et le diabete dans l’ensemble des diagnostics. Resultats Pres d’un tiers des personnes diabetiques d’Entred (âge moyen 65 ans) ont ete hospitalisees au moins une fois dans l’annee. Cardiopathies (taux d’hospitalisation 30‰ patients dont insuffisance cardiaque 10‰, cardiopathie ischemique 22‰), insuffisance renale chronique (13‰) et cancer (22‰) representaient les diagnostics les plus frequents. Le diabete etait mentionne dans 53% des sejours hospitaliers et plus frequemment lors des sejours pour plaie du pied (95%), amputation du membre inferieur (94%), accident vasculaire cerebral ou ischemique transitoire (79%), cardiopathie ischemique (71%) et insuffisance renale chronique (42%). Ces motifs representaient 15% de l’ensemble des sejours et comportaient un diagnostic de diabete dans 62% des cas. Par ailleurs, le diabete etait mentionne dans 78% des sejours hospitaliers pour insuffisance cardiaque et 18% pour cancer. Methodes Chez des personnes diabetiques traitees, le diabete n’apparait pas, a tort, comme diagnostic dans 38% des sejours hospitaliers mentionnant pourtant une complication du diabete, ce qui montre les limites du PMSI pour la surveillance epidemiologique de certaines complications. Le croisement de donnees d’enquete en population diabetique (Entred) avec celles du PMSI a alors un apport reel, par rapport aux seules donnees du PMSI. L’auteur n’a pas transmis de conflit d’interet concernant les donnees diffusees dans cette video ou publiees dans la reference citee. Conference enregistree lors du IIIeme Congres National conjoint ADELF/EMOIS a Dijon les 12 et 13 mars 2012. Session C-2 : PMSI et epidemiologie II (Amphitheâtre Romanee Conti). Moderateurs : J FRESSON, AM SCHOTT Realisation, production : Canal U/3S - CERIMES Mots cles : ADELF, EMOIS, 2012, Dijon, epidemiologie, langue francaise, evaluation, management, organisation, information, sante, PMSI, diabete

Objectif Estimer la prevalence de l'obesite chez les diabetiques de type 2 (DT2) en France metropolitaine, ses caracteristiques et son evolution entre 2001 et 2007. Materiels et methodes En 2007, un tirage au sort a selectionne 8 926 adultes diabetiques rembourses d'au moins 3 antidiabetiques au cours des 12 derniers mois. Les donnees de consommation medicale ont ete extraites, un questionnaire patient (QP) a ete recueilli pour 48 % des personnes diabetiques (n=3894 DT2) et un questionnaire medecin pour 28 % (n=2232 DT2). Les analyses ont ete ponderees sur le plan de sondage et la non-reponse aux questionnaires. Les donnees d'Entred 2007 ont ete comparees a celles de 2001 (n=3324 QP). Resultats En 2007, l'âge moyen etait de 65 ans, 41 % des personnes DT2 etaient obeses, 46 % des femmes et 37 % des hommes. La prevalence de l'obesite diminuait avec l'âge, etait plus elevee chez les personnes DT2 traitees par insuline (45 % vs 41 %, p 2 ). Compares aux DT2 de corpulence normale (IMC 2 ) ils avaient, apres ajustement sur l'âge, le sexe et la duree du diabete, une pression systolique (137 vs 131 mmHg), une HbA1c (7,5 vs 7,0 %) significativement plus elevees ainsi qu'une suspicion d'apnee du sommeil (35 % vs 9 %) plus frequente. Ils beneficiaient plus souvent de consultations dietetiques (35 % vs 16 %), de medecine generale (41 % vs 24 % pour≥12 visites) et podologiques (26 % vs 23 %), mais beneficiaient moins souvent des 3 dosages d'HbA1c dans l'annee (42 % vs 45 %) en secteur liberal. Ils avaient beneficie plus souvent d'une demarche educative. Discussion La prevalence de l'obesite augmente chez les DT2. Les personnes nees au Maghreb sont moins obeses refletant un risque genetique de diabete plus important a un niveau d'obesite moindre. La prise en charge augmente avec le niveau d'obesite mais reste insuffisante face a un risque cardiovasculaire plus eleve.

Onion is the third most important vegetable after tomato and pepper for income generation by farmers in Benin, West Africa (Agossou et al ., 2001; MAEP, 2006). Since 1995, a serious disease of onion has been reported by farmers…