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To determine the prevalence of sleep-related disorders, poor sleeping, and factors associated with poor sleep quality among inhabitants of Parakou, Benin. This was a cross-sectional study conducted from April–August 2018 on 930 randomly selected adults (age ≥ 18 years). Using the Pittsburg Sleep Quality Index, the Insomnia Severity Index, and the Epworth Sleepiness Scale, subjects were questioned on their sleep, on parasomnias, and on movement-related sleep disorders. Overall, the prevalence of insomnia was 22% (95% CI, 19.1–24.4) and severe insomnia was 0.8%. The prevalence of excessive daytime sleepiness was 15% (95% CI, 12.5–17.0). Daily nightmares (2%) and rhythmic movements (6%) were those most commonly reported among parasomnias and movement-related sleep disorders. No major differences were found between men and women. The prevalence of poor sleeping (PSQI > 5) was 39% (95%CI, 36.3–42.5). Adjusted analyses showed a higher risk of poor sleeping in those aged 45–54 years (aOR = 1.78, p = 0.032) or ≥ 55 years (aOR = 3.61, p < 0.001), those overweight or obese (aOR = 1.53, p = 0.007), those underweight (aOR = 2.90, p = 0.030), and among females (aOR = 1.84, p < 0.001). Being divorced was associated with a lower risk of poor sleeping (aOR = 0.18, p = 0.036). Poor sleepers were more commonly found among those who had excessive daytime sleepiness (65% versus 36%, p < 0.001) and insomnia (86% versus 27%, p < 0.001). Sleep-related disorders were common in Parakou city, Benin, with four out of ten persons having poor sleep quality. There is a need to improve the management of sleep-related disorders and promote better sleep practices for the community.

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.

Objective. To determine among retreatment tuberculosis patients in Benin baseline characteristics, culture, and drug sensitivity testing (DST) results and treatment outcomes.Materials and Methods. A retrospective national cohort study of all retreatment tuberculosis patients in Benin in 2013 using registers and treatment cards.Results. Of 3957 patients with tuberculosis, 241 (6%) were retreatment cases. Compared to new pulmonary bacteriologically confirmed tuberculosis (NPBCT) patients, there were significantly higher numbers of males (P=0.04), patients from “Atlantique-Littoral” (P=0.006), patients aged 45–64 years (P=0.007), and HIV-positive patients (P=0.04) among those retreated. Overall, 171 (71%) patients submitted sputum for DST, of whom (163) 95% were positive forMycobacterium tuberculosison Xpert MTB/RIF and/or culture and 17 (10%) were rifampicin resistant (9 with MDR-TB and 8 monoresistant to rifampicin). For those without MDR-TB (n=224), treatment success was 93%. Worse outcomes occurred in those with unknown HIV status (RR: 0.27; 0.05–1.45;P<0.01) while better outcomes occurred in those who relapsed (RR: 1.06, 95 CI: 1.02–1.10,P=0.04).Conclusion. In 2013, a high proportion of retreatment patients received DST. Treatment success was good although more needs to be done to systematically increase the final follow-up smear examination. Reasons of high losses to follow-up from “Oueme-Plateau” should be investigated.

To determine the frequency of the new smear-positive pulmonary tuberculosis patients at the end of the second month of anti-tuberculosis treatment and to analyze the outcomes of their treatment.It was a retrospective comparative study from January 2006 to June 2008, based on the analysis of the records and treatment cards from the diagnosis and treatment centers of Lome. New sputum smear-positive tuberculosis patients at the end of the second month (smear positive 2 months) constituted the study population. A comparison group consisted of the new tuberculosis patients with sputum smear-negative at the end of the second month (negative smear 2 months).The proportion of sputum smear-positive at 2 months was 5.34% (163/3050). Cure and failure rates were respectively 69.3% and 17.2% for smear-positive 2 months versus 79.1% and 3.7% for control group. The death rate was similar in both groups (3% and 3.7%).The smear positive 2 month's patients have a high risk of failure and must receive special attention during their follow-up to improve the results of treatment.Déterminer la fréquence des nouveaux patients tuberculeux pulmonaire à bacilloscopie positive à la fin du 2Il s'agissait d'une étude rétrospective comparative de janvier 2006 à juin 2008, basée sur l'analyse des registres et les cartes de traitement de tuberculose des centres de diagnostic et de traitement de Lomé. Les nouveaux patients tuberculeux à bacilloscopie positive à la fin du deuxième mois (frottis mois 2 positif) constituaient la population de l'étude. Un groupe de comparaison était constitué avec les nouveaux patients tuberculeux à bacilloscopie négatif à la fin du deuxième mois (frottis mois 2 négatif).La proportion des frottis mois 2 positif était de 5,34 % (163/3050). Les taux de guérison et d'échec étaient respectivement de 69,3% et de 17,2% chez les frottis 2 positif contre 79,1% et 3,7 % chez les frottis 2 négatif. Le taux de décès était similaire dans les deux groupes (respectivement 3% et 3,7%).Les patients à frottis 2 positif ont un risque élevé d'échec et doivent bénéficier d'une attention particulière au cours de leur suivi afin améliorer les résultats de leur traitement.

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.

Background: There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. Objective: The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. Methods: The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Results: Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. Conclusions: The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings.

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.

Introduction Au Benin, depuis 2012, une unite de prise en charge du SAHOS est mise en place au centre national hospitalier et universitaire de pneumo-phtisiologie. Les premieres etudes font etat d’une prevalence elevee de sujet a risque dans la population. Neanmoins, le SAHOS, reste peu connu des populations. L’objectif de ce travail etait d’evaluer les CAP des medecins, premiers acteurs de la sante et leaders d’opinion au sein des populations. Methodes Etude transversale descriptive menee d’avril a juin 2017, aupres des medecins exercant a Cotonou. Les centres medicaux de la ville ont ete repertories et les medecins y officiant ont ete soumis a un questionnaire anonyme. Ont ete inclus, les medecins generalistes et les medecins specialistes a l’exception des pneumologues. Le niveau de connaissance est faible lorsque le score de bonne reponse obtenue est inferieur a 60 %, entre 60 % et 80 %, il est moyen et bon entre 80 % et 100 %. Resultats Au total, 363 (80 %) medecins sur 450 attendus ont ete inclus. Cent soixante-treize (47,6 %) etaient des generalistes, 140 (38,6 %) en specialisation et 50 (13,8 %) des specialistes. Le niveau de connaissance global etait faible et moyen respectivement chez 242 (66,7 %) et 90 (26,4 %) des enquetes, avec une difference statistiquement significative entre generalistes et specialistes. 20 (5,5 %) n’avaient jamais entendu parler du SAHOS. L’obesite comme facteur de risque etait connu de 86 %, cependant moins de la moitie 152 (42,1 %) connaissaient la triade (somnolence diurne, ronflement et pause respiratoire). L’HTA, complication cardiovasculaire majeure du SAHOS n’etait citee que par 149 (41 %) des enquetes. Environ 2/3 (64,4 %) n’avaient jamais evoque le SAHOS chez leurs patients. Conclusion Ces resultats montrent le niveau de connaissance generalement faible des medecins et soulignent la necessite et l’urgence de l’enseignement du SAHOS dans la formation medicale initiale et continue des medecins.

Centre National Hospitalier de Pneumo-Phtisi-ologie, Cotonou, Benin.To determine the proportion of individuals needing treatment for multidrug-resistant tuberculosis (MDR-TB) among patients previously treated for TB.A retrospective cross-sectional study of all patients previously treated for TB in Cotonou from 2003 to 2011.Of 956 patients on retreatment, 897 (94%) underwent culture and/or a line-probe assay. For different reasons, 594 (66%) underwent drug susceptibility testing for rifampicin (RMP), of whom 95 (16%) had RMP resistance (68 multidrug-resistance [MDR] and 27 other RMP resistance) and therefore needed treatment for MDR-TB. These represent 39% of patients who failed/relapsed after standardised retreatment, and 20% of those who failed, 19% of defaulters and 11% of relapses after first-line treatment. Residence outside of Benin was associated with a higher risk of RMP resistance (RR 3.13, 95%CI 2.19-4.48, P0.01). From 2003 to 2011, the prevalence of RMP resistance decreased from 25% to 5% among patients living in Benin. Human immunodeficiency virus (HIV) prevalence was 25%; no association was found between HIV and RMP resistance. Of patients failing treatment, 48% were fully susceptible, 22% were monoresistant and 8% polyresistant.The majority of patients who fail retreatment or first-line treatment in Cotonou do not require empirical treatment for MDR-TB.Centre National Hospitalier de Pneumo-Phtisiologie, Cotonou, Bénin.Déterminer la proportion de patients nécessitant un traitement pour une tuberculose multirésistante (TB-MR) parmi les cas en retraitement.Etude rétrospective de type transversal ayant inclus tous les patients en retraitement contre la tuberculose (TB) à Cotonou de 2003 à 2011.Des 956 patients traités par un régime standardisé de retraitement, la culture et/ou le Hain test ont pu être réalisés chez 897 d’entre eux (94%). Pour diverses raisons, le résultat du test de sensibilité à la rifampicine (RMP) était exploitable chez 594 patients (66%). Parmi ceux-ci, 95 (16%) avaient une résistance à la RMP (68 en multirésistance [MR] et 27 résistances à la RMP mais non MR) et par conséquent, nécessitent un traitement de type TB-MR. Ils représentaient 39% des patients en échec/rechute après un régime de retraitement, et 20% des patients en échec, 19% des repris après interruption et 11% des patients en rechute après un régime de primo-traitement. Une résidence habituelle en dehors du Bénin était significativement associée à une résistance à la RMP (RR 3,13 ; IC95% 2,19–4,48 ;A Cotonou, la majorité des patients qui échouent à un traitement de première ligne ou à un régime standard de retraitement ne nécessitent pas un traitement empirique de TB-MR.El Centro Nacional Hospitalario de Neumología de Cotonou, en Benín.Determinar la proporción de pacientes tratados por tuberculosis (TB) que necesitan un régimen de tratamiento contra la TB multidrogorresistente (TB-MDR).Fue este un estudio transversal retrospectivo de todos los pacientes tratados previamente por TB en Cotonou entre el 2003 y el 2011.De los 956 pacientes inscritos en retratamiento, en 897 (94%) se practicó un cultivo o una prueba de Hain. Por razones variadas, se realizó una prueba de sensibilidad a rifampicina (RMP) en 594 pacientes (66%) y se obtuvieron 95 resultados de resistencia (16%; 68 MDR y 27 casos de otro tipo de resistencia a RMP), lo cual indicó la necesidad de un régimen contra la TB-MDR. Estos pacientes representaron 39% de los pacientes que fracasaron o recayeron después de un retratamiento normalizado y 20% de los fracasos, 19% de los abandonos y 11% de las recaídas después de un régimen terapéutico con medicamentos de primera línea. La residencia fuera de Benín fue un factor que se asoció con un mayor riesgo de presentar resistencia a RMP (RR 3,13; IC95% 2,19–4,48;La mayoría de los pacientes que fracasaron el retratamiento o el tratamiento con medicamentos de primera línea en Cotonou no necesitan un tratamiento empírico con un régimen contra la TB-MDR.

Background In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the possible benefits on improving treatment outcomes. This study aimed to determine the contribution of tracing activities for those who missed scheduled appointments towards a successful treatment outcome. Methods A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed to explore factors associated with missing a scheduled appointment. Results Of 457 patients (410 new smear-positive and 47 retreatment tuberculosis), 37 (8 %) missed one or more of their appointments with a total of 44 episodes of missed appointments. The 3.5th (32 %) and 5th (43 %) month appointments were the ones most likely to be missed. Being male was associated with a higher risk of missing appointments (RR = 4.2; 95 % CI = 1.5–11.8, p = 0.004) while having HIV infection was associated with a lower risk (RR = 0.3, 95 % CI = 0.1–0.9, p = 0.03). Principal reasons for missed appointments were travelling outside Cotonou (34 %) and feeling better (21 %). In 24 (55 %) of these 44 episodes of missed appointments, contact was made with the patient who returned to the programme. These follow-up activities increased the treatment success by 4 %. Conclusion In Cotonou, Benin, less than 10 % of tuberculosis patients miss at least one of their scheduled appointments. Tracing activities increase the treatment success rate by 4 % and current on-going practices in the Programme need to be endorsed and encouraged. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-1219-z) contains supplementary material, which is available to authorized users.

Introduction En Afrique noire francophone, la prevalence du SAOS n’est pas connue. Une etude prospective, multicentrique, observationnelle « EPSASAPLF » a ete initiee a ce sujet, par la Societe africaine de pneumologie de langue francaise (SAPLF) et l’Espace francophone de pneumologie (EFP). Nous rapportons les donnees preliminaires de prevalence des symptomes du SAOS dans une population d’adulte a Cotonou. Methodes Etude descriptive transversale par autoquestionnaire standardise, aux usagers internes et externes, ainsi que leurs contacts, d’âge adulte ≥ 25 ans, ayant frequente le CNHU-PPC, entre le 1er juin 2015 et le 29 fevrier 2016. Les symptomes recherches etaient : la somnolence diurne excessive (SDE), le ronflement, la nycturie, les suffocations nocturnes, le sommeil non recuperateur, les attaques mystiques nocturnes. Etaient declares suspects suivant les recommandations de la SPLF 2010, les sujets presentant une SDE associee ou non a 2 au moins des autres symptomes recherches. Resultats Le taux de reponse au questionnaire etait de 81 % (300/372). La sex-ratio homme-femme etait de 1,32. L’âge moyen etait 37 ± 8 ans. L’IMC ≥ 25 etait presente chez 132 sujets (44 %). Les antecedents medicaux etaient domines par l’HTA dans 36 cas (12 %). Les symptomes les plus frequents etaient le ronflement, la SDE et la nycturie avec respectivement une prevalence de 38,1 %, 22,3 % et 18,7 %. La proportion de sujets suspects etait de 28 % [23 %–33 %]. Les frequences de l’IMC ≥ 25 et d’antecedents medicaux chez les suspects et les non-suspects etaient respectivement (39 % vs 20 %, p

Introduction La prise en charge de l’asthme reste onereuse dans nos pays en developpement. Une prise en charge avec acquisition des medicaments antiasthmatiques essentiels (bronchodilatateur courte duree d’action et corticoide inhale) a prix reduits a ete mise en place au centre national hospitalier et universitaire de pneumo-phtisiologue de Cotonou. Le traitement de fond des patients ayant un asthme persistant severe (APS), forme particulierement preoccupante, est constitue de fortes doses de corticoides inhales. L’objectif de ce travail etait d’evaluer la prise en charge de ces patients. Methodes Il s’agissait d’une etude descriptive avec inclusion des patients asthmatiques suivis dans le centre entre janvier 2013 et decembre 2015. Les donnees socio-demographiques, les habitudes tabagiques, l’utilisation de combustibles solides, la regularite au rendez-vous de controle, les resultats du traitement etaient colliges. Les donnees etaient analysees avec le logiciel par EpiData et Open Epi. Resultats Sur 491 patients consultes pendant la periode etudiee, 194 (40 %) avaient un APS, sex--ratio de 0,81, âge median de 47 ans (EI = 28). D’eux, 16 (8 %) etaient fumeurs actuels ou ex-fumeurs, 48 (25 %) etaient exposes a un tabagisme passif, 158 (81 %) a la fumee des combustibles solides a domicile. L’asthme etait deja connu chez 170 (88 %) ; 166 (86 %) avaient aussi une rhinite allergique ou un eczema atopique. Au moins trois visites aux urgences ou une hospitalisation dans l’annee precedant la consultation etaient retrouves respectivement chez 48 (25 %) et 29 (15 %). La proportion de patients ayant honore leur rendez-vous de controle avait progressivement diminue : 98 % au quinzieme jour, 74 % a un mois, 63 % a trois mois, 54 % a six mois, 51 % a neuf mois et 41 % a un an. Et des 79 patients ayant honore leur rendez-vous pour l’evaluation annuelle, 27 (34 %) etaient ameliores. Conclusion La prise en charge de l’APS doit etre amelioree a travers entre autres la subvention d’autres molecules antiasthmatiques.

In recent decades, the world has been experiencing a new epidemic, characterised by an increase in the incidence and prevalence of diabetes mellitus (DM), a non-communicable disease (NCD). According to the International Diabetes Federation (IDF), globally there were an estimated 382 million persons with DM in 2013, of whom 19.8 million lived in sub-Saharan Africa. Furthermore, it is predicted that the number of DM cases globally will rise to 592 million by 2035, more than doubling in sub-Saharan Africa. Nearly 5 million people are estimated to die globally from DM each year, the equivalent of one person dying every six seconds.1,2 Persons with DM can experience many types of complications, of which infectious diseases, including tuberculosis (TB), are common. The association between DM and TB has been documented for many years, with a 2008 systematic review indicating that DM can increase the risk of active TB by a factor of two to three times compared to patients without DM.3 According to recent World Health Organization (WHO) estimates, the number of adult TB cases associated with DM is just over 1 million, almost the same as the number of TB cases associated with the human immunodeficiency virus (HIV). It is thought that the rising burden of DM may adversely affect TB control and reverse the downward trend in TB incidence seen in the last 10 years.4 To tackle this dual burden of disease, a collaborative framework has been launched by the WHO and the International Union Against Tuberculosis and Lung Disease (The Union), which emphasises the need to establish collaborative mechanisms between national TB programmes (NTPs) and diabetes organisations and the bi-directional screening of TB and DM.5 Benin is a small country in West Africa with a stable TB notification rate of between 39 and 41 per 100 000 population and a DM prevalence in adults of 2.6% in 2008.6,7 In Cotonou, the economic centre of Benin, where the majority of TB cases in the country are notified, the prevalence of DM rose from 3.3% in 2002 to 4.7% 5 years later.8 To date, there has been no formal collaboration between the NTP and diabetes organisations in the country and there is little information on the association between TB and DM. A study was therefore undertaken in Cotonou to determine the prevalence of DM among TB patients.

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.

Introduction En milieu tropical africain, la sensibilisation allergenique des enfants suivis pour allergie respiratoire n’est pas documentee. L’objectif de ce travail etait d’evaluer par deux methodes diagnostiques, la sensibilisation aux acariens chez des enfants suivis pour allergie respiratoire a Cotonou. Methodes Le prick-test cutane et le dosage d’IgEs par REAST test a 3 acariens Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), Blomia tropicalis (Bt) ont ete realises chez des enfants de 3 a 15 ans suivis pour asthme et ou rhinite allergique. Le prick-test etait positif lorsque le diametre de la papule etait ≥ a la moitie de celui du temoin positif ou lorsque le diametre de la papule etait ≥ 3 mm de celui du temoin negatif. Pour le dosage, un niveau d’IgEs ≥ 0,35 UI/mL etait considere comme positif. Les resultats des deux methodes ont ete compares. Resultats Des 130 (100 %) enfants inclus, tous etaient eligibles pour le dosage et 119 (91,5 %) pour le prick-test. L’âge moyen etait de 7 ± 1 an, la tranche d’âge [3–7[etait la plus representee avec 68 sujets (52,3 %), suivie de la tranche [7–11[avec 38 sujets (29 %) ; le sex-ratio etait de 1,6 en faveur des garcons. L’association rhinite et asthme etait la plus frequente 72 (55,4 %). Les frequences de sensibilisation pour le prick-test et le dosage etaient respectivement : 79 % vs 34,6 % pour Dp, 38,7 % vs 37,7 % pour Df et 71,4 % vs 36,2 % pour Bt. Les frequences augmentaient significativement en fonction des tranches d’âge. Une correlation statistiquement significative entre les diametres moyens de la papule et les niveaux moyens de concentration des IgEs etait observee. Conclusion La sensibilisation aux acariens chez les enfants est frequente, et croissante avec l’âge. Le prick-test presente une meilleure sensibilite que le test biologique pour Dp et Bf.

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.

The main tuberculosis (TB) centre in Benin, West Africa, where only 2% of adult pulmonary TB cases are sputum smear-negative, all other pulmonary cases being smear-positive.To assess the burden of smear-negative, culture-positive pulmonary TB among TB suspects in Cotonou, and to estimate the total number of non-smear-positive TB cases at country level.For 1 year, one morning sputum culture was performed for every TB suspect (cough lasting3 weeks, as defined in Benin's national guidelines) with three negative sputum smears (fluorescence technique).Of 214 TB suspects for whom culture was performed, only 22 smear-negative, culture-positive cases were identified. During the same period, 831 sputum smear-positive cases were diagnosed. Culture therefore contributed only 2.6% of the total number of bacteriologically proven cases.These results show the relatively low input of culture in TB diagnosis among chronic coughers in Cotonou, Benin, and demonstrates that the expected number of non-smear-positive TB cases in Benin is probably much lower than the World Health Organization's current annual estimates.

Described by Reich and Johnson in 1992 [2], the Lady Windermere syndrome occurs exclusively in non-smoking women over the age of 60 years, without significant pre-existing pulmonary disease. It comprises bronchial dilatation, typically in the middle lobe and lingula, together with secondary infection by atypical mycobacteria (Mycobacterium avium in the first cases). Among the 17 cases of atypical mycobacterial infection that we have seen in the past 14 years, there were seven cases of this syndrome. It was associated with cough, sputum, sometimes haemoptysis, febrile episodes and deterioration of general health. The diagnostic criteria and treatment were defined by the American Thoracic Society. The pathophysiological hypothesis proposed by Reich and Johnson was that voluntary suppression of the cough led to congestion of the bronchi and secondary infection with atypical mycobacteria. Currently it is thought more likely that the following factors are involved: progressive increase in dilatation of small bronchi, delayed diagnosis, morphological abnormalities of the thorax, hormonal factors, immune deficiency, genetic neutrophil dysfunction, and even heterozygous forms of cystic fibrosis.