115 research outputs found
Immunohistochemical monitoring of wound healing in antibiotic treated buruli ulcer patients
No full textWhile traditionally surgery has dominated the clinical management of Buruli ulcer (BU), the introduction of the combination chemotherapy with oral rifampicin and intramuscular streptomycin greatly improved treatment and reduced recurrence rates. However management of the often extensive lesions after successful specific therapy has remained a challenge, in particular in rural areas of the African countries which carry the highest burden of disease. For reasons not fully understood, wound healing is delayed in a proportion of antibiotic treated BU patients. Therefore, we have performed immunohistochemical investigations to identify markers which may be suitable to monitor wound healing progression.; Tissue specimens from eight BU patients with plaque lesions collected before, during and after chemotherapy were analyzed by immunohistochemistry for the presence of a set of markers associated with connective tissue neo-formation, tissue remodeling and epidermal activation. Several target proteins turned out to be suitable to monitor wound healing. While α-smooth muscle actin positive myofibroblasts were not found in untreated lesions, they emerged during the healing process. These cells produced abundant extracellular matrix proteins, such as pro-collagen 1 and tenascin and were found in fibronectin rich areas. After antibiotic treatment many cells, including myofibroblasts, revealed an activated phenotype as they showed ribosomal protein S6 phosphorylation, a marker for translation initiation. In addition, healing wounds revealed dermal tissue remodeling by apoptosis, and showed increased cytokeratin 16 expression in the epidermis.; We have identified a set of markers that allow monitoring wound healing in antibiotic treated BU lesions by immunohistochemistry. Studies with this marker panel may help to better understand disturbances responsible for wound healing delays observed in some BU patients
Emerg Infect Dis
No full textWe reviewed Buruli ulcer (BU) surveillance in Benin, using the World Health Organization BU02 form. We report results of reliable routine data collected on 2,598 new and recurrent cases from 2003 through 2005
Effets de la contamination par les pyréthrinoïdes sur la santé des populations de la commune de Sô-Ava en 2023
No full textIn the municipality of Sô-Ava, Benin, pyrethroids are abused in agriculture to increase crop yields. Prolonged exposure to these pyrethroids could have adverse health consequences. This study aims to assess the effects on the health of contaminated populations. This is a cross-sectional study, involving 30 subjects randomly selected from a population group including farmers, market gardeners and fishermen who handle pyrethroids during their professional activities. Health effects were assessed based on determining urinary metabolites 3PBA (urinary 3-phenoxybenzoic acid) and interviews. The characteristics of sick and non-sick subjects were compared. Most of the subjects surveyed (80%) had been contaminated with pyrethroids during their occupational activities. Nearly 70% were over 45 years of age. Around 46% of those infected had developed pathologies, including sterility (12.50%), chronic bronchopneumopathy (12.50%), goiter (8.40%), cancer (8.40%) and Parkinson's disease (4.20%). This research showed that 46% of subjects contaminated by pyrethroid exposure developed chronic diseases. It is, therefore, necessary to limit the uncontrolled use of these pyrethroids during anthropogenic activities to contribute effectively to the reduction of these diseases. The main limitation of this study is the small sample size, which makes it impossible to generalise the results obtained.en agriculture pour accroitre le rendement des cultures. L’exposition prolongée à ces pyréthrinoïdes pourrait entraîner des conséquences néfastes sur la santé. L’objectif de cette étude est d’évaluer les effets sur la santé des populations contaminées. Il s’agit d’une étude transversale, ayant porté sur 30 sujets choisis de façon aléatoire au sein d’un groupe de population composé d’agriculteurs, de maraîchers et de pêcheurs qui manipulent des pyréthrinoïdes au cours de leurs activités professionnelles. Les effets sur la santé des populations ont été appréciés sur la base des résultats du dosage des métabolites urinaires 3PBA (Acide 3-phénoxybenzoique urinaire) et des interviews. Les caractéristiques des sujets malades et non-malades ont été comparées. La majorité des sujets enquêtés (80%) sont contaminés aux pyréthrinoïdes au cours des activités professionnelles. Près de 70% parmi eux sont âgés de plus de 45ans. Environ 46% des contaminés ont développé des pathologies dont la stérilité (12,50%), les bronchopneumopathies chroniques (12,50%), le goitre (8,40%), les cancers (8,40%), et la maladie de parkinson (4,20%). Ce travail de recherche a montré que 46% des sujets contaminés suite à l’exposition aux pyréthrinoïdes ont développé des maladies chroniques. Il est donc nécessaire de limiter l’usage non contrôlé de ces pyréthrinoïdes au cours des activités anthropiques afin de contribuer efficacement à la réduction de ces maladies. La principale limite de cette étude est la petite taille de l’échantillon qui ne permettrait pas la généralisation des résultats obtenus
The gendered impact of Buruli ulcer on the household production of health and social support networks: Why decentralization favors women
No full textBackgroundBuruli ulcer [BU] is a chronic and debilitating neglected tropical skin disease caused by Mycobacterium ulcerans. The treatment of moderate to severe BU affects the well-being of entire households and places a strain on both gender relations within households and social relations with kin asked for various types of support. In this paper, we employ the conceptual lenses provided by the Household Production of Health approach to understanding the impact of illness on the household as a unit of analysis, gender studies, and social support related research to better understand BU health care decision making and the psychosocial experience of BU hospitalization.MethodsAn ethnography attentive to circumstance and the nested contexts within which stakeholders respond to BU was conducted employing semi-structured interviews, illness narratives, and case studies. An iterative process of data collection with preliminary analyses and reflection shaped subsequent interviews. Interviews were conducted with 45 women in households having a member afflicted with BU in two communes of Benin with high prevalence rates for BU. The first commune [ZE] has a well-established decentralized BU treatment program and a well-functioning referral network linked to the Allada reference hospital specializing in the care of BU and other chronic ulcers. The second commune [Ouinhi] is one of the last regions of the country to introduce a decentralized BU treatment program. A maximum variation purposeful sample was selected to identify information-rich health care decision cases for in-depth study.Principal findingsStudy results demonstrated that although men are the primary decision makers for healthcare decisions outside the home, women are largely responsible for arranging care for the afflicted in hospital in addition to managing their own households. A woman’s agency and ability to influence the decision-making process is largely based on whatever social support and substitute labor she can mobilize from her own network of kin relations. When support wanes, women are placed in a vulnerable position and often end up destitute. Decentralized BU treatment is preferred because it enables a woman to remain in her own household as a patient or caretaker of an ill family member while engaging in child care and petty revenue earing activities. Remaining in the hospital (a liminal space) as either patient or caretaker also renders a woman vulnerable to rumor and innuendo about sexual liaisons and constitutes a form of social risk. Social risk in some cases eclipses the physical risk of the disease in what we would describe as a hierarchy of risks.ConclusionThis study illustrates the importance of decentralized treatment programs for NTDs such as BU. Such programs enable patients to remain in their homes while being treated, and do not displace women responsible for the welfare of the entire household. When women are displaced the well-being of the entire household is placed in jeopardy.</div
Association Between the Number of Antenatal Contacts and Maternal Mortality of Women Admitted for Obstetric Complications at Tessaoua Hospital (Niger): A Case-Control Study
No full textRÉSUMÉ
Introduction. Le décès maternel est un lourd fardeau dans de nombreux pays en développement, dont le Niger, avec un ratio de 509 décès pour 100 000 naissances vivantes en 2021. Cette étude a examiné l'association entre l'absence de contacts prénataux et les décès maternels à l'hôpital de Tessaoua en 2023. Méthodologie. Cette étude cas-témoins non appariés sur les décès maternels à l'hôpital de Tessaoua incluait 124 cas (patientes décédées) et 248 témoins (patientes non décédées). Les cas ont été sélectionnés par choix aléatoire simple, tandis que les témoins ont été choisis de manière raisonnée parmi les dossiers des femmes admises pour complications obstétricales entre 2019 et 2022. L'analyse comprenait des statistiques descriptives et des régressions logistiques simples et multiples. Résultats. La quasi-totalité des patientes étaient mariées (99,73%) et ménagères (98,66%). Les cas étaient majoritairement non instruits (96,77%). Parmi elles, 70,97% n’avaient aucun contact prénatal contre 22,98% des témoins. Les cas présentaient souvent des troubles de conscience à l’admission (61,30% contre 11,7% des témoins). Les facteurs associés aux décès maternels étaient les troubles de conscience à l’admission (OR=13,71, IC à 95% [6,41 ; 29,2]), l’absence de contacts prénatals (OR=11, IC à 95% [3,3 ; 36,7]) et l’absence de traitement avant la référence vers l’hôpital (OR=4,8, IC à 95% [1,5 ; 15,6]). Conclusion. Les facteurs associés aux décès maternels sont modifiables. Pour réduire cette mortalité, il faut augmenter les contacts prénataux et améliorer les premiers soins avant la référence à l’hôpital, dans les formations sanitaires de premier niveau.
ABSTRACT
Introduction. Maternal death is a heavy burden in many developing countries, including Niger, with a ratio of 509 deaths per 100,000 live births in 2021. This study examined the association between lack of antenatal contact and maternal deaths at Tessaoua Hospital in 2023. Methodology. This unmatched case-control study of maternal deaths at Tessaoua Hospital included 124 cases (deceased patients) and 248 controls (non-deceased patients). Cases were selected by simple random choice, while controls were chosen in a reasoned manner from the records of women admitted for obstetric complications between 2019 and 2022. The analysis included descriptive statistics and single and multiple logistic regressions. Results. Almost all patients were married (99.73%) and housewives (98.66%). The majority of cases were uninvestigated (96.77%). Of these, 70.97% had no prenatal contact compared to 22.98% of controls. Cases often had disturbances of consciousness at admission (61.30% compared to 11.7% of controls). Factors associated with maternal deaths were impaired consciousness on admission (OR=13.71, 95% CI [6.41, 29.2]), lack of antenatal contact (OR=11, 95% CI [3.3, 36.7]), and no treatment prior to referral to hospital (OR=4.8, 95% CI [1.5, 15.6]). Conclusion. The factors associated with maternal deaths are modifiable. To reduce this mortality, prenatal contacts must be increased and first aid must be improved before referral to hospital, in first-level health facilities
Perception de la qualité de l’air et de ses conséquences sanitaires chez des populations exposées à Cotonou : cas des carrefours Vedoko cica-Toyota et Akpakpa PK3
No full textAir pollution is a global disaster responsible for millions of deaths each year. To provide solutions adapted to the most vulnerable populations, it is necessary to know and understand their point of view on the issue. This study aims at studying the perception of the exposed populations on air pollution as well as its health consequences.
Within a radius of 500m, from the Vedoko Cica-Toyota and Akpakpa PK3 crossroads in Cotonou, a semi-directive questionnaire was carried out using KoBoCollect software with 217 individuals. Information on socio-demographic characteristics, air quality, sources of pollution, health consequences and means of protection of the populations living or working in these intersections was collected.
Most of the population considers that the air quality is poor, with the main sources of pollution being means of transport, human activities, factories, and lack of hygiene. The health consequences are multiple with a predominance of diseases and respiratory symptoms. Wearing a mask, even if not systematic, is the main means of protection used. The average age of the respondents was 35 years with a minimum of 18 years and a maximum of 83 years. Finally, 64.4% were men and 35.5% were women.
Many of the individuals surveyed are aware of the existence of air pollution and its health consequences. At both sites, the air is perceived in majority as being polluted.La pollution de l’air est un fléau mondial responsable chaque année de millions de morts. Pour apporter des solutions adaptées aux populations les plus vulnérables, il convient de connaître et de comprendre leur point de vue sur la question. Cette étude a pour objectif d’étudier la perception des populations exposées sur la pollution atmosphérique ainsi que ses conséquences sanitaires.Dans un rayon de 500m, à partir des carrefours Vedoko Cica-Toyota et Akpakpa PK3 de Cotonou, un questionnaire semi-directif a été réalisé à l’aide du logiciel KoBoCollect auprès de 217 individus. Des informations sur les caractéristiques socio-démographiques, la qualité de l’air, les sources de pollution, les conséquences sanitaires et les moyens de protection des populations vivant ou travaillant aux alentours de ces carrefours ont été collectées. La majorité de la population estime que l’air est de mauvaise qualité, avec comme principales sources de pollution, les moyens de déplacement, les activités humaines, les usines et le manque d’hygiène. Les conséquences sanitaires sont multiples avec une prédominance de maladies et de symptômes respiratoires. Le port du masque, même non systématique, est le principal moyen de protection utilisé. L’âge moyen des enquêtés est de 35 ans avec un minimum de 18 ans et un maximum de 83 ans. Enfin, il y avait 64,4% d’hommes et 35,5% de femmes. La majorité des individus enquêtés ont conscience de l’existence de la pollution de l’air et de ses conséquences sanitaires. Aux deux sites, l’air est perçu en majorité comme étant pollué
Emergence of apoptotic fat cells after completion of antibiotic therapy.
No full text<p>Histological sections were stained by immunohistochemistry with anti-CC3 antibodies and were counterstained with Haematoxylin. Infiltrated necrotic areas (A, C, E) and fat cell layers (B, D, F) of the subcutaneous tissues are displayed. Before treatment some of the infiltrating cells showed CC3 staining (A). No staining was observed in the subcutaneous layer (B). During treatment (C, D) only very few cells showed CC3 staining. After treatment substantial numbers of infiltrating cells were CC3-positive (E) and in addition larger numbers of CC3-positive fat cells were found (F).</p
Perceived Stress at Work and Associated Factors among E-Waste Workers in French-Speaking West Africa
No full textPerceived stress at work is an important risk factor that affects the mental and physical health of workers. This study aims to determine the prevalence and factors associated with perceived stress in the informal electronic and electrical equipment waste processing sector in French-speaking West Africa. From 14 to 21 November 2019, a cross-sectional survey was carried out among e-waste workers in five countries in the French-speaking West African region, and participants were selected by stratified random sampling. Participants were interviewed on socio-demographic variables and characteristics related to e-waste management activities using a questionnaire incorporating Cohen’s Perceived Stress Scale (10-item version). Factors associated with perceived stress were determined by multivariate logistic regression. A total of 740 e-waste workers were interviewed. The mean age of the workers was 34.59 ± 11.65 years, with extremes of 14 and 74 years. Most of the interviewees were repairers (43.11%). The prevalence of perceived stress among the e-waste workers was 76.76%. Insufficient income, number of working days per week, perceived violence at work, and the interference of work with family responsibilities or leisure were the risk factors that were the most associated with perceived stress. The high prevalence of perceived stress and its associated factors call for consideration and improvement of the working conditions of e-waste workers
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