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Factors Associated with High Blood Pressure in People Living with HIV at the National Teaching Hospital Hubert Koutoukou Maga and Cotonou Teaching Hospital of the Armed Forces

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Open Journal of Internal Medicine 2021年第4期11卷 283-297页

作者： Azon Kouanou Angèle Ayihounton Gaël Derrick Mémoire Dégbo Agbodande Kouessi Anthelme Sokadjo Yves Morel Missiho Mahoutin Semassa Ghislain Faladé Adélakoun Ange Géoffroy zannou djimon marcel Houngbé Fabien Internal Medicine-Medical Oncology Unity of the National Teaching Hospital Center (NTHC)-Hubert Kougougou Maga (HKM) of Cotonou Cotonou Benin National Reference Center for Research and Care (CNRRPEC) of HIV Infection Cotonou Benin

In Benin Republic, few data are available on the prevalence and determinants of arterial hypertension (AH) in people living with the human immunodeficiency virus (PLWHA). The present study was conducted in two outpatient treatment centers for PLWHA in Cotonou and was conducted from June 19 to July 04, 2019 with 314 PLWHA. We performed descriptive statistics and logistic regression for the estimates. The prevalence of high blood pressure (HBP) among PLWHA was 41.4% [CI (95%): (35.9 - 47)]. In univariate analysis: age, smoking, alcoholism, physical inactivity, family history of hypertension, personal history of diabetes, obesity, and total and LDL (low density lipoprotein) hypercholesterolemia were significantly associated with HBP. No association was found with duration of HIV (human immunodeficiency virus) infection, time to ARV (antiretrovirals) exposure, and treatment regimen. In multivariate analysis, age, sex, smoking, family history of hypertension, and total hypercholesterolemia remained associated with HBP. In conclusion, the prevalence of HBP in PLWHA was very high compared with the results in the general population, and the same risk factors described in the general population were found but with a more marked hypertense potential.

关键词： High Blood Pressure HIV Associated Factors Cotonou (Benin)

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Clinical and Immunological Characteristics in HIV-Infected Patients at the Treatment Initiation at the University Hospital of Parakou (Benin)

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Open Journal of Immunology 2017年第3期7卷 51-58页

作者： Dovonou Albert Comlan Alassani Adébayo Cossi Attinsounon Cossi Angelo Saké Kadidjatou Adè Serge Ahoui Séraphin Degla Jivather Tchégnonsi Tognon Francis zannou djimon marcel Adè Gabriel Houngbé Fabien Departemental Teaching Hospital of Borgou Parakou Benin National Teaching Hospital Cotonou Benin

Goal: To describe the clinical and immunological characteristics in the HIV-infected patients at the antiretroviral treatment initiation. Methods: This was a descriptive and retrospective study on the cohort of the patients living with HIV followed at Parakou teaching hospital from the 1st January 2004 to the 31st December 2012. Persons under the age of 15 and the pregnant women have been excluded from the study. Results: The active file was composed of 988 patients under antiretroviral treatment. They were 339 men and 649 women. The sex ratio was 0.52. The average age of the patients was 35.49 ± 9.72 years. The immunodeficiency was profound with 57.65% of patients at the stage 3 of WHO and 42.35% at the stage 4. Opportunistic infections at the antiretroviral treatment initiation were dominated by oral candidiasis (30.16%), the diarrhea (20.45%) and zona (11.03%). Conclusion: HIV infection touched young adults who consult at an advanced stage of immunodeficiency.

关键词： Clinical Immunological HIV Parakou Benin

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Cancer and Covid-19 in the Department of Internal Medicine and Medical Oncology at the National Teaching Hospital Hubert Koutoukou Maga of Cotonou, about 4 Cases: A Review of the Literature

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Open Journal of Internal Medicine 2021年第4期11卷 298-309页

作者： Azon Kouanou Angèle Agbodandé Kouessi Anthelme Sokadjo Yves Morel Missiho Mahoutin Semassa Ghislain Faladé Adélakoun Ange Géoffroy Murhula Katabana Delphin Kouanou Olamidé Marlene Marie Dénise Ahoussoussi Cornelly Tokpanoudé Elodie zannou djimon marcel Internal Medicine-Medical Oncology Unity of the National Teaching Hospital Center (NTHC)-Hubert Kougougou Maga (HKM) of Cotonou Cotonou Benin Internal Medicine Department University Clinics Bukavu (U.O.B) Democratic Republic of the Congo

Coronavirus Disease-19 (COVID-19) manifests itself by a respiratory attack that can go from mild to severe forms. The factors favoring the severe forms are age, arterial hypertension, diabetes mellitus, and cancer. We report 4 cases of COVID-19 on cancer, followed in the Department of Internal Medicine and Medical Oncology of National Teaching Hospital Center Hubert Kougougou Maga (NTHC-HKM). Case 1: A hypertensive 65-year-old female patient with a severe form of COVID-19 on an FIGO (International Federation of Gynecology and Obstetrics) IVB endometrioid adenocarcinoma with pulmonary metastasis: unfavorable evolution under treatment with death. Case 2: A 56-year-old hypertensive patient with severe COVID-19 with pulmonary metastatic recurrence of SBRIII, HER2 positive invasive ductal carcinoma of the left breast: favorable evolution with cure of COVID-19, subsequent death related to active tumor. Case 3: A 37-year-old patient with a moderate form of COVID-19 with hepatocellular carcinoma complicating post alcoholic cirrhosis, CHILD C: favorable evolution with cure of COVID-19, patient lost to follow-up. Case 4: A 56-year-old patient, hypertensive, type II diabetic, presenting a severe form of COVID-19 on a field of ovarian serous adenocarcinoma of high grade FIGO IV A with pleuropulmonary metastasis: favorable evolution with cure of COVID-19, subsequent stroke, patient followed in palliative home hospitalization. The diagnosis of COVID-19 in cancer with pulmonary metastases is difficult. The pulmonary location of tumors seems to be a factor favoring severe forms.

关键词： COVID-19 Cancer NTHC-HKM

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Late Presentation to Care among People Living with HIV in Cotonou, Benin: A Retrospective Analysis from 2003 to 2014

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Open Journal of Internal Medicine 2017年第4期7卷 123-134页

作者： djimon marcel zannou Pacos Bray Gandaho Angèle Azon-Kouanou Carin Ahouada Kuessi Anthelme Agbodande Armand Wanvoegbe Jocelyn Akakpo Fabien Houngbe Department of Internal Medicine National Teaching Hospital Hubert K. Maga (CNHU-Hubert K. Maga) Cotonou Benin National Referral Center for HIV Research and Comprehensive Care at CNHU-Hubert K. Maga Cotonou Benin

Background: Late presentation to care is associated with increased morbidity, mortality and healthcare cost. Objectives: To determine the prevalence of late presentation to care in Benin, describe its trends and identify risk factors associated. Methods: We conducted a retrospective analysis from 2003 to 2014 at the National HIV Referral Centre in Benin. The definition of the European Late Presentation Consensus Group (ELPCG) for late presentation to care was used. Late Presenters (LP) were defined as patients presenting to care with CD4 count below 350 cells/mm3 or with an AIDS defining event, and patients with advanced HIV disease (AHD) were defined as persons with a CD4 count below 200 cells/mm3. Results: 5018 patients were included. Women accounted for 62.9%. Patients ranged in age from 18 to 62 years. 4233 patients (84.4%) were late presenters (LP) and 3126 (62.3%) were in Advanced HIV Disease (AHD). Late presentation decreased from 97.7% in 2003 to 78.7% in 2009. Between 2009 and 2014, there was no substantial decrease. Older age [Odds Ratio (OR) = 3.17;95% Confidence Interval (CI) = [2.52 - 4.00], p Conclusions: The prevalence of late presentation to care in Cotonou is alarming. This prevalence has been on a declining trend, but it remains extremely high. In order to reach the first 90 of the 90-90-90 targets, policymakers should promote the Provider-initiated HIV Testing and Counselling in all health facilities, modeled on the existing PMTCT of HIV screening during pregnancy.

关键词： Late Presentation HIV European Consensus Benin

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Primary Headache Disorders in HIV-Infected Patients within a Hospital Setting in Sub-Saharan Africa, Benin Case: Prevalence and Associated Factors

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World Journal of Neuroscience 2019年第4期9卷 282-293页

作者： Dieu Donne Gnonlonfoun Mendinatou Agbetou Armand Wanvoegbe Constant Adjien Ronald Gnimavo Arlos Sowanou Rodrigue Domingo Joseph Adoco djimon marcel zannou Dismand Houinato Department of Neurology Teaching Hospital Center Cotonou Benin Department of Neurology Teaching Hospital Center Parakou Benin Department of Internal Medicine Teaching Hospital Center Cotonou Benin Department of Public Health Ouidah Benin

Introduction: Headache disorders are common in HIV-infected patients. These disorders are either primary or secondary. Objective: Determine prevalence and factors associated with primary headache disorders in HIV+ patients. Method: It was a cross-sectional, descriptive and analytical study conducted from 2nd May 2017 to 2nd August 2017 which included HIV+ patients aged 18 years and above. Diagnosis of primary headache disorders was carried out by a Neurologist on the basis of ICHD-II diagnostic criteria. The?dependent variable was primary headache disorders. Epi Info Version 7.***.1.0 and STATA11 were used for data analysis. P Results: Primary headache disorders prevalence was 25.2% (124/493).Tension-type headache represented 77.41%. HIV+ patients were aged 42.63 ± 10.14 years. Sex-ratio was estimated at 0.14. Factors associated with primary headache disorders in HIV+ patients were: male (0.36 [0.17 - 0.77];P = 0.008), Dendi ethnicity (14.8 [2.08 - 101.99];P = 0.007), trader (3.09 [01.25 - 7.62];P = 0.02), WHO clinical stage (3.20 [1.43 - 7.17];P = 0.005), screening duration (1.01 [1.00 - 1.01];P = 0.00), hypertension (10.28 [4.44 - 23.83];P ≤ 0.001). Conclusion: This study helped to determine the standard profile of HIV+ patient with primary headache disorders. It will contribute to save costs associated with paraclinical examinations, while in search of secondary etiologies within an African context with limited financial resources.

关键词： Primary Headache HIV Benin

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Frequency of Modifiable Cardiovascular Risk Factors Such as Obesity, Diabetes Mellitus and Hypertension in a Benin Rural Area

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Open Journal of Internal Medicine 2015年第3期5卷 50-57页

作者： djimon marcel zannou Anthelme Kouessi Agbodande Angèle Azon-Kouanou Finagnon Armand Wanvoegbe Léopold Codjo Albert Dovonou Dédé Priscillia Tatiana Baglo Fabien Houngbe National Teaching Hospital-HKM of Cotonou University of Abomey-Calavi Abomey-Calavi Benin Departmental Hospital of Oueme-Plateau (Oueme Plateau) University of Abomey-Calavi Abomey-Calavi Benin Departmental Hospital of Borgou-Alibori University of Parakou Parakou Benin

The fight against cardiovascular diseases requires the knowledge of their modifiable risk factors. This study aimed to assess the level of modifiable cardiovascular risk factors in a rural area in order to develop a prevention program. Methods: This is an analytical and cross-sectional study on data collected during a fairground medical consultation of adults from 20 to 25 May 2013, in both border districts of the municipality of Djidja (Agouna and Houto). The studied parameters were the capillary blood glucose profile, blood pressure profile, waist circumference (WC) and Body Mass Index (BMI). Diabetes is defined by a fasting blood glucose ≥ 1.26 g/L two times. Hypertension is defined according to the criteria of JNC VII and obesity by BMI ≥ 30 kg/m2;abdominal obesity is defined by a WC above 102 cm in men and 88 cm in women. Data were analyzed using SPSS software version 18.0. Results: A total of 926 people were included among whom 57.8% were women. The average age was 38.43 ± 15.84 years. The prevalence of diabetes mellitus was 2.9%. The prevalence of obesity (BMI ≥ 30 kg/m2) was 8.4%;10.8% of studied population had abdominal obesity and 19.2% had hypertension. Age above 35 years and obesity were significantly associated with hypertension. Risk factors of obesity (IMC ≥ 30 kg/m2) were the place of residence (Agouna), the female gender, age between 35 and 64 and abdominal obesity. Conclusion: The frequency of cardiovascular risk factors, although small compared to the national level, remains a concern in the investigated rural communities. This must lead to undertake a survey on the lifestyle and dietary habits of the inhabitants of these areas.

关键词： Rural Area Cardiovascular Risk Factors Diabetes Mellitus Hypertension Obesity

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Epidemiological, Clinical and Paraclinical Aspects of Cirrhosis at Borgou Departmental University Hospital Center (Benin)

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Open Journal of Internal Medicine 2018年第2期8卷 113-122页

作者： Comlan Albert Dovonou Cossi Adébayo Alassani Kadidjatou Sake Cossi Angelo Attinsounon Angèle Azon-Kouanou Agossou Romaric Tandjiekpon djimon marcel zannou Fabien Houngbe Medicine Department and Medical Specialities Medical Faculty Parakou University Parakou Benin Internal Medicine Department Departmental Hospital Center of Borgou Parakou Benin Medicine Department and Medical Specialities of Cotonou Health and Science Faculty Cotonou Benin

Objective: To study the epidemiological, clinical and paraclinical aspects of cirrhosis at Borgou Departmental University hospital Center. Methods: This is a retrospective study for descriptive purpose conducted in the Internal Medicine Department. The study population consists of patients hospitalized in the Internal Medicine Department during the period from 1st January 2009 to 31st December 2016. Results: The frequency of cirrhosis was 1.35%. The sex ratio was 3.76. The average age of patients was 45.22 ± 15.23 years old, with a range from 15 to 82 years. There is a post hepatitis Bcirrhosis predominance in 87.5% of cases, followed by alcoholic cirrhosis in 21.59% of cases. The complications of cirrhosis are dominated by ascites (78.4%) and jaundice (52%). Conclusion: Cirrhosis is a condition that is wide spread. The hepatitis B virusis the main cause of liver cirrhosis followed by alcoholism. Ascites is the most encountered complication. It’s very important now to educate the populations for a behaviour change and to promote vaccination against viral hepatitis.

关键词： Epidemiology Hepatic Cirrhosis Parakou Benin

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Knowledge of General Practitioners in Cotonou about Systemic Lupus Erythematosus

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Open Journal of Internal Medicine 2020年第4期10卷 311-320页

作者： Angèle Azon-Kouanou Nonvignon Carrel Abdias Aboué Mahoutin Semassa Ghislain Missiho Eugénie Dansou Yves Morel Sokadjo Kouessi Anthelme Agbodande Armand Finagnon Wanvoegbe djimon marcel zannou Fabien Houngbé Internal Medicine and Medical Oncology Department National Teaching Hospital (NTH) Hubert Koudougou Maga (HKM) Cotonou Bénin

Introduction: Patients with Systemic Lupus Erythematosus (SLE) are seen late in specialized medical consultation in Benin. The objective of this work was to assess general practitioners’ knowledge in Cotonou about SLE. Materials and Methods: This work was a cross-sectional study that was led in the city of Cotonou from July 1 to September 30, 2017. In the study population, we have general practitioners who practice in the city. Data collection was set in response to a self-questionnaire. Result: The survey involved 209 general practitioners. The average age was 27.5 years with a minimum of 22 and a maximum of 34. Most of them practiced in private clinics. Besides, 17 doctors (8.1%) reported that they never heard of lupus. Among the 192 remaining, only one had an average knowledge of lupus, while the others had insufficient knowledge. Conclusion: From this study, we got that SLE is still little known by the general practitioner. Increasing the knowledge of general practitioners’ knowledge of lupus is compulsory to improve the screening rate.

关键词： General Practitioners Knowledge Systemic Lupus Erythematosus

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Influence of Antiretroviral Therapy on the Metabolic Profile of People Living with HIV Followed at University Hospital, Cotonou, Benin

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Open Journal of Internal Medicine 2015年第4期5卷 106-114页

作者： djimon marcel zannou Angèle Azon-Kouanou Manoela Christelle Ahomadegbe Kuessi Anthelme Agbodande Jocelyn Akakpo Comlan Albert Dovonou Kuassi Daniel Amoussou-Guenou Yessoufou Tchabi Gabriel Ade Fabien Houngbe Internal Medicine Department National University Hospital (CNHU-Hubert K. Maga) Cotonou Benin Ambulatory Care Center for People Living with HIV at CNHU-Hubert K. Maga Cotonou Benin Internal Medicine Department Prefectural University Hospital of Borgou Parakou Benin Endocrinology and Metabolic Diseases Department at CNHU-Hubert K. Maga Cotonou Benin Cardiology Department CNHU-Hubert K. Maga Cotonou Benin

Introduction: Since the advent of antiretroviral therapy, the vital prognosis of people living with HIV (PLWHA) has improved significantly. However, the risk of metabolic complications is high, thus making the bed of cardiovascular disease. Our objective was to compare the prevalence of metabolic abnormalities among PLWHA receiving ARVs to that observed in those who are not treated. Methods: We conducted a cross-sectional study (January to April 2010) at the PLWHA ambulatory care center of national university hospital (CNHU-Hubert K. Maga) in Cotonou, Bénin. We recruited 420 PLWHA (210 treated for at least 6 months and 210 untreated). We determined the prevalence of metabolic syndrome (MS) defined by the criteria of NCEP-ATP III, and the prevalence of abnormal glucose and lipid, and lipodystrophy. Association between metabolic syndrome and ARVs used was analyzed by binomial regression. Confidence intervals were calculated at 95% and 5% alpha level. Results: The prevalence of MS was 16% (18% of patients treated vs. 13% of non-treated, p = 0.18). That of hyperglycemia was 18% (30% of patients treated vs. 6% of untreated;p < 0.001) and of diabetes 7% (12% of patients treated vs 2% of untreated;p < 0.0001). The total cholesterol prevalence was 29% (44% of treated vs 13% of untreated;p <0.02). That of lipodystrophy in 210 patients was 29% (lipoatrophy16%, lipohypertrophy 8%, mixed form 6%). Factors associated with metabolic syndrome were age, hypertension, diabetes (personal or family), BMI, exposure to stavudine (OR = 1.59 [1.02 to 2.47], p = 0.04) and indinavir booted with ritonavir (OR = 2.23 [1.11 to 4 46], p = 0.02). Conclusion: The metabolic abnormalities are more common in PLWHA treated with ARVs. Preventing these anomalies should be made to the initiation of antiretroviral therapy and during the therapeutic monitoring.

关键词： Metabolic Syndrome Diabetes Dyslipidemia Antiretroviral Therapy HIV Infection

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Antiretroviral Therapy among HIV-1 Infected Female Sex Workers in Benin: A Comparative Study with Patients from the General Population

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World Journal of AIDS 2011年第3期1卷 94-99页

作者： Souleymane Diabaté djimon marcel zannou Nassirou Geraldo Annie Chamberland Jocelyn Akakpo Carin Ahouada Marguerite Massinga Loembé Sévérin Anagonou Annie Claude Labbé Michel Alary Cecile Tremblay 不详

Objective: The aim of this study conducted in Benin was to compare HIV-1 infected female sex workers (FSW) and patients from the general population (GP) to see whether there was a difference in adherence level, mortality rate and immuno-virologic response to antiretroviral therapy (ART). Methods: Fifty-tree FSW and 318 patients from the GP were recruited and followed for at least one year. We compared both cohorts according to poor-adherence (taking <95% of the pills), CD4 count increase, undetectable viral load (VL;≤50 copies/mL) and crude mortality rate. We constructed a multivariate regression model to assess factors associated with undetectable VL. Results: During the first year, the proportion of FSW with poor-adherence was significantly higher than that of the GP patients (19.3% versus 7.5%;p < 0.0001) and median gain in CD4 count among FSW was slightly lower (103/mm3 versus 129/mm3;p = 0.085). In the multivariate model (including CD4 at ART initiation and the sub-cohort i.e. FSW vs GP patients), duration under ART (p = 0.003) as well as CD4 count at enrolment in the study (p < 0.0001) and good-adherence (0.057) were independently associated with undetectable VL. When adherence was withdrawn from this model, there was a borderline significant association between detectable VL and being a FSW (p = 0.074). The crude mortality rate was 1.11 per 100 persons-years among the GP patients and 4.65 per 100 persons-years among FSW. Conclusion: Response to ART was lower among FSW compared to GP patients, as a result of poorer adherence. Specific behavioural interventions are needed to improve adherence and response to ART among FSW.

关键词： ART FSW Adherence

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