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Factors Associated with High Blood Pressure and Diabetes Cormobidity in Littoral Department of Benin, in 2023

Open Journal of Internal Medicine 2024年第2期14卷 188-212页

作者： Rodrigue Sèmèvo k.k.o Zannou Georgia Barik.ssou Damien Léopold Codjo Coovi Nonwanou Ignace Tok.anoude Elvire Sègnon Eurydice Djossou Folabi Femi Teddy Attonde Lorens Sènan Zinsalo Mondouk.e Mouinatou Tao Marius Esse Badirou Aguemon Public Health Unit Faculty of Health Sciences University of Abomey-Calavi (UAC) Cotonou Bnin Cardiology Service National Hospital and University Center Hubert Koutoukou Maga de Cotonou (CNHU-HKM) University of Abomey-Calavi (UAC) Cotonou Bnin

Introduction: The number of people suffering from diabetes and hypertension (HBP) is increasing worldwide and particularly in sub-Saharan Africa, despite the fact that they are preventable. The aim of our study is to determine the factors associated with hypertension and diabetes comorbidity in the Department of Littoral in 2023. Study Setting and Methods: Our study took.place in the Department of Littoral in Benin. It was a cross-sectional general population study conducted over a three-month period from April 10 to July 10, 2023. It included subjects aged 18 and over with or without a history of hypertension and/or diabetes. The sampling method was probabilistic and the technique used was a WHO three-stage cluster survey. The dependent variable is comorbidity of hypertension and diabetes. A logistic regression model was used to identify factors associated with hypertension-diabetes comorbidity. Results: The study population was predominantly female (59.9%). The mean age was 44 ± 17. A total of 48 (8.8%) of the subjects in the study suffered from both diabetes and hypertension. Factors associated with comorbidity of hypertension and diabetes were age ≥ 50 years (OR: 5.48;95% CI: 2.69 - 12.20;p = 0.001);male sex (OR: 2.98;95% CI: 1.39 - 6.46;p = 0.005);too much salt or salty sauce consumed (OR: 6.06;95% CI: 1.56 - 22.20;p = 0.034);abdominal obesity (OR: 6.12;95% CI: 2.79 - 14.3;p = 0.001). Conclusion: Hypertension and diabetes are emerging as major public health problems in Benin. The main associated factors were age, gender, the amount of salt or salty sauce consumed and abdominal obesity. A response is urgently needed to act on the factors identified in order to avoid possible complications and an increase in prevalence.

关键词： Comorbidity Hypertension-Diabetes Associated Factors Littoral Department Benin

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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-k.uanou Manoela Christelle Ahomadegbe k.essi Anthelme Agbodande Jocelyn Ak.k.o Comlan Albert Dovonou k.assi 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 mak.ng 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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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-k.uanou Carin Ahouada k.essi Anthelme Agbodande Armand Wanvoegbe Jocelyn Ak.k.o 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

Back.round: 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, policymak.rs 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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Reasons for the Use of Health care in Elderly Persons Undergoing Consultation in the University Clinic of Internal Medicine and Medical Oncology of the hubert k.utouk.u maga National Hospital and University center (cnhu-Hk.) of Cotonou

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Open Journal of Internal Medicine 2020年第3期10卷 280-287页

作者： Angèle Azon-k.uanou Mahougnon Jean-Christ Alix Aïdasso Mahoutin Semassa Ghislain Missiho Eugénie Dansou Faustin Havugimana k.ruhije Janvier k.tumaini k.ndoli Richard Oba k.uessi Anthelme Agbodande Yves Morel Sok.djo Djimon Marcel Zannou Fabien Houngbé Internal Medicine Department of hubert k.utouk.u maga National Hospital and University center in Cotonou (cnhu-Hk.) Cotonou Benin

Introduction: The progressive ageing of the population from southern Sahara is leading to an increase in health needs among the elderly. The purpose of this study was to output an overview about the reasons why the elderly come for consultation in the internal medicine department of the Hk.-NHUC in Cotonou. Methodology: This was a retrospective, descriptive, and analytical study, which included all patients aged 65 years and over, who came for the first time for consultation in the Internal Medicine Department of the cnhu-Hk. between January 1st and December 31st, 2017. Results: Among the 680 new patients received in internal Medicine consultations during the study period, 118 people were aged 65 and over, representing a hospital frequency of 17.35%. The sex ratio was 0.9 with a mean age of 73 ± 7 years. Hypertension was the main comorbidity of the patients (69%). Cough (11.3%) and low back.pain (8.2%) dominated the reasons for consultation. The three main nosological groups of pathologies were, in descending order, diseases of the osteo-articular system (17.5%), diseases of the respiratory system (16.5%) and diseases of the circulatory system (12.4%). Pneumonia (11.3%) and lumbosacral spondylarthrosis (10.3%) were the most frequent pathologies in patients whose health needs remain quite varied. Conclusion: The elderly become gradually an important part of the population in southern Sahara. A better understanding of the health needs of this category of the population is necessary to deal effectively with the health challenges that will accompany this phenomenon.

关键词： The Elderly Reason for Consultation Internal Medicine

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Factors Associated with High Blood Pressure in people living with hiv at the National Teaching Hospital hubert k.utouk.u 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 k.uanou Angèle Ayihounton Gaël Derrick.Mémoire Dégbo Agbodande k.uessi Anthelme Sok.djo Yves Morel Missiho Mahoutin Semassa Ghislain Faladé Adélak.un Ange Géoffroy Zannou Djimon Marcel Houngbé Fabien Internal Medicine-Medical Oncology Unity of the National Teaching Hospital center (NTHC)-hubert k.ugougou maga (Hk.) 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, smok.ng, 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, smok.ng, 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 mark.d hypertense potential.

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

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Bacteriologically Confirmed Neuromeningeal Tuberculosis at the hubert k.utouk.u maga National Hospital and University center in Cotonou: About Two Cases Study and a Review of the Literature

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Open Journal of Internal Medicine 2020年第2期10卷 190-197页

作者： Angèle Azon-k.uanou k.uessi Anthelme Agbodande Leoubou Roger Samuel Dodo Mahoutin Semassa Ghislain Missiho Roberto Dossou Torès k.uassi Prudencio Delphin Murhula Marius Douk.o Eugénie Dansou Thomas Lok.ssou Djimon Marcel Zannou Fabien Fabien Internal Medicine Department of cnhu-Hk. Cotonou Benin Multi-Purpose Anesthesia and Resuscitation Department of cnhu-Hk. Cotonou Benin

Introduction: Tuberculosis remains a major public health problem. The damage to the central nervous system is severe. We reported here two cases. Clinical Case 1: A 37-year-old female patient, naively Human Immunodeficiency Virus1 (hiv1)-positive with antiretroviral (ARV) treatment, hospitalized in the Internal Medicine department for altered consciousness in a febrile context. The clinical examination at admission noted a meningeal syndrome. Cytological analysis of the cerebrospinal fluid (CSF) revealed lymphocytic meningitis with 98% lymphocytes for 3634 leuk.cytes. CSF polymerase chain reaction (PCR) detected Mycobacterium tuberculosis DNA. She was put on anti-tuberculosis treatment. The immediate course was favourable, but a secondary worsening of the clinical picture was the cause of his death. Clinical Case 2: A 34-year-old male patient, naively hiv1-positive with ARV treatment. He is hospitalized in the Multi-Purpose Anaesthesia and Resuscitation Department of the cnhu Hk. for altered consciousness in a feverish context. The clinical examination noted a meningeal syndrome. The cytological analysis of the CSF noted 184 leuk.cytes for 99% lymphocytes. The CSF PCR identified the DNA of Mycobacterium tuberculosis. He was put on anti-tuberculosis treatment. The evolution was mark.d by his death. Conclusion: The neuromeningeal localization of tuberculosis is a poor prognosis. Co-infection with hiv remains a potential deadly combination.

关键词： Neuromeningeal Tuberculosis hiv Infection Death Cotonou

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