Palliative care progress in Benin: a situation analysis using the WHO development indicators.

Context: Palliative care (PC) in most African countries remains under-assessed. Benin has piloted the implementation of a set of indicators proposed by the WHO to measure PC development.

Objectives: To examine the current status of PC in Benin.

[Prevalence of viral hepatitis B and C in men who have sex with men enrolled in a demonstration study of pre-exposure prophylaxis for HIV in Cotonou, Benin].

Introduction: men who have sex with men (MSM) are disproportionately affected by hepatitis B virus (HBV) and hepatitis C virus (HCV) worldwide. In Benin, there are no data on MSM. The purpose of this study was to estimate HBV and HCV prevalence and HBV-associated factors in MSM who were HIV negative.

Prevalence and determinants of high-risk human papilloma virus among men who have sex with men in Benin: a cross-sectional study embedded in a demonstration project on pre-exposure prophylaxis against HIV.

Objectives: This study aims to assess the prevalence and factors associated with anal high-risk human papilloma virus (HR-HPV).

Design: A cross-sectional study conducted from 24 August 2020 to 24 November 2020.

Setting: Primary care, Cotonou, Benin.

Pre-exposure prophylaxis in real life: experience from a prospective, observational and demonstration project among men who have sex with men in Benin, West Africa.

Introduction: Since many countries in sub-Saharan Africa are willing to implement HIV oral pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM), data are needed to assess its feasibility and relevance in real life. The study objectives were to assess drug uptake, adherence, condom use and number of sexual partners, HIV incidence and trends in the prevalence of gonorrhoea and chlamydia.

Methods: In this oral PrEP demonstration study conducted prospectively in Benin, a combination of tenofovir disoproxil fumarate-TDF 300 mg and emtricitabine-FTC 200 mg (TDF-FTC) was offered daily or on-demand to MSM.

Lessons Learnt From the Experiences of Primary Care Physicians Facing COVID-19 in Benin: A Mixed-Methods Study.

Introduction: In sub-Saharan Africa, there is a need to better understand and guide the practice of primary care physicians (PCPs), especially in a crisis context like the COVID-19 pandemic. This study analyses the experiences of PCPs facing COVID-19 in Benin and draws policy lessons.

Methods: The study followed a fully mixed sequential dominant status design.

Determinants of HIV Preexposure Prophylaxis Adherence Among Female Sex Workers in a Demonstration Study in Cotonou, Benin: A Study of Behavioral and Demographic Factors.

Background: HIV preexposure prophylaxis (PrEP) efficacy is closely linked to adherence, and factors associated with PrEP adherence are not well understood and may differ across populations. As PrEP demonstration projects and implementation are ongoing, it is essential to understand factors associated with adherence to oral PrEP to design effective adherence interventions and maximize the public health impact of PrEP. We thus aimed to assess demographic and behavioral factors associated with optimal PrEP adherence (100%) among female sex workers (FSWs) participating in a demonstration project in Cotonou, Benin.

Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin.

Background: Behavioural and structural factors related to sex work, place female sex workers (FSWs) at high risk of maternal mortality and morbidity (MMM), with a large portion due to unintended pregnancies and abortions. In the African context where MMM is the highest in the world, understanding the frequency and determinants of pregnancy and abortion among FSWs is important in order to meet their sexual and reproductive health needs.

Methods: Data from two Beninese cross-sectional surveys among FSWs aged 18+ (2013, N = 450; 2016, N = 504) were merged.

Comparison of adherence measurement tools used in a pre-exposure prophylaxis demonstration study among female sex workers in Benin.

Background: Measuring adherence to PrEP (pre-exposure prophylaxis) remains challenging. Biological adherence measurements are reported to be more accurate than self-reports and pill counts but can be expensive and not suitable on a daily basis in resource-limited countries. Using data from a demonstration project on PrEP among female sex workers in Benin, we aimed to measure adherence to PrEP and compare self-report and pill count adherence to tenofovir (TFV) disoproxil fumarate (TDF) concentration in plasma to determine if these 2 measures are reliable and correlate well with biological adherence measurements.

[Rare location of tuberculosis: endometrial tuberculosis].

Tuberculosis is a public health problem, especially in the developing countries. Bacillary pulmonary tuberculosis is the most common form of tuberculosis while genital tuberculosis is rare and underdiagnosed. We here report a case of endometrial tuberculosis.

[Impact of HIV status on the overall prevalence of chronic hepatitis B infection in Parakou, Benin].

Introduction: The prevalence of hepatitis B is very variable across geographic areas and seems to be influenced by HIV infection. This study aims to evaluate the impact of serologic HIV status on the overall prevalence of hepatitis B in a Hospital in Parakou, Benin.

Methods: We conducted a cross-sectional study of adults aged 18 years old and over hospitalized in the Departmental University Hospital Center in Parakou between May 2011 and June 2012.

Low implementation of Xpert MTB/RIF among HIV/TB co-infected adults in the International epidemiologic Databases to Evaluate AIDS (IeDEA) program.

Objective: Xpert MTB/RIF is recommended by the World Health Organization (WHO) as the initial tuberculosis (TB) diagnostic test in individuals suspected of HIV-associated TB. We sought to evaluate field implementation of Xpert among a cohort of HIV/TB co-infected individuals, including availability, utilization and outcomes.

Design: Observational cohort study (patient-level data) and cross-sectional study (site-level Xpert availability data).

Insights Into Circulating Cytokine Dynamics During Pregnancy in HIV-Infected Beninese Exposed to Plasmodium falciparum Malaria.

We investigated the circulating plasma levels of Th1- (Interleukin-2 [IL-2], tumor necrosis factor-α [TNF-α], interferon-gamma [IFN-γ]) and Th2-type (IL-4, IL-5, IL-10) cytokines in human immunodeficiency virus (HIV)-infected pregnant women living in a malaria-endemic area. We analyzed samples from 200 pregnant women included in the prevention of pregnancy-associated malaria in HIV-infected women: cotrimoxazole prophylaxis versus mefloquine (PACOME) clinical trial who were followed until delivery. Cytokine concentrations were measured by flow cytometry-based multiplex bead array.

Positive impact of increases in condom use among female sex workers and clients in a medium HIV prevalence epidemic: modelling results from Project SIDA1/2/3 in Cotonou, Benin.

Background: A comprehensive, HIV prevention programme (Projet Sida1/2/3) was implemented among female sex workers (FSWs) in Cotonou, Benin, in 1993 following which condom use among FSWs increased threefold between 1993 and 2008 while FSW HIV prevalence declined from 53.3% to 30.4%.

Incidence of malaria-related fever and morbidity due to Plasmodium falciparum among HIV1-infected pregnant women: a prospective cohort study in South Benin.

Background: Malaria and HIV are two major causes of morbidity and mortality among pregnant women in sub-Saharan Africa. Foetal and neonatal outcomes of this co-infection have been extensively studied. However, little is known about maternal morbidity due to clinical malaria in pregnancy, especially malaria-related fever, in the era of generalized access to antiretroviral therapy and anti-malarial preventive strategies.

Cotrimoxazole prophylaxis versus mefloquine intermittent preventive treatment to prevent malaria in HIV-infected pregnant women: two randomized controlled trials.

Background: Malaria during pregnancy has serious consequences that are worsened by HIV infection. Malaria preventive measures for HIV-infected pregnant women include cotrimoxazole (CTX) prophylaxis given to prevent HIV-related opportunistic infections and also protective against malaria, or intermittent preventive treatment (IPTp) with an antimalarial drug. Here, we present the first study evaluating CTX efficacy versus mefloquine (MQ)-IPTp, alone and in combination, in HIV-infected pregnant women.

Assessment of HIV-related risky behaviour: a comparative study of face-to-face interviews and polling booth surveys in the general population of Cotonou, Benin.

Objectives: During the 2008 HIV prevalence survey carried out in the general population of Cotonou, Benin, face-to-face interviews (FTFI) were used to assess risky behaviours for HIV and other sexually transmitted infections (STI). We compared sexual behaviours reported in FTFI with those reported in polling booth surveys (PBS) carried out in parallel in an independent random sample of the same population.

Methods: In PBS, respondents grouped by gender and marital status answered simple questions by putting tokens with question numbers in a green box (affirmative answers) or a red box (negative answers).

Predictive factors of plasma HIV suppression during pregnancy: a prospective cohort study in Benin.

Objective: To investigate the factors associated with HIV1 RNA plasma viral load (pVL) below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT) in Benin.

Design: Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT.

Methods: HIV-infected women were enrolled in the second trimester of pregnancy.

Mortality, AIDS-morbidity, and loss to follow-up by current CD4 cell count among HIV-1-infected adults receiving antiretroviral therapy in Africa and Asia: data from the ANRS 12222 collaboration.

Background: In resource-limited countries, estimating CD4-specific incidence rates of mortality and morbidity among patients receiving antiretroviral therapy (ART) may help assess the effectiveness of care and treatment programmes, identify program weaknesses, and inform decisions.

Methods: We pooled data from 13 research cohorts in 5 sub-Saharan African (Benin, Burkina Faso, Cameroon, Cote d'Ivoire, and Senegal) and 2 Asian (Cambodia and Laos) countries. HIV-infected adults (18 years and older) who received ART in 1998-2008 and had at least one CD4 count available were eligible.

Decline in HIV prevalence among young men in the general population of Cotonou, Benin, 1998-2008.

Objective: To assess changes in the prevalence of HIV and other sexually transmitted infections, as well as in different proximal and distal factors related to HIV infection, in the general population of Cotonou between 1998 and 2008, while an intensive preventive intervention targeting the sex work milieu was ongoing.

Methods: A two-stage cluster sampling procedure was used to select the participants in each study. Subjects aged 15-49 who agreed to participate were interviewed and tested for HIV, syphilis, HSV-2, gonorrhoea and chlamydia.

Tolerability of mefloquine intermittent preventive treatment for malaria in HIV-infected pregnant women in Benin.

Objective: To investigate the tolerability of mefloquine intermittent preventive treatment (MQ IPTp) for malaria in HIV-infected pregnant women compared with HIV-negative women.

Design: Prospective cohort study comparing samples of HIV-negative and HIV-infected pregnant women from 2 clinical trials conducted in Benin.

Methods: One hundred and three HIV-infected women from the ongoing PACOME trial were compared with 421 HIV-negative women from a former trial, both trials aiming to evaluate the efficacy and tolerability of MQ IPTp, administered at the dose of 15 mg/kg.

Transmission of HIV-1 drug resistance in Benin could jeopardise future treatment options.

Objectives: As access to antiretrovirals (ARV) increases in developing countries, the identification of optimal therapeutic regimens and prevention strategies requires the identification of resistance pathways in non-B subtypes as well as the surveillance of drug mutation resistance (SDMR) including the trafficking of viral strains between high-risk groups such as commercial sex workers (CSW) and the general population (GP). In this study, the authors evaluated the rate of primary resistance mutations and the epidemiological link between isolates from GP and CSW from Bénin.

Methods: Plasma samples were obtained from 129 HIV-1-infected treatment-naïve individuals.