Objectives: Study the prevalence and factors associated with the occurrence of surgical site infections in University Clinics of Trauma-Orthopedics, Reconstructive Surgery and Urology in a developing country.Methods: This was a retrospective descriptive and analytical study of 384 people operated on during the period of 2019. Logistic regression was used to study the factors associated with surgical site infections. The associations between the dependent variable and the other variables were assessed by the odds ratio (OR) followed by their 95% confidence interval.Results: The prevalence of surgical site infections was 7.81% CI 95% = (5.12–10.51). The factors linked to the surgical site infections in the studied population were the patient's admission method [OR = 2.74; 95% CI = (1.08–6.95)] and the length of the postoperative stay [OR = 8.75; 95% CI = (2.83–26.98)]. The interview and direct observation identified health care system dysfunctions, medical errors, patient monitoring and financial unavailability as factors that could favor the onset of surgical site infections.Conclusion: Interventions should be focused on the factors identified for the effective management of operated patients.

Background: Hand Hygiene (HH) has been described as the cornerstone and starting point in all infection control. Compliance to HH is a fundamental quality indicator. The aim of this study was to investigate the HH compliance among Health-care Workers (HCWs) in Benin surgical care units. Methods: A multicenter prospective observational study was conducted for two months. The World Health Organization (WHO) Hand Hygiene Observation Tool was used in obstetric and gastrointestinal surgery through six public hospitals in Benin. HH compliance was calculated by dividing the number of times HH was performed by the total number of opportunities. HH technique and duration were also observed. Results: A total of 1315 HH opportunities were identified during observation period. Overall, the compliance rate was 33.3% (438/1315), without significant difference between professional categories (nurses =34.2%; auxiliaries =32.7%; and physicians =32.4%; p = 0.705). However, compliance rates differed (p < 0.001) between obstetric (49.4%) and gastrointestinal surgery (24.3%). Generally, HCWs were more compliant after body fluid exposure (54.5%) and after touching patient (37.5%), but less before patient contact (25.9%) and after touching patient surroundings (29.1%). HCWs were more likely to use soap and water (72.1%) compared to the alcohol based hand rub solution (27.9%). For all of the WHO five moments, hand washing was the most preferred action. For instance, hand rub only was observed 3.9% after body fluid exposure and 16.3% before aseptic action compared to hand washing at 50.6 and 16.7% respectively. Duration of HH performance was not correctly adhered to 94% of alcohol hand rub cases (mean duration 9 ± 6 s instead of 20 to 30 s) and 99.5% of hand washing cases (10 ± 7 s instead of the recommended 40 to 60 s). Of the 432 HCWs observed, 77.3% followed HH prerequisites (i.e. no artificial fingernails, no jewellery). We also noted a lack of permanent hand hygiene infrastructures such as sink, soap, towels and clean water. Conclusion: Compliance in surgery was found to be low in Benin hospitals. They missed two opportunities out of three to apply HH and when HH was applied, technique and duration were not appropriate. HH practices should be a priority to improve patient safety in Benin.

Les effluents générés par les activités hospitalières présentent un danger potentiel pour la santé et l’environnement. L’objectif de cette étude était d’étudier la qualité physico-chimique et toxicologique des effluents produits par les Centres Hospitaliers et Universitaires du département du Littoral. Il s’agissait d’une étude transversale descriptive et analytique sur 60 prélèvements d’effluents hospitaliers provenant des stations d’épuration et des fosses septiques. Les échantillons ont été prélevés dans des bouteilles en plastique de 1,5 litre. Les valeurs moyennes des paramètres avec leurs déviations standards ont été calculées. Une analyse en composante principale a été réalisée. Les paramètres physico-chimiques mesurés et comparés aux normes de rejets des polluants dans l’environnement montraient qu’en dehors du pH, de la température et de la conductivité qui étaient conformes aux normes, tous les autres paramètres présentaient des valeurs supérieures aux normes de rejet. Le potentiel hydrogène, la température et la conductivité mesurés sont respectivement en moyenne de 7,14 ; 24,52 °C et 1243,37 μS/Cm. Les teneurs moyennes en oxygène dissous, en ammonium et en phosphore sont respectivement de 1,29 mg/L, 47,21 mg/L et 33,18 mg/L. La demande biochimique en oxygène est de 86,33 mgO2/L et la demande chimique en oxygène de 164,54 mgO2/L. Les concentrations moyennes du plomb et du cadmium étaient respectivement de 0,53 mg/L et 0,08 mg/L. Ces effluents présentent donc des risques sanitaires et environnementaux. Il apparait alors plus que nécessaire de développer des méthodes de traitement de ces effluents avant leur rejet dans le milieu naturel.Mots clés : Effluents hospitaliers, qualité chimique, risques sanitaires et environnementaux, Bénin. English Title: Physicochemical and toxicological characterization of the effluents of the Hospital and University Centers of the Littoral Department of BeninEffluents generated by hospital activities present a potential danger to health and the environment. The objective was to study the physico-chemical and toxicological quality of the effluents produced by the Hospital and University Centers of the Littoral Department. It was a descriptive and analytical cross-sectional study of 60 samples of hospital effluents from sewage treatment plants and septic tanks. Samples were taken from 1.5 liter plastic bottles. The average values of the parameters with their standard deviations were calculated. A principal component analysis was performed. The physicochemical parameters measured and compared to environmental pollutant release standards showed that, except for the pH, temperature and conductivity that were in compliance with the standards, all other parameters had values that exceeded rejection. The hydrogen potential, the temperature and the conductivity measured are, on average, 7.14, 24.52 °C and 1243.37 μS/cm. The average dissolved oxygen, ammonium and phosphorus contents are respectively 1.29 mg/L, 47.21 mg/L and 33.18 mg/L. The biochemical oxygen demand is 86.33 mgO2/L and the chemical oxygen demand is 164.54 mgO2/L. Mean concentrations of lead and cadmium were 0.53 mg/L and 0.08 mg/L, respectively. These effluents therefore present health and environmental risks. It appears then more than necessary to develop methods of treating these effluents before their release into the natural environment.Keywords: Hospital effluents, chemical quality, health and environmental risks, Benin.

Staphylococcus spp. is most often implicated in nosocomial infections. The objective of this study is to evaluate the susceptibility to antibiotics and the biofilm formation capacity of staphylococci species isolated from surfaces and medicotechnical materials at the university hospital center of Abomey-Calavi/Sô-Ava in Benin. Samples were collected according to ISO/DIS14698-1 standard from the surfaces and medicotechnical materials by the dry swab method. The isolation of Staphylococcus strains was performed on Chapman agar, and their identification was performed using microscopic and biochemical methods. The susceptibility of Staphylococcus isolates to antibiotics was evaluated by the disc diffusion method according to EUCAST and CLSI recommendations. The biofilm formation was qualitatively assessed using microplates. Of the 128 surfaces and medicotechnical material samples analyzed, 77% were contaminated with Staphylococcus spp. Thirteen species of Staphylococcus were isolated in different proportions but the pediatric department was the most contaminated (33%) by S. aureus. Resistance to antibiotics considerably varies according to the species of Staphylococcus. However, antibiotics such as chloramphenicol and vancomycin are the most effective on S. aureus, whereas coagulase-negative staphylococci developed less resistance to gentamycin and ciprofloxacin. The biofilm test reveals that 37% of our isolated strains were biofilm formers. Although regular monitoring of hospital hygiene is crucial, the optimal use of antibiotics is a cornerstone of reducing antimicrobial resistance.

Objective The paper aimed to study the association between household access to water, sanitation and hygiene (WASH) services and the occurrence of diarrhoea and acute respiratory infection among children under 5 years in Benin. Design We performed secondary analyses using Benin’s Fifth Demographic and Health Survey datasets. The dependent variables were diarrhoea and acute respiratory infection (yes=1, no=0). Among the independent variables were the household access to individual WASH services, grouped as follows: ‘basic’, ‘limited’, ‘unimproved’ and ‘no service’. Multivariate logistic regression was used to determine the association between household access to WASH services and the occurrence of diarrhoea and acute respiratory infection. Results from the multivariate logistic regression were presented using adjusted Odds Ratios (aORs) with 95% Confidence Intervals (95% CIs). Setting Benin. Participants Children under 5 years successfully surveyed during Benin’s Fifth Demographic and Health Survey. Outcome measures Diarrhoea and acute respiratory infection. Results In the current study, 12 034 children under 5 years met the selection criteria and were included in the analyses. The prevalence of diarrhoea and acute respiratory infection was 10.5% (95% CI=9.8% to 11.3%) and 2.9% (95% CI=2.5% to 3.4%), respectively. Children living in households without sanitation service, that is, practising open defecation (aOR=1.9, 95% CI=1.4 to 2.6), and with unimproved (aOR=1.9, 95% CI=1.3 to 2.7) and limited (aOR=1.5, 95% CI=1.1 to 2.2) services were more likely to have diarrhoea compared with children with basic sanitation services. Household access to WASH services was not associated with acute respiratory infection. Conclusion We suggest reinforcing household access to basic sanitation services to combat diarrhoea in children under 5 years. Further research is needed on the effects of WASH interventions on diarrhoea and acute respiratory infection in children under 5 years.

Background: Liquid discharges from hospitals (effluents) threaten the environment and are now a central concern of all stakeholders in the health system and those in the protection of the environment. The management of effluents is a major problem in developing countries. The objective of this study was to assess the quality of effluent management at the level of university hospital centers (CHU) in the Littoral region in Benin.Methods: It was a cross-sectional, descriptive, evaluative study that took place in 2020 to assess the “structure”, “process” and “results” components according to standard thresholds (Bad: < 60%; Acceptable: [60–80% [and Good: ≥ 80%).Results: In all the CHUs, all the components, as well as the overall quality of the management of hospital effluents, had a score between 0 and 60%, with an assessment deemed bad. The poor quality of the process highlighted the non-compliance with standards relating to the management of hospital liquid discharges. Several factors linked to the “structure”, “process” and “results” components at the same time explain this poor management of university hospitals effluents.Conclusion: These effluents discharged without prior treatment into wastewater could constitute a source of dissemination of potentially pathogenic microorganisms. It is therefore important to develop methods for treating these effluents before they are released into the natural environment.