IntroductionLes accidents vasculaires cérébraux constituent un véritable problème de santé publique en Afrique avec une charge importante. Les données fiables sur sa réelle charge économique sont rares en Afrique. L'objectif de cette étude était d’évaluer le coût direct hospitalier des AVC à Parakou au Bénin.MéthodesIl s'agissait d'une étude transversale économique ayant inclus des patients hospitalisés pour un AVC à l'hôpital de Parakou entre le 1er Juin 2010 au 31Mai 2011. Les données concernant les différents postes de consommation ont été collectées selon la méthode dite bottom-up. Le coût était envisagé du point de vue de la société et du patient. L'unité du coût était le franc CFA (valeur en 2011). Une régression linéaire multiple était utilisée pour déterminer les meilleurs prédicteurs du coût.RésultatsIls étaient 78 patients dont 52 hommes, âgés en moyenne de 57 ans ± 10.9. Le NIHSS moyen était de 14,4. Le taux de mortalité était de 20,5%. Le coût direct moyen était de 316.810,3 (±230.774,8) F CFA (environ 704 ± 512 Euros). Les grands postes de consommation étaient les explorations paracliniques (34.3%) les soins et médicaments (28.4%) et les frais d'hospitalisation (17.9%). Les meilleurs prédicteurs du coût élevé étaient un AVC hémorragique, un NIHSS élevé à l'admission et une longue durée d'hospitalisation.ConclusionCette étude suggère un coût élevé de la prise en charge actuelle des AVC à Parakou.

Despite the development of knowledge in diagnosis and therapeutic of epilepsy it remains to be cause of rejection and stigma. We aimed to study the knowledge, attitude and practice toward epilepsy and the stigma in a rural community. The cross-sectional study was carried out from 1st to 31st March 2011 in a rural community (Tourou) at Parakou in the northern Benin. It was a door-to-door survey and included 1 031 adults older than 15 years. The diagnosis of epilepsy was based on International League Against Epilepsy. The specific questionnaire was used and comprised 16 items which explored knowledge, attitude and practice toward epilepsy. Another questionnaire was developed to study stigma among epileptics. The associated factors to the misconception toward epilepsy have been studied. All adults have heard about epilepsy and knew the generalized tonic-clonic form of epilepsy and knew someone with epilepsy. Hereditary (98%) and witchcraft (97.9%) and social problems (65.9%) were mentioned as the most cause of epilepsy. Epilepsy was cited as contagious disease by 90.6% of respondents and the associated factors were the sex (p=0.005) and occupational status (0.024). The saliva (98.1%) and witness of the place of seizure (97.8%) were the frequently mentioned modes of transmission. 65% of all mentioned that epileptics can not get marriage and the main associated factors to this belief were the advanced age (p=0.008) and occupational status (0.004). 64.4% believed that children with epilepsy shouldn't be attend to school, age (0.004), ethnicity (0.047) and occupational status were the associated factors with this misconception. Despite 99.4% considered epilepsy as treatable disease only 12.7% would have referred epileptics to the hospital. All the seven epileptics considered themselves as victims of stigma and rejected by their family and the community. The misconceptions associated to the epilepsy can explain the stigma and the therapeutic gap in this rural community.

Introduction: The number of people living with dementia is growing worldwide and most rapidly in low-and middleincome countries. Little is known about dementia in Benin. We estimated the prevalence of dementia among retired people in Parakou, a northern city in Benin, and then assessed associated factors. Methods: A cross-sectional study was performed in Parakou from July to August 2014. Participants were recruited at 2 centers, the National Center of Social Security and the Public Treasury of Benin. Participants with cognitive impairment were defined as having a low cognitive score (< 7) for the brief version of the Community Screening Interview for Dementia and were invited to neurological examination. DSM-IV-TR criteria were used to diagnose dementia and the HACHINSKI score was used to differentiate dementia subtypes. A logistic regression model was performed to identify factors associated with dementia. Results: Overall, 440 retired people were included in the study. They were mainly male (92.3%) and their mean age was 64.9 ± 6.0 years. The prevalence of cognitive impairment was 7.7% (95% CI 5.2-10.2). Fourteen participants were diagnosed with dementia, representing a prevalence of 3.2% (95% CI 1.5-4.8). Alzheimer disease was the most frequent subtype (64.3%), followed by vascular dementia (21.4%). Retired people diagnosed with dementia were all men and were aged between 61 and 71 years. Most of them were living alone. The main factors associated with dementia were older age, low fruit and vegetables consumption, and living alone. Discussion: This study showed a low prevalence of dementia among retired older people in Benin. Despite this, greater attention must be given to the potential burden dementia places on families for better care, before the expected aging of the population becomes more significant.