Yolaine Glèlè Ahanhanzo

Summary Gambling is rapidly expanding across Africa, particularly through sports betting. However in Benin, data on gambling behaviors among adolescents is scarce. This study aimed to estimate the prevalence of problem gambling and identify associated factors among secondary school students in Benin. A cross-sectional study was conducted with 1,831 secondary school students from three cities in Benin, using a three-stage random sampling. Problem gambling was assessed using the Canadian Problem Gambling Index (CPGI ≥ 8). Multivariable analyses were used to identify associated factors. Among the 1,831 students surveyed, 341 (18.6%) reported engaging in gambling activities. Among these gamblers, 84 (24.6%) met the criteria for problem gambling. The overall prevalence of problem gambling was 4.59% (95% CI: 3.62–5.55). Factors associated with problem gambling included residing in Dassa-Zoumè (AOR = 2.39; 95% CI: 1.64–3.48) or in Parakou (AOR = 2.18; 95% CI: 1.51–3.15), having low pocket money (0–1,000 XOF) (AOR = 1.74; 95% CI: 1.37–2.21), engaging in problematic alcohol consumption (AOR = 2.65; 95% CI: 2.03–3.47), frequently attending nightclubs (AOR = 1.73; 95% CI: 1.34–2.22), being frequently influenced by friends or relatives (AOR = 1.94; 95% CI: 1.50–2.52), and accessing gambling through both online and physical channels (AOR = 3.06; 95% CI: 2.23–4.22). In contrast, having friends who gamble was associated with a lower likelihood of problem gambling (AOR = 0.43; 95% CI: 0.29–0.66). Problem gambling significantly affects a notable proportion of secondary school students in Benin and is influenced by various geographical, behavioral, and familial factors. Implementing school-based prevention programs and enhancing gambling regulations may help mitigate gambling-related harms among adolescents.

Routine immunisation programmes generate large volumes of data, yet their effective analysis and use for decision-making remain limited at the operational level. For over three decades, Benin has institutionalized a semi-annual monitoring system to assess effectiveness, quality, and develop problem resolution plans (PRPs). This study evaluated its effectiveness in fostering data analysis and use within vaccination services. A descriptive cross-sectional study using mixed methods was conducted from January to June 2025 in eleven health centers across four departments. Data collected via direct observation, semi-structured interviews (n = 38), and document review underwent descriptive and qualitative analysis. Input availability and service accessibility remained optimal (100%). Variability persisted in utilisation, continuity, and quality, with recurrent over-coverage rates. During self-monitoring, technical tasks were frequently performed, whereas in-depth analysis and PRP development were limited (9.09%). Although 90.9% of centers had PRPs, their quality was mostly acceptable, with low innovation and weak follow-up mechanisms. Community participation was irregular. Nevertheless, 81.82% of managers perceived PRPs as contributing to improved vaccination performance. Semi-annual monitoring remains functional and relevant; however, strengthening analytical capacity, digital tools, follow-up mechanisms, and community engagement is essential to institutionalise a sustainable culture of data use for decision-making.

Background: In Benin, two third of health facilities experienced stockouts for at least one tracer product, revealing persistent weaknesses in supply chain management. To address this, the Couffo department adopted the PUSH model in one health zone while maintaining the PULL model in another. Objective: This study aimed to evaluate the technical contributions of the PUSH model to health product supply chain performance through a comparative analysis of both logistics models. Methods: A descriptive cross-sectional study with an evaluative and analytical purpose was conducted across 32 public health facilities in the Couffo department from September 2024 to February 2025. Data on inputs, processes, and outcomes were collected via observations, interviews, and documentary review, then analysed using the Varkevisser scale and comparative statistical tests (Chi-squared, Fisher's exact, Student's t-test) at the 5% significance threshold. Results: The PUSH model demonstrated higher overall performance (86.13% vs. 71.0%). Stockout frequency was significantly lower (31.48% vs. 68.52%; OR=0.21; p<0.001), delivery lead times shorter (8.2 vs. 20.9 days), and distribution (93.3% vs. 36.1%) and quality assurance scores (100% vs. 66.6%) substantially higher. Conclusion: The PUSH model significantly improves supply chain efficiency. Its gradual extension, supported by appropriate technical and financial assistance, is recommended to sustain universal access to quality health products in Benin.

Background: The supply chain plays a central role in ensuring continuity and quality of healthcare services. In response to recent supply chain failures, Benin has initiated a shift in its health commodity logistics model, moving from a fragmented PULL system to an integrated PUSH approach. This study was conducted to assess the contribution of the new model to supply chain performance. Methods: A descriptive cross-sectional study with evaluative and analytical components was carried out among 176 participants from two health zones in the Couffo Department, including health facilities, district warehouses, logistics professionals, and patients. Data were collected through observation, interviews, and document review. Data were analysed using the Varkevisser scoring scale, statistical tests, and odds ratio estimation at a 5% significance level. Results: Overall performance was higher under the PUSH model, particularly in the Klouékanmè-Toviklin-Lalo (KTL) health zone compared with the Aplahoué-Djakotomey-Dogbo (ADD) health zone (86.13% vs 71.00%; p=0.000001). Significant improvements were observed in product availability (odds ratio, OR=2.00; p=0.002), reduction in stock-outs (OR=0.21; p=0.001), shorter delivery lead times (β=−12.65; p=0.001), lower logistics costs (OR=8.56; p=0.008), and higher stakeholder satisfaction (OR=4.40; p=0.044). Some indicators (patient satisfaction and reduction in spoilage) were not statistically significant. Conclusions: Improved logistical and economic performance of the supply chain is associated with the implementation of the PUSH model. Its scale-up, supported by a longitudinal study examining the determinants of its sustainability, represents a relevant strategic perspective for health procurement policies.

Background: Acute respiratory infections are among the leading causes of morbidity and mortality in children under five years, particularly in low- and middle-income countries. This study aimed to estimate the prevalence of ARIs and to identify the determinants of their occurrence in children under five in the Sado arrondissement (or borough) in Benin. Methods: This was an analytical cross-sectional study involving 131 children under five years and their mothers recruited by convenience sampling in the community and at the Sado health centre using the integrated management of childhood illness (IMCI) register. Data collected through a questionnaire were analysed using STATA version 14. The primary outcome was the occurrence of acute respiratory infections in the child. Associations between independent variables and the occurrence of acute respiratory infections were explored using bivariate analyses and multivariate logistic regression at a 5% significance threshold. Results: The prevalence of acute respiratory infections was 64.12% (95% CI=55.45-71.95%). The determinants for the occurrence of acute respiratory infections were: mother’s marital status (OR=6.06; 95% CI=1.59-23.02; p=0.008), number of people living in the household (OR=0.34; 95% CI=0.12-0.94; p=0.038), cooking meals inside the rooms of the house (OR=0.39; 95% CI=0.16-0.91; p=0.030) and living near a dusty road (OR=3.19; 95% CI=1.18-8.58; p=0.022). Conclusions: The high frequency of acute respiratory infections in Sado and the influence of sociodemographic and environmental factors underscore the necessity for integrated interventions. Strengthening mother’ awareness and control measures targeting these factors (housing conditions, exposure to domestic and environmental pollutants, social determinants) will sustainably reduce the burden of acute respiratory infections in children under five years.

Background : Access to tuberculosis (TB) preventive services in prisons is a performance indicator for disease reduction strategies in the general population. People deprived of liberty often face constraints in utilizing these services. This survey aimed to study prisoners' access to TB prevention in 2023. Methods : This was a cross-sectional analytical study, including a retrospective analysis, on a non-probabilistic sample. It was conducted at the Abomey-Calavi remand center and involved 60 people deprived of liberty. Interviews were conducted with the head nurse and their deputy, followed by a review of the curative care registers from the prison infirmary. Coverage rates for screening, awareness, and isolation during and after treatment were determined, and associations with factors were assessed at a significance threshold of p=5%. Results : Less than half (43.75%) of prisoners with a cough lasting two weeks or more were screened. Among the 60 surveyed prisoners, 38.33%, 46.67%, and 10% had access respectively to screening, awareness and isolation for TB prevention. The care pathway for prisoners includes several key steps from screening to isolation, but it faces discontinuities that compromise effective TB treatment. Factors associated with TB screening were the effectiveness of awareness-raising activities (OR= 6.21; 95% CI= [1.67; 23.05]) and perception regarding seeking TB screening and treatment (OR= 9.36; 95% CI= [1.44; 60.79]). Conclusion : The decrescendo decrease in coverage indicates the presence of several bottlenecks limiting prisoners' access to TB prevention. Their consideration by health interventions will be necessary to ensure the protection of prisoners against TB.

Introduction : De nos jours, l’addiction à Internet est une préoccupation majeure en raison de l’évolution croissante du nombre d’internautes mais aussi de ses conséquences. But de l’étude : Dans cette étude, nous avons déterminé la prévalence et les facteurs associés à l’addiction à Internet chez les étudiants des sciences de la santé de l’Université d’Abomey-Calavi. Méthodes : Il s’agit d’une étude transversale menée auprès de 346 étudiants de la Faculté des sciences de la santé et de l’Institut national médico-sanitaire de l’Université d’Abomey-Calavi. Ces derniers ont été sélectionnés par échantillonnage aléatoire simple. L’addiction à Internet a été mesurée grâce à l’outil « Internet addiction test de Young ». Une modélisation par régression logistique a été utilisée pour explorer les facteurs associés à l’addiction à Internet. La force de l’association a été évaluée avec un rapport de cotes et son intervalle de confiance (IC) à 95 % ; une valeur p <0,05 dans le modèle final a été considérée comme significative. Résultats : La prévalence de l’addiction à Internet était de 31,8 % (IC95 % : [23,26 % - 41,38 %]). La filière d’études, les mauvaises relations avec les proches, les difficultés de communication, la dépression et la consommation de substances psychoactives étaient associées à l’addiction à Internet. Conclusions : Il existe des évidences qui montrent l’addiction à Internet des étudiants des institutions universitaires de santé au Benin. Ces évidences peuvent soutenir la mise en place de stratégies de prévention et de prise en charge axées sur la communication autour d’un phénomène encore insuffisamment perçu comme le problème de santé publique qu’il constitue.

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Purpose: The aim of this study was to determine, using geographic information system (GIS), the spatial characteristics and factors associated with injury crashes among vulnerable road users (VRUs) in Cotonou, Benin. Patients and Methods: This study was based on road crash data collected by the police in Cotonou from 2008 to 2017. Spatial analyses were performed using density method of QGIS cartography software to identify road crash hotspot for VRUs. Logistic regression analysis was conducted using Stata 15 software. Finally, field observations were used to assess the physical characteristics of the road environment at each hotspot. Results: From 2008 to 2017, six main crash hotspots involving VRUs were identified on the roads of Cotonou. The majority were located at intersections of main roads. These sites did not meet the standards for traffic safety for VRUs. Factors associated with injury crashes among VRUs were intersections (adjusted odds ratio (aOR) = 3.3; 95% CI: 1.8– 6.1) and pavement condition (aOR = 7; 95% CI: 2.9– 17.1). Conclusion: The present study has made it possible to identify the locations on Cotonou’s road network where road safety interventions could be implemented to protect VRUs.

Purpose: Post-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals. Materials and Methods: An institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05. Results: Out of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36– 29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38– 3.33), hospitalization (AOR = 1.87, 95% CI 1.21– 2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16– 8.25), and no return to work (AOR = 3.17, 95% CI: 1.99– 5.06). Conclusion: The prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin’s hospitals.