First report of an Ivorian family with nonsyndromic hearing loss caused by GJB2 compound heterozygous variants.

The primary etiology of congenital hearing loss is attributed to genetic factors, with GJB2 identified as a pivotal gene across diverse ethnic groups. Additionally, nonsyndromic hearing loss is predominantly inherited in an autosomal recessive manner. We used Sanger sequencing to analyze GJB2 in 17 deaf children from 13 unrelated Ivory Coast families. One family had two children born with severe congenital deafness and exhibited pathogenic compound heterozygous variants. These variants included a nonsense substitution (c.132G > A or p.Trp44Ter) and a newly discovered duplication of 7 base pairs (c.205_211dupTTCCCCA or p.Ser72ProfsTer32). Segregation testing confirmed these variants, marking the first identification of GJB2 in an Ivorian family with congenital hearing loss.

Decomposing Education-Based Inequalities in Pre-Exposure Prophylaxis Knowledge for HIV Prevention Among Women in Cote d'Ivoire.

Background: Antiretroviral chemoprophylaxis is a promising strategy for preventing the spread of human immunodeficiency virus (HIV). The knowledge of pre-exposure prophylaxis (PrEP) is required for intervention uptake and adherence to prevent the spread of HIV. This study aimed to decompose education-based inequalities in PrEP knowledge for HIV prevention among reproductive-aged women in Cote d'Ivoire. Methods: A cross-sectional study design with a nationally representative sample of 12,934 women aged 15-49 years was analyzed from the 2021 Cote d'Ivoire Demographic and Health Survey. The survey was conducted between September to December, 2021. The outcome variable was the knowledge of PrEP for HIV prevention. Statistical analysis was conducted using percentage, concentration index, and Lorenz curve. The level of significance was set at p<0.05. Results: A weighted prevalence of 14.5% (95% CI: 12.5-16.3%) was estimated for PrEP knowledge for HIV prevention. Overall, educated women had a higher knowledge of PrEP for HIV prevention (Conc. Index= 0.225; SE= 0.012; p<0.001). Across the levels of women's characteristics, the results showed higher PrEP knowledge for HIV prevention among educated women. Education (Contri: 40.7327%, Ec: 0.5390), exposure to internet (Contri: 20.1039%, Ec: 0.3484), place of residence (Contri: 12.9801%, Ec: -0.0537), household wealth (Contri: 10.0062%, Ec: 0.0642) and religion (Contri: 5.7509%, Ec: 0.0354) were positive contributors to PrEP knowledge for HIV prevention. On the other hand, age (Contri: -8.8298%, Ec: -0.0950) and region (Contri: -3.5942, Ec: -0.0768) were negative contributors to PrEP knowledge regarding HIV prevention among women of reproductive age in Cote d'Ivoire. Conclusion: There is limited knowledge of PrEP for HIV prevention among women in Cote d'Ivoire. Educated women had greater knowledge of PrEP for HIV prevention. The results of this study could guide interventions targeted to enhance the knowledge of PrEP as an HIV prevention option.

Treatment adherence in retinoblastoma: A retro-prospective cohort study in Ivory Coast and the Democratic Republic of Congo.

BACKGROUND: In high-income countries, retinoblastoma is curable in more than 95% of cases, whereas in low-income countries, mortality remains high, especially when the diagnosis is made late or the treatment is discontinued. AIMS: To determine the factors associated with adherence to the treatment of retinoblastoma in the Ivory Coast and the Democratic Republic of Congo (DRC). METHODS AND RESULTS: A retro-prospective cohort study was carried out. Data were collected from patient folders and follow-up records of parents. RESULTS: A total of 175 children with retinoblastoma were registered from January 2013 to December 2015. Seventy-six children (43%) were 5 years old and above. Care costs were covered by families in 86.9% of cases. Chemotherapy refusal was recorded in 39 cases (22.3%), and enucleation refusal was recorded in 79 cases (45.1%). After 36 months of follow-up, we recorded 16.6% deaths, 27.4% treatment dropouts, and 18.3% loss to follow-up after treatment. The commonest cause for enucleation refusal was fear of infirmity, while chemotherapy refusal and absconding treatment were due to financial constraints. CONCLUSION: Poor adherence to retinoblastoma management was due to financial constraints, and a lack of knowledge of the disease and its treatment. Family psychosocial support is needed to improve this condition.

Residents' perception and impact of COVID-19 on ecotourism in West Africa: The case of Banco National Park in Côte d'Ivoire.

Ecotourism, as a means of fostering socio-economic level of local communities and contributing to the conservation of forest resources, is important for development in low-income countries. This work investigates the extent to which local people support the continuation of ecotourism during the COVID-19 pandemic and their attitudes towards resource conservation in Banco National Park in Côte d'Ivoire using social exchange theory (SET) as a foundation. A closed-ended questionnaire was used to conduct a survey with 150 informants selected among residents around the park. The data were analyzed using descriptive, correlational, and Partial Least Squares Structural Equation Modelling (PLS-SEM) approaches. The results showed that residents' perception of the impacts of ecotourism strongly affects their support for tourism development during the COVID-19 pandemic (ß = 0.918, p < 0.05). The socio-cultural (ß = 0.275, p < 0.05) and environmental (ß = 0.309, p < 0.05) benefits of ecotourism are the key determinants of the residents' perception and their support for ecotourism within the park during COVID-19 pandemic. The findings also revealed that economic benefits from ecotourism are linked to residents' perceptions of the qualities of the tourism place (ß = 0.363, p < 0.05). Overall, local people around Banco Park recognize that ecotourism produces more benefits than detriments. The COVID-19 pandemic, a painful and unexpected event, has not blunted their support for the continuation of ecotourism. This study calls for the integration of local residents' opinions in the development of the ecotourism sector in Côte d'Ivoire. It is a first step in determining residents' attitudes towards ecotourism in West Africa in a post-COVID context, and the results constitute a starting point for future studies.

Assessment of cyanotoxins in water and fish in an African freshwater lagoon (Lagoon Aghien, Ivory Coast) and the application of WHO guidelines.

In comparison with northern countries, limited data are available on the occurrence and potential toxicity of cyanobacterial blooms in lakes and ponds in sub-Saharan countries. With the aim of enhancing our knowledge on cyanobacteria and their toxins in Africa, we performed a 17-month monitoring of a freshwater ecosystem, Lagoon Aghien (Ivory Coast), which is used for multiple practices by riverine populations and for drinking water production in Abidjan city. The richness and diversity of the cyanobacterial community were high and displayed few variations during the entire survey. The monthly average abundances ranged from 4.1 × 104 to 1.8 × 105 cell mL-1, with higher abundances recorded during the dry seasons. Among the five cyanotoxin families analyzed (anatoxin-a, cylindrospermopsin, homoanatoxin, microcystins, saxitoxin), only microcystins (MC) were detected with concentrations ranging from 0 to 0.364 µg L-1 in phytoplankton cells, from 32 to 1092 µg fresh weight (FW) kg-1 in fish intestines, and from 33 to 383 µg FW kg-1 in fish livers. Even if the MC concentrations in water and fish are low, usually below the thresholds defined in WHO guidelines, these data raise the issue of the relevance of these WHO guidelines for sub-Saharan Africa, where local populations are exposed throughout the year to these toxins in multiple ways.

[Epidemiology of malaria in the French Armed Forces]. / Épidémiologie du paludisme dans les armées françaises.

Because of the individual morbidity and lethality and the resulting collective incapacity, malaria has always been a risk for the Armed Forces in operation. The fight against malaria is a real public health plan carried out by the Armed Forces Health Service (SSA) for the benefit of the Forces. This plan has four main components: vector control, which targets larvae and adult mosquitoes of the genus Anopheles, personal vector protection, which limits human-vector contact, chemoprophylaxis, and early diagnosis and treatment of malaria.Since 2001, the epidemiology of malaria in the Armed Forces have suffered from large-scale epidemics during operational engagements in Côte d'Ivoire, Guyana and the Central African Republic. The start of a military operation is accompanied by strategic and logistical priorities that take precedence over prevention. In addition, the rigorous application of personal protection measures remains difficult and even more so in a combat situation.The development of urban malaria in Africa, the use of causal chemoprophylaxis, the alternative to "nothing but insecticides", and the development of efficient diagnostic tools allowing for early and adapted management are the challenges ahead for the SSA.

Disclosure of HIV status and adherence to antiretroviral treatment in children and adolescents from Lomé and Abidjan.

Introduction: in Africa, the proportion of minors with AIDS is ever increasing and adherence to treatment protocols is still suboptimal. The study investigated the conditions of HIV status disclosure and adherence to treatment in patients < 19 in two West African cities. Methods: in 2016, thirteen health professionals and four parents filled out questionnaires to identify problems and solutions relative to disclosure of HIV status and adherence to treatment in 208 children and adolescents seen at University Hospitals in Abidjan (Ivory Coast) and Lomé (Togo). Results: medians (extrema) of patients´ ages at start and end of status disclosure process were 10 (8-13) and 15 (13-17.5) years. In 61% of cases, disclosure was made individually after preparation sessions. The main difficulties were: parents´ disapproval, skipped visits, and rarity of psychologists. The solutions proposed were: recruiting more full-time psychologists, improving personnel training, and promoting patients´ "clubs". One out of three respondents was not satisfied with patients´ adherence to treatments. The major reasons were: intake frequencies, frequent omissions, school constraints, adverse effects, and lack of perceived effect. Nevertheless, 94% of the respondents confirmed the existence of support groups, interviews with psychologists, and home visits. To improve adherence, the respondents proposed increasing the number of support groups, sustaining reminder phone calls and home visits, and supporting therapeutic mentoring. Conclusion: despite persisting disclosure and adherence problems, appropriate measures already put into practice still need to be taken further, especially through engaging psychologists, training counsellors, and promoting therapeutic support groups.

Molecular epidemiology of non-falciparum Plasmodium infections in three different areas of the Ivory Coast.

BACKGROUND: Malaria is a major public health problem, particularly in the tropical regions of America, Africa and Asia. Plasmodium falciparum is not only the most widespread but also the most deadly species. The share of Plasmodium infections caused by the other species (Plasmodium ovale and Plasmodium malariae) is clearly underestimated. The objective of the study was to determine the molecular epidemiology of plasmodial infection due to P. malariae and P. ovale in Côte d'Ivoire. METHODS: The study was cross-sectional. The study participants were recruited from Abengourou, San Pedro and Grand-Bassam. Sample collection took place from May 2015 to April 2016. Questionnaires were administered and filter paper blood samples were collected for parasite DNA extraction. The molecular analysis was carried out from February to March 2021. A nested PCR was used for species diagnosis. The data was presented in frequencies and proportions. RESULTS: A total of 360 patients were recruited, including 179 men (49,7%) for 181 women (50,3%). The overall Plasmodium positive rate was 72.5% (261/360). The specific index was 77.4% and 1.5% for P. falciparum and P. malariae in mono-infection, respectively. There was also 15% P. falciparum and P. malariae co-infection, 3.4% P. falciparum and P. ovale co-infection and 2.3% P. falciparum, P. malariae and P. ovale triple-infection. Typing of P. ovale subspecies showed a significant predominance of P. ovale curtisi (81.2% of cases). CONCLUSION: Plasmodium falciparum remains the most prevalent malaria species in Côte d'Ivoire, but P. malariae and P. ovale are also endemic mostly in co-infection. Malaria elimination requires a better understanding of the specific epidemiological characteristics of P. malariae and P. ovale with a particular emphasis on the identification of asymptomatic carriers.

Specific Diversity of Helminth Parasites of the Edible Frog Hoplobatrachus occipitalis (Günther, 1858) in Agricultural Landscapes in the South-East of Ivory Coast, Africa.

OBJECTIVE: This study describes the specific diversity of Helminth parasites of the edible frog Hoplobatrachus occipitalis (Günther, 1858) to assess the rate of infestation in three types of plantations (coconut, palm and banana plantations) in the south-east of Africa. METHODS AND RESULTS: A total of 156 frog specimens were collected in November 2019 from all the plantations and ten parasitic Helminth taxa were recorded. The overall prevalence (93.6%) showed a high infestation of the frog in these anthropized environments. The banana plantations that use the most fertilizers and pesticides had the highest prevalence (95.2%) suggesting pollution-related parasitic load. The number of parasites was higher in female frogs than in males, suggesting a sex-specific immune resistance. This study also highlights the parasite specificity and the sites of Helminth infestations. Trematodes of the genus Haematoelochus and Diplodiscus showed strict specificity in the lungs and large intestine/rectum of the host. The other parasites colonized the digestive tract with a more or less marked specificity. CONCLUSION: Our study provides several elements of response on the population of Helminth parasites of the edible frog Hoplobatrachus occipitalis, with a view to better knowledge, management, conservation and protection.

Nonreplacement therapy for hemophilia in low-income countries: experience from a prospective study in Ivory Coast.

Background: Hemophilia management has fundamentally evolved over the last decades with the development of ground-breaking therapies. Because of their mode of action and biochemical properties, these innovative therapies that are available in developed countries could be readily implemented among people from low-income countries who are either not or inadequately treated with clotting factor concentrates (CFCs). Objectives: We aimed at evaluating the impact of prophylaxis with emicizumab, a bispecific monoclonal antibody mimicking the FVIII activity administered subcutaneously, among boys with severe hemophilia A (HA) from the Ivory Coast, where access to CFCs is limited to humanitarian aid. Methods: We prospectively collected data on the implementation and outcomes of prophylaxis with emicizumab, in 33 Ivorian boys aged 2 to 13 years with severe HA (with and without inhibitors). Bleeds, CFC consumption, quality of life and satisfaction of the patients and their parents were assessed. Results: Overall, 12 months after initiating emicizumab, a 99% reduction in bleeding rates was observed, with a raise from 18% to 100% of boys having zero spontaneous joint bleeds. Three boys required a single FVIII infusion following a traumatic bleed. Health-related quality of life measures significantly improved, and perception of treatment efficacy was positively rated in children and parents. Acceptance, tolerance, and adherence were excellent. Emicizumab was instrumental in successfully implementing uninterrupted, highly efficacious, and well-tolerated prophylaxis in 72% of the Ivorian children aged ≤ 13 years identified with severe hemophilia A. Conclusion: These data illustrate how innovative and disruptive nonreplacement therapies that are already accessible in developed countries could potentially provide equity in care by profoundly and rapidly modifying hemophilia burden with a magnified impact in low-income countries.

[Career choice of ivorian medical students at the end of curriculum: influencing factors and aspirations]. / Choix de carrière des étudiants en médecine ivoiriens en fin de cursus : facteurs d'influence et aspirations.

Introduction: The implantation of health structures in Côte d'Ivoire to improve geographical accessibility to care remains unequal between rural and urban areas. The medical student has to decide on his or her career choice in this context, while also taking into account personal preferences. The aim of our study was to evaluate the factors influencing the speciality choice of medical students at the faculty of medicine of Félix Houphouët-Boigny University in Abidjan. Methodology: Medical students enrolled in the 6th year completed an anonymous self-administered questionnaire. The questionnaire was in paper format and was divided into three parts: socio-demographic criteria; speciality choice; and factors influencing career choice. Students were asked to rate the extent to which they perceived each of the 24 items as influencing their career choice using a Likert scale ranging from 1 (no influence) to 5 (strong influence). The factors were compared according to the speciality choice (medical or surgical). Results: The 3 most chosen specialties were: cardiology (17.9%), gynaecology-obstetrics (15.7%) and paediatrics (9.6%). The desire to take the internship competition was more frequent among students who chose a surgical speciality (p = 0.02). The choice of a medical speciality was more influenced by the willingness to work part-time (p = 0.04). Students who choose a medical speciality were more guided by social commitment than those who chose a surgical speciality (p = 0.04). In contrast, the latter were more influenced by prestige among colleagues (p = 0.04) and immediate postoperative outcomes (p = 0.01). Conclusion: The efficient equipment of health structures could contribute to the development of other less chosen specialities by making them more attractive. A reorganisation of the system with the deployment of teachers in regional hospitals with a minimum of equipment is indispensable in order to allow a "decentralization" of the specialization curriculum, especially for the surgical specialties.As for the aspiration to part-time work, it can be explained by the need to reconcile family and professional life, but also by a sometimes unspoken project to develop a lucrative extra-medical activity in order to make up insufficient wages.

High level of heterozygous haplotype of hemoglobin in Abidjan population with mild malaria.

BACKGROUND: Sickle cell disease (SCD) is a hemoglobin disorders that concern 300,000 newborns each year around the world. There are hemoglobin haplotypes that affect SCD clinic expression. METHODS: Our goal was to identify the hemoglobin's haplotypes among individuals with mild malaria independently of SCD status in Côte d'Ivoire. To determine these haplotypes, specific restriction enzyme (RE) is used after PCR amplification with each primer. According to the digestion of PCR product by RE, five hemoglobin's haplotypes are found in the world. RESULTS: In Côte d'Ivoire, no study has yet deeply described the distribution of haplotypes. Four different "classical" haplotypes of hemoglobin were detected: Benin (56.5%), Bantou (28.5%), Senegal (4%), Cameroun (1%); and 10% of atypical profiles. Heterozygous haplotype (69%) were more frequent than homozygous haplotype (31%). CONCLUSIONS: In this preliminary study, we note a high prevalence of atypical and heterozygous haplotype. Benin haplotype that is associated with severity of SCD was most predominant in our studied population.

Impacts of nutrient loading and fish grazing on the phytoplankton community and cyanotoxin production in a shallow tropical lake: Results from mesocosm experiments.

Given the increasing eutrophication of water bodies in Africa due to increasing anthropogenic pressures, data are needed to better understand the responses of phytoplankton communities to these changes in tropical lakes. These ecosystems are used by local human populations for multiple purposes, including fish and drinking water production, potentially exposing these populations to health threats if, for example, an increase in toxic cyanobacterial blooms is associated with increasing eutrophication. To test the short-term response of the phytoplankton community to the addition of nutrients (phosphorus and nitrogen, alone or in combination) and Nile tilapia, we developed an in situ mesocosm experiment in a freshwater lagoon located near Abidjan (Ivory Coast). We found that phytoplankton growth (estimated by chlorophyll-a quantification) was highly stimulated when both nitrogen and phosphorus were added, while there was no clear evidence for such colimitation by these two nutrients when considering their concentrations in the lagoon. Phytoplankton growth was accompanied by significant changes in the diversity and composition of this community and did not lead to an increase in the proportions of cyanobacteria. However, the addition of fish to some mesocosms resulted in a drastic decrease in phytoplankton biomass and a dominance of chlorophytes in this community. Finally, these experiments showed that the addition of nitrogen, alone or combined with phosphorus, stimulated microcystin production by cyanobacteria. In addition, no evidence of microcystin accumulation in the fish was found. Taken together, these data allow us to discuss strategies for controlling cyanobacterial blooms in this tropical ecosystem.

Novel Lineage of Infectious Bronchitis Virus from Sub-Saharan Africa Identified by Random Amplification and Next-Generation Sequencing of Viral Genome.

Avian infectious bronchitis (IB) is among the major viral respiratory and reproductive diseases of chickens caused by Avian coronavirus. In the African continent, IB was first described in countries located in the Mediterranean basin. In other parts of the continent, the epidemiological situation of IB remains unclear. In this study, the complete genome sequences of five IBV strains, originating from the sub-Saharan area were determined. Phylogenetic analysis based on the full-length S1 sequences identified three lineages (GI-14, GI-16, and GI-19) common in Africa and revealed that a strain, D2334/11/2/13/CI, isolated in Ivory Coast may represent a novel lineage within genotype GI. The maximum inter- and intragenotype sequence identities between this strain and other IBVs were 67.58% and 78.84% (nucleotide) and 64.44% and 78.6% (amino acid), respectively. The whole-genome nucleotide identity of the novel variant shared the highest values with a reference Belgian nephropathogenic strain (B1648, 92.4%) and with another study strain from Ivory Coast (D2334/12/2/13/CI, 94.6%). This study illustrates the importance of epidemiological monitoring of IBV in sub-Saharan Africa, as the area may serve as a focal point for newly emerging viral lineages.

I Buy Medicines From the Streets Because I Am Poor: A Qualitative Account on why the Informal Market for Medicines Thrive in Ivory Coast.

The informal market for medicines has been growing. In Ivory Coast, this informal market is an unofficial core part of the health system. Given the risks associated with the informal market for medicines, it is important to understand why this market continues to grow. It becomes even more important in the context of COVID-19, as a huge chunk of falsified medical products end up at the informal market. A qualitative case study design was chosen for this study, with in-depth interviews (IDIs) and focus group discussions (FGDs) being the methods for data collection. 20 IDIs and 3 FGDs were conducted. Participants in this study are sellers, buyers, and pharmaceutical experts. We found out that the informal market for medicines thrives because it is highly accessible, convenient, affordable, and that it is used for various social, cultural, and religious reasons. The study concludes that although this informal market presents a clear danger to public health, it is thriving. For authorities to address this public health challenge, there is need for a holistic and multi-pronged approach, which includes addressing health systems factors and strengthening regulatory framework.

[Characteristic and evolution of pacemaker complications in a Subsaharan Africa Heart Centre]. / Caractéristiques et évolution des complications de la stimulation cardiaque dans un centre de cardiologie de l'Afrique de Subsaharienne.

AIM OF THE STUDY: The working environment and the low rate of pacemaker insertions increase the risk of complications in sub-Saharan Africa. The objective of our work was to assess the impact of specific preventive measures on these complications over the long term. PATIENT AND METHODS: We conducted a retrospective study of all pacemaker implantations from June 2006 to June 2016 at the Abidjan Heart Institute. We evaluated the incidence of pacemaker complications, their risks factors and their impact on the overall prognosis of patients. RESULTS: Three hundred and two procedures were performed in 286 patients (49% male, mean age: 67±12 years), with a predominance of primary implantation (82.8%) of single-chamber ventricular pacemakers (66.6%). Twenty-five major complications (8.27%) and 14 minor (4.6%) occurred with a predominance of lead displacements (3.64%). The major complications were favored by the subclavian approach (P=0.018; OR=2.34; 95% CI [1.16-4.75]) and intraoperative incidents (P=0.02; OR=2.17; 95% CI [1.16-4.75]. The preventive measures taken made it possible to achieve a significant (P=0.017) and linear (P=0.009) reduction of these complications, with no effect the patients prognosis (Log-Rank=0.217; P=0.64). CONCLUSION: Quality cardiac stimulation is possible in Sub-Saharan Africa with preventive measures adapted to the environment.

Dengue virus serotype 2 imported case from Côte d'Ivoire to Senegal, 2017.

Dengue fever is the most common arboviral infection worldwide. Its epidemiology in Africa is not yet fully understood due to the lack of awareness, the presence of other dengue-like febrile diseases, and insufficient laboratory capabilities. This paper reports on the import of dengue virus serotype 2 case from Côte d'Ivoire to Senegal in West Africa. Phylogenetic analysis based on full-length genome sequence revealed that the isolate clustered with strains of cosmopolitan genotypes from the Burkina Faso outbreak in 2016 and those from the ongoing dengue fever outbreak in Côte d'Ivoire. This suggests a possible spread of strains from the Burkina Faso outbreak to other West African countries including Côte d'Ivoire and Senegal.

[Study Of Musculoskeletal Disorders Among The Secretaries Of The Yopougon University Hospital Center - Ivory Coast]. / Etude Des Troubles Musculosquelettiques Chez Les Secretaires Du Chu De Yopougon-Côte D'Ivoire.

INTRODUCTION: Musculoskeletal disorders are the most common occupational disease in the world. They constitute a major health problem. METHODS: A cross-sectional study was carried out over a period of three months involving the secretaries of the Yopougon University Hospital. The data were collected using a questionnaire inspired by the National Research and Security Institute (INRS) questionnaire. RESULTS: The study found an exclusively female population with an average age of 40.6 years ± 8.6, mostly overweight or obese (71%). Almost half of the secretaries had more than ten years of seniority in the post (44.7%) and the absence of an ergonomic chair was noted in 84% of cases. In this population of 38 secretaries, the prevalence of MSDs was 89.5% with pain as the main symptom (89.5%). The preferred locations for MSDs were the dorsolumbar spine (78.9%) and the cervical spine (57.9%). The study showed a predominance of MSDs in the following populations: overweight secretaries (63.1%); more than ten years in the post (39.6%); poor working posture (68.4%); the use of a non-ergonomic seat (81.6%). CONCLUSION: Musculoskeletal disorders are common among secretaries. They are associated with many factors. It is imperative to implement preventive measures to reduce their risk of occurrence.

INTRODUCTION: Les troubles musculo-squelettiques (TMS) représentent la maladie professionnelle la plus courante dans le monde. Ils constituent un problème majeur de santé. MÉTHODES: Une étude transversale a été conduite sur une durée de trois mois ayant concernée les secrétaires du Centre Hospitalier et Universitaire(CHU) de Yopougon. Les données ont été recueillies à l'aide d'un questionnaire inspiré du questionnaire de l'Institut National de Recherche et de Sécurité (INRS). RÉSULTATS: L'étude a mis en évidence une population exclusivement féminine avec un âge moyen de 40.6 ans ± 8,6, en majorité en surpoids ou obèse (71%). Près de la moitié des secrétaires avaient plus de dix ans d'ancienneté au poste (44,7 %) et l'on a noté l'absence de siège ergonomique dans 84 % des cas. Dans cette population de 38 secrétaires, La prévalence des TMS était de 89,5 % avec la douleur comme symptôme principal (89,5 %). Les localisations préférentielles des TMS étaient le rachis dorsolombaire (78,9 %) et le rachis cervical (57,9 %). L'étude a montré une prédominance des TMS dans les populations suivantes : les secrétaires en surcharge pondérale (63,1 %) ; une ancienneté au poste de plus de dix ans (39,6 %) ; une mauvaise posture de travail (68,4 %) ; l'utilisation d'un siège non ergonomique (81,6 %). CONCLUSION: Les troubles musculo-squelettiques sont fréquents chez les secrétaires. Ils sont associés à de nombreux facteurs. Il est impératif de mettre en application les mesures préventives afin de réduire leur risque de survenue.

Artemisinin derivative-containing therapies and abnormal hemoglobin: Do we need to adapt the treatment?

BACKGROUND: Artemisinin-based treatment in malaria patients with abnormal hemoglobin may be ineffective because of their genetic particularity, which could lead to resistance. The main purpose of this study was to assess the effect of artemisinin derivatives on in vivo parasite clearance according to erythrocyte variants. In vivo response was investigated through retrospective data obtained over a 42-day artemether-lumefantrine/artesunate amodiaquine efficacy protocol conducted from 2012 to 2016. RESULTS: A total of 770 patients in Côte d'Ivoire attending the hospitals of Anonkoua-koute (Abidjan), Petit Paris (Korhogo), Libreville (Man), Dar es salam (Bouaké), Ayamé and Yamoussoukro with acute uncomplicated falciparum malaria were selected for successful hemoglobin typing. HbAS, HbSS, HbAC, and HbSC genotypes were found. Parasite clearance time was obtained for 414 patients. In the population with abnormal hemoglobin, parasite densities on admission and parasite clearance rates were significantly lower in the HbSC group compared to HbAA (p = 0.02 and p = 0.007, respectively). After PCR correction on day 42, the acute treatment rate was 100% for each group. Parasite half-life and time for initial parasitaemia to decline by 50 and 99% were longer for the HbSC group (p < 0.05). The study also investigated the prevalence of K13-propeller polymorphisms across different hemoglobin genotype groups. A total of 185 and 63 samples were sequenced in the HbAA group and patients with abnormal Hb, respectively. Only two nonsynonymous mutations D559N and V510M were found in the HbAA group. CONCLUSION: Although this study proved good efficacy of artemether-lumefantrine and artesunate amodiaquine in the treatment of uncomplicated Plasmodium falciparum malaria in patients with abnormal hemoglobin, the increased delay of parasite clearance may represent a threat to health in these patients in relation with sickle cell crisis, which could support selection of parasites resistant to artemisinin.

TITLE: Thérapies contenant des dérivés de l'artémisinine et hémoglobine anormale : faut-il adapter le traitement ? ABSTRACT: Contexte : Le traitement à base d'artémisinine chez les patients atteints de paludisme et présentant une hémoglobine anormale peut être inefficace en raison de leur particularité génétique, ce qui pourrait entraîner une résistance. L'objectif principal de cette étude était d'évaluer in vivo l'effet des dérivés de l'artémisinine sur la clairance du parasite en fonction des variantes érythrocytaires. La réponse in vivo a été étudiée à travers des données rétrospectives obtenues au cours d'un protocole d'efficacité de 42 jours artéméther-luméfantrine/artésunate-amodiaquine mené dans les années 2012 à 2016. Résultats : Un total de 770 patients en Côte d'Ivoire fréquentant les hôpitaux d'Anonkoua-koute (Abidjan), Petit Paris (Korhogo), Libreville (Man), Dar es salam (Bouaké), Ayamé et Yamoussoukro, présentant un paludisme aigu non compliqué à falciparum ont été sélectionnés pour un typage réussi de l'hémoglobine. Les génotypes HbAS, HbSS, HbAC et HbSC ont été trouvés. Le temps de clairance du parasite a été obtenu pour 414 patients. Dans la population avec une hémoglobine anormale, les densités parasitaires à l'admission et le taux de clairance parasitaire étaient significativement plus faibles dans le groupe HbSC par rapport au groupe HbAA (respectivement, p = 0,02 et p = 0,007). Le RCPA était de 100 % pour chaque groupe après correction par PCR au jour 42. La demi-vie du parasite et le temps nécessaire pour que la parasitémie initiale diminue de 50 et 99 % étaient plus longs pour le groupe HbSC (p < 0,05). L'étude a également examiné la prévalence des polymorphismes du gène K13 dans différents groupes de génotype d'hémoglobine. Un total de 185 et 63 échantillons ont été séquencés respectivement dans le groupe HbAA et chez les patients présentant une Hb anormale. Seules deux mutations non synonymes D559N et V510M ont été trouvées dans le groupe HbAA. Conclusion : Bien que cette étude ait prouvé la bonne efficacité de l'artéméther-luméfantrine et de l'artésunate amodiaquine dans le traitement du paludisme simple à Plasmodium falciparum chez les patients présentant une hémoglobine anormale, le retard accru de clairance parasitaire peut représenter une menace pour la santé de ces patients en relation avec la crise drépanocytaire, et peut favoriser la sélection de parasites résistants à l'artémisinine.

Viral and bacterial factors of mother-to-child transmission of hepatitis B virus.

Hepatitis B virus (HBV) infection is the tenth leading cause of death worldwide. Mother-to-child transmission of HBV occurring mainly at delivery remains one of the most common routes of infection in developing countries. One of the main challenges concerning HBV in Africa is to implement a prevention policy aiming at interrupting the cycle of pseudo-vertical transmission of this infection. The aim of this study was to assess the implication of certain bacterial and viral factors in mother-to-child transmission of HBV. This prospective study was conducted on 165 pregnant women carriers of HBV surface antigen (HBsAg) and their 169 newborns who attended care at the Gynecology Department of the University Hospital of Cocody. Serological, molecular, and bacteriological analyses were performed on blood samples and vaginal secretions. Mean viral load (VL) was 4.5 ± 1.3 log10  IU/ml, while mean HBsAg titres were 3.5 ± 0.9 log10  IU/ml. HBV DNA was found in vaginal secretions in 13.3% of mothers and in the blood of 10.3% of the newborns. Six bacterial species were identified in the vaginal discharge of pregnant women during labour before delivery. Staphylococcus aureus and Enterococcus faecalis were the most frequent species found in 23.0% and 13.9% of cases. Mothers positive for vaginal HBV DNA displayed higher plasma HBV DNA loads than negative mothers (6.2 ± 1.6 log10  IU/ml vs. 4.3 ± 1.0 log10  IU/ml, p < .0001). In conclusion, our study showed that presence of HBV DNA in vaginal secretions and the presence of S. aureus could play a role in mother-to-child transmission of HBV. HBV DNA detection in vaginal discharge represents a promising biomarker to identify newborns at risk of perinatal persistent infection.