Acceptabilité de la vaccination contre la COVID-19 chez les professionnels de santé en Côte d'Ivoire, 2021.

Objective : Faced with the uncertainty about the acceptability of COVID-19 vaccination, we conducted this study to better guide communication strategies for health worker adherence to vaccination.Methods : We conducted a cross-sectional study for analytical purposes, from 15 to 26 February 2021 among health workers in health facilities in the Gbêkê health region.Results : Health workers were predominantly female (53.5 %) and the 30-39 age group was the most represented (52 %). Television was the main source of information (74.4 %). The respondents knew that they were at risk of contracting COVID-19 (82.5 %) and that people with co-morbidities were the most victim of severe forms (70.4 %). The majority of respondents systematically wear a mask in hospital (91%). They said that 51.1 % of them would get vaccinated. The majority of respondents would systematically wear a mask in hospital (91 %). Multivariate analysis shows that vaccine acceptability was statistically associated with fear of dying from the disease (p=0.046) and case management (p=0.026).Conclusion : In order to achieve better adherence to COVID-19 vaccination, it would be necessary to strengthen the capacity of these agents.

The Thai Red Cross protocol experience in Côte d'Ivoire.

Rabies is a public health problem in the world especially in Côte d'Ivoire. The epidemiological surveillance of rabies revealed 10,197 exposures with 17 deaths in 2015 and 11,481 exposures with 18 deaths in 2016. The management of exposed people was based on WHO's intramuscular (IM) protocols (Essen and Zagreb). The usual results from these anti-rabies protocols showed low compliance corresponding to 45-50% exposed people who did not complete the Post Exposure Prophylaxis (PEP) schedule,mainly due to the cost of vaccines. The main objective of the project was to test the feasibility of a free rabies PEP based on the Thai Red Cross (TRC) protocol used by intradermal route. The study population was exposed people (patients) vaccinated in the anti-rabies center of Bouake and San Pédro which were two departments selected for this study. The TRC protocol was implemented in y ear 2017. Patients have been vaccinated according to IM post exposure protocols or by the TRC schedule.This new protocol was administered free of charge to exposed people with their consent. Patients who did not complete the PEP schedule were researched and interviewed for having the reasons related to this non-completion. In 2017, 1625 exposures were registered including 1121 in Bouaké and 504 in San Pedro. Overall immunization compliance was 63%. Patients who received the TRC schedule were 829 (52%)With 70% PEP compliance The PEP compliance of Zagreb protocol was 67%%and the Essen protocol recorded 38% of PEP compliance. The research of exposed people who did not complete the PEP schedule has shown that cost effectively remains the major limiting factor among exposed people vaccinated by Essen or Zagreb protocols. But negligencewas main cause for the non-completion PEP among exposed people who accepted the TRC schedule. Introduction of free rabies PEP through the TRC protocol has found the population support. This experience has been successful with a better PEP compliance, which means safe protection of people from rabies.This study has demonstrate that free rabies vaccine used by ID route is one of the best solutions to improve the PEP compliance in Côte d'Ivoire.Nevertheless, alternatives ways should be provided in order to minimize vaccine wastage rates in anti-rabies center receiving very few exposed persons.Community engagementwould be necessary for more rabies awareness raising and improving bite victim's follow-up.

Risk factors for rabies in Côte d'Ivoire.

Rabies affects more than 150 countries worldwide. Côte d'Ivoire is one of the rabies-endemic countries that has recorded deaths every year since 2006. The evolution of these deaths is almost constant with an average of 18 annual deaths (annual incidence = 0.06-0.08 per 100,000). Children predominate among these victims. However, prevention measures exist in anti-rabies centers distributed throughout the country. The objective of this study was to determine the factors related to rabies risk in Côte d'Ivoire through Gavi rabies project entitled 'Impact of rabies and immunization in Central and West Africa'. The implementation was conducted from 2016 to 2018 in two departments of Côte d'Ivoire (Bouake and San Pedro). The study population was dog-bite victims vaccinated in anti-rabies centers of project sites from January to December 2016. Two non-free rabies immunization protocols are used in the country (Essen and Zagreb). Information was collected from bites victims for an adequate follow-up. It was to apprciate the risk of developing rabies through access to care, the immunization status of biting animal, the category of exposure and the result of rabies post exposure prophylaxis (compliance). Local program implementers responsible for these bite-management activities and veterinary staff had receved training and the necessary material. The public health education and information dissemination activities were carried out in support of promoting a wide spread of rabies prevention messages. Household surveys were conducted by sociology students in 4002 households each in urban and in rural areas. This activity helped to find people exposed by dogs and who did not receive any Post Exposure Prophylaxis (PEP). The study registered 1,263 bite victims in pilot anti-rabies centers in 2016, 51% of them were children. People living in urban areas were strongly represented (87%) because of anti-rabies centers proximity. Dog was the most animal associated to exposure (94%). Seventy-two percent (72%) of them had owners, but only 14% were vaccinated against rabies. More than half of dog bite victims had category III of exposure (58%). PEP compliance record was very low (37%), which means that 63% of bite victims have not completed the protocol. This study conducted in Bouaké and San Pedro showed somes factors responsible for rabies deaths evolution in Côte d'Ivoire. Main issues identified are the geographical accessibility of anti-rabies centers, frequent bites caused by unvaccinated dogs, often category III of exposure and many non-completions of rabies PEP in ignorance context. The establishment of national comprehensive and integrated rabies control program is needed in Côte d'Ivoire. It must take into account all these factors by focusing on public awareness, dog vaccination and adoption of modern intradermal vaccination regimens to better manage rabies situation in Côte d'Ivoire.

Perceptions and practice of health care workers regarding hepatitis B vaccination, Bouaké, Côte d'Ivoire, 2016.

Barriers to immunization are seen in both the general population and the health care workforce. We conducted this study to determine the perception of health workers on vaccination and the immunization of their patients. This cross-sectional descriptive analytical study was carried out among the medical staff in Bouaké, from 10 January to 07 March 2016. The data collected from the interviews were analyzed using Epi info 2000 software and SPSS 17.0. The Chi-2 test and logistic regression were performed and the significance threshold of the tests was 5%. The vaccination status of the 291 health care workers (HCWs) for the hepatitis B virus (HBV) was statistically related to their participation in the course in vaccination during their training (ORa = 1.69, 95% CI: 1.04-2.75 P<0.05) and the systematic verification of the vaccination status of the patient was statistically related to the vaccination status of the HCW (ORa = 4.33, 95% CI: 2.97-8.18, P<0.05). Promoting the vaccination among the population should be dependent on the promotion among HCWs.