Influence of vodou rites and initiation practices on incidence of early pregnancy in the maritime region of Togo.

Togo, like other sub-Saharan African countries, is not spared from the phenomenon of teenage pregnancies. Each year, on average, about ten cases of teenage student pregnancies are recorded in schools. Despite multiple efforts by the Togolese government and non-governmental organizations to stem this phenomenon, it still persists and is growing. This paper aims to analyse the influence of the Vodou workshop practice on the occurrence of adolescent pregnancies. The paper relied on analysis of 105 Key Informant Interviews in four villages in the maritime region. The results reveal that the Vodou rites and initiations practices constitute a major preventable factor in the causation of early pregnancies among teenagers in rural Togo.

Le Togo, à l'instar d'autres pays de l'Afrique sub-Saharienne, n'est pas épargné du phénomène des grossesses précoces. Chaque année, en moyenne, une dizaine de cas de grossesses des élèves d'adolescentes est enregistrée dans les établissements scolaires. Malgré de multiples efforts déployés par le gouvernement togolais et les organisations non gouvernementales pour endiguer ce phénomène, il persiste toujours, et prend de l'ampleur. L'objectif de cet article est d'analyser l'influence de la pratique du culte Vodou sur la survenue des grossesses des adolescentes initiées. La recherche est basée sur l'analyse de 105 interviews individuels conduites dans quatre localités dans la région maritime. Les résultats révèlent que les rites et initiations pratiqués dans les couvents Vodou constituent un facteur de prévention des grossesses précoces chez les adolescentes initiées.

Traditional socio-cultural practices and early pregnancies in Togo: Between social norms and violation of adolescent rights.

This article shows how certain traditional socio-cultural practices that influence the root causes of teenage pregnancy violate the rights of adolescents. The data came from the action-research entitled "Multisectoral and transformative approaches to rites and initiations for adolescent sexual and reproductive health rights", conducted by the Togolese Association for Family Welfare (ATBEF) in May 2022. The option is made for a qualitative approach. The information collected was recorded on dictaphones and then transcribed from the local languages of collection into French. Content analysis was used to write the research report. The results reveal that these practices, which are still prevalent in the localities of the study, and which exert pressure on adolescent girls, are also products of violations of many girls' rights.

Cet article montre en quoi certaines pratiques socio-culturelles traditionnelles qui influencent les causes profondes de la survenue des grossesses chez les adolescentes, constituent une violation des droits de ces dernières. Les données proviennent de la recherche action titrée « Approches multisectorielles et transformatrices des rites et initiations pour les droits en santé sexuelle et de la reproduction des adolescentes ¼, menée par l'Association Togolaise pour le Bien-Etre Familial (ATBEF) en mai 2022. L'option est faite pour une approche qualitative. Les informations collectées ont été enregistrées sur dictaphones puis transcrites des langues locales de collecte vers le français. L'analyse de contenu a été utilisée pour la rédaction du rapport de recherche. Les résultats révèlent que ces pratiques encore prégnantes dans les localités de l'étude et qui exercent des pressions sur les adolescentes, sont aussi des produits des violations de nombreux droits des filles.

Gendered socialization and sexual violence - A socio-anthropological study in Togo.

This article bases its argument on the social representations that justify sexual violence against adolescent girls and women and make it commonplace. It looks at the constructions of masculinity and femininity and their potential effects on the occurrence of sexual violence among adolescent girls. This is a socio-anthropological study carried out in the plateau regions of Togo. The empirical data came from individual semi-directive interviews (55), life stories (4) of adolescent rape victims and group interviews (40) with several stakeholders (adolescents, parents of adolescents, educators, community leaders and religious leaders). The results show that despite the efforts of the State and non-governmental organisations, local sexuality logics often have an impact on the persistence of sexual violence. (.

Cet article fonde son argumentaire sur les représentations sociales qui justifient et rendent ordinaires les violences sexuelles sur les adolescentes et les femmes. Il appréhende les constructions de la masculinité et de la féminité et leurs effets potentiels sur la survenue des violences sexuelles chez les adolescentes. Il s'agit d'une étude socio-anthropologique réalisée dans la région des plateaux au Togo. Les données empiriques proviennent d'entretiens individuels semi-directifs (55), des histoires de vie (4) d'adolescentes victimes de viol et des entretiens de groupes (40) avec plusieurs acteurs (adolescent(e)s, parents d'adolescent(e)s, éducateurs, leaders communautaires et leaders religieux). Les résultats révèlent que, malgré les efforts des acteurs de l'Etat et des Organisations Non Gouvernementales, les logiques locales de la sexualité ont souvent des incidences sur la persistance des violences sexuelles.

Initiatory rites, sexual activity, and early pregnancies of adolescent girls in the savannah region of Togo: Views of canton chiefs, priests and initiates.

Teenage pregnancy and marriage are major concerns in many schools in Togo, due to the large number of cases recorded each year by the Ministry of Primary, Secondary, Technical Education, and Handicrafts. The aim of this article is to describe the rites associated with early pregnancy and the perceptions held by the populations of Gando in the Savannah region. The study was based on documentary research and interviews with several actors, including initiating priests, canton chiefs, and young initiates. The results show that the rites: Okpenkpen, Tkonte, Ignogues have a link with early pregnancy, and the populations perceive them relatively well.

Les grossesses et mariages chez les adolescentes constituent une vive préoccupation dans beaucoup d'établissements scolaires au Togo en raison du nombre important de cas recensés chaque année par le Ministère des enseignements primaire, secondaire, technique et de l'artisanat. L'objectif de cet article est de décrire les rites ayant un lien avec les grossesses précoces et les perceptions qu'ont les populations de Gando dans la région des Savanes. Pour y parvenir, la méthodologie utilisée est basée sur la recherche documentaire et les entretiens avec plusieurs acteurs, entre autres, les prêtres initiateurs, les chefs de cantons et les jeunes initiés. Les résultats montrent que les rites : Okpenkpen, Tkonte, Ignogues ont un lien avec les grossesses précoces et les populations les perçoivent relativement bien.

Are children of key population individuals at higher risk of HIV than other children? Results from a multi-country analysis of routine program data.

INTRODUCTION: Children of key population individuals (CPK) often face the same stigma and discrimination as their parents, limiting their access to HIV services. The Meeting Targets and Maintaining Epidemic Control project analyzed pediatric HIV testing data from project-supported sites to better understand risk among CKP and improve comprehensive prevention, testing, and treatment for KP families. METHODS: We conducted a retrospective analysis of routine program data collected October 1, 2021-September 30, 2022, in project-supported sites in Burundi, Côte d'Ivoire, Democratic Republic of Congo, Tanzania, and Togo. We compared HIV case finding (defined as the percentage of children diagnosed with HIV among those who were tested) and treatment initiation (defined as the percentage of children diagnosed with HIV who were initiated on antiretroviral therapy) data for children <15 years disaggregated by index versus non-index testing and CKP versus children of non-KP individuals (non-CKP). RESULTS: A total of 5,651 children were tested (n = 2,974 index testing; n = 2,677 non-index testing). Of those diagnosed with HIV, 33% (181/541) were CKP, with case finding 17% (181 positive/1,070 tested) among CKP and 8% among non-CKP (360 positive/4,581 tested). Almost half of CKP diagnosed were ages 1-4 years. Among the 2,974 (53%) reached through index testing, overall case finding was higher among CKP (17%; 178 positive/1,052 tested) than non-CKP (11%; 219 positive/1,922 tested). Treatment initiation was 97% among CKP and 94% among non-CKP. DISCUSSION: CKP were identified primarily through index testing which, although considered a priority strategy to identify children at high risk, has not been widely used within KP family networks. Most CKP reached were children of female sex workers, but those of other KPs should also be prioritized. CONCLUSIONS: KP-focused programs have often excluded children, but the case-finding approaches in the project's KP programs were effective in reaching CKP. Comprehensive, family-centered KP programming is needed that includes family planning, prevention of vertical transmission, early infant diagnosis, and other maternal and child health services to reduce the impact of HIV on families and achieve an HIV-free generation.

Gender socialization and adolescent pregnancies in Togo.

The aim of this article is to understand the significance of the gender socialisation of adolescents and its impact on sexuality. This socio-anthropological study is based on qualitative surveys conducted as part of two action-research programmes implemented between 2018 and 2022 in Togo. The empirical data comes from individual semi-directed interviews, group interviews and life stories relating to the themes of sexuality, early pregnancy and gender-based violence. The results show that in these patriarchal societies, the socialisation of adolescents is structured around gender relations. The social construction of masculinity is based on a position of decision-making power for young boys, while that of femininity inculcates submissive behaviour in young girls. In these contexts, many young girls, even if they do attend school, find it difficult to express their opinions on matters of love and sex.

L'objectif de cet article consiste à appréhender la prégnance de la socialisation des adolescents.es et son impact sur la sexualité. Cette étude socio-anthropologique s'appuie sur des enquêtes qualitatives conduites dans le cadre de deux programmes de recherche action mis en œuvre entre 2018 à 2022 au Togo. Les données empiriques sont issues d'entretiens individuels semi-directifs, d'entretiens de groupes et de récits de vie relatifs aux thèmes de la sexualité, des grossesses précoces et des violences basées sur le genre. Les résultats indiquent que dans ces sociétés patriarcales, la socialisation des adolescents.es est structurée sur des rapports de genre. La construction sociale de la masculinité s'établit sur une position de pouvoir de décision des jeunes garçons tandis que celle de la féminité inculque aux jeunes filles des conduites de soumission. Dans ces contextes, de nombreuses jeunes filles, bien que scolarisées éprouvent des difficultés à exprimer leurs avis sur les questions amoureuses et sexuelles.

[Auricular and periauricular pathologies in the ENT department of Sylvanus Olympio Teaching Hospital in Lome (Togo)]. / Pathologies auriculaires et périauriculaires au service d'ORL du Centre hospitalier universitaire Sylvanus Olympio de Lomé (Togo).

Objective: The aim of this study is to describe the epidemiological aspects, clinical features and principles of management of different types of auricular and peri-auricular pathologies. Patients and Methods: This is a 5-year retrospective descriptive study (from May 1, 2018 to April 30, 2023) of the records of patients who consulted for a functional or cosmetic complaint relating to the auricle or periauricular region in the ENT and cervico-facial surgery department of the Centre hospitalier universitaire Sylvanus Olympio. Results: A total of 159 cases over 5 years, i.e. an annual frequency of 31 cases, met the study criteria. The mean age of the patients was 22.2 years. Children and students accounted for 24.5% and 23.9% of cases respectively. Auricular pathologies accounted for 64.8% of cases and peri-auricular pathologies for 36.2%.Tumors and trauma accounted for 33.3% and 29.6% of cases respectively, and congenital pathologies were found in 29.9% of cases. Among traumatic lesions, intentional assault and battery was the cause in 21.3%, followed by road accidents in 17.2%. The right ear was affected in 48% and the lobule in 40.4%. Keloids accounted for 17.6% of all cases, and 53% of tumors and pseudotumors. The left ear was involved in 50% of cases. Piercing was the cause of keloids in 10.7% of cases. Conclusion: Auricular and peri-auricular pathologies were dominated by benign tumors, trauma and congenital pathologies, and involved young subjects. Management is based on the type of lesion, with functional and aesthetic considerations in mind.

Using the role model approach to optimise caregiver administration of sulfadoxine-pyrimethamine amodiaquine to children aged 3-59 months in Burkina Faso, Chad and Togo: findings from an evaluation.

BACKGROUND: Seasonal malaria chemoprevention (SMC) is a World Health Organization-recommended intervention for the prevention of malaria among children at high risk in areas with seasonal transmission. During the coronavirus disease 2019 (COVID-19) pandemic, SMC drug distribution was rapidly adapted to reduce contact and mitigate the risk of transmission between communities and community distributors, with caregivers administering doses. To address the challenges and find local solutions to improve administration and adherence, the role model approach was designed, implemented and evaluated in selected communities of Burkina Faso, Chad and Togo. This paper describes the results of this evaluation. METHODS: Focus group discussions were held with primary caregivers in all three countries to understand their perceptions of the approach's acceptability and feasibility. In Burkina Faso and Togo, household surveys assessed the characteristics of caregivers reached by role model activities. Key indicators on SMC coverage and adherence allowed for an assessment of caregiver engagement outcomes related to participation in activities. Statistical associations between participation in study's activities and caregiver beliefs related to SMC had been tested. RESULTS: The majority of caregivers believed the approach to have a positive effect on drug administration, with most adopting the promoted strategies. Greater involvement of fathers in drug administration and acknowledgement of their joint responsibility was a notable positive outcome. However, several barriers to participation were noted and there was criticism of the group approach. In Burkina Faso and Togo, end-of-round survey results revealed that 98.4% of respondents agreed the approach improved their knowledge and skills in malaria prevention, while 100% expressed a desire to continue practicing the behaviours learned. However, there was a relatively low level of awareness of the approach among communities. Participation was strongly associated with participants' self-reported belief in ease of remembering to administer, and ease of administering, SMC medicines. CONCLUSION: Caregivers perceived the role model approach to be beneficial in aiding drug administration, with other positive impacts also reported. Replication and scale-up should utilize the most popular communication channels and existing community structures to ensure activities are promoted effectively. A mixture of group and one-on-one approaches should be used where appropriate and feasible.

Proactive home-based malaria management in rural communities of Bassar Health District in northern Togo from 2014 to 2017: PECADOM + , a pilot experiment.

BACKGROUND: Togo's National Malaria Control Programme has initiated an active home-based malaria management model for all age groups in rural areas of Bassar Health District. This report describes the model, reports its main results, and determines the factors associated with positive rapid diagnostic test results. METHODS: From 2014 to 2017, in three peripheral care units of Bassar Health District (Binaparba, Nangbani, and Baghan), community health workers visited residents' homes weekly to identify patients with malaria symptoms, perform rapid diagnostic tests in symptomatic patients, and give medication to positive cases. Univariate and multivariate logistic regression models were used to determine the factors associated with positive tests. RESULTS: The study covered 11,337 people (817 in 2014, 1804 in 2015, 2638 in 2016, and 6078 in 2017). The overall mean age was 18 years (95% CI 5-29; min-max: 0-112 years). The median age was 10 years (SD: 16.9). The proportions of people tested positive were 75.3% in Binaparba, 77.4% in Nangbani, and 56.6% in Baghan. The 5-10 age group was the most affected category (24.2% positive tests). Positive tests were more frequent during the rainy than during the dry season (62 vs. 38%) and the probability of positive test was 1.76 times higher during the rainy than during the dry season (adjusted OR = 1.74; 95% CI 1.60-1.90). A fever (37.5 °C or higher) increased significantly the probability of positive test (adjusted OR = 2.19; 95% CI 1.89-2.54). The risk of positive test was 1.89 times higher in passive than in active malaria detection (adjusted OR = 1.89; 95% CI 1.73-2.0). CONCLUSIONS: This novel experimental community and home-based malaria management in Togo suggested that active detection of malaria cases is feasible within 24 h, which allows rapid treatments before progression to often-fatal complications. This PECADOM + program will help Togo's National Malaria Control Programme reduce malaria morbidity and mortality in remote and hard-to-reach communities.

[Clinical, aetiological and therapeutic features of severe sickle cell related vaso-occlusive crisis at the Sylvanus Olympio University Hospital, Lomé]. / Crise vaso-occlusive drépanocytaire sévère: aspects cliniques, étiologiques et thérapeutiques au CHU Sylvanus Olympio de Lomé.

Introduction: vaso-occlusive crisis (VOC) is the most common manifestation of sickle cell disease and the leading cause of hospitalization among affected children. The purpose of this study is to describe the clinical features of severe VOCs, to determine the etiologies of infectious syndromes that accompany them and to describe their management. Methods: we conducted a descriptive cross-sectional study of 137 adult patients with sickle cell disease hospitalised for severe VOC in the Paediatric Department of the Sylvanus Olympio University Hospital from 1st January 2009 to 31st December 2011. Results: the majority of patients (n=98; 71.5%) had homozygous sickle cell (SS), followed by double heterozygous SC disease (n=28; 20.5). The median of consultation time was 4.7 ± 4.4 days. Treatment before admission was based on antibiotics (28.5%). VOCs were mainly osteoarticular (70.8%). In 98.5% of cases, an associated bacterial infection was confirmed (48.9%) or suspected (49.6%). The main etiologies included acute chest syndrome (26.3%), acute osteomyelitis (10.9%), urinary tract infection (6.6%) and septicaemia (3.6%). One germ was isolated from 14.6% of patients: Escherichia coli (30%), followed by Klebsiella pneumoniae (25%), Staphylococcus aureus (15%), Salmonella typhi (10%), Streptococcus pneumoniae (5%), Streptococcus D (5%), Enterobacter (5%) and Acinetobacter (5%). Mortality rate was 2.2%. The average length of stay in hospital was 11.4 ± 8.8 days. Conclusion: severe sickle cell-related vaso-occlusive crisis is mainly associated with bacterial infections in tropical environments. Appropriate and early antibiotic therapy is the essential therapeutic means to prevent or treat these patients.

Street adolescents in low income setting exposed to hepatitis B and C, and disadvantaged by lifestyle: a Togolese cross-sectional study.

BACKGROUND: In Togo, few data are available on viral hepatitis in street adolescents, a vulnerable population due to their lifestyle. The aim of this study was to describe the lifestyle of street adolescents (sexual practices and drug use), to estimate the prevalence of hepatitis B and C viruses, and to describe their HBV immunization profile in Togo. METHODS: A cross-sectional study was conducted in Lomé (Togo) in July 2021. Street adolescents aged between 13 and 19 years were included. A questionnaire was used to document lifestyle. ELISA tests were performed for Hepatitis B surface antigen (HBsAg), Hepatitis B core and surface antibodies (anti-HBc, anti-HBs), and antibodies against hepatitis C virus (anti-HCV). RESULTS: A total of 299 adolescents (5.4% female) with a median age of 15 years (IQR: 14-17) were included. Of these, 70.6% (211/299) were sexually active and 70.6% (149/211) had not used a condom during their last sexual intercourse. Drug use was reported by 42.1% of the adolescents. The most used substances were cannabis (39.0%), cocaine (36.6%), glue solvents (19.5%), and tramadol (11.4%). However, cocaine use may have been overestimated due to information bias. Current HBV infection (HBsAg+) was detected in 3.7% (95%CI: 1.9-6.5) of the adolescents. Isolated anti-HBc + was present in 5.3%. All three HBV markers (HBsAg, anti-HBs, and anti-HBc) were negative in 71.6% of adolescents. Anti-HCV was detected in 4.7% of adolescents. CONCLUSION: Nearly one in 10 street adolescents has markers for HBV contact/current infection, and approximately 72% of street adolescents may still be infected with HBV, as they have no HBV markers. HCV is also circulating in this population. Given the reported high-risk sexual practices and high levels of drug use, there is an urgent need to develop integrated strategies to prevent infections, including HBV, and drug dependence in this population.

Impact of ivermectin and vector control on onchocerciasis transmission in Togo: Assessing the empirical evidence on trends in infection and entomological indicators.

BACKGROUND: The World Health Organization's 2021-2030 Road Map for Neglected Tropical Diseases boosted global commitment towards the elimination of onchocerciasis, but the timeline to elimination will vary strongly between countries in Africa. To assess progress towards elimination in the Republic of Togo, we reviewed the history of control and time trends in infection. METHODOLOGY/PRINCIPAL FINDINGS: We collated all available programmatic, entomological, and epidemiological data since the initiation of the Onchocerciasis Control Programme (OCP) in Togo through different data sources. We then visualised data trends over time, to assess the impact of interventions on infection and transmission levels. Vector control was initiated by OCP from 1977 (northern and central parts of Togo) or 1988 (southern regions) up to 2002 (most areas) or 2007 ("special intervention zones" [SIZ], parts of Northern and Central Togo). Between 1988 and 1991, Togo initiated ivermectin mass drug administration (MDA) in eligible communities. The impact of vector control was high in most river basins, resulting in low annual biting rates and annual transmission potential declining to very low levels; the impact was lower in river basins designated as SIZ. Repeated, longitudinal ivermectin mass treatments have overall strongly reduced onchocerciasis transmission in Togo. Epidemiological surveys performed between 2014 and 2017 showed that the prevalence of skin microfilariae (mf) and anti-OV16 IgG4 antibodies had declined to low levels in several districts of the Centrale, Plateaux, and Maritime region. Yet, relatively high mf prevalences (between 5.0% and 32.7%) were still found in other districts during the same period, particularly along the Kéran, Mô and Ôti river basins (SIZ areas). CONCLUSIONS/SIGNIFICANCE: Trends in infection prevalence and intensity show that onchocerciasis levels have dropped greatly over time in most areas. This demonstrates the large impact of long-term and wide-scale interventions, and suggest that several districts of Togo are approaching elimination.

Epidemiology of alcohol use disorder in the general population of Togo and Benin: the ALCOTRANS study.

INTRODUCTION: Access to data concerning mental health, particularly alcohol use disorders (AUD), in sub-Saharan Africa is very limited. This study aimed to estimate AUD prevalence and identify the associated factors in Togo and Benin. METHODS: A cross-sectional study was conducted between April and May 2022, targeting individuals aged 18 years and above in the Yoto commune of Togo and the Lalo commune of Benin. Subjects were recruited using a multi-stage random sampling technique. AUD diagnoses were made using the MINI adapted to DSM-5 criteria. Our study collected sociodemographic information, data on psychiatric comorbidities, stigmatization, and assessed cravings, using a series of scales. The association between AUD and various factors was analyzed using multivariable logistic regression. RESULTS: In Togo, 55 of the 445 people investigated had AUD (12.4%; [95% CI: 9.5-15.7%]). Among them, 39 (70.9%) had severe AUD and the main associated comorbidities were suicidal risk (36.4%), and major depressive disorder (16.4%). Associated factors with AUD were male gender (aOR: 11.3; [95% CI: 4.8-26.7]), a higher Hamilton Depression Rating Scale (HDRS) score (aOR: 1.2; [95% CI: 1.1-1.3]) and a lower Stigma score measured by the Explanatory Model Interview Catalogue (EMIC) (aOR: 0.9; [95% CI: 0.8-0.9). The stigma scores reflect perceived societal stigma towards individuals with AUD. In Benin, 38 of the 435 people investigated had AUD (8.7%; [95% CI: 6.4-11.7]), and the main associated comorbidities were suicidal risk (18.4%), tobacco use disorder (13.2%) and major depressive episode (16.4%). Associated factors with AUD were male gender (aOR: 6.4; [95% CI: 2.4-17.0]), major depressive disorder (aOR: 21.0; [95% CI: 1.5-289.8]), suicidal risk (aOR: 3.7; [95% CI: 1.2-11.3]), a lower Frontal Assessment Battery (FAB) score (aOR:0.8; [95% CI: 0.8-0.9]) and a lower perceived stigma score (by EMIC )(aOR: 0.9; [95% CI: 0.8-0.9]). CONCLUSION: In these communes of Togo and Benin, AUD prevalence is notably high. A deeper understanding of the disease and its local determinants, paired with effective prevention campaigns, could mitigate its impact on both countries.

Any resurgence of leprosy cases in the Togo's post-elimination period? Trend analysis of reported leprosy cases from 2010 to 2022.

BACKGROUND: Leprosy, or Hansen's disease, is a chronic infectious disease caused by Mycobacterium leprae. Togo achieved the target of eliminating leprosy as a public health problem in 2000 (less than 1 case/10 000 population). However, new cases of leprosy are still being reported. The aim of this study was to describe and map trends of leprosy cases notified in Togo from 2010 to 2022. METHODS: This was a descriptive cross-sectional study covering a thirteen-year period from January 1, 2010, to December 31, 2022. The data of the study were leprosy surveillance system's data collected monthly between 2010 and 2022. The estimated number of leprosy cases and the incidence rate of leprosy cases were reported for the whole population by region, by district, by calendar year (2010-2022) and by target sub-population (children under 15, women and people with disabilities). Observed case incidence rates were mapped by health district and by year. RESULTS: From January 1, 2010, to December 31, 2022, 1031 new cases of leprosy were diagnosed in Togo. The median age of subjects was 46 years (interquartile range: 33-60), with extremes from 4 to 96 years. Half the subjects were women (50.7%). Variations in the leprosy incidence rate by year show an increase between 2010 and 2022, from 0.7 cases /100,000 population to 1.1 /100,000 population respectively. From 2010 to 2022, the proportion of cases in children remained low, between 0 and 9%. The proportion of women fluctuated between 39.7% and 67.2% between 2010 and 2017, then stabilized at an average of 50% between 2018 and 2022. The proportion of multi-bacillary leprosy cases increased quasi-linearly between 2010 and 2022, from 70 to 96.6%. Mapping of leprosy cases showed that leprosy was notified in all Togo health districts during the study period, apart from the Lacs district, which reported no leprosy cases. CONCLUSION: Togo has achieved the elimination of leprosy as a public health problem. However, the increase in the number of new leprosy cases and the proportion of leprosy cases in children indicate that transmission of the disease is continuing and that supplementary measures are needed.

Knowledge, attitudes, and practices of health care professionals regarding dengue fever: need for training and provision of diagnostic equipment in Togo in 2022, a cross-sectional study.

Background: Health statistics on dengue are virtually non-existent, despite the fact that the virus is circulating in Togo. This study aimed to assess the knowledge, attitudes, and practices (KAP) of health professionals in the Kara health region. Methods: A cross-sectional study was conducted from March to June 2022 among healthcare professionals who had worked in the Kara region of northern Togo were selected using an exhaustive recruitment method. Data were collected by trained resident doctors with a face-to-face interview using a standardized, pretested questionnaire based on the WHO 2009 dengue guide. Three multivariate regression models were utilized to investigate factors associated with knowledge, attitudes and, and practices. Results: A total of 464 respondents (37.1% female), median age 35 years, interquartile range (29-43 years) were included. Only (3.0%) of the participants had received training on dengue fever diagnosis, treatment and prevention in the last 3 years, and 10.3% had dengue rapid diagnostic tests available at their hospital. Half of the respondents (49.1%) had good knowledge of dengue fever, compared with 30.0% who had positive attitudes. Of a total of 256 professionals who had encountered a case of dengue fever in their practice, only 24 (9.4%) had appropriate practices for diagnosing and treating dengue fever. In multivariate analysis, the healthcare professionals who had taken part in ongoing training on dengue fever were more likely to have adequate dengue diagnosis and treatment practice aOR = 8.1; CI 95% = [1.7-36.0]. Conclusion: Strengthening healthcare professionals' dengue-related skills through ongoing training and the provision of dengue diagnostic tests could help improve early detection practices and management of dengue fever in Togo.

Use of gynaecological care by young women in Togo: focus on students and analysis of the determinants at the University of Lomé.

OBJECTIVES: The study aims to gain a better understanding of the needs and health behaviours of young women at the University of Lomé (Togo) with regard to gynaecological care. STUDY DESIGN: The data comes from a self-administered online survey. METHODS: A logistic regression was applied to model the likelihood of non-use of gynaecological care. RESULTS: Among the 281 women who completed the survey, 75% declared they had not consulted a gynaecologist or healthcare professional for a question related to intimacy or contraception in the last 12 months, mainly because of the financial barrier (65%). But needs do exist as 73% of women would like to be able to consult for such reasons. Multivariate analysis shows that increasing age (21-24 years, odds ratio [OR] = 0.442, P value < 0.05); 25-33 years, OR = 0.190, P value < 0.001), practicing Christian religion (OR = 0.331, P value < 0.1), being insured (OR = 0.398, P value < 0.05), having a father with primary education level (OR = 0.320, P value < 0.05) were protective factors. In contrast, the size of the households [6-8 members, OR = 2.763, P value < 0.1), and the student's income (Q2, OR = 3.136, P value < 0.05; Q3, OR = 2.993, P value < 0.05; Q4, OR = 4.433, P value < 0.001) favoured a higher probability of non-use of gynaecological care. CONCLUSION: Gynaecological needs are real among young women, and gynaecological health promotion is a necessity among this cohort. Quality health promotion can be achieved practically through the enlargement of health insurance, and partnership with healthcare professionals as well as community/religious leaders. This would further demystify biases related to seeking gynaecological care.

Epidemiological, clinical, therapeutic and evolutionary specificities of the association between venous thromboembolic event and cancer in sub-Saharan Africa: Case of Togo.

BACKGROUND: Our study aimed to describe the clinical, paraclinical, therapeutic and outcomes of patients with venous thromboembolic event (VTE) associated with cancer in the context of limited resources. MATERIALS AND METHODS: This was a descriptive cross-sectional study over a period of six years from March 1, 2016 to March 31, 2022, in the cardiology department and the oncology unit of the Sylvanus Olympio Teaching Hospital of Lome. Our study examined medical records of patients who were at least 18 years old and had venous thromboembolic disease and cancer that was histologically confirmed. This study did not include records that were incomplete or records from patients with coronavirus disease. RESULTS: Our study included 87 patients with average age of 56.36±15.26 years. The discovery of VTE occurred incidentally in 28.74%. Venous thrombosis was isolated in 68.96% and proximal in 95%. Pulmonary embolism was bilateral in 77.77%. Gynaecological and urological cancers were found in 33.33% and 32.19% respectively. Adenocarcinoma was the histological type of cancer found in 47.13%. Cancers were at a very advanced stage in 74.71%. Treatment with antivitamin K was prescribed in 12.65%. In our study, there were 58 patients who passed away with a mortality rate of 66.66%. The cause of death was a complication of VTE in 22.42% and related to the course of cancer in 63.79% of cases. CONCLUSION: VTE during cancer is particular with a fatal evolution due to the severity of VTE and the very advanced stage of cancer.

Health status and public health needs in a Togolese child health care centre modelled after the Dutch system.

BACKGROUND: The charity foundation Association Soutien Enfants Togo started a child health care (CHC) centre in Togo that was modelled after the Dutch high-quality CHC system to improve child health. AIM: To describe health care data of children who visited the centre. SUBJECTS AND METHODS: Data were routinely collected between October 2010-July 2017. Outcomes were completed vaccinations, growth, development, lifestyle, physical examination, and laboratory testing results. RESULTS: In total, 8,809 children aged 0-24 years were available. Half (47.5%) of children aged 0-4 years did not receive all eligible free vaccinations from the government. The proportions of stunted children (all) or with a developmental delay (0-4 years) were 10.1% and 9.5%, respectively. In total, 40-50% of all children did not wash their hands with soap after toilet or before eating, or did not use clean drinking water. Furthermore, 5.1-6.6% had insufficient vision, high eye pressure or hearing loss. Sickle cell disease was detected in 5.3%. CONCLUSION: A large group of children in need of prevention and early treatment were detected, informed and treated by the centre. Further research is needed to confirm if this strategy can improve children's health in Sub-Saharan Africa. Our data are available for further research.

Balto and Togo during the cold winter of Alaska (1925): the two canine heroes in the fight against diphtheria.

In recent years, diphtheria has re-emerged in areas with inadequate vaccination coverage, and Europe has not been spared with several cases among migrants. Diphtheria is a potentially fatal infection caused mainly by toxigenic strains of Corynebacterium diphtheriae. Due to the high mortality rate, especially among young children, the fight against diphtheria is considered one of the first conquests of immunization. In the history of medicine, there is a unique case of an unconventional response to a diphtheria outbreak in which sled dogs were used to overcome the supply difficulties of diphtheria antitoxin. The mass media followed the medical response to the outbreak and raised audience awareness of public health issues. The facts of Nome, Alaska, in 1925 can serve as a catalyst to rethink conventional responses to diphtheria outbreaks in low-income countries today and promote mass media awareness of public health importance.