[Therapeutic patient education practices in Ivory Cost: investigation among health professionals] / Pratique de l'éducation thérapeutique du patient en Côte d'Ivoire : enquête auprès des professionnels de santé.

INTRODUCTION: Patient education is an important component in the management and monitoring of chronic diseases. It plays an important role in the decline of the disease severity, mortality and socioeconomic burden and the complications of these chronic diseases. In Côte d'Ivoire, there are few studies to evaluate the reality of this activity. OBJECTIVE: To explore the practice of patient education in Ivory Coast. METHOD: This qualitative study has been carried out by means of semi-structured interviews with 24 healthcare professionals including 14 health managers for individual interviews and 10 care providers for focus group discussion. RESULTS: There are various representations of therapeutic patient education among health professionals. There was no real distinction between patient education and the broader concept of health education. Absence of national patient education policy, the lack of training in TPE and lack of experience of educational practice lead health professionals to realize an unstructured educational activity. CONCLUSION: These results show the need for Côte d'Ivoire to have a national policy of patient education to educate patients in accordance with international recommendations.

[Improved adherence to post-exposure prophylaxis through the use of mobile telephony at the Treichville anti-rabies center, Côte d'Ivoire.] / Amélioration de l'observance de la prophylaxie post-exposition par l'usage de la téléphonie mobile, Côte d'Ivoire.

OBJECTIVE: The objective of this study is to determine the effects of mobile telephony on the improvement of post-exposure prophylaxis compliance at the Abidjan anti-rabies center. METHODS: This is a descriptive and analytical cross-sectional study, which ran from September 2014 to May 2015. The data collection took place in two stages: first interview of all patients at the anti-rabies center at their first consultation, then a telephone interview three days after, only for those who had abandoned their prophylaxis. RESULTS: The results indicated that after telephone calls, the dropout rate dropped from 59.3% to 44.8%. Discontinuations were less frequent in patients who received a veterinary surveillance notice (ORa = 0.23, 95% CI [0.11-0.48]), who had at least one veterinary certificate (ORa = 0.25 95% CI [0.15-0.43]) or more than two doses of vaccine (ORa = 0.23, 95% CI [0.12-0.42]) before telephone call. However, dropout rates were high in patients aged 20 to 29 years (ORa = 2.66, 95% CI [1.25-5.68]) and in patients with category III exposure (ORa = 2.19, 95% CI [1.12-54.3]). CONCLUSION: These results show that mobile telephony is a useful tool for educating patients to adhere to post-exposure prophylaxis. However, information and public awareness campaigns on the fatal outcome of rabies must be organized.

Determinants of Fatal Road Traffic Injuries in Côte d'Ivoire from 2002 to 2011 / Déterminants des accidents mortels de la circulation routière en Côte d'Ivoire de 2002 à 2011.

Introduction : In most developing countries, with rapidly changing lifestyles, urbanization, and increasing numbers of vehicles, Road Traffic Injuries (RTI) are expected to have a growing impact on mortality and morbidity.The objective of this study was to identify factors associated with fatal RTI in Côte d'Ivoire.Methods : We conducted a cross-sectional study of data concerning RTI in Côte d'Ivoire over a ten-year period (2002 to 2011) from the Road Safety Office (RSO) database. All RTI reported by the police were included in the study. Fatal RTI was the dependent variable, while sociodemographic, behavioural and environmental risk factors were independent variables. Data were analysed using SPSS Version 16 software.Results : Out of a total of 56,966 reported RTI, 3008 were fatal, representing 0.6 deaths per 100,000. The majority (93.5%) of RTI occurred in urban areas. Pedestrian victims were identified in more than one half (59.3%) of cases. Subjects under the age of 18 and subjects between the ages of 43 and 47 years had 2.4-fold and 4.9-fold higher risks of fatal accidents, respectively. Excessive speed (OR = 5.3 ; p = 0.000) and dangerous overtaking (OR = 4.9 ; p = 0.000) were the leading causes of fatal accidents. Mechanical failure was also a risk factor (OR = 3.9 ; p < 0.005). The risk of a fatal accident was 6.8-fold higher in rural areas than in urban areas.Conclusion : Fatal RTI were related to human and environmental factors, hence the need for awareness campaigns to promote behaviour changes among road users.

[Socioeconomic factors influencing exclusive breastfeeding among primiparous women in Abidjan (Ivory Coast)]. / Facteurs socioprofessionnels et pratique de l'allaitement exclusif par les primipares à Abidjan (Côte d'Ivoire).

OBJECTIVE: To ensure complete adhesion of primiparous women with exclusive breastfeeding, we need to understand the factors influencing this practice. The objective of this study was to determine the socioeconomic factors related to exclusive breastfeeding of infants less than six months old born to primiparous mothers. METHODS: This cross-sectional descriptive and analytical study was conducted over a two-month period from 4 June to 6 August 2012 in three health facilities in the city of Abidjan. A total of 188 primiparous women were surveyed by a direct face-to-face questionnaire-based interview technique. RESULTS: The mean age of primiparous women was 26.56 ± 5.05 years. The majority (76.60%) were in a couple relationship and 40.43% had completed higher education. 36.17% of women were working, while 23.94% were students. Only 33.51% of women performed exclusive breastfeeding. Exclusive breastfeeding rates decreased progressively with increasing age of the infant, from 46.67% at the age of one month to 16.67% at the age of six months. Factors associated with failure to perform exclusive breastfeeding were marriage, working in the public or private sector, delivery in a private health facility, delivery by caesarean section, living in Cocody, and lack of knowledge concerning exclusive breastfeeding. CONCLUSION: It is essential to take socio-economic factors into account when developing strategies designed to increase exclusive breastfeeding rates and maintenance of exclusive breastfeeding until the age of six months among primiparous women in Abidjan.

[The quality of immunization services in community centers in Abidjan, Côte d'Ivoire]. / Qualité des prestations vaccinales des centres sociaux publics d'Abidjan, Côte d'Ivoire.

In addition to health care centers, other institutions such as community centers are also involved in providing immunization services, the purpose being to address the inadequate provision of services in this area. The purpose of this study was to assess the quality of immunization services provided by non-medical staff. A cross-sectional descriptive study was conducted over the course of two months in the 15 public community centers providing immunization services in Abidjan. Data collection was performed by two physicians using three questionnaires (one for center managers, one for vaccinators and one for vaccine recipients) and two observation checklists (to assess vaccination equipment and to observe the behaviors and practices of vaccinators). The study found that none of the centers had a generator. One community center had no refrigerator. Refrigerators were not placed in a ventilated area in 14.3 % of the centers and were not exclusively used for the storage of vaccines in 26.7 % of the centers. None of the centers had an incinerator. 21.1 % of staff did not know the correct storage temperature. In 88.9 % of cases, the swab used to stop bleeding was also used to clean the injection site. The injection site was not sterilized in 10.8 % of cases. 73.9 % of the recipients did not know what vaccine they had been administered, while 95 % of the recipients did not know the date of their next vaccination appointment. The results indicate that immunization services in public community centers have many shortcomings. To address these issues, it is necessary to implement a training policy and to provide appropriate equipment and supervision.

[Evolution of gender-based violence during the emergence of COVID-19 pandemic in Greater Abidjan (March 2020-May 2021)]. / Évolution des violences basées sur le genre lors de l'émergence de la pandémie de COVID-19 dans le Grand Abidjan (Mars 2020-Mai 2021).

In Côte d'Ivoire, a country of 28 million inhabitants in West Africa, a survey conducted by the Ministry of the Family in 2018 showed the extent of gender-based violence (GBV) in the Greater Abidjan area (5 million inhabitants), the country's economic capital. The social workers employed for this work were mobilized during the Covid-19 pandemic to raise awareness and help the population fight against SARS-CoV-2. The results collected by these workers during the first period (January 2019 - February 2020) and the second period (March 2020 - April 2021) are the subject of this article.From the first period to the second, the number of rapes increased from 41 to 77, sexual assaults from 4 to 7, physical assaults from 139 to 171, and forced marriages from 4 to 7. In total, the social workers helped 303 victims during the pre-pandemic period and 402 during the pandemic. This evolution varies from municipality to municipality in the Greater Abidjan area, and is not related to the number of inhabitants per municipality and without any link with the frequency of Covid-19 in each municipality. Despite possible biases, this study highlights a major health problem, GBV, and demonstrates the probable negative effects of the pandemic.

[Prevalence and determinants of childbirth at home in two vulnerable neighborhoods of Yopougon (Abidjan), Côte d'Ivoire]. / Prévalence et déterminants des accouchements à domicile dans deux quartiers précaires de la commune de Yopougon (Abidjan), Côte d'Ivoire.

A household survey was conducted from February 13 to May 12, 2006, to determine the frequency of childbirth at home in two vulnerable districts of the township of Yopougon, and to identify the factors that determine this choice. We interviewed all women residing in these districts who gave birth during the period from January 2005 to the date of our investigation. This study showed that 17% of deliveries took place outside of a maternity ward. Most of the women interviewed, averaging 26 years of age, were illiterate and had no professional occupation; 64% were unaware of the risks associated with pregnancy and home birth. Furthermore, 25% of these women found the services and the reception at the maternity hospital to be poor and 54% felt the cost of delivery at the maternity ward to be too high. Factors that promote the choice of home birth are geographic and financial inaccessibility, ignorance of women and the poor perception of maternity services. All of the determining influences that can sway and impact a women's decision on where to give birth should be taken into account in order to improve the use of maternity services and reduce the frequency of home childbirth without medical assistance.