Déterminants du recours au test de dépistage du VIH chez les femmes en âge de procréer au Burundi.

INTRODUCTION: In sub-Saharan Africa, particularly in Burundi, uptake of HIV testing, which is fundamental to initiating treatment is relatively low. The present study aims to identify the individual and contextual determinants related to the uptake of HIV testing among women of childbearing age in this country. MATERIALS AND METHODS: This was an analysis of secondary data from Burundi's 2016-2017 demographic and health surveys. Our target population was women aged 15 to 49. Data were analyzed with the software stata 15.1. In bivariate analysis, the chi-square test and simple logistic regression allowed us to identify the candidate variables for modeling at the 20% threshold. Multilevel binary logistic regression made it possible to identify the individual and contextual determinants of the uptake of HIV / AIDS testing in these women. RESULTS: Out of a total of 8,537 women included in this study, 17.63% were between 15 and 24 years old, 46.44% between 25 and 34 and 35.93% between 35 and 49. The individual determinants of uptaking HIV testing were age, level of education, parity, marital status, decision-making power, and frequency of radio listening. Note that 1.36% of the use of the HIV testing was attributable to the region and the place of residence was an important variable of the context. CONCLUSION: This analysis of population data from DHS surveys in Burundi made it possible to identify the individual and contextual determinants influencing the uptake of HIV testing in Burundi. Further qualitative research should also address the contextual barriers that influence the uptake of screening.

[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.

[Predictors Of The Use Of Prenatal Care Among Women Who Have Given Birth In Burundi: A Multilevel Analysis]. / Predicteurs Du Recours Aux Soins Prenataux Chez Les Femmes Ayant Accouchees Au Burundi : Une Analyse Multiniveau.

OBJECTIVE: Identify the predictors of the use of antenatal care in Burundi. DATA AND METHODS: This were an analysis of secondary data from the 2016 - 2017 demographic and health surveys in Burundi. The survey population was women who gave birth in the last five (05) years prior to the survey and gave their informed consent. Our sample consisted of 7,372 women. The data were analyzed with Stata 15.1 software. In bivariate analysis, the Chi-2 test, and simple logistic regression allowed us to identify the candidate variables for modelling at the 20% threshold. Multilevel ordinal logistic regression identified individual and contextual predictors of prenatal care use. RESULTS: The use of antenatal care by women who gave birth in Burundi was influenced by the area of residence (rural area : OR=1.25; 95% CI [1.05 - 1.49]), level of education (secondary level: OR=1.36; 95% CI [1.12 - 1.65]), parity (OR=0.77; 95% CI [0.68 - 0.87]), HIV transmission during pregnancy (OR=1.22; 95% CI [1.06 - 1.41]) and internet use frequency (OR=1.60; 95% CI [1.16 - 2.20]). The intraclass correlation coefficient was (Ii 3 = 0.0050083). CONCLUSION: Consideration of these determinants in the development of strategies to improve antenatal care utilization is necessary.

OBJECTIF: Identifier les facteurs prédictifs du recours aux soins prénatals au Burundi. DONNÉES ET MÉTHODES: Il s'agissait d'une analyse de données secondaires provenant des enquêtes de démographie et de santé 2016 ­ 2017 du Burundi. Notre échantillon était constitué de 7372 femmes. Les données ont été analysées avec le logiciel stata 15.1. La régression logistique ordinale multiniveau a permis d'identifier les prédicteurs individuels et contextuels du recours aux soins prénatals. RÉSULTATS: Le recours aux soins prénataux par les femmes ayant accouché au Burundi était influencé par le milieu de résidence (milieu rural : OR=1.25 ; IC 95% [1.05 ­ 1.49]), le niveau d'éducation (niveau secondaire : OR=1.36 ; IC 95% [1.12 ­ 1.65]), la parité (OR=0.77 ; IC 95% [0.68 ­ 0.87]), la transmission du VIH pendant la grossesse (OR=1.22 ; IC 95% [1.06 ­ 1.41]) et la fréquence d'utilisation de l'internet (OR=1.60 ; IC 95% [1.16 ­ 2.20]). Le coefficient de corrélation intraclasse était (Ii 3 = 0.0050083). CONCLUSION: La prise en compte de ces déterminants dans l'élaboration des stratégies d'amélioration de l'utilisation des soins prénataux s'avère nécessaire.

Health service utilisation during the COVID-19 pandemic in sub-Saharan Africa in 2020: a multicountry empirical assessment with a focus on maternal, newborn and child health services.

INTRODUCTION: There are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women's, Children's and Adolescents' Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation. METHODS: Monthly routine health facility data by district for the period 2017-2020 were compiled by 12 country teams and adjusted after extensive quality assessments. Mixed effects linear regressions were used to estimate the size of any change in service utilisation for each month from March to December 2020 and for the whole COVID-19 period in 2020. RESULTS: The completeness of reporting of health facilities was high in 2020 (median of 12 countries, 96% national and 91% of districts ≥90%), higher than in the preceding years and extreme outliers were few. The country median reduction in utilisation of nine health services for the whole period March-December 2020 was 3.9% (range: -8.2 to 2.4). The greatest reductions were observed for inpatient admissions (median=-17.0%) and outpatient admissions (median=-7.1%), while antenatal, delivery care and immunisation services generally had smaller reductions (median from -2% to -6%). Eastern African countries had greater reductions than those in West Africa, and rural districts were slightly more affected than urban districts. The greatest drop in services was observed for March-June 2020 for general services, when the response was strongest as measured by a stringency index. CONCLUSION: The district health facility reports provide a solid basis for trend assessment after extensive data quality assessment and adjustment. Even the modest negative impact on service utilisation observed in most countries will require major efforts, supported by the international partners, to maintain progress towards the SDG health targets by 2030.

[A description of the yaws infection and prevention conditions in the health district of Adzopé]. / Description de la situation du plan dans ie district sanitaire d'Adzopé : cas des localités d'Asseudji.

This article reports on a cross-sectional study which aims to describe the situation of yaws in the boroughs of Asseudji located in the health district of Adzopé. The study's population group consisted of 206 household heads, and 2182 subjects who were tested and examined for yaws. The primary sources of pollution levels for a household were domestic animal waste (100%) and garbage stored in close proximity to the household's dwelling (49%). Signs of over-crowding were found in 43.7% of households. The sore "mother yaw" is the most common manifestation of yaws (81.5%). However, the majority of household heads were ignorant of the supporting causes and risk factors (64.1%) and the contagious natures of the infection (52.9%). Among the 2182 subjects examined, 11 (5%) had contracted yaws. The proportion of households with at least one case of yaws was 3.4%. The results of this census demonstrate that swift and strong action should be taken in these towns to prevent the outbreak of an epidemic.