[Abortion practices in high school students in Yamoussoukro, Côte d'Ivoire]. / Pratiques d?avortement chez des lycéennes à Yamoussoukro, Côte d?Ivoire.

INTRODUCTION: Induced abortion is illegal in Cote d'Ivoire, except when the mother's life is in danger. The primary objective of this study was to describe abortion practices among Yamoussoukro high school students. More specifically, this study estimated the prevalence of induced abortion, described the pathway and the methods used for abortion and determined any abortion-related complications. MATERIAL AND METHODS: This cross-sectional study was conducted in July 2011 on 312 randomly selected girls attending the Lycée Jeunes Filles in Yamoussoukro. RESULTS: These girls had a mean age (SD) of 16.1 (4.7) years; 258 (82.7%) of them had already had sexual intercourse and 81 (31.4%) had already been pregnant. Fifty (61.7% [56.3-67.1%]) of these 81 girls had already had an abortion. The abortion pathway was as follows: the main method was self-prescribed medication (70%) as first attempt, followed, in case of failure, by traditional healers (56.4%). Healthcare practitioners were usually consulted at the third attempt (85.7%). The most commonly used methods of abortion were drugs (91.9%), ingestion of plants/beverages (68.5%) and introduction of devices into the uterine cavity (62.3%). Twenty-two (44%) out of 50 induced abortions resulted in complications, mostly infectious complications (81.8%), and bleeding (68.2%). Complications were significantly associated with self-induced abortions or abortions performed by traditional healers (p < 0.001). CONCLUSION: More intensive sexual education, access to modern methods of contraception, awareness campaigns concerning the risks related to unwanted pregnancies and abortions performed by non-medical personnel need to be implemented to prevent school abortions. The quality and accessibility of post-abortion services also need to be reinforced.

[Preparation of healthcare workers against the threat of Ebola virus disease in Ivory Coast]. / Préparation du personnel de santé d’une région sanitaire de Côte d’Ivoire face à la menace du virus Ebola.

INTRODUCTION: Since the declaration of the Ebola virus disease outbreak in West Africa, the government of Ivory Coast has organized the training of medical staff in all health regions of the country. This study was conducted one month after this training in order to assess the knowledge, attitudes and practices of health workers concerning Ebola virus disease in an Ivory Coast health region their preparation in relation to this disease. METHODS: In May-June 2014, we conducted a descriptive cross-sectional study of 176 health workers from private and public health facilities in 5 health districts. RESULTS: Among the respondents, 15.5% attended the training on Ebola disease organized by the Ministry of Health. They knew that the disease is transmitted from animals to humans by body fluids (85.6%), and from human to human by body fluids of a sick person or a cadavre (82.8%). 96% said they were at risk of contracting the disease. DISCUSSION: In view of the persistent threat of the disease, ignorance of certain aspects of the disease could be a weakness in the prevention of nosocomial transmission of the disease. Knowledge of the disease should lead to adoption of prevention measures. However, routine use of protection equipment, including gloves, depends on its availability. CONCLUSION: The lack of infection prevention and control equipment could be a weak point in preparation of the response to an Ebola disease outbreak.

[Effect of reproductive health services restructuring on antenatal care at Marcory General Hospital, Ivory Coast]. / Effet de la réorganisation des services sur les consultations prénatales à l’Hôpital Général de Marcory, Côte d’Ivoire.

INTRODUCTION: Improvement of the work environment and staff training are health promotion strategies that can contribute to improving the supply of health care. This study evaluated the effects of reorganization of health services on antenatal care (ANC) activities. MATERIALS AND METHODS: A cross-sectional study was conducted over a period of 4 months in the ANC unit of Marcory General Hospital in Abidjan. The study population was health workers in charge of ANC and pregnant women attending the health facility. Self-administered questionnaires and observation sheets were used to collect data that were analysed with Epi Info 3.5.1 software. results: After reorganization, health workers said they were satisfied with the work environment and the care provided in 91% and 96.9% of cases, respectively. These results were confirmed by all pregnant respondents (100%) attending the centre, who said they were satisfied with the quality of care received. This could explain the ANC 4 coverage rate, which increased from 39.4% in 2010 to 56.7% in 2012 and tetanus vaccination coverage which increased from 59.4% to 87.5%, although the waiting time was still too long. CONCLUSION: This study showed an increase of ANC activity indicators, such as ANC 4 and tetanus vaccination coverage rate, after reorganization of health care services. This strategy could be an opportunity to strengthen ANC services.

[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.

[Urban alcohol consumption among secondary school students in Côte d'Ivoire]. / Consommation d'alcool en milieu urbain chez les élèves du secondaire en Côte d'Ivoire.

INTRODUCTION: Alcohol consumption is both a health and social risk factor. Few studies have been conducted on alcohol use among students in Côte d'Ivoire. This study was designed to determine factors associated with alcohol consumption among secondary school students in Côte d'Ivoire. METHODS: A cross-sectional study was conducted in May 2011 among public secondary school students in Abidjan. One class for each year of study was randomly selected. Multivariate analysis was conducted between alcohol consumption and independent variables. RESULTS: A total of 316 students participated in the survey. The mean age (SD) of the study population was 16.1 (2.7) years. One hundred and fourteen respondents (36.1%) reported having already drunk alcohol. Age of first alcohol consumption was 10-14 years among girls (48.8%) and 15-19 years among boys (49.3%). Multivariate logistic regression identified the following factors associated with alcohol use among students: Christian religion, more pocket money, living with parents who drink alcohol and the student's perception of alcohol as a refreshing drink or having an antidepressant effect. CONCLUSION: In the light of the determinants of alcohol consumption and the students'suggestions in our study, it appears essential to involve students in actions concerning alcohol abuse.

[Knowledge, attitudes and practices of household heads regarding rabies in the Abobo district (Abidjan, Côte d'Ivoire) in 2008]. / Connaissances, attitudes et pratiques des chefs de ménage de la commune d'Abobo (Abidjan, Côte d'Ivoire) en matière de rage, en 2008.

INTRODUCTION: In order to investigate the factors predisposing to human rabies in Abobo, we conducted a study to assess the knowledge, attitudes and practices of household heads in this district. MATERIALS AND METHODS: This cross-sectional study was conducted from 13 September to 13 December 2008 and consisted of interviewing, by means of a questionnaire, household heads or their representatives at home. We randomly selected 53 households in each sub-district, with a total of 702 households for the 13 sub-districts. Informed consent was obtained from each participant prior to the interview. Data were analysed using Epi-Info 2000. RESULTS: Of the total of 152 households, 22% had a pet; 109 (71.7%) households had a dog, that was not vaccinated in 38% of cases. Furthermore, 577 (82.19%) of household heads knew about rabies and school was the source of information for 511 households (88.6%). Five hundred fifty five household heads (96.18%) did not know that the wound should be washed with soap and water immediately after exposure and 118 household heads (20.45%) reported that nothing should be done after a bite. After exposure, only 30.70% of household heads would attend a health centre 50 kilometres from home. CONCLUSION: This study shows a good level of knowledge of household heads concerning rabies. However, harmful health practices persist. Public awareness of rabies therefore needs to be reinforced.

[Knowledge, and attitudes of Civil Society Organizations in the implementation of the Expanded Program on Immunization in Côte d'Ivoire]. / Connaissances et attitudes des organisations de la sociéteé civile à la mise en oeuvre du Programme élargi de vaccination de routine en Côte d'Ivoire.

INTRODUCTION: The objective of this study was to assess the level of involvement of leaders of Civil Society Organizations (CSOs) in implementation of routine EPI activities. METHODS: This was a cross-sectional descriptive study of the knowledge and attitudes of CSOs concerning implementation of routine EPI activities in the health district of Adiaké (Côte d'Ivoire). RESULTS: This study shows that 77.1% of CSO leaders were literate and 92.9% of them were practicing Catholics or Muslims. They had a good knowledge of the existence of EPI (97.1%) and EPI target diseases, but were ignorant about the immunization schedule (82%). 90% of CSO leaders considered EPI to be an important activity for the prevention of childhood diseases. They considered the reception in immunization units to be satisfactory (60%) and believed that rumours about the sterility of women were the cause of refusal of vaccination by communities. Although 41.4% of leaders had participated in social mobilization activities, none had participated in the mobilization of resources. DISCUSSION: Vaccination was not rejected by CSO leaders, but their lack of participation in implementation of EPI could induce errors and lead them to believe the rumours and refuse vaccination of their community. CONCLUSION: The effective integration of the socio-cultural bases of communities in which immunization programmes are conducted will promote the adhesion of the people responsible for these programmes.

[The use of ultrasound to reduce maternal and neonatal mortality in a primary care facility in Ivory Coast]. / Apport de I'échographie dans la surveillance de la grossesse dans un établissement sanitaire de premier contact à Yopougon en Côte d'lvoire.

INTRODUCTION: In pregnancy care, ultrasound is used to detect pregnancy-related complications. The purpose of this study was to assess the use of ultrasound in monitoring pregnant women in a primary care facility for the purposes of reducing maternal and neonatal mortality. PATIENTS AND METHOD: A cross-sectional descriptive study was conducted from February 16, 2009 to April 16, 2009. Interviews were conducted with pregnancy women who had an ultrasound was recommended by a health worker or requested by the women. A Comprehensive recruitment strategy was used. The variables studied were sociodemographic characteristics, the indications or reasons for the ultrasound scan, the results of the ultrasound examination, the final diagnosis and the recommended behaviors. RESULTS: A total of 353 pregnant women aged between 15 and 45 years underwent an ultrasound examination. Sixty-six percent (66.3%) of the prescribers were midwives. In terms of pregmancy related pathologies, the main reasons for the ultrasound were pelvic pains (5.4%0, bleeding in the first trimester (4%0, and dystocia (3.7%). The main results were dystocic presentations (4.2%0, pregnancy loss (4%), and causes of bleeding in the first trimester (2.5%). As a result of these findings, 9.3% of at-risk women were sent to a specialized hospital. CONCLUSION: Ultrasound contributes to reducing maternal and dneonatal mortallity in primary care facilities. The results suggest that the health authorities need to improve equipment in primary care facilities to include ultrasound as a diagnosis tool in order to reduce maternal and neonatal mortality.

[Seroprevalence of HIV infection in the context of a mobile counseling and voluntary testing strategy in rural areas of Côte d'Ivoire]. / Séroprévalence de l'infection à VIH en conseil et dépistage volontaire par stratégie mobile en Zone rurale en Côte d'Ivoire.

INTRODUCTION: In Côte d'Ivoire, HIV testing and counselling has been identified as a priority in the National 2006-2010 AIDS Strategic Plan, which is designed to evaluate the prevalence of HIV in rural areas measured by means of a mobile strategy. METHODS: We conducted a cross-sectional descriptive and analytical study from 1st April, 2007 to 31st March 2008 in six rural areas of Côte d'Ivoire: Dabou, San Pedro, Abengourou, Tanda, Daloa, and Soubré*. The study population consisted of subjects attending the mobile voluntary counselling and testing units. RESULTS: The mean prevalence of HIV infection in this study was 5.30%. The mean prevalence rate in men was 5.26%, with a peak of 7.55% in the 30-34 years age-group. The mean prevalence rate in women was 5.35%, with a peak of 6.59% in the same age-group. Type HIV-1 was predominant (84.2% of the total). The most affected area was Dabou, with a rate three times higher (15.83%) than the average rate observed during the study. More educated people (university level) presented 3.5-fold (for men) or 6-fold (for women) higher infection rates than illiterate people. Although 100% of people who tested positive received a medical or community referral according to their specific needs, only 62.1% were first-line referred for medical care. CONCLUSION: In the light of the results of this study, we believe that community mobilization must be redirected to the most severely affected populations to facilitate earlier diagnosis. Actions such as training and prevention based on communication to encourage changes of behaviour should therefore be priorities in the national counselling and testing programme.