[Sexual and reproductive health of adolescents living with HIV in pediatric care programs in Abidjan : Structured provision of care and perceptions of health care workers in 2019]. / Santé sexuelle et reproductive des adolescent(e)s vivant avec le VIH dans les programmes de prise en charge pédiatrique à Abidjan : offre de services des structures et perceptions des professionnels de santé en 2019.

INTRODUCTION: The majority of adolescents living with HIV (ALHIV) reside in sub-Saharan Africa, with sexual and reproductive health (SRH) needs to be met. The health care facilities and professionals involved have a major role to assume in the quality of SRH services offered to these teenagers. OBJECTIVE: To investigate the SRH services offered to ALHIV subjects in pediatric facilities in Abidjan, Ivory-Coast. METHODS: In 2019 we conducted an exploratory cross-sectional study using qualitative and quantitative methods in three pediatric facilities caring for ALHIV subjects (CIRBA, CTAP and CePReF) and participating in the IeDEA (International epidemiologic databases to Evaluate AIDS project) in Abidjan, Ivory Coast. This study included: (1) an inventory of SRH services, using a questionnaire and direct observation, describing their adaptation to the teenagers' needs and their inclusion in provision of care; (2 an assessment by means of semi-structured interviews of 14 health professionals' perceptions of the SRH needs of the ALHIV subjects with whom they worked. Quantitative data were expressed in percentages and qualitative data from the interviews were analyzed through inductive thematic analysis. RESULTS: The care provided in the three facilities was poorly adapted to the teenagers' needs. Few SRH services were effectively provided to the ALHIV subjects in the different centers. The services essentially consisted in condom distribution and organization of SRH-based focus groups. Exceptionally, hormonal contraception was offered to teenage girls. Barriers to the services were largely due to poorly equipped facilities, particularly in terms of SRH offer, health professionals' experience, and support provided for ALHIV subjects and their parents. The health professionals were desirous of SRH skill-building programs enabling them to deliver optimal, adequately contextualized SRH services to the teenagers. CONCLUSIONS: In pediatric programs addressed to ALHIV subjects in three Abidjan facilities, the teenagers' SRH needs remain unmet. It is urgently necessary to strengthen the health facilities by means of improved equipment, enhanced awareness of teenagers' needs, and training programs enabling the health professionals to provide more adapted sexual and reproductive health services.

First Report of Banana mild mosaic virus Infecting Plantain in Ivory Coast.

Plantain (Musa sp., genomic group AAB) is an important crop for millions of the world's poorest people. In Ivory Coast, it is the second most consumed food and an important source of income for farmers. Between 2010 and 2011, a survey for viruses infecting plantain (AAB) was conducted in 10 major plantain-growing regions located in eastern (Abengourou), middle-western (Bouaflé, Daloa, Issia, Oumé, Sinfra, Zuenoula), central (Yamoussoukro), and southern (Aboisso, Gagnoa) Ivory Coast. Leaf samples showing yellow streaks or mild chlorotic streaks were collected and dried on CaCl2 for storage. A representative sample from each location was selected and tested for the presence of Cucumber mosaic virus (CMV, genus Cucumovirus), Banana streak virus (BSV, genus Badnavirus), Banana mild mosaic virus (BanMMV, family Flexiviridae), and Banana bract mosaic virus (BBrMV, genus Potyvirus). Immunocapture (IC)-PCR was used for the detection of BSV while reverse transcription (RT)-PCR was used for the detection of CMV, BanMMV, and BBrMV. The following primers sets were used: BSV cl1 and BSV cl2 (1), CMV 3' and CMV 5' (3), BanMMV BanCP1 and BanCP2 (4), BBrMV Bract N2 and Bract NR (2). BanMMV was detected as mixed infections with BSV in the 10 tested samples, one of which also contained CMV. To confirm the identity of the amplification products from the BanMMV primers, one cDNA fragment was directly sequenced in the forward direction (Macrogen Inc., Seoul, South Korea). BLAST search in GenBank revealed that the partial coat protein (CP) sequence of the Ivorian isolate shared 80 to 88% nucleotides and 81 to 92% deduced amino acid similarities with BanMMV isolates. In contrast, partial CP sequence of the Ivorian isolate had less than 40% deduced amino acid sequence identity with other Flexiviridae CP sequence. The partial CP sequence of the Ivorian BanMMV isolate was deposited in GenBank under Accession No. JX014304. To further confirm the identification, all the samples were tested by plate trapped antigen (PTA)-ELISA with rabbit polyclonal antiserum specific to BanMMV (obtained from B. E. Lockhart, University of Minnesota, U.S.A.) and anti-rabbit IgG (Sigma-Aldrich, Belgium/A3687). The 10 samples reacted positive for BanMMV by ELISA. CMV and BSV have been reported in Ivory Coast, but to our knowledge, this is the first report of BanMMV in the country. The detection of BanMMV in association with BSV or CMV in mixed infection in 10 locations which are important plantain growing areas is a first step in the evaluation of the impact of virus diseases on plantain production in this country. References: (1) S. Dallot et al. Arch. Virol. 146:2182, 2001. (2) M.-L. Iskra-Caruana et al. J. Virol. Methods 153:224, 2008. (3) M. Sharman et al. J. Virol. Methods 89:77, 2000. (4) P.-Y. Teycheney et al. J. Gen. Virol. 86:3181, 2005.

[Complete immunization coverage and reasons for non-vaccination in a periurban area of Abidjan]. / Couverture vaccinale complete des enfants de 12 a 59 mois et raisons de non-vaccination en milieu periurbain abidjanais en 2010.

An immunization coverage survey was conducted among children aged 12-59 months in a suburban neighbourhood in Abidjan. The objective was to determine the complete immunization coverage, the reasons for non-vaccination and factors influencing the immunization status of children. The method of exhaustive sampling enabled us to interview the mothers of 669 children using a questionnaire. Overall vaccination coverage was 68.6% with 1.2%, with 1.2% of children never having received vaccine. The logistic regression analysis showed that the level of education, knowledge of the immunization schedule and the marital status of mothers, as well as the type of habitat, were associated with full immunization of children. These determinants must be taken into account to improve vaccination coverage.

[Ingestion of unusual foreign bodies in adults about two cases observed at the treichville university hospital center]. / Ingestion de corps etrangers insolites chez l'adulte a propos de deux cas observes au centre hospitalier universitaire de treichville.

Most of ingested foreign bodies passthrough the digestive tract spontaneously. The surgical care represents less than 1%. We report two cases of unexpected ingested foreign bodies treated surgically during the year 2019 in order to identify the surgical indications through a literaturereview. There were one woman and one man respectivelyaged 46 and 33. The accidentlyingestedforeign bodies werea denture and a toothbrush. An attempt to endoscopically extract the denture was unsuccessful. Peritonitis appeared as the complication in both cases. A radiography of unprepared abdomen showed the foreign body in the epigastic area, associated with a pneumoperitonitis in one case. Gastrostomy through laparotomy allowed to extract the foreign body without any complication. Surgery should be indicated either in complications or failure of endoscopic means to extractlocked foreign bodies.

La majorité des corps étrangers ingérés passent spontanément le long du tube digestif. Lerecours à la chirurgie représente moins de 1%.Nous rapportons deux cas de corps étrangers insolites ingérés et traités chirurgicalement au cours de l'année 2019afin d'en préciser les indications chirurgicales à travers une revue de la littérature.Il s'agissait d'une femme et d'un homme âgés respectivement de 46 et de 33 ans. Les corps étrangers accidentellement ingérésétaient un dentier et une brosse à dent.Une tentative d'extraction endoscopique du dentier a été pratiquée sans succès.L'évolutionétait marquée par la survenue d'une péritonite dans les deux cas. La radiographie de l'abdomen sans préparation (ASP) montraitle corps étranger dans l'aire épigastrique, associé à un pneumopéritoine dans un cas. Une gastrotomie par laparotomie a permis d'extraire le corps étranger avec des suites simples.La chirurgie doit être indiquée en cas de complications ou d'échec des moyens d'extraction endoscopique de corps étrangers enclavés.

[Acute respiratory distress syndrome secondary to a viper envenomation in children]. / Syndrome de détresse respiratoire aiguë secondaire à une envenimation vipérine chez l'enfant.

Viper envenomation is responsible for inflammatory disorders, hemorrhagic complications, and local or extended necrosis. The occurrence of respiratory complications such as Acute Respiratory Distress Syndrome (ARDS) is exceptional. We report on the case of a 15-year-old with no particular history who had, 24h after a viper bite, swelling of the right lower limb associated with blood dyscrasia. Despite the administration of antivenom treatment, the progression was marked by the onset of ARDS and the patient's death within 48h.

[Acute peritoneal tuberculosis in HIV-infected patients. Study of 4 cases in Abidjan, Côte-d'Ivoire]. / Péritonite aiguë tuberculeuse au cours de l'infection par le VIh. Etude de 4 cas à Abidjan, Côte-d'Ivoire.

This paper presents 4 cases of histologically verified peritoneal tuberculosis in HIV-infected patients followed in a 18 month-period. The patients were admitted in emergency and were suspected of present acute appendiceal peritonitis. There were 3 females of 18, 22 and 27 years old, and a 41-year-old male. The main symptoms were acute abdominal pain (4 cases), fever superior to 38 degrees C (4 cases) and abdominal defence (4 cases). Laboratory findings were hyperleucocytosis with lymphocytic predominance, anemia and CD4+ rate variable from 250 to 460/mm3. They underwent emergency laparotomy which led to diagnosis of peritoneal tuberculosis by histopathological analysis of peritoneal biopsies. Two patients died from surgery at days 3rd and 10th. The 2 remaining patients were successfully treated by tuberculostatic tritherapy with rifampicin, isoniazid, and pirazinamid. Acute peritoneal tuberculosis in HIV-infected patients is not to be missed in our practice. It must be considered in differential diagnosis of acute abdomens.

[Viper bite at the external genitalia in a child]. / Morsure de vipère des organes génitaux chez un enfant.

We report on a case of severe envenomation due to viper bites at the external genitalia in an 8-year-old child. The grade III poisoning involved hemostatic disorders and severe swelling. The patient consulted in a timely manner and recovered rapidly after antivenom FAV Africa(®) administration.

[Total rectal prolapse in adults: report of 26 cases in the Ivory Coast]. / Le prolapsus rectal total de l'adulte: étude de 26 cas en milieu ivoirien.

Several studies are still in progress to improve the results of rectopexy for treatment of full thickness rectal prolapse in adults. The purpose of this study was to evaluate etiologic factors of full thickness rectal prolapse in Ivory Coast and to describe results in 26 patients treated surgically in Africa over a period of 10 years. There were 23 men with ages ranging from 30 to 45 years and 3 women with ages ranging from 45 to 50 years. All three women were multiparous. Related factors in the men were chronic constipation in 69.2%, diarrhea in 11.5%, and dysuria in 7.7%. Fifteen patients (59.7%) presented anal incontinence prior to surgery. Rectoscopy was performed in 23 cases and findings were always normal. Barium enema x-rays were performed in 3 cases and demonstrated dolicho-colon. The Orr-Loygue rectopexy procedure was performed in 23 patients and direct rectopexy in 3 patients. No operative deaths occurred and no recurrences have been observed with a follow-up of 24 months. Constipation developed following surgery in two patients and persisted in all patients who presented this symptom prior to surgery. Progressive improvement was observed in all fifteen patients with preoperative anal incontinence. Based on these results, our current management strategy includes determination of colonic transit time to select indications for direct rectopexy with sigmoidectomy.

[Perineal gangrene: report of 30 cases observed at Abidjan]. / Gangrene perineale: a propos de 30 cas observes a Abidjan.

Perineal gangrene may be classified as primary, e.g. Fournier's gangrene of the external genitals, or secondary due to locoregional injury. Perineal gangrene is still a topic of interest in tropical zones where mortality remains high despite current therapeutic modalities. The purpose of this retrospective study was to analyze etiologic, bacteriologic, and therapeutic data in 30 cases observed over a one-year period in a surgical setting in the Ivory Coast. There were 26 men and 4 women with a mean age of 43 years. All were treated by extensive removal of necrotic tissue in association with antimicrobial therapy for the likeliest agent and appropriate supportive measures. Colostomy was performed in 6 cases and drainage of the urinary tract was required in 11 cases. Anti-tetanus treatment was administered in all cases. Thirteen patients were HIV-positive, five were diabetic, and two presented chronic renal insufficiency. Perineal gangrene was classified as secondary in 17 cases and primary (Fournier's gangrene) in 13 cases. Bacteriologic study of puss and tissue specimens collected from necrotic areas demonstrated a mixed population of microbial organisms predominated by streptococcus A (n = 19) and Escherichia coli (n = 13). Positive diagnostic results were obtained in 5 of 20 hemocultures and in 8 of 11 cystobacteriologic tests. Eight patients died and nine presented complications including necrosis of the testicles, atrophy of the testicles, shock, and coma. Healing was obtained without skin grafting in 22 survival cases but 5 of them required secondary suturing. The mean duration of hospitalization was 45 days. In our experience, perineal gangrene led to severe consequences despite adequate management especially in HIV-infected patients. The treatment of choice is still extensive emergency surgical removal (repeated, if necessary) of necrotic tissue in association with adequate supportive measures and wide spectrum antimicrobial therapy.

[Detection and management of the yellow fever epidemic in the Ivory Coast, 2001]. / Detection et gestion de l'epidemie de fievre jaune en Cote d'Ivoire, 2001.

From March to December 2001, an outbreak of yellow fever was observed in Cote d'Ivoire. Sentinel surveillance for hemorrhagic fever allowed detection of the first case in the Duekoue health district in the heavily wooded western part of the country. A weekly reporting system was established. For each suspected case recorded and reported to the Epidemiological Surveillance Department at the National Institute of Public Hygiene, a sample was collected and sent for confirmation at the Pasteur Institute of the Cote d'Ivoire. The outbreak progressed from West to East reaching Abidjan, the economic capital of the country located in the southeast. The epidemic emergency plan consisted of setting up a crisis committee to implement epidemiological, entomological and virological surveillance, mass vaccination campaigns in areas around confirmed cases, and vector control. A total of 280 cases were reported including 32 confirmed cases and 6 deaths. Eleven out of 62 districts were affected with most cases occurring in cities with more than 10000 inhabitants. Over 3.7 million persons were vaccinated for an overall coverage of 92.2% in the areas where campaigns were carried out. As a result of this outbreak, surveillance for potentially epidemic diseases has been reinforced and surveillance of viral transmission is now being considered. A vaccination program for adults has also been established.

[Investigation of urinary schistosomiasis outbreak in the primary school of the village Guébo 2, Abidjan, Côte d'Ivoire]. / Investigation d'un foyer épidémique de bilharziose urinaire dans l'école primaire du village de Guébo 2, Abidjan, Côte d'Ivoire.

We report the results of an outbreak investigation of urinary schistosomiasis in 2012 among school children at Guébo 2. Among the 250 school children, 107 (42.8%) had confirmed urinary schistosomiasis. Age ≥ 10y (OR = 2.6 [1.1 to 6.2]) and self-reported bathing in the river (OR = 14.0 [4.7 to 42.5]) were associated with the presence of S.h. in the adjusted analyses. A massive deworming of the population of Guébo-1&2 was conducted as epidemic-response.

Taxonomic diversity and structure of benthic macroinvertebrates in Aby Lagoon (Ivory Coast, West Africa).

The benthic macroinvertebrates of Aby lagoon (West Africa: Ivory coast) was studied during four seasons (high dry season, high rainy season, low dry season and low rainy season, respectively) from June 2006 to March 2007. The distribution of the benthic macroinvertebrates species was recorded at 13 stations on the whole of the lagoon. A total of 62 taxa of benthic macroinvertebrates belonging to 28 families and 10 orders were listed. The molluscs and crustaceans dominate qualitatively by adding up 51 and 24%, respectively of the total number of organisms. Five taxa (Corbula trigona (20%), Pachymelania aurita (12%), Clibernhardius cooki (7%), Oligochaeta (7%) and Crassostrea gasar (6%) accounted for 52% of total abundance. Classification analysis used to perform the characterisation of the lagoon on the basis of benthic macroinvertebrates showed the existence of four main clusters in which the seasonal pattern in benthic macroinvertebrates were very similar in the four seasons. In contrast the species richness and diversity indices were significantly different. Furthermore these indices where higher in the stations closer to the sea and surrounded by mangrove trees (southern area) compared to the inland ones.

[Splenectomy for splenomegaly in Ivory Coast. Indications and short term results]. / Splenectomies pour splenomegalie en Cote d'Ivoire. Indications et résultats précoces.

AIM: To study the indications and evaluate the short term results of splenectomy for splenomegaly. PATIENTS AND METHODS: This retrospective analysis concerned 31 males and 21 feméles with a mean age of 30,5 yersin old, from February 1998 to December 2003. The aetiologies of splenomegaly were parasites (n=6), benign haematological diseases (n= 24), haematological malignancies (n=6), infections (n=3) and cysts (n=3). The indications were due to hypersplenism in 39 cases (79,5%), risk of splenic rupture in 46 cases (88,5%), infection or risk of infection in 3 cases and painful splenomegaly in 3 cases. 49 nine patients underwent complete splenectomy and the 3 remaining had a partial splenectomy. A spleno-renal shunt in three cases, mesenterico-adrenal shunt and mesenterico-cave shunt were associated for portal hypertension. A lengthy penicillinotherapy in all the patients and thromboembolic prevention in some were performed. RESULTS: The mean hospital stay was 6.3 days. Correction of cytopenia and permanent pain relief occurred in all cases. One patient died from intraoperative haemorrhage and 2 other from unknown cause postoperatively (09%). Morbidity was due to hyperthermy in 3 cases, abdominal haemorrhage by splenic vessel ligation leakage and bridles obstruction in one case. CONCLUSION: This study shows that hypersplenism constituted the mean indication of splenectomy. Its low mortality and morbidity suggest that it might be usually used in our practice. These results may be improve by laparoscopic splenectomy and systematic prevention of postoperative complications.

[Chemotherapy in advanced rectal cancers]. / Chimiotherapie des cancers du rectum localement avances.

AIM OF THE STUDY: The aim of this retrospective study was to specify the therapeutic strategy in the management of locally advanced rectal cancers in our practice in front of lack of radiotherapy. PATIENTS AND METHODS: This study had concerned 52 patients suffering from locally advanced rectal cancers, with mean age of 44 years old (range: 22-68). Evaluation for down staging was based on clinical, CT scan and intraoperative features. Patients were classified as T4NXM0. Thirty one patients (57,7%) had left iliac colostomy associated with a neoadjuvant chemotherapy, 12 had a left iliac palliative colostomy and 9 had chemotherapy only. RESULTS: Thirty two patients (80%) suffered from digestive toxicity due to chemotherapy, 11 patients had hematologic toxicity and 4 other had skin and mucous toxicity. Between the thirty one patients who had colostomy and chemotherapy, 4 (12,9%) responded well and underwent to curative rectal resection, in the remaining patients, the colostomy stayed palliative. The median survey time was 9,5 months. CONCLUSION: Our poor results confirmed the need of early detection and radiotherapy in the management of our patients.

Biotransformation of ellipticine into 5-formyl ellipticine by Choisya ternata strains.

Sixteen Choisya ternata strains of same genotypic origin were examined for their capacities to biotransform ellipticine. Four strains were able to convert the drug into 5-formylellipticine with good yields. The reaction occurred only in agar medium and was different from ellipticine bioconversion by microorganisms or mammals.

Pathogens and predictors of fatal septicemia associated with human immunodeficiency virus infection in Ivory Coast, west Africa.

In East Africa, bacteremia is more common in hospitalized human immunodeficiency virus (HIV) type 1-positive than -negative patients. In 1991, blood cultures and clinical and laboratory data were obtained from 319 patients in Ivory Coast, where both HIV-1 and -2 infections occur. Forty-three bacterial, 10 mycobacterial, and 8 fungal pathogens were isolated from blood of 54 patients (17%). Pathogens isolated significantly (P < or = .05) more frequently from HIV-positive than -negative patients were nonmycobacterial bacteria, particularly Salmonella enteritidis; mycobacteria, particularly Mycobacterium tuberculosis-Mycobacterium bovis; and yeast or fungus. HIV-1 or -2 positivity was associated with a 3-fold increased risk for septicemia (P < .02). HIV-positive patients with fever or with lymphocyte counts < 1000 were more likely to be septicemic than those without these characteristics. Mortality increased significantly with HIV positivity (40% vs. 14%, P < .001) and, among HIV-positive patients, with having pathogens isolated from blood (63% vs. 33%, P < .001).