Evaluation of the impact of COVID-19 in people coinfected with HIV and/or tuberculosis in low-income countries: study protocol for mixed methods research in Burkina Faso.

BACKGROUND: An issue of particular concern is the impact of the 2019 novel coronavirus (2019 nCOV) on the people coinfected with the Human Immuno-deficiency Virus (HIV) and/or tuberculosis (TB). Unfortunately, this interaction has not been well explored in African despite the large proportion of these risk populations living with HIV and/or patients and/or tuberculosis (TB) in the African region. This study aims to design a research protocol for assessment of the impact of coronavirus disease 2019 (COVID-19) on these risk populations in response to COVID-19 strategic plans in Burkina Faso by generating serological, epidemiological, virological, clinical and socio-anthropological evidence-based data. METHODS: A multidisciplinary research will be conducted in the city of Bobo-Dioulasso, Burkina Faso using mixed methods. Data will be collected from a cohort of people living with HIV and/or TB patients in the city (i) to determine the proportion of people with specific antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using retrospective data ; (ii) to determine the proportion of people infected with Covid-19 and the dynamics of viral loads and antibodies in these people based on prospective data; (iii) to identify circulating SARS-COV-2 variants and novel biomarkers using prospective data ; (iv) to analyze perceptions, community experiences and response strategies during the public health emergencies imposed by COVID-19 through a qualitative study. DISCUSSION: This study will generate factual and comprehensive data that will contribute in improving response strategies to COVID-19 and the other possible emerging diseases with keen interest on the risk populations living with HIV and/or TB infected patients.

[From information to the decision: the motives of consent to a vaccine trial for hepatitis B in the Ivory Coast]. / De l'information à la décision: les motifs du consentement à un essai vaccinal contre l'hépatite B en Côte d'Ivoire.

Consent represents a key element in any biomedical research on humans. Ideally conceived as free from any constraints, informed by well-understood information and attested to by signature, its authorization in the context of clinical trials conducted in Southern hemisphere countries raises a certain number of difficulties. For this presentation, we studied the motivations of a group of Abidjan women (n=127) to participate or not, with their newborn, in a vaccine protocol trial against Hepatitis B called HEPACI. Consent seemed to stem from various decision-making factors. Firstly, it demonstrated a pragmatic strategy aimed at improving the care of the mother and child regarding healthcare institutions. This was followed by other factors, but according to levels of importance and variable intrications. Trust in the healthcare staff or in the clinical trial managers, the point of view of the spouse, the comprehension of information, the fears regarding the trial (fed or not by rumor phenomena) and the socio-political context also influenced the agreement of the participants.

Acceptability of tetanus toxoid vaccine by pregnant women in two health centres in Abidjan (Ivory Coast).

A study was conducted in two health centres in Abidjan, Ivory Coast (Abobo and Port Bouet) to compare the knowledge of pregnant women regarding tetanus and hepatitis B and to evaluate the acceptability of tetanus immunisation. A total of 124 women were interviewed. In spite of Information Education Communication (IEC) meetings held by midwives focusing on both diseases, knowledge about tetanus appeared to be substantially higher than that about hepatitis B. The acceptability of tetanus toxoid vaccine was good, the only barrier being the fear of useless injections. However, the risk of tetanus transmission during delivery should be better explained to women, who often give birth at home in the presence of traditional birth assistants. The awareness of men should also be raised by information campaigns, using different local networks.