[Behavior and attitudes towards smoking among student midwives in Libreville]. / Comportements et attitudes des élèves sages-femmes de Libreville vis-à-vis du tabagisme.

BACKGROUND: The midwife, in taking on a public health role, is one of the most important resources for the prevention of smoking and in helping smoking cessation among women of childbearing age thanks to their numerous contacts with pregnant women. With this in mind, we conducted a study among student midwives to examine their smoking behavior, their attitudes towards smoking, and their participation in prevention. METHOD: This was a descriptive cross-sectional study conducted from 15 January to 15 February 2018 using a self-administered questionnaire and included the student midwives of the University of Health Science at Libreville (Gabon). RESULTS: A total of 188 student midwives completed the questionnaires (70.7% of students of the 1st year, 15.0% of students of the 2nd year and 14.3% of students of the 3rd year). Gaps exist in the knowledge of student midwives regarding the risks of cigarette smoking in pregnancy and its role in the development of complications for the mother and foetus. Overall, 17.1% of student midwives think that smoking is responsible for the occurrence of ectopic pregnancies, 20.3% believe it is responsible for retro-placental haematoma, 17.6% for premature rupture of the membranes. The prevalence of smoking was 11.1% and was most frequent in 2nd year students (25.0%) and 3rd year students (14.8%) (P<0.023). The mean age of beginning smoking was 19.0±4.4 years. The main initiating factors were peer influence (28.6%), pleasure (19.0%) and stress (14.3%). Nicotine dependence was weak to moderate among 48.8% of smokers and absent in 52.2%. CONCLUSION: Gaps exist in the knowledge of student midwives regarding the risks of cigarette smoking to complications of pregnancy. There is need therefore to include formal training on tobacco control strategies at an early stage in the medical curriculum.

Transmission of Staphylococcus aureus between mothers and infants in an African setting.

Staphylococcus aureus colonization is a risk factor for invasive disease. There is a need to understand S. aureus colonization in infancy as the burden of S. aureus infections in infants is high. We aimed to investigate the transmission of S. aureus between mothers and their newborns during the first year after delivery in an African setting. In a longitudinal cohort study, colonization of Gabonese mother-infant pairs was assessed at delivery and after 1, 9 and 12 months. Swabs were taken from mothers (nares, mammillae) and infants (nares and throat). Isolates were characterized and risk factors for colonization were assessed using a standardized questionnaire. We recruited 311 mothers and 318 infants including seven sets of twins. Maternal and infant colonization rates declined synchronously following a peak after 1 month at 40% (mothers) and 42% (infants). Maternal colonization was a risk factor for S. aureus carriage in infants. Based on spa typing, direct mother-to-infant transmission was evident in 5.6%. Of all methicillin-resistant isolates (n = 9), 44.4% were related to the USA300 clone; 56.7% (n = 261) of all S. aureus carried Panton-Valentine leukocidin encoding genes. Direct mother-to-infant transmission was rare and cannot explain the increase of carriage in infants within the first month. A transmission from external sources is likely and challenges the S. aureus infection control in newborns and infants in an African setting. The detection of USA300-related MRSA fuels the concern about the spread of this clone in Central Africa.