Prévalence de Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum et du VIH chez les femmes à Kara, en 2022.

OBJECTIVE OF THE STUDY: To estimate the prevalence of four STIs in women of reproductive age in the Kara region. METHODS: A cross-sectional study was conducted in March 2022. Data were collected using a standardized questionnaire. Screening for HIV and syphilis was performed using the SD-BIOLINE HIV/Syphilis Duo® rapid tests. The GeneXpert PCR technique was used to test for Chlamydia trachomatis and Neisseria gonorrhoeae. The prevalences of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and HIV) were reported with 95% confidence intervals. RESULTS: A total of 300 women with a median age of 32 years (interquartile range 24–39) were included. Of these, 25.7% had consulted a gynecologist in the last twelve months. The prevalence of Chlamydia trachomatis was 4.3% (95% CI [2.4–7.5]); Neisseria gonorrhoeae 3.3% [95% CI: 1.7–6.2], Treponema pallidum 0.3% [95% CI: 0.02–2.1] and HIV 3.7% [95% CI: 1.9–6.7]. Three cases of co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis were reported; no cases of co-infection with HIV and bacterial STIs were reported. CONCLUSION: This study confirms the women’s limited access to gynecological consultations, the low circulation of syphilis, and the presence of Neisseria gonorrhoeae and Chlamydia trachomatis in women of reproductive age in the Kara region. An STI surveillance system is needed to improve STI management among this population.

Prevalence and risk factors associated with malaria infection in children under two years of age in southern Togo prior to perennial malaria chemoprevention implementation.

BACKGROUND: Malaria remains the leading cause of mortality and morbidity in young children in sub-Saharan Africa. To prevent malaria in children living in moderate-to-high malaria transmission areas, the World Health Organization has recommended perennial malaria chemoprevention (PMC). Prior to piloting PMC implementation in southern Togo, a household survey was conducted to estimate malaria infection prevalence in children under 2 years of age (U2). METHODS: A cross-sectional community-based household survey was conducted in the Haho district in the Togo Plateaux region. A three-stage random sampling method was used to select study participants aged 10-23 months whose caretakers gave informed consent. The prevalence of Plasmodium infection, defined as a positive rapid diagnostic test (RDT), was estimated with 95% confidence interval (CI). Clinical malaria was defined as having a positive RDT plus fever (≥ 37.5 °C) or history of fever in the last 24 h. Mixed-effects logistic regression models were used to assess the child's, caretaker's, and household's factors associated with malaria infection. RESULTS: A total of 685 children were included in the survey conducted January-February in 2022 (dry season). Median age was 17 months (interquartile range: 13-21). About 80% of the children slept under a bed net the night before the interview. Malaria infection prevalence was 32.1% (95% CI 27.7-37.0) with significant area variation (cluster range: 0.0-73.3). Prevalence of clinical malaria was 15.4% (95% CI 12.2-19.2). Children whose caretakers were animist (aOR: 1.71, 95% CI 1.19-2.46) and those living in mother-headed households (aOR: 2.39, 95% CI 1.43-3.99) were more likely to have a positive RDT. Living more than 5 km away from the nearest health facility (aOR: 1.60, 95% CI 1.04-2.44) and presence of two or more under-5-years children in the household (aOR: 1.44, 95% CI 1.01-2.07) were also associated with increased risk of infection. CONCLUSION: One-third of the children U2 who participated in this survey had malaria infection, thus PMC could be a promising strategy to reduce malaria burden in young children in Plateaux region. Reinforcement of outreach services and targeting the poorest households should be prioritized to reduce the inequity in malaria prevention in children exposed to the infection.

SARS-CoV-2 antibody seroprevalence in Togo: a national cross-sectional household survey, May-June, 2021.

BACKGROUND: The extent of SARS-CoV-2 circulation in African countries is still unclear. Seroprevalence studies are a common approach to epidemiological surveillance, allowing estimation of the proportion of people who have had contact with the virus. We aimed at estimating the seroprevalence of anti-SARS-CoV-2 antibodies and associated factors in Togo at the national level in 2021 according to age groups, gender, and place of residence (rural or urban). METHODS: From 15 May to 31 June 2021, we conducted a nationally representative cross-sectional serological survey in 12 health districts (two districts per health region) in the > 5 years old population in Togo. The Wantai SARS-CoV-2 total antibody assay S protein receptor-binding domain-based ELISA (Wantai Biological Pharmacy Enterprise Co.; Beijing, China) was used to determine the presence of SARS-CoV-2 total antibodies in plasma. Crude and weighted seroprevalences (weighted by age, sex and place of residence) were calculated and then weighted seroprevalences were adjusted according to sensitivity and specificity of the ELISA test. Finally, logistic regression models were performed in order to describe factors associated. RESULTS: Of the 7593 participants, the overall weighted and adjusted seroprevalence of total anti-SARS-CoV-2 antibodies was 65.5% (CI95%: 18.9-21.1). Urban dwellers, young adults (30-49 years) and vaccinated individuals were significantly more likely to be seropositive. CONCLUSION: The high seroprevalence we observed is consistent with observations across West Africa. Quantification of the level of immunity in the population is needed to know how close we are to herd immunity. In the meantime, vaccination against the COVID-19 remains necessary.

Prevalence and factors associated with trichomonas vaginalis infection among female sex workers in Togo, 2017.

BACKGROUND: The aim of this study was to estimate the prevalence and factors associated with Trichomonas vaginalis (T. vaginalis) among female sex workers (FSW) in Togo in 2017. A cross-sectional bio-behavioral study was conducted from August to October 2017 using a respondent-driven sampling method in four cities in Togo. METHOD: A standardized questionnaire was used to record socio-demographic data and sexual behavior patterns. T. vaginalis detection by molecular biology tests was performed using Allplex STI Essential Assay which detect also 6 others micro-organisms. A blood sample was drawn and serological test using SD Bioline Duo VIH/Syphilis rapid test was performed for Human immunodeficiency virus (HIV) and syphilis testing. RESULTS: A total of 310 FSW with median age 25 years, interquartile range (IQR) [21-32 years] were included. The prevalence of T. vaginalis was 6.5% (95%CI = [4.1-9.9]) and, overall, prevalence of other STI ranged from 4.2% (95%CI = [2.3-7.2]) for N. gonorrhoeae to 10.6% (95% CI = [7.5-14.7]) for HIV. Binary logistic regression was conducted to assess factors associated with T. vaginalis infection. Living in Lomé (aOR = 3.19; 95%CI = [1.11-11.49]), having had sexual intercourse before the age of 18 (aOR = 5.72; 95%CI = [1.13-10.89]), and being infected with C. trachomatis (aOR = 3.74; 95%CI = [2.95-12.25]) were factors associated with T. vaginalis among FSW. CONCLUSION: The prevalence of T. vaginalis infection using molecular test was low among FSW in Togo. Extensive studies are needed to confirm and to better understand the epidemiology of T. vaginalis among this population and in other populations in Togo.

Predictors of three-month mortality among hospitalized older adults in Togo.

BACKGROUND: Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo. METHODS: We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality. RESULTS: The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5 and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases. CONCLUSION: Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

Knowledge, attitudes, and practices of health care professionals regarding dengue fever: need for training and provision of diagnostic equipment in Togo in 2022, a cross-sectional study.

Background: Health statistics on dengue are virtually non-existent, despite the fact that the virus is circulating in Togo. This study aimed to assess the knowledge, attitudes, and practices (KAP) of health professionals in the Kara health region. Methods: A cross-sectional study was conducted from March to June 2022 among healthcare professionals who had worked in the Kara region of northern Togo were selected using an exhaustive recruitment method. Data were collected by trained resident doctors with a face-to-face interview using a standardized, pretested questionnaire based on the WHO 2009 dengue guide. Three multivariate regression models were utilized to investigate factors associated with knowledge, attitudes and, and practices. Results: A total of 464 respondents (37.1% female), median age 35 years, interquartile range (29-43 years) were included. Only (3.0%) of the participants had received training on dengue fever diagnosis, treatment and prevention in the last 3 years, and 10.3% had dengue rapid diagnostic tests available at their hospital. Half of the respondents (49.1%) had good knowledge of dengue fever, compared with 30.0% who had positive attitudes. Of a total of 256 professionals who had encountered a case of dengue fever in their practice, only 24 (9.4%) had appropriate practices for diagnosing and treating dengue fever. In multivariate analysis, the healthcare professionals who had taken part in ongoing training on dengue fever were more likely to have adequate dengue diagnosis and treatment practice aOR = 8.1; CI 95% = [1.7-36.0]. Conclusion: Strengthening healthcare professionals' dengue-related skills through ongoing training and the provision of dengue diagnostic tests could help improve early detection practices and management of dengue fever in Togo.

COVID-19 vaccination coverage among travellers at Lomé international airport (Togo), in 2022.

COVID-19 pandemic management leads to new health policies including the requirement of a vaccination pass or a negative Polymerase Chain Reaction (PCR) test for cross-border flights. The objective of this study was to estimate COVID-19 vaccination coverage among travellers, as well as factors associated with a full vaccination. A cross sectional study was conducted in July 2022 at the Gnassingbé Eyadema International Airport (LFW) in Lomé. Travellers met at LFW, aged 12 years or above, and who agreed to participate in the study have been submitted a questionnaire. Logistic regression analysis was performed to identify factors associated with full vaccination defined as having received at least two doses of COVID-19 vaccine according to a validated vaccine schedule. A total of 847 travellers were included. 67% were men The median age was 40 years, Interquartile Range [31-48]. The main health document presented by travellers was the vaccination pass (69.1%). The majority (84.4%) of travellers had received at least one dose of COVID-19 vaccine and 63.9% had received at least two doses. Being 40 years of age or above (aOR=1.42; P=0.046), and travelling from a country outside Africa (aOR=2.18, P=0.003), were positively associated with full vaccination. Vaccination coverage among travellers at the LFW was relatively high. Travellers from a region outside Africa and aged 40 years or above were more likely to be full vaccinated. Better communication and strengthening of the vaccination strategies in Africa could help reduce these gaps.

Knowledge and practices among healthcare workers regarding dengue in Togo.

In Togo where malaria is endemic, because main signs of malaria and dengue are similar, the use of malarial drugs first could contribute to a delay in the diagnosis of dengue and the dissemination of the disease. Thus, it is important that healthcare workers (HCW) have a good knowledge of these diseases. To assess the knowledge, and practices regarding dengue infection among HCW in Togo. A cross-sectional study was carried out from November 2020 to March 2021 among HCW in Togo. A pre-tested digital questionnaire was used for data collection. Based on clinical signs of dengue, preventive measures, infection type and disease type, a knowledge score was constructed with eight questions. A total of 334 HCW with median age 32 years, IQR:(28-38) responded to the survey and the sex ratio male/female was 5.9. The majority (94.0%) of HCW have heard about dengue through training (73.3%), internet (38.0%) and media (33.2%). Compared with lower executive HCW, senior manager were more knowledgeable about the causative agent, the symptoms and preventive methods of dengue infection (p<0.001). Globally, good knowledge (score ≥6) about dengue was found for 47.1% of HCW. More than 9 out of 10 HCW (91.3%) reported the lack of dengue diagnostic tools. Providing health structures with dengue diagnostic tools and training health personnel in their use in any febrile patient with a negative or positive malaria test would help prevent dengue epidemic.

Prevalence and factors associated with burnout among healthcare workers during the COVID-19 pandemic in Togo, June 2021.

COVID-19 pandemic is responsible for increased demand for care and patient mortality, resulting in emotional and physical stress for healthcare workers (HCWs). We aimed to estimate the prevalence of burnout and its associated factors among HCWs in Togo during the pandemic. We conducted an online cross-sectional study from June 14 to 29, 2021 targeting HCWs in Togo. The variable of interest was burnout measured by the Copenhagen Burnout Inventory. Of the 523 participants, the overall burnout prevalence was 53.5% (95% CI= 49.2 - 57.9). The prevalence by burnout dimension was respectively 39.4%, 38.4% and 22.1% for personal, work-related and patient-related burnout. Our results suggest that occupational health teams should engage in the prevention, screening, and management of burnout among HCWs.

HIV prevalence and risk behaviors among female sex workers in Togo in 2017: a cross-sectional national study.

BACKGROUND: The HIV epidemic remains an important public health challenge for the sub-Saharan region. Female Sex Workers (FSW) in this region are among the most vulnerable of the key population groups with HIV prevalence as high as twice that of the general population. The aim of this study was to estimate HIV prevalence and explore sexual risk behaviors among FSW in Togo. METHODS: A cross-sectional study using a Respondent Driven Sampling method was conducted across the six regions of country among FSW in 2017. A comprehensive questionnaire was used to explore socio-demographic characteristics, sexual history, HIV knowledge, and sexual behaviors. HIV rapid tests were used to assess HIV infection. RESULTS: A total of 1,036 FSW, with a median age of 26 years old [interquartile range (IQR): 22-33], participated in the study, with 49.2% (n = 510) of them having reached secondary school. Median age at first sexual intercourse was 20 years old [IQR: 17-25] and estimated number of clients per week was of 5 [IQR: 3-10]. A total of 936 (95.6%) reported the use of a condom during last sexual intercourse with a client and 493 (47.6%) reported the use of a condom during their last sexual intercourse with a partner or husband. HIV prevalence was 13.2% [95% CI: 11.2 - 15.4], and was associated with age (being between 26 and 32 years old; aOR = 4.5; 95% CI: [2.4 - 9.1], p < 0.0001) and ≥ 33 years old; aOR = 6.4; 95% CI [3.5 - 12.7], p < 0.0001), education level (being in primary school or less; aOR = 1.7; 95% CI: [1.1-2.6]; p = 0.012) and the number of partners per week (more than 2 and 3 partners; aOR = 2.5; 95% CI [1.2-5.2]; p = 0.014). CONCLUSIONS: HIV prevalence and sexual risk behaviors remain high among FSW in Togo, despite prevention efforts aimed at curbing this trend. Other factors, such as access and availability of condoms, the social and legal environment in which FSW operate, should be considered for HIV prevention strategies in this population.

Estimation of yellow fever incidence in Togo between 2010 and 2020.

BACKGROUND: Yellow fever virus is an arbovirus transmitted to humans by Aedes and Haemogogus mosquito species. To date, there is no specific treatment for yellow fever. However, an effective vaccine is available for the prevention. After a decline in yellow fever cases in Africa between 2004 and 2015, large-scale transmission of the virus was observed in Africa during 2019, with outbreaks recorded in West Africa. The objective of this study was to estimate the incidence of yellow fever cases recorded in the national reference laboratory of Togo from 2010 to 2020. METHOD: Data were extracted from the National Institute of Hygiene database from 2010 to 2020 with an Excel sheet and descriptive analyses were performed. RESULTS: A total of 4350 samples were collected between 2010 and 2020 in Togo from yellow fever suspected cases. These cases had a median age of 12 years (IQR: 5-24), and 21% of them were from the Maritime region. Among them, 30 cases were reported by national laboratory, with a global incidence of 0.7% (confidence interval 95%: [0.4-1.0]). At the yellow fever regional laboratory, 14 cases were confirmed with an incidence of 0.33% (confidence interval 95%: [0.18-0.55]). In this population, 37.7% had been immunized against yellow fever. CONCLUSION: This study shows that Togo presents cases of yellow fever. Identification of the vectors and implementation of efficient vector control measures could help prevent this disease, as well as other diseases transmitted by the same vectors. Yellow fever vaccination should be a priority in vaccination programs.

Knowledge and practices of female students at university of Kara regarding sexually transmitted infections in Togo, 2021.

A good knowledge of sexually transmitted infections (STI) in female students is an important element in the prevention of STI transmission. The objective of this study is to describe the level of knowledge and practices on STI among female students at the University of Kara. A cross-sectional study was conducted at the University of Kara from July to September 2021. Data were collected using a standard, digitalised, selfadministered questionnaire. Logistic regression analysis was used to describe factors associated with the level of knowledge of STIs. A total of 1,055 female students with a median age of 21 years (interquartile range: 20-24) participated in the study. More than one-third (33.7%) of the students had good knowledge of STI. Having already been tested for HIV (aOR=3.25; 95% CI 2.36-4.52), having already had sex (aOR=1.56; 95% CI 1.10-2.24) and the level of education (AOR=3.46; 95% CI 2.10-5.85) were significantly associated with good STIs knowledge. Among the 723 female students (68.5%) who already had sex, 32.5% reported inconsistent use of condoms during sexual intercourse and 18.9% reported having multiple sexual partners. The results of this study highlight the importance of intensifying STIs prevention efforts (awareness, screening, and vaccination) among female students at the University of Kara.

Prevalence of Malaria and Covid-19 in Febrile Patients in Lomé, Togo in 2020.

PURPOSE: The objective of this study was to estimate the prevalence of malaria and Covid-19 by PCR and serological tests in febrile patients in Lomé. METHODS: A cross-sectional study was conducted from September 1 to October 31, 2020 in febrile patients ≥ 10 years in three health facilities in Lomé. Finger stick blood was collected to detect Plasmodium spp. using thin/thick smear and venous blood on EDTA tubes to test for malaria Histidin-Rich-Protein-2 antigen using rapid diagnostic tests (RDT) and SARS-CoV-2 antibodies specific immunoglobulin (Ig) M and G. Detection of SARS-CoV-2 in nasopharyngeal samples was performed by rRT-PCR using GeneXpert. RESULTS: A total of 243 participants (61.7% of female) with median age 28 years (IQR 18-41) were included in the study. Prevalence of malaria was 25.1%, 95% CI [19.8-31.0] and 30.4%, 95% CI [24.7-36.7] for thin/thick smear and rapid malaria test, respectively. Eighteen patients (7.4%, 95% CI [4.4-11.5]) were positive for SARS-CoV-2 and forty-two (17.3%, 95% CI [12.8-22.6]) were positive for IgM and/or IgG against SARS-CoV-2. SARS-CoV-2 IgM seroprevalence was significantly higher in malaria RDT positive participants (33.8% vs. 10.1%, p < 0.001). CONCLUSION: This study confirms a possible cross-reactivity between Covid-19 and malaria in case of single use of rapid tests, suggesting a possible past contamination. In case of clinical signs related to Covid-19 in malaria-endemic areas, PCR screening should be requested in order to identify and isolate patients.

Monitoring migrant groups as a post-validation surveillance approach to contain the potential reemergence of lymphatic filariasis in Togo.

BACKGROUND: In March 2017, Togo was declared the first country in sub-Saharan Africa to eliminate lymphatic filariasis as a public health problem, but post-validation surveillance has been lacking. In some areas of the country, migrant groups from neighboring countries that are still endemic for LF pose a risk of reintroduction of LF to Togo. The objective of this study was to identify the risk posed by migrant groups by measuring their prevalence of LF infection and investigating any positive case using Togo's case investigation algorithm to prevent resurgence of LF and sustain Togo's elimination success. METHOD: A cross-sectional study was conducted in 2018 in the northernmost region of the country. Three migrant populations were identified: (i) nomadic Peuhls, (ii) Togolese members of local communities who migrate annually to neighboring countries for seasonal labor, and (iii) refugees from Ghana who came to Togo because of a communal conflict in Ghana. A questionnaire was designed to collect data on demographics and history of LF and MDA; all participants were tested for circulating filariasis antigen (CFA) using the filariasis test strip (FTS). Any CFA-positive case was confirmed with nocturnal microfilaremia. RESULTS: Refugees, seasonal economic migrants and nomadic Peuhls represented 42.1%, 31.4% and 26.5% of the study participants, respectively. The overall prevalence of CFA was 4.2% (58/1391) with the highest prevalence in the nomadic Peuhl group (11.9%), but only one of them (0.07%) was confirmed positive with nocturnal microfilaremia. Using the case investigation algorithm, no other positive case was identified in the positive case's surroundings. CONCLUSION: This study demonstrates that nomadic Peuhls, with a CFA prevalence of 11.9%, pose a potential risk for reintroduction of LF into Togo while Ghanaian refugees and seasonal economic migrants do not appear to pose a significant risk. Periodic monitoring of migrants, especially the nomadic Peuhl population, is a potential post-validation surveillance approach that could be used to promptly detect any LF cluster that may arise.

Prevalence of hepatitis B and C among female sex workers in Togo, West Africa.

BACKGROUND: Hepatitis B and C are endemic in sub-Saharan Africa, with prevalence among the highest in the World. However, several challenges impede the progression towards the elimination of viral hepatitis by 2030 as suggested by the World Health Organization Global health sector strategy on viral hepatitis, including the lack of knowledge on the scale of this epidemic in the region. The aim of this study was to estimate the prevalence of hepatitis B and C among female sex workers (FSW) in Togo. METHODS: This ancillary study from a national cross-sectional bio-behavioral study was conducted in 2017 using a respondent-driven sampling (RDS) method, in eight towns of Togo among FSW. Socio-demographic, behavioral and sexual characteristics were assessed using a standardized questionnaire. Blood samples were collected for HIV, hepatitis B and C serological testing. Data were analyzed using descriptive analysis and a logistic regression model. RESULTS: Out of the 1,036 FSW recruited for this study, biological analyses for viral hepatitis were completed for 769 of them. The median age was 26 years [IQR: 22-33] and 49.8% (n = 383) had attained secondary school. The prevalence of hepatitis B was 9.9% [95% CI: (7.9-12.2)] and the prevalence of hepatitis C was 5.3% [95% CI: (3.9-7.2)]. Higher hepatitis B and C prevalence was associated with recruitment out of Lomé (aOR: 6.63; 95%CI: 3.51-13.40, p <0.001 and OR: 2.82; 95% CI: [1.37-5.99]; p<0.001, respectively) and, for hepatitis B, with never using condoms for vaginal intercourse (OR: 3.14; 95%CI: [1.02-8.71]; p<0.05). CONCLUSIONS: Results from this study reveals high prevalence of hepatitis B and C among FSW in Togo and an opportunity for advocacy toward the introduction of immunizations and treatment in this population.

HIV testing uptake and prevalence among hospitalized older adults in Togo: A cross-sectional study.

OBJECTIVES: This study aimed to describe HIV testing uptake, as well as HIV prevalence and its associated factors among older adults aged ≥50 years in health facilities in Togo. METHODS: A cross-sectional study was carried out from February 2018 to June 2019 among hospitalized older adults aged ≥50 years in tertiary and secondary hospitals in Togo. HIV testing was performed according to the national algorithm. Socio-demographic data and HIV testing history were collected using a standardized questionnaire. RESULTS: A total of 619 patients (43.9% female) of median age 61 years, (IQR: 55-70) were recruited and offered HIV testing. Among them, 25.7% had never previously tested for HIV. In total, 91.6% (567/619) accepted HIV testing while 8.4% (52/619) refused to be tested. Of those who tested, forty patients were HIV positive, yielding a prevalence of 7.1%. Twenty-three patients (57.5%) were newly diagnosed with HIV infection. In multivariable analysis, two factors were associated with HIV infection: living alone (aOR = 5.83; 95%CI = [2.26-14.53]) and being <60 years (aOR = 3.12; 95%CI = [1.51-6.66]). CONCLUSION: The majority of older adults in this study accepted testing for HIV and almost three in five HIV positive older adults were newly diagnosed with HIV as a result of this testing. There is an urgent need to integrate older adults into responses to the HIV epidemic and to strengthen targeted prevention care and treatment in this population.

Prevalence of severe adverse events among health professionals after receiving the first dose of the ChAdOx1 nCoV-19 coronavirus vaccine (Covishield) in Togo, March 2021.

BACKGROUND: The coronavirus disease 2019 (COVID-19) vaccines can cause adverse events that can lead to vaccine hesitancy. This study aims at estimating the prevalence of severe adverse events (SAEs) and their associated factors among health professionals vaccinated with ChAdOx1 nCoV-19 vaccine in Togo. METHODS: A cross-sectional study was conducted from March 13th to 19th, 2021 in Togo among health professionals who received the first dose of the vaccine. An online self-administered questionnaire was used to collect sociodemographic and vaccination data. SAEs were defined as one resulting in hospitalization, medical consultation, or inability to work the day following the administration of the vaccine. Data analysis were performed using R© 4.0.1 software, and a 5% significance level was considered. RESULTS: A total of 1,639 health professionals (70.2% male) with a median age of 32 (interquartile range: 27-40) were enrolled. At least one adverse event was reported among 71.6% of participants (95% CI = [69.3-73.8]). The most commonly reported adverse events were injection site pain (91.0%), asthenia (74.3%), headache (68.7%), soreness (55.0%), and fever (47.5%). An increased libido was also reported in 3.0% of participants. Of the participants who experienced adverse events, 18.2% were unable to go to work the day after vaccination, 10.5% consulted a medical doctor, and 1.0% were hospitalized. The SAEs' prevalence was 23.8% (95% CI = [21.8-25.9]). Being <30 years (AOR = 5.54; p<0.001), or 30-49 years (AOR = 3.62; p<0.001) and being female (AOR = 1.97; p<0.001) were associated with SAEs. CONCLUSIONS: High prevalence of SAEs have been observed in health professionals in Togo after ChAdOx1 nCoV-19 vaccination especially in young people and females. However, these data are reassuring as they inform on COVID-19 vaccines' SAE management. Systematic prescription of antalgics or antipyretics could be proposed to young people who get vaccinated.

Prevalence and factors associated with poor self-rated health among communitydwelling older adults in Lomé (Togo) in 2019.

The number of older adults is increasing worldwide, including in sub-Saharan Africa (SSA). However, there is a paucity of data on the overall health status of older adults living in SSA. To assess the prevalence and factors associated with poor Self-Rated Health (SRH) among community-dwelling older adults in Lomé, Togo, we conducted a cross-sectional study from January to June 2019 in Lomé among community-dwelling older adults aged 50 years and older. A 30- minute questionnaire was used to collect socio-demographic characteristics, medical history, patterns of medication use and use of herbal products and dietary supplements during a face-to-face interview. SRH was assessed using a single item: Overall, you would say that your health is… (1) excellent, (2) very good, (3) good, (4) fair and (5) poor with response fair or poor defining poor SRH. A total of 344 respondents with median age 63 years, (IQR: 55-72) were enrolled in the study. Women represented 57.6% of the sample. Overall prevalence of poor SRH was 56.4% (95%CI: 51.0-61.9) and was the highest among females (62.6% vs 47.9%; P=0.007) and participants ³60 years (61.5% vs 51.1%; P=0.021). Female sex, aged ≥60 years, osteoarthritis, hospitalization within the 12 months preceding the survey, polypharmacy, and the use of herbal products were factors associated with poor SRH (P<0.05). More than half of community- dwelling older adults had poor SRH in Lomé. Further studies are needed to guide policymakers in their efforts to design and implement meaningful policies to improve older adults health conditions.

Prevalence and factors associated with psychological distress among key populations in Togo, 2017.

OBJECTIVES: Mental health is a largely neglected issue among in Sub-Saharan Africa, especially among key populations at risk for HIV. The aim of this study was to estimate the prevalence of psychological distress (PD) and to assess the factors associated among males who have sex with males (MSM), female sex workers (FSW) and drug users (DU) in Togo in 2017. STUDY DESIGN: A cross-sectional bio-behavioral study was conducted in August and September 2017 using a respondent-driven sampling (RDS) method, in eight cities in Togo. METHODS: A standardized questionnaire was used to record sociodemographic characteristics and sexual behaviors. The Alcohol Use Disorders Identification Test (AUDIT) and a subset of questions from the Tobacco Questions for Survey were used to assess alcohol and tobacco consumption respectively. PD was assessed with the Kessler Psychological Distress Scale. A blood sample was taken to test for HIV. Descriptive statistics, univariable and multivariable ordinal regression models were used for analysis. RESULTS: A total of 2044 key populations including 449 DU, 952 FSW and 643 MSM with a median age of 25 years, interquartile range (IQR) [21-32] were recruited. The overall prevalence of mild PD among the three populations was 19.9% (95%CI = [18.3-21.8]) and was 19.2% (95%CI = [17.5-20.9]) for severe/moderate PD. HIV prevalence was 13.7% (95%CI = [12.2-15.2]). High age (≥ 25 years) [aOR = 1.24 (95% CI: 1.02-1.50)], being HIV positive [aOR = 1.80 (95% CI: 1.31-2.48)] and hazardous alcohol consumption [aOR = 1.52 (95% CI: 1.22-1.87)] were risk factors for PD. Secondary [aOR = 0.52 (95% CI: 0.42-0.64)] or higher [aOR = 0.46 (95% CI: 0.32-0.64)] education levels were protective factors associated with PD. FSW [OR = 0.55 (95% CI: 0.43-0.68)] and MSM [OR = 0.33 (95% CI: 0.24-0.44)] were less likely to report PD compared with DU. CONCLUSION AND RECOMMENDATIONS: This is the first study conducted among a large, nationally representative sample of key populations in Togo. The prevalence of PD is high among these populations in Togo and was associated to HIV infection. The present study indicates that mental health care must be integrated within health programs in Togo with a special focus to key populations through interventions such as social support groups.