Medicinal plant use and adherence problems to TB treatment.

BACKGROUND: Good adherence is essential in the treatment of TB. The aim of this study was to describe medication consumption patterns and to assess factors associated with adherence to TB treatment among TB patients in Lomé, Togo.METHODS: A cross-sectional study was conducted among TB patients in 10 health structures in Lomé from September 2019 to January 2020. TB patients aged ≥18 years and under treatment for at least 2 months were eligible for this study. Adherence to TB treatment was assessed using the Girerd compliance test.RESULTS: A total of 195 TB patients (61.5% male) with a median age of 35 years (IQR 27-44) were recruited. TB-HIV coinfection was 11.3%. Polypharmacy (≥5 medications/day) and using medicinal plants were observed in respectively 6.2% and 42.6% of patients. Prevalence of TB treatment adherence problems was 68.2% (95% CI 61.2-74.7). Being <35 years (aOR 2.79; P = 0.005) and taking medicinal plants (aOR 4.31; P < 0.001) were associated with TB treatment adherence problems.CONCLUSION: Treatment adherence problems, a major obstacle to TB elimination, are highly prevalent in TB patients in Lomé, and were associated with the use of medicinal plants. Reasons for the use of medicinal plants should be documented in order to propose appropriate interventions to reinforce adherence to TB treatment.

Prevalence and factors associated with COVID-19 vaccine hesitancy in health professionals in Togo, 2021.

OBJECTIVES: The aim of this study was to assess the prevalence and factors associated with COVID-19 vaccine hesitancy among health professionals (HPs) in Togo. STUDY DESIGN: Cross-sectional study. METHODS: The study was conducted between 24 February and 3 March 2021 among HPs in Togo. Data on sociodemographic characteristics and intention of vaccination were collected using an online questionnaire. Willingness to get vaccinated against COVID-19 was assessed using a single item: "Would you be willing to be vaccinated against COVID-19?". Responses were grouped into three categories: acceptance (Yes, I will get vaccinated), hesitancy (Not decided yet) and refusal (No). Multinomial regression analyses were performed to assess factors associated with vaccine hesitancy or refusal. RESULTS: A total of 1115 HPs (79.1% male) with a median age of 35 years were enrolled in the study. Vaccine acceptance, hesitancy and refusal were 44.1%, 32.2% and 23.7%, respectively. Female gender was associated with an increased risk of hesitancy (adjusted odds ratio [aOR] = 1.93; p = 0.005) and refusal (aOR = 1.77; p = 0.005). Participant age ≥ 50 years, having a personal history of COVID-19 infection and a good knowledge of COVID-19 vaccination were factors that reduced the risk of refusal [(aOR = 0.30; p < 0.001), (aOR = 0.43; p = 0.031) and (aOR = 0.62; p = 0.020)] or hesitancy [(aOR = 0.53; p = 0.005), (aOR = 0.13; p < 0.001) and (aOR = 0.35; p < 0.001)] of the vaccine. CONCLUSIONS: Acceptance of the COVID-19 vaccine before the vaccination campaign was mixed among HPs, especially young HPs. Sensitisation and information campaigns should be reinforced to combat misinformation and increase COVID-19 vaccination acceptance in the context of the ongoing global pandemic.

Prevalence of HIV infection and hepatitis B and factors associated with them among men who had sex with men in Togo in 2017.

Men who have sex with men (MSM) are a population at risk of contracting both HIV and hepatitis B virus (HBV). The objective of this study was to assess the prevalence of these diseases and the factors associated with them among MSM in Togo in 2017. This cross-sectional study took place in eight major cities in Togo from August through September, 2017. MSM aged 18 years and older were recruited with the respondent-driven sampling method. Data on sexual behavior were collected with a standardized questionnaire. Rapid tests were used to screen for HIV and HBV. In all, 678 MSM with a median age of 23 years (interquartile range: 21-26) were recruited, 68.7% of them living in Lomé, the capital of Togo. The prevalence of HIV was 22.0% (95% confidence interval [95% CI] 18.9-25.3) and that of HBV 7.1% (95% CI 5.3-9.3). Seven (1.0%) MSM were co-infected with HIV and HBV. Age, place of residence, living with a male partner, the number of male partners in the 12 months before the study, and history of HIV testing were associated with HIV infection (P<0.05). Age and living in Lomé were associated with HBV infection (P<0.05). The results of this study highlight the importance of focusing response efforts on populations at risk of contracting STIs through routine screening and vaccination.

Prevalence of human papillomavirus, human immunodeficiency virus and other sexually transmitted infections among female sex workers in Togo: a national cross-sectional survey.

OBJECTIVES: Sub-Saharan Africa is a region with high incidence of both human immunodeficiency virus (HIV) and cervical cancer. We conducted the first national study in Togo to assess prevalence of human papillomavirus (HPV), HIV and other sexually transmitted infections (STIs) among female sex workers (FSW). METHODS: A multicentric cross-sectional study was conducted among FSW recruited in hot spots (clubs, streets) in four Togolese cities. HPV and STIs were tested from cervical and anal swabs. HIV and syphilis were screened with rapid tests. RESULTS: In all, 310 FSW were recruited; HIV and cervical high-risk HPV (hrHPV) prevalence were 10.6% (33/310) and 32.9% (102/310), respectively. The most frequent hrHPV types were HPV58 (13.6%, 19/140), HPV35 (12.9%, 18/140), HPV31 (12.1%, 17/140) and HPV16 (10.7%, 15/140). Prevalence of hrHPV and multiple hrHPV infections showed higher rates in HIV-positive than in HIV-negative FSW (48.5% versus 31.0%, p 0.04 and 21.2% versus 9.0%, p 0.03; respectively). Prevalence of hrHPV was higher in cervical than anal swabs (34.1% versus 20.7%, p 0.0004). High-risk HPV anal infections were more frequent among HIV-positive than HIV-negative FSW (51.9% versus 17.3%, p 2 × 10-5). Concomitant anal and cervical hrHPV infections were present in 43.2% (41/95) of hrHPV-positive FSW. Overall prevalence in the cervix of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis were 4.2%, 6.1%, 5.5% and 6.5%, respectively. CONCLUSIONS: This first African study on paired cervical and anal samples showed a high prevalence of genital HPV infections with a rather high rate of concomitant HPV infections but low type concordance. We report an unusual distribution of hrHPV types. These findings highlight the critical need for implementation of a national HPV vaccination strategy.