RESUMEN
In 2006, because of the chloroquine-resistance and following the World Health Organization (WHO) recommendations, Côte d'Ivoire adopted a new policy for the prevention of malaria during pregnancy by intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, its implementation remains limited. Objectives of this study were to evaluate the knowledge of the TPIp-SP regimen and prescribers opinion concerning this protocol. It was a knowledge attitude and pratices (KAP) cross-sectional descriptive study. We used a two-stage stratified sounding. The study took place in 12 health facilities in the health region of Abidjan 2 from march to august 2016 and involved 187 health professionals. We performed descriptive analysis, univariate and bivariate comparative analysis. The study found that half of the prescribers surveyed actually knew the ITPp program (SP - 3 doses - 2nd and 3rd trimesters). Knowledge was better among practitioners with more than 5 years of exercise (P=0.011) and at the level of first contact of health institution (P=0.001). Half of the prescribers were in favor of applying the protocol. The level of knowledge of prescribers has changed little in 2016 compared to 2008 for physicians (Pr (|Z|<|z|)=0.4861) or midwives Pr (|Z|<|z|)=0.4786). Prescribers remained faithful to the old 2-dose protocol. The opinion on the protocol was better in 2016 compared to 2008 Pr (ZAsunto(s)
Antimaláricos/administración & dosificación
, Conocimientos, Actitudes y Práctica en Salud
, Malaria/tratamiento farmacológico
, Complicaciones Parasitarias del Embarazo/tratamiento farmacológico
, Pirimetamina/administración & dosificación
, Sulfadoxina/administración & dosificación
, Adulto
, Competencia Clínica/estadística & datos numéricos
, Côte d'Ivoire/epidemiología
, Estudios Transversales
, Esquema de Medicación
, Combinación de Medicamentos
, Escolaridad
, Femenino
, Humanos
, Transmisión Vertical de Enfermedad Infecciosa/prevención & control
, Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos
, Malaria/epidemiología
, Masculino
, Cuerpo Médico/educación
, Cuerpo Médico/normas
, Cuerpo Médico/estadística & datos numéricos
, Persona de Mediana Edad
, Pautas de la Práctica en Medicina/estadística & datos numéricos
, Embarazo
, Complicaciones Parasitarias del Embarazo/epidemiología
, Medicina Preventiva/educación
, Medicina Preventiva/métodos
, Medicina Preventiva/estadística & datos numéricos
, Adulto Joven
RESUMEN
INTRODUCTION: Prior studies have shown an association between the onset of hepatonephritis and the use of arteminisin-based combination therapy (ACT) during the treatment of uncomplicated malaria. The objective of this study was to identify the risk factors of hepatonephritis occurrence because of the uncertainty regarding the appearance and the aggravation of this syndrome. METHODS: A case-non case study was carried out on 428 notifications of pharmacovigilance extracted from the database of the clinical pharmacology department of the teaching hospital of Cocody from 2008 to 2012. Twenty-two cases of hepatonephritis were identified. Univariate analysis and multivariate logistic regression were performed to identify the risk factors and an adjusted odds ratio (AOR) was calculated for each factor. The cut-off for significant association was set at 0.05. RESULTS: The average age of cases was comparable with that of non-cases (34.04±3.68 years versus 33.94±3.92 years) with a median duration of therapy of 5 days and 6 days respectively. Male (AOR: 6.71; P<0.0001), toxic antecedents, traditherapy (AOR: 6.25; P<0.0001), consumption of CTA (AOR: 1.25; P<0.0001), betalactam (AOR: 0.46; P<0.0001), fluoroquinolone and self-medication (AOR: 2.89; P<0.0001) would be the majors risk factors associated with hepatonephritis onset. The risk increased with the number of antimalarial drugs taken. The evolution towards the offset was less frequent (AOR: 0.078; P<0.02). CONCLUSION: The risk factors of hepatonephritis were the consumption of malarial drugs and connected molecules, self-medication and misuse. The outcome was generally unfavourable. Both the general population and health professionals should be trained on the good use of the antimalarial drugs.
Asunto(s)
Antimaláricos/uso terapéutico , Enfermedad Hepática Inducida por Sustancias y Drogas/epidemiología , Malaria/tratamiento farmacológico , Nefritis/inducido químicamente , Adolescente , Adulto , Sistemas de Registro de Reacción Adversa a Medicamentos , Niño , Preescolar , Côte d'Ivoire/epidemiología , Bases de Datos Factuales , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Nefritis/epidemiología , Farmacovigilancia , Adulto JovenRESUMEN
In the pathophysiology of hypertension, the profile hemodynamic is modified by the relation between the increased sodium intake and blood pressure (BP) level. An increased sodium diet is related not only on the amount of fluid volume within the organism but also to the elasticity of the cardiovascular system. In humans, age and salt excess reduced elasticity is linked to BP level and to stiffness material within the vascular wall of larges arteries. Actions of vasoactives hormones such as angiotensin II, antidiuretic hormone, and aldosterone are also linked. The purpose of this article is : (i) to report existing work in Africa relating to "salt and hypertension", (ii) to determine the characteristic of hypertension among black populations, and for epidemiologic study in Ivory Coast, (iii) to determine the various characteristics of hypertension, prevention of cardiovascular risk, and to show usual antihypertensive drugs for reduce rigidity and vascular fibrosis.
Asunto(s)
Presión Sanguínea/fisiología , Hipertensión/epidemiología , Sodio en la Dieta/efectos adversos , África/epidemiología , África del Sur del Sahara/epidemiología , Enfermedades Cardiovasculares/epidemiología , Humanos , RiesgoRESUMEN
OBJECTIVE: To precise adverse effects of atazanavir, fosamprenavir and tipranavir "in real life". METHOD: Descriptive study of 3 protease inhibitor adverse effects stored in the French Bank of Pharmacovigilance. RESULTS: Nineteen adverse effects having at least possible links with antiretroviral drugs studied were reported. It was essentially hepatobiliary (atazanavir: 29/59, tipranavir: 4/6) and skin (fosamprenavir: 10/20) adverse reactions. These reactions, relatively "serious" (35.1%) led to the interruption of the person (or persons) medication (s) suspected (s) in 69 folds (82.1%) and evolved to healing without sequelae in 68 folds (81%). CONCLUSION: The drug side effects were for the most expected. However, their frequency and their seriously underline the interest of a post-AMM monitoring to reassess the drugs risk-benefit report.
Asunto(s)
Carbamatos/efectos adversos , Inhibidores de la Proteasa del VIH/efectos adversos , Oligopéptidos/efectos adversos , Organofosfatos/efectos adversos , Piridinas/efectos adversos , Pironas/efectos adversos , Sulfonamidas/efectos adversos , Fármacos Anti-VIH/efectos adversos , Sulfato de Atazanavir , Francia , Furanos , Humanos , Hígado/efectos de los fármacos , Hígado/patología , Hepatopatías/etiología , Hepatopatías/patología , Enfermedades de la Piel/inducido químicamente , Enfermedades de la Piel/patologíaRESUMEN
BACKGROUND: The importance of traditional medicine, one of the fundamentals of the cultural heritage of African, Asian and South American peoples, is evident in that such medicine is practised by more than 80% of these populations. METHODS: To analyse the methodology of clinical trials using medicinal plants, we reviewed articles published on this topic between 1980 and 2000. RESULTS: Forty-eight clinical trials were identified. Most were carried out in developed countries. Standard methodological principles were applied in almost all the trials: randomisation (85.4%), comparison (87.5%) versus placebo (95.2%), and blinded design (81.3%). The duration of the studies was short. Sample sizes were generally small, ranging from 30 to 99 subjects; statistical tests were used in 90% of the trials. Adverse effects were infrequently collected. CONCLUSION: Most clinical trials included in this survey were conducted in accordance with WHO guidelines. Respect for methodological principles and the implementation of a legislative framework are important in obtaining credibility and international recognition of the traditional pharmacopoeia.