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1.
Parasit Vectors ; 14(1): 134, 2021 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-33653393

RESUMEN

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.

2.
PLoS One ; 16(2): e0246151, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33529263

RESUMEN

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.

3.
BMC Geriatr ; 20(1): 507, 2020 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-33243161

RESUMEN

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.

4.
PLoS One ; 15(11): e0242124, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166369

RESUMEN

BACKGROUND: In December 2019, the COVID-19 outbreak began in China and quickly spread throughout the world and was reclassified as a pandemic in March 2020. The first case of COVID-19 was declared in Togo on March 5. Two months later, few data were available to describe the circulation of the new coronavirus in the country. OBJECTIVE: This survey aimed to estimate the prevalence of SARS-CoV-2 in high-risk populations in Lomé. MATERIALS AND METHODS: From April 23, 2020, to May 8, 2020, we recruited a sample of participants from five sectors: health care, air transport, police, road transport and informal. We collected oropharyngeal swabs for direct detection through real-time reverse transcription polymerase chain reaction (rRT-PCR) and blood for antibody detection by serological tests. The overall prevalence (current and past) of infection was defined by positivity for both tests. RESULTS: A total of 955 participants with a median age of 36 (IQR 32-43) were included, and 71.6% (n = 684) were men. Approximately 22.1% (n = 212) were from the air transport sector, 20.5% (n = 196) were from the police sector, and 38.7% (n = 370) were from the health sector. Seven participants (0.7%, 95% CI: 0.3-1.6%) had a positive rRT-PCR test result at the time of recruitment, and nine (0.9%, 95% CI: 0.4-1.8%) were seropositive for IgM or IgG against SARS-CoV-2. We found an overall prevalence of 1.6% (n = 15), 95% CI: 0.9-2.6%. CONCLUSION: The prevalence of SARS-CoV-2 infection among high-risk populations in Lomé was relatively low and could be explained by the various measures taken by the Togolese government. Therefore, we recommend targeted screening.


Asunto(s)
Infecciones por Coronavirus/patología , Neumonía Viral/patología , Adulto , Anticuerpos Antivirales/sangre , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Estudios Transversales , Femenino , Humanos , Inmunoensayo , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Prevalencia , ARN Viral/genética , ARN Viral/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Factores de Riesgo , Togo/epidemiología
5.
J Public Health Afr ; 11(1): 1302, 2020 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-33209236

RESUMEN

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.

6.
PLoS One ; 15(4): e0231726, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32298337

RESUMEN

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.


Asunto(s)
Consumidores de Drogas/psicología , Infecciones por VIH/epidemiología , Homosexualidad Masculina/psicología , Distrés Psicológico , Trabajadores Sexuales/psicología , Adulto , Estudios Transversales , Demografía , Consumidores de Drogas/estadística & datos numéricos , Femenino , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Prevalencia , Factores de Riesgo , Trabajadores Sexuales/estadística & datos numéricos , Factores Sociológicos , Encuestas y Cuestionarios , Togo/epidemiología , Adulto Joven
7.
BMJ Open ; 9(11): e028934, 2019 11 03.
Artículo en Inglés | MEDLINE | ID: mdl-31685493

RESUMEN

OBJECTIVES: The aim of this study was to estimate alcohol and tobacco use prevalence and their correlates among female sex workers (FSW), men who have sex with men (MSM) and drug users (DU) in Togo. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional bio-behavioural study was conducted among 2115 MSM, FSW and DU in 2017 using a respondent-driven sampling method, in the eight biggest towns of Togo. Selection criteria for the MSM were being male and having had oral or anal intercourse with a man in the previous 12 months; for FSW, being a female and having exchanged sex for money in the previous 12 months; and for DU, consuming heroin, cocaine or hashish for MSM, FSW and DU, respectively. All participants had to be at least 18 years old and residing in the territory for the past 3 months. RESULTS: The prevalence of alcohol consumption, hazardous/harmful consumption and binge drinking was 64.8%, 38.4% and 45.5%, respectively. Current tobacco use was reported by 30.6% of participants and HIV prevalence was estimated at 12.5%. DU were more likely to engage in binge drinking compared with other key populations (adjusted odds ratio (aOR)=2.0; 95% CI 1.4 to 2.8; p=0.001). Participants who were identified as having hazardous/harmful alcohol consumption had almost three times the odds of tobacco consumption than those with no risky consumption (aOR=2.6; 95% CI 2.0 to 3.4; p=0.001). Hazardous/harmful alcohol consumption was three times more likely among participants with severe psychological distress compared with those with no psychological distress (aOR=3.3, 95% CI 2.2 to 5.1; p=0.001). CONCLUSION: Findings from this study demonstrate the need for the integration of mental health and substance abuse reduction interventions into HIV prevention programme, particularly those geared towards key populations.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Borrachera/epidemiología , Infecciones por VIH/epidemiología , Distrés Psicológico , Uso de Tabaco/epidemiología , Adolescente , Adulto , Estudios Transversales , Demografía , Consumidores de Drogas/psicología , Consumidores de Drogas/estadística & datos numéricos , Femenino , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Análisis Multivariante , Prevalencia , Trabajadores Sexuales/psicología , Trabajadores Sexuales/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Togo/epidemiología , Adulto Joven
8.
PLoS One ; 14(9): e0221335, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31525222

RESUMEN

BACKGROUND: In Côte d'Ivoire, people living with HIV (PLHIV) have free access to antiretroviral therapy (ART) and cotrimoxazole. Yet, they may use other medications to treat non-HIV diseases. Scarce data are available regarding the use of non-HIV medications in Africa. This study describes the use of non-HIV medications and identifies the factors associated with their use by PLHIV on ART in Côte d'Ivoire. METHODS: A cross-sectional study was conducted in six HIV clinics in 2016. HIV-1-infected adults receiving ART for at least one year were eligible. A standardized questionnaire was used to collect demographics, HIV characteristics and medication use data. Associated factors were identified using a multivariate adjusted Poisson regression. RESULTS: A total of 1,458 participants (74% women) were enrolled. The median age was 44 years, and the median duration of ART was 81 months. A total of 696 (48%) participants reported having used at least one non-HIV medication. Among the 1,519 non-HIV medications used, 550 (36%) had not been prescribed and 397 (26%) were from the nervous system class. Individuals who were more likely to report the use of at least one non-HIV medication included those who had been treated in an Abidjan HIV clinic, had a high school education level, had a monthly income between 152 and 304 euros, had a poor perceived health status, had WHO advanced clinical stage, had used traditional medicine products and had not used cotrimoxazole. CONCLUSION: Almost half PLHIV on ART reported using non-HIV medication. Further research is needed to assess whether the use of non-HIV medication is appropriate given about a third of those medications are not being prescribed.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Utilización de Medicamentos/estadística & datos numéricos , Medicamentos bajo Prescripción/administración & dosificación , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Anciano , Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/uso terapéutico , Costa de Marfil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Combinación Trimetoprim y Sulfametoxazol/administración & dosificación , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico
9.
Pan Afr Med J ; 33: 29, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31384344

RESUMEN

Introduction: In February 2011, the Togolese Government established a compulsory health insurance for public officials and assimilated employees. Four years later, this study investigated the satisfaction of beneficiaries of this insurance plan in Lomé. Methods: The survey was conducted among a sample of beneficiaries using an anonymous face to face questionnaire outside eight health care facilities. The analysis of survey responses allowed measuring the degree of satisfaction. Quantitative data were described using median and extended interquartile range (IQR) and qualitative data were transcribed verbatim. Results: Out of 288 subjects invited to participate, 279 agreed to participate of whom 58% were women and 88% were officials in active employment. The average age of the participants was 38 years (IQR: 30-47). A very large majority of respondents (93.5%) considered this health insurance "satisfactory". The mean overall satisfaction score was 6/10 (min: 5, max: 9). The main elements of dissatisfaction involved the refusal of care to those people with long-term illnesses (84% dissatisfied), the complexity of administrative formalities (84% dissatisfied) and care delays (67% dissatisfied). Conclusion: The very high level of satisfaction promotes the maintenance and the development of this health insurance in Togo. However, the elements of dissatisfaction should receive prompt attention and genuine efforts should be made to correct them.


Asunto(s)
Comportamiento del Consumidor/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Anciano , Femenino , Humanos , Seguro de Salud/normas , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Togo
10.
BMC Res Notes ; 12(1): 140, 2019 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-30876448

RESUMEN

OBJECTIVE: The objective of this study is to assess the quality of life and to identify factors associated with good global quality of life among people living with HIV/AIDS (PLWHA) in Togo. RESULTS: In total, 880 PLWHA with mean age (standard deviation) of 39.6 (10.1) years, were interviewed. Most of them (78.4%) were female. The global score of quality of life was ranged from 42.6 to 112, with a mean (standard deviation) estimated at 86.3 ± (13.3). More than the three-quarters (76.2%) of the participants had a good global quality of life. In multivariate analysis, secondary education level or higher (adjusted odds ratio = 1.78, 95% confident interval (CI) [1.10-2.85]), living in Kara health region (adjusted odds ratio = 4.39, 95% CI [2.94-6.57]), being on antiretroviral therapy (adjusted odds ratio = 6.99, 95% CI [4.11-11.9]) and HIV sero-status disclosure (adjusted odds ratio = 1.83, 95% CI [1.28-2.61]) were associated with a better overall quality of life (score ≥ 77.3).


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/fisiopatología , Infecciones por VIH/fisiopatología , Encuestas Epidemiológicas/estadística & datos numéricos , Calidad de Vida , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/virología , Adulto , Antirretrovirales/uso terapéutico , Estudios Transversales , Femenino , VIH/efectos de los fármacos , VIH/fisiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , Encuestas Epidemiológicas/métodos , Humanos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Análisis Multivariante , Factores de Riesgo , Togo
12.
BMC Public Health ; 19(1): 32, 2019 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-30621652

RESUMEN

BACKGROUND: In Togo, the prevalence of Hepatitis B Virus Surface Antigen (HBsAg) among young people aged 15-24 years was estimated at 16.4% in 2010; however, risk factors for HBsAg carriage are poorly documented. We sought to identify risk factors for HBsAg carriage and the serological profile of HBsAg carriers in Lomé (capital city of Togo). METHOD: We conducted a case control study from October 2016 to March 2017 in Lomé. Cases and controls were randomly selected from a database of Institut National d'Hygiène (INH) of Lomé during a free screening campaign for hepatitis B. We calculated means, frequencies, proportions, odds ratios (OR), and 95% confidence interval (CI) and performed logistic regression. RESULTS: We included 83 confirmed cases and 249 controls. The median age was 31 years among cases and 30 years among the controls. The sex ratios (M/F) were 11/6 among cases and 4/3 for the controls. The independent risk factors for HBsAg carriage were the awareness of hepatitis B serological status (OR = 3.56, 95% CI [1.80-7.04]) and Kabyè-tem ethnic group (OR = 3.56, 95% CI [1.98-6.39]). Among HBsAg carriers, 13.3% were at the viral replication stage (all of whom were between 30 and 45 years of age) and 1.2% were at the acute stage of the disease. The prevalence of co-infection with hepatitis B and C was 4.80%. All co-infections were in women aged 24-28 years. CONCLUSION: The Kabyè-tem ethnic group is at risk of HBsAg carriage in Lomé. Of note, most HBsAg carriers in this ethnic group are aware of their HBsAg serological status. Furthermore, the prevalence of Hepatitis among adults of reproductive age is high and is cause for concern. We therefore recommend screening and vaccination campaigns at subsidized prices among people aged 30 years and older.


Asunto(s)
Portador Sano/sangre , Portador Sano/epidemiología , Antígenos de Superficie de la Hepatitis B/sangre , Adulto , Portador Sano/etnología , Estudios de Casos y Controles , Coinfección/epidemiología , Grupos Étnicos/estadística & datos numéricos , Femenino , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Togo/epidemiología , Adulto Joven
13.
Clin Infect Dis ; 69(6): 1019-1026, 2019 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-30520971

RESUMEN

BACKGROUND: Sub-Saharan Africa is a region of both high human immunodeficiency virus (HIV) and anal cancer incidence. We conducted the first national study in Togo to assess human papillomavirus (HPV), HIV, and other sexually transmitted infection (STI) prevalence among men who have sex with men (MSM). METHODS: A multicentric cross-sectional study was conducted among MSM recruited in 4 Togolese cities. Anal swabs were collected to test HPV, herpes simplex virus (HSV), and 7 STIs. RESULTS: Among the 207 MSM, HIV and high-risk HPV (hrHPV) overall prevalence were 26.1% and 44.9%, respectively. The most common hrHPV types were HPV-35 (15.0%) and HPV-16 (13.0%). Prevalence of hrHPV and multiple HPV infections were higher among HIV-infected than among HIV-uninfected MSM (85.2% vs 30.7%, P < 10-5 and 85.2% vs 28.7%, P < 10-5, respectively). Other STIs, except hepatitis B virus, were also more prevalent among HIV-infected MSM (Neisseria gonorrhoeae, P = .03; Mycoplasma genitalium, P = .04; HSV-2, P = .001; and a trend for Chlamydia trachomatis, P = .06). In multivariate analysis (adjusted odds ratio [95% confidence interval]), HIV (10.1 [4.0-25.6]), living in Lomé (2.8 [1.1-7.1]), HSV-2 excretion (26.7 [2.9-244.3]), C. trachomatis (11.7 [2.3-58.9]), and M. genitalium infection (9.6 [3.1-29.9]) were associated with increased risk of hrHPV infection. CONCLUSIONS: We report a high burden of anal STIs with an unusual hrHPV type distribution among MSM, highlighting the critical need of implementation of a national strategy regarding prevention of STIs and vaccination against HPV.


Asunto(s)
Infecciones por VIH/epidemiología , Homosexualidad Masculina , Infecciones por Papillomavirus/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Coinfección , Estudios Transversales , Susceptibilidad a Enfermedades , Femenino , VIH , Infecciones por VIH/transmisión , Infecciones por VIH/virología , Humanos , Masculino , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/transmisión , Infecciones por Papillomavirus/virología , Prevalencia , Vigilancia en Salud Pública , Factores de Riesgo , Enfermedades de Transmisión Sexual/etiología , Enfermedades de Transmisión Sexual/transmisión , Encuestas y Cuestionarios , Togo/epidemiología , Adulto Joven
14.
BMJ Open ; 8(4): e019006, 2018 04 24.
Artículo en Inglés | MEDLINE | ID: mdl-29691241

RESUMEN

INTRODUCTION: Contraceptive use among HIV-infected women in Togo is poorly documented. We aim at assessing the prevalence of modern contraceptive use and associated factors among HIV-infected women in Togo. DESIGN: Cross-sectional study. SETTING: The study was conducted in five HIV care centres in the Centrale and Kara regions in Togo. PARTICIPANTS: We included 461 HIV-positive women aged between 15 and 49 years and who were sexually active. MAIN OUTCOME MEASURE: The outcome variable was HIV-infected women who were using modern contraceptive methods. RESULTS: A total of 461 HIV-infected women were interviewed, with an average age of 34.3 (±7.1). Among them, 332 (73.1%) women reported using contraceptive methods, mostly condom alone (74.7%) or in combination with hormonal contraceptive (16.9%). In multivariate analysis, education level (primary: adjusted OR (aOR)=1.99, 95% CI (1.05 to 3.76); secondary level and higher: aOR=3.95, 95% CI (2.03 to 7.67)), WHO clinical stage (stage II: aOR=0.7, 95% CI (0.37 to 1.33)), follow-up in private care facilities (aOR=2.54, 95% CI (1.22 to 5.29)) and having a child (aOR=2.51, 95% CI (1.41 to 4.5)) were associated with higher contraceptive use, while marital status (living in union: aOR=0.45, 95% CI (0.28 to 0.74)) and WHO stages III and IV (aOR=0.47, 95% CI (0.24 to 0.94)) were associated with lower contraceptive use. CONCLUSION: About three-quarters of sexually active HIV-infected women in Togo were using contraceptive methods, and private health facilities favoured this contraceptive use. It is important to strengthen the implementation of interventions to increase the incentives for HIV-infected women to use contraception in Togo.


Asunto(s)
Conducta Anticonceptiva , Anticonceptivos , Infecciones por VIH , Adolescente , Adulto , Anticoncepción , Anticonceptivos/uso terapéutico , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Togo , Adulto Joven
15.
Public Health Nutr ; 21(6): 1048-1056, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29362003

RESUMEN

OBJECTIVE: Overweight and obesity in childhood are serious public health issues, both in developing and developed countries. The present study aimed to ascertain overweight and obesity prevalence rates among Togolese schoolchildren in Lomé, Togo, and their correlation with physical activity, socio-economic conditions and eating habits. DESIGN: Cross-sectional survey conducted in December 2015. Overweight and obesity were defined using age- and sex-specific BMI cut-off points of the International Obesity Task Force. Physical activity, socio-economic conditions and eating habits were assessed with a standardized questionnaire. Specially trained medical students interviewed children and collected the data. After bivariate regression analyses, factors associated with overweight/obesity were identified by multivariate logistic regression. Statistical significance was two-sided P<0·05. SETTING: Lomé, Togo. SUBJECTS: Representative sample of 634 children (288 boys, 346 girls), aged 8-17 years, who were studying in primary schools. RESULTS: Overweight and obesity respectively affected 5·2 and 1·9 % of children surveyed. Watching television (>4 h) on weekends (OR; 95 % CI: 3·8; 1·2, 12·0, P=0·02) and medium dietary diversity score (3·0; 1·1, 8·1, P=0·03) were independently associated with overweight/obesity in a multivariate regression model. Eating breakfast in the school cafeteria (0·2; 0·1, 0·8, P=0·03) and eating fruits (0·4; 0·1, 0·9, P=0·03) significantly reduced the risk of overweight/obesity. CONCLUSIONS: Overweight and obesity prevalence were linked with sedentary behaviour and non-optimal food diversity. Promoting physical activity and fruit consumption should be explored as interventions to reduce and prevent overweight and obesity in Lomé schoolchildren. In addition, preventive approaches in the social environment of children should be considered.


Asunto(s)
Obesidad/epidemiología , Sobrepeso/epidemiología , Estudiantes/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Niño , Estudios Transversales , Dieta/estadística & datos numéricos , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Conducta Sedentaria , Togo/epidemiología
16.
J Public Health Dent ; 77(3): 234-243, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28233316

RESUMEN

INTRODUCTION: The objectives of this study were to investigate the association between HIV infection and dental caries among children in West Africa, and to identify factors associated with dental caries among HIV-infected children. METHODS: We conducted a multi-center cross-sectional study in Mali, Senegal and Côte d'Ivoire with a random sample of HIV-infected children aged 5-15 years on antiretroviral therapy and their uninfected siblings. A standardized examination was performed by calibrated dentists. The association between the number of decayed, missing or filled permanent and primary teeth surfaces (DMFdefS) and HIV status was investigated by fitting multivariable zero-inflated negative binomial models, for each age group (<12 and ≥12 years). Factors associated with dental caries could be investigated only for HIV-infected children <12 years old. RESULTS: The sample included 420 HIV-infected children and 418 non-infected siblings. The median DMFdefS was 7 for the HIV-infected children and 2 for the uninfected siblings. The proportion of children with DMFdefS ≥1 was significantly higher among the HIV-infected children than uninfected children (86.0 percent versus 64.4 percent, P < 0.001). The HIV-infected children were less likely to be caries-free than the uninfected siblings in both age groups. We found a higher degree of caries experience among HIV-infected children < 12 years old, in whom it was associated with sweet drink consumption, history of night bottle use, immunosuppression, and younger age at study entry. CONCLUSIONS: Although preventable, the burden of dental disease was high in children from families affected by HIV in West Africa and was associated with HIV infection and immunosuppression.


Asunto(s)
Caries Dental/epidemiología , Infecciones por VIH/epidemiología , Adolescente , África Occidental/epidemiología , Niño , Preescolar , Estudios Transversales , Índice CPO , Femenino , Humanos , Masculino , Prevalencia , Hermanos
17.
AIDS Res Treat ; 2016: 2403936, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27872760

RESUMEN

Background. Many countries are working to reduce or eliminate mother-to-child transmission (MTCT) of HIV. Prevention efforts have been conceptualized as steps in a cascade but cascade completion rates during and after pregnancy are low. Methods. A cross-sectional survey was performed across 26 communities in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Women who reported a pregnancy within two years were enrolled. Participant responses were used to construct the PMTCT cascade with all of the following steps required for completion: at least one antenatal visit, HIV testing performed, HIV testing result received, initiation of maternal prophylaxis, and initiation of infant prophylaxis. Factors associated with cascade completion were identified using multivariable logistic regression modeling. Results. Of 976 HIV-infected women, only 355 (36.4%) completed the PMTCT cascade. Although most women (69.2%) did not know their partner's HIV status; awareness of partner HIV status was associated with cascade completion (aOR 1.4, 95% CI 1.01-2.0). Completion was also associated with receiving an HIV diagnosis prior to pregnancy compared with HIV diagnosis during or after pregnancy (aOR 14.1, 95% CI 5.2-38.6). Conclusions. Pregnant women with HIV infection in Africa who were aware of their partner's HIV status and who were diagnosed with HIV before pregnancy were more likely to complete the PMTCT cascade.

18.
Pan Afr Med J ; 23: 118, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27279945

RESUMEN

INTRODUCTION: In 2011, the prevalence of HIV among men who have sex with men (MSM) in Togo was estimated at 19.6% compared to 3.4% in the general population. This study aimed to describe condom use and associated factors among MSM in Togo. METHODS: In 2011, a cross-sectional survey was conducted using the snowball sampling method among MSM in Togo. This study enrolled MSM aged 18 years and above who reported having sexual contact with other men within the last 30 days. A standardized survey form was used for data collection, and multivariate analyses were performed. RESULTS: A total of 724 MSM were included in this study. The median age was 25 years [22-28], 90.3% had at least a secondary school level. The sexual practices during the last sexual encounter with another man included: insertive anal sex (62.2%), receptive anal sex (56.6%), oral sex (33.8%) and oral-anal sex (8.6%). A condom was used during the last insertive and receptive anal encounters in 78.4% and 81.2% of the time, respectively. In multivariate analysis, condom use was positively associated with previous participation in HIV/STD prevention activities (aOR=1.72; 95% CI=[1.09-2.71]), with the consideration of the last sexual partner as a casual one (aOR=1.87; 95% CI=[1.24-2.82]) and with having at least a secondary school level (aOR=2.40; 95% CI=[1.22-4.69]). CONCLUSION: One out of five MSM did not use a condom during the last anal encounter with another man. HIV prevention programs in Africa should develop specific interventions targeting MSM to reduce the incidence of HIV in this hidden population.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Conducta Sexual/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Humanos , Masculino , Análisis Multivariante , Encuestas y Cuestionarios , Togo , Adulto Joven
19.
J Int AIDS Soc ; 19(1): 20044, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26861115

RESUMEN

INTRODUCTION: Response to antiretroviral therapy (ART) among individuals infected with HIV-2 is poorly described. We compared the immunological response among patients treated with three nucleoside reverse-transcriptase inhibitors (NRTIs) to boosted protease inhibitor (PI) and unboosted PI-based regimens in West Africa. METHODS: This prospective cohort study enrolled treatment-naïve HIV-2-infected patients within the International Epidemiological Databases to Evaluate AIDS collaboration in West Africa. We used mixed models to compare the CD4 count response to treatment over 12 months between regimens. RESULTS: Of 422 HIV-2-infected patients, 285 (67.5%) were treated with a boosted PI-based regimen, 104 (24.6%) with an unboosted PI-based regimen and 33 (7.8%) with three NRTIs. Treatment groups were comparable with regard to gender (54.5% female) and median age at ART initiation (45.3 years; interquartile range 38.3 to 51.8). Treatment groups differed by clinical stage (21.2%, 16.8% and 17.3% at CDC Stage C or World Health Organization Stage IV for the triple NRTI, boosted PI and unboosted PI groups, respectively, p=0.02), median length of follow-up (12.9, 17.7 and 44.0 months for the triple NRTI, the boosted PI and the unboosted PI groups, respectively, p<0.001) and baseline median CD4 count (192, 173 and 129 cells/µl in the triple NRTI, the boosted PI and the unboosted PI-based regimen groups, respectively, p=0.003). CD4 count recovery at 12 months was higher for patients treated with boosted PI-based regimens than those treated with three NRTIs or with unboosted PI-based regimens (191 cells/µl, 95% CI 142 to 241; 110 cells/µl, 95% CI 29 to 192; 133 cells/µl, 95% CI 80 to 186, respectively, p=0.004). CONCLUSIONS: In this observational study using African data, boosted PI-containing regimens had better immunological response compared to triple NRTI combinations and unboosted PI-based regimens at 12 months. A randomized clinical trial is still required to determine the best initial regimen for treating HIV-2 infected patients.


Asunto(s)
Infecciones por VIH/tratamiento farmacológico , VIH-2 , Adulto , Recuento de Linfocito CD4 , Estudios de Cohortes , Femenino , Infecciones por VIH/inmunología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
20.
Rev Prat ; 64(8): 1060-6, 2014 Oct.
Artículo en Francés | MEDLINE | ID: mdl-25510126

RESUMEN

In 2012, an estimated 35.3 million people were living with HIV worldwide and new HIV infections (2.3 million) were down 20% compared to 2001. Over the past year, tremendous progress has been achieved in the fight against HIV, including expanded access to antiretroviral therapy (ART) and services to prevent mother-to-child transmission of HIV. However, progress is uneven. The regions most affected by HIV, Sub-Saharan Africa and the Caribbean, have seen a significant increase in ART coverage and drop in new HIV infections, while for other regions, such as the Middle East, North Africa, Eastern Europe and Central Asia, HIV trends have become worrisome. In many high-income countries, such as France, HIV epidemics are far from over, especially among men who have sex with men, where the HIV epidemic remains uncontrolled. Global, rapid scale-up of ART programs significantly decreased HIV/AIDS-related morbidity and mortality but has not been successful in preventing late HIV diagnosis. Reducing the time interval between HIV infection and diagnosis remains one of the biggest challenges that all HIV-affected countries have to face to further reduce HIV/AIDS-related mortality and control the HIV epidemic.


Asunto(s)
Infecciones por VIH/epidemiología , Francia/epidemiología , Salud Global , Humanos
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