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1.
BMC Public Health ; 21(1): 58, 2021 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-33407321

RESUMEN

BACKGROUND: To date, there is no effective treatment for COVID-19, which is a pandemic disease, caused by a novel coronavirus called SARS-CoV-2. In Togo, where four in five people practice self-medication, the absence of a cure for COVID-19 and the constant progression of the disease requires an assessment of self-medication patterns in the context of the pandemic. This study aimed to estimate the prevalence of self-medication to prevent COVID-19 and its associated factors in Lomé, Togo. METHODS: A cross-sectional study was conducted in Lomé, the capital city of Togo, from April 23rd to May 8th, 2020, with a sample of participants from five sectors: the healthcare, air transport, police, road transport and informal sectors. The participants were invited to provide information about their self-medication practices to prevent COVID-19 in the 2 weeks preceding the survey. RESULTS: A total of 955 participants (71.6% men) with a median age of 36 (IQR 32-43) were included. Approximately 22.1% were in the air transport sector, 20.5% were in the police sector, and 38.7% were in the health sector. The overall prevalence of self-medication to prevent COVID-19 was 34.2% (95% CI: 31.2-37.3%). The most commonly used products were vitamin C (27.6%) and traditional medicine (10.2%). Only 2.0% of participants reported using chloroquine/hydroxychloroquine. Female sex (aOR=1.90; p< 0.001), work in the health sector (aOR=1.89; p= 0.001), secondary education level (aOR= 2.28; p= 0.043) and university education level (aOR= 5.11; p< 0.001) were associated with self-medication. CONCLUSION: One-third of the individuals in high-risk populations in Lomé practiced self-medication. Intensifying awareness campaigns is crucial to fight misinformation about alleged COVID-19 prevention products on social media.


Asunto(s)
/prevención & control , Brotes de Enfermedades , Automedicación/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Togo/epidemiología
2.
J Psychiatr Res ; 132: 13-17, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33035760

RESUMEN

OBJECTIVE: Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. METHODS: A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. RESULTS: Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 (ß = 0.06, p = .005), stigmatization related to COVID-19 (ß = 0.03, p < .001), and resilience (ß = -0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries (ß = 0.02, p < .00; ß = 0.05, p = .013; ß = 0.03, p = .021; ß = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). CONCLUSIONS: The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.


Asunto(s)
Ansiedad/epidemiología , Países en Desarrollo/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Resiliencia Psicológica , Estigma Social , Adulto , Ansiedad/etiología , Congo/epidemiología , Femenino , Haití/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores Protectores , Factores de Riesgo , Rwanda/epidemiología , Togo/epidemiología
3.
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
4.
BMC Infect Dis ; 20(1): 839, 2020 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-33183254

RESUMEN

BACKGROUND: Hepatitis B virus (HBV) infection is a public health problem in Togo and transmission to the child occurs mainly during childbirth. The objective of this study was to estimate the prevalence of HBV among childbearing women and infants born to HBV positive mothers in Togo. METHODS: A national cross-sectional study was carried out in six cities in Togo in the six health regions in Togo. Mother-child pairs were recruited from immunization centers or pediatric wards in Lomé, Tsévié, Atakpamé, Sokodé, Kara and Dapaong in 2017. Women aged 18 and over with one child of at least 6 months old were included. A standardized questionnaire was used for data collection and HBV screening was performed using Determine® rapid tests. The prevalence of HBV, defined by a positive HBV surface antigen (HBsAg), was estimated in mothers and then in infants of mothers who were positive for HBsAg. Logistic regression model was performed to identify risk factors for HBsAg positivity in mothers. RESULTS: A total of 2105 mothers-pairs child were recruited. The median age of mothers and infants was 29 years, interquartile range (IQR) [25-33] and 2.1 years, IQR [1-3] respectively. About 35% of women were screened for HBV during antenatal care and 85% of infants received three doses of HBV immunization. Among mothers, the prevalence of HBV was 10.6, 95% confidence interval (95% CI) [9.4-12.0%], and 177 had detectable HBV viral load (> 10 IU/mL). Among mothers with positive HBsAg, three infants also had positive HBsAg, a prevalence of 1.3, 95% CI [0.2-3.8%]. In multivariable analysis, HIV-infection (aOR = 2.19; p = 0.018), having at least three pregnancies (aOR = 1.46; p = 0.025) and living in Tsévié (aOR = 0.31; p < 0.001) compared to those living in Lomé, were associated to HBV infection in mothers. CONCLUSION: In this study, one out of 10 childbearing women were infected with HBV, but less than 2% of infant born to HBV positive mothers under 5 years' old who received immunization under the Expanded Program on Immunization were infected. Improving antenatal screening and providing targeted interventions in babies could help eliminate HBV in Togo.


Asunto(s)
Virus de la Hepatitis B/inmunología , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Vacunación , Adulto , Preescolar , Estudios Transversales , Femenino , VIH , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , Hepatitis B/virología , Antígenos de Superficie de la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/inmunología , Virus de la Hepatitis B/genética , Humanos , Lactante , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Atención Prenatal , Prevalencia , Togo/epidemiología , Adulto Joven
5.
PLoS One ; 15(5): e0233136, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32433689

RESUMEN

BACKGROUND: Access to antiretroviral treatment has improved the life expectancy of HIV-positive patients, most often associated with a desire to limit childbearing. Women living with HIV (WLHIV) commonly have unmet need for contraception and could be at risk of unintended pregnancy. Preventing unintended pregnancies among women living with HIV are effective strategies to eliminate mother-to-child transmission of HIV. OBJECTIVE: The aim of this study was to assess unmet need for limiting childbirth and its associated factors among women living with HIV in Togo. METHODS: This facility based cross-sectional study was conducted, between June and August 2016, among WLHIV in their reproductive age (15-49 years) in HIV-care settings in Centrale and Kara regions Data was collected using a structured and pretested questionnaire. WLHIV who desired to limit childbirth but not using contraception were considered to have unmet need of birth limitations. Univariate and multivariate Poisson regression models with robust variance were performed to identify associated factors with unmet needs. A multi-model averaging approach was used to estimate the degree of the association between these factors and the unmet need of birth limitations. RESULTS: A total of 443 WLHIV were enrolled, with mean age of 34.5 years (standard deviation [SD] = 7.0). Among them 244 (55.1%) were in couple and 200 (45.1%) had at least the secondary level of education. 39.1% were followed-up in a private healthcare facility. At the time of the survey, 40.0% did not desire childbearing but only 9.0% (95% CI [6.7-12.1]) of them expressed unmet needs for limiting childbirth. In multivariable analysis, associated factors with unmet needs of birth limitations were: being aged 35 years or more (adjusted prevalence ratio (aPR) = 3.11, 95% confidence intervals (95% CI) [1.52-6.38]), living in couple (aPR = 2.32 [1.15-4.65]), living in Kara region (aPR = 0.10 [0.01-0.76]), being followed in a private healthcare facility (aPR = 0.08[0.01-0.53]) and having severe HIV symptoms (aPR = 3.50 [1.31-9.37]). CONCLUSION: Even though the unmet need for births limitation was relatively low among WLHIV in Togo, interventions to improve more access to contraceptive methods, and targeting 35 to 49 years old women, those in couple or followed in the public healthcare facilities would contribute to the eradication of mother-to-child transmission of HIV.


Asunto(s)
Conducta Anticonceptiva , Anticoncepción , Infecciones por VIH/epidemiología , Parto , Embarazo no Planeado , Encuestas y Cuestionarios , Adolescente , Adulto , Estudios Transversales , Femenino , Estudios de Seguimiento , Infecciones por VIH/tratamiento farmacológico , Humanos , Persona de Mediana Edad , Embarazo , Togo/epidemiología
6.
Am J Trop Med Hyg ; 103(2): 696-703, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32458777

RESUMEN

Despite the implementation of effective conjugate vaccines against the three main bacterial pathogens that cause meningitis, Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis serogroup A, the burden of meningitis in West Africa remains high. The relative importance of other bacterial, viral, and parasitic pathogens in central nervous system infections is poorly characterized. Cerebrospinal fluid (CSF) specimens were collected from children younger than 5 years with suspected meningitis, presenting at pediatric teaching hospitals across West Africa in five countries including Senegal, Ghana, Togo, Nigeria, and Niger. Cerebrospinal fluid specimens were initially tested using bacteriologic culture and a triplex real-time polymerase chain reaction (PCR) assay for N. meningitidis, S. pneumoniae, and H. influenzae used in routine meningitis surveillance. A custom TaqMan Array Card (TAC) assay was later used to detect 35 pathogens including 15 bacteria, 17 viruses, one fungus, and two protozoans. Among 711 CSF specimens tested, the pathogen positivity rates were 2% and 20% by the triplex real-time PCR (three pathogens) and TAC (35 pathogens), respectively. TAC detected 10 bacterial pathogens, eight viral pathogens, and Plasmodium. Overall, Escherichia coli was the most prevalent (4.8%), followed by S. pneumoniae (3.5%) and Plasmodium (3.5%). Multiple pathogens were detected in 4.4% of the specimens. Children with human immunodeficiency virus (HIV) and Plasmodium detected in CSF had high mortality. Among 220 neonates, 17% had at least one pathogen detected, dominated by gram-negative bacteria. The meningitis TAC enhanced the detection of pathogens in children with meningitis and may be useful for case-based meningitis surveillance.


Asunto(s)
Infecciones por Escherichia coli/epidemiología , Malaria Cerebral/epidemiología , Meningitis Neumocócica/epidemiología , Meningitis/epidemiología , Meningitis/microbiología , África Occidental/epidemiología , Preescolar , Técnicas de Cultivo , Infecciones por Citomegalovirus/líquido cefalorraquídeo , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/epidemiología , Infecciones por Escherichia coli/líquido cefalorraquídeo , Infecciones por Escherichia coli/diagnóstico , Femenino , Ghana/epidemiología , Infecciones por VIH/líquido cefalorraquídeo , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Vacunas contra Haemophilus/uso terapéutico , Humanos , Lactante , Recién Nacido , Infecciones por Klebsiella/líquido cefalorraquídeo , Infecciones por Klebsiella/diagnóstico , Infecciones por Klebsiella/epidemiología , Malaria Cerebral/líquido cefalorraquídeo , Malaria Cerebral/diagnóstico , Masculino , Meningitis/líquido cefalorraquídeo , Meningitis/diagnóstico , Meningitis por Haemophilus/líquido cefalorraquídeo , Meningitis por Haemophilus/epidemiología , Meningitis por Haemophilus/prevención & control , Meningitis Meningocócica/líquido cefalorraquídeo , Meningitis Meningocócica/epidemiología , Meningitis Meningocócica/prevención & control , Meningitis Neumocócica/líquido cefalorraquídeo , Meningitis Neumocócica/prevención & control , Vacunas Meningococicas/uso terapéutico , Técnicas de Diagnóstico Molecular , Mortalidad , Reacción en Cadena de la Polimerasa Multiplex , Niger/epidemiología , Nigeria/epidemiología , Vacunas Neumococicas/uso terapéutico , Reacción en Cadena en Tiempo Real de la Polimerasa , Infecciones por Roseolovirus/líquido cefalorraquídeo , Infecciones por Roseolovirus/diagnóstico , Infecciones por Roseolovirus/epidemiología , Senegal/epidemiología , Infecciones Estafilocócicas/líquido cefalorraquídeo , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/epidemiología , Togo/epidemiología
7.
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
8.
Soc Psychiatry Psychiatr Epidemiol ; 55(6): 757-764, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32047974

RESUMEN

BACKGROUND: With the introduction of the prolonged grief disorder (PGD) in the ICD-11 and most likely in the future DSM-5-TR, there is clinical need to examine cultural variations in grief phenomenon. We tested whether grief symptoms differ cross-culturally by examining the prevalence rates and predictors of PGD among French and Togolese bereaved individuals. METHODS: The sample comprised 235 widowed persons (73 French and 162 Togolese participants). They all completed the Prolonged Grief Scale-11 items. There were no statistically significant differences between both groups in terms of sociodemographic information (except for education). However, they differed on loss-related characteristics. We used two different symptom-diagnostic tests to estimate the prevalence rates. RESULTS: We found that French and Togolese bereavers reported almost similar PGD prevalence rates (21.9% [95% CI 0.13, 0.36] and 15.4% [95% CI 0.10, 0.23], respectively for the first test, 26% [95% CI 0.16, 0.41] and 17.3% [95% CI 0.12, 0.25], respectively for the second test). Through regression analyses, PGD severity was predicted by low education, being unemployed, long duration of a marital relationship, and traumatic death in the French sample, whereas it was predicted by being male and highly educated in the Togolese sample. Both groups only shared a recent bereavement period as a common risk factor. CONCLUSIONS: Even though French and Togolese widowed persons reported almost similar prevalence rates of PGD, etiology, risk, and protective factors are culturally distinctive. It is critical to consider cultural and individual differences when conducting research on diagnosis and intervention in cases of prolonged grief.


Asunto(s)
Aflicción , Depresión/etnología , Depresión/epidemiología , Viudez/etnología , Adulto , Comparación Transcultural , Cultura , Depresión/psicología , Femenino , Francia/epidemiología , Humanos , Clasificación Internacional de Enfermedades , Masculino , Matrimonio/etnología , Matrimonio/psicología , Persona de Mediana Edad , Prevalencia , Factores Protectores , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Factores de Riesgo , Factores Socioeconómicos , Factores de Tiempo , Togo/epidemiología , Viudez/psicología , Adulto Joven
9.
Sex Transm Infect ; 96(2): 115-120, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31371449

RESUMEN

OBJECTIVES: Whether regular HIV testing and counselling reduce risky sexual behaviours in African men who have sex with men (MSM) is still a matter for debate. We aimed to identify behavioural trajectories based on HIV risk exposure (HRE) and factors affecting their evolution. METHODS: Data were collected from 621 HIV-negative West African MSM (Mali, Cote d'Ivoire, Burkina Faso and Togo) included in a community-based cohort providing quarterly HIV testing and counselling. Sociobehavioural data were collected every 6 months. HRE was defined as reporting inconsistent condom use during receptive anal sex with male partners of unknown HIV status in the previous 6 months. Using 18-month follow-up data, group-based trajectory modelling helped identify behavioural trajectories and determine the factors associated with their evolution. HIV seroconversions (n=67) were specified in each group trajectory. RESULTS: Two distinct group trajectories were identified: medium-risk exposure MSM (ME-MSM) (61%, 6.4% of whom having seroconverted) and high-risk exposure MSM (HE-MSM) (39%, 17.5% of whom having seroconverted). A significant declining trend in the probability of reporting HRE over time ((95% CI)) was observed for HE-MSM (from 0.59 (0.48 to 0.70) at M0 to 0.31 (0.22 to 0.41) at M18), while it remained constant for ME-MSM (0.034 (0.0 to 0.079)). This can be explained by a progressive use of risk reduction strategies (less receptive anal sex, better knowledge of their partners' status and increasing condom use). Being younger, living in Burkina Faso, self-considering both a man and a woman and reporting a higher level of depression were all associated with HE membership. Among HE-MSM, HRE was higher in those practising transactional or group sex and those experiencing psychological harassment. CONCLUSIONS: Quarterly HIV testing and counselling seem to reduce risky sexual behaviours in HIV-negative MSM at greatest risk of infection. Specific support for young MSM, focusing on identity and mental health, is needed to strengthen HIV prevention in West African MSM.


Asunto(s)
Consejo , Infecciones por VIH/prevención & control , Conductas de Riesgo para la Salud , Conducta Sexual/estadística & datos numéricos , Minorías Sexuales y de Género , Sexo Inseguro/estadística & datos numéricos , Adulto , Factores de Edad , Bisexualidad , Burkina Faso/epidemiología , Estudios de Cohortes , Condones/estadística & datos numéricos , Costa de Marfil/epidemiología , Depresión , Identidad de Género , Infecciones por VIH/diagnóstico , Humanos , Violencia de Pareja/estadística & datos numéricos , Modelos Logísticos , Masculino , Malí/epidemiología , Conducta de Reducción del Riesgo , Autoimagen , Trabajo Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Estigma Social , Togo/epidemiología , Adulto Joven
10.
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
11.
J Infect Dis ; 220(220 Suppl 4): S216-S224, 2019 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-31671438

RESUMEN

BACKGROUND: During 2014, 4 regions in Togo within the African meningitis belt implemented vaccination campaigns with meningococcal serogroup A conjugate vaccine (MACV). From January to July 2016, Togo experienced its first major Neisseria meningitidis serogroup W (NmW) outbreak. We describe the epidemiology, response, and management of the outbreak. METHODS: Suspected, probable, and confirmed cases were identified using World Health Organization case definitions. Through case-based surveillance, epidemiologic and laboratory data were collected for each case. Cerebrospinal fluid specimens were analyzed by polymerase chain reaction, culture, or latex agglutination. Vaccination campaigns were conducted in affected districts. RESULTS: From January 11 to July 5, 2016, 1995 suspected meningitis cases were reported, with 128 deaths. Among them, 479 (24.0%) were confirmed by laboratory testing, and 94 (4.7%) and 1422 (71.3%) remained as probable and suspected cases, respectively. Seven epidemic districts had cumulative attack rates greater than 100 per 100 000 population. Of the confirmed cases, 91.5% were NmW; 39 of 40 available NmW isolates were sequence type-11/clonal complex-11. CONCLUSIONS: This outbreak demonstrates that, although high coverage with MACV has reduced serogroup A outbreaks, large meningococcal meningitis outbreaks due to other serogroups may continue to occur; effective multivalent meningococcal conjugate vaccines could improve meningococcal disease prevention within meningitis belt populations.


Asunto(s)
Meningitis Meningocócica/epidemiología , Meningitis Meningocócica/microbiología , Neisseria meningitidis/clasificación , Brotes de Enfermedades , Geografía , Historia del Siglo XXI , Humanos , Incidencia , Vacunación Masiva , Meningitis Meningocócica/historia , Meningitis Meningocócica/prevención & control , Vacunas Meningococicas/administración & dosificación , Vacunas Meningococicas/inmunología , Vigilancia de la Población , Serogrupo , Togo/epidemiología
12.
JMIR Mhealth Uhealth ; 7(11): e13741, 2019 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-31719023

RESUMEN

BACKGROUND: The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. OBJECTIVE: The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. METHODS: A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d'Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. RESULTS: A total of 1131 PLHIV-643 from Côte d'Ivoire, 239 from Togo, and 249 from Burkina Faso-participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; P<.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; P=.01). CONCLUSIONS: The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.


Asunto(s)
Infecciones por VIH/terapia , Aceptación de la Atención de Salud/psicología , Interfaz Usuario-Computador , Adulto , Burkina Faso/epidemiología , Costa de Marfil/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Aceptación de la Atención de Salud/estadística & datos numéricos , Calidad de la Atención de Salud/normas , Calidad de la Atención de Salud/estadística & datos numéricos , Encuestas y Cuestionarios , Togo/epidemiología
13.
Pan Afr Med J ; 34: 19, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31762888

RESUMEN

Introduction: The purpose of this study was to determine the knowledge, attitudes and practices of the populations relating to schistosomal infestation. Methods: We conducted a cross-sectional descriptive and analytical study of knowledges, attitudes and practices of the population of the township of Légbassito relating to schistosomiasis. The sampling calculated on the basis of the population of the township by the software DosBox 0.74 of Epi Info 3.5.4 allowed to investigate 380 subjects. Results: The study highlighted that out of 380 people investigated, 57,30% were not aware of the symptoms of the disease, 40,10% did not know the mode of transmission of the disease, 26.40% knew that avoiding any contact with contaminated surface water could prevent the disease, 18,20% came into contact with fresh waters of the area in which 46,40% of them went to bathe. Regarding sewage disposal, 90,80% used latrines, 1.30% urinated sometimes in the streams, 85,80% used wells water for domestic needs, 48.40% didn't think they could live with an individual whose urine or stool contains blood, 24.5% were not often involved in mass treatment. Conclusion: The township of Légbassito is an endemic area for schistosomiasis infestation. Population attitudes and practices are unfavorable to the elimination of the disease, such as bathing during the hot hours, urinating in fresh waters and coming into contact with other water courses. These practices could lead to new cases of infestation.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Esquistosomiasis/prevención & control , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquistosomiasis/epidemiología , Esquistosomiasis/transmisión , Togo/epidemiología , Adulto Joven
15.
Med Sante Trop ; 29(3): 294-301, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31573525

RESUMEN

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.


Asunto(s)
Infecciones por VIH/epidemiología , Hepatitis B/epidemiología , Homosexualidad Masculina , Adulto , Estudios Transversales , Humanos , Masculino , Prevalencia , Factores de Riesgo , Togo/epidemiología , Adulto Joven
16.
Clin Infect Dis ; 69(Suppl 2): S97-S104, 2019 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-31505623

RESUMEN

BACKGROUND: Pediatric bacterial meningitis (PBM) causes severe morbidity and mortality within Togo. Thus, as a member of the World Health Organization coordinated Invasive Bacterial Vaccine Preventable Diseases network, Togo conducts surveillance targeting Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae, at a sentinel hospital within the capital city, Lomé, in the southernmost Maritime region. METHODS: Cerebrospinal fluid was collected from children <5 years with suspected PBM admitted to the Sylvanus Olympio Teaching Hospital. Phenotypic detection of pneumococcus, meningococcus, and H. influenzae was confirmed through microbiological techniques. Samples were shipped to the Regional Reference Laboratory to corroborate results by species-specific polymerase chain reaction. RESULTS: Overall, 3644 suspected PBM cases were reported, and 98 cases (2.7%: 98/3644) were confirmed bacterial meningitis. Pneumococcus was responsible for most infections (67.3%: 66/98), followed by H. influenzae (23.5%: 23/98) and meningococcus (9.2%: 9/98). The number of pneumococcal meningitis cases decreased by 88.1% (52/59) postvaccine introduction with 59 cases from July 2010 to June 2014 and 7 cases from July 2014 to June 2016. However, 5 cases caused by nonvaccine serotypes were observed. Fewer PBM cases caused by vaccine serotypes were observed in infants <1 year compared to children 2-5 years. CONCLUSIONS: Routine surveillance showed that PCV13 vaccination is effective in preventing pneumococcal meningitis among children <5 years of age in the Maritime region. This complements the MenAfriVac vaccination against meningococcal serogroup A to prevent meningitis outbreaks in the northern region of Togo. Continued surveillance is vital for estimating the prevalence of PBM, determining vaccine impact, and anticipating epidemics in Togo.


Asunto(s)
Meningitis Bacterianas/epidemiología , Meningitis Bacterianas/etiología , Vacunas Neumococicas/administración & dosificación , Vigilancia de Guardia , Vacunación/estadística & datos numéricos , Preescolar , Femenino , Haemophilus influenzae/clasificación , Hospitales Universitarios/estadística & datos numéricos , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Meningitis Bacterianas/prevención & control , Neisseria meningitidis/clasificación , Prevalencia , Serogrupo , Streptococcus pneumoniae/clasificación , Togo/epidemiología , Secuenciación Completa del Genoma
17.
Nephrol Ther ; 15(6): 448-451, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31377136

RESUMEN

OBJECTIVE: To determine the etiological and evolutionary profile of renal failure of chidren in Togo. METHODS: This is a cross-sectional study over the period of 12 months (2016-2017) including children aged 1 to 18 years hospitalized in the pediatric ward of Sylvanus Olympio university teaching hospital of Lome (Togo) for renal failure. RESULTS: Of 2374 patients hospitalized in our unit, 58 (2.4%) had renal failure. The mean age was 8.17±4 years with a sex ratio of 1.32. The average consultation time was 11.9 days. The mean duration of hospitalization was 12.7±7.7 days. Thirty-seven patients (63.8%) were referred from a peripheral center. Thirty-seven children out of 58 (63.1%) were oligoanuric. Renal failure was acute in 94.8% and chronic in 5.2%. Anemia was found in 84.4% of children. The main etiologies found were severe malaria (63.8%), glomerulonephritis (10.3%) and nephrotic syndrome (10.3%). Thirteen children (22.4%) benefited from dialysis sessions. The evolution was favorable in 79.3% of the cases. CONCLUSION: The renal failure of child is relatively common in our daily practice. The low socio-economic level and the lack of adapted equipment make the care difficult.


Asunto(s)
Insuficiencia Renal/epidemiología , Adolescente , Distribución por Edad , Anemia/epidemiología , Niño , Preescolar , Comorbilidad , Estudios Transversales , Países en Desarrollo , Femenino , Hospitales Universitarios , Humanos , Lactante , Tiempo de Internación/estadística & datos numéricos , Malaria/complicaciones , Masculino , Diálisis Renal , Insuficiencia Renal/etiología , Insuficiencia Renal/terapia , Determinantes Sociales de la Salud , Togo/epidemiología , Resultado del Tratamiento
18.
Artículo en Inglés | MEDLINE | ID: mdl-31244995

RESUMEN

Background: Qnr genes are known to confer a low-level resistance to fluoroquinolone in Enterobacteriaceae. They are often found on the same resistance plasmids as extended spectrum ß-lactamase (ESBL) and constitute the most common antibiotic resistance mechanism. This study aimed to detect the presence of qnr genes in ESBL-producing E. coli and Klebsiella spp. Methods: From May 2013 to July 2015, 91 E. coli and 64 Klebsiella spp. strains with phenotypic resistance to quinolone were collected from several specimens and analyzed for the detection of qnrA, qnrB, qnrS genes and the ß-lactamase resistance genes (blaCTX-M, blaTEM, blaSHV) using simplex and multiplex PCR. Results: In the present study, 107 (69%; 61 E. coli and 46 Klebsiella spp.) of 155 bacterial strains tested were found harboring at least one qnr gene consisting of 74 (47.74%) qnrB, 73 (47.10%) qnrS and 4 (2.58%) qnrA. Of the 107 strains encoding qnr genes, 102, 96 and 52 carried CTX-M1, TEM and SHV type ESBL respectively. Conclusion: This study identified quinolone resistance (qnr) gene in ESBL-producing E. coli and Klebsiella spp. in Togo. These finding which suggest a possible resistance to quinolone are of high interest for better management of patients and control of antimicrobial resistance in Togo.


Asunto(s)
Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana , Infecciones por Enterobacteriaceae/microbiología , Escherichia coli/genética , Fluoroquinolonas/farmacología , Klebsiella/genética , Infecciones por Enterobacteriaceae/epidemiología , Escherichia coli/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Proteínas de Escherichia coli/genética , Femenino , Frecuencia de los Genes , Humanos , Klebsiella/efectos de los fármacos , Klebsiella/aislamiento & purificación , Masculino , Pruebas de Sensibilidad Microbiana , Togo/epidemiología , Resistencia betalactámica , beta-Lactamasas/genética
19.
Malar J ; 18(1): 177, 2019 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-31118032

RESUMEN

BACKGROUND: Malaria, one of the world's greatest public health challenges, is an endemic disease with stable transmission in Togo. Combating malaria requires an effective vector control. This study provides temporal data on insecticide resistance status in the major malaria vector Anopheles gambiae sensu lato (s.l.) from Togo. METHODS: Two to 5 days old females of An. gambiae s.l., originating from three localities (Baguida, Kovié, Kolokopé) were subjected to insecticide-impregnated papers during 3 years (2012, 2013, 2016) as follows: organochlorides (4% DDT), pyrethroids (0.05% deltamethrin, 0.75% permethrin, 0.05% lambdacyhalothrin), carbamates (0.4% bendiocarb and 0.1% propoxur), and organophosphates (5% malathion, 0.4% chlorpyrifos methyl, 1% fenitrothion) following the WHO standard protocol. Dead and surviving mosquitoes were stored separately in Eppendorf tubes containing silica gel for DNA extraction, species identification, and kdr and ace-1 genotyping. RESULTS: Knockdown times (KDT50 and KDT95) were high in An. gambiae s.l. The lowest KDTs were recorded at Baguida in 2013 for deltamethrin (KDT50 = 24.7, CI [22.4-27.12] and KDT95 = 90.78, CI [76.35-113.49]). No KDTs were recorded for DDT and in some instances for permethrin. In general, An. gambiae s.l. was resistant to most of the four classes of insecticides during the survey periods regardless of locality and year, except to chlorpyrifos methyl. In some instances, mosquitoes were fully susceptible to fenitrothion (Kolokopé: 100% and Kovié: 98.05%, CI [95.82-100.26]) and malathion (100% at both Kolokopé and Kovié) in 2013, and malathion only (Kolokopé; 100%) in 2016. Anopheles coluzzii, An. gambiae and Anopheles arabiensis were the three sibling species identified at the three localities with some hybrids at Baguida (2013), and Kovié (2012 and 2016), respectively. Anopheles gambiae was relatively dominant (61.6%). The kdr 1014F allele frequency was > 0.9 in most of the cases, except at Kolokopé (f (1014F) = 0.63, CI [0.55-0.71]) in 2013. The kdr 1014S allele frequency was below 0.02. The highest ace-1 frequencies were identified in An. gambiae at Baguida (2012: 0.52, CI [0.34-0.69] and 2013: 0.66, CI [0.46-0.86]). CONCLUSION: The resistance status is worrying in Togo and should be considered in future malaria vector resistance management programmes by decision-makers.


Asunto(s)
Anopheles/genética , Resistencia a los Insecticidas/genética , Insecticidas , Malaria/prevención & control , Control de Mosquitos/métodos , Animales , Vectores de Enfermedades , Femenino , Frecuencia de los Genes , Genes de Insecto , Mosquiteros Tratados con Insecticida , Malaria/epidemiología , Mosquitos Vectores/genética , Organofosfatos , Piretrinas , Encuestas y Cuestionarios , Togo/epidemiología
20.
Matern Child Nutr ; 15(4): e12843, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31102494

RESUMEN

Adequate complementary feeding (CF) practices are essential for achieving optimal growth but challenging to measure comprehensively. This paper describes CF practices in 2,034 children aged 6-23 months and investigates their relationships with length-for-age z-score (LAZ) and stunting, using cross-sectional data collected from May to July 2014 in rural Northern Togo. The World Health Organization infant and young child feeding indicators were computed, along with ancillary indicators on feeding style and timing of introduction of complementary foods. The associations between those indicators and children's LAZ and stunting were assessed using linear and logistic regressions after stratification by age group and adjustment for children, maternal, and household characteristics. CF practices were suboptimal, and their associations with child's growth varied across indicators and age groups. In children aged 6-11 months, reaching the minimum dietary diversity and the minimum acceptable diet was associated with higher LAZ (p < .05). In 18- to 23-month-old children, only the consumption of iron-rich food was associated with both LAZ (p = .02) and stunting (p = .05). The late introduction of family foods was associated with higher odds of being stunted and lower LAZ in children aged 12-17 months (p < .001). The untimely introduction of porridge was associated with higher odds of stunting in children aged 9-23 months (p < .05). Unexpectedly, helping the child to eat was negatively associated with linear growth in all age groups. These findings nurture the ongoing process of review of the World Health Organization infant and young child feeding indicators showing that, in their current version, they hardly capture the links between CF and child's growth at different ages.


Asunto(s)
Desarrollo Infantil/fisiología , Dieta/estadística & datos numéricos , Fenómenos Fisiológicos Nutricionales del Lactante/fisiología , Factores de Edad , Estatura/fisiología , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Togo/epidemiología
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