Anxiety and depression among HIV patients of the infectious disease department of Conakry University Hospital in 2018.

Anxiety and depression continue to be significant comorbidities for people with human immunodeficiency virus (HIV) infection. The aim of this study was to determine the prevalence of anxiety and depression disorder among HIV patients at Conakry, Guinea. In this cross-sectional study, we described socio-demographic, clinical and psychosocial data related to anxiety and depression in 160 HIV patients of the University Teaching Hospital, Conakry, Guinea. The Hospital Anxiety and Depression Scale (HADS) was used for measuring depression and anxiety in the prior month. The HADS score of ⩾8 was used to identify possible cases of depression and anxiety. Multivariate logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of comorbid depression and anxiety among HIV patients was 8.1% and the prevalence of anxiety and depressive symptoms among HIV-infected patients was 13.8% and 16.9%, respectively. Multivariate analysis showed that individuals having BMI ⩽ 18 (AOR = 3.62, 95% confidence interval (CI) 1.37-9.57) and who did not receive antiretroviral treatment (AOR = 18.93, 95% CI 1.88-188.81) were significantly more likely to have depressive symptoms. Similarly, having age <40 years (AOR = 2.81, 95% CI 1.04-7.58) was also significantly associated with anxiety. Prevalence of symptoms of anxiety and depression was high in these HIV patients. This suggests a need for training on the screening and management of anxiety and depression among HIV patients.

[Knowledge, attitudes and practices of healthcare providers on suspected Ebola cases in Guinea]. / Connaissances, attitudes et pratiques des prestataires de soins de santé de face aux cas suspects d'Ebola en Guinée.

BACKGROUND: Developing a more resilient health system to Ebola Virus Disease (EVD) is a necessity in Guinea. This implies having information on the knowledge and practices that health staffs had during the preceding the EVD outbreak. The objective of this study was to compare the knowledge, attitudes and practices of routine healthcare providers on suspected EVD cases in the affected and non-affected districts in Guinea. METHODS: A cross-sectional analytic study was conducted from December 6th to 30th, 2014 with health staffs and community health workers from 120 health facilities, in four health districts more affected by the EVD and four others less affected. RESULTS: Health staffs who declared being able to identify a suspected EVD case were represented more in the more affected districts (95.2%) than in the less affected districts (78.7%, P<0.01). The main practice towards a suspected case in the more affected districts was referral to the Ebola treatment centre (79.2%, versus 20% in the less affected districts, P<0.05), while in the less affected districts, cases were first tested for malaria prior to treatment or referral (3 cases out of 5). Community health workers who declared being able to identify a suspected EVD case were significantly more represented in the more affected districts (73%) than in the less affected districts (38.1%, P<0.001). CONCLUSION: This study suggests that health system managers should prioritize capacity building of health providers in EVD affected as well as in non-affected districts to ensure better preparation for and response to EVD outbreaks.

[Factors associated to loss of follow-up in patients underwent antiretroviral therapy in an ambulatory HIV treatment center at Conakry]. / Facteurs associés aux perdus de vue des patients sous traitement antirétroviral dans un centre de traitement ambulatoire du VIH à Conakry, Guinée.

BACKGROUND: Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry. METHODS: A retrospective cohort study was conducted in HIV patients aged over 15 years and who receiving antiretroviral therapy. Between August 1, 2008 and July 31, 2015, all patients managed by the ambulatory treatment center of the Guinean Women Association against AIDS and sexually and transmissible infection were included. Loss of follow-up was defined as no follow-up visit within 3 months. Kaplan-Meier curves and multivariate Cox regression models were used to analyze factors associated with loss of follow-up. Analyses were performed by using Stata 13 software. RESULTS: 614 patients aged 36.3±11.2 years, mainly females (68.4%) and living in Conakry (80.5%) were included. Among them, 104 were loss to follow-up, corresponding to a proportion rate of 16.9% (95% CI: 14.2-19.7%) or 5.79/100 person-years. The results of multivariate analyses showed that factors independently associated with loss of follow-up were malnutrition (AHR=7.05; 95% CI: 2.05-24.27; P=0.002) and CD4 cells account at the initiation of AHR (2.35; 95% CI: 1.61-6.39; P=0.016) in patients with 201-350 CD4/µL and 5.83 (95% CI: 2.85-11.90; P<0.001) in patients with less than 150CD4/µL. CONCLUSION: Despite efforts of health care workers and free antiretroviral therapy, many patients were loss to follow-up. Multivariate analysis showed that malnutrition and low CD4 account were independently associated with loss to follow-up.

Integration of Family Planning Counselling to Mass Screening Campaign for Cervical Cancer: Experience from Guinea.

AIM: To assess feasibility of integrating family planning counselling into mass screening for cervical cancer in Guinea. METHODOLOGY: This was a descriptive cross-sectional study conducted over a month in Guinea regional capital cities. The targeted population comprised women aged 15 to 49 years. Nearly 4000 women were expected for the screening campaigns that utilized VIA and VIL methods with confirmation of positive tests through biopsy. A local treatment was immediately performed when the patient was eligible. RESULTS: Overall 5673 women aged 15 to 60 years were received, a surplus of 42% of the expected population. 92.3% of women were aged 15-49 years and 90.1% were 25-49 years. Long-acting methods were the most utilized (89.2% of family planning users). 154 precancerous and cancerous lesions were screened, a global positivity rate of 2.7%. CONCLUSION: Integration of counselling and family planning services provision during cervical cancer mass screening is a feasible strategy. A cost-effective analysis of this approach would help a better planning of future campaigns and its replication in other contexts.

Influence of the 2014-2015 Ebola outbreak on the vaccination of children in a rural district of Guinea.

Setting: All health centres in Macenta District, rural Guinea. Objective: To compare stock-outs of vaccines, vaccine stock cards and the administration of various childhood vaccines across the pre-Ebola, Ebola and post-Ebola virus disease periods. Design: This was an ecological study. Results: Similar levels of stock-outs were observed for all vaccines (bacille Calmette-Guérin [BCG], pentavalent, polio, measles, yellow fever) in the pre-Ebola and Ebola periods (respectively 2760 and 2706 facility days of stock-outs), with some variation by vaccine. Post-Ebola, there was a 65-fold reduction in stock-outs compared to pre-Ebola. Overall, 24 facility-months of vaccine stock card stock-outs were observed during the pre-Ebola period, which increased to 65 facility-months of stock-outs during the Ebola outbreak period; no such stock-out occurred in the post-Ebola period. Apart from yellow fever and measles, vaccine administration declined universally during the peak outbreak period (August-November 2014). Complete cessation of vaccine administration for BCG and a prominent low for polio (86% decrease) were observed in April 2014, corresponding to vaccine stock-outs. Post-Ebola, overall vaccine administration did not recover to pre-Ebola levels, with the highest gaps seen in polio and pentavalent vaccines, which had shortages of respectively 40% and 38%. Conclusion: These findings highlight the need to sustain vaccination activities in Guinea so that they remain resilient and responsive, irrespective of disease outbreaks.

Contexte: Tous les centres de santé de la Préfecture de Macenta, en Guinée rural.Objectif: Comparer la rupture en vaccins, en cartes de stock de vaccins et l'administration des différents vaccins d'enfance pendant les périodes pré-Ebola, Ebola et post-Ebola.Schéma: Une étude écologique.Résultats: Des niveaux similaires de rupture étaient observés pour tous les vaccins (bacille Calmette-Guérin [BCG], pentavalent, polio, rougeole, fièvre jaune) dans les périodes pré-Ebola et Ebola (respectivement 2760 et 2706 jours-structure de rupture), avec quelques variations par vaccin. Post-Ebola, il y avait 65 fois plus de réduction en rupture, comparé à la période pré-Ebola. Un total de 24 mois-structure de rupture en cartes de stock de vaccins était observé pendant la période pré-Ebola, qui a augmenté à 65 mois-structure de rupture pendant la période Ebola ; une telle rupture ne s'est pas produite dans la période post-Ebola. Excepté la fièvre jaune et la rougeole, l'administration de vaccin a diminué universellement pendant la période de pointe de l'épidémie (août­novembre 2014). L'arrêt complet de l'administration de vaccin pour le BCG et une baisse marquée pour la polio (diminution de 86%) étaient observés en avril 2014, correspondant à une rupture de vaccins. Post-Ebola, l'administration globale de vaccins n'a pas atteint les niveaux pré-Ebola, avec les plus grands écarts observés aux niveaux de la polio et du pentavalent (respectivement des baisses de 40% et 38%).Conclusion: Ces résultats soulignent le besoin de maintenir les activités de vaccination en Guinée afin qu'elles restent résilientes et réactives, indépendamment de l'épidémie d'une maladie.

Marco de referencia: Todos los centros de atención de salud del distrito de Macenta en una zona rural de Guinea.Objetivo: Comparar el desabastecimiento de vacunas, las tarjetas de existencias de vacunas y la administración de las diversas vacunas de la infancia durante diferentes períodos, en función de la epidemia de fiebre hemorrágica del Ébola, a saber: antes, durante el brote y después del mismo.Método: Un estudio ecológico.Resultados: Se observaron niveles equivalentes de desabastecimientos de todas las vacunas (BCG, pentavalente, antipoliomielítica, antisarampionosa y antiamarílica) antes de la epidemia del Ébola y durante la misma (2760 y 2706 días de desabastecimiento por establecimiento, respectivamente), con alguna variación en función de las vacunas. En el período posterior a la epidemia se presentó una tasa de desabastecimientos 65 veces menor, en comparación con el período anterior a la epidemia. En general, se observaron 24 meses-centro de desabastecimiento en las tarjetas de existencias vacunales durante el período pre-Ébola, que aumentaron a 65 meses-centro de desabastecimiento durante la epidemia; en el período posterior al brote no ocurrió este tipo de desabastecimiento. Con la excepción de la vacuna antiamarílica y la antisarampionosa, la administración de vacunas disminuyó globalmente durante el período de máxima actividad de la epidemia (de agosto a noviembre del 2014). Se observó una interrupción total de la administración de BCG y una tasa considerablemente baja de administración de vacuna antipoliomielítica (disminución de un 86%) en abril del 2014, que correspondió con el desabastecimiento de vacunas. Después de la epidemia del Ébola, la administración general de vacunas no recuperó el nivel anterior al brote y las mayores carencias se observaron con la vacuna antipoliomielítica y la pentavalente (40% y 38% de déficit, respectivamente).Conclusión: Los resultados del presente estudio destacan la necesidad de sostener las actividades de vacunación en Guinea, de manera que conserven su capacidad de recuperación y de respuesta, con independencia de los brotes epidémicos.

Nutritional status of people living with HIV/AIDS in the Ratoma community medical center (Republic of Guinea).

The nutritional status of people living with HIV/AIDS (PLHIV) has a direct impact on their health. The aim of this study was to describe the nutritional status of PLWHA receiving care at the Ratoma community medical center in Conakry, Guinea. This quantitative cross-sectional study assessed the nutritional status of 184 people PLHIV receiving antiretroviral treatment. The sample comprised 184 PLHIV selected by a systematic random sampling from the complete list of PLHIV. The data were collected by individual questionnaires. Two groups were defined according to their nutritional status, based on their body mass index (BMI): a malnourished group (BMI < 18,5kg/m2) and a well-nourished group (BMI ≥ 18,5kg/m2). CD4 lymphocyte counts were also collected. Of the 184 PLVIH, 19.6% were malnourished (95%CI: 14.1-25.0). The mean BMI was 22.2 ± 4.3 kg/m2). The mean CD4 count differed significantly between the groups (328.7±237.7 CD4 cells/mm3 for the malnourished group and 432.9±256.9 for the well-nourished, p <0.017). Malnutrition was significantly associated with a low CD4 count. To improve survival and quality of life among PLHIV, this high frequency of malnutrition calls for sustained attention to the prevention and early detection and treatment of malnutrition in the early stages of HIV.

Profils épidémiologiques et cliniques des urgences ORL infantiles à l'Hôpital National Ignace Deen (CHU de Conakry)

Introduction : Les urgences ORL de l'enfant constituent une entité relativement fréquente. Elles exigent un diagnostic et une prise en charge précoce. En Guinée, la fréquence de ces affections est mal connue. Le but de cette étude était de décrire le profil épidémiologique et clinique des urgences ORL infantiles dans le Service ORL de l'hôpital national Ignace Deen du CHU (Centre Hospitalier Universitaire) de Conakry. Patients et méthodes : Il s'est agi d'une étude prospective de type descriptif d'une durée de 6 mois. Les données sociodémographiques et cliniques de 159 enfants ont été recueillies à l'aide d'un questionnaire anonyme, structuré et analysées à l'aide du logiciel Stata Version 13, StataCorp, College, Texas. Résultats : Les urgences ORL de l'enfant représentaient 17,3% des admissions du service ORL. L'âge moyen des enfants était de 6 ans avec une prédominance masculine (52,2%). 54,1% étaient reçus plus de 72 heures après le début des symptômes. Les principaux motifs de consultation étaient l'otalgie (85,5%) et la fièvre (74,8%). Le diagnostic était dominé par les urgences relatives (87,4%) contre 11,9% d'urgences absolues. Les principales circonstances de survenue des urgences absolues étaient les accidents de la voie publique (47,4%), les accidents de jeux (26,3%). Les urgences relatives, étaient découvertes de façon fortuite dans 85,6% des cas. Les pathologies infectieuses, les corps étrangers étaient les principaux diagnostics observés.Conclusion : Les urgences ORL infantiles sont relativement fréquentes dans notre contexte. Elles sont dominées par les urgences relatives qui regroupent les pathologies infectieuses et les corps étrangers. Elles surviennent de façon fortuite ou suite à un accident domestique