Randomised controlled trial on the effect of social support on disease control, mental health and health-related quality of life in people with diabetes from Côte d'Ivoire: the SoDDiCo study protocol.

INTRODUCTION: Diabetes mellitus (DM) and its severe complications contribute significantly to disability and, hence, burden of disease. Poor mental health, a frequent DM consequence, may hinder successful diabetes control in low-income and middle-income countries (LMICs). Evidence suggests social support as a cost-effective tool to improve diabetes self-management, behaviour and mental health. However, its real-world application in LMICs has rarely been tested. We aim to investigate the effect of a social support intervention on disease control, mental health and health-related quality of life in people with diabetes from Côte d'Ivoire (SoDDiCo) through a randomised controlled trial. METHODS AND ANALYSIS: The trial will take place in the Centre Antidiabétique d'Abidjan, Institut National de Santé Publique, Abidjan, Côte d'Ivoire. We will prospectively randomise up to 1500 people with newly diagnosed diabetes into two parallel arms: intervention (routine care+family supporter accompanying clinical management) and control (routine care), using gender-stratified blocked randomisation with random block sizes of 10, 16, 20 and 24. Participants will undergo baseline, 3-month and 12-month postrandomisation assessments. The primary study outcome will be glycated haemoglobin (HbA1c). Secondary outcomes will include glycaemic control (HbA1c<7.0%), presence at follow-up visits, mental health and quality of life scores. Using intention-to-treat framework, we will assess the impact of the family support intervention on these endpoints over the course of the 1-year follow-up. Effect modification by baseline social capital will be assessed. ETHICS AND DISSEMINATION: The SoDDiCo trial was approved by the Ethikkommission Nordwest- und Zentralschweiz (ref: AO_2021-00041; approved: 12 July 2021) and by Comité National d'Éthique des Sciences de la Vie et de la Santé (ref: 049-22/MSHPCMU/CNESVS-kp; approved: 20 April 2022). The randomised intervention trial will follow good clinical practice guidelines. All results will be made available to the public through abstracts at conferences as well as through peer-reviewed articles. International guidelines for authorship will be respected. TRIAL REGISTRATION NUMBER: ISRCTN10901121, ISRCTN registry.

[Leprosy epidemiology in Daoukro health district (Côte d'Ivoire) from 1999 to 2017]. / Épidémiologie de la lèpre dans le district sanitaire de Daoukro (Côte d'Ivoire) de 1999 à 2017.

Introduction: Leprosy is a real problem in the Daoukro health district despite the actions of the National programme for elimination. Objective: To describe the epidemiological and clinical profile of new leprosy cases in the Daoukro health district from 1999 to 2017. Method: Descriptive survey including leprosy patients admitted to the dermato-leprology department from 1999 to 2017. Results: From 1999 to 2017, the incidence of leprosy fluctuated from 4.4 to 0 per 100,000 with a peak of 14.2 in 2003. In 2016 and 2017 no cases of leprosy were reported. The mean age was 36.8 years (SD=20). A majority of cases were uneducated and living in rural areas. Females and children under 15 years of age accounted for 53% and 16% of cases respectively. Clinically, cutaneous signs were predominant in the patients. The multibacillary form accounted for 82%. Nearly 1 out of 4 patients had a grade 2 disability (24%). All patients received treatment (multidrug therapy). Among them, 83.8% were cured, while 0.5% were not cured. In addition, regarding 29 patients (15.7%) details of how their disease progressed were not available. Among the patients declared cured, 26% had sequels. Conclusion: Leprosy control activities must be strengthened in order to maintain the achievements in this non-endemic district.

Profil des diabétiques de 20 ans a 79 ans de l'enquête nationale sur la prévalence et caractéristiques du diabète en Côte d'Ivoire / NA

Le diabète constitue un problème de santé publique en Côte d'Ivoire. L'objectif général de la présente étude est de dresser le profil des diabétiques de l'enquête nationale sur la prévalence et les caractéristiques du diabète en Côte d'Ivoire chez les personnes de 20 ans à 79 ans.Il s'agit d'une étude transversale à visée analytique à partir d'une analyse secondaire des données de l'enquête nationale sur la prévalence et les caractéristiques du diabète en Côte d'Ivoire,réalisée du 25 Novembre au 22 Décembre 2017. Elle concerne193 sujetssur un total de 197 ayant participéà l'étude. Les facteurs associés au statut de diabétique(diabétique connu ou diabétique méconnu) ont été recherchés par la régression logistique binaire. L'étude primaire a porté sur 3198 personnes âgées de 20 ans à 79 ans.Les participants,en majorité de sexe féminin (59,05),avaient un âge moyen de 48,72 ans, vivaient en milieu urbain (78,1) et n'avaient pas de protection sociale ou assurance maladie (92,51%). De l'analyse multivariée, la probabilité d'ignorance de l'état d'hyperglycémie chronique chez les personnes âgées de 20 ans et 79 ans était plus élevée chez les diabétiques vivant en zone rurale, grignotant entre les principaux repas, non hypertenduset sans antécédent de diabète familial (p<0,05, OR>1). Cependant celle-ci est faible chez les diabétiques de plus de 50 ans (p<0,05, OR<1). Cette étude souligne la nécessité de l'adoption de stratégies appropriées et de la mise en œuvre d'interventions en faveur de la prévention, du dépistage, du diagnostic du diabète et de la prise en charge précoce des diabétiques en Côte d'Ivoire.

Diabetes is a public health problem in Côte d'Ivoire. The general objective of this study is to profile the diabetics of the national survey on the prevalence and characteristics of diabetes in Côte d'Ivoire among people aged 20 to 79 years. This is a cross-sectional study for analytical purposes based on a secondary analysis of data from the national survey on the prevalence and characteristics of diabetes in Côte d'Ivoire, carried out from November 25 to December 22, 2017. It concerns 193 subjects out of a total of 197 who participated in the study. Factors associated with diabetic status (known diabetic or unrecognized diabetic) were investigated by binary logistic regression. The primary study involved 3,198 people aged 20 to 79. The participants, mostlyfemale (59.05%), had an average age of 48.72 years, lived in urban areas (78.1%) and had no social protection or health insurance (92.51 %). From the multivariate analysis, the probability of being unaware of the chronic hyperglycemic state in people aged20 and 79 years was higher in diabetics living in rural areas, snacking between main meals, not hypertensive and without history of familial diabetes (p<0.05, OR>1). However, this is low in diabetics over 50 (p<0.05, OR<1). This study highlights the need for the adoption of appropriate strategies and the implementation of interventions for the prevention, screening, diagnosis of diabetes and early management of diabetics in Côte d'Ivoire.

[Dietary habits among type 2 diabetic patients attending the Abidjan Diabetes Centre]. / Pratiques alimentaires des diabétiques de type 2 suivis au Centre Antidiabétique d'Abidjan.

Objectives: The prevalence of diabetes is rapidly increasing in sub-Saharan Africa. Healthy lifestyle and dietary conditions play a key role in the control of blood sugar imbalance and cardiovascular complications of diabetes. This study was designed to describe the profile and dietary habits of type 2 diabetic patients attending the Abidjan Diabetes Centre (CADA), and to identify related factors. Methods: This cross-sectional, descriptive and analytic study was conducted in 2014 at the CADA. A total of 384 patients were included. Results: Patients had a mean age of 56.2 (SD: 11.7) years and had been living with diabetes for a mean duration of 8.6 years. Main comorbidities associated with diabetes were overweight (56.8%) and high blood pressure (45.3%). More than one-half of patients (60.7%) did not have a good knowledge of the recommended diet for diabetics: 88.5% did not have regular meal times, 11.7% reported snacking and 61.5% had their meals outside of the home. In addition, 60.4% stated that, during the week preceding the survey, they had eaten at least one "not recommended" food, most commonly fatty meals and fried food (31.5%). Patients who did not know that eating fatty meals and fried food was not recommended for diabetics were 3 times more likely to each this type of food (p < 0.001). Conclusion: Strengthening nutritional support by therapeutic education sessions is a key strategy that should be implemented to improve dietary habits among type 2 diabetic patients in Ivory Coast.

[Abortion practices in high school students in Yamoussoukro, Côte d'Ivoire]. / Pratiques d?avortement chez des lycéennes à Yamoussoukro, Côte d?Ivoire.

INTRODUCTION: Induced abortion is illegal in Cote d'Ivoire, except when the mother's life is in danger. The primary objective of this study was to describe abortion practices among Yamoussoukro high school students. More specifically, this study estimated the prevalence of induced abortion, described the pathway and the methods used for abortion and determined any abortion-related complications. MATERIAL AND METHODS: This cross-sectional study was conducted in July 2011 on 312 randomly selected girls attending the Lycée Jeunes Filles in Yamoussoukro. RESULTS: These girls had a mean age (SD) of 16.1 (4.7) years; 258 (82.7%) of them had already had sexual intercourse and 81 (31.4%) had already been pregnant. Fifty (61.7% [56.3-67.1%]) of these 81 girls had already had an abortion. The abortion pathway was as follows: the main method was self-prescribed medication (70%) as first attempt, followed, in case of failure, by traditional healers (56.4%). Healthcare practitioners were usually consulted at the third attempt (85.7%). The most commonly used methods of abortion were drugs (91.9%), ingestion of plants/beverages (68.5%) and introduction of devices into the uterine cavity (62.3%). Twenty-two (44%) out of 50 induced abortions resulted in complications, mostly infectious complications (81.8%), and bleeding (68.2%). Complications were significantly associated with self-induced abortions or abortions performed by traditional healers (p < 0.001). CONCLUSION: More intensive sexual education, access to modern methods of contraception, awareness campaigns concerning the risks related to unwanted pregnancies and abortions performed by non-medical personnel need to be implemented to prevent school abortions. The quality and accessibility of post-abortion services also need to be reinforced.

[Urban alcohol consumption among secondary school students in Côte d'Ivoire]. / Consommation d'alcool en milieu urbain chez les élèves du secondaire en Côte d'Ivoire.

INTRODUCTION: Alcohol consumption is both a health and social risk factor. Few studies have been conducted on alcohol use among students in Côte d'Ivoire. This study was designed to determine factors associated with alcohol consumption among secondary school students in Côte d'Ivoire. METHODS: A cross-sectional study was conducted in May 2011 among public secondary school students in Abidjan. One class for each year of study was randomly selected. Multivariate analysis was conducted between alcohol consumption and independent variables. RESULTS: A total of 316 students participated in the survey. The mean age (SD) of the study population was 16.1 (2.7) years. One hundred and fourteen respondents (36.1%) reported having already drunk alcohol. Age of first alcohol consumption was 10-14 years among girls (48.8%) and 15-19 years among boys (49.3%). Multivariate logistic regression identified the following factors associated with alcohol use among students: Christian religion, more pocket money, living with parents who drink alcohol and the student's perception of alcohol as a refreshing drink or having an antidepressant effect. CONCLUSION: In the light of the determinants of alcohol consumption and the students'suggestions in our study, it appears essential to involve students in actions concerning alcohol abuse.