Prevalence and correlates of hypothyroidism in pregnancy: a cross-sectional study at Bouget General Hospital, Ivory Coast.

Introduction: several adverse pregnancy outcomes have been reported in gestations with associated hypothyroidism. The prevalence of hypothyroidism has not been frequently reported in Black Africans. This study sorts to report the prevalence and associated factors of hypothyroidism in Black African pregnant women. Methods: this was a hospital-based cross-sectional study, including all pregnant women attending the gynecologic unit of Bouget General Hospital Abidjan. Serum thyroid-stimulating hormone and T4 were obtained from all participants and analyzed using a fluorescent Immunochemistry assay. Data were analyzed using R version 4.05. Univariable and multivariable logistic regression was used to assess factors associated with hypothyroidism and statistical significance considered as p < 0.05. Results: overall there were 693 participants, mean age of 28.1(SD 6.4) years with an average gestational age of 24.1 (SD 8) weeks, and a majority of study participants were in the second trimester of gestation. The prevalence of hypothyroidism was 12.1% (n = 84) (10.8% subclinical hypothyroidism and 1.3% clinical hypothyroidism) whereas 1.9% (n = 13) had hyperthyroidism. In addition, patients with reported type 1 diabetes mellitus had an increased risk of hypothyroidism (aOR: 12.6, 95% CI 1.9-100.8; p ≤ 0.01). Conclusion: this study revealed a high prevalence of hypothyroidism, though mostly in the subclinical form. Further research is warranted to confirm these findings which may have implications on early screening of hypothyroidism in black African women.

[Evaluation of the operational capacity of first-line health facilities in the management of malaria in Ivory Coast]. / Evaluation de la capacité opérationnelle des établissements sanitaires de première ligne dans la prise en charge du paludisme en Côte d'Ivoire.

INTRODUCTION: Do health facilities (HF) have basic resources needed to manage malaria? The purpose of our study was to analyze the operational capacity (OC) of first-line health facilities in Ivory Coast in the management of malaria. METHODS: SARA methodology was used to conduct a descriptive cross-sectional study from 10 to 30 July 2016. The operational capacity in the management showed an average availability of 9 identification tracers divided in 3 areas: (i) staff and guidelines; (ii) capacity of diagnosis; (iii) drugs and products. This operational capacity was assessed through the calculation of an index and then compared with the health facilities according to the management authority and the geographical area using Chi-square test with p-values α fixed at 0.05. RESULTS: Out of 818 HFs, 651(79.6%) were in the public sector and 487(59.5%) were located in the rural area. The operational capacity of first line health facilities was 74.5%. This OC was higher in the public sector (81.3%) than in the private sector (48.8%) (p < 10-3) as well as in the rural area (82.7%) compared to the urban area (62.9%) (p < 10-3). CONCLUSION: In 2016, first line health facilities in Ivory Coast had basic resources needed to manage malaria. It is necessary to focus on the need to strengthen health facility services in addition to prevention.