[Entomological evaluation of the risk of urban outbreak of yellow fever in 2008 in Abidjan, Côte d'Ivoire]. / Évaluation entomologique du risque d'épidémie urbaine de fièvre jaune survenue en 2008 dans le district d'Abidjan, Côte d'Ivoire.

In April 2008, seven years after the outbreak of 2001, Abidjan faced another epidemic of yellow fever. Three weeks after the case detected in the commune of Treichville at 28(th) of April 2008, two other cases were notified, the first one in Port-Bouet and the second one in Cocody located respectively in the south and north of the city of Abidjan. In order to determine a large-scale risk of urban yellow fever epidemic, epidemiological and entomological investigations were conducted by the Ministry of Health and Public Hygiene of Cote d'Ivoire with the support of the Global Outbreak Alert and Response Network. Entomological investigations revealed the predominance of Aedes ægypti, urban vector of yellow fever in neighborhood visited with larval density indices between 2 and 5, indicating the existence of a sufficient density of the vector for cause an explosion of the epidemic. In fact, the massive influx of people from inside cities towards Abidjan caused by the socio-political crisis occurred in the country in 2002, the deterioration of environment with the creation of more breeding sites of Ae. ægypti as corollary and the circulation of the virus at mosquito level were many factors favorable to the yellow fever outbreak in Abidjan city.

[Entomological investigations conducted around ten cases of yellow fever in 2009 in the Denguélé sanitary region, Côte-d'Ivoire]. / Investigations entomologiques menées autour de dix cas de fièvre jaune survenus en 2009 dans la région sanitaire du Denguélé, Côte-d'Ivoire.

In November 2009, ten suspicious cases of yellow fever, including six deaths, were notified in the region of Denguélé, in the northwest of Côte-d'Ivoire. In order to evaluate the extent of yellow fever virus circulation and the risk for local people, a mission of entomological investigation was carried out by the Ministry of Health and Public Hygiene of Côte-d'Ivoire. Entomological investigations were conducted in the villages of confirmed cases (Banakoro and Tron-Touba) and the centers of consultation and hospitalization of cases during illness. Breteau index and recipient index were quasi nil. Aedes aegypti was absent among the captured mosquitoes. On the other hand, Aedes luteocephalus and Aedes opok were present at Banakoro and Tron-Touba with respective average biting rates of 0.8 and 0.6 bite/man/twilight. This situation of epidemic in the northwest of Côte-d'Ivoire could be explained by the deterioration of Denguélé region's health system which is a consequence of the war started in the country in 2002 and which has lowered the immunity of the population.

[Epidemiologic monitoring of human rabies in an endemic canine rabies area in the Ivory Coast]. / Surveillance épidémiologique de la rage humaine dans un contexte d'endémie de rage canine en Cote d'Ivoire.

AIM: The objective of this study was to analyze the epidemiologic monitoring of human rabies in the rabies medical center of Abidjan. PATIENT: A cross-sectional study was undertaken based on files of patients having consulted in the rabies center after exposure and suspicion of human rabies between January 2001 and June 2009. RESULTS: Twenty-six cases of human rabies were reported in 10,706,136 inhabitants (annual incidence of 0.028 cases per 100,000). The number of detected cases increased considerably after reinforcing the monitoring of the disease. Most cases occurred in an urban environment and concerned both sexes. The most concerned age range was under 31 years. The patients' were mostly school children and housewives. In all cases, the rabid animal was a dog and the type of exposure was a bite. Fifty-six percent of the victims had not received any local treatment and almost all no post-exposure prophylaxis. The mean delay before the first symptoms was 49.5 days after exposure and for death, 4 days after the onset of symptoms. Virological diagnosis was made in four cases. CONCLUSION: In spite of the increase of cases observed since 2006, certainly due to reinforcement of the monitoring network, improvement is needed to assess the real incidence of rabies in the Ivory Coast.

[Five years of cholera surveillance in Ivory Coast during social and political crisis, 2001 to 2005]. / Cinq années de surveillance du choléra en Côte d'Ivoire dans un contexte de crise socio-politique, 2001 à 2005.

For an efficient struggle against infectious diseases with epidemic potential, the Cdte d'Ivoire set up a precocious alert system in 2001 with a main objective: to detect epidemics of cholera, measles, yellow fever and meningitis and to provide necessary information for their control and their prevention. During the 2001 to 2005 period, the country was marked by military and political crisis which occurred in 2002; the country had to face up to a reappearance of cholera. How did it evolve in such a context? The question was to describe the performances of the system and the evolution of cholera from weekly data collected by the centers of epidemiological monitoring in health districts. The cases and declared deaths were compiled and the indicators of morbidity and mortality were then studied according to time site and individual features on the period of 2001 to 2005. From 2001 to 2005, 11,874 cases were notified with 564 deaths and a lethal rate of 4.7%. In 2001, from the initial source of infection, the civil jail, the epidemic of cholera disseminated itself through visitors in the whole city of Abidjan where 3250 cases were notified. Out of city, 20 outbreaks have been declared with a total of 3010 cases. The yearly highest impact, 37 living cases/100,000 inhabitants recorded in 2001, decreased regularly until 2005 with 0.2 living cases/100,000. After 2002, outbreaks were located mainly in the half south of the country which welcomed displaced populations from the north, preferably in transition or settling zones near the front line. The lethal rate in Abidjan (2.3%) was less important than that of other health districts (8.6%). The lethal rate globally increased as the impact decreased. Vibrio cholerae was responsible for the epidemics. The group of 15 years old and over was the most affected (12.69 living cases/100,000) whereas the highest lethal rate appeared in the group under 5 years old (6.6%). The reappearance and constant cholera epidemics in Côte d'Ivoire are due to bad general hygiene conditions, insufficient supply of drinking water from wells or packaged, concentration of populations in the south of the country due to war and uncontrolled development of the poor and unsanitary precarious boroughs. Outburst during the dry season is a warning signal of an important epidemic during the raining season especially in poor urban areas. The precocious alert system has permitted to detect the epidemics, to follow up their evolution and to orientate the struggle against cholera in Côte d'Ivoire.

[Malaria transmission in Tiassalékro, a irrigated rice growing village situated in the South forest area of Côte d'Ivoire]. / Transmission du paludisme a Tiassalèkro, village de riziculture irriguèe situé en zone sud forestière de Côte d'Ivoire.

A longitudinal entomological study was carried out from January to June 2007 in the rice-growing area of Tiassaékro, a village located in the forest, South of Côte d'Ivoire. The study was based on samples of mosquitoes caught on human volunteers indoors and outdoors. During the 6 months of the study 29481 female mosquitoes were caught. The average biting rate was 272.9 bites per man per night (b/m/n). An. gambiae was the most predominant with 79.1% of mosquitoes caught. The average biting rate of An. gambiae was of 216 b/m/n. The biting activity of this species was noticed between 8 p.m. and 6 a.m. The estimated average sporozoite index was 0.32% (n = 3423 dissected). The inoculation rate was 0.69 ib/m/n with the highest rate (1.99 ib//n) recorded in April. The entomological parameters of the transmission are influenced by the different stages of rice growing.