[Evaluation of epidemiological monitoring of post-vaccination adverse reactions in Abidjan]. / Évaluation de la surveillance épidémiologique des manifestations adverses post-immunisations à Abidjan.

INTRODUCTION: This study was designed to evaluate the adverse events following immunization (AEFI) monitoring system in Abidjan health districts. METHODS: This cross-sectional study focused on activities conducted between 1st January and 31st December 2015 in the nine health districts of Abidjan. Data were collected by means of a questionnaire based on the model of World Health Organization evaluation forms. These questionnaires were administered to personnel in charge of epidemiological surveillance in the health districts and the personnel of district hospitals and health centres. RESULTS: The AEFI monitoring system, apart from its simplicity and flexibility, remains fairly ineffective due to the relatively low acceptability by all health workers involved. Only 4% of healthcare personnel respondents participate in this activity; 55% of health districts reported cases of AEFI and 25% of health centres reported cases of adverse events. The low acceptability makes this system less sensitive and ineffective for health policy decision-making designed to reduce adverse events following immunization. CONCLUSION: Improved performance of the AEFI monitoring system requires better training of health workers, better data processing equipment and improved community participation.

[Sociodemographic factors associated with incomplete immunization of children aged 12 to 59 months in six West African countries]. / Facteurs sociodémographiques associés à la vaccination incomplète des enfants de 12 à 59 mois dans six pays d’Afrique de l’ouest.

Every year, thousands of children worldwide remain unimmunized or partially immunized, especially in developing countries. It therefore appears important to examine soda-demographic factors associated with incomplete immunization of children in West Africa. The present cross-sectional study examined factors associated with incomplete immunization of children aged 12 to 59 months in Cote d'lvoire, Ghana, Burkina Faso, Mali, Guinea, and Liberia, based on Demographic and Health Surveys data. The findings of the study showed that birth at home, absence of access of mothers to media, no religion, poverty, and illiteracy were associated with incomplete immunization of children. Health officials should take these immunization status predictors into account when making policies and immunization strategies in countries included in this study in order to achieve immunization coverage targets.

[Sociodemographic factors associated with incomplete immunization or children aged 12 to 59 months in six West African countries]. / Facteurs sociodémographiques associés à la vaccination incomplète des enfants de 12 à 59 mois dans six pays d’Afrique de l’ouest.

INTRODUCTION: Every year, thousands of children in the world remain unimmunized or partially immunized, especially in developing countries. It therefore appears important to examine sociodemographic factors associated with incomplete immunization of children in West Africa. METHODS: This cross-sectional study examined factors associated with incomplete immunization of children aged 12 to 59 months in Côte d'Ivoire, Ghana, Burkina Faso, Mali, Guinea, and Liberia based on Demographic and Health Survey data. RESULTS: The findings of the study showed that birth at home, mothers with no access to media, no religion, poverty, and illiteracy were associated with incomplete immunization of children. DISCUSSION: Health officials should take these immunization status predictors into account when developing policies and immunization strategies in countries included in this study in order to achieve immunization coverage targets.

[Knowledge, and attitudes of Civil Society Organizations in the implementation of the Expanded Program on Immunization in Côte d'Ivoire]. / Connaissances et attitudes des organisations de la sociéteé civile à la mise en oeuvre du Programme élargi de vaccination de routine en Côte d'Ivoire.

INTRODUCTION: The objective of this study was to assess the level of involvement of leaders of Civil Society Organizations (CSOs) in implementation of routine EPI activities. METHODS: This was a cross-sectional descriptive study of the knowledge and attitudes of CSOs concerning implementation of routine EPI activities in the health district of Adiaké (Côte d'Ivoire). RESULTS: This study shows that 77.1% of CSO leaders were literate and 92.9% of them were practicing Catholics or Muslims. They had a good knowledge of the existence of EPI (97.1%) and EPI target diseases, but were ignorant about the immunization schedule (82%). 90% of CSO leaders considered EPI to be an important activity for the prevention of childhood diseases. They considered the reception in immunization units to be satisfactory (60%) and believed that rumours about the sterility of women were the cause of refusal of vaccination by communities. Although 41.4% of leaders had participated in social mobilization activities, none had participated in the mobilization of resources. DISCUSSION: Vaccination was not rejected by CSO leaders, but their lack of participation in implementation of EPI could induce errors and lead them to believe the rumours and refuse vaccination of their community. CONCLUSION: The effective integration of the socio-cultural bases of communities in which immunization programmes are conducted will promote the adhesion of the people responsible for these programmes.

[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.

[The use of ultrasound to reduce maternal and neonatal mortality in a primary care facility in Ivory Coast]. / Apport de I'échographie dans la surveillance de la grossesse dans un établissement sanitaire de premier contact à Yopougon en Côte d'lvoire.

INTRODUCTION: In pregnancy care, ultrasound is used to detect pregnancy-related complications. The purpose of this study was to assess the use of ultrasound in monitoring pregnant women in a primary care facility for the purposes of reducing maternal and neonatal mortality. PATIENTS AND METHOD: A cross-sectional descriptive study was conducted from February 16, 2009 to April 16, 2009. Interviews were conducted with pregnancy women who had an ultrasound was recommended by a health worker or requested by the women. A Comprehensive recruitment strategy was used. The variables studied were sociodemographic characteristics, the indications or reasons for the ultrasound scan, the results of the ultrasound examination, the final diagnosis and the recommended behaviors. RESULTS: A total of 353 pregnant women aged between 15 and 45 years underwent an ultrasound examination. Sixty-six percent (66.3%) of the prescribers were midwives. In terms of pregmancy related pathologies, the main reasons for the ultrasound were pelvic pains (5.4%0, bleeding in the first trimester (4%0, and dystocia (3.7%). The main results were dystocic presentations (4.2%0, pregnancy loss (4%), and causes of bleeding in the first trimester (2.5%). As a result of these findings, 9.3% of at-risk women were sent to a specialized hospital. CONCLUSION: Ultrasound contributes to reducing maternal and dneonatal mortallity in primary care facilities. The results suggest that the health authorities need to improve equipment in primary care facilities to include ultrasound as a diagnosis tool in order to reduce maternal and neonatal mortality.

[Seroprevalence of HIV infection in the context of a mobile counseling and voluntary testing strategy in rural areas of Côte d'Ivoire]. / Séroprévalence de l'infection à VIH en conseil et dépistage volontaire par stratégie mobile en Zone rurale en Côte d'Ivoire.

INTRODUCTION: In Côte d'Ivoire, HIV testing and counselling has been identified as a priority in the National 2006-2010 AIDS Strategic Plan, which is designed to evaluate the prevalence of HIV in rural areas measured by means of a mobile strategy. METHODS: We conducted a cross-sectional descriptive and analytical study from 1st April, 2007 to 31st March 2008 in six rural areas of Côte d'Ivoire: Dabou, San Pedro, Abengourou, Tanda, Daloa, and Soubré*. The study population consisted of subjects attending the mobile voluntary counselling and testing units. RESULTS: The mean prevalence of HIV infection in this study was 5.30%. The mean prevalence rate in men was 5.26%, with a peak of 7.55% in the 30-34 years age-group. The mean prevalence rate in women was 5.35%, with a peak of 6.59% in the same age-group. Type HIV-1 was predominant (84.2% of the total). The most affected area was Dabou, with a rate three times higher (15.83%) than the average rate observed during the study. More educated people (university level) presented 3.5-fold (for men) or 6-fold (for women) higher infection rates than illiterate people. Although 100% of people who tested positive received a medical or community referral according to their specific needs, only 62.1% were first-line referred for medical care. CONCLUSION: In the light of the results of this study, we believe that community mobilization must be redirected to the most severely affected populations to facilitate earlier diagnosis. Actions such as training and prevention based on communication to encourage changes of behaviour should therefore be priorities in the national counselling and testing programme.

[Estimated costs of the expanded program of immunization in the health district of Grand Bassam, Cote d'Ivoire]. / Estimation des coûts du programme élargi de vaccination dans le district sanitaire de Grand Bassam, Côte d'Ivoire.

The vaccines of the Expanded Immunization Program are administered free of charge to beneficiaries. However, these vaccines are purchased by countries and partners of immunization. These costs need to be estimated to be better understood. We conducted a descriptive cross-sectional study of the costs of the Expanded Immunization Program in the health district of Grand-Bassam from January 1 to December 31, 2006, with questions aiming to understand the costs from the point of view of the state and partners. We aimed to determine costs by level of expenditure, calculate the cost per child who received 3 doses of vaccine against Diphtheria-Tetanus-Pertussis-Hepatitis B and cost per strategy. Vaccines and injection supplies accounted for 49% of recurrent costs. Vehicles and motorcycles for transport accounted for 73% of non-recurrent costs. The recurrent cost per child who received 3 doses of the vaccine was 10 797 FCFA (16 euros). The recurrent cost per dose administered was 1,041 FCFA (1,58 euros) for the fixed strategy, 4,232 FCFA (6,45 euros) for the outreach strategy and 4,058 FCFA (6,18 euros) for the mobile strategy. Because of the scarcity of financial resources, the Côte d'Ivoire government must strengthen efficient public-health measures, including vaccination.

[Estimated operational costs of vaccination campaign to combat yellow fever in Abidjan]. / Coûts de la riposte vaccinate contre la fièvre jaune à Abidjan, 2001.

A cost effectiveness study was conducted with the main objective to assess the operational costs of a vaccination campaign against yellow fever organised and implemented in Abidjan from September 21st to October 2nd, 2001. The study was carried out from the perspective of the health authorities. Data was collected retrospectively on all information related to resources needed and required activities. The justification of the monetary value of resources was provided with written proof and receipts as well as other supporting documents. The coverage achieved was 91.33% with 2 584 360 doses of vaccine having been administered. Spending on vaccines and vaccine supplies amounted to 1 123 177 128 FCFA; the average cost per dose was 539.40 FCFA. Human resource costs amounted to 2590 people who were mobilized for a total cost of 125 678 400 FCFA. The total operational cost of the vaccination campaign was 1 394 010 829 FCFA. Vaccines and supplies were the largest item of expenditure, or 80.57% of the total spent. The results of this study could serve as a tool for decision-making related to funding a vaccination campaign. Taking account of these results could contribute to the development of strategies to effectively reduce the operational cost of a vaccination campaign.