Epidemiological and virological surveillance of the prevention of mother-to-child transmission of HIV among pregnant women in Togo.

BACKGROUND: In 2015, Togo introduced the "test-and-treat" strategy for the prevention of mother-to-child transmission (PMTCT) of HIV. Pediatric HIV infection remains a public health problem in Togo, with a mother-to-child transmission (MTCT) rate of 3.6% in 2020. This study aimed to estimate cases of HIV seroconversion during pregnancy and to identify pregnant women at high risk of transmitting HIV to their children in Lomé, Togo. METHODS: A descriptive cross-sectional study was carried out from 18 March to 22 May 2022 among women who had given birth in five maternity units providing PMTCT services in Lomé. Umbilical cord blood samples were taken from the maternal side by midwives after delivery. HIV serology was performed in the laboratory using the Alere™ HIV Combo SET and First Response HIV 1-2. Card Test version 2.0. A sample was considered positive if both tests were positive. The HIV-1 viral load in HIV-1-positive samples was measured using Cobas/Roche 4800 equipment. Information on the women was extracted from maternal antenatal records and antenatal consultation registers. RESULTS: A total of 3148 umbilical cord blood samples (median maternal age: 28 years (interquartile range [24-32]) were collected. Among them, 99.3% (3145/3148) had presented for at least one antenatal clinic visit before giving birth, and 78.7% (2456/3122) had presented for at least four visits. One hundred and twenty-one (121) cord samples were HIV-1 positive, representing a seroprevalence of 3.8% (95% CI = [3.2-4.6]). Among them, 67.8% (82/121) were known HIV-positive before the current pregnancy, 29.7 (36/121) were diagnosed as HIV-positive at the antenatal visits and 2.5% (3/121) were diagnosed as HIV-positive in the delivery room. Of the HIV-positive women, 85.9% (104/121) were on ARV treatment before delivery. The viral load was < 1000 copies/ml in 97.5% (118/121) cases. CONCLUSION: This study explored the virologic and epidemiological aspects of HIV among pregnant women in Togo. The results show significant viral suppression at delivery in women ART. Surveillance based on umbilical cord blood specimen screening is an interesting approach for monitoring the effectiveness of PMTCT programmes.

Effect of the COVID-19 pandemic on HIV, malaria and tuberculosis indicators in Togo: an interrupted time series analysis.

BACKGROUND: Limited data are available on the effects of the COVID-19 pandemic on health-related indicators in sub-Saharan Africa. This study aimed to estimate the effect of the COVID-19 pandemic on nine indicators of HIV, malaria and tuberculosis (TB) in Togo. METHODS: For this interrupted time series analysis, national health information system data from January 2019 to December 2021 and TB programmatic data from the first quarter of 2018 to the fourth quarter of 2022 were analysed. Nine indicators were included. We used Poisson segmented regression to estimate the immediate impact of the pandemic and per-pandemic period trends through incidence rate ratios (IRRs) with 95% CIs. RESULTS: Overall, there was a decrease in six of the nine indicators, ranging from 19.3% (IRR 0.807, 95% CI 0.682 to 0.955, p=0.024) for the hospitalisation of patients for malaria to 36.9% (IRR 0.631, 95% CI 0.457 to 0.871, p=0.013) for TB diagnosis by Mycobacterium tuberculosis Xpert immediately after the declaration of the COVID-19 pandemic. A comparison of the observed and predicted trends showed that the trend remained constant between the prepandemic and pandemic periods of COVID-19 for all malaria indicators. A significant downward monthly trend was observed in antiretroviral therapy initiation (IRR 0.909, 95% CI 0.892 to 0.926, p<0.001) and positive TB microscopy (IRR 0.919, 95% CI 0.880 to 0.960, p=0.002). CONCLUSION: HIV, malaria and TB services were generally maintained over time in Togo despite the COVID-19 pandemic. However, given the decline in levels immediately after the onset of the pandemic, there is an urgent need to improve the preparedness of the healthcare system.

Factors Associated With Precancerous Cervical Lesions in Human Immunodeficiency Virus-Infected Women: A Cross-Sectional Survey in Togo.

Background: The burden of human immunodeficiency virus (HIV) in cervical cancer remains a major public health challenge in developing countries, like Togo. Precancerous lesions include all cellular abnormalities that have malignant potential that can develop into cancer. The objective of this study was to determine the prevalence and factors associated with precancerous cervical lesions in HIV-infected women in our context. Methods: A cross-sectional descriptive study was carried out from November 31, 2022, to January 31, 2023, in an HIV care center in Lomé (Non-Governmental Organization Espoir Vie Togo [NGO EVT] Grand-Lomé-Togo). Results: A total of 271 women were included with a mean age of 47.0 years and a standard deviation of 10.0 years, among whom 20.7% do not have any scholar education. Only 6.7% of them had previously performed cervical smear examinations. The prevalence of precancerous cervical lesions observed in people living with human immunodeficiency virus (PLHIV) was 11.4% with a 95% confidence interval (CI) of 5.0 to 15.4. Cytological abnormalities were marked by low-grade squamous intraepithelial lesion (LSIL) (5.1%), followed by the presence of atypical squamous cells of undetermined significance (ASCUS) (3.5%). A statistically significant association was found between parity and the presence of precancerous lesions (P = .014). Conclusions: In this study, more than 1 out of 10 women living with HIV had precancerous cervical lesions, and parity was the factor associated. The implementation of a systematic screening program for precancerous cervical lesions and human papillomavirus (HPV) infection integrated into HIV care is necessary for early treatment.

Unmet needs for modern contraceptive methods among sexually active adolescents and young women in Togo: a nationwide cross-sectional study.

Background: The unmet need for modern contraceptives among sexually active adolescent and young women (AYW) in Africa contributes to high morbidity and mortality. To investigate the prevalence of unmet need for modern contraceptives and its associated factors among AYW in Togo, we performed a secondary analysis of data from the MICS-62017 survey. Method: We extracted data from sexually active AYW aged 15-24 years for the analysis and used multi-level logistic regression models to identify factors associated with unmet need for modern contraceptives. Results: Among the AYW, the median age was 20 years. The prevalence of unmet need for modern contraceptives was 27.02%. Factors that increased the likelihood of having unmet need for contraceptives included being in the "Poor" or "Middle" quintile of household wealth, aged 20-24 years, and completing primary or secondary education. Living in a household headed by a woman and having a household head aged 19-38, 39-58, or greater than 78 years decreased the likelihood of unmet need for modern contraceptives. Conclusion: The study highlights the high-unmet need for modern contraceptives among sexually active AYW in Togo and emphasizes the importance of addressing individual and household/community factors to improve their sexual and reproductive health. Interventions such as increasing AYW awareness, providing social marketing campaigns in schools, and targeting men-headed households could help promote modern contraceptive use and improve the sexual and reproductive health of AYW in Togo.

The elimination of trachoma as a public health problem in Togo: Successes and challenges.

BACKGROUND: As of May 2022, 15 countries have declared that they have reached their trachoma elimination targets, but only 13 of them, including Togo, have been validated by the World Health Organization as having eliminated the disease as a public health problem. The aim of this study was to describe the broad interventions that have supported the elimination of trachoma as a public health problem in Togo from its inception in 2006 to the validation of its elimination in 2022. METHOD: A review and compilation of data and information contained in the country's submission to World Health Organization for validation of trachoma elimination as a public health problem was conducted. Data from national and local surveillance systems and reports on actions taken after achieving the elimination target were also included. RESULTS: Togo has achieved the elimination of trachoma as a public health problem by 2022. The prevalence of follicular trachoma among children aged 1-9 years is <5% in all nationally defined administrative units suspected of having trachoma after stopping mass treatment for at least 2 years. The prevalence of trichiasis among persons aged 15 years and older is less than 0.2% in all administrative units previously endemic for trachoma and evidence of the ability to manage incident cases of emerging trichiasis in the community has been demonstrated. The key of the success in the elimination process was primarily the political commitment of the health authorities with financial and technical support from various international organizations. CONCLUSION: The elimination of trachoma as a public health problem in Togo is a real success story that can serve as an example for the elimination of other neglected tropical diseases in Africa. But regular monitoring and surveillance is essential to avoid the re-emergence of such disease in the country.

High SARS-CoV-2 seroprevalence among street adolescents in Lomé, Togo, 2021.

BACKGROUND: There is almost no data on the circulation of SARS-CoV-2 among street adolescents. We conducted a study to document the immunization status of street adolescents in Togo against different variants of SARS-CoV-2. METHODS: A cross-sectional study was carried out in 2021 in Lomé, the city with the highest number of COVID 19 cases in Togo (60%). Adolescents aged 13- and 19 years old living on the street were eligible for inclusion. A standardized questionnaire was administered face-to-face to adolescents. A sample of blood was taken and aliquots of plasma were transported to the virology laboratory of the Hôpital Bichat-Claude Bernard (Paris, France). SARS-CoV-2 anti-S and anti-N IgG were measured using chemiluminescent microparticle immunoassay. A quantitative miniaturized and parallel-arranged ELISA assay was used to detect IgG antibodies specifically directed against the different SARS-CoV-2 Variants of Concern (VOC). RESULTS: A total of 299 street adolescents (5.2% female), median age 15 years, interquartile range (14-17 years), were included in this study. The prevalence of SARS-CoV-2 infection was 63.5% (95%CI: 57.8-69.0). Specific-IgG against the ancestral Wuhan strain was developed by 92.0% of subjects. The proportion of patients being immunized against each VOC was 86.8%, 51.1%, 56.3%, 60.0, and 30.5% for the Alpha, Beta, Gamma, Delta, and Omicron VOCs, respectively. CONCLUSION: This study showed a very high prevalence with approximately 2/3 of Togolese street adolescents having antibodies to SARS-CoV-2 due to a previous infection. These results confirm an under-reporting of COVID-19 cases in Togo, questioning the hypothesis of low virus circulation in Togo and even in Africa.

COVID-19 vaccination coverage among travellers at Lomé international airport (Togo), in 2022.

COVID-19 pandemic management leads to new health policies including the requirement of a vaccination pass or a negative Polymerase Chain Reaction (PCR) test for cross-border flights. The objective of this study was to estimate COVID-19 vaccination coverage among travellers, as well as factors associated with a full vaccination. A cross sectional study was conducted in July 2022 at the Gnassingbé Eyadema International Airport (LFW) in Lomé. Travellers met at LFW, aged 12 years or above, and who agreed to participate in the study have been submitted a questionnaire. Logistic regression analysis was performed to identify factors associated with full vaccination defined as having received at least two doses of COVID-19 vaccine according to a validated vaccine schedule. A total of 847 travellers were included. 67% were men The median age was 40 years, Interquartile Range [31-48]. The main health document presented by travellers was the vaccination pass (69.1%). The majority (84.4%) of travellers had received at least one dose of COVID-19 vaccine and 63.9% had received at least two doses. Being 40 years of age or above (aOR=1.42; P=0.046), and travelling from a country outside Africa (aOR=2.18, P=0.003), were positively associated with full vaccination. Vaccination coverage among travellers at the LFW was relatively high. Travellers from a region outside Africa and aged 40 years or above were more likely to be full vaccinated. Better communication and strengthening of the vaccination strategies in Africa could help reduce these gaps.

COVID-19 vaccination coverage among travellers at Lomé International airport (Togo), in 2022

Introduction: COVID-19 pandemic management leads to new health policies including the requirement of a vaccination pass or a negative Polymerase Chain Reaction(PCR)test for cross-border flights. The objective of this study was to estimate COVID-19 vaccination coverage among travelers, as well as factors associated with a full vaccination. Materials and Methods: A cross sectional study was conducted in July 2022 at the Gnassingbé Eyadema International Airport (LFW) in Lomé. Travellers met at LFW, aged 12 years or above, and who agreed to participate in the study have been submitted a questionnaire. Logistic regression analysis was performed to identify factors associated with full vaccination defined as having received at least two doses of COVID-19 vaccine according to a validated vaccine schedule. Results: A total of847travellerswere included. 67% were menThe median age was 40 years, Interquartile Range [31-48]. The main health document presented by travellers was the vaccination pass(69.1%). The majority (84.4%) of travellershad received at least one dose of COVID-19 vaccine and 63.9% had received at least two doses. Being 40 years of age or above(aOR=1.42;p=0.046), and travellingfrom a country outside Africa (aOR=2.18, p=0.003), were positively associated with full vaccination. Conclusion: Vaccination coverage among travellers at the LFWwas relatively high. Travellersfrom a region outside Africa and aged40 years or above were more likely to be full vaccinated. Better communication and strengthening of the vaccination strategiesin Africa could help reduce these gaps.

SARS-CoV-2 antibody seroprevalence in Togo: a national cross-sectional household survey, May-June, 2021.

BACKGROUND: The extent of SARS-CoV-2 circulation in African countries is still unclear. Seroprevalence studies are a common approach to epidemiological surveillance, allowing estimation of the proportion of people who have had contact with the virus. We aimed at estimating the seroprevalence of anti-SARS-CoV-2 antibodies and associated factors in Togo at the national level in 2021 according to age groups, gender, and place of residence (rural or urban). METHODS: From 15 May to 31 June 2021, we conducted a nationally representative cross-sectional serological survey in 12 health districts (two districts per health region) in the > 5 years old population in Togo. The Wantai SARS-CoV-2 total antibody assay S protein receptor-binding domain-based ELISA (Wantai Biological Pharmacy Enterprise Co.; Beijing, China) was used to determine the presence of SARS-CoV-2 total antibodies in plasma. Crude and weighted seroprevalences (weighted by age, sex and place of residence) were calculated and then weighted seroprevalences were adjusted according to sensitivity and specificity of the ELISA test. Finally, logistic regression models were performed in order to describe factors associated. RESULTS: Of the 7593 participants, the overall weighted and adjusted seroprevalence of total anti-SARS-CoV-2 antibodies was 65.5% (CI95%: 18.9-21.1). Urban dwellers, young adults (30-49 years) and vaccinated individuals were significantly more likely to be seropositive. CONCLUSION: The high seroprevalence we observed is consistent with observations across West Africa. Quantification of the level of immunity in the population is needed to know how close we are to herd immunity. In the meantime, vaccination against the COVID-19 remains necessary.

How mHealth Can Contribute to Improving the Continuum of Care: A Scoping Review Approach to the Case of Human Immunodeficiency Virus in Sub-Saharan Africa.

Objectives: To determine mHealth's contribution to improving the continuum of care in sub-Saharan Africa towards achieving treatment targets for human immunodeficiency virus (HIV) endorsed by the 2016 Political Declaration on ending acquired immunodeficiency syndrome (AIDS). Methods: PubMed, Medline, Embase, Web of Science Core Collection and Cochrane databases; three observatories and four repositories were searched to identify and select relevant articles, projects and guidelines published from 1 January 2017, to 30 April 2021. Records focusing on the use of mHealth related to HIV treatment cascade or healthcare provider/patient relationship were considered. Results: From 574 identified records, 381 (206 scientific manuscripts and 175 mHealth projects) were considered. After screening, 36 articles (nine randomized control trials, five cohort studies, 19 qualitative studies, and three economic studies) and 23 projects were included. Conclusion: The cross-cutting benefits of mHealth that enhance patient empowerment have been identified. Important challenges such as gaps between research and implementation, lack of transdisciplinary collaboration, and lack of economic evidence were identified to support future mHealth research and accelerate the achievement of treatment targets for HIV.

Estimation of yellow fever incidence in Togo between 2010 and 2020.

BACKGROUND: Yellow fever virus is an arbovirus transmitted to humans by Aedes and Haemogogus mosquito species. To date, there is no specific treatment for yellow fever. However, an effective vaccine is available for the prevention. After a decline in yellow fever cases in Africa between 2004 and 2015, large-scale transmission of the virus was observed in Africa during 2019, with outbreaks recorded in West Africa. The objective of this study was to estimate the incidence of yellow fever cases recorded in the national reference laboratory of Togo from 2010 to 2020. METHOD: Data were extracted from the National Institute of Hygiene database from 2010 to 2020 with an Excel sheet and descriptive analyses were performed. RESULTS: A total of 4350 samples were collected between 2010 and 2020 in Togo from yellow fever suspected cases. These cases had a median age of 12 years (IQR: 5-24), and 21% of them were from the Maritime region. Among them, 30 cases were reported by national laboratory, with a global incidence of 0.7% (confidence interval 95%: [0.4-1.0]). At the yellow fever regional laboratory, 14 cases were confirmed with an incidence of 0.33% (confidence interval 95%: [0.18-0.55]). In this population, 37.7% had been immunized against yellow fever. CONCLUSION: This study shows that Togo presents cases of yellow fever. Identification of the vectors and implementation of efficient vector control measures could help prevent this disease, as well as other diseases transmitted by the same vectors. Yellow fever vaccination should be a priority in vaccination programs.

Knowledge and practices of female students at university of Kara regarding sexually transmitted infections in Togo, 2021.

A good knowledge of sexually transmitted infections (STI) in female students is an important element in the prevention of STI transmission. The objective of this study is to describe the level of knowledge and practices on STI among female students at the University of Kara. A cross-sectional study was conducted at the University of Kara from July to September 2021. Data were collected using a standard, digitalised, selfadministered questionnaire. Logistic regression analysis was used to describe factors associated with the level of knowledge of STIs. A total of 1,055 female students with a median age of 21 years (interquartile range: 20-24) participated in the study. More than one-third (33.7%) of the students had good knowledge of STI. Having already been tested for HIV (aOR=3.25; 95% CI 2.36-4.52), having already had sex (aOR=1.56; 95% CI 1.10-2.24) and the level of education (AOR=3.46; 95% CI 2.10-5.85) were significantly associated with good STIs knowledge. Among the 723 female students (68.5%) who already had sex, 32.5% reported inconsistent use of condoms during sexual intercourse and 18.9% reported having multiple sexual partners. The results of this study highlight the importance of intensifying STIs prevention efforts (awareness, screening, and vaccination) among female students at the University of Kara.

Knowledge and practices among healthcare workers regarding dengue in Togo.

In Togo where malaria is endemic, because main signs of malaria and dengue are similar, the use of malarial drugs first could contribute to a delay in the diagnosis of dengue and the dissemination of the disease. Thus, it is important that healthcare workers (HCW) have a good knowledge of these diseases. To assess the knowledge, and practices regarding dengue infection among HCW in Togo. A cross-sectional study was carried out from November 2020 to March 2021 among HCW in Togo. A pre-tested digital questionnaire was used for data collection. Based on clinical signs of dengue, preventive measures, infection type and disease type, a knowledge score was constructed with eight questions. A total of 334 HCW with median age 32 years, IQR:(28-38) responded to the survey and the sex ratio male/female was 5.9. The majority (94.0%) of HCW have heard about dengue through training (73.3%), internet (38.0%) and media (33.2%). Compared with lower executive HCW, senior manager were more knowledgeable about the causative agent, the symptoms and preventive methods of dengue infection (p<0.001). Globally, good knowledge (score ≥6) about dengue was found for 47.1% of HCW. More than 9 out of 10 HCW (91.3%) reported the lack of dengue diagnostic tools. Providing health structures with dengue diagnostic tools and training health personnel in their use in any febrile patient with a negative or positive malaria test would help prevent dengue epidemic.

Prevalence of Malaria and Covid-19 in Febrile Patients in Lomé, Togo in 2020.

PURPOSE: The objective of this study was to estimate the prevalence of malaria and Covid-19 by PCR and serological tests in febrile patients in Lomé. METHODS: A cross-sectional study was conducted from September 1 to October 31, 2020 in febrile patients ≥ 10 years in three health facilities in Lomé. Finger stick blood was collected to detect Plasmodium spp. using thin/thick smear and venous blood on EDTA tubes to test for malaria Histidin-Rich-Protein-2 antigen using rapid diagnostic tests (RDT) and SARS-CoV-2 antibodies specific immunoglobulin (Ig) M and G. Detection of SARS-CoV-2 in nasopharyngeal samples was performed by rRT-PCR using GeneXpert. RESULTS: A total of 243 participants (61.7% of female) with median age 28 years (IQR 18-41) were included in the study. Prevalence of malaria was 25.1%, 95% CI [19.8-31.0] and 30.4%, 95% CI [24.7-36.7] for thin/thick smear and rapid malaria test, respectively. Eighteen patients (7.4%, 95% CI [4.4-11.5]) were positive for SARS-CoV-2 and forty-two (17.3%, 95% CI [12.8-22.6]) were positive for IgM and/or IgG against SARS-CoV-2. SARS-CoV-2 IgM seroprevalence was significantly higher in malaria RDT positive participants (33.8% vs. 10.1%, p < 0.001). CONCLUSION: This study confirms a possible cross-reactivity between Covid-19 and malaria in case of single use of rapid tests, suggesting a possible past contamination. In case of clinical signs related to Covid-19 in malaria-endemic areas, PCR screening should be requested in order to identify and isolate patients.

Regional heterogeneity of malaria prevalence and associated risk factors among children under five in Togo: evidence from a national malaria indicators survey.

BACKGROUND: Malaria remains a major cause of morbidity and death among children less than 5 years of age. In Togo, despite intensification of malaria control interventions, malaria remained highly prevalent, with significant heterogeneity from one region to another. The aim of this study is to explore further such regional differences in malaria prevalence and to determine associated risk factors. METHODS: Data from a 2017 cross-sectional nationally representative malaria indicator survey was used. Children aged 6-59 months in selected households were tested for malaria using a rapid diagnostic test (RDT), confirmed by microscopy. Univariate and multivariate logistic regression analysis were performed using Generalized Linear Models. RESULTS: A total of 2131 children aged 6-59 months (1983 in rural areas, 989 in urban areas) were enrolled. Overall 28% of children tested positive for malaria, ranging from 7.0% in the Lomé Commune region to 4% 7.1 in the Plateaux region. In multivariate analysis, statistically significant differences between regions persisted. Independent risk factors identified were higher children aged (aOR = 1.46, 95% CI [1.13-1.88]) for those above 24 months compared to those below; households wealth quintile (aOR = 0.22, 95% CI [0.11-0.41]) for those richest compared to those poorest quintiles; residence in rural areas (aOR = 2.02, 95% CI [1.32-3.13]). CONCLUSION: Interventions that target use of combined prevention measures should prioritise on older children living in poorest households in rural areas, particularly in the regions of high malaria prevalence.

Prevalence and factors associated with burnout among healthcare workers during the COVID-19 pandemic in Togo, June 2021.

COVID-19 pandemic is responsible for increased demand for care and patient mortality, resulting in emotional and physical stress for healthcare workers (HCWs). We aimed to estimate the prevalence of burnout and its associated factors among HCWs in Togo during the pandemic. We conducted an online cross-sectional study from June 14 to 29, 2021 targeting HCWs in Togo. The variable of interest was burnout measured by the Copenhagen Burnout Inventory. Of the 523 participants, the overall burnout prevalence was 53.5% (95% CI= 49.2 - 57.9). The prevalence by burnout dimension was respectively 39.4%, 38.4% and 22.1% for personal, work-related and patient-related burnout. Our results suggest that occupational health teams should engage in the prevention, screening, and management of burnout among HCWs.

Prevalence of severe adverse events among health professionals after receiving the first dose of the ChAdOx1 nCoV-19 coronavirus vaccine (Covishield) in Togo, March 2021.

BACKGROUND: The coronavirus disease 2019 (COVID-19) vaccines can cause adverse events that can lead to vaccine hesitancy. This study aims at estimating the prevalence of severe adverse events (SAEs) and their associated factors among health professionals vaccinated with ChAdOx1 nCoV-19 vaccine in Togo. METHODS: A cross-sectional study was conducted from March 13th to 19th, 2021 in Togo among health professionals who received the first dose of the vaccine. An online self-administered questionnaire was used to collect sociodemographic and vaccination data. SAEs were defined as one resulting in hospitalization, medical consultation, or inability to work the day following the administration of the vaccine. Data analysis were performed using R© 4.0.1 software, and a 5% significance level was considered. RESULTS: A total of 1,639 health professionals (70.2% male) with a median age of 32 (interquartile range: 27-40) were enrolled. At least one adverse event was reported among 71.6% of participants (95% CI = [69.3-73.8]). The most commonly reported adverse events were injection site pain (91.0%), asthenia (74.3%), headache (68.7%), soreness (55.0%), and fever (47.5%). An increased libido was also reported in 3.0% of participants. Of the participants who experienced adverse events, 18.2% were unable to go to work the day after vaccination, 10.5% consulted a medical doctor, and 1.0% were hospitalized. The SAEs' prevalence was 23.8% (95% CI = [21.8-25.9]). Being <30 years (AOR = 5.54; p<0.001), or 30-49 years (AOR = 3.62; p<0.001) and being female (AOR = 1.97; p<0.001) were associated with SAEs. CONCLUSIONS: High prevalence of SAEs have been observed in health professionals in Togo after ChAdOx1 nCoV-19 vaccination especially in young people and females. However, these data are reassuring as they inform on COVID-19 vaccines' SAE management. Systematic prescription of antalgics or antipyretics could be proposed to young people who get vaccinated.

Prevalence and factors associated with trichomonas vaginalis infection among female sex workers in Togo, 2017.

BACKGROUND: The aim of this study was to estimate the prevalence and factors associated with Trichomonas vaginalis (T. vaginalis) among female sex workers (FSW) in Togo in 2017. A cross-sectional bio-behavioral study was conducted from August to October 2017 using a respondent-driven sampling method in four cities in Togo. METHOD: A standardized questionnaire was used to record socio-demographic data and sexual behavior patterns. T. vaginalis detection by molecular biology tests was performed using Allplex STI Essential Assay which detect also 6 others micro-organisms. A blood sample was drawn and serological test using SD Bioline Duo VIH/Syphilis rapid test was performed for Human immunodeficiency virus (HIV) and syphilis testing. RESULTS: A total of 310 FSW with median age 25 years, interquartile range (IQR) [21-32 years] were included. The prevalence of T. vaginalis was 6.5% (95%CI = [4.1-9.9]) and, overall, prevalence of other STI ranged from 4.2% (95%CI = [2.3-7.2]) for N. gonorrhoeae to 10.6% (95% CI = [7.5-14.7]) for HIV. Binary logistic regression was conducted to assess factors associated with T. vaginalis infection. Living in Lomé (aOR = 3.19; 95%CI = [1.11-11.49]), having had sexual intercourse before the age of 18 (aOR = 5.72; 95%CI = [1.13-10.89]), and being infected with C. trachomatis (aOR = 3.74; 95%CI = [2.95-12.25]) were factors associated with T. vaginalis among FSW. CONCLUSION: The prevalence of T. vaginalis infection using molecular test was low among FSW in Togo. Extensive studies are needed to confirm and to better understand the epidemiology of T. vaginalis among this population and in other populations in Togo.

Effets de la COVID-19 sur la variation du revenu et la sécurité alimentaire des ménages au Togo.

L'objectif de ce papier est d'analyser les effets de la COVID-19 sur la variation des revenus, la modification de la consommation alimentaire et les stratégies d'adaptations des ménages au Togo. Pour se faire, les modèles probit et logit multinomiale ont été utilisés en se basant sur des données collectées auprès de 1405 ménages dans 44 districts des 6 régions sanitaires. Les résultats révèlent que les ménages dans lesquels le chef a perdu son emploi sont plus exposés à une baisse de revenu et donc à une réduction de leur consommation alimentaire pendant la pandémie. Toutefois, les transferts monétaires octroyés aux personnes vulnérables ont un effet positif, mais non significatif sur le changement de leur revenu. Par ailleurs, les ménages bénéficiaires de prestations sociales au sein desquels le chef a un niveau d'éducation supérieur, sont plus susceptibles de supporter les effets de la pandémie. Ainsi, pour les ménages ayant ressenti un effet modéré ou sévère de la crise, la probabilité est élevée qu'ils diminuent leur consommation alimentaire. A cet effet, il serait intéressant d'étendre les prestations sociales aux acteurs du secteur informel et d'accélérer la mise en place du registre social unique pour un meilleur ciblage des ménages vulnérables.