Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.399
Filtrar
1.
Infect Dis Poverty ; 11(1): 3, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34983662

RESUMO

BACKGROUND: Schistosomiasis remains an important public health problem, also among adults, and infected individuals not treated serve as a reservoir for continued transmission. Despite this fact, evidence on the epidemiology of schistosomiasis in adults in Côte d'Ivoire is scanty. This study aimed to determine the prevalence and risk factors of Schistosoma infection and co-infection with other helminth species and Plasmodium among adults in the Taabo region in the south-central part of Côte d'Ivoire. METHODS: A cross-sectional survey was carried out in April and May 2017 in the frame of the "Côte d'Ivoire Dual Burden of Disease Study" (CoDuBu). A total of 901 randomly selected individuals, aged 18-90 years, provided blood, stool and urine samples for the diagnosis of malaria and helminth infections. Stool samples were subjected to the Kato-Katz technique for detection of Schistosoma mansoni and soil-transmitted helminth eggs, while urine samples were examined for eggs of Schistosoma haematobium and circulating cathodic antigen of S. mansoni. Risk factors and morbidity profiles were assessed using health examination and questionnaires. Multinomial logistic regressions were employed to identify risk factors and morbidity patterns associated with S. mansoni mono- and co-infections. RESULTS: The prevalence of S. mansoni and S. haematobium was 23.2% and 1.0%, respectively. Most S. mansoni were mono-infections (81.3%). Independent determinants of S. mansoni infection were young age, low socioeconomic status (mono- and co-infection) and poor hygiene practices (co-infection) (P < 0.05). S. mansoni infection was independently associated with higher pain and symptom scores (mono-infection), poor self-rated health and low healthcare use (co-infection) (P < 0.05). CONCLUSIONS: This study showed that adults represent a substantial reservoir of S. mansoni. To sustain schistosomiasis control and improve people's wellbeing, it is important to expand preventive chemotherapy from school-aged children to adults, coupled with hygiene and health education.


Assuntos
Coinfecção , Parasitos , Esquistossomose mansoni , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Coinfecção/epidemiologia , Costa do Marfim/epidemiologia , Estudos Transversais , Fezes , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Schistosoma haematobium , Schistosoma mansoni , Esquistossomose mansoni/epidemiologia , Adulto Jovem
2.
BMC Pregnancy Childbirth ; 21(1): 848, 2021 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-34965869

RESUMO

INTRODUCTION: Despite the important increase in in-facility births, perinatal mortality rates have remained high and slow to decrease in many developing countries. This situation is attributed to poor childbirth care quality. The reason why women delivering in health facilities do not always receive care of an adequate standard is unclear. We assessed the determinants of childbirth care quality along the care continuum by means of different approaches. METHODS: A health facility-based cross-sectional study with a direct observation of health care workers' practices while caring for mother-newborn pairs was carried out in Burkina Faso and Côte d'Ivoire. The performance of a set of essential best practices (EBPs) was assessed in each birth event at the admission, prepushing and immediate postpartum stages. A quality score, in the form of the additive sum of EBPs effectively delivered, was computed for each stage. We used negative binomial regression models and a structural equation modeling analysis to assess the determinants of care quality at each stage and the relationships of the quality delivered at the different stages, respectively. RESULTS: A total of 532 and 627 mother-newborn pairs were evaluated in Burkina Faso and Côte d'Ivoire, respectively. In both countries, delivery care quality varied significantly at all stages between health districts. Predelivery care quality was consistently higher in referral hospitals than in primary health care facilities (incident rate ratio (IRR) = 1.02, p < 0.05, and IRR = 1.10, p < 0.05, respectively, for Burkina Faso and Côte d'Ivoire). Quality at admission was poorer among nurses than among midwives in Burkina Faso (IRR = 0.81, p < 0.001). Quality at the admission and predelivery stages was positively correlated with immediate postpartum care quality (ß = 0.48, p < 0.001, and ß = 0.29, p < 0.001, respectively). CONCLUSION: Quality improvement strategies must target both providers and health facilities, and different inputs are needed depending on the stage in the care continuum.


Assuntos
Continuidade da Assistência ao Paciente , Instalações de Saúde/normas , Pessoal de Saúde/normas , Parto , Qualidade da Assistência à Saúde/normas , Adulto , Burkina Faso , Costa do Marfim , Estudos Transversais , Feminino , Instalações de Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Análise de Classes Latentes , Gravidez , Indicadores de Qualidade em Assistência à Saúde , Qualidade da Assistência à Saúde/estatística & dados numéricos
3.
Reprod Health ; 18(1): 251, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34930322

RESUMO

BACKGROUND: Women use various terms when discussing the management of their fertility and menstrual irregularities and may interpret the experience of ending a possible pregnancy in nuanced ways, especially when their pregnancy status is ambiguous. Our study aims to understand the terminology used to refer to abortion-like experiences (specifically menstrual regulation and pregnancy removal), and the specific scenarios that these practices encompass among women who reported doing something to bring back a late period or ending a pregnancy in Nigeria and Côte d'Ivoire. METHODS: Our analysis draws upon surveys with women in Nigeria (n = 1114) and Cote d'Ivoire (n = 352). We also draw upon qualitative in-depth interviews with a subset of survey respondents in Anambra and Kaduna States in Nigeria, and Abidjan, Cote d'Ivoire (n = 30 in both countries). We examine survey and interview questions that explored women's knowledge of terminology pertaining to ending a pregnancy or bringing back a late period. Survey data were analyzed descriptively and weighted, and interview data were analyzed using inductive thematic analysis. RESULTS: We find that the majority (71% in Nigeria and 70% in Côte d'Ivoire) of women perceive menstrual regulation to be a distinct concept from pregnancy removal, yet there is considerable variability in whether specific scenarios are interpreted as referring to menstrual regulation or pregnancy removal. Menstrual regulation is generally considered to be more ambiguous and not dependent on pregnancy confirmation in comparison to pregnancy removal, which is consistently interpreted as voluntary termination of pregnancy. CONCLUSIONS: Overall, menstrual regulation and pregnancy removal are seen as distinct experiences in both settings. These findings have relevance for researchers aiming to document abortion incidence and experiences, and practitioners seeking to address women's reproductive health needs.


Assuntos
Fertilidade , Costa do Marfim , Feminino , Humanos , Nigéria , Gravidez
4.
Front Public Health ; 9: 653481, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733811

RESUMO

Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Côte d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted. The study was conducted from September to November 2019 within 3 months of the initiation of HIVST distribution. Individual interviews were conducted with 60 key informants involved in the project or in providing support and care to key populations: members of health ministries, national AIDS councils, international organizations, national and international non-governmental organizations, and peer educators. Semi structured interviews were recorded, translated when necessary, and transcribed. Data were coded using Dedoose© software for thematic analyses. We found that stakeholders' perceptions and attitudes are favorable to the introduction and integration of HIVST for several reasons. Some of these reasons are held in common, and some are specific to each key population and country. Overall, HIVST is considered able to reduce stigma; preserve anonymity and confidentiality; reach key populations that do not access testing via the usual strategies; remove spatial barriers; save time for users and providers; and empower users with autonomy and responsibility. It is non-invasive and easy to use. However, participants also fear, question and doubt users' autonomy regarding their ability to use HIVST kits correctly; to ensure quality secondary distribution; to accept a reactive test result; and to use confirmation testing and care services. For stakeholders, HIVST is considered an attractive strategy to improve access to HIV testing for key populations. Their doubts about users' capacities could be a matter for reflective communication with stakeholders and local adaptation before the implementation of HIVST in new countries. Those perceptions may reflect the West African HIV situation through the emphasis they place on the roles of HIV stigma and disclosure in HIVST efficiency.


Assuntos
Infecções por HIV , Profissionais do Sexo , Minorias Sexuais e de Gênero , Atitude , Costa do Marfim , Feminino , Infecções por HIV/diagnóstico , Homossexualidade Masculina , Humanos , Masculino , Mali , Percepção , Autoteste , Senegal
5.
BMC Health Serv Res ; 21(1): 1211, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34753464

RESUMO

BACKGROUND: Kangaroo Mother Care (KMC) is a high impact, low technology and cost-effective intervention for the care of preterm and low birth weight newborn. Cote d'Ivoire adopted the intervention and opened the first KMC unit in 2019. This study aimed to assess barriers and facilitators of KMC implementation in Cote d'Ivoire, a year after its introduction, as well as proposed solutions for improving KMC implementation in the country. METHOD: This was a qualitative study, using semi-structured interviews, carried out in September 2020 in the first KMC unit opened at the Teaching Hospital of Treichville. The study involved healthcare providers providing KMC and mothers of newborn who were receiving or received KMC at the unit. A thematic analysis was performed using both inductive and deductive (Consolidated Framework for Implementation Research-driven) approaches. NVivo 12 was used to assist with coding. RESULTS: A total of 44 semi-structured interviews were conducted, 12 with healthcare providers and 32 with mothers. The barriers identified were lack of supplies, insufficiency of human resources, lack of space for admission, lack of home visits, lack of food for mothers, lack of collaboration between health services involved in newborn care, increased workload, the beliefs of carrying the baby on the chest, father's resistance, low rate of exclusive breastfeeding, lack of community awareness. Facilitators identified were training of healthcare providers, strong leadership, the low cost of KMC, healthcare providers' perceived value of KMC, mothers-healthcare providers' relationship, mothers' adherence to KMC and the capacity of the KMC unit to network with external organizations. The proposed solutions for improving KMC implementation were volunteer staff motivation, intensifying education and counselling of mothers and families, the recruitment of a psychologist and the involvement of all stakeholders. CONCLUSION: Our study highlighted the challenges to implement KMC in Cote d'Ivoire with unique and specific barriers to implementation. We recommend to researchers and decision makers to respectively design strategies and adopt intervention that specifically address these barriers and facilitators to a better uptake of KMC. Decision makers should also take into account the proposed solutions for a better implementation and scaling up of KMC.


Assuntos
Método Canguru , Criança , Costa do Marfim , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Pesquisa Qualitativa
6.
Geospat Health ; 16(2)2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34730317

RESUMO

Fascioliasis, caused by an infection with liver flukes of the genus Fasciola, is an important disease of livestock in most parts of the world. However, little is known about the distribution of fascioliasis in sub-Saharan Africa. We report results of a cross-sectional study conducted in 2014 in the district des Savanes in the northern part of Côte d'Ivoire. We obtained 275 livers from bovine suspected with fascioliasis and 51 unsuspected livers from 24 slaughterhouses. Livers were dissected using a standard operating procedure and all Fasciola gigantica flukes were removed from the tissues of the liver and the biliary ducts. We found F. gigantica in 125 livers from bovines suspected with fascioliasis (45.5%) in 10 departments of the district des Savanes. Among the unsuspected livers, five were positive for F. gigantica (9.8%). The distribution of fascioliasis showed considerable spatial heterogeneity, both at regional (ranging from 18.0% to 52.3%) and departmental level (ranging from 14.3% to 64.0%). Poro region was the most affected (52.3%) with a relatively homogeneous distribution. The departments most affected by fascioliasis were M'Bengué (64.0%), Sinématiali (62.1%) and Ferkessédougou (52.9%). Our study confirms that fascioliasis is an important veterinary disease in the northern part of Côte d'Ivoire, and hence, high-risk areas need to be targeted for prevention and control measures.


Assuntos
Doenças dos Bovinos , Fasciola , Fasciolíase , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Costa do Marfim/epidemiologia , Estudos Transversais , Fasciolíase/epidemiologia , Fasciolíase/veterinária
7.
Molecules ; 26(20)2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34684809

RESUMO

The chemical variability and the in vitro anti-inflammatory activity of the leaf essential oil from Ivorian Isolona dewevrei were investigated for the first time. Forty-seven oil samples were analyzed using a combination of CC, GC(RI), GC-MS and 13C-NMR, thus leading to the identification of 113 constituents (90.8-98.9%). As the main components varied drastically from sample to sample, the 47 oil compositions were submitted to hierarchical cluster and principal components analyses. Three distinct groups, each divided into two subgroups, were evidenced. Subgroup I-A was dominated by (Z)-ß-ocimene, ß-eudesmol, germacrene D and (E)-ß-ocimene, while (10ßH)-1ß,8ß-oxido-cadina-4-ene, santalenone, trans-α-bergamotene and trans-ß-bergamotene were the main compounds of Subgroup I-B. The prevalent constituents of Subgroup II-A were germacrene B, (E)-ß-caryophyllene, (5αH,10ßMe)-6,12-oxido-elema-1,3,6,11(12)-tetraene and γ-elemene. Subgroup II-B displayed germacrene B, germacrene D and (Z)-ß-ocimene as the majority compounds. Germacrene D was the most abundant constituent of Group III, followed in Subgroup III-A by (E)-ß-caryophyllene, (10ßH)-1ß,8ß-oxido-cadina-4-ene, germacrene D-8-one, and then in Subgroup III-B by (Z)-ß-ocimene and (E)-ß-ocimene. The observed qualitative and quantitative chemical variability was probably due to combined factors, mostly phenology and season, then harvest site to a lesser extent. The lipoxygenase inhibition by a leaf oil sample was also evaluated. The oil IC50 (0.020 ± 0.005 mg/mL) was slightly higher than the non-competitive lipoxygenase inhibitor NDGA IC50 (0.013 ± 0.003 mg/mL), suggesting a significant in vitro anti-inflammatory potential.


Assuntos
Annonaceae/química , Anti-Inflamatórios/química , Anti-Inflamatórios/farmacologia , Óleos Voláteis/química , Óleos Voláteis/farmacologia , Óleos Vegetais/química , Óleos Vegetais/farmacologia , Anti-Inflamatórios/isolamento & purificação , Costa do Marfim , Avaliação Pré-Clínica de Medicamentos , Cromatografia Gasosa-Espectrometria de Massas , Técnicas In Vitro , Lipoxigenase/efeitos dos fármacos , Inibidores de Lipoxigenase/química , Inibidores de Lipoxigenase/isolamento & purificação , Inibidores de Lipoxigenase/farmacologia , Espectroscopia de Ressonância Magnética , Óleos Voláteis/classificação , Folhas de Planta/química , Óleos Vegetais/classificação , Plantas Medicinais/química , Soja/enzimologia
8.
Parasitol Res ; 120(11): 3663-3671, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34586479

RESUMO

Agroecosystems have been associated with risk of malaria. The aim of this study was to determine the relationship between three agroecosystems: (i) rubber plantation (RP); (ii) oil palm plantation (OPP); (iii) no cash crop plantation (NCCP) and the prevalence of Plasmodium falciparum infection among children living in the Aboisso region. In the three villages within (Ehania-V5) or close (N'zikro) or far from (Ayébo) to each agroecosystem (RP, OPP, and NCCP), two cross-sectional parasitological surveys were carried out during the dry and the peak of the long wet seasons. A total of 586 children aged 1-14 years were recruited in the three villages to determine the prevalence of malaria using conventional microscopy. Plasmodium falciparum was the dominant species with an overall infection prevalence of 40.8%. There was a significant difference in prevalence between agroecosystems, during both the dry (p = 0.002) and wet seasons (p < 0.001), which was higher in agricultural settings compared with the NCCP environment, whatever the season. The prevalence of P. falciparum infection increased from the dry to the wet season in agricultural settings (RP and OPP), whereas no difference was noted for NCCP. Less than 18% of children use insecticide-treated nets (ITNs) in the three villages, ranging from 6 (in RP) to 30% (in OPP). Multivariate analysis indicated that age (1-4; 5-9; and 10-14 years) was not associated with malaria risk, but the season and living in agricultural villages were associated with a greater risk of malaria infection. Risk of malaria exposure was fourfold higher in children from agricultural villages than their counterpart from the non-agricultural area. Our findings highlight significant variations in the prevalence of P. falciparum according to agroecosystem and season. The findings will be useful in designing and implementing malaria control interventions by the National Malaria Control Program.


Assuntos
Inseticidas , Malária Falciparum , Criança , Costa do Marfim/epidemiologia , Estudos Transversais , Humanos , Malária Falciparum/epidemiologia , Malária Falciparum/prevenção & controle , Plasmodium falciparum , Prevalência , Estações do Ano
9.
Parasite ; 28: 67, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34569928

RESUMO

BACKGROUND: Artemisinin-based treatment in malaria patients with abnormal hemoglobin may be ineffective because of their genetic particularity, which could lead to resistance. The main purpose of this study was to assess the effect of artemisinin derivatives on in vivo parasite clearance according to erythrocyte variants. In vivo response was investigated through retrospective data obtained over a 42-day artemether-lumefantrine/artesunate amodiaquine efficacy protocol conducted from 2012 to 2016. RESULTS: A total of 770 patients in Côte d'Ivoire attending the hospitals of Anonkoua-koute (Abidjan), Petit Paris (Korhogo), Libreville (Man), Dar es salam (Bouaké), Ayamé and Yamoussoukro with acute uncomplicated falciparum malaria were selected for successful hemoglobin typing. HbAS, HbSS, HbAC, and HbSC genotypes were found. Parasite clearance time was obtained for 414 patients. In the population with abnormal hemoglobin, parasite densities on admission and parasite clearance rates were significantly lower in the HbSC group compared to HbAA (p = 0.02 and p = 0.007, respectively). After PCR correction on day 42, the acute treatment rate was 100% for each group. Parasite half-life and time for initial parasitaemia to decline by 50 and 99% were longer for the HbSC group (p < 0.05). The study also investigated the prevalence of K13-propeller polymorphisms across different hemoglobin genotype groups. A total of 185 and 63 samples were sequenced in the HbAA group and patients with abnormal Hb, respectively. Only two nonsynonymous mutations D559N and V510M were found in the HbAA group. CONCLUSION: Although this study proved good efficacy of artemether-lumefantrine and artesunate amodiaquine in the treatment of uncomplicated Plasmodium falciparum malaria in patients with abnormal hemoglobin, the increased delay of parasite clearance may represent a threat to health in these patients in relation with sickle cell crisis, which could support selection of parasites resistant to artemisinin.


Assuntos
Antimaláricos , Artemisininas , Hemoglobinas Anormais , Malária Falciparum , Antimaláricos/uso terapêutico , Artemeter/uso terapêutico , Combinação Arteméter e Lumefantrina , Artemisininas/uso terapêutico , Costa do Marfim/epidemiologia , Combinação de Medicamentos , Etanolaminas/uso terapêutico , Hemoglobinas Anormais/uso terapêutico , Humanos , Malária Falciparum/tratamento farmacológico , Malária Falciparum/epidemiologia , Plasmodium falciparum/genética , Estudos Retrospectivos , Resultado do Tratamento
10.
Front Public Health ; 9: 671782, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34490179

RESUMO

Background: Physical inactivity and low cardiorespiratory fitness (CRF) are independent cardiovascular risk factors among children, but have rarely been investigated concurrently in sub-Saharan Africa. The purpose of this study was to compare physical activity (PA) and CRF of primary schoolchildren living in Côte d'Ivoire (CI), South Africa (ZA), and Tanzania (TZ), to test sex- and age-related differences, and to examine whether PA and CRF are associated with each other. Methods: Baseline data from an ongoing cluster-randomized controlled trial were used, including 499 children from CI (Taabo, 49% girls, M = 8.0 ± 1.6 years), 1,074 children from ZA (Gqeberha, 49% girls, M = 8.3 ± 1.4 years), and 593 children from TZ (Ifakara, 51% girls, M = 9.4 ± 1.7 years). PA was assessed by accelerometry and CRF by a 20 m shuttle-run test. The data were analyzed using multi-/univariate analyses of variance and mixed linear models. Results: Most children met recommendations put forward by the World Health Organization for moderate-to-vigorous PA (MVPA) and achieved high CRF scores. In CI, 89.6% of the children met MVPA recommendations (boys: 91.7%, girls: 87.4%), whereas this rate was 76.9% in ZA (boys: 91.0%, girls: 62.4%), and 93.8% in TZ (boys: 95.5%, girls: 92.0%). Children from TZ had the highest CRF and MVPA levels, followed by children from CI and ZA. Boys had higher MVPA levels than girls, whereas girls engaged in more sedentary behavior. Sex differences were strongest in ZA. Sedentary behavior and MVPA were higher among older schoolchildren compared to their younger peers. Higher MVPA, but not sedentary behavior, was associated with better CRF. Conclusions: In all three settings, higher levels of MVPA were associated with higher CRF scores. Nevertheless, children living in the most urbanized setting (such as observed in ZA) were physically less active and had lower CRF than peers living in more rural areas (such as observed in CI and TZ). Particularly for girls, urbanization might increase the risk for insufficient MVPA, which may have negative effects on their CRF, thus negatively influencing health and well-being at later age.


Assuntos
Aptidão Cardiorrespiratória , Criança , Costa do Marfim/epidemiologia , Exercício Físico , Feminino , Humanos , Masculino , África do Sul/epidemiologia , Tanzânia/epidemiologia
11.
Sante Publique ; 33(2): 285-293, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34553873

RESUMO

INTRODUCTION: Cessation of care for financial reasons is an indicator of the affordability of care. OBJECTIVE: The objective of this work was to identify the determinants of the renunciation of care for financial reasons among women in a peri-urban area of Abidjan. METHOD: This cross-sectional study was conducted from March to May 2019 among women aged 18 years and over in Anonkoi 3 in the north of Abidjan. The socio-demographic, economic, health status and health care abandonment characteristics were collected using a questionnaire. The associations between the renunciation of care for financial reasons and women’s characteristics were measured using logistic regression models with a 5% risk. RESULTS: The sample consisted of 423 women with a median age of 28 ± 11 years. Only 30% of them had health insurance. The rate of financial reasons for discontinuing care was 59.1%. This renunciation was more pronounced for the purchase of drugs, biological examinations, dental care, and surgical procedures. The number of dependent (P = 0.035), young age (P ≤ 0.035), low level of education (P = 0.024), low level of income (P ≤ 0.004) and the absence of an associative life (P = 0.004) and perceived poor health (P = 0.021) were identified as determinants of the renunciation of care for financial reasons. CONCLUSION: Empowerment, literacy, health education for women and adherence to universal health coverage should help to remove the financial barrier to women’s access to care.


Assuntos
Atenção à Saúde , Classe Social , Adolescente , Adulto , Costa do Marfim , Estudos Transversais , Feminino , Humanos , Seguro Saúde , Fatores Socioeconômicos , Adulto Jovem
12.
PLoS Negl Trop Dis ; 15(8): e0009656, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34460829

RESUMO

BACKGROUND: Little is known about the diagnostic performance of rapid diagnostic tests (RDTs) for passive screening of human African trypanosomiasis (HAT) in Côte d'Ivoire. We determined HAT prevalence among clinical suspects, identified clinical symptoms and signs associated with HAT RDT positivity, and assessed the diagnostic tests' specificity, positive predictive value and agreement. METHODS: Clinical suspects were screened with SD Bioline HAT, HAT Sero-K-Set and rHAT Sero-Strip. Seropositives were parasitologically examined, and their dried blood spots tested in trypanolysis, ELISA/Tbg, m18S-qPCR and LAMP. The HAT prevalence in the study population was calculated based on RDT positivity followed by parasitological confirmation. The association between clinical symptoms and signs and RDT positivity was determined using multivariable logistic regression. The tests' Positive Predictive Value (PPV), specificity and agreement were determined. RESULTS: Over 29 months, 3433 clinical suspects were tested. The RDT positivity rate was 2.83%, HAT prevalence 0.06%. Individuals with sleep disturbances (p<0.001), motor disorders (p = 0.002), convulsions (p = 0.02), severe weight loss (p = 0.02) or psychiatric problems (p = 0.04) had an increased odds (odds ratios 1.7-4.6) of being HAT RDT seropositive. Specificities ranged between 97.8%-99.6% for individual RDTs, and 93.3-98.9% for subsequent tests on dried blood spots. The PPV of the individual RDTs was below 14.3% (CI 2-43), increased to 33.3% (CI 4-78) for serial RDT combinations, and reached 67% for LAMP and ELISA/Tbg on RDT positives. Agreement between diagnostic tests was poor to moderate (Kappa ≤ 0.60), except for LAMP and ELISA/Tbg (Kappa = 0.66). CONCLUSION: Identification of five key clinical symptoms and signs may simplify referral for HAT RDT screening. The results confirm the appropriateness of the diagnostic algorithm presently applied, with screening by SD Bioline HAT or HAT Sero-K-Set, supplemented with trypanolysis. ELISA/Tbg could replace trypanolysis and is simpler to perform. TRIAL REGISTRATION: ClinicalTrials.gov NCT03356665.


Assuntos
Testes Diagnósticos de Rotina/métodos , Trypanosoma brucei gambiense/imunologia , Tripanossomíase Africana/diagnóstico , Adulto , Animais , Antígenos de Protozoários/sangue , Antígenos de Protozoários/imunologia , Costa do Marfim/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Transtornos Motores/epidemiologia , Valor Preditivo dos Testes , Prevalência , Convulsões/epidemiologia , Sensibilidade e Especificidade , Transtornos do Sono-Vigília/epidemiologia , Tripanossomíase Africana/epidemiologia , Tripanossomíase Africana/fisiopatologia , Perda de Peso
13.
Artigo em Inglês | MEDLINE | ID: mdl-34444615

RESUMO

In rural settings of Côte d'Ivoire, access to water, sanitation, and hygiene (WASH) at schools is often lacking. The purpose of this study was to assess the availability, quality, and use of WASH infrastructure in schools in the south-central part of Côte d'Ivoire, and to determine the hygiene practices of schoolchildren. A cross-sectional study was conducted in 20 primary schools with (n = 10) or without (n = 10) direct access to drinking water. The survey was comprised of a questionnaire directed at schoolchildren aged 8-17 years, an assessment of the WASH infrastructure, and the testing of drinking water samples for Escherichia coli and total coliforms. Overall, 771 schoolchildren were enrolled in the study. One out of four children (24.9%) reported that they used available toilets. Among those children not using toilets, more than half (57.5%) reported that they practised open defecation. Drinking water infrastructure was limited in most schools because of poor storage tanks, the low flow of water, or broken wells. All drinking water samples (n = 18) tested positive for total coliforms and 15 (83.3%) tested positive for E. coli. The lack of WASH infrastructures in primary schools in the south-central part of Côte d'Ivoire, in combination with poor hygiene practices, might govern disease transmission and absenteeism at school, especially among females.


Assuntos
Saneamento , Água , Criança , Costa do Marfim , Estudos Transversais , Escherichia coli , Feminino , Humanos
14.
Am J Trop Med Hyg ; 105(3): 627-629, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34339384

RESUMO

Environmental Mycobacterium ulcerans causes a disabling skin disease called Buruli ulcer. Recent studies completed the knowledge of the evolving geographic extension and epidemiology of Buruli ulcer in West Africa, where Côte d'Ivoire is reporting the highest number of cases. We report seven polymerase chain reaction-documented patients in Burkina Faso, a neighboring country of Côte d'Ivoire, where previously Buruli ulcer cases were confirmed primarily using clinical arguments.


Assuntos
Úlcera de Buruli/diagnóstico , Mycobacterium ulcerans/genética , Adolescente , Adulto , Burkina Faso/epidemiologia , Úlcera de Buruli/epidemiologia , Úlcera de Buruli/transmissão , Costa do Marfim , Transmissão de Doença Infecciosa , Doenças Endêmicas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Patologia Molecular , Reação em Cadeia da Polimerase em Tempo Real , População Rural , Adulto Jovem
16.
BMC Public Health ; 21(1): 1490, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34340668

RESUMO

BACKGROUND: In early March 2020, the COVID-19 pandemic hit West Africa. In response, countries in the region quickly set up crisis management committees and implemented drastic measures to stem the spread of the SARS-CoV-2 virus. The objective of this article is to analyse the epidemiological evolution of COVID-19 in seven Francophone West African countries (Benin, Burkina Faso, Côte d'Ivoire, Guinea, Mali, Niger, Senegal) as well as the public health measures decided upon during the first 7 months of the pandemic. METHODS: Our method is based on quantitative and qualitative data from the pooling of information from a COVID-19 data platform and collected by a network of interdisciplinary collaborators present in the seven countries. Descriptive and spatial analyses of quantitative epidemiological data, as well as content analyses of qualitative data on public measures and management committees were performed. RESULTS: Attack rates (October 2020) for COVID-19 have ranged from 20 per 100,000 inhabitants (Benin) to more than 94 per 100,000 inhabitants (Senegal). All these countries reacted quickly to the crisis, in some cases before the first reported infection, and implemented public measures in a relatively homogeneous manner. None of the countries implemented country-wide lockdowns, but some implemented partial or local containment measures. At the end of June 2020, countries began to lift certain restrictive measures, sometimes under pressure from the general population or from certain economic sectors. CONCLUSION: Much research on COVID-19 remains to be conducted in West Africa to better understand the dynamics of the pandemic, and to further examine the state responses to ensure their appropriateness and adaptation to the national contexts.


Assuntos
COVID-19 , Pandemias , África Ocidental/epidemiologia , Benin , Burkina Faso , Controle de Doenças Transmissíveis , Costa do Marfim , Guiné , Humanos , Mali/epidemiologia , Níger , SARS-CoV-2 , Senegal/epidemiologia
17.
Front Public Health ; 9: 653565, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34354973

RESUMO

Background: The ATLAS program promotes and implements HIVST in Côte d'Ivoire, Mali, and Senegal. Priority groups include members of key populations-female sex workers (FSW), men having sex with men (MSM), and people who use drugs (PWUD)-and their partners and relatives. HIVST distribution activities, which began in mid-2019, were impacted in early 2020 by the COVID-19 pandemic. Methods: This article, focusing only on outreach activities among key populations, analyzes quantitative, and qualitative program data collected during implementation to examine temporal trends in HIVST distribution and their evolution in the context of the COVID-19 health crisis. Specifically, we investigated the impact on, the adaptation of and the disruption of field activities. Results: In all three countries, the pre-COVID-19 period was marked by a gradual increase in HIVST distribution. The period corresponding to the initial emergency response (March-May 2020) witnessed an important disruption of activities: a total suspension in Senegal, a significant decline in Côte d'Ivoire, and a less pronounced decrease in Mali. Secondary distribution was also negatively impacted. Peer educators showed resilience and adapted by relocating from public to private areas, reducing group sizes, moving night activities to the daytime, increasing the use of social networks, integrating hygiene measures, and promoting assisted HIVST as an alternative to conventional rapid testing. From June 2020 onward, with the routine management of the COVID-19 pandemic, a catch-up phenomenon was observed with the resumption of activities in Senegal, the opening of new distribution sites, a rebound in the number of distributed HIVST kits, a resurgence in larger group activities, and a rebound in the average number of distributed HIVST kits per primary contact. Conclusions: Although imperfect, the program data provide useful information to describe changes in the implementation of HIVST outreach activities over time. The impact of the COVID-19 pandemic on HIVST distribution among key populations was visible in the monthly activity reports. Focus groups and individual interviews allowed us to document the adaptations made by peer educators, with variations across countries and populations. These adaptations demonstrate the resilience and learning capacities of peer educators and key populations.


Assuntos
COVID-19 , Infecções por HIV , Profissionais do Sexo , Minorias Sexuais e de Gênero , Costa do Marfim/epidemiologia , Feminino , Infecções por HIV/diagnóstico , Homossexualidade Masculina , Humanos , Masculino , Mali/epidemiologia , Pandemias , SARS-CoV-2 , Autoteste , Senegal/epidemiologia
18.
PLoS One ; 16(7): e0255074, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34324545

RESUMO

BACKGROUND: Although people living with HIV in Côte d'Ivoire receive antiretroviral therapy (ART) at no cost, other out-of-pocket (OOP) spending related to health can still create a barrier to care. METHODS: A convenience sample of 400 adults living with HIV for at least 1 year in Côte d'Ivoire completed a survey on their health spending for HIV and chronic non-communicable diseases (NCDs). In addition to descriptive statistics, we performed simple linear regression analyses with bootstrapped 95% confidence intervals. FINDINGS: 365 participants (91%) reported OOP spending for HIV care, with a median of $16/year (IQR 5-48). 34% of participants reported direct costs with a median of $2/year (IQR 1-41). No participants reported user fees for HIV services. 87% of participants reported indirect costs, with a median of $17/year (IQR 7-41). 102 participants (26%) reported at least 1 NCD. Of these, 80 (78%) reported OOP spending for NCD care, with a median of $50/year (IQR 6-107). 76 participants (95%) with both HIV and NCDs reported direct costs, and 48% reported paying user fees for NCD services. Participants had missed a median of 2 HIV appointments in the past year (IQR 2-3). Higher OOP costs were not associated with the number of HIV appointments missed. 21% of participants reported spending over 10% of household income on HIV and/or NCD care. DISCUSSION AND CONCLUSIONS: Despite the availability of free ART, most participants reported OOP spending. OOP costs were much higher for participants with co-morbid NCDs.


Assuntos
Infecções por HIV , Gastos em Saúde , Adulto , Efeitos Psicossociais da Doença , Costa do Marfim , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade
19.
BMC Geriatr ; 21(1): 446, 2021 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-34330220

RESUMO

BACKGROUND: Frailty, a syndrome resulting in heightened risk of negative outcomes for older adults, is increasing across the globe. However, little is known about the health service impacts of frailty in low-income countries (LICs), and in particular, sub-Saharan Africa (SSA). This study explores the relationship between frailty and health service 1) utilisation and 2) expenditure within Côte d'Ivoire. METHODS: Participants aged 50 years and over participated in the Living Condition, Health and Resilience among the Elderly study. Frailty was assessed using a 30-item Frailty Index (FI). The association between frailty and self-reported health service utilisation was analysed for general practitioners (GPs), specialists, overnight hospitalisations, traditional practitioners and self-medication. Expenditure over the previous month included consulting, medications, hospitalisations and total expenditure. RESULTS: Among participants [n = 860, mean age (SD) = 61.8 (9.7) years, 42.9% female], 60.0% were frail, 22.8% pre-frail and 17.2% robust. The mean (SD) FI was 0.28 (0.17). Increased health service utilisation was associated with frailty for GP attendance, traditional practitioners and self-medication but not specialists or overnight hospitalisation. Pre-frailty and frailty were associated with increased total health service expenditure, with frailty also associated with aggregate consulting costs and medications. CONCLUSIONS: Although frailty is associated with health service utilisation and expenditure in a variety of contexts, the study results suggest that such impacts may vary across the globe. The experience of frailty in LICs is likely to differ from that experienced elsewhere due to cultural traditions, attitudes to the health system, and accessibility, with more research needed.


Assuntos
Fragilidade , África ao Sul do Saara/epidemiologia , Idoso , Costa do Marfim/epidemiologia , Feminino , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Fragilidade/terapia , Gastos em Saúde , Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade
20.
BMJ Open ; 11(7): e051823, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34326056

RESUMO

INTRODUCTION: Front-line health workers in remote health facilities are the first contact of the formal health sector and are confronted with life-saving decisions. Health information systems (HIS) support the collection and use of health related data. However, HIS focus on reporting and are unfit to support decisions. Since data tools are paper-based in most primary healthcare settings, we have produced an innovative Paper-based Health Information System in Comprehensive Care (PHISICC) using a human-centred design approach. We are carrying out a cluster randomised controlled trial in three African countries to assess the effects of PHISICC compared with the current systems. METHODS AND ANALYSIS: Study areas are in rural zones of Côte d'Ivoire, Mozambique and Nigeria. Seventy health facilities in each country have been randomly allocated to using PHISICC tools or to continuing to use the regular HIS tools. We have randomly selected households in the catchment areas of each health facility to collect outcomes' data (household surveys have been carried out in two of the three countries and the end-line data collection is planned for mid-2021). Primary outcomes include data quality and use, coverage of health services and health workers satisfaction; secondary outcomes are additional data quality and use parameters, childhood mortality and additional health workers and clients experience with the system. Just prior to the implementation of the trial, we had to relocate the study site in Mozambique due to unforeseen logistical issues. The effects of the intervention will be estimated using regression models and accounting for clustering using random effects. ETHICS AND DISSEMINATION: Ethics committees in Côte d'Ivoire, Mozambique and Nigeria approved the trials. We plan to disseminate our findings, data and research materials among researchers and policy-makers. We aim at having our findings included in systematic reviews on health systems interventions and future guidance development on HIS. TRIAL REGISTRATION NUMBER: PACTR201904664660639; Pre-results.


Assuntos
Sistemas de Informação em Saúde , Criança , Costa do Marfim , Confiabilidade dos Dados , Humanos , Moçambique , Nigéria , Atenção Primária à Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...