[Sexual and reproductive health of adolescents living with HIV in pediatric care programs in Abidjan : Structured provision of care and perceptions of health care workers in 2019]. / Santé sexuelle et reproductive des adolescent(e)s vivant avec le VIH dans les programmes de prise en charge pédiatrique à Abidjan : offre de services des structures et perceptions des professionnels de santé en 2019.

INTRODUCTION: The majority of adolescents living with HIV (ALHIV) reside in sub-Saharan Africa, with sexual and reproductive health (SRH) needs to be met. The health care facilities and professionals involved have a major role to assume in the quality of SRH services offered to these teenagers. OBJECTIVE: To investigate the SRH services offered to ALHIV subjects in pediatric facilities in Abidjan, Ivory-Coast. METHODS: In 2019 we conducted an exploratory cross-sectional study using qualitative and quantitative methods in three pediatric facilities caring for ALHIV subjects (CIRBA, CTAP and CePReF) and participating in the IeDEA (International epidemiologic databases to Evaluate AIDS project) in Abidjan, Ivory Coast. This study included: (1) an inventory of SRH services, using a questionnaire and direct observation, describing their adaptation to the teenagers' needs and their inclusion in provision of care; (2 an assessment by means of semi-structured interviews of 14 health professionals' perceptions of the SRH needs of the ALHIV subjects with whom they worked. Quantitative data were expressed in percentages and qualitative data from the interviews were analyzed through inductive thematic analysis. RESULTS: The care provided in the three facilities was poorly adapted to the teenagers' needs. Few SRH services were effectively provided to the ALHIV subjects in the different centers. The services essentially consisted in condom distribution and organization of SRH-based focus groups. Exceptionally, hormonal contraception was offered to teenage girls. Barriers to the services were largely due to poorly equipped facilities, particularly in terms of SRH offer, health professionals' experience, and support provided for ALHIV subjects and their parents. The health professionals were desirous of SRH skill-building programs enabling them to deliver optimal, adequately contextualized SRH services to the teenagers. CONCLUSIONS: In pediatric programs addressed to ALHIV subjects in three Abidjan facilities, the teenagers' SRH needs remain unmet. It is urgently necessary to strengthen the health facilities by means of improved equipment, enhanced awareness of teenagers' needs, and training programs enabling the health professionals to provide more adapted sexual and reproductive health services.

Prescribing practices in the management of childhood diarrhoea in primary health care centres in a sub-urban community in Nigeria

Background: Childhood diarrhoea remains the second leading cause of morbidity and mortality among children under the age of five. Oral rehydration therapy and zinc tablets are the cornerstone for its management both at home and in the health facilities. Primary health care is the first level of contact of individuals and communities with the health care system and appropriate prescription is crucial for sustainable health benefits. This study assessed the prescribing pattern for childhood diarrhoea management and determined the appropriateness of treatment for acute watery diarrhoea without comorbidities in Primary Health Care (PHC) facilities in a sub-urban community in Nigeria.Methods: This descriptive study was done in 19 PHC facilities in Ikorodu Local Government Area of Lagos State, Nigeria. A retrospective review of 1271 prescriptions for diarrhoeal cases of children between 6 to 59 months was done using the records from the Outpatient Department register for a period of one year. Descriptive analysis was done. Results: From the cases reviewed, 1239 (97.5%) had acute watery diarrhoea (AWD), either alone 819 (64.4%), or with malaria/fever 347 (27.3%), cough/URTI 59 (4.6%), and other conditions 14 (1.1%). For cases of AWD alone, there were 499 (60.9%) prescriptions for ORS/Zinc, 249 (30.4%) for antibiotics and 203 (28.4%) for antimalarials. Antibiotic and antimalarial injections were also included in the prescriptions.Conclusion: This study found the prescription pattern for childhood diarrhoea to be inadequate with suboptimal prescriptions of ORS/Zinc. The prescriptions of antibiotics and antimalarials for acute watery diarrhoea was high and unnecessary