Crise vaso-occlusive drépanocytaire sévère: aspects cliniques, étiologiques et thérapeutiques au CHU Sylvanus Olympio de Lomé / Clinical, aetiological and therapeutic features of severe sickle cell related vaso-occlusive crisis at the Sylvanus Olympio University Hospital, Lomé

Introduction: la crise vaso-occlusive (CVO) est la plus fréquente manifestation de la drépanocytose et la première cause d´hospitalisation des enfants atteints. L´objectif de cette étude est de décrire les aspects cliniques des CVO sévères, de déterminer les étiologies des syndromes infectieux qui les accompagnent et de décrire leur prise en charge. Méthodes: il s'agit d'une étude transversale descriptive portant sur 137 drépanocytaires majeurs hospitalisés pour CVO sévères du 1er janvier 2009 au 31 décembre 2011 dans le service de pédiatrie du CHU Sylvanus Olympio. Résultats: les drépanocytaires homozygotes SS étaient les plus nombreux (n=98; 71,5%), suivis des doubles hétérozygotes SC (n=28; 20,5). Le délai moyen de consultation était de 4,7 ± 4,4 jours. Le traitement avant l´admission comportait des antibiotiques (28,5%). Les CVO étaient surtout ostéo-articulaires (70,8%). Dans 98,5% des cas, une infection bactérienne associée a été confirmée (48,9%) ou présumée (49,6%). Les principales étiologies étaient le syndrome thoracique aigu (26,3%), l´ostéomyélite aiguë (10,9%), l´infection urinaire (6,6%), la septicémie (3,6%). Un germe a été isolé chez 14,6% des patients, Escherichia coli (30%) étaient en tête suivi de Klebsiella pneumoniae (25%), Staphylococcus aureus (15%), Salmonella typhi (10%), Streptococcus pneumoniae (5%), le Streptocoque D (5%), l´Enterobacter (5%) et l´Acinetobacter (5%). Le taux de mortalité était de 2,2%. La durée moyenne d´hospitalisation était de 11,4 ± 8,8 jours. Conclusion: les CVO drépanocytaires sévères sont en majorité associées aux infections bactériennes en milieu tropical. Une antibiothérapie adaptée et précoce constitue le moyen thérapeutique indispensable pour prévenir ou traiter ces patients.

Introduction: vaso-occlusive crisis (VOC) is the most common manifestation of sickle cell disease and the leading cause of hospitalization among affected children. The purpose of this study is to describe the clinical features of severe VOCs, to determine the etiologies of infectious syndromes that accompany them and to describe their management. Methods: we conducted a descriptive cross-sectional study of 137 adult patients with sickle cell disease hospitalised for severe VOC in the Paediatric Department of the Sylvanus Olympio University Hospital from 1 January 2009 to 31 December 2011. Results: the majority of patients (n=98; 71.5%) had homozygous sickle cell (SS), followed by double heterozygous SC disease (n=28; 20.5). The median of consultation time was 4.7 ± 4.4 days. Treatment before admission was based on antibiotics (28.5%). VOCs were mainly osteoarticular (70.8%). In 98.5% of cases, an associated bacterial infection was confirmed (48.9%) or suspected (49.6%). The main etiologies included acute chest syndrome (26.3%), acute osteomyelitis (10.9%), urinary tract infection (6.6%) and septicaemia (3.6%). One germ was isolated from 14.6% of patients: Escherichia coli (30%), followed by Klebsiella pneumoniae (25%), Staphylococcus aureus (15%), Salmonella typhi (10%), Streptococcus pneumoniae (5%), Streptococcus D (5%), Enterobacter (5%) and Acinetobacter (5%). Mortality rate was 2.2%. The average length of stay in hospital was 11.4 ± 8.8 days. Conclusion: severe sickle cell related vaso-occlusive crisis is mainly associated with bacterial infections in tropical environments. Appropriate and early antibiotic therapy is the essential therapeutic means to prevent or treat these patients.

Factors contributing to rise in teenage pregnancy in Sekhukhune district, Limpopo province

Background: The Department of Health in South Africa has reported an alarming total of 90 037 teenage girls between the ages of 10 years and 19 years who gave birth from March 2021 to April 2022, across all provinces and districts. The rise in teenage pregnancy is of serious concern as adolescents girls are more likely to experience difficult pregnancies and deliveries which could lead to detrimental effects on their health. Objectives: The study aimed to explore and describe factors contributing to the increase in teenage pregnancy in the Sekhukhune district of Limpopo. Method: The study was conducted in the healthcare facilities of Sekhukhune area. A qualitative, exploratory design was followed. Participants were purposively selected, and data were gathered through face-to-face individual interviews. Data analysis employed Tesch's inductive, descriptive coding method. Results: Negligence, peer pressure, ambiguity, choice, lack of contraceptive use, and lack of family attachment were identified as exacerbating factors in the district's surge in teenage pregnancy. Conclusion: To reduce teen pregnancy, it is crucial to promote contraception, enhance cooperation between schools and the government, involve families in sexual and reproductive health discussions, prioritise a supportive home environment, advocate for child support grants, revitalise school health services, and empower teenagers to make informed choices and resist peer pressure. Contribution: The study will provide guidance to policy makers and other stakeholders in developing appropriate programmes to address the problem and improve the health and socioeconomic status of adolescents in rural areas. This will reduce healthcare costs associated with complications and premature birth. Keywords: factors; teenager; pregnancy; tee

Constipation de l'enfant dans un service de pédiatrie générale à Bamako / Childhood constipation in a general pediatrics Unit in Bamako

Introduction : La constipation est un symptôme qui correspond à une anomalie des selles ou de leur élimination : elles sont trop volumineuses ou trop dures, trop rares, ou leur élimination est douloureuse, voire incomplète. Objectif : le but de cette étude était de déterminer la fréquence, les facteurs favorisants, les signes et les modalités thérapeutiques de la constipation de l'enfant dans le département de pédiatrie du CHU Gabriel Touré. Patients et Méthode : Il s'agissait d'une étude transversale descriptive à collecte prospective allant du 1 avril 2019 au 31 Janvier 2020. Ont été inclus tous les patients de 0 à 15 ans ayant consulté dans le département de pédiatrie pour constipation et répondant aux critères de Rome IV. Résultat : Nous avions enregistré 75 patients.Lafréquence hospitalière était de 0,23 %. La tranche d'âge d'un mois à deux ans représentait 61,3% des patients, l'âge moyen était de 27,7 +/- 43 mois. Le sexe masculin prédominait avec 58,7%. La constipation était le motif de consultation le plus fréquent avec 62,6%. Une selle par semaine a été retrouvée chez 77,3 % des patients. La douleur à la défécation a été retrouvée chez 65,3 % des patients. La constipation était fonctionnelle chez 69,3% des patients. La maladie de Hirschsprung était la cause de la constipation organique chez 65,2% des patients. Les laxatifs ont été prescrits chez 64 % des patients à la consultation. Conclusion: La constipation est une pathologie fréquente qui touche les enfants à tout âge. Elle est d'origine fonctionnelle dans la majeure partie des cas.

Introduction: Constipation is a symptom that corresponds to an anomaly of the stools or their elimination: they are too bulky or too hard, too rare, or their elimination is painful, even incomplete. Objective: was to determine the frequency, the contributing factors, the signs and the therapeutic methods of constipation in children in the pediatric department of the CHU Gabriel Touré. Patients and Method: This was a descriptive cross-sectional study with prospective collection from April 1, 2019 to January 31, 2020. All patients aged 0 to 15 who consulted in the pediatric department for constipation and responding to the Rome IV criteria. Result: We registered 75 patients. The hospital frequency of 0.23%. The age group from one month to two years represented 61.3% of the patients, the average age was 27.7 +/- 43 months. The male gender predominated with 58.7%. Constipation alone was the most common reason for consultation with 62.6%. One stool per week was found in 77.3% of patients. Pain on defecation was found in 65.3% of patients. Constipation was functional in 69.3% of patients. Hirschsprung disease was the cause of organic constipation in 65.2% of patients. Laxatives were prescribed in 64% of patients at the consultation. Conclusion: Constipation is a frequent pathology that affects children at all ages. It is of functional origin in most case

Sepsis et choc septique en réanimation à Brazzaville (Congo) / Sepsis and septic shock in polyvalent intensive care at Brazzaville (Congo)

Objectifs. Décrire les aspects cliniques, bactériologiques et évolutifs du sepsis et du choc septique dans le service de réanimation polyvalente du CHUB. Patients et méthodes. Il s'agit d'une étude transversale, monocentrique et descriptive, durant 12 mois, incluant les patients âgés d'au moins 18 ans admis en réanimation polyvalente pour un sepsis ou choc septique. Les variables épidémiologiques, cliniques, bactériologiques et évolutives ont été analysées avec Excel 2019. Résultats. 56 patients ont été retenus (20,7%). Leur âge moyen était de 43,1 ± 17,9 ans (extrêmes de 18 et 84 ans), avec 66,1% des hommes. Le foyer infectieux initial était péritonéal (64,3 %). À l'admission, le nombre médian de défaillances d'organes par patient était de trois (maximum 5). Les défaillances rénale (71,4%), hépatique (69,6%) et hémodynamique (62,5%) étaient les plus représentées. Le taux de réalisation du bilan bactériologique était de 35,7% : hémoculture (10,7%), uroculture (14,3%), porte d'entrée infectieuse (7,1%). La durée d'hospitalisation des patients sortis vivants était de 8,1 ± 6,3 jours (extrêmes de 2 et 31 jours). Le taux de mortalité était de 57,1%. Les décès survenaient au-delà de 24 h d'hospitalisation (75%), chez des patients avec comorbidités (65,6%), porte d'entrée péritonéale (59,4%), et défaillances hémodynamique (81,2%) et rénale (75%). Conclusion. Les prévalences du sepsis et du choc septique dans notre série sont superposables à celles de la littérature. Le taux de réalisation des bilans bactériologiques reste faible. La mortalité du sepsis demeure très élevée.

Introduction. No accurate data on sepsis and septic shock in intensive care unit (ICU) in the Republic of Congo are available. The aim of the study was to describe the course of patients with sepsis and/or septic shock in the polyvalent ICU of the University Teaching Hospital of Brazzaville. Patients and methods. This was a cross-sectional, monocentric and descriptive study, lasting 12 months, including patients aged at least 18 years admitted to ICU for sepsis or septic shock. The clinical presentation, the bacteriological findings and the outcome were analyzed with Excel 2019. Results. 56 patients were selected (20.7%). The average age was 43.1 ± 17.9 years (extremes 18 and 84 years), with 66.1% of men. The initial infection was peritoneal (64.3%). At admission, the median number of organ failures per patient was three (maximum 5). Renal (71.4%), hepatic (69.6%) and hemodynamic (62.5%) failures were the most common. Bacteriological assessment rate was 35.7%: blood culture (10.7%), urine culture (14.3%). The duration of hospitalization of alive patients was 8.1 ± 6.3 days (extremes 2 and 31 days). The mortality rate was 57.1%. Deaths occurred beyond 24 hours of hospitalization (75%), in patients with comorbidities (65.6%), peritonitis (59.4%), hemodynamic (81.2%) and renal (75%) failures. Conclusion. The prevalence of sepsis and septic shock in our study is comparable to other published series. The bacteriological assessments rate is still low. The mortality is very high.

Profil évolutif de la limboconjonctivité endémique des tropiques à l'hôpital gynéco-obstétrique et pédiatrique de Yaoundé / Gynecological cancer in oncology practice in Lomé

Introduction. La limbo-conjonctivite endémique des tropiques (LCET) est une kérato-conjonctivite allergique récidivante du jeune enfant qui s'améliore après la puberté mais peut persister. Le but de cette étude était de déterminer le profil évolutif de la LCETdans notre pratique. Méthodologie. Étude longitudinale descriptive menée dans l'unité d'ophtalmologie de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé. Tous les dossiers de LCET reçus de janvier 2011 à décembre 2019 avec un recul d'aumoins deux ans de suivi ont été recensés. Les patients qui ont accepté de participer après apptéléphonique ont été inclus de janvier à mai 2021.Les variables d'étudeétaient: âge, sexe, acuité visuelle (AV), caractéristiques de la LCET selon Diallo, pronostic fonctionnel et anatomique en post puberté (plus de 15 ans). Résultats. Au total,30 patients (60 yeux) ont été étudiés. Le sex-ratio était de 2. La moyenne d'âge était de 15 ans ± 9 ans. Initialement, le prurit était le maitre symptôme (96,7%). Après un recul moyen de cinq ans, l'AV était utile chez tous les patients (100%) et la LCET stade 2 plus représentée (60%). Le nombre moyen de récidives était de trois. Les patients post pubertaires on eu une amélioration anatomique dans 56.7% des caset une aggravation dans 10%des casConclusion. Notre travail confirme l'amélioration post pubertaire globale de la LCET, nonobstant quelques formes graves depronosticpéjoratif pour la fonction visuelle.

Introduction. Tropical endemiclimbo-conjunctivitis (TELC) is a recurrent allergic kerato-conjunctivitis in young children which improves after puberty but may persist. The aim of this study was to determine the evolutionof TELCin our setting. Methodology. This was a longitudinal descriptive study conducted in the ophthalmology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital. All TELC files received from January 2011 to December 2019 with a follow-up of at least two years of follow-up were identified. Patients who agreed to participate after a phone call were included from January to May 2021. The variables of interest were: age, sex, visual acuity (VA), TELC classification according to Diallo, functional and anatomical prognosis in post puberty (more than 15 years).A totalof30 patients (60 eyes) were recruited. The sex ratio was 2. The average age was 15 ± 9 years. Initially, pruritus was the main symptom (96.7%). After an average follow-up of five years, VA was usefulin all patients (100%) and TELCstage 2 was the most frequent stage (60%). The mean number of recurrences was three. Postpubertal patients had anatomical improvement in 56.7% of cases and worsening in 10%of cases. Conclusion. Our study confirms the overall postpubertal improvement ofTELC, except some serious forms with poor prognosis ofvisual function

Aspects épidémiologiques des enfants diabétiques perdus de vue à Abidjan / Epidemiological aspects of children with diabetes lost to follow-up at Abidjan

Introduction. Ces vingt dernières années, on assiste à une augmentation spectaculaire du nombre de cas de diabète de type 1 avec une mortalité plus élevée en Afrique Noire en lien avec les difficultés d'accès aux soins, à la rupture de suivi engendrant un nombre élevé de perdus de vue. L'objectif du travail est de déterminer le profil épidémiologique des enfants diabétiques perdus de vue dans notre pratique. Patients et méthodes. C'est une étude transversale à visée descriptive et analytique qui a concerné les enfants diabétiques perdus de vue de 2002 à 2019 dans le service de diabétologie du CHU de Yopougon. Résultats. Durant l'étude 195 enfants ont été suivi dans le service, 90 ont été considérés comme perdus de vue soit une fréquence de 46,15 %. L'âge moyen des perdus de vue était de 14,6 ± 5,3 avec des extrêmes allant de 2 à 20 ans. Ils sont majoritairement de sexe F dans 50,6 %. Dans 37 % on retrouve un niveau socio-économique faible calculé selon l'indice IPSE avec une association statistiquement significative entre les classes socio-économiques moyenneinferieure et moyenne (p respectivement < 0,01 et 0,001). La plupart des perdus (84,5 %) n'ont pas d'assurance maladie. Le lieu de résidence était urbain (Abidjan) dans 73 %. Ils ont issus d'une famille biparentale dans 79 ,8 % des cas. Une association statistiquement significative a été retrouvée entre la non-scolarisation et la perte de vue (P < 0,05).Conclusion. Le manque de suivi chez les enfants diabétiques a des conséquences drastiques sur le pronostic de la maladie au long cours, marqué par une mortalité de 11 % qui touche essentiellement les populations à revenu faible

Introduction. Over the past twenty years, there has been a spectacular increase in the number of cases of type 1 diabetes with a higher mortality rate in Black Africa due to difficulties in accessing care but also a lack of follow-up resulting in a high number of people being lost to follow-up. Our work aims to determine the epidemiological profile of diabetic children lost to follow-up. Patients and methods. This was a cross-sectional study with descriptive and analytical aims which concerned diabetic children lost to follow-up from 2002 to 2019 in the diabetes department of the University Hospital of Yopougon. Results. During the study period, 195 children were followed up in the department, 90 were considered as lost to follow-up, i.e. a frequency of 46.15%. The average age of the lost to follow-up was 14.6 ± 5.3 years with extremes ranging from 2 to 20 years. The majority of them were male (50.6%). Thirty-seven percent had a low socioeconomic level calculated according to the IPSE index, with a statistically significant association between the lowermiddle and middle socioeconomic classes (p < 0.01 and 0.001 respectively). Most of the lost (84.5%) did not have health insurance. The place of residence was urban (Abidjan) in 73%. They came from a two-parent family in 79.8% of cases. A statistically significant association was found between non-education and loss of sight (P < 0.05). Conclusion. The lack of follow-up in diabetic children has drastic consequences on the prognosis of the disease in the long term marked by a mortality of 11% which affects mainly low-income populations.

Implementation of maternal guidelines for gravid teenagers with hypertensive disorders in KwaZulu-Natal

Background: The worldwide phenomenon of teenage pregnancy among 13­9-year-olds is complicated by obstetric conditions. Among the top three causes of maternal mortality, hypertension is the third in South Africa. Quality maternal care is assured by obstetric practitioners (OPs) implementing guidelines specific for management of hypertension in pregnancy. Objective: The objective of this study was to investigate implementation of maternal guidelines for hypertension in pregnancy among teenagers. Methods: As a retrospective quantitative research design was used, 173 maternal records of pregnant teenagers from 13 to 19 years were sampled from six district hospitals and Community Health Centres (CHCs) between 01 January 2017 and 31 December 2019 to undergo systematic random sampling. A pretested structured checklist was used to record data from sampled maternal records. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis, and results were presented using simple descriptive statistics. Results: Research results indicated that teenagers who suffered from hypertension intrapartum and postpartum did not receive maternal care according to the guidelines for maternity care in South Africa. Blood pressure was not measured of six (3.47%) intrapartum and five (2.9%) postpartum teenagers. Seventeen (9.8%) hypertensive postpartum teenagers received their antihypertensives. Conclusion: Public health institutions (PHIs) compromised provision of quality maternal care among teenagers, evidenced by incomplete intrapartum and postpartum assessment, diagnosis and management of hypertensive disorders in pregnancy (HDP).

Adolescents' lived experiences of substance abuse in the Greater Giyani Municipality

Background: Adolescence is a unique and distinct stage of development that involves changes in the physical, psychological and social aspects of adolescents. It is a critical transition into adulthood whereby heightened risk-taking and sensation-seeking takes place, such as substance abuse. In a South African context, this transition sometimes occurs under economic stress, poverty, unemployment, high levels of crime and political instability. This can place adolescents at risk of substance abuse. Objectives: To explore and describe the lived experiences of adolescents abusing substances in the Greater Giyani Municipality in the Limpopo province, South Africa. Method: A qualitative, exploratory, descriptive and contextual research design with a phenomenological approach was used. Data were collected through individual, in-depth, phenomenological interviews and field notes. Thematic coding was utilised to analyse the collected data, and literature was reviewed to support the findings. Moreover, measures to ensure trustworthiness and ethical principles were applied throughout the research process. Results: Five themes were identified: substance abuse behaviour among adolescents, adolescents' motivation for continuing substance abuse, the effects of substance abuse on the lives of adolescents, factors affecting adolescents' discontinuation of substance abuse and a need to discontinue substance abuse. Conclusion: The study concluded that adolescents abusing substances in the Greater Giyani, Limpopo province, experience loss of control, broken relationships, poor academic performance, stigma attached to mental illness and negative emotions. The adolescents foresaw their future as uncertain and without direction. It is recommended that mental healthcare professionals introduce and implement interventions that will assist the adolescents who abuse substances in the Greater Giyani, Limpopo province. Contribution: The findings in this study could add knowledge in developing and implementing of strategies for psychiatric nurses to support adolescents abusing substances in the Greater Giyani, Limpopo province.

Évaluation de la prescription et de l'utilisation des benzodiazépines dans la ville de Sidi Bel-Abbès / Evaluation of the prescription and use of benzodiazepines in Sidi Bel-Abbes city

Introduction :Une forte consommation des benzodiazépines (BZDs) a été remarquée en dehors parfois des règles de recommandations de prescription, ce qui rend leur consommation un problème majeur de santé publique. La présente étude a eu pour objectif d'évaluer la prescription et l'usage des BZDs dans la ville de Sidi Bel-Abbès. Méthodes-Il s'agissait d'une étude descriptive transversale réalisée du 01 Février 2018 au 30 Juin 2018 évaluant la prescription et l'usage des BZDs dans la ville de Sidi Bel-Abbès au moyen d'un questionnaire distribué aux patients de l'hôpital psychiatrique, du service de psychiatrie du CHU et aux pharmaciens d'officine.Le critère de jugement principal était l'évaluation de la prescription et de l'utilisation des BZDs dans cette ville. La saisie et l'analyse des données ont été réalisées par le logiciel SPSS. Résultats-Au total, 353 patients traités au moins par une BZD ont été inclus dont 178 hommes. Le taux de prescription des BZDs était de 1.10, des jeunes (59,77 %) et des personnes mariées (60,34%) constituaient les consommateurs privilégiés. La prescription était l'apanage des psychiatres, en monothérapie (07,42%), la molé cule la plus fréquemment prescrite était le Bromazépam (31,07%) et la prise noc turne était la plus importante (49,01%). Les BZDs étaient utilisées pour combattre l'insomnie (25,21%), l'anxiété (16,43%), pour une durée de plus d'une année (57,79 %). Conclusion-La prescription et l'utilisation des BZDs dans la ville de Sidi Bel-Abbès s'est avérée importante. L'insomnie et l'anxiété constituaient les principales raisons de leur utilisation, et le Bromazépam était la molécule la plus fréquemment utilisée .

Introduction-A high consumption of benzodiazepines (BZDs) has been noticed so metimes outside the rules of prescription recommendations, which makes their consumption a major public health problem. The present study aimed to evaluate the prescription and use of BZDs in Sidi Bel-Abbès city. Methods-: This was a descriptive cross-sectional study carried out from February 01st, 2018 to June 30th, 2018 evaluating the prescription and use of BZDs in of Sidi Bel-Abbès by means of a questionnaire distributed to patients from the psychiatric hospital, the CHU psychiatry department and community pharmacists. The primary endpoint was the assessment of the prescription and use of BZDs in this city. Data entry and analysis were performed using SPSS software. Results-A total of 353 patients treated with at least one BZD were included, including 178 men. The prescription rate of BZDs was 1.10, young people (59.77%) and married people (60.34%) were the privileged consumers. The prescription was the prerogative of psychiatrists, in monotherapy (07.42%), the molecule most frequent ly prescribed was Bromazepam (31.07%) and night intake was the most important (49.01%). BZDs were used to combat insomnia (25.21%), anxiety (16.43%), for a period of more than a year (57.79%). Conclusion-The prescription and use of BZDs in Sidi Bel-Abbès has proven to be important. Insomnia and anxiety were the main reasons for their use, and Bromazepam was the most molecule frequently used.

Use of contraceptive methods in rural areas in Cote d'Ivoire: a cross-sectional study

Patients and methods: This cross-sectional survey took place in May, 2018 in Kodjokro, a village in the south-east of Côte d'Ivoire. The study population consisted of women of reproductive age, from 15 to 49 years old. A questionnaire was used to collect data on socio-demographic, gyneco-obstetrical characteristics, knowledge and attitudes and he use of contraceptive methods. The chi-square test was used to measure the associations between the use of contraceptive methods and each of the characteristics studied

Socioecological analysis of determinants of early adolescent sexuality in Benin: a qualitative study

Introduction: early adolescent sexuality is associated with an increase in risky sexual behaviour, unwanted pregnancies, and the occurrence of sexually transmitted infections. However, despite the efforts of governments and their partners, the implementation and effectiveness of appropriate and adapted services to improve adolescent sexual and reproductive health are lagging. Therefore, this study aimed to document determinants of early adolescent sexuality in the central district of Tchaourou in Benin based on a socio-ecological approach. Methods: an explorative and descriptive qualitative study was conducted using focus groups and individual interviews based on the socio-ecological model. Participants included adolescents, parents, teachers, and community leaders in Tchaourou. Results: the number of participants in each focus group was 8 (32). There were 20 girls and 12 boys aged 10-19 years, of whom 16 were students (7 females and nine males) and 16 were apprentice dressmakers and hairdressers. In addition, five participants attended individual interviews (two community leaders, one religious' leader, one teacher and one parent). Four themes were identified that influence early sexuality among adolescents and grouped into individual determinants related to knowledge about early sexuality; interpersonal determinants related to adolescents' function, including the influence of family and peers; community and organizational determinants related to where harmful sociocultural norms; political determinants comprising the disadvantaged socioeconomic status of the communities where adolescents live. Conclusion: many factors at multiple social levels influence early adolescent sexuality in the commune of Tchaourou in Benin. Therefore, interventions directed at these various levels are needed urgently.

Prévalence de l'infection par l'hépatite virale B et facteurs associés chez les enfants des sujets ivoiriens porteurs de l'AGHBS / Prevalence of hepatitis B infection and factors associated in children of Ivorian HBsAg carrier

Objectifs : Déterminer la prévalence de l'infection par le virus de l'hépatite B (VHB) chez les enfants (sujets contact) des sujets porteurs chroniques de l'Ag HBs (sujets index) et rechercher les facteurs associés à cette infection chez ces enfants.Patients et méthodes: il s'est agi d'étude rétrospective transversale portant sur les patients positifs pour l'Ag HBs (sujets index), dont la famille (sujets contact: conjoints et enfants) a été soumise à un dépistage systématique de l'infection par le VHB. Résultats: L'âge médian de nos 44 sujets était de 43,1 ± 7,49 ans. Le nombre moyen d'enfants par sujet index était de 2,3 ± 1,1. L'âge médian des 92 enfants était de 9,3 ± 4,55 (de 1 à 15 ans) et 43 (44,8%) étaient vaccinés contre le VHB. La fréquence de l'infection par le VHB était de 24%. Les facteurs indépendants associés à l'infection par le VHB chez les enfants étaient l'ADN du VHB pour les sujets index> 2000 UI/ml (OR = 11,5; p = 0,001), l'existence du VHB chez les deux parents (OR = 7,9; p = 0,03) et l'absence de vaccination contre le VHB chez les enfants (OR = 30,9; p = 0,003). Conclusion: La couverture vaccinale des enfants des sujets index était insuffisante. Outre la transmission verticale, le risque de transmission intrafamiliale était élevé en présence d'au moins un des trois facteurs associés

Objectives: To determine the prevalence of hepatitis B virus (HBV) infection in children (contact subjects) of chronic HBsAg (index subjects) and to investigate the factors associated with this infection in these children. Patients and methods: this was a retrospective cross-sectional study of HBsAg positive patients (index subjects), whose families (contact subjects: spouses and children) were routinely screened for HBV infection. Results: The median age of our 44 subjects was 43.1 ± 7.49 years. The average number of children per index subject was 2.3 ± 1.1. The median age of the 92 children was 9.3± 4.55 (1 to 15 years) and 43 (44.8%) were vaccinated against HBV. The prevalence of HBV infection was 24%. The independent factors associated with HBV infection in children were HBV DNA for index subjects> 2000 IU/ml (OR = 11.5; p = 0.001), the existence of HBV in both parents (OR = 7.9; p = 0.03) and no HBV vaccination in children (OR = 30.9; p = 0.003). Conclusion: Immunization coverage of children of index subjects was insufficient. In addition to vertical transmission, the risk of intrafamilial transmission was high in the presence of at least one of the three associated factors.

Adolescents infectés par le VIH au cours de la transition des soins pédiatriques aux soins pour adultes dans un hôpital de référence à Abidjan (Côte d'Ivoire). Etudes des caractéristiques cliniques / Hiv-infected adolescents during the transition from paediatric to adult care in a referral hospital in abidjan (cote d'ivoire). Clinical characteristics study

Les adolescents vivant avec le VIH ont de moins bons résultats que les adultes en matière de soins, en particulier lors de la transition entre les soins pédiatriques et les soins aux adultes. L' Objectif était de décrire les particularités socio familiales, cliniques, para cliniques et thérapeutiques des adolescents au cours de cette phase charnière de leur prise en charge. Méthodes. Il s'agissait d'une étude rétrospective à visée descriptive qui s'est déroulé du 1er au 31 mars 2020 (1 mois) sur la cohorte d'enfants vivant avec le VIH suivi au CHU de Cocody (Abidjan) de novembre 2005 à mars 2020 (15 ans). Résultats. Trente-huit adolescents en phase de transition ont été inclus. L'âge moyen était de 17 ans avec des extrêmes de 15 et 20 ans. Le sex ratio était de 1,37. La majorité des enfants étaient scolarisé (81,57%) avec un retard scolaire chez plus de la moitié (58%). Près de la moitié des cas était orphelin d'un ou des 2 parents (47,4%). Les conditions socioéconomiques étaient modestes ou défavorable (73,7%). Près de la moitié des adolescents était suivi depuis plus de 10 ans (42%). Un surpoids a été retrouvé dans 21% des cas. On notait un échec immunologique dans 10,5% des cas et un échec virologique dans un tiers des cas (31,6%). L'observance était moyenne ou mauvaise chez près de la moitié des adolescents (44,7%). La majorité des adolescents (94,7%) n'avait jamais eu de contact avec un médecin d'adulte. Conclusion. La transition des soins pédiatriques aux soins pour adulte est un processus au cours duquel l'adolescent est confronté à des diffi cultés socio familiale et scolaire, a l'inobservance avec échec thérapeutique qui doit être repéré de façon précoce. Le succès de cette étape nécessite également le rapprochement entre pédiatres et médecins d'adultes pour une prise en charge optimal des patients.

First trimester antenatal care utilization and associated factors among adolescent mothers in Rwanda

Background First trimester antenatal care (ANC) initiation has been shown to improve the health outcomes for both mothers and unborn children. This study aimed at determining the prevalence of first trimester ANC use and associated factors among adolescent mothers in Rwanda. Methods This study was a cross-sectional study and analyzed the data of 6th Rwanda demographic and health survey (RDHS 2019-2020). Proportion, bivariate and multivariable analysis were employed to identify factors associated with first ANC use. Results The prevalence of first trimester antenatal care utilization among 354 adolescent mothers was 46%. Advanced age (AOR=1.82; 95%CI = 1.096-2.305), secondary education level (AOR=1.36; 95%CI = 1.080 - 1.960), coming to rich family (AOR = 2.10; 95%CI = 1.830 ­ 5.162), residing near health facility (AOR=1.17; 95%CI= 1.065 - 2.011), permitted to go to health facility (AOR=2.13; 95%CI = 1.857 ­ 3.363) were positively associated with ANC services use. However, the negative association was found with later pregnancy desire (AOR = 0.42; 95%CI = 0.149 ­ 0.781). Conclusion The prevalence of first trimester ANC was low. In view of that, more effort should be made to increase adolescent mothers' knowledge regarding the ANC services utilization and timely booking.

Medication Adherence, Barriers to Adherence and Treatment Satisfaction with Antiretroviral Therapy Among Adolescents Living with HIV in Lagos, Nigeria

The advent of antiretroviral therapy (ART) in controlling Human Immunodeficiency Virus (HIV) disease has been quite effective in ensuring that infected people can enjoy healthy, long, and productive lives. Medication adherence is an essential part of patient care, especially among patients with HIV, as it greatly determines the effectiveness of treatment. Few studies have explored factors influencing medication adherence and treatment satisfaction among adults, with little focus on adolescents. Objectives: To assess medication adherence, treatment satisfaction and factors influencing adherence to ART medication among adolescents living with HIV in Lagos, Nigeria. Methods: This descriptive, cross-sectional study was conducted among diagnosed and registered adolescents aged 10-19 years living with HIV and receiving treatment at eight selected antiretroviral centres in Lagos state, Nigeria. A total of 203 adolescents were recruited in stages, and data were collected using an interviewer-administered semi-structured questionnaire. Results: There was a low level of adherence as only 59/203 (29.1%) of the respondents adhered to ART. Depression, perceived stigma, being away from home, side effects of drugs, pill burden, and forgetfulness were some factors identified as barriers to adherence. The respondents were most satisfied with the effectiveness of the medication and least satisfied with the side effects. Conclusions: Medication adherence among adolescents was relatively low; the level of satisfaction with ART medication is an entity that significantly impacts adherence

Factors associated with viral load suppression among human immunodeficiency virus (HIV) positive adolescents and young adults in Ngororero District, Rwanda

Background Optimal viral load suppression results from good adherence to treatment. The viral load suppression advantages include the reduction of virus transmission. In Rwanda, however, viral load suppression among adolescents and young adults has been proven relatively low than in other age groups. Objectives To assess the factors associated with viral load suppression among adolescent and young adults in Ngororero district, Rwanda. Methods A cross sectional study that included 151 adolescents and young adults aged from 15 to 24 years was conducted in Ngororero district. Data were entered in Epi-Info version 7 software and analyzed using STATA15. Results Females and males were 68% and 32% respectively. Sixty percent of the participants were aged20-24 years. Multivariable analysis revealed the factors associated with viral load suppression: Ubudehe category 2, P= 0.016, AOR = 6.6, CI [1.4, 31.1]; ubudehe category 3, P= 0.004, AOR = 8.9, CI [2.01,39.8]; spending between 5 to 9 years on ART, P= 0.022, AOR = 0.16 [CI0.03, 0.89;) and often forget to take medication, P= 0.011, AOR = 0.35, CI [0.13, 0.97.] Conclusion Viral load suppression among adolescents and young adults was low. Improving socio-economic conditions of adolescents and young adults, as well as provision of continuous counselling to them during their whole treatment life can improve significantly their adherence.

Knowledge of cervical cancer among women of reproductive age in Ibadan North LGA, Oyo State, Nigeria

Background: Nigeria has one of the highest rates of cervical cancer morbidity and mortality in Sub-Saharan Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive measures. Cervical cancer is a deadly disease claiming the lives of many women in developing countries due to late presentation which might be influenced by a lack of knowledge of the disease and its prevention. Method: This descriptive study examined the knowledge assessment of cervical cancer among women of reproductive age (15-49), about cervical cancer, its prevention, and their utilization of Pap smear screening; using a convenience sample of 426 women in Ibadan North Local Government Area of Oyo State, Nigeria. Women voluntarily completed a structured questionnaire. Result: Results showed that women who participated in the study were aware of cervical cancer (77%; n=328) but many (62.9%; n= 268) were unaware of Pap smears as the screening tests for cervical cancer. Although 41.3% (n=176) were knowledgeable about cervical cancer, risk factors and prevention, only 9.4% (n=40) had Pap smear tests done. Conclusion: Health care professionals, need to intensify efforts to increase awareness about cervical cancer screening, and encourage women through the different clinics to use these services. The benefits of screening and early diagnosis of cervical cancer should be emphasized to enhance the utilization of cervical cancer screening services.

Exposure to tobacco advertisements, promotions, and sponsorships among in­school adolescents in Lagos, Nigeria: A cross­sectional study

Background: The Nigerian government implemented the National Tobacco Control Act (NTCA) in 2015, which prohibits tobacco advertising, promotion, and sponsorship (TAPS) exposure to children under 18 years of age. This study was conducted to assess the prevalence of attitudes and exposure to TAPS among in school adolescents in Lagos State, Nigeria, 5 years after the implementation of the Act and to identify the factors associated with TAPS exposure among the adolescents. Materials and Methods: This cross-sectional study was conducted among 968 in school adolescents selected through multistage random sampling. The data were collected using self-administered questionnaires adapted from the Global Youth Tobacco Survey. Results: Overall, 77% had been exposed to at least one form of TAPS in the past 30 days. The most frequently reported channel of exposure was through product placements, with 62% reporting exposure in films, TV, and videos. Up to 15.2% and 12.6% were exposed to TAPS through promotional activities and sponsorships, respectively. The majority (82.3%) had pro tobacco attitudes, while about a third (33.1%) had pro TAPS attitudes. Factors associated with TAPS exposure were having pro TAPS attitudes (odds ratio [OR]: 3.5, 95% confidence interval [CI]: 2.3­5.3), being female (OR: 2, 95% CI: 1.4­2.7), and residing in a rural area (OR: 1.6, 95% CI: 1.2­2.3). Conclusion: Five years after implementing the NTCA, more than two thirds of the adolescents reported exposure to TAPS, mainly through films, TV, and videos. This suggests that the NTCA is poorly enforced. Efforts to ensure the effective implementation of comprehensive TAPS bans are warranted. Gender sensitive strategies that target adolescents' attitudes and school level factors should be emphasized.

Factors associated with risky sexual behaviour among sexually experienced undergraduates in Osun state, Nigeria

Background: Risky sexual behavior (RSB) is common among youths which predispose them to sexually transmitted infections. This study sets out to identify the factors associated with RSB among undergraduates in Osun state. Methods: The study design was descriptive cross sectional and a total of 550 respondents from two universities in Osun state were sampled using a multistage sampling technique, out of which data from 266 sexually experienced respondents was further analyzed. Data collected via a semi­structured self-administered questionnaire and analyzed using univariate, bivariate and multivariate analyses. Results: The 266 respondents consisted of 54.5% males and 45.5% females and larger percentage of them were in the age group 15-24years. Seven out of ten respondents (69.9%) were sexually active while 65.8% were involved in at least one RSB. Of the 266 respondents, 28.6% ever had concurrent multiple sexual partners, 15.8% used alcohol/drugs at last sex while 48.1% did not use condom at last sex. More males (71.7%), alcohol users (76.8%), drug users (78.0%), pornography watchers (82.7%), internet users (71.2%) respondents "not in good terms with mum" (86.7%) and "those whose mum doesn't instruct them morally" (84.2%) were involved in RSB compared to their respective counterparts (p<0.05). However, there were no identifiable predictors of RSB on regression analysis. Conclusion: Risky Sexual Behavior is prevalent among undergraduates with males being more involved, among other associated factors. Concerned stakeholders should engage youths via behavioral change communication strategies so as to significantly reduce their involvement in RSB

Baseline anthropometric measurements and obesity among students in Sagamu, Ogun State, southwest, Nigeria

Objectives: This study was designed to determine the anthropometric characteristics and prevalence of obesity among secondary and undergraduate students in Sagamu. Methods: This cross-sectional study involved a selection of 260 students aged 10 to 33 years in Sagamu using a convenience sampling method. The weight, height, and waist and hip circumferences of each subject were measured. The body mass index was then calculated. Data were analyzed using SPSS version 25.0 and p-values< 0.05 were considered statistically significant. Results: The age ranges were 1o to 17 years (Secondary school (SS) students) and 14 to 33 years (undergraduate students). There were 130 students in each group, comprising 52.7% males and 47.4% females. Underweight was commoner among the SS students (20.8% versus 6.2%). Most of the subjects were of normal weight 52.3% in SS and 68.5% in undergraduates. Only 3.1% of SS students were obese compared to 4.6% of undergraduate students. The mean BMI of SS students (22.2± 0.39 versus 23.24±0.34) was statistically lower (p=0.019). The mean waist circumference of SS students (66.92±0.44 versus 74.64±0.67) was also statistically lower (p=0.000). The mean BMI of SS students was higher in females than in male subjects (23.14±0.62 versus 20.86±0.42). The mean waist and hip circumferences and BMI were lower in female subjects for both study groups. Conclusions: The mean BMI and hip circumferences were higher in female subjects while the mean waist circumferences were lower in females than males in both study groups.