COVID-19 vaccine hesitancy among pregnant women in an antenatal clinic in Durban, South Africa

Background: Mass administration of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most efficient intervention against the coronavirus disease 2019 (COVID-19) pandemic. Recently, vaccinations were shown to be safe and effective during pregnancy. However, vaccination rates are low in low- and middle-income countries, and vaccine hesitancy is a major limiting factor. Objectives: To investigate the rate of COVID-19 vaccine hesitancy among pregnant women. Method: A cross-sectional questionnaire-based investigation of 313 unvaccinated pregnant women attending an antenatal clinic in Durban, South Africa (SA). The questionnaire included clinical and socio-demographic data, and reasons for vaccine hesitancy were recorded and evaluated. Results: Of 313 women participating, 126 (40.3%) were vaccinated against COVID-19, 21/313 = 6.7%; for those unvaccinated, 21/187 (13.9%) were planning to be vaccinated. However, most unvaccinated women, 174 of 187 (93%), showed COVID-19 vaccine hesitancy. Conclusion: The COVID-19 vaccination hesitancy among pregnant women in Durban, SA, is exceptionally high. This requires urgent attention by the relevant health authorities (both professional health organisations and the SA Department of Health) as many countries experience different waves of the variants of SARS-CoV-2 and herd immunity may not have been achieved. Contribution: This study showed a high vaccine acceptance hesitancy rate among pregnant women in SA.

Hepatitis B chronic infection among pregnant women attending the antenatal care in Bor State Referral Hospital, South Sudan

Introduction: Hepatitis B virus (HBV) is a major public health problem affecting 400 million people worldwide, and is a common cause of chronic liver failure (cirrhosis) and hepatocellular carcinoma. Sixty-eight percent of infected people are from the African and Pacific regions. Vertical transmission from mother to newborn baby is one of the mechanisms by which chronic hepatitis virus infection spreads, besides infections from contaminated needles and syringes and sexual contact. Hepatitis B chronic infection is endemic in many poor countries, especially in Africa. Method: A cross-sectional study was conducted between July and August 2021. Pregnant women attending the antenatal care (ANC) in Bor State referral hospital, South Sudan, were interviewed to collect information on their socio-demographic characteristics and risk factors for hepatitis B infection. The objective was to determine the seroprevalence of hepatitis B chronic infection through blood testing. Prevalence ratios for certain risk factors were calculated. Results: Two hundred pregnant women were enrolled. The Prevalence Rate for chronic infection with hepatitis B virus, diagnosed using the rapid immune-chromatographic assay for Hepatitis B surface antigen (HBsAg), was 8.5%. (95% CI; 4.7% - 12.3%). None of the suspected risk factors studied were found to be significantly associated with testing positive for HBV, except for a history of previous jaundice. Conclusion: The prevalence of HBV chronic infection among pregnant women in Bor, Jonglei State, is high hence there is a need for established public health interventions that can lead to a reduction of HBV vertical transmission. Treatment of pregnant women with HBV chronic infection using anti-viral medications during pregnancy might curb the vertical transmission rates.

Pattern of liver enzymes and maternal outcome in eclamptic patients admitted to the Intensive Care Unit, University College Hospital, Nigeria

Introduction: Eclampsia, a hypertensive disorder, is one of the leading causes of maternal mortality in developing countries like Nigeria. We evaluated the relationship between the pattern of liver enzymes and maternal mortality in eclamptic women. Method: A retrospective study of 55 eclamptic women admitted to the Intensive Care Unit (ICU), University College Hospital, Nigeria, was conducted. Data were obtained on their demographic, obstetric, and clinical characteristics, liver enzyme patterns, and maternal outcome. Analysis was by descriptive statistics, univariate analysis, and non-parametric tests with level of significance set at p<0.05. Results: Maternal deaths occurred in 27.3% and elevation of liver enzymes was observed more among the dead patients compared with those who survived. Alanine aminotransferase (ALT) was the most commonly elevated liver enzyme, occurring in almost all (90.9%) the patients. Maternal mortality was significantly associated with age (p=0.001), saturated oxygen levels (p=0.007), elevated alkaline phosphatase (p=0.008), alanine aminotransferase (p=0.013), aspartate aminotransferase (p=0.016), and total bilirubin (p<0.001). Conclusion: Maternal mortality due to eclampsia was clinically associated with age, elevated liver enzymes and a lower serum level of total bilirubin. Liver transaminases are therefore important prognostic indicators associated with eclampsia.

Prevalence of middle ear effusion among children with adenoid hypertrophy at a national referral hospital in Tanzania

Introduction: Middle ear effusion (MEE) is a common childhood disorder that causes hearing impairment due to the presence of fluid in the middle ear which reduces the middle ear's ability to conduct sound. Temporary or persistent hearing loss as a result of MEE causes speech, language and learning delays in children. There are few studies on MEE in Tanzania despite the huge burden of hearing loss among children with adenoid hypertrophy which is a known risk factor for MEE. Method: A cross-sectional study was conducted among 420 children aged nine years and below having adenoid hypertrophy with or without MEE. The diagnosis of adenoid hypertrophy was confirmed with a lateral view x-ray of the nasopharynx and tympanometry for cases with MEE. The primary objective of the study was to assess the prevalence of MEE among children with adenoid hypertrophy. Results: The prevalence of MEE among children with adenoid hypertrophy was 61.7%, with 218 (51.9%) males and 202 (48.1%) females. The most affected age group was 2-4 years with an incidence 193 (46%) and in this age group, males (53.9%) were more affected than females (46.1%). Generally, males, 134 (51.7%) were more affected by MEE than females, 125 (48.3%) of all 259 children with MEE. In terms of age group predominance by MEE, children aged 3-4 years, 107(41.3%) were more affected than all other age groups. Additionally, 4 (1.5%) children with MEE presented with hearing loss. Conclusion: There is a high prevalence of MEE among children with adenoid hypertrophy but no significant association with hearing loss.

Uptake of HIV voluntary counseling and testing and associated factors among students in the Higher Institutions of Learning in Kigali, Rwanda: A cross-sectional study

Background HIV/AIDS remains a significant global public health challenge with youth bearing the brunt of the burden. One essential method for preventing and accessing AIDS care is through Voluntary Counselling and Testing (VCT). Regardless of this, youth population continues to have low utilization of VCT services. Objective To assess the uptake of HIV VCT services and associated factors among university students in Kigali. Methods A cross-sectional study among 374 students recruited using stratified sampling was conducted. A structured questionnaire was used to gather information. A multivariable logistic regression analysis was used to assess the independent factors associated with VCT uptake. Results The prevalence of VCT uptake was 59.9%. The logistic regression revealed that being Catholic (AOR = 11.99, 95%CI: 5.44-26.41) and Moslem (AOR = 37.34, 95%CI: 2.67-128.36) compared to Protestant, as well as availability of VCT services (AOR = 5.15, 95%CI: 3.11 - 8.541) favored the use VCT. On the other hand, being aged 20 to 24 years (AOR = 0.112, 95%CI: 0.04 - 0.29) had low likelihood of using VCT than those more than 24 years of age. Conclusion VCT uptake was significantly positively associated with religion and VCT services availability, and negatively associated with age 20-24 years in the campus. Therefore, targeted actions of disseminating information on benefits of VCT and enhancing accessibility of VCT services among students are necessary for the increased VCT uptake to be attained.

Prevalence of human immunodeficiency virus among female sex workers and associated risk factors in Rwanda, 2019

Background Female sex workers (FSWs) are more likely to be infected by Human immunodeficiency virus (HIV) than the general population. In Sub-Saharan countries, 18% of new HIV infections is attributed to FSWs. Study objective To determine HIV prevalence and its determinants among FSWs in Rwanda. Methodology A cross-sectional biological and behavioral surveillance survey in hotspots was conducted among FSWs countrywide. HIV laboratory tests were performed. Proportions and 95% confidence interval (CI) were calculated. Multivariable logistic regression was performed to determine factors associated with HIV in FSWs. Results The survey enrolled 1,883 FSWs. Of 1,770 FSWs who consented for HIV testing, 607 were HIV positive, giving the prevalence of 34% (95%CI= 32.11-36.54). High HIV prevalence was associated with age of 25 years or more (aOR = 3.68; 95%, CI: 2.62­5.18) and more than 5 years of sexwork (aOR = 1.31; 95% CI: 1.05­1.63). HIV prevalence and having more than three dependents (aOR= 0.34; 95%CI=0.23-0.5) and completing secondary and beyond education (aOR=0.50; 95%CI=0.36-0.71) were inversely related. Conclusion HIV prevalence is still high among FSWs in Rwanda. Prevention strategies should target the old ones in five first years of sex work and the less educated.

Boosting COVID-19 vaccine inoculation and booster shots: a systematic review and meta-analysis of factors that influence coronavirus vaccine uptake in practice

Introduction: Vaccines alone do not control pandemics, but vaccinations. The hope of COVID-19 pandemic control is hinged on vaccinations and other public health measures. This systematic review/meta-analysis (SR/MA) investigated the factors that inform coronavirus vaccine uptake globally in an attempt to improve COVID-19 immunization. Method: The PRISMA 2020 methodology was used for this review. A total of 2902 articles were identified from electronic databases and other sources. After screening, 33 articles were included in the review and quantitative meta-analysis. Comprehensive meta-analysis software version 3 was used for the meta-analysis. Results: We observed that vaccine effectiveness, side effects and the proportion of acquaintances vaccinated significantly influenced respondents' COVID-19 immunization decision. Also, associations of vaccine effectiveness, smaller risks to serious side effects, free and voluntary vaccinations and fewer vaccine doses, and longer duration to wanning were observed. We also observed variations in vaccine hesitancy trends in studies carried out in Asia, Europe, America, and Africa. Conclusion: Wanning and acquaintance's vaccination status as factors to vaccination are insights the present paper is bringing to the limelight. Health promotion and COVID-19 vaccination planning are crucial for enhancing vaccine uptake

Pediatric procedural sedation in African clinical settings: A mixed methods study of African providers' sedation practices

Background: Little is known about the practice of pediatric procedural sedation in Africa, despite being incredibly useful to the emergency care of children. This study describes the clinical experiences of African medical providers who use pediatric proceduralsedation, including clinical indications, medications, adverse events, training, clinical guideline use, and comfort level. The goals of this study are to describe pediatric sedation practices in resource-limited settings in Africa and identify potential barriers to the provision of safe pediatric sedation. Methods: This mixed methods study describes the pediatric procedural sedation practices of African providers using semi-structured interviews. Purposive sampling was used to identify key informants working in African resource-limited settings across a broad geographic, economic, and professional range. Quantitative data about provider background and sedation practices were collected concurrently with qualitative data about perceived barriers to pediatric procedural sedation and suggestions to improve the practice of pediatric sedation in their settings. All interviews were transcribed, coded, and analyzed for major themes. Results: Thirty-eight key informants participated, representing 19 countries and the specialties of Anesthesia, Surgery, Pediatrics, Critical Care, Emergency Medicine, and General Practice. The most common indication for pediatric sedation was imaging (42%), the most common medication used was ketamine (92%), and hypoxia was the most common adverse event (61%). Despite 92% of key informants stating that pediatric procedural sedation was critical to their practice, only half reported feeling adequately trained. The three major qualitative themes regarding barriers to safe pediatric sedation in their settings were: lack of resources, lack of education, and lack of standardization across sites and providers. Conclusions: The results of this study suggest that training specialized pediatric sedation teams, creating portable "pediatric sedation kits," and producing locally relevant pediatric sedation guidelines may help reduce current barriers to the provision of safe pediatric sedation in resource-limited African settings.

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.

Seroprevalence and associated risk factors for hepatitis B virus among pregnant women attending health facility in Osogbo, Nigeria

Background Hepatitis B virus (HBV) infection among pregnant women has a high rate of vertical transmission and consequential effects on fetal and neonatal outcomes. The aim of this study was to determine the prevalence and associated risk factors of infection among pregnant women attending antenatal care services in Osogbo, Nigeria. Methodology This hospital based cross-sectional study was conducted among pregnant women attending routine antenatal care clinic between April and June 2021. Systematic random sampling technique was used to recruit 240 pregnant women, their data were collected by face to face interview using a pretested questionnaire, while blood sample was collected aseptically to determine hepatitis B surface antigen by enzyme linked immunosorbent assay test kit. Univariate and multivariate logistic regression were used to examine the association between explanatory variables and outcome variable. Results The mean age and seroprevalence of the study population were 27.50 ± 4.4 years and 5.8% respectively. The significant risk factors for HBV infection were tattooing (aOR = 5.22; 95% CI = 0.52­8.01; p = 0.0000), history of multiple sexual partners (aOR = 2.88; 95% CI = 1.92­12.42; p = 0.0044); and past history of contact with HBV patient (aOR = 2.17; 95% CI = 1.21­15.32; p = 0.0310) were significant predictors of HBV infection. Conclusion The seroprevalence of HBV from this study was of intermediate endemicity. We therefore, advocate for continuous health education programs on the mode of HBV transmission, high-risk behaviors and methods of preventions at antenatal care clinics to raise the awareness of mothers and limit the spread of infection.

Dental caries risk assessment in primary school children aged 11 to 12 years: Case of Nyarugenge District, Rwanda

Background Dental caries in children is a public health concern affecting 60-90% of children worldwide. Dental caries perturbs children's eating ability, school performance as well as overall quality of life. This study aimed to determine the prevalence of dental caries and its risk factors among children aged 11 to 12 years in Nyarugenge District in Kigali, Rwanda. Methods The cross-sectional analytical study design involved 400 children from Nyarugenge district. By stratified sampling, we selected Gitega and Butamwa primary schools and used systematic sampling to choose the pupils into the sample. An interview and oral examination were performed. Descriptive statistics and logistic regression were done. Results Dental caries was observed in 25.5% of children. Deep pits and fissures carried a two-fold risk of getting dental caries than children without deep pits and fissures (OR = 2.4, 95% CI = [1.5; 4.0], P-value < 0.001). Dental plaque was identified as a risk factor for getting dental caries (OR=2.2, 95% CI = [1.2; 3.3], P-value: 0.01). Conclusion Dental caries is a public health concern associated with poor oral hygiene, deep pit, and fissures among children aged 11 to 12 years old. Oral hygiene education, application of ART, and regular screening programs are in need.

An adapted collaborative care model to manage co-morbidities of depression and chronic non-communicable diseases in Rwanda

Background The World Health Organization has recommended the implementation of the Collaborative Care Model in all countries to manage the comorbidities of depression and chronic non-communicable diseases. In Rwanda depression is major problem not only among patients with chronic illnesses but also in general population considering the unique history of war and genocide in Rwanda. Purpose The purpose of this paper is to describe the process of adaptation and testing of the Collaborative Care Model in the Rwandan healthcare context. Methods The larger study used the Action Research design with mixed method ­sequential explanatory design. A research-practice partnership method and an iterative process was used to adapt and test the Collaborative Care Model. Qualitative content analysis was used to analyse the data. Results Four structural components to the model were adapted including the addition of a registered nurse to the team, relocation of the model to the district level, consultation with a psychiatrist every 3 months and involvement of community health workers. The evaluation indicated that the model was applicable and acceptable. Conclusions Initial evaluation of the Adapted Collaborative Care Model shows promise in Rwanda. Implementation of this model in other Rwandan districts is warranted.

Risk factors of transfusion transmissible infections among blood donors at Karongi Regional Centre for blood transfusion in Rwanda

Background Blood transfusion saves human lives, but also it can be a route for TransfusionTransmissible Infections (TTIs) including Human Immuno-Deficiency Virus (HIV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), and syphilis. Objective This study aimed to explore the risk factors associated with TTIs among blood donors at Regional Centre for Blood Transfusion (RCBT) of Karongi, Rwanda. Methods This was a retrospective cross-sectional study design conducted among 36,708 blood donors from 2015 to 2019. Data were extracted from the system known as eProgesaused and the outcome variable were TTIs including HBV, HCV and HIV (measured using Enzyme Immuno-Assay/Chemiluminescence Immunoassay) and syphilis (determined by Rapid Reagin Plasma). Descriptive statistics was computed to describe the characteristics of the blood donors. Bivariate and multivariable logistic regression were performed to assess the risk factors associated with TTIs. P value less than 0.05 was considered statistically significant. Results The study found that the overall prevalence of TTIs was 2.1%, while the prevalences of HBV, HCV, HIV, and syphilis were 1.3%, 0.4%, 0.06%, and 0.34%, respectively. Multivariable analysis showed that the factors associated with HBV, HCV, HIV and syphilis were being male, age more than 25 years, being married, living in urban areas, first time blood donors and blood donors living in Rusizi, Rusizi, Nyamasheke and Karongi districts. Conclusion This study revealed that the most frequent TTI was HBV among blood donors and the main risk groups were males, age group of 26-35 years, married and first time donors. Hence, while developing health policies to reduce the effects of HBV infection on safe blood transfusion, these study findings should be taken into account.

Determining compliance with the COVID-19 daily symptom monitoring tool used to identify suspected COVID-19 workers of the military health support formation employees of the South African national defence force

Introduction: the COVID-19 pandemic had prompted governments in many countries to enact laws and policies to combat the spread of COVID-19 at work. The DEL required every worker to be screened when they arrived at work. Screening methods included self-reporting symptoms using a symptom monitoring tool. This study aimed to determine compliance with the symptom monitoring tool by assessing the knowledge, attitude, and practice of the MHSF employees. Methods: a cross-sectional questionnaire was administered to the employees. Information related to demographic, COVID-19 exposure, knowledge of COVID-19 and the symptom monitoring tool, attitude towards the symptom monitoring tool and practices towards COVID-19 and the symptom monitoring tool was collected. Results: a total of 90 participants participated in the study. The majority (N=45; 50%) of respondents were aged between 30 and 39 years old, with more female (N=50) than male (N=40) participants. The majority (N=51; 56.7%) only had grade 12 as the highest level of education. There were 25% (N=10) of males and 20% (N=10) of females who contracted COVID-19. The relationship between the COVID-19 positive cases and the symptom monitoring tool identifying symptoms had a strong negative correlation (-0.932). Respondent's knowledge of COVID-19 and the symptom monitoring tool was moderate (72.4%), with the attitude to the symptom monitoring tool being moderate (63.3%) as well. However, the practices of the COVID-19 guidelines and the symptom monitoring tool were good (93.3%).

HIV awareness campaigns, Knowledge and practices among pregnant women living with HIV in northern Uganda

Introduction: despite significant progress made in HIV care and research, there are still many misconceptions on acquisition, treatment and progress of HIV especially in rural communities. Different strategies have been utilized to spread reliable knowledge to different audiences. One of the strategies has been the use of community awareness campaigns. However, it is not clear if these campaigns have been effective and if they reached the different sub-populations in the community. This study aimed to assess the knowledge and practices of HIV community awareness campaigns and associated factors among pregnant women living with HIV in Oyam district in northern Uganda. Methods: it was a quantitative cross-sectional study in a consecutively selected sample of 416 pregnant women living with HIV. An interviewer-administered questionnaire was used to collect data on awareness, sources of information, content of the messages, utilization of the awareness messages and the perceptions about the campaigns. In addition, we determined factors associated with knowledge about the community campaigns. The level of knowledge was determined by the participant' response indicating whether they had prior knowledge about awareness campaigns or not. Data were analyzed using SPSS version 23 using Chi-square and logistic regression at 95% confidence interval and a p-value of 0.05 for statistical significance. Results: of the 416 participants in the study, 92.5% (n=385) had prior knowledge about HIV awareness campaigns and 97.6% (n=406) had specifically heard about anti-HIV-related stigma campaigns. The most common sources of information were radio (43.3%), health education sessions at health facilities (44%), and family members (2.9%). The received information was on HIV transmission, antiretroviral therapy, HIV related stigma as well the effect of stigma on self-esteem, hopelessness, HIV related abuse and ART adherence. Knowledge was associated with having a source of income (OR= 0.162, 95%CI 0.034-0.775, P= 0.023), having heard about HIV-related Stigma (OR=0.051, 95%CI 0.003-.949, P= 0.046), availability of community linkage facilitators (OR= 0.077, 95% CI 0.011-0.537, P= 0.010), use of awareness messages by community members (OR= 13.887, 95% CI 1.316-146.6, P=0.029) and the source of HIV awareness information (OR= 0.462, 95% CI 0.237-.902, P=0.024). Conclusion: although there is still high HIV-related stigma in general public, there is increased awareness among pregnant women. Availability of community linkage facilitators and use of appropriate sources of information seems to be helping with increasing community knowledge about HIV awareness campaigns.

Profil épidémiologique et mortalité due à la tuberculose dans la zone de Santé de Kamina, Province du Haut-Lomami, en Démocratique du Congo / Epidemiological profile and deaths related to TB disease in the Kamina´s Health Zone, Haut-Lomami Province, Democratic Republic of the Congo

Introduction: Était de décrire le profil épidémiologique, clinique et évolutif des patients tuberculeux suivis dans le milieu urbano-rural de Kaminaen République Démocratique du Congo (RDC). Méthodes: il s´agit d´une étude transversale par analyse rétrospective de dossiers des patients suivis pour tuberculose sur une période allant du 1er Janvier 2018 au 31 Décembre 2021. Résultats: sur un total de 612 échantillons analysés, 216 cas de tuberculose ont été confirmés par le laboratoire, soit une fréquence de 35,3 %. Notre échantillon était constitué de 138 hommes et 78 femmes, soit un sex-ratio de 1,77. L´âge moyen était de 35,37±18,14 années. La majorité des patients était dans la tranche d´âge comprise entre 21-40 ans. La profession libérale représentait 94,4 % de notre effectif, soit 204 patients. Il y a eu 63,4% des patients souffraient d´une tuberculose pulmonaire dont 70,9 % était guéris. La sérologie VIH était positive chez 6 patients, soit un taux de séroprévalence VIH de 2,77 %. Au total, 27 malades sont décédés sur les 612, soit un taux de mortalité de 4,41 %. C´est la tranche d´âge de malades ages de plus de 60 ans qui a connu une mortalitéélévée, soit 5 cas sur 20 (25 %), suivie de celle des malades ages de moins de 20 ans, 11 cas sur 49 (22,4 %). D´autre part, le résultat a montré un taux de mortalité plus élévé chez les tuberculeux séropositif, 33,3 %, contre 11.9 % chez les séronégatifs. Conclusion: ce rapport montre un taux élevé de tuberculose dans la zone de santé de Kamina ; il confirme le fait que la TB est endémique dans la région. Il est nécessaire d'améliorer les conditions de vie de la population et le système de santé local en ce qui concerne la prévention et la gestion de la TB afin de réduire sa morbi-mortalité.

Introduction: the purpose of this study was to describe the epidemiological, clinical and evolutionary profile of patients with tuberculosis followed in the urban-rural area of Kamina, Democratic Republic of the Congo (DRC). Methods: we conducted a cross-sectional study based on a retrospective analysis of the medical records of patients followed for tuberculosis over the period January 1, 2018 -December 31, 2021. Results: out of 612 samples analysed, 216 cases had received lab confirmation of tuberculosis, reflecting a rate of 35.3%. Our sample consisted of 78 women and 138 men (sex ratio 1.77). The average age of patients was 35,37±18.14 years. The majority of patients were in the age range 21-40 years. Self-employed people accounted for 94.4% of our workforce (204 patients); 63.4% of patients suffered from pulmonary tuberculosis, 70.9% of whom were cured. Serology test for HIV was positive in 6 patients (i.e. an HIV seroprevalence rate of 2.77%). In total, 27 patients out of 612 died, (i.e. a mortality rate of 4.41%). Patients aged over 60 had higher mortality rates (5 out of 20 cases; 25%), followed by patients under 20 (11 out of 49 cases; 22.4%). On the other hand, our results showed a higher mortality rate among HIV-positive patients with tuberculosis (33.3%, compared to 11.9% among HIV-negative patients). Conclusion: this study shows a high rate of tuberculosis in the Kamina health zone, confirming the fact that TB is endemic in the region. There is a need to improve the living conditions of the population and the local health system with regard to the prevention and management of TB in order to reduce morbidity and mortality

Attitudes and practices of travelers regarding COVID-19 vaccine and adverse reactions

Objective.In the context of the global COVID-19 pandemic, COVID-19 vaccines were made available to different countries. This study aimed to assess travelers' attitudes and practices toward the COVID vaccine and adverse events. Methods. A survey was conducted using a questionnaire from April 1 to June 30, 2021, among travelers who came for their COVID-19 test at the Institut Pasteur of Côte d'Ivoire.Results. A total of 527 travelers agreed to participate in this study, including 336 men and 161 women. Overall, 26% of respondents had already received their COVID-19 vaccine, while 76% of respondents responded they did not want to be vaccinated. The age of those most vaccinated (116) ranged from 25 to 64 years with a small proportion for those over 65 years (0.8%). Travelers (41) to France were the most vaccinated. All vaccinated persons (135) had a high level of education and were either Christian (89 persons), Muslim (45 persons) or animist (1 person). Adverse events related to the COVID vaccination were reported in seven individuals. These included muscle pain, fever and nausea. Conclusion.Negative attitudes towards vaccines are a major public health concern. In view of these results, for awareness raising, vaccination campaign may be focused on youthand people over 65 years of age. Public health messages containing information about vaccine safety should be tailored to address this vaccine hesitancy

Association of acute COVID-19 with 24 hours-pulse wave velocity in cameroonian workers

Introduction. COVID-19appears to have a vascular tropism responsible for diffuse vasculitis-like cell damage. The aim of our study was to evaluate the impact of Sars-Cov-2 infection on arterial stiffness.Material and methods. This was a cross-sectional analytical case-controlstudy with 1:1 matching (1 case to 1 control) over a six-month period from January 1, 2021 to June 30, 2021 at the medical-social centerof the autonomous port of Douala. We measured the pulse wave velocity (PWV) in two groups of patients (group 1: COVID-19and group 2: non-COVID-19) using a MOBIL-O-GRAPH 24h PWA MonitorTM. A p-value < 0.05 was considered significant.Result. A total of 122 patients (61 COVID-19and 61 non-covid) were included in this study, among which 68 (55.7%) male. The mean age was 41±11 years. PWV as well as POV adjusted for age and mean BP were similar in both groups. The mean 24-hour, diurnal and nocturnal PWV were slightly higher in COVID-19patients than in controls by 0.1 m/s (p=0.67), 0.2m/s (p=0.37) and 0.2m/s (p=0.25) respectively. COVID-19infection was not significantly associated with PWV (p=0.082).Conclusion. PWV were slightly higher in COVID-19patients and increased arterial stiffness was not significantly associated with COVID-19status in the acute phase of infection.

Knowledge and practices toward COVID-19 preventive measures and symptoms: A case-control study in Benin

Introduction. Following communication and awareness actions related to COVID-19, we assessed the knowledge and practices about COVID-19 in Benin. Methods. A case-control survey was conducted from 14 September to 20 October 2020 in Benin. Questions relatingto knowledge and practices on COVID-19 were collected through a questionnaire survey. A total of 312 respondents (104 cases and 208 controls) were included in the study. Logistic regression and Spearman correlation tests were used to examine the relation between participants knowledge and practice at a 5% significance level. Results. From the survey, 65.4% of cases and 68.3% of controls knew about COVID-19 transmission via air droplets. Most of the cases (67.31%) and control (79.81%) participants reported cough as a symptom of COVID-19. Handwashing with soap and water was the most protective measure known by 87.5% of cases and 90.87% of controls. Concerning practice, the cloth mask was the type mostly worn by cases (54.81%) and controls (58.65%). Wearing a face mask in public areas was significantly associated with the COVID-19 health status of respondents (OR = 2.98, CI95% [1.16-7.67]; p = 0.022). Furthermore, a significantly positive correlation exists between knowledge of the COVID-19 protective measures and hand hygiene practices when leaving a public place (r = 0.184, p=0.001). Conclusion. Through this study, we observed some discrepancies between the knowledge and practices related to COVID-19 among cases and controls surveyed. Therefore, efforts should be directed toward raising awareness about the disease to improve their knowledge and practices

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.