Impact of COVID-19 on breast cancer stage at discovery and time to treatment in Cote d'Or, France

State of the matterDue to the COVID-19 pandemic, and the resulting bottlenecks in the French healthcare system, the management of patients with COVID-19 has been prioritized over that of patients with other pathologies, in particular chronic diseases. The objective of this study was to investigate the impact of COVID-19 on the discovery stage of cancers diagnosed in an organized breast cancer screening program, as well as the impact on the time to supported. Material and methodsAll women aged 50 to 74 for whom cancer has been diagnosed in Cote d'Or as part of the national organized breast cancer screening program (first or second reading) from January 1, 2019 to December 31, 2020 have were included in this study. Using data from pathological anatomy laboratories, clinical centers, and the breast and gynecological cancer registry in Cote d'Or, France, we collected sociodemographic, clinical, and treatment data from all patients. We compared data from the year 2019 (pre-COVID) with that of the year 2020 (COVID). ResultsIn this study, we did not observe any change in the stage of discovery of the cancer at the time of diagnosis, nor any change in the therapeutic strategy. However, we observed a significant increase in infiltrated tumors, a decrease in in situ tumors, and the finding of larger clinical size of in situ tumors after the COVID pandemic. ConclusionWhile these results are reassuring, continued monitoring is needed to determine post-pandemic effects.

Diabetic patients and factors associated with a reluctance to vaccinate against COVID-19 in Abidjan, Ivory Coast

Vaccine hesitancy is a common issue in many countries and is likely to hamper the fight against the COVID-19 pandemic. This reluctance is alarming in diabetic patients who are more prone to severe forms of the disease. The aim of this study was to determine the COVID-19 vaccination rate in a population of diabetics followed for their diabetes and to analyze the factors associated with vaccine hesitancy. This cross-sectional, multicenter study, was carried out over 3 months (January 1st-March 31, 2022) in five consultation centers in Abidjan, Ivory Coast. All 254 patients with diabetes who had a consultation were included. There were more women than men (56.3%) and more with under high school diploma (72.8%). Among them, 2% had COVID-19 once and 14% had relatives affected with COVID-19;63.8% knew the symptoms of COVID-19 and the media (TV and social networks) were the main source of information (81.9%). Among the patients included, 51.9% were not vaccinated against COVID-19;25.9% refused vaccination while 12.0% were hesitant due to their diabetes. The reasons for refusal were: fear of side effects, questionable effectiveness of the vaccine and fear of injections.Copyright © 2022 Elsevier Masson SAS

COVID-19, living income differential and decline in income of cocoa producers in C..te d'Ivoire. (Agriculture et syst..mes alimentaires face .. la Covid-19.) [French]

Cocoa farmers in C..te d'Ivoire are mostly below the poverty line. In September 2019, the Ivorian and Ghanaian governments imposed the Living Income Differential (LID) on private companies, an additional $ 400 per ton compared to the international market price, passed on to the producer price (farm gate price). At the beginning of 2020, the Covid-19 arose. In this dual context, how did prices change? Has the hope of increased income been achieved? Three approaches are used: (a) monitoring of the selling price of cocoa beans and monitoring of the price of purchased cocoa farming inputs and basic necessities for households;(b) monthly monitoring of farm gate cocoa price in 2020-2021;(c) an analysis of national production data from C..te d'Ivoire and Ghana, the world price, variations in the demand for beans by the grinding industry, and the price paid to producers, over 20 years. The first result is a very temporary and limited rise in the farm gate price of cocoa at the end of 2020, then its fall in 2021 as the price of inputs and basic necessities soar. The 2021-2022 campaign is even more harmful with a tightening of the price scissor. It is therefore the failure of the LID, but the role of Covid-19 in this failure is very nuanced with regard to the declarations of the State and the multinationals. The drop in prices and the loss of income for cocoa farmers in 2020-2022 rather fits into the economic theory of games. Without control of their supply, an agreement between two companies or countries cannot work. The failure is part of a largely endogenous structural change: demographic growth, policies to encourage migration and deforestation, opacity of the sector and finally continued growth of the supply of cocoa from C..te d'Ivoire on the international market.

First assessment of the knowledge, attitudes, and practices of health actors in Togo and Ivory Coast in regard to antibiotic resistance

Background and Aim: Bacterial resistance to antibiotics has now become a threat to global public health. This study aimed to assess the knowledge, attitudes, and practices of health actors in relation to antibiotic resistance (ABR) in two African countries. Materials and Methods: A cross-sectional and descriptive questionnaire study was conducted in Ivory Coast and Togo from August 2020 to July 2021. Actors were interviewed both in person 63% (n = 141) and remotely due to COVID-19 restrictions. Qualitative variables were described by frequencies and quantitative variables by the mean and associated standard deviation. The bivariate analysis was conducted through the Chi-square test and exact Fisher test with an acceptable risk of 5%. Results: The results showed that 88% and 50% of the actors from Togo and Ivory Coast, respectively, had a good knowledge of ABR even if most of the stakeholders had limited knowledge of antibiotics that are banned or of critical importance in human and animal medicine. More than 75% of the actors had good perceptions in regard to ABR and these were significantly related to their profession. As for the factors leading to an increase in ABR, the interviewees perceived selfmedication in humans as the main contributing factor. Approximately 70% of the actors admitted to following inadequate practices in terms of the use and/or distribution of antibiotics, and 58% and 46% of them used preventive antibiotic therapy in Togo and Ivory Coast, respectively. Similarly, in the two countries, 39% and 69% of the actors, respectively, claimed that they do not systematically use the antibiogram, and 69% and 61% of drug distributors, also respectively, admitted to occasionally selling antibiotics without a prescription. Finally, more than 80% thought that the authorities in their country did not communicate sufficiently about ABR. Among the actions that could help to combat ABR, actors considered the strengthening of controls on the distribution of antibiotics and the education of nonprofessionals on the importance of antibiotic preservation as priorities. Conclusion: Although this first study had some limitations, that is, the low number of surveyed actors and non-standardized questionnaire used, it revealed that health actors in Togo and Ivory Coast have a good knowledge and perception in regard to antibiotics and ABR, but also follow inadequate practices. © Bedekelabou, et al. This article is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

[Covid-19 in Côte d'Ivoire (March 2020 - April 2021) a year under the seal of the Coronavirus]. / La Covid-19 en Côte d'Ivoire (mars 2020 - avril 2021) une année sous le sceau du coronavirus.

After a year of coronavirus epidemic, Côte d'Ivoire is completing a third wave of Covid-19. Although the epidemic has been confined mainly to Greater Abidjan, thanks in particular to the isolation measures imposed on the Ivorian economic capital, the impact of the health crisis has nevertheless been marked. Like other West African countries, Côte d'Ivoire did not experience the epidemic tsunami that some predicted in March 2020, but more than 45 000 cases and nearly 300 deaths have been reported, although these figures underestimate the epidemiological reality. With the advent of vaccination, Côte d'Ivoire hopes to control the epidemic, but the possible circulation of variants, particularly South African variants, and the difficulties in obtaining vaccine doses are challenges that the Ivorian health authorities will have to overcome. The resilience of the population has been significant during this crisis, illustrating the ability of Ivorians to withstand the impact of this crisis.

Contribution of the herbarium of the national center of floristics of Cote d'Ivoire in the fight against the symptoms caused by the COVID-19 disease: a bibliographic synthesis

This study was undertaken to identify herbal remedies that may be involved in the symptomatic management of COVID-19 disease. From a list of 247 medicinal plants, a bibliographic study was carried out with the richness, the floristic composition, the methods of preparation and use and the active principles of the plants as a variable. The importance value of these plants was also calculated. A Principal Component Analysis showed the links between the parts of plants used, the methods of preparation, the symptoms of COVID-19 disease that can be treated and the active ingredients. The results show that 226 medicinal plants divided into 190 genera and 79 families can be used to treat the symptoms of COVID- 19 disease namely otolaryngologic signs, pulmonary signs and general signs. Of these, twenty-eight (28) can relieve the majority of symptoms of COVID-19 disease. These symptoms are rhinorrhea, cough, fever, headache, vomiting, diarrhea, and muscle aches. These plants are mainly prepared in the form of a decoction and administered mainly orally. They mainly contain flavonoids, coumarins, alkaloids, tannins, steroids, terpenoids, saponosides, essential oils, mucilages, quinones, coumarins. The importance value of these plants is between 85.71 and 57.14%. The results also showed that eight (8) groups of medicinal plants can be distinguished according to the organs used, the methods of preparation, the symptoms of the COVID-19 disease treated and the active ingredients. The results of this study could serve as a database for the formulation of improved traditional drugs in the management of symptoms of COVID-19 disease in Cote d'Ivoire.

[Effects of Covid-19 Pandemic on the Vaccine Activities on a Reference Immunization Center in Treichville, Côte D'ivoire]. / Effets de la Pandémie à Covid-19 sur les Activités Vaccinales D'un Centre de Vaccination de Référence de Treichville en Côte D'ivoire.

Introduction: Since March 11, 2020, Côte d'Ivoire has been affected by the coronavirus epidemic, declared that same day as pandemic by WHO. March 11, 2021, one year after the pandemic, Côte d'Ivoire has notified 36,824 cases of Covid-19 patients and among them 211 have died. As of May 31, 2020, Côte d'Ivoire had already notified 2,833 cases and 33 deaths. At that time, false rumors were circulating in Africa about the setting up of clinical trials on candidate vaccines. The impact of these rumors on the overall use of health services had to be measured and in particular on vaccination centers. Objectives: The objective of this study was to determine the effects of the pandemic on the activities of the immunization services of the National Institute of Public Hygiene in Abidjan, which comprises four departments: International Vaccination Center, Community Vaccination Service, Rabies Center, and Vaccination Unit of the Expanded Program on Immunization. The study was based on activity reports of the immunization services. Results: At the International Vaccination Center, activities fell by about 50% in March, 86% in April and 82% in May in comparison with 2018 and 2019. Activities of Community Vaccination Service decreased by about 26% in March and 99% in April and May. At the Rabies Control Center, this reduction was estimated at 38% in April and 45% in May. The highest losses were for yellow fever and meningitis vaccines. Conclusion: The drop in attendance at vaccination services could increase the risk of epidemics, especially yellow fever, which are recurrent in Abidjan. Intensive awareness and catch-up actions should be carried out and further studies performed to assess the impact of the pandemic on immunization activities.

Novel Lineage of Infectious Bronchitis Virus from Sub-Saharan Africa Identified by Random Amplification and Next-Generation Sequencing of Viral Genome.

Avian infectious bronchitis (IB) is among the major viral respiratory and reproductive diseases of chickens caused by Avian coronavirus. In the African continent, IB was first described in countries located in the Mediterranean basin. In other parts of the continent, the epidemiological situation of IB remains unclear. In this study, the complete genome sequences of five IBV strains, originating from the sub-Saharan area were determined. Phylogenetic analysis based on the full-length S1 sequences identified three lineages (GI-14, GI-16, and GI-19) common in Africa and revealed that a strain, D2334/11/2/13/CI, isolated in Ivory Coast may represent a novel lineage within genotype GI. The maximum inter- and intragenotype sequence identities between this strain and other IBVs were 67.58% and 78.84% (nucleotide) and 64.44% and 78.6% (amino acid), respectively. The whole-genome nucleotide identity of the novel variant shared the highest values with a reference Belgian nephropathogenic strain (B1648, 92.4%) and with another study strain from Ivory Coast (D2334/12/2/13/CI, 94.6%). This study illustrates the importance of epidemiological monitoring of IBV in sub-Saharan Africa, as the area may serve as a focal point for newly emerging viral lineages.

COVID-19 in C..te d'Ivoire: focusing on the "social figure" of the disease in Abidjan

COVID-19 has affected Africa like the rest of the world. However, it can be assumed that the population's representation of the disease differs from one country to another. Based on a qualitative survey, we analyze its social representation in C..te d'Ivoire, and more specifically in Abidjan, the main area of contamination. Our results show that the "social figure" of the disease in this country is marked, on the one hand, by a vision anchored in clientelism with regard to the prohibitions and authorizations linked to the restrictions imposed, and, on the other hand, by a trivialization based on the images of "massification", "generalization", and "naturalization", in particular with respect to HIV-AIDS or Ebola.

I Buy Medicines From the Streets Because I Am Poor: A Qualitative Account on why the Informal Market for Medicines Thrive in Ivory Coast.

The informal market for medicines has been growing. In Ivory Coast, this informal market is an unofficial core part of the health system. Given the risks associated with the informal market for medicines, it is important to understand why this market continues to grow. It becomes even more important in the context of COVID-19, as a huge chunk of falsified medical products end up at the informal market. A qualitative case study design was chosen for this study, with in-depth interviews (IDIs) and focus group discussions (FGDs) being the methods for data collection. 20 IDIs and 3 FGDs were conducted. Participants in this study are sellers, buyers, and pharmaceutical experts. We found out that the informal market for medicines thrives because it is highly accessible, convenient, affordable, and that it is used for various social, cultural, and religious reasons. The study concludes that although this informal market presents a clear danger to public health, it is thriving. For authorities to address this public health challenge, there is need for a holistic and multi-pronged approach, which includes addressing health systems factors and strengthening regulatory framework.

Survey on the level of knowledge of medicinal plants used against Coronavirus disease, influenza and colds among travelers who came for the COVID-19 test at the Institut Pasteur de C..te d'Ivoire

Objective: This study was conducted to identify medicinal plants in the fight against Coronavirus disease, influenza and colds cited by travelers who came for their Covid test at the Institut Pasteur of C..te d'Ivoire. Methodology and Results: A semi-structured interview was conducted with 527 travelers from April 1 to June 30, 2021. The interviewed travelers were predominantly male (69.4%). Travelers going to France (28.46%) were the most numerous. The most represented age groups were 41-64 (43.83%) and 25-40 (43.26%). When the level of education is considered, the surveyed travelers have a higher level of education (89.94%). Entrepreneurs (13.85%), traders (12.66%), company directors (12.33%), students (8.54%) and health workers (6.45%) are the majority. Only 21.63% of travelers used traditional medicine in the last 12 months prior to the survey. Various plants are used to fight (33.43%) or prevent (56.57%) Coronavirus disease (7.02%), influenza (3.60%) and colds (2.84%). In total, 13 species of medicinal plants divided into 13 genera and 13 families were cited. Azadirachta indica (Meliaceae) with citation frequencies (cf) of 22%, Zingiber officinale (Zingiberaceae) with cf of 21% and Citrus limon (Rutaceae) with cf of 14% were the most cited species. Conclusion and application of results: These plants could be used for research and development of phytomedicines against Coronavirus, influenza and cold.

Pro-poor and inclusive growth in West Africa

PurposeThis paper focuses on three key metrics of poverty, income distribution and employment to ascertain the pro-poor and inclusive-growth position of the western African region. The roles of governance structures and their interactive effects are also accommodated to capture the peculiarity of the region.Design/methodology/approachThe paper employs fixed and dynamic models.FindingsEvidence suggests that growth is pro-poor, although virtually all governance indicators are sterile in stimulating poverty reduction. The authors observe that health and education spending coupled with trade-openness stimulate pro-poor growth potentials, whereas conflicts culminate the pervasiveness of poverty in the region. By empirically answering the question of how inclusive is economic growth through the lens of income-distribution and employment, the authors show that growth has been exclusive as per-capita-GDP growth rather dampens income shared by the poorest 20%. Also, it is observed that growth has not been inclusive as the jobless-growth argument remains valid while high inequality further exacerbates unemployment in the region. It is further shown that governance has been generally weak in propelling inclusive growth except where the institutional-component of governance stimulates inclusive growth through improvement in equality and labor employability.Originality/valueThe study jointly examines the metrics of poverty, income distribution and employment to ascertain growth pro-poorness and inclusivity which are key for the achievement of African-union (AU) agenda 2063. The study captures cross-sectional dependence among selected countries which previous studies ignored.