[Leprosy epidemiology in Daoukro health district (Côte d'Ivoire) from 1999 to 2017]. / Épidémiologie de la lèpre dans le district sanitaire de Daoukro (Côte d'Ivoire) de 1999 à 2017.

Introduction: Leprosy is a real problem in the Daoukro health district despite the actions of the National programme for elimination. Objective: To describe the epidemiological and clinical profile of new leprosy cases in the Daoukro health district from 1999 to 2017. Method: Descriptive survey including leprosy patients admitted to the dermato-leprology department from 1999 to 2017. Results: From 1999 to 2017, the incidence of leprosy fluctuated from 4.4 to 0 per 100,000 with a peak of 14.2 in 2003. In 2016 and 2017 no cases of leprosy were reported. The mean age was 36.8 years (SD=20). A majority of cases were uneducated and living in rural areas. Females and children under 15 years of age accounted for 53% and 16% of cases respectively. Clinically, cutaneous signs were predominant in the patients. The multibacillary form accounted for 82%. Nearly 1 out of 4 patients had a grade 2 disability (24%). All patients received treatment (multidrug therapy). Among them, 83.8% were cured, while 0.5% were not cured. In addition, regarding 29 patients (15.7%) details of how their disease progressed were not available. Among the patients declared cured, 26% had sequels. Conclusion: Leprosy control activities must be strengthened in order to maintain the achievements in this non-endemic district.

Determinants of contraceptive use in Abidjan (Côte d'Ivoire).

In Côte d'Ivoire, contraceptive prevalence is low (21%). The search for determinants of contraceptive use could make it possible to redirect existing strategies. The objective is to identify the determinants of the use of contraception among women in Abidjan. A cross-sectional survey was conducted from May to June 2018 in the Dallas neighborhood of Adjamé municipal (Abidjan). Women of reproductive age (15 to 49 years old) were selected there. Sociodemographic, gyneco-obstetrical characteristics, educational level, attitudes and practices of women on contraception were collected. Univariate and multivariate analyzes were performed. A total of 301 women aged 29.34±8.98 years were selected. The proportion of women using modern contraception was 27.24%. In univariate analysis, the factors associated with use were: level of education (p=0.005), unwanted pregnancies (p=0.017), abortions (p<0.001), consultation of the gynecologist (p=0.003) or a family planning service (p=0.001). Hearing about contraception (p=0.043), knowing (p<0.001) and talking about it with their partner (p=0.027) was significantly associated with its use. In the multivariate analyses, the women who consulted a gynecologist and those who knew the contraceptive methods used them respectively 2 times more (OR= 2.16 [1.14-4.15], p=0.019) and 22 times more (OR= 22.38 [8.42-78.56], p<0.001). Women with primary school education used them significantly less (OR= 0.15 [0.05-0.41], p<0.001). Awareness, the gynecologist's consultation, and the level of education were the main determinants of contraceptive use. Also, it is necessary to adapt awareness messages to the characteristics of women.

Prevalence and Risks Factors of Prehypertension in Africa: A Systematic Review.

Background: Hypertension is one of the major factors for high mortality of adults in Africa. However, complications occur at lower values than those previously classified as hypertension. Thus, prehypertension is considered as a new category of hypertension and a major risk factor for developing clinical hypertension relative to those with normotension, it has been linked with increased future risk of hypertension as well as cardiovascular diseases. Objectives: The objective of this review was to determine prevalence of prehypertension and describe the associated factors of prehypertension in Africa during the past 10 years. Methods: We did a systematic review using the databases PubMed/Medline, and search engine google scholar. We selected sources of publications and conducted an analysis of articles. Keywords in English were: prehypertension, high normal blood pressure, high blood pressure, elevated blood pressure, Africa. Keywords in french were: préhypertension artérielle, préhypertension, pression artérielle normale haute, pression artérielle normale, Afrique. Mesh terms were: Prehypertension, Africa. Results: Twenty-seven articles were selected. Prevalence of prehypertension ranged from 2.5% to 34% in children and adolescents. In adults, prevalence varied from 32.9% to 56.8%. Several factors were associated with prehypertension in Africa. These factors included: age; sex; lifestyle such as smoking, alcohol consumption, low physical activity, overweight and obesity. There were also cardiometabolic factors and few others factors which were associated with prehypertension. Conclusion: This review allowed us to observe that the prevalence of prehypertension was variable according to age of the population and prehypertension is associated with several factors.

Determinants of contraceptive use in Abidjan (Côte d'Ivoire)

In Côte d'Ivoire, contraceptive prevalence is low (21%). The search for determinants of contraceptive use could make it possible to redirect existing strategies. The objective is to identify the determinants of the use of contraception among women in Abidjan. A cross-sectional survey was conducted from May to June 2018 in the Dallas neighborhood of Adjamé municipal (Abidjan). Women of reproductive age (15 to 49 years old) were selected there. Sociodemographic, gyneco-obstetrical characteristics, educational level, attitudes and practices of women on contraception were collected. Univariate and multivariate analyzes were performed. A total of 301 women aged 29.34±8.98 years were selected. The proportion of women using modern contraception was 27.24%. In univariate analysis, the factors associated with use were: level of education (p=0.005), unwanted pregnancies (p=0.017), abortions (p<0.001), consultation of the gynecologist (p=0.003) or a family planning service (p=0.001). Hearing about contraception (p=0.043), knowing (p<0.001) and talking about it with their partner (p=0.027) was significantly associated with its use. In the multivariate analyses, the women who consulted a gynecologist and those who knew the contraceptive methods used them respectively 2 times more (OR= 2.16 [1.14-4.15], p=0.019) and 22 times more (OR= 22.38 [8.42-78.56], p<0.001). Women with primary school education used them significantly less (OR=0.15 [0.05-0.41], p<0.001). Awareness, the gynecologist's consultation, and the level of education were the main determinants of contraceptive use. Also, it is necessary to adapt awareness messages to the characteristics of women.

Feasibility of the eight or more contacts of the WHO new antenatal care model in Cote d'Ivoire: an antenatal care providers' perspective.

This paper examines the feasibility of the eight or more ANC contacts in Cote d'Ivoire through a qualitative study among twenty antenatal care providers through individual interviews. The eight or more ANC contacts were found useful as they will allow a better follow up of the pregnancy. Main barriers were: the lack of training on the 2016 WHO ANC model, the late initiation of ANC and the fear of increased workload. Drivers identified were: availability of supplies, adoption and dissemination of the new guidelines, assignment of antenatal care providers in underserved area, digitization of the mother and child health handbook, pregnant women and community engagement, intensification of communication for behavior change and a good relationship provider-pregnant woman-community. To ensure appropriate design and effective delivery of the eight or more ANC contacts, attention should be paid to barriers and facilitators identified.

Obstacles socioculturels liés à l'utilisation de la contraception moderne en Côte d'Ivoire.

INTRODUCTION: In Côte d’Ivoire, national modern contraceptive prevalence remains low, at 21% in 2017.Purpose of research: The objective of this study was to identify socio-cultural obstacles related to the use of modern contraception among women of reproductive age. METHODS: We conducted a descriptive and qualitative study in Dallas, in the Adjamé commune, located in the center of Abidjan. The survey took place from 9th June to 7th July 2018. In addition, we conducted four focus groups with men over 20 years old, women of reproductive age between 15 and 49 years old, and two religious leaders recruited according to a reasoned sampling. Group discussion guides and individual interview guides were used as data collection tools. Moreover, we analyzed data after recording and transcribing, following a thematic content analysis. RESULTS: We interviewed thirty participants including 14 men, 14 women, and two religious leaders. The main obstacles described were the lack of reliable and adequate information, misconceptions about contraception, fear of side effects, illiteracy, male decision-making power, religious prohibitions, and the socio-cultural contradictions. To circumvent these obstacles, women secretly used contraceptives, thereby exposing themselves to social risks. CONCLUSION: Our study highlighted the persistence of socio-cultural practices. For that reason, taking into account people’s perceptions is necessary to improve the use of modern contraception at the community level.

Prevalence of abdominal obesity and its correlates among adults in a peri-urban population of West Africa.

INTRODUCTION: Prevalence of abdominal obesity dramatically increases both in developed countries and in developing countries. In several regions in Africa, obesity (especially abdominal) is seen as a sign of affluence, dignity and respect. The objective of this study was to determine prevalence of abdominal obesity and seek some factors associated in a peri-urban population of West Africa. METHODS: During April-May 2014, a cross-sectional study was conducted in Anonkoi 3, a neighborhood of Abidjan (Ivory Coast). Adults of 18 years old and over, not bedridden were included. Sampling was done in two stages. First, we selected the households. Then in each household we randomly chose one adult. Abdominal obesity was measured using a measuring tape and defined by waist circumference ratio (TT) to hip circumference (TH) greater or equal to 0.80 in women and greater or equal to 0.95 in men. Data from sociodemographic, corpulence, socioeconomic level, food habit, level of physical activity and blood pressure were analyzed. Univariate analysis using the Pearson KHI-square test at a significance level of 0.05 and a logistic regression was performed. RESULTS: We visited 486 households in which 486 people aged 36.1 ± 12.83 years agreed to participate in the study. Prevalence of abdominal obesity was 50.8%. Those aged 30-45 years, women, couples, those with a primary level of education, the poor, people with high blood pressure, subjects less active and obese (general obesity) had more abdominal obesity. After logistic regression, individuals aged 30-45 years (adjusted OR = 2.35; p = 0.004) and 45 years and older (adjusted OR = 3.18; p = 0.001); females (adjusted OR = 49.05; p = 0.000); hypertension (adjusted OR = 2.26; p = 0.014) and obesity (OR = 2.94; p = 0.009). CONCLUSION: This work allowed us to estimate a relatively high prevalence of abdominal obesity in a peri-urban African population.

[A description of the yaws infection and prevention conditions in the health district of Adzopé]. / Description de la situation du plan dans ie district sanitaire d'Adzopé : cas des localités d'Asseudji.

This article reports on a cross-sectional study which aims to describe the situation of yaws in the boroughs of Asseudji located in the health district of Adzopé. The study's population group consisted of 206 household heads, and 2182 subjects who were tested and examined for yaws. The primary sources of pollution levels for a household were domestic animal waste (100%) and garbage stored in close proximity to the household's dwelling (49%). Signs of over-crowding were found in 43.7% of households. The sore "mother yaw" is the most common manifestation of yaws (81.5%). However, the majority of household heads were ignorant of the supporting causes and risk factors (64.1%) and the contagious natures of the infection (52.9%). Among the 2182 subjects examined, 11 (5%) had contracted yaws. The proportion of households with at least one case of yaws was 3.4%. The results of this census demonstrate that swift and strong action should be taken in these towns to prevent the outbreak of an epidemic.