Adverse Childhood Experiences and Associations with Mental Health, Substance Use, and Violence Perpetration among Young Adults in sub-Saharan Africa.

Background: Adverse childhood experiences (ACEs) can have debilitating effects on child well-being, with consequences persisting into adulthood. Most ACE studies have been conducted in high-income countries and show a graded relationship between multiple ACE exposures and adverse health outcomes. Less is known about the types and burden of ACEs in sub-Saharan Africa (SSA). Objective: To estimate the pooled prevalence of six individual and cumulative ACE exposures (physical, sexual, and emotional violence; orphanhood; witnessing interparental and community violence) and assess their association with mental health outcomes, substance use, and violence perpetration among young adults in SSA. Participants and setting: Aggregate data from the Violence Against Children and Youth Survey (VACS) in Cote d'Ivoire 2018, Kenya 2019, Lesotho 2018, Mozambique 2019, and Namibia 2019 included a sample of 11,498 young adults aged 18-24 years. Methods: Cumulative ACEs were defined by an integer count of the total number of individual ACEs (0 to 6). Weighted prevalence and adjusted odds ratios were estimated. Result: ACEs prevalence ranged from 7.8% (emotional violence) to 55.0% (witnessing community violence). Strong graded relationships between cumulative ACE exposure and all study outcomes for both males and females were observed. Among females, witnessing interparental violence was the only individual ACE risk factor significantly associated with increased odds of substance use; among males, emotional violence was significantly associated with all outcomes. Conclusion: ACEs are associated with adverse mental health, substance use, and violence perpetration in SSA. Gender-specific and culturally sensitive intervention strategies are needed to effectively mitigate ACEs in this population.

Etude du paiement électronique des agents de santé: cas de la campagne de vaccination contre la rougeole et la rubéole en Côte d'Ivoire / NA

La motivation des agents de santé à travers le paiement à temps et complet constitue l'un des éléments clés pour atteindre de bonne couverture vaccinale. Notre objectif était de décrire le paiement électronique utilisé lors de la campagne rubéole-rougeole et d'apprécier la satisfaction du personnel de santé. Nous avons réalisé une étude transversale à visée analytique qui s'est déroulée en Côte d'Ivoire du 15 janvier au 18 février 2019. La population d'étude était constituée des acteurs impliqués à la fois dans la campagne de vaccination contre la rougeole- rubéole en 2018 et dans le paiement électronique. Une recherche documentaire et des entretiens structurés ont permis le recueil des données. Les données ont été analysées à partir du logiciel R studio© version 2021. Le système assurant le paiement électronique se composait des autorités sanitaires, d'un opérateur privé de téléphonie mobile, d'un partenaire technique et financier et des agents de santé bénéficiaires. Un système de critères d'identification, des listes de validation et de vérification à plusieurs niveaux de la pyramide sanitaire a été mis en place. Un peu moins de trois quarts des acteurs du niveau primaire ont été satisfaits par ce mode de paiement. Le paiement électronique constitue un procédé pour améliorer le paiement des agents de santé durant les campagnes de vaccination. Des leçons d'un tel système de paiement devraient être tirées pour un déploiement à grande échelle.

Motivating healthcare workers through timely and complete payment is one of the key elements to achieve high vaccination coverage. Our objective was to describe the use of electronic payment during the measles-rubella campaign and assess the satisfaction of healthcare personnel. We conducted a cross-sectional analytical study in Côte d'Ivoire from January 15 to February 18, 2019. The study population consisted of individuals involved in both the measles-rubella vaccination campaign in 2018 and electronic payment. Data collection was done through documentary research and structured interviews. The data were analyzed using R Studio© software version 2021. The electronic payment system involved health authorities, a private mobile network operator, a technical and financial partner, and the beneficiary healthcare workers. A system of criteria for identifying lists, validation, and multilevel verification within the healthcare pyramid was established. Just under three-quarters of primarylevel actors were satisfied with this payment method. Electronic payment presents an opportunity to improve healthcare worker payment during vaccination campaigns. Lessons from such a payment system should be drawn for large-scale deployment.

Analyse du coût économique direct du cancer du sein en Côte d'ivoire en 2022 / NA

La prise en charge du cancer du sein constitue un fardeau économique important dans les pays àressources limitées. L'objectif était d'estimer les coûts médicaux directs des patientes suivies pour un cancer du sein en côte d'ivoire Une étude transversale a été conçue et réalisée dans les principales structures sanitaires de référence en gynécologie-obstétrique et en oncologie en Côte d'Ivoire. L'étude incluait les patientes avec un cancer du sein confirmé par l'histologie. Les données ont été recueillies à partir des dossiers médicaux et des entretiens avec les patientes. Au total, 102 patientes à différents stades de la maladie ont été incluses dans l'étude. Les coûts augmentent aux stades avancés. La chimiothérapie était le principal facteur de coût (3 121 $ par patiente) avant la radiothérapie (1 714 $). Les femmes atteintes d'un cancer du sein ont dû faire face à un coût moyen estimé à 442 $ (allant de 322 $ à 933 $). Le coût de la radiothérapie était également exorbitant (1 714 $ par patient). La chirurgie était le traitement le moins onéreux (1 416 dollars). Le coût total moyen des examens radiologiques et des tests de laboratoire s'élevait respectivement à 304 et 247 dollars. Les soins de suivi ont été estimés à 631 dollars. Cette étude fournit une analyse perspicace qui servira de base à une évaluation économique plus poussée et pourrait également être utile aux décideurs en matière de santé pour l'inclure dans le plan national de couverture de la santé.

The management of breast cancer is a major economic burden in countries with limited resources. The aim was to estimate the direct medical costs of patients treated for breast cancer in the Ivory Coast. A cross-sectional study was designed and carried out in the main referral health facilities for gynaecology-obstetrics and oncology in the Ivory Coast. The study included patients with histologically confirmed breast cancer. Data were collected from medical records and patient interviews. A total of 102 patients at different stages of the disease were included in the study. Costs increase in advanced stages. Chemotherapy was the main cost factor ($3,121 per patient), followed by radiotherapy ($1,714). Women with breast cancer faced an estimated average cost of $442 (ranging from $322 to $933). The cost of radiotherapy was also exorbitant ($1,714 per patient). Surgery was the least expensive treatment ($1,416). The average total cost of radiological examinations and laboratory tests was $304 and $247 respectively. Follow-up care was estimated at $631. This study provides an insightful analysis that will serve as a basis for further economic evaluation and could also be useful to healthcare decision-makers for inclusion in the national health coverage plan.

Facteurs de demande de services de santé préventifs en contexte épidémique (Dengue et COVID 19), Côte d'Ivoire, 2020 / NA

Introduction : L'une des missions de l'Institut National d'Hygiène est de prévenir et contrôler les maladies transmissibles et autres urgences de santé publique à travers ses services compétents. En situation de crises sanitaires comme une épidémie, les besoins augmentent et alors les bénéficiaires sont exemptés de paiement pour toute intervention préventive de masse. Le paiement rentre en vigueur lorsque la demande est exprimée dans une perspective individuelle. L'objectif de l'étude était d'analyser les facteurs de la demande des prestations du service de lutte anti-vectorielle (LAV) en période épidémique de Dengue et de COVID-19. Méthodes : Une étude transversale a été réalisée de janvier 2018 à décembre 2020 dans une antenne communale, celle d'Abobo. La collecte des données a été effectuée à travers une revue documentaire et l'administration d'un questionnaire auprès du gestionnaire et des techniciens du centre. L'analyse des données a été réalisée avec le tableur Excel. Résultats : La recette cumulée du service LAV pour ces trois dernières années s'élèvait à 57 708 100 F CFA (≈ 88 103 €) avec une accentuation de l'ordre de 65,6% en 2020, année de pandémie à Covid-19. Les ménages ont été pour les trois années, les principaux demandeurs du service LAV. Leurs recettes cumulées s'élevaient à 22 663 120 FCFA (≈ 34 600 €). Les facteurs de la demande pour le service LAV étaient le lieu de résidence, le niveau d'instruction, le niveau de revenu et la source d'information. Conclusion: La pandémie à COVID 19 a favorisé une augmentation plus importante des recettes. Les gestionnaires du centre devront ajuster les objectifs de recettes en tenant compte des facteurs de la demande en service de soins préventifs.

Introduction: The National Institute of Hygiene's mission is to prevent communicable diseases andother public health emergencies. During health crises, beneficiaries are exempt from payment. The study's objective was to analyze the factors that influence the demand for vector control services during Dengue and COVID-19 epidemics. Methods: This was a cross-sectional study from January 2018 to december 2020 at the Abobo public health unit. Data collection was done through a literature review and the administration of a questionnaire. Data analysis was performed using Excel software. Results: The cumulative revenue of the LAV service for the last three years amounted to 57,708,100 F CFA (≈ 88,103 €). Households were the principal applicants for the LAV service for the three years. Their cumulative revenue amounted to 22,663,120 FCFA (≈ 34 600 €). Factors influencing demand for the LAV service were residence, level of education, income level, and source of information. Conclusion: Center managers will need to adjust revenue targets by considering demand factors for preventive care services.

"You have to vape to make it through": E-cigarette Outcome Expectancies among Youth and Parents.

Objectives: Outcome expectancies are central to explaining health behavior and have been shown to predict tobacco use. Research on outcome expectancies for e-cigarette use among youth is scarce but increasingly important given the growing rates of use, particularly of high-nicotine pod devices and the recent outbreak of e-cigarette related lung disease. Methods: In 2019, we conducted 3 focus groups with middle school youth (N=25), 5 with high school youth (N=38), and 4 with parents (N=27). Youth and parents were not related and groups included both users and non-users. Participants discussed reasons for e-cigarette use and bad and good things that might happen to a person who vapes. Results: Participants described positive and negative psychoactive/sensory, social, and health-related outcome expectancies. Both youth and parents mentioned stress relief and appearing older as positive outcome expectancies, and e-cigarette flavors, acting rebellious, and structural opportunities as other reasons for initiating e-cigarette use. Social consequences and health outcomes were negative outcome expectancies deterring use. Conclusions: Regulations and public communication campaigns can counteract the positive outcome expectancies (flavor regulation, providing stress reduction tips) and capitalize on negative ones (communicating negative health outcomes) to decrease youth e-cigarette use.

"Don't do vape, bro!" A qualitative study of youth's and parents' reactions to e-cigarette prevention advertisements.

INTRODUCTION: Growing rates of e-cigarette use among youth have reached epidemic proportions. Media messages have been deployed to counteract this trend, but their evaluations are lacking. We assessed youth's and parents' reactions to various existing e-cigarette prevention messages. METHODS: In 2019, 12 focus groups were conducted with youth (n = 63) and parents (n = 27). Participants discussed their reactions to 9 existing messages with various topics. RESULTS: Information on chemicals in e-cigarettes was seen as new and scary, but unknown chemical names created confusion. Youth appreciated novel ways to visualize health effects of e-cigarettes (parasites in the body) and nicotine's effect on behavior (mood swings), but they cautioned that some of these effects (irritability) are not always caused by nicotine. Some participants did not know if e-cigarette companies were "Big Tobacco." Some found it hard to argue with the financial costs of vaping, but others did not think they were too great. Participants recommended messages featuring testimonials from diverse adolescents and messages aimed at youth who are struggling with addiction to e-cigarettes. CONCLUSION: Messages would be particularly effective if they featured real youth and did not look like adults created them for youth. Another area that is currently not covered in media messages is talking to youth who are using e-cigarettes and might be already addicted but do not know where to turn for help. These adolescents need to be referred to resources for cessation.

Surveillance des paralysies flasques aiguës en Côte d'Ivoire de 2007 à 2016 : importance et profil épidémiologique des entérovirus non poliovirus.

INTRODUCTION: Côte d'Ivoire's status as a polio-free country requires high quality surveillance of acute flaccid paralysis. Our study aims to determine the prevalence of non-poliovirus enteroviruses found in the surveillance of Acute Flaccid Paralysis (AFP) in Côte d'Ivoire and to study their distribution according to individual characteristics and associated factors. METHOD: We conducted an exhaustive descriptive and analytical cross-sectional retrospective study on 3597 cases of acute flaccid paralysis notified in the context of surveillance of AFP from 2007 to 2016 in Côte d'Ivoire. RESULTS: The mean annual rate of non-poliovirus enterovirus over the period was 11.3% over the study period with extremes of 9.2% and 15.9%. The absence of fever at the onset of illness and early age were factors associated with the occurrence of acute flaccid paralysis due to non-poliovirus enterovirus. CONCLUSION: Our study found a downward trend in non-poliovirus enteroviruses detected in AFP surveillance in Côte d'Ivoire, and identified the absence of fever and the age of the subject as being the factors associated with their occurrence. It is therefore necessary to type all cases of non-poliovirus enteroviruses detected in AFP surveillance to assess the risks of vaccine-derived polioviruses.

[Surveillance of acute flaccid paralysis in Ivory Coast between 2007 and 2016: Significance and epidemiological profile of non-poliovirus enteroviruses]. / Surveillance des paralysies flasques aiguës en Côte d'Ivoire de 2007 à 2016 : importance et profil épidémiologique des entérovirus non poliovirus.

INTRODUCTION: Côte d'Ivoire's status as a polio-free country requires high quality surveillance of acute flaccid paralysis. Our study aims to determine the prevalence of non-poliovirus enteroviruses found in the surveillance of Acute Flaccid Paralysis (AFP) in Côte d'Ivoire and to study their distribution according to individual characteristics and associated factors. METHOD: We conducted an exhaustive descriptive and analytical cross-sectional retrospective study on 3597 cases of acute flaccid paralysis notified in the context of surveillance of AFP from 2007 to 2016 in Côte d'Ivoire. RESULTS: The mean annual rate of non-poliovirus enterovirus over the period was 11.3% over the study period with extremes of 9.2% and 15.9%. The absence of fever at the onset of illness and early age were factors associated with the occurrence of acute flaccid paralysis due to non-poliovirus enterovirus. CONCLUSION: Our study found a downward trend in non-poliovirus enteroviruses detected in AFP surveillance in Côte d'Ivoire, and identified the absence of fever and the age of the subject as being the factors associated with their occurrence. It is therefore necessary to type all cases of non-poliovirus enteroviruses detected in AFP surveillance to assess the risks of vaccine-derived polioviruses.

[Sociodemographic factors associated with incomplete immunization of children aged 12 to 59 months in six West African countries]. / Facteurs sociodémographiques associés à la vaccination incomplète des enfants de 12 à 59 mois dans six pays d’Afrique de l’ouest.

Every year, thousands of children worldwide remain unimmunized or partially immunized, especially in developing countries. It therefore appears important to examine soda-demographic factors associated with incomplete immunization of children in West Africa. The present cross-sectional study examined factors associated with incomplete immunization of children aged 12 to 59 months in Cote d'lvoire, Ghana, Burkina Faso, Mali, Guinea, and Liberia, based on Demographic and Health Surveys data. The findings of the study showed that birth at home, absence of access of mothers to media, no religion, poverty, and illiteracy were associated with incomplete immunization of children. Health officials should take these immunization status predictors into account when making policies and immunization strategies in countries included in this study in order to achieve immunization coverage targets.

[Sociodemographic factors associated with incomplete immunization or children aged 12 to 59 months in six West African countries]. / Facteurs sociodémographiques associés à la vaccination incomplète des enfants de 12 à 59 mois dans six pays d’Afrique de l’ouest.

INTRODUCTION: Every year, thousands of children in the world remain unimmunized or partially immunized, especially in developing countries. It therefore appears important to examine sociodemographic factors associated with incomplete immunization of children in West Africa. METHODS: This cross-sectional study examined factors associated with incomplete immunization of children aged 12 to 59 months in Côte d'Ivoire, Ghana, Burkina Faso, Mali, Guinea, and Liberia based on Demographic and Health Survey data. RESULTS: The findings of the study showed that birth at home, mothers with no access to media, no religion, poverty, and illiteracy were associated with incomplete immunization of children. DISCUSSION: Health officials should take these immunization status predictors into account when developing policies and immunization strategies in countries included in this study in order to achieve immunization coverage targets.