[Influence of the knowledge of patients consulting at the Treichville antirabies Center on adherence to post-exposure prophylaxis]. / Influence des connaissances des patients consultant au centre antirabique de Treichville, Côte d'Ivoire, sur l'observance de la prophylaxie post-exposition.

AIM: Human rabies is a major public health problem in many African countries, including Ivory Coast. The objective of this study was to evaluate the influence of human rabies knowledge on compliance with post-exposure prophylaxis. MATERIALS AND METHODS: We conducted a descriptive and analytical cross-sectional study from September 2014 to May 2015 at the Abidjan Rabid Center, Treichville. After having given their consent, were interviewed, patients who came for a first consultation and who gave a mobile phone number available for the appointment reminder after abandoning or not starting the post-exposure prophylaxis. Data were processed with Epi Info version 3.5.3. Pearson's chi-square test and Fisher's exact test were used for statistical analysis with a significance level of 5%. RESULTS: A total of 744 patients were interviewed. Men accounted for the majority (58.2%) of those surveyed, with a sex ratio (M/F) of 1.7. The average age of patients was 24.55 (±17.3) years. The analysis showed that 42.6% (317/744) of the interviewees had heard of human rabies. However, having heard of human rabies did not influence adherence to post-exposure prophylaxis (P>0.05). Nevertheless, the post-exposure prophylaxis regimen was completed more often by subjects who knew that agitation is a sign of rabies than those who did not (ORa=0.4343, 95%CI=[0.204-0.925]). Subjects knowledgeable about disease transmission (animal bites) were less likely to continue their post-exposure prophylaxis than those unaware of this relationship (ORa=8.544, 95%CI=[1.002-72.869]). CONCLUSION: The main factors identified in this study that influenced the observance of post-exposure prophylaxis were knowledge of the manifestation of human rabies (signs of agitation) and of the mode of transmission of this disease (animal bites). With a view for better prevention against human rabies, rural and urban populations should be informed, educated and sensitized about this 100% life-threatening but vaccination-preventable disease.

[Discontinuation of postexposure prophylaxis at the anti-rabies Center of Abidjan, Côte d'Ivoire]. / Abandons de prophylaxie post-exposition au Centre antirabique d'Abidjan, Côte d'Ivoire.

Despite the availability of effective anti-rabies vaccine, rabies keeps affecting people in developing countries such as Côte d'Ivoire. The low compliance with Post Exposure Prophylaxis (PEP) partially explains this situation. This study was aiming at studying the reasons to abandon PEP. This descriptive and cross-sectional study has taken place at the anti-rabies Center of Abidjan from October 1st to December 2009. Data were collected in two steps: we first interviewed all the patients at the anti-rabies center during their first consultation, and then phone interviews were conducted one month later, only with exposed patients who abandoned their PEP. These phone calls allowed us to complete the questionnaire (the status of the animal and PEP discontinuation). Patients' verbal informed consent was obtained prior to data collection. Besides, patients were explained the risks they were exposed to and were advised to complete immunization. The results obtained revealed that, out of 220 people included in the study, 116 (52.7%) abandoned the PEP. The compliance was lower with the protocol of five injections compared to that of four injections. More than half of the patients abandoned PEP after the first injection. In 32.8% of patients who abandoned PEP, the animal was dead, disappeared, was destroyed or there were no information about it one month after bite or scratch. Animal owners' refusal of taking in charge the victims (20%) and the lack of financial resources for purchasing the vaccine (13.6%) were the most frequent reasons to abandon PEP. To increase the protection of the human population against rabies and to increase the compliance with PEP protocols, the improvement of financial accessibility to the vaccine for population and the elaboration of compulsory regulations for animal owners to take in charge the PEP are necessary.

[Impact of armed conflict on the health care system of a sanitary district in Cote d'Ivoire]. / Impact du conflit armé sur le système de santé d'un district sanitaire en Côte d'Ivoire.

Since September 2002, Côte d'Ivoire has been in the throes of armed conflict that has split the country in two. In the government-controlled area, access to health care services has continued. In the area under the control of the "New Forces", access to health care services decreased dramatically due to departure of qualified health personnel and subsequent shutdown of sanitary facilities. The purpose of this transversal descriptive survey was to measure the impact of this crisis on the health care system in the Séguéla sanitary district that is located in the war zone. Findings showed that 60.7% of sanitary facilities are no longer operational, that 77.7% of qualified personnel have left their workstation, and that 46.2% of sanitary structures have been damaged. A few reference hospitals and sanitary facilitates have been able to remain open thanks to the support of the humanitarian organisations. As a result of declining access to health care services, a recrudescence of measles and IST has been observed and gastritis and traumatology have appeared among the top 10 causes of morbidity. Access to effective health care in the Séguéla sanitary district cannot be envisioned without the return of qualified health care personnel and the renovation of the sanitary facilities.

[Compliance with veterinary surveillance orders at the rabies control center in Abijan, Ivory Coast]. / Observance de la surveillance vétérinaire au centre antirabique d'Abidjan.

Rabies remains a major health public health problem in many developing countries. This is particularly the case in the Ivory Coast. Surveillance orders play an important role in patient management. The purpose of this transverse study conducted at Abidjan Rabies Control Center from July 1 to September 30, 2003 was to assess compliance with veterinary surveillance orders by owners of animals that have bitten or scratched persons. Persons reporting to the rabies control center after exposure to the risk of rabies infection and owners of the animals that had bitten, scratched, or licked these persons were included in this study. Most animals involved in these cases (94.8%) were dogs including 69.5% that had been vaccinated. Most persons (71.7 %) at risk reported within two days following exposure and 31.3% provided all three veterinary certificates. The mean time required to provide the first certificate was 4.2 days. The gender of the persona at risk and the vaccination status of the animal involved were correlated with compliance with veterinary surveillance orders. Four main difficulties were cited as hindrances for compliance with veterinary surveillance, i.e., cost (373%), distance (28.4%), time (9.9%), and veterinary clinic accessibility (2.5%). These findings indicate that stricter laws and a national prevention program are needed.

[Systematic serologic detection of treponema at the antivenereal centre of the National Institute of Public Health in Abidjan (Côte-d'Ivoire), from 1994 to 1999]. / Dépistage systématique sérologique des tréponé- matoses au dispensaire antivénérien (DAV) de l'Ins- titut national d'hygiène publique (INHP) d'Abidjan (Côte-d'Ivoire) de 1994 a 1999.

We conducted a medical records review on 11,662 patients consulting the antivenereal clinic of Treichville from 1994 to 1999. The main objective of the study was to analyse the data from systematic screening of syphilis in this specialized centre for sexual transmitted infection. The results of this study were: 162 (1.39%) patients had active syphilis; we noticed a decreasing incidence of syphilis during the last six years, 98.77% of the patients had symptoms of sexual transmitted diseases that did not directly evoke syphilis. In summary we can say that syphilis remains an important problem in the sexually transmitted infections consultation. The screening of syphilis must continue and needs to be extended to other services, because of the high frequency of asymptomatic forms and the existence of severe complications.

[Prevalence of HIV infection in patients of the anti-venereal center of the National Institute of Public Hygiene, Abidjan]. / Séroprévalence du VIH au dispensaire antivénérien de l'Institut national d'hygiène publique d'Abidjan.

This cross-sectional study includes all new patients consulting for the first time in the anti-venereal center of the National Institute of Public Health (NIPH) during the period of May to July 1997. Among them, 20.1% of the consulting patients and 31.3% of those suffering from STI were positive to HIV. The STI particularly those with ulceration are a risk factor in HIV transmission. This study points up the need of an adequate management of sexual transmitted diseases as a main strategy to struggle against HIV/AIDS infection.