Nutritional status and associated factors among the elderly in Guinea: a first national cross-sectional study.

Aging of the Guinean population is a public health concern for the coming years, and the nutritional status of older people is virtually unknown. We also know that this population is growing and that undernutrition and obesity can affect the health of older adults. This study aimed to assess the nutritional status of older people in the general population of Guinea and its associated factors. A representative cross-sectional survey was conducted using sociodemographic, clinical, and anthropometric data (weight and height). Oral status was assessed by using the University of Nebraska Oral Status Scale. Visual acuity was assessed using the Monoyer scale. The standardized prevalence ratio (SPR) of the nutritional status was calculated for each region. The sample included 1698 subjects with a mean BMI of 22.6 ± 4.3 kg/m2. A total of 50.3% had impaired oral status and 20.3% had moderately to severely impaired visual acuity. The prevalence of undernutrition was 14.4% and of obesity 5.7%. Differences in the prevalence of nutritional status were found between regions, with an SPR > 1 for undernutrition in the Labé region (SPR 1.9, 95% CI = 1.5-2.5) and for obesity in the Conakry and Kindia regions (SPR of 2.90, 95% CI = 2.0-4.05 and 2.32, 95% CI = 1.5-3.3, respectively). In Guinea, The prevalence of nutritional disorders was approximately 20%. Screening and management of the health and nutritional status of older adults should be a national priority, and management should be adapted to each region of the country.

Integrating nutrition assessments and seasonal malaria chemoprevention: Results from a mixed-methods feasibility study in Guinea.

BACKGROUND: Seasonal malaria chemoprevention (SMC) has become a critical intervention for malaria prevention and control. There is a growing interest to generate evidence that health campaigns such as SMC can be leveraged for integration or co-administration of other health efforts such as nutritional supplements, immunizations, or vitamin A. OBJECTIVE: We conducted a pilot study to assess whether nutrition assessments could be integrated into existing SMC programming in two districts in Guinea. METHODS: Of 106,480 children under 5 years of age (CU5) who received sulfadoxine-pyrimethamine plus amodiaquine as part of SMC by community drug distributors (CDDs), 2210 had their mid-upper arm circumference (MUAC) assessed by CDD supervisors. RESULTS: Of these, 177 (8.0%) had a MUAC < 125 mm and were therefore classified as acutely malnourished; 161 CU5 were referred to health facilities for follow-up. Importantly, no drop in SMC programmatic coverage was observed in districts conducting MUAC on top of SMC. Key informant interviews with district officials and focus group discussions with CDD supervisors showed a generally positive effect of integrating MUAC into SMC, although CDD supervisors had concerns about workload with added responsibilities of MUAC assessments. CONCLUSION: Integrating other health interventions with SMC is accepted-and indeed welcomed-by the population and health workers, and does not result in a drop in SMC programmatic coverage.

A theory-based behavioural change communication intervention to decrease the provision of water to infants under 6 months of age in the Republic of Guinea.

OBJECTIVE: In many countries, the provision of water in the early months of a baby's life jeopardises exclusive breast-feeding (EBF). Using a behavioural theory, this study assessed the impact of a behaviour change intervention on mothers' intention to act and, in turn, on the water provision in addition to breast milk to their infants under 6 months of age (IU6M) in two regions of Guinea. DESIGN: A quasi-experimental design. Data on individual and environmental factors of the theoretical framework, sociodemographic and outcomes were collected using validated questionnaires before and after the intervention. The outcomes examined were the intention to provide water to IU6M, the provision of water and EBF. Path analyses were performed to investigate pathways by which psychosocial and environmental factors influenced the water provision in addition to breast milk. SETTING: Four health centres were assigned randomly to each study's arm (one control/CG and one intervention group/IG per region). PARTICIPANTS: The sample included 300 mothers of IU6M: 150 per group. RESULTS: In IG, the proportion of mothers providing water decreased from 61 % to 29 % before and after the intervention (P < 0·001), while no difference was observed in CG (P = 0·097). The EBF rate increased in IG (from 24·0 % to 53·8 %, P < 0·001) as opposed to CG (36·7 % to 45·9 %, P = 0·107). An association (P < 0·001) between the intention and the behaviour was observed in both groups. CONCLUSIONS: An intervention developed using a sound framework reduces the provision of water among IU6M and improves EBF.

A tool to assess underlying factors to water provision among Guinean children.

In many countries, water is provided to children under 6 months of age (CU6M) in addition to breast milk (BM), hence increasing the risk of child mortality and morbidity. Factors related to this practice have not been thoroughly investigated either a tool to assess them. Based on the extended theory of planned behaviour (eTPB), we aim to develop and validate a questionnaire to assess psychosocial and environmental factors that may contribute/limit the water provision in addition to BM by mothers of CU6M in the Republic of Guinea. A three-step process was used. Ten focus group discussions (FGDs) were held to identify salient beliefs related to each of the four constructs of the eTPB. Data from FGDs were used to develop a questionnaire composed of 88 items administered to 428 mothers. Exploratory factor analyses were conducted to identify latent factors for each construct. A shorter version of the questionnaire was administered to another sample of 300 mothers. Confirmatory factor analyses (CFAs) were performed. Hancock and Mueller's H reliability indices were computed on final models to assess the tool's validity and reliability. The final questionnaire included 57 items. For all four final models, most criteria for fit indices of CFA were generally met. Reliability coefficients were all equal to or above 0.90 for each construct. This research offers a tool that could be used to investigate determinants of water provision besides BM among mothers of CU6M. Further validation in other contexts is warranted.

Violences conjugales à l'unité de médecine légale de l'hôpital national de Donka (Guinée)

Contexte et objectif. La violence faite aux femmes est aussi importante dans la sphère domestique qu'en dehors. Des femmes subissent, très souvent, des violences physiques et ou sexuelles par leur partenaire intime. L'objectif de cette étude était de déterminer la fréquence des violences conjugales, leurs caractéristiques épidémiologiques et médico-légales tant chez les victimes que chez les agresseurs. Méthodes. Il s'agissait d'une étude rétrospective de type descriptif qui s'est déroulée du 1er janvier 2016 au 31 /12/2017. L'étude avait porté sur 194 dossiers médicaux de femmes et hommes victimes de violences conjugales munies de réquisitions en provenance du parquet ou des services de police judiciaire de la ville de Conakry. Les données ont été recueillies à partir des dossiers médico-légaux. Les données sociodémographiques (âge, sexe, profession, état matrimonial) avaient été recueillies. Les éléments de l'interrogatoire tels que la date de consultation, le lien de connaissance avec l'agresseur ont été pris en compte, ceux de l'examen physique (types de lésion, siège des lésions) avaient été également recueillies Résultats. Nous avons recensé 13,52% cas de violence conjugale. Parmi eux, 31,44 % étaient victimes de violences sexuelles contre 68,56 % de victimes de violences physiques. Les victimes ont souffert de plusieurs problèmes de santé notamment les lésions corporelles (plaie, hématome, excoriation, ecchymose) et algies corporelles, le tout justifi ant dans la plupart de cas une période d'ITT ≥ 21jours. Conclusion. Ces différents résultats montrent une fois encore que la violence vécue dans le milieu familial ne soit pas sans conséquence

Correction: Implications of the Ebola virus disease outbreak in Guinea: Qualitative findings to inform future health and nutrition-related responses.

[This corrects the article DOI: 10.1371/journal.pone.0202468.].

Implications of the Ebola virus disease outbreak in Guinea: Qualitative findings to inform future health and nutrition-related responses.

INTRODUCTION: Due to the close relationship between EVD and nutrition, the humanitarian community implemented various nutrition-specific and -sensitive interventions to stem the Ebola Virus Disease (EVD) outbreak in West Africa. Little, however, is known about stakeholder and community members' perspectives toward this response in Guinea. Therefore, we aimed to firstly understand how EVD may have influenced the nutrition situation; and secondly to assess the perceived acceptability and effectiveness of the nutrition response. MATERIALS AND METHODS: Using 27 in-depth interviews conducted in April-May 2016, this descriptive, qualitative study had three iterative phases in an emergent design. Phase 1 explored the perceptions of 11 high-level policy and management staff. Phase 2 assessed the views of 16 community members, survivors, and front-line workers. Phase 3 compared the qualitative findings to relevant nutrition indicators from secondary data for final interpretations. A systematic, team-based coding approach using Dedoose software identified key themes during textual analysis. RESULTS: Overall, several plausible pathways through an interrelated network of bio-social factors help describe EVD impacts on the nutrition situation of Guinea. At a basic level, complex social dimensions of health, response unpreparedness, and market disruptions were perceived to be major determinants affecting the nutrition situation, especially among IYC. At an underlying level, household food security was negatively impacted, along with weakened care-seeking practices, IYC feeding practices, and coping strategies. Consequently, treatment coverage for childhood illnesses and IYC diets were negatively impacted during the outbreak. In hindsight, most participants had positive perceptions toward the overall EVD response, but described salient considerations for improving upon this nutrition response during future outbreaks. DISCUSSION: This study highlighted the complex web of inter-related factors through which EVD was perceived to impact the nutrition situation in Guinea. Considering the multi-level social and behavioral dimensions of health and nutrition is critical for effectively responding to infectious disease outbreaks.