[The use of ultrasound to reduce maternal and neonatal mortality in a primary care facility in Ivory Coast]. / Apport de I'échographie dans la surveillance de la grossesse dans un établissement sanitaire de premier contact à Yopougon en Côte d'lvoire.

INTRODUCTION: In pregnancy care, ultrasound is used to detect pregnancy-related complications. The purpose of this study was to assess the use of ultrasound in monitoring pregnant women in a primary care facility for the purposes of reducing maternal and neonatal mortality. PATIENTS AND METHOD: A cross-sectional descriptive study was conducted from February 16, 2009 to April 16, 2009. Interviews were conducted with pregnancy women who had an ultrasound was recommended by a health worker or requested by the women. A Comprehensive recruitment strategy was used. The variables studied were sociodemographic characteristics, the indications or reasons for the ultrasound scan, the results of the ultrasound examination, the final diagnosis and the recommended behaviors. RESULTS: A total of 353 pregnant women aged between 15 and 45 years underwent an ultrasound examination. Sixty-six percent (66.3%) of the prescribers were midwives. In terms of pregmancy related pathologies, the main reasons for the ultrasound were pelvic pains (5.4%0, bleeding in the first trimester (4%0, and dystocia (3.7%). The main results were dystocic presentations (4.2%0, pregnancy loss (4%), and causes of bleeding in the first trimester (2.5%). As a result of these findings, 9.3% of at-risk women were sent to a specialized hospital. CONCLUSION: Ultrasound contributes to reducing maternal and dneonatal mortallity in primary care facilities. The results suggest that the health authorities need to improve equipment in primary care facilities to include ultrasound as a diagnosis tool in order to reduce maternal and neonatal mortality.

[Seroprevalence of HIV infection in the context of a mobile counseling and voluntary testing strategy in rural areas of Côte d'Ivoire]. / Séroprévalence de l'infection à VIH en conseil et dépistage volontaire par stratégie mobile en Zone rurale en Côte d'Ivoire.

INTRODUCTION: In Côte d'Ivoire, HIV testing and counselling has been identified as a priority in the National 2006-2010 AIDS Strategic Plan, which is designed to evaluate the prevalence of HIV in rural areas measured by means of a mobile strategy. METHODS: We conducted a cross-sectional descriptive and analytical study from 1st April, 2007 to 31st March 2008 in six rural areas of Côte d'Ivoire: Dabou, San Pedro, Abengourou, Tanda, Daloa, and Soubré*. The study population consisted of subjects attending the mobile voluntary counselling and testing units. RESULTS: The mean prevalence of HIV infection in this study was 5.30%. The mean prevalence rate in men was 5.26%, with a peak of 7.55% in the 30-34 years age-group. The mean prevalence rate in women was 5.35%, with a peak of 6.59% in the same age-group. Type HIV-1 was predominant (84.2% of the total). The most affected area was Dabou, with a rate three times higher (15.83%) than the average rate observed during the study. More educated people (university level) presented 3.5-fold (for men) or 6-fold (for women) higher infection rates than illiterate people. Although 100% of people who tested positive received a medical or community referral according to their specific needs, only 62.1% were first-line referred for medical care. CONCLUSION: In the light of the results of this study, we believe that community mobilization must be redirected to the most severely affected populations to facilitate earlier diagnosis. Actions such as training and prevention based on communication to encourage changes of behaviour should therefore be priorities in the national counselling and testing programme.