[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.

[Beriberi, recurrent nutritional disease in a detention house in Côte-d'Ivoire]. / Le béribéri, maladie nutritionnelle récurrente en milieu carcéral en Côte-d'Ivoire.

As a re-emerging disease, beriberi caused by a lack of thiamine in food threatens more and more prisons in developing countries. Indeed in 2008, a beriberi epidemic occurred in a detention house of Côte-d'Ivoire called Maca. The goal of our retrospective investigation was to describe this epidemic in order to improve prisoners' health. The study related to 131 subjects, 64% of cases affected (N = 205). The total rate of beriberi attack was estimated at 38.6‰. The mean age was 33; all patients were male and they were detained in "Batiment C" (70.2%), synonymous with heavy punishment. They spent about 28.1 month in Maca. The clinical symptoms were neurological signs (swarming: 41%) and cardiovascular signs (dyspnoea: 42%, thoracic pain: 35%). Half of the patients (51%) presented oedemas of the lower limbs. The rate of healing was about 97% when patients followed treatment. Providing good nutrition to the prisoners and the distribution of vitamin complements will avoid other epidemics.

[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.

[Oral hygiene habits and the state of periodontal health among a population of 1228 students in Abidjan]. / Habitudes d'hygiène bucco-dentaire et état de santé parodontal: cas d'une population de 1228 élèves à Abidjan.

The purpose of our study was to determine the customs of oral hygiene and the health periodontal of a population of pupils in Abidjan. We led a transverse inquiry on a sample of 1228 pupils. Our results showed that the pupils had bad habits of bucco-dental hygiene which is translated by a bad periodontal health. More than 80% of them presents deposits of tartar and 9.6% of the population have periodontal pockets.

[Bacillary angiomatosis in an adult infected with HIV-1 at an early stage of immunodepression in Abidjan, Côte d'Ivoire]. / Angiomatose bacillaire chez un adulte infecté par le VIH-1 à un stade d'immunodépression peu avancé à Abidjan, Côte d'Ivoire.

Human immunodeficiency virus (HIV)-associated bacillary angiomatosis has rarely been described in Africa. We report here the first case in Côte d'Ivoire. Although in industrialised countries bacillary angiomatosis has been described in patients with low CD4 count, this episode occurred in the first year following HIV-seroconversion in an adult patient with more than 500 CD4 cells per cubic millimetre. Symptoms rapidly and totally disappeared under erythromycin treatment, although with a relapse two years after the end of the first episode. In Africa where people living with HIV often present chronic cutaneous lesions, bacillary angiomatosis may be under-diagnosed. Bacillary angiomatosis must be systematically considered in face of lesions similar to Kaposi's sarcoma. Improving knowledge on symptoms of bacillary angiomatosis in Africa should lead to better treatment and a better estimation of its true frequency which may be underestimated.