SARS-CoV-2 Infection in Ivory Coast: A Serosurveillance Survey among Gold Mine Workers.

Of the 107 million COVID-19 cases worldwide, less than 2 million have been reported in African countries. The aim of this study was to evaluate the seroprevalence of SARS-CoV-2 infection in Ivory Coast mine workers. From July 15 to October 13, 2020, a voluntary serological test campaign was conducted in 3 sites: two gold mines, and the headquarters in Abidjan. Rapid tests to detect IgG and IgM on capillary blood were performed. To identify independent sociodemographic characteristics associated with a higher SARS-CoV-2 seroprevalence rate, a multivariate logistic regression analysis was performed. A total of 1,687 subjects were tested; 91% were male (n = 1,536), and the mean age was 37 years. The overall seroprevalence was 25.1% (n = 422), ranging between 13.6% (11.2-16.1%), 34.4% (31.1-37.7%), and 34.7% (26.2-43.2%) in mine A, in mine B, and in Abidjan, respectively. Among the 422 seropositive subjects, 74 reported mild symptoms in the three previous months and one was hospitalized for severe COVID-19 infection. SARS-CoV-2 seroprevalence is high in both gold miners and administrative staff working in Ivory Coast. The burden of infection in West Africa has probably been underestimated till now.

[Léon Lapeyssonnie On the trail to its end]. / Léon Lapeyssonnie Sur les chemins du bout de la piste.

He would have celebrated his 100th birthday in 2015, but finally, it doesn't matter, since by leaving his name to African meningitis belt, that isohyetal band in sub-Saharan Africa where epidemics of cerebrospinal meningitis are rife, Lapeyssonnie, the trailblazer at the end of his trail, has gone straight into the textbooks of tropical medicine. There was probably nothing he enjoyed more than wandering the lateritic paths and Sudano-Sahelian bush in that zone. His first job, in the Mossi country in Upper Volta that had not yet become Burkina Faso, was of course an initiation. At the age of 27, applying the Jamot doctrine and tracking the vectors of sleeping sickness down into the most remote villages, like his illustrious predecessor, the young physician who became a Physician-General never stopped defending these precepts of tropical public health and promoting the "eccentric battalions" (as the English physicians, Dr Waddy, described them) of bush doctors from the School of Pharo (Army Institute of Tropical Medicine in Marseille). Foreshadowing the French doctors and "without borders" movement, Lapeyssonnie was able to implement the results of research in vaccinology. Thus, in 1974, during a meningitis epidemic in Brazil, he convinced Charles Merieux to manufacture the lifesaving vaccine on a large scale. Merieux then mobilized all the resources of his company to produce and deliver millions of doses of the only vaccine then available. Ten million inhabitants of Sao Paulo were vaccinated in five days, 90 million Brazilians in 6 months. Another victory at the end of the trail. But Lapeyssonnie was more than a man dealing with great endemics, more than a researcher and a teacher. "Those who liked to be taught like to teach in their turn," he liked to repeat, talking about his time at Pharo. Writer and novelist, he could sometimes write poetry, recount the bygone époque when he went out hunting in the African bush and shared with nurses there unique moments of great humanity. It is probably because of this humanity that from his retirement in Brittany, in 2000, a year from the end of his trail, he could still inveigh in the Parisian newspaper, Le Monde, against the bureaucrats at the World Health Organization, who were asleep in the battle against sleeping sickness; his task then was to awaken consciences and Africa so that the populations at the end of the trail would not be forgotten.

[Inequalities in access to care in Africa]. / Inégalités d'accès aux soins en Afrique.

Social inequalities in health are increasingly in the news in Africa. While appeals, international declarations and new strategies for health in Africa have succeeded one another over the years, we must admit that the health inequalities are increasing. It is perhaps time to take health out of its compartment and understand that it is one of the components of overall development and that we cannot act effectively against these health inequalities unless we also act on the pressing need to see all States (in the North and South) finally meet their financial commitments, demand of African leaders that they provide good government and fight against corruption, the leaders of African good government and a fight against corruption, and finally ensure that the strategies proposed in Africa focus on the health priorities of each country. If we mention the Scandinavian example, we must admit that the Nordic countries have demonstrated their capacity to obtain excellent results in health, to narrow social inequalities, and provide public transparency and aid to development. They constitute today an excellent example for most Western countries and for African countries - and also for African and western civil societies, which can be inspired by the concrete measures of transparency and strong public activity, which promote improvement in the overall statistics of their societies, in particular, in health. Accordingly we propose a new approach that looks at health statistics in the light of inequalities (especially via the Gini coefficient) and public transparency (especially via the benchmarks of perceived corruption). A New Deal for health in Africa is needed, and all the organization involved should be asked to act together for a holistic public health vision that will benefit the populations of Africa. Health cannot be separated from a political, ethical and equitable vision of society.

[Role of traditional medicine in the health care system of the cities of sub-Saharan Africa: Libreville in Gabon]. / Place de la médecine traditionnelle dans le système de soins des villes d'Afrique subsaharienne : le cas de Libreville au Gabon.

Traditional medicine in Libreville is undergoing changes, despite the refusal of some actors in the modern health-care system to recognize it. It is gradually adopting the methods and techniques of modern medicine for patient management. It therefore occupies the same medical space as the modern care system, creating competition. Traditional medicine is positioning itself to deal with pathologies related to the body, thus competing with -- and annoying -- some of the actors of the modern system of care. At the same time, it lays claim to pathologies related to the spirit, thus distinguishing itself.

[Sensitisation about condom use in Gabon (1999): evaluation of the impact of a comic book]. / Sensibilisation sur le préservatif au Gabon (1999): évaluation de l'impact d'une bande dessinée.

The authors report the evaluation of the impact of a comic book about condom use distributed to Gabonese high school students in Libreville and Lambarene in 1999. This evaluation was conducted through a self-administered questionnaire completed by 954 students in 11 high schools immediately before distribution of a comic book about condoms and by 771 students 15-30 days afterwards. The anonymous questionnaire contained multiple-choice and open questions about knowledge, attitudes and practices. During the second survey (same schools and same classes), the questions tested knowledge about AIDS and about the stories in the book. The student populations who responded to the two questionnaires were homogeneous for sex, age, school class, and province of residence. Knowledge about the modes of HIV/AIDS contamination improved substantially between the two questionnaires, with knowledge about the mother-child transmission pathway increasing from 47% to 75% of responders. At the same time, and without any significant difference by sex, class or province, individual adhesion to the role of the condom as a means of prevention against AIDS progressed from 64% to 95%. The students questioned wanted AIDS prevention information to be better integrated into their curriculum and, in particular, they wanted educational activities in this area in their school, either by their teachers or in special information areas. Thus, the 48-page comic book by young Gabonese artists was perceived as a good method of condom education for the young (75%) and as an excellent method for inducing awareness about it among them (89%). The book's contents had been absorbed, and the students found that the stories and the message were well matched. Moreover, the extension of the readership beyond the initial distribution at the first evaluation (7.5 readers reported per copy) showed that the messages in the book spread well beyond the student group.