Organisation et le fonctionnement de la surveillance épidémiologique de la rougeole dans le district sanitaire de Yopougon-est, Côte d'Ivoire de janvier 2022 à juin 2022 / NA

La rougeole est une maladie infantile banale, peut être mortelles quand elle est sous-estimée. Nous avons initié cette étude dont l'objectif général est d'analyser le système de surveillance épidémiologique de la rougeole dans le district sanitaire de Yopougon-Est.MéthodesNous avons procédé à une évaluation normative de la surveillance épidémiologique de la rougeole réalisée en 6 (Six) mois dans ledit district sanitaire. Les critères de sélection nous ont permis de sélectionner 30 personnels de santé impliqués dans la surveillance de la rougeole. RésultatsLes médecins étaient les plus représentés (40%), suivi des infirmiers (33,3%). Les agents avaient plus de 3 ans de service (73,3%). Plus de la moitié des agents étaient formés (56%) la moyenne d'année de service était de 5,33 ans.Dans notre étude, 93,3 % des agents connaissaient la définition d'un cas de rougeole. Les seuils d'alerte et épidémique étaient connus par 56,6% des agents enquêtés. La disponibilité des registres de consultation, fiche de notification hebdomadaire de cas au niveau des structures de santé étaient de 86,7 %. Pour la transmission des données, 70% des enquêtés avaient déclarés que les rapports se transmettaient au district hebdomadairement.Les prélèvements de sang avaient été réalisés chez tous les cas suspects (100%). Les cas confirmés de rougeole représentaient 26,8 % des échantillons.ConclusionLa rougeole est une maladie de l'enfance qui est évitable par la vaccination. Cependant à défaut de vaccination, il est impérieux de mettre en place une organisation pour la détection des cas de rougeole afin d'éviter des épidémies

Reflecting on knowledge translation strategies from global health research projects in Tunisia and the Republic of Côte d'Ivoire.

OBJECTIVES: We describe the knowledge translation strategies in two projects and share lessons learned about knowledge sharing and uptake. METHODS: To generate findings for dissemination: (1) the Republic of Côte d'Ivoire (RCI) project relied on a multiple case study design to document barriers and facilitators to implementing a community-led prevention strategy targeting Ebola virus disease; and (2) the Tunisia project used several designs to assess a mental health training's effectiveness, and a case study design to explore contextual factors that may influence anticipated outcomes. RESULTS: To share findings with participants, the RCI project relied on workshops and a pamphlet, and the Tunisia project relied on a structured half-day dissemination workshop and research summary. Facilitators that may have encouraged sharing and using findings include involving champions in dissemination activities, ongoing collaboration, and developing/implementing context-specific knowledge sharing strategies. Barriers include omitting to assess strategies, limited consideration of a wider audience, and the exclusion of a knowledge translation training component. CONCLUSIONS: Our experiences might be useful to contexts involved in global and public health research that wish to address the "know-do gap."

[Improved adherence to post-exposure prophylaxis through the use of mobile telephony at the Treichville anti-rabies center, Côte d'Ivoire.] / Amélioration de l'observance de la prophylaxie post-exposition par l'usage de la téléphonie mobile, Côte d'Ivoire.

OBJECTIVE: The objective of this study is to determine the effects of mobile telephony on the improvement of post-exposure prophylaxis compliance at the Abidjan anti-rabies center. METHODS: This is a descriptive and analytical cross-sectional study, which ran from September 2014 to May 2015. The data collection took place in two stages: first interview of all patients at the anti-rabies center at their first consultation, then a telephone interview three days after, only for those who had abandoned their prophylaxis. RESULTS: The results indicated that after telephone calls, the dropout rate dropped from 59.3% to 44.8%. Discontinuations were less frequent in patients who received a veterinary surveillance notice (ORa = 0.23, 95% CI [0.11-0.48]), who had at least one veterinary certificate (ORa = 0.25 95% CI [0.15-0.43]) or more than two doses of vaccine (ORa = 0.23, 95% CI [0.12-0.42]) before telephone call. However, dropout rates were high in patients aged 20 to 29 years (ORa = 2.66, 95% CI [1.25-5.68]) and in patients with category III exposure (ORa = 2.19, 95% CI [1.12-54.3]). CONCLUSION: These results show that mobile telephony is a useful tool for educating patients to adhere to post-exposure prophylaxis. However, information and public awareness campaigns on the fatal outcome of rabies must be organized.

[Evaluation of epidemiological monitoring of post-vaccination adverse reactions in Abidjan]. / Évaluation de la surveillance épidémiologique des manifestations adverses post-immunisations à Abidjan.

INTRODUCTION: This study was designed to evaluate the adverse events following immunization (AEFI) monitoring system in Abidjan health districts. METHODS: This cross-sectional study focused on activities conducted between 1st January and 31st December 2015 in the nine health districts of Abidjan. Data were collected by means of a questionnaire based on the model of World Health Organization evaluation forms. These questionnaires were administered to personnel in charge of epidemiological surveillance in the health districts and the personnel of district hospitals and health centres. RESULTS: The AEFI monitoring system, apart from its simplicity and flexibility, remains fairly ineffective due to the relatively low acceptability by all health workers involved. Only 4% of healthcare personnel respondents participate in this activity; 55% of health districts reported cases of AEFI and 25% of health centres reported cases of adverse events. The low acceptability makes this system less sensitive and ineffective for health policy decision-making designed to reduce adverse events following immunization. CONCLUSION: Improved performance of the AEFI monitoring system requires better training of health workers, better data processing equipment and improved community participation.

Skin disease prevalence study in schoolchildren in rural Côte d'Ivoire: Implications for integration of neglected skin diseases (skin NTDs).

BACKGROUND: Early detection of several skin-related neglected tropical diseases (skin NTDs)-including leprosy, Buruli ulcer, yaws, and scabies- may be achieved through school surveys, but such an approach has seldom been tested systematically on a large scale in endemic countries. Additionally, a better understanding of the spectrum of skin diseases and the at-risk populations to be encountered during such surveys is necessary to facilitate the process. METHODS: We performed a school skin survey for selected NTDs and the spectrum of skin diseases, among primary schoolchildren aged 5 to 15 in Côte d'Ivoire, West Africa. This 2-phase survey took place in 49 schools from 16 villages in the Adzopé health district from November 2015 to January 2016. The first phase involved a rapid visual examination of the skin by local community healthcare workers (village nurses) to identify any skin abnormality. In a second phase, a specialized medical team including dermatologists performed a total skin examination of all screened students with any skin lesion and provided treatment where necessary. RESULTS: Of a total of 13,019 children, 3,504 screened positive for skin lesions and were listed for the next stage examination. The medical team examined 1,138 of these children. The overall prevalence of skin diseases was 25.6% (95% CI: 24.3-26.9%). The predominant diagnoses were fungal infections (n = 858, prevalence: 22.3%), followed by inflammatory skin diseases (n = 265, prevalence: 6.9%). Skin diseases were more common in boys and in children living along the main road with heavy traffic. One case of multi-bacillary type leprosy was detected early, along with 36 cases of scabies. Our survey was met with very good community acceptance. CONCLUSION: We carried out the first large-scale integrated, two-phase pediatric multi-skin NTD survey in rural Côte d'Ivoire, effectively reaching a large population. We found a high prevalence of skin diseases in children, but only limited number of skin NTDs. With the lessons learned, we plan to expand the project to a wider area to further explore its potential to better integrate skin NTD screening in the public health agenda.

Assessment of the impact of adherence and other predictors during HAART on various CD4 cell responses in resource-limited settings.

OBJECTIVE: The aim of this study was to quantify, by modeling, the impact of significant predictors on CD4 cell response during antiretroviral therapy in a resource-limited setting. METHODS: Modeling was used to determine which antiretroviral therapy response predictors (baseline CD4 cell count, clinical state, age, and adherence) significantly influence immunological response in terms of CD4 cell gain compared to a reference value at different periods of monitoring. RESULTS: At 6 months, CD4 cell response was significantly influenced by baseline CD4 count alone. The probability of no increase in CD4 cells was 2.6 higher in patients with a baseline CD4 cell count of ≥200/mm(3). At 12 months, CD4 cell response was significantly influenced by both baseline CD4 cell count and adherence. The probability of no increase in CD4 cells was three times higher in patients with a baseline CD4 cell count of ≥200/mm(3) and 0.15 times lower with adherent patients. At 18 months, CD4 cell response was also significantly influenced by both baseline CD4 cell count and adherence. The probability of no increase in CD4 cells was 5.1 times higher in patients with a baseline CD4 cell count of ≥200/mm(3) and 0.28 times lower with adherent patients. At 24 months, optimal CD4 cell response was significantly influenced by adherence alone. Adherence increased the probability (by 5.8) of an optimal increase in CD4 cells. Age and baseline clinical state had no significant influence on immunological response. CONCLUSION: The relationship between adherence and CD4 cell response was the most significant compared to that of baseline CD4 cell count. Counseling before initiation of treatment and educational therapy during follow-up must always help to strengthen adherence and optimize the efficiency of antiretroviral therapy in a resource-limited setting.