[Rabies knowledge, attitudes, and practices of human and animal healthcare providers in Chad]. / Connaissances-Attitudes-Pratiques des agents de santé humaine et animale sur la rage au Tchad.

INTRODUCTION: Rabies, an infectious disease mainly transmitted by dog bites, is fatal due to lack of appropriate knowledge-attitudes-practices (KAP). The KAP of healthcare providers are particularly important because of their presence in the communities and their profession and were evaluated in the present study. METHODS: A cross-sectional, questionnaire-based descriptive study was conducted in healthcare providers recruited from four health districts in Chad in 2015. Data were analysed with Epi Info. 7. RESULTS: 270 health care providers were interviewed. 87% defined rabies as a disease transmitted from dogs to man. The main reservoir of rabies was the dog (96.7%), the cat (68.9%), but also other animals (35%). All respondents reported dogs to be a vector and 79.6% reported cats. Healthcare providers considered that the virus was transmitted by bites (99.3%) and scratches (50%). The primary means of prevention was vaccination of dogs (82.1%) and post-exposure prophylaxis (16.4%). Immediate washing of the wounds was reported by 65.2% of respondents. CONCLUSION: Healthcare providers have a good knowledge of the dog as a reservoir and vector of rabies. However, continuous training is needed to enable them to acquire knowledge about the role of cats and the importance of scratching in the transmission of rabies virus, the need for wound washing, and appropriate bite management based on collaboration between human and veterinary health sectors.

[Evaluation of Knowledge-Attitudes-Practices of the populations in the health districts of Benoye, Laoukassy, Moundou and South N'Djamena towards canine rabies in Chad]. / Evaluation des Connaissances-Attitudes-Pratiques des populations des districts sanitaires de Benoye, Laoukassy, Moundou et N'Djaména Sud sur la rage canine au Tchad.

INTRODUCTION: Canine rabies remains a concern in Africa as well as in Chad. Our study aimed to evaluate the knowledge, attitudes and practices of the populations towards the appropriate management of people exposed to canine rabies and effective fight against it. METHODS: We conducted a cross-sectional, descriptive study in four health districts in Chad in July and in September 2015. Data were collected from households recruited by three-stage random sampling by means of a questionnaire. RESULTS: We conducted a survey of 2428 individuals having completed at least primary education level (54,12%). The average age was 36 ± 13.50 years. Surveyed individuals were farmers (35,17%), merchants (18,04%), households (12.81%). Rabies was defined as a disease transmitted from the dog to the man (41.43%), an alteration in brain function (41.27%), an undernourishment (10.26%). The cat was little-known to be a reservoir(13.84%) and a vector (19,77%) as well as licking was little-known to be a transmission medium (4.61%) and cat vaccination to be a preventive measure (0.49%). First aid for a bite at home was the traditional practice (47,69%), wounds washing (19.48%) or no action undertaken (20.43%). Households consulted the Health Service (78.50%), the Animal Health Service (5.35%) and the traditional healers (27%). CONCLUSION: A communication campaing for implementing first aid at home in the event of a bite, knowledge about the cat as a reservoir and a vector and licking as a transmission medium as well as the promotion of the consultation of veterinary services in the event of a bite are necessary.

[Factors associated with the poor coverage of Intermittent Preventive Treatment in pregnant women in the Pobè-Adja-Ouèrè-Kétou health zone in Benin]. / Facteurs associés à la faible couverture du Traitement Préventif Intermittent chez les femmes enceintes de la zone sanitaire béninoise de Pobè-Adja-Ouèrè-Kétou.

World Health Organization estimates indicate 216 million malaria episodes in 2010, including 81% in the African region. One of the recommended means of prevention in pregnant women is intermittent preventive treatment, until 2012, two doses of sulfadoxine/pyrimethamine or three doesfor a woman living with HIV In the Pobè-Adja-Ouèrè-Kétou health zone of Benin, coverage ofintermittent preventive treatment remains low (49% against a forecast of 80%) several years after implementation of this strategy. We conducted a cross-sectional study in June and July 2012 to identify factors associated with low intermittent preventive treatment coverage in this area. A total of 339 women were interviewed and 48% ofthem received less than two doses of sulfadoxine pyrimethamine during their prenatal consultations. The variables associated with low intermittent preventive treatment coverage were low antenatal care coverage (p < 0.001) and a prenatal consultation in the private sector (p = 0.039). In the light of our results, actions must be taken by this health zone to encourage women to complete the four visits during pregnancy.

[Factors associated with psychoactive substance use among Beninese adolescents]. / Facteurs associés à l’'usage de substances psychoactives chez les adolescents au Bénin.

INTRODUCTION: Psychoactive substances use among adolescents is a serious public health problem, as it exposes them to risks and health hazards and can ultimately lead to dependence. The present study investigated the prevalence and factors associated with substance use in the Kpomassè Ouidah Tori-Bossito health area in Benin. METHODS: This was a cross-sectional study conducted from 1st May to 15 July 2014 in 451 adolescents aged 10 to 19 years selected by the cluster sampling technique. Data were collected using a questionnaire about the adolescents' individual, family and socio-environmental factors. Associated factors were investigated by backward stepwise logistic regression. RESULTS: Alcohol was the substance most commonly abused with a prevalence of 30.1%, followed by tobacco, with a prevalence of 21.7% and finally cannabis, cocaine or amphetamine with a prevalence of 13.9%. More than one in ten teenagers (16.6%) consumed two or three substances. Factors associated with alcohol misuse were male gender, the area of urban residence, being married, depression, search for pleasure, conflictual family relationships and having neighbours who drink alcohol. Significant risk factors for smoking were male gender, having a single parent or being an orphan, poor parental involvement in the child's education, smoking friends and neighbours. Cannabis, cocaine and amphetamine use was mostly associated with an urban residential environment, depression, conflictual family relationships and poor parental involvement in the child's education, drug use by the parents and illicit drug use by friends. CONCLUSION: These results show that psychoactive substance use is a public health problem in the Tori-Bossito Kpomassè Ouidah health area. Communication interventions for behaviour change, advocacy, and a better public understanding of the legislation on psychoactive substances should be conducted.

[An evaluation of the implementation of the national treatment protocol for uncomplicated malaria in rural areas of Burkina Faso]. / Évaluation de l'application du protocole national de traitement des cas de paludisme simple en milieu rural au Burkina Faso.

The purpose of this study was to evaluate the implementation of a treatment protocol based on artemisinin-based combination therapy for the treatment of uncomplicated malaria in rural areas. Population and methods. A descriptive and comparative study was conducted in the rural health district of Houndé (Burkina Faso). The study involved health care providers, managers of essential drug depots and health centers, and patients receiving a prescription for an antimalarial drug. The data were entered and analyzed using the Epi Info 3.3.1 software package. The Chi-square test was used to compare proportions at the 0.05 level. A total of 130 prescribers and 30 managers of essential drug depots were interviewed in 28 health centers. In addition, 165 prescriptions including an antimalarial drug were collected. Of the 130 prescribers surveyed, 84.6% knew about the new treatment guidelines for uncomplicated malaria. The study found that 64.8% of the prescriptions were for ACTs, while quinine accounted for 35.2% of the prescriptions. Artesunate-amodiaquine combination therapy accounted for 98.1% of the prescriptions for antimalarial drug combination therapy. 82.4% of the prescriptions were adequate, with significantly more adequate prescriptions in clinics than in maternity hospitals (p = 0.009). Children under 5 years of age were treated better than other age groups (p < 0.001). In 89.7% of drug depots, there was evidence of a shortage of artemisinin-based combination drugs at least once in the two months before the study, most notably in the case of artesunate-amodiaquine therapy. The results highlight the importance of continuing training for treatment providers and of strict procedures for managing stocks of artemisinin-based combination drugs.