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.

[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.

[Factors associated with adherence to therapy among HIV-infected patients in Bangui]. / Facteurs associés à une bonne observance thérapeutique chez les patients infectés par le VIH à Bangui.

OBJECTIVE: To identify the factors related to good or non-adherence met among patients under highly active antiretroviral therapy (HAART) or cotrimoxazole prophylaxis (CTX) in Bangui. METHOD: A cross-sectional study was conducted on a sample representative of patients with HIV followed up in two health centres in Bangui. Patients had been under treatment for at least 2 months. Information concerning adherence was collected through a questionnaire and by interview of the patients. The questionnaire was designed to measure if patients with HIV were taking less than the total number of antiretroviral or CTX pills prescribed by their physician. Adherence was measured by the patient self-reported question of taking the drugs during the last 4 days and the remaining pill count (RPC). RESULTS: 141 patients with the criteria of inclusion were questioned; among these, 89 patients under antiretroviral treatment (d4T/3TC/NVP) and 52 patients under cotrimoxazole. In the study, adherence varies from 67.3 to 94.3 %. According to the type of treatment, adherence of the patients under CTX is lower (65.4 %) than that of the patients under HAART (77.5 %). Adherence was better for the patients who had a personal project and with a need of information on HIV infection. It is worse for the patients with another affection. CONCLUSION: These results suggest the necessity of assessing and supporting HIV-infected adult's adherence routinely in AIDS care institutions. In addition, the method used to assess adherence must be simple, accessible and low-cost for the countries with limited resources.

Factores determinantes en el cumplimiento de tratamientos antirretroviral en Camerún durante el periodo inicial (2000-2002) / Determining factors of observance of antiretroviral treatments in Cameroon during the start-up period (2000-2002)

Objetivo: Destacar los factores socioeconómicos y ambientales determinantes del cumplimiento a largo plazo de los tratamientos antiretrovirales en países en vías de desarrollo. Métodos: Se midió la regularidad de la renovación de prescripciones de antiretrovirales en la farmacia central del Hospital Central de Yaounde (Camerún) mediante el análisis de los ficheros médicos y farmacéuticos de 230 pacientes durante el periodo de iniciación de 21 meses. También se entrevistó a 99 pacientes durante los últimos seis meses. Se analizaron los factores determinantes de acuerdo a los diversos criterios socio-económicos, unidos con el estudio longitudinal de cumplimiento terapéutico. Resultados: El enorme descenso de precio de los tratamientos VIH durante el periodo inicial condujo a un aumento de nuevos tratamientos en un factor de 5,76. En este contexto de demanda explosiva, el artículo demuestra que la adherencia es primero dependiente de la calidad de la información sobre la enfermedad y el protocolo del tratamiento, mientras que el cumplimiento a largo plazo es parcialmente dependiente de la capacidad financiera e incluye una fuerte influencia de las condiciones de vida y de actividad. Conclusión: El artículo recomienda la introducción de tratamiento gratuito como objetivo en las políticas nacionales y la organización de un seguimiento a largo plazo de pacientes. En el contexto de pobreza africana y actual descentralización de la sanidad, la cuestión de la disponibilidad de los recursos destaca profundamente (AU)

Objective: highlight the socioeconomic and environmental determining factors of long-term observance to antiretroviral treatments in developing countries. Method: The regularity of antiretroviral prescriptions renewal at the central pharmacy of the Yaounde Central Hospital (Cameroon) was measured through analysing the medical and pharmaceutical files of 230 patients over the 21 month start-up period. 99 patients were also interviewed during the last six months. The determining factors were analysed according to various socio-economic criteria, linked with the longitudinal study of treatment observance. Results: The huge price decrease of HIV treatments during the start-up period was conducive to an increase in new treatments by a factor 5.76. In this context of an exploding demand, the paper shows that observance is firstly dependent on quality information about illness and treatment protocols, while longer term adherence is partly dependent on financial capability, and includes the strong influence of living conditions and behaviours. Conclusion: The paper recommends the introduction of free treatment as an objective in national sector policies and the organisation of a long term following-up of patients. In the African context of poverty and actual decentralisation of healthcare, the question of the availability of human resources is profoundly enhanced (AU)

Determining factors of observance of antiretroviral treatments in Cameroon during the start-up period (2000-2002).

OBJECTIVE: highlight the socioeconomic and environmental determining factors of long-term observance to antiretroviral treatments in developing countries. METHOD: The regularity of antiretroviral prescriptions renewal at the central pharmacy of the Yaounde Central Hospital (Cameroon) was measured through analysing the medical and pharmaceutical files of 230 patients over the 21 month start-up period. 99 patients were also interviewed during the last six months. The determining factors were analysed according to various socio-economic criteria, linked with the longitudinal study of treatment observance. RESULTS: The huge price decrease of HIV treatments during the start-up period was conducive to an increase in new treatments by a factor 5.76. In this context of an exploding demand, the paper shows that observance is firstly dependent on quality information about illness and treatment protocols, while longer term adherence is partly dependent on financial capability, and includes the strong influence of living conditions and behaviours. CONCLUSION: The paper recommends the introduction of free treatment as an objective in national sector policies and the organisation of a long term following-up of patients. In the African context of poverty and actual decentralisation of healthcare, the question of the availability of human resources is profoundly enhanced.

[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.