[Influence of social perceptions and practices on the use of bednets in the malaria control programme in Ivory Coast (West Africa)]. / Representations sociales et pratiques liées à l'utilisation des moustiquaires dans la lutte contre le paludisme en Côte d'Ivoire (Afrique de l'Ouest).

The National Malaria Programme in Ivory Coast has encountered difficulty in winning public acceptance of insecticide-treated bednets. We speculate that resistance to the use of bednets could be rooted in social perceptions, beliefs and practices in the communities. The purpose of this study was to identify sociocultural and environmental factors that could be used to support promotion strategies and acceptance of impregnated bednets in Ivory Coast. Survey findings confirmed that bednets were not in widespread use among the population (25%). The most widely used methods were burning mosquito coils (50%) and indoor spraying (31%). Use of impregnated bednets was low (6%). Most survey respondents (73%) indicated initial appreciation for the effectiveness of bednets in protecting against mosquitoes as a nuisance. However only 9% of respondents thought that impregnated bednets provided protection against malaria although they did not necessarily use them. Design was a determinant factor for the use, and even acceptance, of bednets. The population want rectangular, permanently impregnated bednets large enough to accommodate at least 2 persons. Cost was a major obstacle to wider use by the population. According to our data the best price for the population would be between 2000 and 2500 FCFA as compared to the current price of 3500 FCFA in Ivory Coast.

Representations sociales et pratiques liees a l'utilisation des moustiquaires dans la lutte contre le paludisme en Cote d'Ivoire (Afrique de l'Ouest)

Devant les difficultes que rencontre le Programme National de Lutte contre le Paludisme (PNLP) de Cote d'Ivoire; dans sa volonte d'amener les populations a adopter les moustiquaires impregnees d'insecticide; nous nous sommes demandes si les representations sociales; les attitudes et les pratiques des communautes liees a l'utilisation des moustiquaires n'expliquent pas cette contre-performance. Notre etude a eu pour but de documenter les facteurs socioculturels et environnementaux pour renforcer les strategies de promotion et de vulgarisation de la moustiquaire impregnee en Cote d'Ivoire. Les resultats obtenus montrent qu'au niveau des enquetes quantitatives; la moustiquaire en general est faiblement utilisee par les populations (25). Les moyens les plus utilises sont les serpentins fumigenes (50) et les bombes aerosols (31). La moustiquaire impregnee est tres faiblement utilisee (6). La moustiquaire est; de maniere generale; appreciee dans un premier temps pour son efficacite dans la protection contre les nuisances dues aux moustiques par 73des enquetes. Seulement 9de ces enquetes pensent que la moustiquaire impregnee sert a se proteger contre le paludisme; mais ne l'utilisent pas necessairement. L'organisation des unites de couchage; voire leur inadaptation; sont determinantes dans l'utilisation de la moustiquaire. La moustiquaire souhaitee par les populations est celle d'au moins 2 places; de forme rectangulaire; de couleur blanche; faite en tulle a mailles fines; transparente; impregnee d'insecticide et a impregnation definitive. Toutefois; son cout semble etre le handicap majeur a son adoption par les populations; pour qui le cout ideal de la moustiquaire a l'achat; se situe entre 2000 et 2500 FCFA contre les 3 500 Frs actuellement pratiques en Cote d'Ivoire

[Evaluation of the efficacity of coconut (Cocos nucifera), palm nut (Eleais guineensis) and gobi (Carapa procera) lotions and creams in indivirual protection against Simulium damnosum s.l. bites in Côte d'Ivoire]. / Evaluation de l'efficacité de lotions et de crémes à base d'huiles de coco (Cocos nucifera), de palmiste (Eleais guineensis) et de gobi (Carapa procera) dans la protection individuelle contre les piqûres de Simulium damnosum s.l. en Côte d'Ivoire.

With the interruption of larva treatments done by OCP as part of onchocerciasis control in West Africa, Simulium came back in abundance in forest regions and savannah fertile valleys. In addition to the severe discomfort, nuisance by Simulium is in certain cases incompatible with land use. Since ground treatment of larval breading sites using insecticides is not always possible or efficient, it is therefore a necessity to develop other methods among which individual protection against Simulium bites. The general objective of our study was to evaluate different vegetable oil compound repellent formulas against Simulium bites. Activities were carried out in savannah zone (Niakaramandougou) and in forest zone (Soubré) in Côte d'Ivoire. The methodology consisted in catching blackflies on volunteers whose legs were rubbed with a repellent. Gobi raw oil and coconut, palm nut and gobi formulas (lotions and creams) were tested. During each session, which lasted from 07:00 am to 12:00 and from 03:00 pm to 06:00 pm, one person did not apply any repellent and was used as the control person. The results of our experimentations show that for a given zone (savannah, forest), a repellent (coconut, palm nut, gobi) and a compound (shea butter, vaseline), there is no significant difference between protection rates obtained with lotions (maximum: 21 bites/person/day) and those obtained with creams (maximum: 30 bites/person/day). In other respects, the lotion of a given repellent seems to be efficient in savannah as in the forest, in protecting against Simulium bites. It is the same situation with creams. So, repellents can be an efficient solution against Simulium nuisance. However, experimentations should continue to confirm the high repellency of tested formulas, proceed to the identification of principles and evaluate the toxicity and irritant effect of repellents to be applied on the skin.

[Variability according to the individual of the efficacy of repellents with a base of vegetable oils in the individual protection against Simulium damnosum s. l. bites]. / Variabilité selon le captureur de l'efficacité de répulsifs à base d'huiles végétales dans la protection individuelle contre les piqûres de Simulium damnosum s. l.

In Ivory Coast, treatments against black flies larva are interrupted since December 1998 and these flies are back everywhere in abundance. They are now a severe source of discomfort, so it is therefore very important to propose to rural populations a personal protection method against their bites. This article is about the individual attraction of fly boys on the efficiency of lotions and creams of the different repellents (coconut, palm nut, gobi). Our works were carried out in savanna zone (Niakaramandougou) and in forest zone (Soubré) in Ivory Coast. The methodology consisted in capturing black flies on volunteers whose legs were rubbed with repellent. Coconut, palm nut and gobi formulas (lotions and creams) were tested on Simulium damnosum s.l. During each session, which lasted from 07:00 am to 12:00 and from 03:00 pm to 06:00 pm, one person without repellent was used as a control person. The results show that the least efficient repellent (gobi) ensures nonetheless a reduction of 90% of the number of bites that an individual would have received if he was not protected by the repellent. Experimentations allows to say that for a given repellent and formulas (lotion and cream), there is no significant difference between the number of Simulium damnosum s. l. bites received by fly boys.

[Evaluation of cocoa oil for individual protection against Simulium damnosum s.i]. / Evaluation de l'efficacité de l'huile de coco contre les piqûres de Simulium damnosum s.i.

Thanks to larviciding and distribution of ivermectine, transmission of onchocerciasis was virtually halted in all countries covered by the WHO Onchocerciasis Control Program (OCP). However as a result of this success vector control has been stopped in most areas covered by the program and a recrudescence of files is an increasing problem. In some rural communities fly biting hinders normal agricultural activity. Since local farmers cannot afford ground larviciding, many rely on topical repellents. For this reason, development of an inexpensive method of individual protection is a major priority. The purpose of this study carried out in the savannah area of the Côte d'Ivoire was to assess the repellent properties of cocoa oil, which is frequently used in some rural areas of the Côte d'Ivoire to prevent fly biting. Results showed that cocoa oil provides excellent protection against Simulium damnosum s.l.

[Impact of pyrethrin resistance on the efficacity of impregnated mosquito nets in the prevention of malaria: results of tests in experimental cases with deltamethrin SC]. / Impact de la résistance aux pyréthrinoïdes sur l'efficacité des moustiquaires imprégnées dans la prévention du paludisme: résultats des essais en cases expérimentales avec la deltaméthrine SC.

The effects of impregnated bednets treated with deltamethrin at a dosage of 25 mg a.i./m2 were evaluated at two testing stations in Côte d'Ivoire. The first one was located in Yaokoffikro, where Anopheles gambiae s.s. are resistant to pyrethroids (including deltamethrin), and the second in M'be, close to a large rice-growing area where An. gambiae s.s. are susceptible pyrethroids. In both situations, treating bednets with deltamethrin was very effective in limiting contact between man and vector. 72% fewer female An. gambiae entered the huts in the susceptible area, whereas a decrease of 43% was recorded in the resistant area, indicating that deltamethrin still has a certain repellent effect on resistant populations of An. gambiae s.s. Overall mortality induced by bednets treated with insecticide was significantly higher in the resistant area (56.4% as versus 44.3%). An explanation for this apparent paradox is that the mosquitoes being less repelled by the insecticide remain on the treated material for longer periods of time and most of them eventually die. The results of this study indicate that bednets treated with deltamethrin are an effective prophylactic measure even in areas where An. gambiae s.s. are resistant to pyrethroids and should still be considered as a practical means of personal protection against malaria even in pyrethroid resistance areas with high frequency of kdr resistance genes.

[Impact of resistance of Anopheles gambiae s.s. to permethrin and deltamethrin on the efficacy of impregnated mosquito nets]. / Impact de la résistance d'Anopheles gambiae s.s. à la perméthrine et à la deltaméthrine sur l'efficacité des moustiquaires imprégnées.

Trials to assess the impact of resistance of Anopheles gambiae s.s. to permethrin and deltamethrin on the efficacy of insecticide-treated bednets were carried out from October 1997 to April 1998 in six experimental huts at the Yaokoffikro testing station in Côte d'Ivoire. Six polyester bednets were used. Two bednets were treated with permethrin at a dose of 500 mg/m2 and two with deltamethrin at 25 mg/m2. The remaining two untreated bednets served as controls. The number of Anopheles gambiae s.s. entering the hut was reduced 18% with permethrin-treated bednets and 43% with deltamethrin-treated bednets. Threefold fewer female mosquitoes were found under insecticide-treated bednets than under untreated nets (controls). The number of mosquitoes passing through the treated net was threefold lower. The number of mosquitoes exiting from the treated bednets increased twofold. The blood-feeding rate dropped by 55%. Forty percent of mosquitoes entering the permethrin-treated bednets and 56% entering the deltamethrin-treated bednets died. Immediate mortality was always greater (> 85%) than delayed mortality (< 15%). Bioassays confirmed the results from hut experiments. A lower knockdown effect was recorded with permethrin in the resistant strain. Conversely deltamethrin showed the same knockdown effects in the susceptible (Kisumu) and resistant (Yaokoffikro) strain. Mortality rates were low with both permethrin and deltamethrin. This study shows that, even in areas where Anopheles gambiae s.s. is resistant to permethrin and deltamethrin, bednets treated with these insecticides remain effective and can still be considered as an excellent method of personal protection.

Traitement du plastron appendiculaire .[Lettre]

Soixante-quinze patients porteurs d'un plastron appendiculaire ont ete traites au cours d'une seule hospitalisation. Le traitement medical reposant sur une double antibiotherapie (Cefuroxime et Metronidazole) faisant place a l'appendicectomie des la disparition clinique de la masse. Un abces appendiculaire est survenu au cours du traitement medical soit 1;3 pour cent d'echec. La disparition clinique de la masse a eu lieu en 11 jours en moyenne. Le traitement chirurgical a ete entrepris en moyenne apres 24 jours d'hospitalisation. La mortalite operatoire a ete nulle. La morbidite; representee exclusivement par des abces de paroi sans gravite; a ete de 8 pour cent. Le traitement chirurgical des plastrons appendiculaires ''refroidis'' peut donc etre realise de facon efficace et en toute securite au bout de trois semaines