[Evaluation of the health status of 0-to-4-year-old children in an urban community of Abidjan]. / Evaluation de l'état clinique des enfants de 0 à 4 ans dans une commune urbaine d'Abidjan.

During summer 1985 a survey was realized in an administrative territorial division of Abidjan (2 M. residents) in Ivory Coast. Four thousand households were randomly selected (EPI*/WHO model) including 653 children, from 0 to 4 years old. Mothers were interviewed and children examined. Seventeen per cent of children were below the weight curve standardised for Ivory Coast, 8% had a ratio arm diameter on head diameter lower or level of 0.27 and 54% a ratio between 0.28 and 0.31. Diarrhoea was noted among 10% of children, bronchopneumopathy among 44.7%, rhinitis among 53.6% and otitis 15.4%. The interview of mothers confirmed these results; in addition it appeared that 3% of children have had measles in the preceding month. The diarrhoeas and ORL infections prevalence is linked with the lack of drinking water at home, the IRA prevalence with community habitat; ORL infections are more frequent among children from illiterate mothers. The authors think that an amelioration of this situation is possible only by socio-economic progress for families (the work over lunch generalisation would be already an important progress) and putting the specific accent on measles immunization (the incidence rate of measles didn't changed since 1978 in spite of EPI application).

Mortality from neonatal tetanus in rural Côte d'Ivoire.

A 30-cluster survey was carried out in order to estimate the incidence of neonatal tetanus in rural Côte d'Ivoire. Births in the 19 months preceding the survey were enumerated by interviewers in house-to-house visits. If a child born in that period had died, the interviewer asked a series of questions to establish a presumptive diagnosis of neonatal tetanus. A total of 41 deaths from neonatal tetanus was found in the study area among 2324 live births that occurred from 1 January 1981 to 31 July 1982. This gives a neonatal tetanus mortality rate of about 2%. Most deliveries and almost all deaths occurred at home, and only about 2% of neonatal tetanus cases were reported through the routine health information system. Birth in a clinic and antiseptic care of the umbilical cord protected infants from neonatal tetanus. Tetanus immunization of all women of child-bearing age is recommended as a preventive measure.

[Setting-up a system of health statistics collection in a rural environment in the Ivory Coast]. / Mise en place d'un système de recueil de statistiques sanitaires en milieu rural ivoirien.

In order to improve the sanitary data collection system from the rural Health Centers, Ivory-Coast has modified it in acting upon the three stages of collection. At the level of rural Health Centers, it has been created, from observations and data collected in a sample of 5 centers, a new classification of diseases including 128 items allowing all male and female nurses to classify 94% of the patients examined. At intermediary level, their monthly reports are collected and checked by the chief Medical Practitioner of the Rural Health Sector, who is responsible for all medicine not pertaining to hospital centers. At central level, computerised data treatment and exploitation make possible national data spreading and back-up during the third month after the writing of their report by the nurse.