Medicinal plant use and adherence problems to TB treatment.

BACKGROUND: Good adherence is essential in the treatment of TB. The aim of this study was to describe medication consumption patterns and to assess factors associated with adherence to TB treatment among TB patients in Lomé, Togo.METHODS: A cross-sectional study was conducted among TB patients in 10 health structures in Lomé from September 2019 to January 2020. TB patients aged ≥18 years and under treatment for at least 2 months were eligible for this study. Adherence to TB treatment was assessed using the Girerd compliance test.RESULTS: A total of 195 TB patients (61.5% male) with a median age of 35 years (IQR 27-44) were recruited. TB-HIV coinfection was 11.3%. Polypharmacy (≥5 medications/day) and using medicinal plants were observed in respectively 6.2% and 42.6% of patients. Prevalence of TB treatment adherence problems was 68.2% (95% CI 61.2-74.7). Being <35 years (aOR 2.79; P = 0.005) and taking medicinal plants (aOR 4.31; P < 0.001) were associated with TB treatment adherence problems.CONCLUSION: Treatment adherence problems, a major obstacle to TB elimination, are highly prevalent in TB patients in Lomé, and were associated with the use of medicinal plants. Reasons for the use of medicinal plants should be documented in order to propose appropriate interventions to reinforce adherence to TB treatment.

Prevalence and factors associated with COVID-19 vaccine hesitancy in health professionals in Togo, 2021.

OBJECTIVES: The aim of this study was to assess the prevalence and factors associated with COVID-19 vaccine hesitancy among health professionals (HPs) in Togo. STUDY DESIGN: Cross-sectional study. METHODS: The study was conducted between 24 February and 3 March 2021 among HPs in Togo. Data on sociodemographic characteristics and intention of vaccination were collected using an online questionnaire. Willingness to get vaccinated against COVID-19 was assessed using a single item: "Would you be willing to be vaccinated against COVID-19?". Responses were grouped into three categories: acceptance (Yes, I will get vaccinated), hesitancy (Not decided yet) and refusal (No). Multinomial regression analyses were performed to assess factors associated with vaccine hesitancy or refusal. RESULTS: A total of 1115 HPs (79.1% male) with a median age of 35 years were enrolled in the study. Vaccine acceptance, hesitancy and refusal were 44.1%, 32.2% and 23.7%, respectively. Female gender was associated with an increased risk of hesitancy (adjusted odds ratio [aOR] = 1.93; p = 0.005) and refusal (aOR = 1.77; p = 0.005). Participant age ≥ 50 years, having a personal history of COVID-19 infection and a good knowledge of COVID-19 vaccination were factors that reduced the risk of refusal [(aOR = 0.30; p < 0.001), (aOR = 0.43; p = 0.031) and (aOR = 0.62; p = 0.020)] or hesitancy [(aOR = 0.53; p = 0.005), (aOR = 0.13; p < 0.001) and (aOR = 0.35; p < 0.001)] of the vaccine. CONCLUSIONS: Acceptance of the COVID-19 vaccine before the vaccination campaign was mixed among HPs, especially young HPs. Sensitisation and information campaigns should be reinforced to combat misinformation and increase COVID-19 vaccination acceptance in the context of the ongoing global pandemic.

Prevalence of HIV infection and hepatitis B and factors associated with them among men who had sex with men in Togo in 2017.

Men who have sex with men (MSM) are a population at risk of contracting both HIV and hepatitis B virus (HBV). The objective of this study was to assess the prevalence of these diseases and the factors associated with them among MSM in Togo in 2017. This cross-sectional study took place in eight major cities in Togo from August through September, 2017. MSM aged 18 years and older were recruited with the respondent-driven sampling method. Data on sexual behavior were collected with a standardized questionnaire. Rapid tests were used to screen for HIV and HBV. In all, 678 MSM with a median age of 23 years (interquartile range: 21-26) were recruited, 68.7% of them living in Lomé, the capital of Togo. The prevalence of HIV was 22.0% (95% confidence interval [95% CI] 18.9-25.3) and that of HBV 7.1% (95% CI 5.3-9.3). Seven (1.0%) MSM were co-infected with HIV and HBV. Age, place of residence, living with a male partner, the number of male partners in the 12 months before the study, and history of HIV testing were associated with HIV infection (P<0.05). Age and living in Lomé were associated with HBV infection (P<0.05). The results of this study highlight the importance of focusing response efforts on populations at risk of contracting STIs through routine screening and vaccination.

[Nuptiality and fertility in Senegal]. / Nuptialite et fecondite au Senegal.

PIP: Data from Senegal's 1978 World Fertility Survey were used to demonstrate the decisive role of intermediate variables in the determination of general and marital fertility rates. Senegal's total fertility rate of 7.2 in 1974-78 indicates a high level of fertility which, moreover, appears to have changed little over time. Marital fertility is slightly higher than general fertility: married women had an average of 4.03 live births, vs. 3.53 for all women. A seemingly significant fertility differential by maternal educational status amounting to 1.34 child disappears when age and age at marriage are controlled. Age at marriage is a significant influence on fertility in the 1st 5 years of marriage, with fertility lower among women aged 15 or under at marriage. Abortion is a marginal practice in Senegal, and contraception is not widespread. 10% of ever married women reported having ever used a traditional method, and 1% a modern method. At the time of the survey only .5% used a modern method. Few significant differentials were noted in abortion or contraception by rural or urban residence. A slightly longer period of breastfeeding in rural areas (19.1 months vs. 17.6 months in urban areas) probably accounts for more of the slight rural-urban fertility differential than does abortion or contraception. Nuptiality in Senegal is early and intense, but is less stable than in most other African countries. The average age at 1st marriage of women aged 20-29 years was 16.4 for urban women, 15.6 for rural women, 17.0 for literate women, 15.7 for illiterate women, 16.0 for Wolofs, 15.1 for Poulars, 15.5 for Mandingos, 16.5 for Serers, 17.0 for Diolas, and 15.8 for the entire sample. Differences in age at marriage by rural or urban residence and women's educational level were more marked in younger cohorts. 95.6% of women aged 25-29 and 99.8% of those aged 30-34 at the time of the survey were already married. Age at marriage influences the propensity to divorce. 23.6% of marriages of women married at under 20 years vs. 19.1% of marriages of women over 20 ended in divorce. But 89% of divorced women subsequently remarried. Education, residence, and ethnic group also influenced the risk of divorce. 33% of Poular women, 27% of urban women, 27% of literate women, and 23% of Serer women ended their 1st unions in divorce. Wolof, Diola, and illiterate women had an average tendency to divorce, with 19% in each group terminating their 1st unions. 17% or rural women and 11% of Mandingo women divorced. Polygamy is widespread in Senegal. 48% of married women and 32% of married men are in polygamous unions. Senegal Fertility Survey data were limited to the current union, preventing a profound study of the interrelations between fertility and polygamy. But available data suggest that there are no fertility differences between monogamous and polygamous women either in the early years of marriage or overall. But divorce is much more likely for women infertile in the 1st years of marriage.^ieng