[Effects of Covid-19 Pandemic on the Vaccine Activities on a Reference Immunization Center in Treichville, Côte D'ivoire]. / Effets de la Pandémie à Covid-19 sur les Activités Vaccinales D'un Centre de Vaccination de Référence de Treichville en Côte D'ivoire.

Introduction: Since March 11, 2020, Côte d'Ivoire has been affected by the coronavirus epidemic, declared that same day as pandemic by WHO. March 11, 2021, one year after the pandemic, Côte d'Ivoire has notified 36,824 cases of Covid-19 patients and among them 211 have died. As of May 31, 2020, Côte d'Ivoire had already notified 2,833 cases and 33 deaths. At that time, false rumors were circulating in Africa about the setting up of clinical trials on candidate vaccines. The impact of these rumors on the overall use of health services had to be measured and in particular on vaccination centers. Objectives: The objective of this study was to determine the effects of the pandemic on the activities of the immunization services of the National Institute of Public Hygiene in Abidjan, which comprises four departments: International Vaccination Center, Community Vaccination Service, Rabies Center, and Vaccination Unit of the Expanded Program on Immunization. The study was based on activity reports of the immunization services. Results: At the International Vaccination Center, activities fell by about 50% in March, 86% in April and 82% in May in comparison with 2018 and 2019. Activities of Community Vaccination Service decreased by about 26% in March and 99% in April and May. At the Rabies Control Center, this reduction was estimated at 38% in April and 45% in May. The highest losses were for yellow fever and meningitis vaccines. Conclusion: The drop in attendance at vaccination services could increase the risk of epidemics, especially yellow fever, which are recurrent in Abidjan. Intensive awareness and catch-up actions should be carried out and further studies performed to assess the impact of the pandemic on immunization activities.

[Influence of the knowledge of patients consulting at the Treichville antirabies Center on adherence to post-exposure prophylaxis]. / Influence des connaissances des patients consultant au centre antirabique de Treichville, Côte d'Ivoire, sur l'observance de la prophylaxie post-exposition.

AIM: Human rabies is a major public health problem in many African countries, including Ivory Coast. The objective of this study was to evaluate the influence of human rabies knowledge on compliance with post-exposure prophylaxis. MATERIALS AND METHODS: We conducted a descriptive and analytical cross-sectional study from September 2014 to May 2015 at the Abidjan Rabid Center, Treichville. After having given their consent, were interviewed, patients who came for a first consultation and who gave a mobile phone number available for the appointment reminder after abandoning or not starting the post-exposure prophylaxis. Data were processed with Epi Info version 3.5.3. Pearson's chi-square test and Fisher's exact test were used for statistical analysis with a significance level of 5%. RESULTS: A total of 744 patients were interviewed. Men accounted for the majority (58.2%) of those surveyed, with a sex ratio (M/F) of 1.7. The average age of patients was 24.55 (±17.3) years. The analysis showed that 42.6% (317/744) of the interviewees had heard of human rabies. However, having heard of human rabies did not influence adherence to post-exposure prophylaxis (P>0.05). Nevertheless, the post-exposure prophylaxis regimen was completed more often by subjects who knew that agitation is a sign of rabies than those who did not (ORa=0.4343, 95%CI=[0.204-0.925]). Subjects knowledgeable about disease transmission (animal bites) were less likely to continue their post-exposure prophylaxis than those unaware of this relationship (ORa=8.544, 95%CI=[1.002-72.869]). CONCLUSION: The main factors identified in this study that influenced the observance of post-exposure prophylaxis were knowledge of the manifestation of human rabies (signs of agitation) and of the mode of transmission of this disease (animal bites). With a view for better prevention against human rabies, rural and urban populations should be informed, educated and sensitized about this 100% life-threatening but vaccination-preventable disease.

Factors associated with the abandonment of postexposure prophylaxis at the antirabies center in Abidjan, Côte d'Ivoire.

The main objective of this work is to analyze the factors associated with patients dropping out of postexposure prophylaxis (PEP) at the antirabies center of Abidjan (ARC). This descriptive, analytic cross-sectional study took place at the ARC of Abidjan from September 2014 through May 2015. Data were collected in two stages: first, all patients were interviewed at their first consultation. Exposed patients who failed to return were interviewed by telephone three days later. We recorded 441 subjects (59.3%) who had dropped out of their PEP. After multivariate analysis of social and demographic factors, the dropout rate was low in the groups aged 40-49 years (aOR = 0.40, 95% CI = 0.2, 0.8), 50-59 years (aOR = 0.40, 95% CI = 0.21; 0.82), and 60 years and older (aOR = 0.26, 95% CI = 0.09; 0.76), while it was elevated in retired persons (aOR = 10.07, 95% CI = [1.11, 91 , 7]). Moreover, the choice of protocol influenced PEP adherence, with subjects who chose the 5-dose protocol dropping out more frequently (P≤0.001). The main reason given by the subjects exposed to a suspect animal to explain dropping out of PEP was the lack of financial resources (41.5%). To alleviate this dropout problem, the ARC should strengthen public awareness of human rabies and the Ivorian government must implement universal health coverage to help the poor or make the vaccine available for free to all.

Analysis of the follow-up of AIDS patients with ARV treatment at the Treichville sexually transmitted disease center of the National Institute of Public Hygiene (INHP), Abidjan, from 2009 to 2013.

INTRODUCTION: free access to antiretroviral (ARV) treatment has made possible the large-scale management of people living with HIV (PLHIV). Nonetheless, some of them abandon treatment and thus become lost to follow-up. Retention is therefore a challenge for treatment programs, especially in resource-limited countries. To improve retention of patients in our active file, we undertook this study, aimed generally at analyzing the follow-up of our patients on ARV. Materials and méthods: This cross-sectional, descriptive, retrospective, and analytical study covered the period from January 2009 to December 2013 at the Treichville sexually transmitted disease (STD) center and reviewed the records of all AIDS patients with ARV treatment aged 16 years and older with complete records. All patients who had not consulted again within 3 months of their last treatment visit were considered lost to follow-up. RESULTS: This study involved 346 patient records. Their average age was 37.5 years, with a sex ratio of 2.17 in favor of women. The overall dropout rate (percentage of patients lost to follow-up) was 19.94% and peaked at 33.33% in 2011. The average age of the patients lost to follow-up was 35.6 years. Patients who transferred to another care center accounted for 14.16% of all patients, deaths for 4.05%, and 61.56% continued care. Only 1 patient stopped treatment. CONCLUSION: The rate of discontinuation of ARV therapy was high in our study. Knowledge of the sociological aspects of those lost to follow-up is necessary to develop strategies for their retention in active treatment.

Epidemiological aspects of genital ulcers at the STI center of the National Institute of Public Hygiene (Abidjan, Côte d'Ivoire) 2008 to 2010.

Genital ulcers are among the seven syndromes of sexually transmitted infections (STIs) identified in Côte d'Ivoire. Ulcerative STIs present a public health problem because of their frequency and their role in the spread of HIV. Our objective was to investigate the epidemiological characteristics of genital ulcers observed in the STI center of the National Institute of Public Hygiene in Abidjan. This cross-sectional, descriptive and analytical study examined cases seen at the center in 2008 through 2010. We retrospectively reviewed all files of clients aged 10 and older who sought care for the first time at the STI center and received a clinical diagnosis, confirmed by the laboratory, of a STI. Overall, we selected 2488 records. Men accounted for 52.30%. The patients' average age was 32 years. The prevalence of genital ulcers was 3.90%. Genital herpes was the diagnosed mentioned most often by doctors (71.43%), followed by scabies (19.39%) and chancroids (9.18%). Male sex and multiple sexual partners appeared to be risk factors for genital ulcers at this center. Genital ulcers are infrequent. Public awareness campaigns to encourage changes in behavior must continue and intensify. In particular, they must stress control of genital herpes by well-known prevention methods: regular and correct condom use and fewer sexual partners.

Effects of a collaborative approach to documentation of care for people living with HIV (PLWHIV) in Côte d'Ivoire.

The aim of this project implemented in 37 treatment settings for PLWHIV in Côte d'Ivoire was to improve the documentation of the provision of their care through a collaborative approach. This study aims to evaluate the impact of this approach. This descriptive cross-sectional study took place from July to September 2011 and focused on the documentation of care provided to PLWHIV at 32 sites according to the collaborative approach for improving care and services that was introduced from January 2009 to June 2010. We found that the documentation was improved at these sites because of the collaborative approach. The documentation quality indicator rose from less than 20% at the beginning of the project to about 85% at the end. This improvement differed according to facilities' level on the health pyramid. Primary health facilities improved more than general or regional hospitals because the former used the data documented for making decisions about how to improve their quality. On the other hand, the archiving of the files was faulty (lack of space in the cabinets and absence of data managers in all the sites). The collaborative approach method should to be extended to other health facilities in the country to improve the documentation of health activities to improve patient welfare.

Effects of climatological parameters in modeling and forecasting seasonal influenza transmission in Abidjan, Cote d'Ivoire.

BACKGROUND: In temperate regions, influenza epidemics occur in the winter and correlate with certain climatological parameters. In African tropical regions, the effects of climatological parameters on influenza epidemics are not well defined. This study aims to identify and model the effects of climatological parameters on seasonal influenza activity in Abidjan, Cote d'Ivoire. METHODS: We studied the effects of weekly rainfall, humidity, and temperature on laboratory-confirmed influenza cases in Abidjan from 2007 to 2010. We used the Box-Jenkins method with the autoregressive integrated moving average (ARIMA) process to create models using data from 2007-2010 and to assess the predictive value of best model on data from 2011 to 2012. RESULTS: The weekly number of influenza cases showed significant cross-correlation with certain prior weeks for both rainfall, and relative humidity. The best fitting multivariate model (ARIMAX (2,0,0) _RF) included the number of influenza cases during 1-week and 2-weeks prior, and the rainfall during the current week and 5-weeks prior. The performance of this model showed an increase of >3 % for Akaike Information Criterion (AIC) and 2.5 % for Bayesian Information Criterion (BIC) compared to the reference univariate ARIMA (2,0,0). The prediction of the weekly number of influenza cases during 2011-2012 with the best fitting multivariate model (ARIMAX (2,0,0) _RF), showed that the observed values were within the 95 % confidence interval of the predicted values during 97 of 104 weeks. CONCLUSION: Including rainfall increases the performances of fitted and predicted models. The timing of influenza in Abidjan can be partially explained by rainfall influence, in a setting with little change in temperature throughout the year. These findings can help clinicians to anticipate influenza cases during the rainy season by implementing preventive measures.

[Assessment of measles diagnostic from gingival fluid in Côte d'Ivoire]. / Évaluation du diagnostic de la rougeole à partir des fluides gingivaux en Côte d'Ivoire.

After the adoption of the Global Initiative for Measles Elimination in 2001, Côte d'Ivoire has created monitoring case by case. Thus, the diagnosis of measles from the gingival fluid was implemented, through a pilot project. This study aimed to evaluate the performance of this diagnostic test. We conducted a cross-sectional survey, in four health districts of Abidjan, during a period from July 2010 to December 2012. The study consisted in collecting gingival fluid and serum samples in all suspected measles children. These samples were analyzed by ELISA test at Pasteur Institute of Côte d'Ivoire. Standard formulas were used to calculate sensitivity, specificity, positive predictive value and negative predictive value of oral fluid compared to serum taken as the "gold standard" and confidence intervals were estimated with error alpha risk (α =0.05). The concordance of kappa coefficient (k) was used to estimate agreement level between the results of oral fluid analysis and those of serum. The sensitivity and specificity of the test were 98% and 82% respectively while the positive predictive value and the negative predictive value were 84% and 98%. The comparison of oral fluid with the reference test showed high agreement, between 0.61 and 0.80. The diagnostic test on gingival fluid is acceptable because its sensitivity, specificity and negative predictive value had high level. Therefore it can be extended to all sanitary districts.

[The impact of urbanization on malaria infection rate and parasite density in children in the municipality of Yopougon, Abidjan (Côte d'Ivoire)]. / Impact de l'urbanisation sur l'indice plasmodique et les densités parasitaires chez les enfants de 0 à 5 ans dans la commune de Yopougon, Abidjan (Côte d'Ivoire).

From September 23-30, 2005, we conducted a cross-sectional study in six townships of Yopougon, a municipality of Abidjan. These townships were grouped in three levels of urbanization (village, precarious township, and residential township). The main objective of this survey was to determine the impact of urbanization on the malaria infection (parasite) rate and parasite density, and their consequences on the heterogeneity of malaria transmission in urban Abidjan. Specifically we compared these rates in all three urbanization levels, selecting two townships for each level to take environmental specificities observed from previous data into account. The study included 400 households per township. All children younger than 5 years in these households were included. Thick and thin blood smears were taken for each child on slides, and each slide was examined by microscope after staining. The malaria infection rate was 21.8%, indicating mesoendemic malaria. Its distribution varied significantly between the three urbanization levels. Malaria parasite densities also varied significantly between them. These results confirm the involvement of urbanization in the heterogeneity of malaria transmission in the city of Abidjan.

[Description of sexual practices of women who have sex with other women to HIV / AIDS in Abidjan (Côte d'Ivoire)]. / Description des pratiques sexuelles des femmes ayant des rapports sexuels avec d'autres femmes face au VIH/sida à Abidjan (Côte d'Ivoire).

The response to HIV must be based on all situations of risk and vulnerability related to sexual behavior. Sexual practices of women who have sex with other women to HIV described in his study come within this framework. This transversal and descriptive study on the sexual practices of 150 women who have sex with other women to HIV was conducted from July to September 2010 in Abidjan. Mean age of the respondents was 26.6 years. Among them, 21.3% was illiterate, 41.4% had no earned income and 57.3% was Christians. At the time of data collection, the majority (70.7%) did not know their HIV status. The analysis of sexual practices has found 13.3% of lesbians, bisexual, 36% and 50.7% of women who say they are lesbian even if they have had sex with men. Women who have sex with other women had sexual risk behavior. It was mostly the non-systematic use of the condom during sexual relation (60%). Among the 26.7% of respondents who had lesbian practices with penetration, 40% took no precaution to prevent HIV and other sexually transmitted infections. Taking into account these results could help to develop specific strategies to promote responsible sexual practices among women who have sex with other women.

[Discontinuation of postexposure prophylaxis at the anti-rabies Center of Abidjan, Côte d'Ivoire]. / Abandons de prophylaxie post-exposition au Centre antirabique d'Abidjan, Côte d'Ivoire.

Despite the availability of effective anti-rabies vaccine, rabies keeps affecting people in developing countries such as Côte d'Ivoire. The low compliance with Post Exposure Prophylaxis (PEP) partially explains this situation. This study was aiming at studying the reasons to abandon PEP. This descriptive and cross-sectional study has taken place at the anti-rabies Center of Abidjan from October 1st to December 2009. Data were collected in two steps: we first interviewed all the patients at the anti-rabies center during their first consultation, and then phone interviews were conducted one month later, only with exposed patients who abandoned their PEP. These phone calls allowed us to complete the questionnaire (the status of the animal and PEP discontinuation). Patients' verbal informed consent was obtained prior to data collection. Besides, patients were explained the risks they were exposed to and were advised to complete immunization. The results obtained revealed that, out of 220 people included in the study, 116 (52.7%) abandoned the PEP. The compliance was lower with the protocol of five injections compared to that of four injections. More than half of the patients abandoned PEP after the first injection. In 32.8% of patients who abandoned PEP, the animal was dead, disappeared, was destroyed or there were no information about it one month after bite or scratch. Animal owners' refusal of taking in charge the victims (20%) and the lack of financial resources for purchasing the vaccine (13.6%) were the most frequent reasons to abandon PEP. To increase the protection of the human population against rabies and to increase the compliance with PEP protocols, the improvement of financial accessibility to the vaccine for population and the elaboration of compulsory regulations for animal owners to take in charge the PEP are necessary.

[Impact of armed conflict on the health care system of a sanitary district in Cote d'Ivoire]. / Impact du conflit armé sur le système de santé d'un district sanitaire en Côte d'Ivoire.

Since September 2002, Côte d'Ivoire has been in the throes of armed conflict that has split the country in two. In the government-controlled area, access to health care services has continued. In the area under the control of the "New Forces", access to health care services decreased dramatically due to departure of qualified health personnel and subsequent shutdown of sanitary facilities. The purpose of this transversal descriptive survey was to measure the impact of this crisis on the health care system in the Séguéla sanitary district that is located in the war zone. Findings showed that 60.7% of sanitary facilities are no longer operational, that 77.7% of qualified personnel have left their workstation, and that 46.2% of sanitary structures have been damaged. A few reference hospitals and sanitary facilitates have been able to remain open thanks to the support of the humanitarian organisations. As a result of declining access to health care services, a recrudescence of measles and IST has been observed and gastritis and traumatology have appeared among the top 10 causes of morbidity. Access to effective health care in the Séguéla sanitary district cannot be envisioned without the return of qualified health care personnel and the renovation of the sanitary facilities.

[Socio-economic impact at the household level of the health consequences of toxic waste discharge in Abidjan in 2006]. / Impact socio-économique du déversement de déchets toxiques à Abidjan en 2006 à l'échelle des ménages.

In August 2006, toxic wastes were discharged in the district of Abidjan, causing important health consequences in many households in the area. In order to appreciate the socio-economic impact of the consequences of toxic waste discharge on the households and of the measures taken by the authorities to deal with this catastrophe, and to appreciate the spatial extent of the pollution, we undertook a multidisciplinary transversal investigation at the sites of discharge of oxic waste, from October the 19th to December the 8th, 2006, using a transect sampling methodology. This paper presents the results related to the socio-economic aspects of the survey while the environmental and epidemiological results are presented in two other published papers. The socioeconomics investigation, conducted using a questionnaire, concerned 809 households across the various sites of discharge of toxic waste. More than 62% of households had at least one person who had been affected by toxic waste (affected households). 62.47% of these households were in Cocody district (with 2 sites and 4 points of discharge), 30.14% in Abobo district (with 2 sites and 3 points) and 7.39% in Koumassi district (with 1 site and 1 point). To escape the bad smell and the nuisance, 22.75% of the 501 "affected" households had left their houses. To face the health consequences generated by the toxic waste, 30.54% of the "affected" households engaged expenses. Those were on average of 92 450 FCFA (€141), with a minimum of 1 000 FCFA (€1.5) and a maximum of 1500000 FCFA (€2.287), in spite of the advertisement of the exemption from payment treatment fees made by the government. The decision of destroying cultures and farms near the points of discharge of the toxic products in a radius of 200 meters, taken by the authorities, touched 2.22% of the households. For these households, it did nothing but worsen their state of poverty, since the zone of influence of the toxic waste went well beyond the 200 meters prescribed by the authorities as the limit of the operations of destruction.

[Epidemiologic monitoring of human rabies in an endemic canine rabies area in the Ivory Coast]. / Surveillance épidémiologique de la rage humaine dans un contexte d'endémie de rage canine en Cote d'Ivoire.

AIM: The objective of this study was to analyze the epidemiologic monitoring of human rabies in the rabies medical center of Abidjan. PATIENT: A cross-sectional study was undertaken based on files of patients having consulted in the rabies center after exposure and suspicion of human rabies between January 2001 and June 2009. RESULTS: Twenty-six cases of human rabies were reported in 10,706,136 inhabitants (annual incidence of 0.028 cases per 100,000). The number of detected cases increased considerably after reinforcing the monitoring of the disease. Most cases occurred in an urban environment and concerned both sexes. The most concerned age range was under 31 years. The patients' were mostly school children and housewives. In all cases, the rabid animal was a dog and the type of exposure was a bite. Fifty-six percent of the victims had not received any local treatment and almost all no post-exposure prophylaxis. The mean delay before the first symptoms was 49.5 days after exposure and for death, 4 days after the onset of symptoms. Virological diagnosis was made in four cases. CONCLUSION: In spite of the increase of cases observed since 2006, certainly due to reinforcement of the monitoring network, improvement is needed to assess the real incidence of rabies in the Ivory Coast.

[The fight against rabies in Africa: from recognition to action]. / Lutte contre la rage en Afrique: du constat à l'action.

As a follow-up to the first AfroREB (Africa Rabies Expert Bureau) meeting, held in Grand-Bassam (Côte-d'Ivoire) in March 2008, African rabies experts of the Afro-REB network met a second time to complete the evaluation of the rabies situation in Africa and define specific action plans. About forty French speaking rabies specialists from Northern, Western and Central Africa and Madagascar met in Dakar (Senegal), from March 16th to 19th, 2009. With the participation of delegates from Tunisia, who joined the AfroREB network this year, 15 French speaking African countries were represented. Experts from the Institut Pasteur in Paris, the Alliance for Rabies Control, and the Southern and Eastern African Rabies Group (SEARG, a network of rabies experts from 19 English speaking Southern and Eastern African countries) were in attendance, to participate in the discussion and share their experiences. AfroREB members documented 146 known human rabies cases in all represented countries combined for 2008, for a total population of 209.3 million, or an incidence of 0.07 cases per 100,000 people. Even admitting that the experts do not have access to all reported cases, this is far from the WHO estimation of 2 rabies deaths per 100,000 people in urban areas and 3.6 per 100,000 in rural Africa. It was unanimously agreed that the priority is to break the vicious cycle of indifference and lack of information which is the main barrier to human rabies prevention.

[Five years of cholera surveillance in Ivory Coast during social and political crisis, 2001 to 2005]. / Cinq années de surveillance du choléra en Côte d'Ivoire dans un contexte de crise socio-politique, 2001 à 2005.

For an efficient struggle against infectious diseases with epidemic potential, the Cdte d'Ivoire set up a precocious alert system in 2001 with a main objective: to detect epidemics of cholera, measles, yellow fever and meningitis and to provide necessary information for their control and their prevention. During the 2001 to 2005 period, the country was marked by military and political crisis which occurred in 2002; the country had to face up to a reappearance of cholera. How did it evolve in such a context? The question was to describe the performances of the system and the evolution of cholera from weekly data collected by the centers of epidemiological monitoring in health districts. The cases and declared deaths were compiled and the indicators of morbidity and mortality were then studied according to time site and individual features on the period of 2001 to 2005. From 2001 to 2005, 11,874 cases were notified with 564 deaths and a lethal rate of 4.7%. In 2001, from the initial source of infection, the civil jail, the epidemic of cholera disseminated itself through visitors in the whole city of Abidjan where 3250 cases were notified. Out of city, 20 outbreaks have been declared with a total of 3010 cases. The yearly highest impact, 37 living cases/100,000 inhabitants recorded in 2001, decreased regularly until 2005 with 0.2 living cases/100,000. After 2002, outbreaks were located mainly in the half south of the country which welcomed displaced populations from the north, preferably in transition or settling zones near the front line. The lethal rate in Abidjan (2.3%) was less important than that of other health districts (8.6%). The lethal rate globally increased as the impact decreased. Vibrio cholerae was responsible for the epidemics. The group of 15 years old and over was the most affected (12.69 living cases/100,000) whereas the highest lethal rate appeared in the group under 5 years old (6.6%). The reappearance and constant cholera epidemics in Côte d'Ivoire are due to bad general hygiene conditions, insufficient supply of drinking water from wells or packaged, concentration of populations in the south of the country due to war and uncontrolled development of the poor and unsanitary precarious boroughs. Outburst during the dry season is a warning signal of an important epidemic during the raining season especially in poor urban areas. The precocious alert system has permitted to detect the epidemics, to follow up their evolution and to orientate the struggle against cholera in Côte d'Ivoire.

[Compliance with veterinary surveillance orders at the rabies control center in Abijan, Ivory Coast]. / Observance de la surveillance vétérinaire au centre antirabique d'Abidjan.

Rabies remains a major health public health problem in many developing countries. This is particularly the case in the Ivory Coast. Surveillance orders play an important role in patient management. The purpose of this transverse study conducted at Abidjan Rabies Control Center from July 1 to September 30, 2003 was to assess compliance with veterinary surveillance orders by owners of animals that have bitten or scratched persons. Persons reporting to the rabies control center after exposure to the risk of rabies infection and owners of the animals that had bitten, scratched, or licked these persons were included in this study. Most animals involved in these cases (94.8%) were dogs including 69.5% that had been vaccinated. Most persons (71.7 %) at risk reported within two days following exposure and 31.3% provided all three veterinary certificates. The mean time required to provide the first certificate was 4.2 days. The gender of the persona at risk and the vaccination status of the animal involved were correlated with compliance with veterinary surveillance orders. Four main difficulties were cited as hindrances for compliance with veterinary surveillance, i.e., cost (373%), distance (28.4%), time (9.9%), and veterinary clinic accessibility (2.5%). These findings indicate that stricter laws and a national prevention program are needed.

Fighting rabies in Africa: the Africa Rabies Expert Bureau (AfroREB).

Rabies experts from 14 francophone African countries met in Grand Bassam (Côte d'Ivoire), 10-13 March 2008. They presented the situation in their respective countries, acknowledging the lack of rabies awareness among the population, health care workers and health authorities. They recognized that infrastructure for the management of rabies exposure is scarce, modern vaccines are in limited quantity and immunoglobulins are lacking in most of their countries. They defined as a priority the need to have reliable figures on the disease burden, which is necessary for informed decision making and priority setting, and for applying for aid in controlling the disease. This meeting sealed the establishment of the Africa Rabies Expert Bureau (AfroREB).

[Systematic serologic detection of treponema at the antivenereal centre of the National Institute of Public Health in Abidjan (Côte-d'Ivoire), from 1994 to 1999]. / Dépistage systématique sérologique des tréponé- matoses au dispensaire antivénérien (DAV) de l'Ins- titut national d'hygiène publique (INHP) d'Abidjan (Côte-d'Ivoire) de 1994 a 1999.

We conducted a medical records review on 11,662 patients consulting the antivenereal clinic of Treichville from 1994 to 1999. The main objective of the study was to analyse the data from systematic screening of syphilis in this specialized centre for sexual transmitted infection. The results of this study were: 162 (1.39%) patients had active syphilis; we noticed a decreasing incidence of syphilis during the last six years, 98.77% of the patients had symptoms of sexual transmitted diseases that did not directly evoke syphilis. In summary we can say that syphilis remains an important problem in the sexually transmitted infections consultation. The screening of syphilis must continue and needs to be extended to other services, because of the high frequency of asymptomatic forms and the existence of severe complications.

[Impact of aerial mosquito control on populations of Aedes aegypti in two communities of Abidjan]. / Impact de la demoustication sur les populations d'Aedes aegypti de deux communes de la ville d'Abidjan.

INTRODUCTION: From May 2nd to 13th 1997, an aerial mosquito control took place in Abidjan. This mosquitoes control has been undertaken by the municipality. He made two Ultra Low Volume (ULV) applications of d eltamethrine (K O thrineR). The second application took place one week after the first one. Each application used 2g per ha of deltamethrine diluted with gasoil. MATERIALS AND METHOD: We evaluated the impact of this mosquitoes control on Aedes aegypti populations in two districts : Port-Bouët and Yopougon. We compared the bite number per person and per day obtained by catching mosquitoes on human from 16 pm to midnight. RESULTS: We thus captured 308 females of mosquitoes with 33% of Aedes aegypti representing 5.58 bites per person and per day in Port-Bouët and 2.5 bites per person and per day in yopougon. We noticed that 49% of Aedes aegypti live and bite inside. The bite number per person and per day has been reduce to 37.5% after treatment in Port-Bouët and to 66% in Yopougon. But we noted that five days after treatment the bite number per person and per day was the same level before the treatment. Aerial application of insecticide has more impact on Aedes aegypti population biting outside than the population biting inside. CONCLUSION: Aerial application of insecticide reduces the bite number of mosquitoes per person and per day and in particular of Aedes aegypti but this reduction does not last long. This reduction is better on outside population than the inside one; so bio ecology studies are required before aerial application of insecticide.