Profils Sociodemographique, Economique Et Alimentaire Chez Des Enfants Malnutris Aigus, Ages De 06 A 59 Mois, Reçus Au Centre Hospitalier Universitaire De Treichville (Abidjan-Cote D’ivoire)

In this descriptive and transversal work, the main objective is to establish the socio-demographic, economic and nutritional profiles of the children, aged between 06 and 59 months, acutely malnourished, consulted and / or hospitalized in pediatric emergency departments and Of the University Hospital of Treichville (UHT). This study is conducted on 290 children, aged between 06 and 59 months. A questioning anthropometric, socio-demographic, economic and food data allows the diagnosis of the nutritional status of each child and the descriptive statistical analysis of the patient. The results show that the prevalence of acute malnutrition is 55.86%, with 35.17 % cases of severe acute malnutrition and 20.68 % of cases of moderate acute malnutrition. The population of acute malnourished children in this study consisted of 84 girls and 78 boys, a sex ratio of 0.928. The children (133) victims of this type of malnutrition come, predominantly and significantly, from the precarious habitats. 126 have out-of-school mothers and 129 have consumed food of diversification or poor quality supplement. In 110 acute malnutrition, the daily family food budget is between 1500 FCFA and 3000 FCFA. At last, the index of food consumption score, also called food consumption, is referred to as a limit in 98. Finally, in this study, the risk factors having a significant impact on nutritional status are the precariousness of the habitat Place of residence), maternal education, complement food quality or diversification, food insecurity, age of complement and current diet

Application d’un modèle conceptuel et d’un modèle de réseaux de neurones artificiels à la simulation des débits annuels dans le bassin versant du N’zi-Bandama (Côte d’Ivoire)

Cette étude présente la comparaison de deux approches de modélisation de la transformation pluie-débit à l'échelle annuelle : un modèle conceptuel et un réseau de neurones artificiels (RNA). Les deux modèles sont appliqués sur trois sous-bassins du fleuve N’zi-Bandama en Côte d'Ivoire. L’analyse comparative est basée sur les performances de simulation en termes de critère de Nash-Sutcliffe. Les modèles ont été testés sur deux périodes, l’une sèche (1973-1997) et l’autre humide (1961-1972). Les données d’entrée des deux modèles sont la pluie et l’évapotranspiration potentielle au pas de temps annuel. Les principaux résultats de ce travail montrent que les performances des deux modèles (conceptuel et neuronal) restent en général satisfaisantes avec des critères de Nash-Sutcliffe supérieurs à 60%. Ces modèles se sont révélés aussi robustes et adaptés pour la simulation des débits annuels des rivières. La comparaison des deux modèles a montré que le réseau de neurones a obtenu des résultats significativement meilleurs que le modèleconceptuel.Mots-clés : modélisation pluie-débit, modèle conceptuel, réseaux de neurones artificiels, N’zi-Bandama, Côte d’Ivoir.Application of a conceptual model and a model of artificial neural networks for the simulation of annual flows in the N'Zi-Bandama watershed (Ivory Coast).This study presents the comparison of two approaches of modelisation of the rainfall-runoff transformation on an annual scale: a conceptual model and an artificial neural network. The two models are applied to three watersheds of the N’zi-Bandama river in Ivory Coast. The comparative analysis is based on the performances of simulation in terms of criterion of Nash-Sutcliffe. The models were tested over two periods, one dries (1973-1997) and the other wet one (1961-1972). The data input of the two models are the rain and the potential evapotranspiration with the step of annual time. The principal results of this work show that the performances of the two models (conceptual and neuronal) remain satisfactory in general with criteria of Nash-Sutcliffe higher than 60%. These models appeared also robust and adapted for the simulation of the annual flow of the rivers. The comparison of the two models showed that the network of neurons had results significantly better than the conceptual model.Keywords : rainfall-runoff modelling, conceptual model, artificial neural network, N’zi-Bandama, Ivory Coast

Access to water and sanitation infrastructures for primary schoolchildren in the south-central part of Côte d'Ivoire

In rural settings of Côte d'Ivoire, access to water, sanitation, and hygiene (WASH) at schools is often lacking. The purpose of this study was to assess the availability, quality, and use of WASH infrastructure in schools in the south-central part of Côte d'Ivoire, and to determine the hygiene practices of schoolchildren. A cross-sectional study was conducted in 20 primary schools with (n = 10) or without (n = 10) direct access to drinking water. The survey was comprised of a questionnaire directed at schoolchildren aged 8-17 years, an assessment of the WASH infrastructure, and the testing of drinking water samples for Escherichia coli and total coliforms. Overall, 771 schoolchildren were enrolled in the study. One out of four children (24.9%) reported that they used available toilets. Among those children not using toilets, more than half (57.5%) reported that they practised open defecation. Drinking water infrastructure was limited in most schools because of poor storage tanks, the low flow of water, or broken wells. All drinking water samples (n = 18) tested positive for total coliforms and 15 (83.3%) tested positive for E. coli. The lack of WASH infrastructures in primary schools in the south-central part of Côte d'Ivoire, in combination with poor hygiene practices, might govern disease transmission and absenteeism at school, especially among females

Optimizing implementation of preventive chemotherapy against soil-transmitted helminthiasis and intestinal schistosomiasis using high-resolution data: Field-based experiences from Côte d'Ivoire

BACKGROUND: Despite efforts to control neglected tropical diseases (NTDs) using preventive chemotherapy (PC), soil-transmitted helminthiases and schistosomiasis remain widely prevalent in sub-Saharan Africa. The current PC regimen in endemic settings is defined based on health district-level prevalence. This work aims to highlight the need for high-resolution data when elimination, rather than morbidity control, is the targeted goal. METHODOLOGY: Cross-sectional parasitological surveys were conducted from July to August 2019 and from September to October 2019, respectively, across the entire Dabou and Jacqueville health districts in southern Cote d'Ivoire. From every village, 60 school-aged children (6-15 years) were randomly selected and invited to provide one fresh stool sample, whereof duplicate Kato-Katz thick smears were prepared and read by two independent technicians. PRINCIPAL FINDINGS: 4338 school-aged children from 77 villages were screened from the Dabou (n = 2174; 50.12%, 39 villages) and Jacqueville (n = 2164; 49.88%, 38 villages) health districts. The prevalence of any soil-transmitted helminth (STH) infection was 12.47% and 11.09% in the Dabou and Jacqueville health districts, respectively. Species-specific district-level prevalence remained below 10%, varying between 0.51% (hookworm in Jacqueville) and 9.06% (Trichuris trichiura in Dabou). However, when considering sub-districts or villages only, several STH infection hotspots (five sub-districts with >/=20% and four villages with more than 50% infected) were observed. Schistosoma mansoni infection was found in less than 1% of the examined children in each health district. CONCLUSIONS/SIGNIFICANCE: We conclude that keeping health district-level prevalence as a reference for PC implementation leaves many high-risk sub-districts or villages requiring PC (>/=20% prevalence) untreated. To avoid maintaining those high-risk villages as STH reservoirs by skipping control interventions and jeopardizing the successes already achieved in STH control through PC during the past two decades, precision mapping is required. Further investigation is needed to assess cost-efficient approaches to implement small-scale disease surveillance

Management of Vesicouterine fistulae during fistulae surgical caravan in Cote d'Ivoire

Background: The urogenital fistula (UGF) which designate a solution of continuity between the urinary and genital tracts in women, are divided into several entities of variable gravity. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of patients treated for vesicouterine fistula during ‘fistulas surgical caravans’.Methods: This was a prospective and descriptive study on a cohort of 34 patients treated for Vesico-uterine fistulae during ‘‘fistulas surgical caravans '' from 1st January 2012 to 31st December 2016.Results: Vesico uterine fistulae represented 2.1% of all urogenital fistulae treated. At the time of occurrence of fistulas, the average age of the patients stay was 33.3 years, and the majority was not educated (88.2%), lived in rural areas without occupations (73.5%). All the fistulae were secondary to childbirth, the majority of which took place on a scarred uterus (67.6%). And this childbirth responsible for the fistula was done by caesarean section in 97.7% of cases. Then the average duration of the fistula before management was 6 years. Finally, all the patients were operated by the same surgical technique, made by abdominal extra peritoneal transvesical way. The cure rate after this surgical technique was 97.1% (33 patients). The only case of failure required a second operation by another technique which permitted the healing of the patient.Conclusions: The vesicouterine fistulae were rare and the satisfactory results of their management invite us to sustain these surgical caravans and ensure their widespread

Plant yields and fodder quality related characteristics of millet-stylo intercropping systems in the Sahel

In trials at Sadoré, Niger in 1988-90, Pennisetum glaucum cv. Composite Inter-Varietal de Tarna, Stylosanthes fruticosa cv. ILCA 13860 and S. hamata cv. Verano were grown for 1 or 2 years as pure stands or as cereal-legume intercrops with different row ratios. In the 2-year intercrop, P. glaucum was resown on land on which the legume would regrow from the previous crop stubble. Intercropping the legumes with P. glaucum for 1 year in alternate single rows did not affect P. glaucum grain yield because of poor legume competition. Total DM yield of the intercrop was similar to pure P. glaucum, while CP concentration increased significantly with intercropping. During the 2nd year of association the legumes were more competitive, depressing P. glaucum yield by 67% in 1989 and 48% in 1990 compared with pure stands. Yield was decreased more by S. hamata than by S. fruticosa in 1990 but not in 1989, and alternate triple-row sowing of P. glaucum with the legumes gave higher grain yields than alternate single-row sowing in 1990 while the reverse pattern occurred in 1989. Total DM and CP yields, and CP concentration of the harvested fodder were, respectively, 1.4, 3.0 and 2.3 times greater in intercrops than in pure P. glaucum stand

Evaluation des propriétés hydrauliques des aquifères fracturés des formations cristalline et métamorphique dans la région des Lacs (centre de la Côte d’Ivoire)

Groundwater is the main source of water supply for rural populations in the Region des Lacs area in central Côte d’Ivoire (West Africa). The area is underlain by the metamorphic and crystalline fractured hard rock aquifers. This paper focuses on the assessment of their hydraulic properties. To this end, a data base comprising pumping tests data and the technical reports were gathered. 105 values of transmissivity (T ) and specific capacity (Q/s) have been deduced after pumping tests interpretation by the Jacob recovery method. Statistical analyses of all these data have been done. Depth of wells range from 49.50 to 99 m with an average of 69 m. The thickness of the weathered zone has averaged 16.52 m and lies between 1.90 and 63.10 m. Wells average rate is 2.32 m3/s. The depths of open fractures are significantly in the first 60 meters of hard rock drilling and averaged 42.94 m. The transmissivity and specific capacity of each aquifer span over several orders of magnitude revealing the strong heterogeneity of the aquifer. Both variables are lognormal variables A significant empirical relationship between T and Q/s was found T = 0,937(Q/s)^1.118 with a coefficient of determination (R^2 = 0.82). This relationship enabled the transmissivity data to be supplemented with the 95% prediction interval in order to assess the uncertainty associated with the estimates of transmissivity in the area of the study. These results are significant and can be used as an input in forthcoming modeling these aquifers and facilitate groundwater management policy.[fr] Dans la région des Lacs, centre de la Côte d’Ivoire (Afrique de l’Ouest), l’alimentation en eau potable des populations rurales est assurée en majorité par les eaux souterraines contenues dans les aquifères discontinus cristallin et cristallophyllien. L’objet de cet article est d’évaluer les propriétés hydrauliques de ces aquifères afin d’entreprendre des études pour la gestion optimale de cette ressource. Pour ce faire, une compilation de données regroupant les fiches techniques de forage de même que les essais de pompage disponibles dans la région a été faite. L’interprétation des essais de pompage par la méthode de remontée de Jacob a permis de déterminer 105 valeurs de transmissivité (T ) et de débit spécifique (Q/s). Une analyse statistique des paramètres de forages et des paramètres hydrauliques déterminés a été réalisée. Les forages ont une profondeur totale qui varie de 49,50 à 99 m avec une moyenne de 69 m. L’épaisseur des altérites est comprise entre 1,90 et 63,10 m pour une moyenne de 16,52 m. Les forages ont un débit moyen de 2,32 m3/s. Les profondeurs de venues d’eau sont en moyenne de 42,94 m dans la roche non altérée. Les transmissivités et les débits spécifiques s’échelonnent sur trois ordres de grandeur avec des coefficients de variation supérieurs à 100% traduisant ainsi l’hétérogénéité structurale du milieu aquifère. Ces deux paramètres sont également distribués selon la loi log-normale au seuil de 10%. Une relation empirique significative entre la transmissivité et le débit spécifique a été établie. Elle permet d’estimer la transmissivité par l’expressionT = 0,937(Q/s)^1,118 avec R^2 = 0,82 dans un intervalle de confiance de 95% pour les aquifères de la zone d’étude. Ces résultats sont importants car, ils seront utiles dans les études de modélisation de ces aquifères et faciliteront la politique de gestion des eaux souterraines

A Trial of Early Antiretrovirals and Isoniazid Preventive Therapy in Africa

BACKGROUND: In sub-Saharan Africa, the burden of human immunodeficiency virus (HIV)-associated tuberculosis is high. We conducted a trial with a 2-by-2 factorial design to assess the benefits of early antiretroviral therapy (ART), 6-month isoniazid preventive therapy (IPT), or both among HIV-infected adults with high CD4+ cell counts in Ivory Coast. METHODS: We included participants who had HIV type 1 infection and a CD4+ count of less than 800 cells per cubic millimeter and who met no criteria for starting ART according to World Health Organization (WHO) guidelines. Participants were randomly assigned to one of four treatment groups: deferred ART (ART initiation according to WHO criteria), deferred ART plus IPT, early ART (immediate ART initiation), or early ART plus IPT. The primary end point was a composite of diseases included in the case definition of the acquired immunodeficiency syndrome (AIDS), non-AIDS-defining cancer, non-AIDS-defining invasive bacterial disease, or death from any cause at 30 months. We used Cox proportional models to compare outcomes between the deferred-ART and early-ART strategies and between the IPT and no-IPT strategies. RESULTS: A total of 2056 patients (41% with a baseline CD4+ count of ≥500 cells per cubic millimeter) were followed for 4757 patient-years. A total of 204 primary end-point events were observed (3.8 events per 100 person-years; 95% confidence interval [CI], 3.3 to 4.4), including 68 in patients with a baseline CD4+ count of at least 500 cells per cubic millimeter (3.2 events per 100 person-years; 95% CI, 2.4 to 4.0). Tuberculosis and invasive bacterial diseases accounted for 42% and 27% of primary end-point events, respectively. The risk of death or severe HIV-related illness was lower with early ART than with deferred ART (adjusted hazard ratio, 0.56; 95% CI, 0.41 to 0.76; adjusted hazard ratio among patients with a baseline CD4+ count of ≥500 cells per cubic millimeter, 0.56; 95% CI, 0.33 to 0.94) and lower with IPT than with no IPT (adjusted hazard ratio, 0.65; 95% CI, 0.48 to 0.88; adjusted hazard ratio among patients with a baseline CD4+ count of ≥500 cells per cubic millimeter, 0.61; 95% CI, 0.36 to 1.01). The 30-month probability of grade 3 or 4 adverse events did not differ significantly among the strategies. CONCLUSIONS: In this African country, immediate ART and 6 months of IPT independently led to lower rates of severe illness than did deferred ART and no IPT, both overall and among patients with CD4+ counts of at least 500 cells per cubic millimeter. (Funded by the French National Agency for Research on AIDS and Viral Hepatitis; TEMPRANO ANRS 12136 ClinicalTrials.gov number, NCT00495651.)

Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial.

BACKGROUND: Temprano ANRS 12136 was a factorial 2 × 2 trial that assessed the benefits of early antiretroviral therapy (ART; ie, in patients who had not reached the CD4 cell count threshold used to recommend starting ART, as per the WHO guidelines that were the standard during the study period) and 6-month isoniazid preventive therapy (IPT) in HIV-infected adults in Côte d'Ivoire. Early ART and IPT were shown to independently reduce the risk of severe morbidity at 30 months. Here, we present the efficacy of IPT in reducing mortality from the long-term follow-up of Temprano. METHODS: For Temprano, participants were randomly assigned to four groups (deferred ART, deferred ART plus IPT, early ART, or early ART plus IPT). Participants who completed the trial follow-up were invited to participate in a post-trial phase. The primary post-trial phase endpoint was death, as analysed by the intention-to-treat principle. We used Cox proportional models to compare all-cause mortality between the IPT and no IPT strategies from inclusion in Temprano to the end of the follow-up period. FINDINGS: Between March 18, 2008, and Jan 5, 2015, 2056 patients (mean baseline CD4 count 477 cells per μL) were followed up for 9404 patient-years (Temprano 4757; post-trial phase 4647). The median follow-up time was 4·9 years (IQR 3·3-5·8). 86 deaths were recorded (Temprano 47 deaths; post-trial phase 39 deaths), of which 34 were in patients randomly assigned IPT (6-year probability 4·1%, 95% CI 2·9-5·7) and 52 were in those randomly assigned no IPT (6·9%, 5·1-9·2). The hazard ratio of death in patients who had IPT compared with those who did not have IPT was 0·63 (95% CI, 0·41 to 0·97) after adjusting for the ART strategy (early vs deferred), and 0·61 (0·39-0·94) after adjustment for the ART strategy, baseline CD4 cell count, and other key characteristics. There was no evidence for statistical interaction between IPT and ART (pinteraction=0·77) or between IPT and time (pinteraction=0·94) on mortality. INTERPRETATION: In Côte d'Ivoire, where the incidence of tuberculosis was last reported as 159 per 100 000 people, 6 months of IPT has a durable protective effect in reducing mortality in HIV-infected people, even in people with high CD4 cell counts and who have started ART. FUNDING: National Research Agency on AIDS and Viral Hepatitis (ANRS)