Offres De Soins Et Qualité De Vie Des Professionnels (Les) Du Sexe Sous ARV Les Communes De Marcory Et San-Pedro En Côte d’Ivoire

Cette étude a porté sur les PVVIH au niveau des professionnelles du sexe en Côte d’Ivoire, singulièrement dans les communes de Marcory et San Pedro. Malgré les politiques mises en oeuvre au niveau international et national en matière de lutte contre le VIH/SIDA, le taux de contamination ne fait que s’accroître. Ainsi, comment les offres de soins de santé à l’endroit des personnes vivant avec le VIH influencent-elles la qualité de vie des professionnels (les) du sexe sous ARV ? Pour répondre à cette interrogation, l’approche qualitative a été mobilisée. Elle a été réalisée avec un échantillon de 25 professionnels du sexe recrutés à l’aide de l’échantillonnage par réseaux ou en boule de neige. Avec ce groupe cible composé de 8 hommes et de 17 femmes dont l’âge varie de 10-13 à 27 ans et plus, des entrevues approfondies ont été menées. Aussi, 05 représentants de la population experte ont été interviewés. Il en ressort que les représentations sociales des ARV expliquent la non observance du traitement. De la même manière, les itinéraires thérapeutiques, l’environnement social et les difficultés économiques influencent l’état de santé physique et psychologique des PS vivant avec le VIH. Il est aussi pointé du doigt les effets secondaires des médicaments. Leur stigmatisation les encourage à une sorte d’auto-victimation qui les éloigne de plus en plus des traitements antirétroviraux. Malgré tout, une radiographie du système de santé en la matière y compris les dispositifs médicaux est à revoir pour mieux aborder la prise en charge de ces malades. This paper focuses on VPHIV at the level of sex workers in Côte d'Ivoire, particularly in the communes of Marcory and San Pedro. Despite the policies implemented at the international and national level in the fight against HIV/AIDS, the rate of transmission is increasing. So, how does the health care offered to people living with HIV influence the quality of the life of ARV sex workers? To answer this question, the qualitative approach was employed in this study. It was conducted with a sample of 25 sex workers recruited using network or snowball sampling. With this target group of 8 men and 17 women ranging in age from 10-13 to 27 years and over, in-depth interviews were conducted. Also, 05 representatives of the expert population were interviewed. It appears that the social representations of ARVs explain the non-observance of the treatment. Also, therapeutic routes, the social environment, and economic difficulties have a significant positive influence on the physical and psychological health of people living with HIV. Consequently, the side effects of the drug were pointed out. The stigmatization makes them self-victimized, which moves them away from antiretroviral therapy. Nevertheless, a radiography of the health system in this area, including medical devices, should be reviewed to better address the care of these patients

Impact des Intrusions Paysannes sur la Physionomie et la Dynamique de la Végétation de la Forêt Classée de Laouda au Centre-Ouest de la Côte d’Ivoire

Forests disappearance in Côte d’Ivoire is attributable to peasant intrusions into protected areas, including classified forests. The loss of biodiversity is a consequence of this disappearance. Laouda classified forest, which is the subject of this study, is strongly penetrated by peasants for crops. To better understand the impact of these intrusions, this paper focuses on evaluating the dynamics between 1986 and 2017 starting from the satellite imagery, and then to characterize land covers or land uses of the classified forest. The supervised classification method by neuron network was used on the Landsat TM and OLI images of 1986 and 2017. This was preceded by physiognomic characterization of vegetation types. The different vegetation formations present in this classified forest are dense forests, secondary forests, regenerated forest, and fallows. These habitats have low density values (904.16 to 608.33 stems/ ha) and basal area (1.06 to 4.3 m² / ha). The dynamics over time of land use between 1986 and 2017 showed a regression of forests in favor of crops and fallows. Forest formations degradation process is dissection and fragmentation for respectively dense forests and secondary forests. Artificializations or apparitions have been observed at the level of fallows and crops, with the process of creation and aggregation, respectively. During this period, 14.27% or 568.37 ha of the landscape occupied by the forests was converted into crops and fallows. This situation occurs due to demographic pressure and export crops development.La disparition des forêts en Côte d’Ivoire est imputable aux intrusions paysannes dans les aires protégées dont les forêts classées. Cette disparition a pour conséquences la perte de biodiversité. La forêt classée de Laouda, objet de la présente étude, est fortement pénétrée par les paysans à des fins de cultures. Pour mieux comprendre l’impact de ces intrusions, cette étude se propose d’évaluer la dynamique entre 1986 et 2017 à partir de l’imagerie satellitaire, puis de caractériser les occupations ou utilisations du sol de la forêt classée. La méthode de la classification supervisée par le réseau de neurone a été utilisée sur les images Landsat TM et OLI de 1986 et de 2017. Cela a été précédé par la caractérisation physionomique des types de végétation. Les différentes formations végétales présentes dans cette forêt classée sont les forêts denses, les forêts secondaires, les plantations forestières et les jachères. Ces habitats ont de faibles valeurs de densité (904,16 à 1608,33 tiges/ha) et d’aire basale (1,06 à 4,3 m²/ha). La dynamique temporelle de l’occupation du sol entre 1986 et 2017 a montré une régression des forêts au profit des cultures et des jachères. Le processus de dégradation des formations forestières est la dissection et la fragmentation pour respectivement les forêts denses et les forêts secondaires. Les artificialisations ou apparitions ont été observées au niveau des jachères et cultures, avec respectivement le processus de création et d’agrégation. Pendant cette période, 14,27 % soit 568,37 ha du paysage occupé par les forêts ont été converti en cultures et en jachères. Cette situation est consécutive à la pression démographique et au développement des cultures d’exportations

Dynamique et structure de la flore de la Savane Protégée des Feux dans la Réserve Scientifique de Lamto (Centre de la Côte d’Ivoire)

This work that is one of the first of its kind in Unburned Savannah in Lamto, center of Ivory Coast, intends to characterize the vegetation in terms of dynamic evolution and plant structure, 53 years after its protection from fires. Surfaces plot, linear surveys and itinerant methods were used to collect floristic data. The diversity and the wealth of flora, as well as the structure of the different types of vegetation has been analyzed. 176 plant species belonged to genera 143 kinds and 49 families were indentified. The most important families are the Leguminosae (14.77 %), Rubiaceae (13.63 %) and Apocynaceae (10.79 %). About 15.37 % (27 species) of this flora represents the particular statute species. Among the inventoried species, 11 are exploitable species or exploited as timber of which ten are forest species. Due to richnes of its flore and flora dynamic, the Unburned Savannah must be protected. Based on an ascending hierarchical classification performed by using 11 linear surveys, this study has demonstrated the existence of a floristic variability to three groups

Distribution of ace-1R and resistance to carbamates and organophosphates in Anopheles gambiae s.s. populations from Côte d'Ivoire

<p>Abstract</p> <p>Background</p> <p>The spread of pyrethroid resistance in <it>Anopheles gambiae s.s. </it>is a critical issue for malaria vector control based on the use of insecticide-treated nets. Carbamates and organophosphates insecticides are regarded as alternatives or supplements to pyrethroids used in nets treatment. It is, therefore, essential to investigate on the susceptibility of pyrethroid resistant populations of <it>An. gambiae s.s. </it>to these alternative products.</p> <p>Methods</p> <p>In September 2004, a cross sectional survey was conducted in six localities in Côte d'Ivoire: Toumbokro, Yamoussoukro, Toumodi in the Southern Guinea savannah, Tiassalé in semi-deciduous forest, then Nieky and Abidjan in evergreen forest area. <it>An. gambiae </it>populations from these localities were previously reported to be highly resistant to pyrethroids insecticides. Anopheline larvae were collected from the field and reared to adults. Resistance/susceptibility to carbamates (0.4% carbosulfan, 0.1% propoxur) and organophosphates (0.4% chlorpyrifos-methyl, 1% fenitrothion) was assessed using WHO bioassay test kits for adult mosquitoes. Then, PCR assays were run to determine the molecular forms (M) and (S), as well as phenotypes for insensitive acetylcholinesterase (AChE1) due to G119S mutation.</p> <p>Results</p> <p>Bioassays showed carbamates (carbosulfan and propoxur) resistance in all tested populations of <it>An. gambiae s.s. </it>In addition, two out of the six tested populations (Toumodi and Tiassalé) were also resistant to organophosphates (mortality rates ranged from 29.5% to 93.3%). The M-form was predominant in tested samples (91.8%). M and S molecular forms were sympatric at two localities but no M/S hybrids were detected. The highest proportion of S-form (7.9% of <it>An. gambiae </it>identified) was in sample from Toumbokro, in the southern Guinea savannah. The G119S mutation was found in both M and S molecular forms with frequency from 30.9 to 35.2%.</p> <p>Conclusion</p> <p>This study revealed a wide distribution of insensitive acetylcholinesterase due to the G119S mutation in both M and S molecular forms of the populations of <it>An. gambiae s.s. </it>tested. The low cross-resistance between carbamates and organophosphates highly suggests involvement of other resistance mechanisms such as metabolic detoxification or F290V mutation.</p

Niveau De Contamination Du Poivron (Capsicum L., 1753) Par Les Pesticides

The study was done on two species of peppers capsicumannuum and capsicum fructescens. It concerned ninety samples of these two species, collected during three countrysides in two localities of Côte d’Ivoire (Bouake and Dabou). These samples were handled by means of a liquid-phase leading chromatograph SHIMADZU with the aim of determining the residues of pesticides. The observed results revealed a contamination of both species : capsicum annuum and capsicum fructescens, indeed, six residues of pesticides (chlorothalonil, chlorpyrifos, carbendazim, maneb, dimethoate and lambdacyaholothrine) were detected in these two species distributed in four families of pesticides (organochlorines, organophosphates, carbamates and pyrethrinoïds). The analysis showed that pyrethrinoïdes with respective proportions of 76,17% and 75,95% in capsicum annuum and capsicum fructescens were the most important ; followed organophosphate with respective proportions of 10,93% and 20,04% in capsicum annuum and capsicum fructescens.The study also showed that the concentrations of residues of pesticides detected in the edible part (pericarp ) peppers are appreciably equal those found in the part inedible(pulp). However, the residues of pesticides detected in peppers of both localities have all average concentrations lower than the standards established by the Codex Alimentarius

Évaluation du Risque Cardiovasculaire Absolu Chez les Patients Hémodialysés Diabétiques et Non diabétiques au Centre National d’Hémodialyse de Donka Conakry

Le risque cardiovasculaire chez les hémodialysés semble varier en fonction du statut diabétique ainsi que d’autres facteurs associés et constitue un problème de santé publique en Afrique en général et particulièrement en Guinée. Dans ce sens, l’objectif de cette étude était d’évaluer le risque de survenue d’une pathologie cardiovasculaire absolu chez les patients hémodialysés diabétiques, par rapport aux patients hémodialysés non diabétiques. La présente, étude transversale, descriptive et analytique a été réalisée entre le 1 ier avril et le 30 juin 2019 au Centre National d’Hémodialyse de Donka. L’étude a inclus les 140 patients hémodialysés durant la période. Le recrutement était exhaustif et concernait tous les patients hémodialysés répondant aux critères de sélection. Les données ont été recueillies prospectivement chez les patients hémodialysés puis compilées et traitées dans Epi info. 7.2.2.6. Un questionnaire semi-administré a été utilisé à ce fin. Pour évaluer le risque cardiovasculaire chez les patients le FRAMINGHAM RISK SCORE (FRS) a été aussi utilisé. L’enquête a concerné 140 individus dont 91 (65,00%) étaient des hommes, contre 49 (35,00%) de femmes, soit un sex- ratio de 1,86 soit 2 hommes pour une femme. L’âge moyen était de 41 ± 4,1 ans avec des extrêmes de (30 ; 74) ans. On notait une prédominance chez les hommes des facteurs de risque, pour le tabagisme. L’étude a trouvé 39 diabétiques contre 101 non diabétiques. Le risque était élevé chez 23 diabétiquessur 39 ; et 25 sur 101 des patients non diabétiques. L’étude montre qu’un patient sur quatre aurait un risque absolu élevé chez les patients non diabétiques et un patient sur deux chez les patients diabétiques. Ce risque est majoré par d’autres facteurs associés. Introduction: Cardiovascular risk in hemodialysis appears to vary depending on diabetic status and other associated factors and is a public health problem in Africa in general and particularly in Guinea. The objective of this study was to assess the risk of absolute cardiovascular disease in diabetic hemodialysis patients, compared to non-diabetic hemodialysis patients. Methods: Between April 1 and June 30, 2019, a descriptive and analytical cross-sectional study was conducted at the National Hemodialysis Centre in Donka. The study included 140 hemodialysis patients during the period. Recruitment was comprehensive and involved all hemodialysis patients meeting the selection criteria. The data were collected prospectively in hemodialysis patients and then compiled and processed in Epi info. 7.2.2.6. A semi-administered questionnaire had been used. To assess cardiovascular risk in patients, FRAMINGHAM RISK SCORE (FRS) was used. Results: The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking. The study found 39 diabetics versus 101 non-diabetics. The risk was high in 23 out of 39 diabetics; and 25 out of 101 non-diabetic patients. Conclusion: The study shows that one in four patients would have a high absolute risk in diabetic and non-diabetic patients and also confirms the association of other factors that increase this risk. The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking and diabetes. In our series, most of our patients had a low risk level of 56 (40%). Conclusion: This survey finds a low risk in this hemodialysis population. This should lead to strengthening strategies for preventing cardiovascular disease in this at-risk population

R ES EA R CH Open Access Phenetic and genetic structure of tsetse fly populations (Glossina palpalis palpalis) in southern Ivory Coast

Abstract Background: Sleeping sickness, transmitted by G. p. palpalis, is known to be present in the Ivory Coast. G. p. palpalis has recently been reported to occur in several places within the town of Abidjan, including: (i) the Banco forest, (ii) the Abobo Adjamé University campus and (iii) the zoological park. Could these three places be treated sequentially, as separate tsetse populations, or should they be taken as one area comprising a single, panmictic population? Methods: The amount of gene flow between these places provides strategic information for vector control. It was estimated by the use of both microsatellite DNA and morphometric markers. The idea was to assess the interest of the faster and much less expensive morphometric approach in providing relevant information about population structure. Thus, to detect possible lack of insect exchange between these neighbouring areas of Abidjan, we used both genetic (microsatellite DNA) and phenetic (geometric morphometrics) markers on the same specimens. Using these same markers, we also compared these samples with specimens from a more distant area of south Ivory Coast, the region of Aniassué (186 km north from Abidjan). Results: Neither genetic nor phenetic markers detected significant differentiation between the three Abidjan G. p. palpalis samples. Thus, the null hypothesis of a single panmictic population within the city of Abidjan could not be rejected, suggesting the control strategy should not consider them separately. The markers were also in agreement when comparing G. p. palpalis from Abidjan with those of Aniassué, showing significant divergence between the two sites. Conclusions: Both markers suggested that a successful control of tsetse in Abidjan would require the three Abidjan sites to be considered together, either by deploying control measures simultaneously in all three sites, or by a continuous progression of interventions following for instance the &quot;rolling carpet&quot; principle. To compare the geometry of wing venation of tsetse flies is a cheap and fast technique. Agreement with the microsatellite approach highlights its potential for rapid assessment of population structure

Multicentric assessment of the efficacy and tolerability of dihydroartemisinin-piperaquine compared to artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa

<p>Abstract</p> <p>Background</p> <p>The choice of appropriate artemisinin-based combination therapy depends on several factors (cost, efficacy, safety, reinfection rate and simplicity of administration). To assess whether the combination dihydroartemisinin-piperaquine (DP) could be an alternative to artemether-lumefantrine (AL), the efficacy and the tolerability of the two products for the treatment of uncomplicated falciparum malaria in sub-Saharan Africa have been compared.</p> <p>Methods</p> <p>A multicentric open randomized controlled clinical trial of three-day treatment of DP against AL for the treatment of two parallel groups of patients aged two years and above and suffering from uncomplicated falciparum malaria was carried out in Cameroon, Côte d'Ivoire and Senegal. Within each group, patients were randomly assigned supervised treatment. DP was given once a day for three days and AL twice a day for three days. Follow-up visits were performed on day 1 to 4 and on day 7, 14, 21, 28 to evaluate clinical and parasitological results. The primary endpoint was the recovery rate by day 28.</p> <p>Results</p> <p>Of 384 patients enrolled, 197 were assigned DP and 187 AL. The recovery rates adjusted by genotyping, 99.5% in the DP group and 98.9% in the AL group, were not statistically different (p = 0.538). No Early Therapeutic Failure (ETF) was observed. At day 28, two patients in the DP group and five in AL group had recurrent parasitaemia with <it>Plasmodium falciparum</it>. In the DP group, after PCR genotyping, one of the two recurrences was classified as a new infection and the other as recrudescence. In AL group, two recurrences were classified after correction by PCR as recrudescence. All cases of recrudescence were classified as Late Parasitological Failure (LPF). In each group, a rapid recovery from fever and parasitaemia was noticed. More than 90% of patients did no longer present fever or parasitaemia 48 hours after treatment. Both drugs were well tolerated. Indeed, no serious adverse events were reported during the follow-up period. Most of the adverse events which developed were moderate and did not result in the treatment being stopped in either treatment group.</p> <p>Conclusions</p> <p>Dihydroartemisinin-piperaquine was as effective and well-tolerated as artemether-lumefantrine in the treatment of uncomplicated falciparum malaria. In addition, dihydroartemisinin-piperaquine, a single daily dose, could be an advantage over artemether-lumefantrine in Africa because of better treatment observance.</p

Ebola virus disease in West Africa — the first 9 Months of the epidemic and forward projections

BACKGROUND On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a "public health emergency of international concern." METHODS By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa - Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14. RESULTS The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R-0) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total. CONCLUSIONS These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months