Tuberculose ostéoarticulaire (mal de Pott exclu) : à propos de 120 cas à Abidjan

Introduction: La tuberculose ostéoarticulaire (TOA) représente 2 à 5 % de l'ensemble des tuberculoses .Elle demeure d'actualité surtout dans les pays à forte endémicité tuberculeuse. L'objectif était de déterminer la prévalence, les aspects topographiques, radiologiques de la TOA en milieu hospitalier ivoirien. Méthodes: Les auteurs rapportent une expérience de 11 ans, à travers une étude rétrospective de 120 dossiers de patientsatteints de la tuberculose ostéoarticulaire (le mal de Pott est exclu de cette étude).N'ont pas été inclus dans l'étude les dossiers ne comportant pas d'imagerie. Résultats: L'atteinte extra vertébrale représentait 09,2% de la tuberculose ostéoarticulaire. Il s'agissait de 54 hommes et 66 femmes, l'âge moyen était de 43,13 ans. On notait 123 cas d'ostéoarthrites, et 8 cas d'ostéites des os plats. L'atteinte des membres inférieurs prédominait dans 91,87% des cas. La hanche était la première localisation (45,04%), suivie du genou (25,19%). Les atteintes étaient multifocales dans 20% des cas. L'atteinte osseuse était associée à une tuberculose pulmonaire dans 05,83% des cas. Des localisations inhabituelles ont été rapportées : poignet (n=2), branches ischiopubiennes (n=4), atteinte sternoclaviculaire (n=4), médiopieds (n=2). Les lésions radiologiques étaient avancées (stades III et IV) dans 55,73% des cas. A la TDM, la prévalence des abcès était de 77%. Un geste chirurgical a été réalisé sur 16 articulations (2 épaules, 13 genoux, une cheville). Conclusion: La TOA des membres est peu fréquente contrairement à l'atteinte vertébrale. La hanche est la principale localisation. Le retard au diagnostic explique l'étendue des lésions anatomoradiologiques

A rare case of anatomical variation of the femoral artery and vein

During a dissection of the two femoral trigons in a female corpse, about 14 years old, we discovered on the right side, the deep artery of the thigh arising from the medial side of the femoral artery and passed in front of the femoral vein above the mouth of the great saphenous vein; on both sides, there was the presence of a collateral canal which communicated the external iliac vein with the femoral vein on the right, on the left, it communicated the external iliac vein with the quadricipital vein. The lower part of the femoral vein was duplicated on both sides, but on the right, there was an interconnecting channel between the two trunks of the duplication. Variations of the femoral vessels are very frequent and can be responsible for an incident during the practice of certain gestures at the level of the femoral trigon such as: catheterization of the femoral artery or vein, the treatment of femoral hernias. Key words: Deep thigh artery, collateral venous canal, external iliac vein, anatomic variations

Improving coverage of antenatal iron and folic acid supplementation and malaria prophylaxis through targeted information and home deliveries in Côte d'Ivoire: a cluster randomised controlled trial

INTRODUCTION: Coverage of antenatal iron and folic acid (IFA) supplementation and malaria chemoprophylaxis remains low in many low-income and middle-income settings. We assessed the effectiveness of personal information (INFO) sessions and personal information session plus home deliveries (INFO+DELIV) to increase coverage of IFA supplementation and intermittent preventive treatment in pregnancy (IPTp), and their effectiveness on postpartum anaemia and malaria infection. METHODS: We included 118 clusters randomised to a control (39), INFO (39) and INFO+DELIV (40) arm, in a trial conducted between 2020 and 2021 with pregnant women (age >/=15 years) in their first or second trimester of pregnancy in Taabo, Cote d'Ivoire. We used generalised linear regression models to assess intervention impact in postpartum anaemia and malaria parasitaemia, and displayed resulting estimates as prevalence ratios. RESULTS: Overall, 767 pregnant women were enrolled and 716 (93.3%) were followed up after delivery. Neither intervention had an impact on postpartum anaemia, with estimated adjusted prevalence ratios (aPRs) of 0.97 (95% CI 0.79 to 1.19, p=0.770) for INFO and 0.87 (95% CI 0.70 to 1.09, p=0.235) for INFO+DELIV. While INFO had no effect on malaria parasitaemia (aPR=0.95, 95% CI 0.39 to 2.31, p=0.915), INFO+DELIV reduced malaria parasitaemia by 83% (aPR=0.17, 95% CI 0.04 to 0.75, p=0.019). No improvements in antenatal care (ANC) coverage (aPR=1.05, 95% CI 0.81 to 1.36, p=0.692), IFA (aPR=2.00, 95% CI 0.89 to 4.46, p=0.093) and IPTp (aPR=1.03, 95% CI 0.87 to 1.21, p=0.728) compliance were found for INFO. INFO+DELIV increased ANC attendance (aPR=1.35, 95% CI 1.02 to 1.78, p=0.037) and compliance with IPTp (aPR=1.60, 95% CI 1.41 to 1.80, p<0.001) and IFA recommendations (aPR=7.06, 95% CI 3.68 to 13.51, p<0.001). CONCLUSIONS: INFO+DELIV can substantially increase compliance with IFA supplementation and improve malaria prevention. However, the increases in IFA supplementation are likely insufficient to address the prevalence of often severe anaemia in this population. TRIAL REGISTRATION NUMBER: NCT04250428

Study protocol of a cluster randomized controlled trial of strategies to increase antenatal iron and folic acid supplementation and malaria prophylaxis in rural south-central Côte d'Ivoire

BACKGROUND: Coverage of antenatal iron and folic acid supplementation (IFAS) and intermittent preventive treatment of malaria in pregnancy (IPTp) remains low in many countries. Evidence on the most effective ways to increase both IFASIPTp is mixed overall, with only few studies directly identifying cost-effective ways to increase coverage of both interventions. The proposed study aims to assess the cost, impact and relative cost-effectiveness of two complementary strategies of increasing IFAS and malaria chemoprophylaxis coverage among pregnant women relative to the current default system in a rural low-income setting of sub-Saharan Africa. METHODS/DESIGN: This study will be carried out in the Taabo health and demographic surveillance system (HDSS) in south-central Cote d'Ivoire. This is a cluster-randomized trial targeting 720 consenting pregnant women aged >/=15 years. The 118 clusters constituting the Taabo HDSS monitoring area will be randomly allocated to one of the following three groups with equal probability: a control group, an information only group, and an information plus home delivery group. To assess the relative effectiveness of each strategy, we will conduct an endline survey within the first 2 weeks after delivery. The primary outcomes of the trial will be maternal post-partum anaemia and malaria infection. Anaemia will be assessed using HEMOCUE devices; malaria infections will be assessed using standard rapid diagnostic tests named CareStart Malaria Pf (HRP2) Ag RDT (Multi Kit with capped lancet and inverted cup specimen transfer device). Other outcomes will include self-reported adherence to supplementation and malaria chemoprophylaxis, as well as miscarriages, stillbirths and low birth weight deliveries. DISCUSSION: This study will assess the cost-effectiveness of two alternative strategies to increase antenatal IFAS and malaria chemoprophylaxis coverage among pregnant women in rural Cote d'Ivoire and similar settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT04250428 ; Registered 31 January 2020

Variabilité Climatique Et Changements Dans L’environnement À Korhogo En Côte D’ivoire : Mythes Ou Réalité ?

Climate change which is considered as a threat to biodiversity, causes paradoxical situations everywhere it manifests itself. These include, among others, drought and desertification; floods and storms; sea level rise, reduction of the vegetation cover; water supply sources and, animal and plant species disappearance. In Korhogo, in the North of Côte d’Ivoire, the climate variability and environmental change phenomena are perceived and described by the population. A qualitative approach with historical and comparative analysis tools are used in this study to focus on the perceptions of the populations through indicators of both climate variability and environmental changes. It also analyses the major challenges the population will face, which are mainly related to alteration in farming practices and seasons, loss of production, and extension of the lean period, the risk of food insecurity and conflicts related to the exploitation and the distribution of water resources; and mostly, to the lack of information- educationcommunication on the phenomenon. On the whole, although the study brings out an awareness about climate variability and environmental changes, it especially show the need for emergent multidimensional actions for effective response strategies to the changes observed in the area

Pression d’inoculum de la maladie des raies noires (MRN) causée par Mycosphaerella fijiensis Morelet, dans les plantations industrielles de bananiers, en Côte d’ivoire

The Black Leaf Streak Disease (BLSD) is one of main parasitic constraints of the agro-industrial plantations of banana in the world. Caused by a fungus ascomycete (Mycosphaerella fijiensis Morelet), the losses of yield are up to 50 %, without of resistant cultivars and effective management. This study relative to the level of the disease has been conducted in 12 industrial plantation in 6 production area: Aboisso, Grand- Bassam, Dabou, Agboville, Azaguié and Tiassalé; for a total surface of 2576 ha. The observations concerned the ranks of Youngest Leaf Spotted (YLS), of the Youngest Leaf Necrosed (YLN), the Number of Standing Leaves (NSL) and the gap between the Youngest Leaf Spotted and the Number of Standing Leaves. The results showed that chronic re-infestation of industrial plantation during the last five years, except CDBCI Tiassalé-Songon in 2011 and 2012. An acceptable level of re-infestation was observed in 2012 on other plantations, with the rank of YLS greater than or equal to 3, except BATIA Tiassalé and CDBCI Azaguié. The internal inoculum pressure (YLS) varied a lot from one plantation to another and from one year to another. Except plantation SBMK Aboisso and BATIA Tiassalé, other plantations had at least one value of the rank of the top YLS or equal to 8, during the study indicating a relatively low severity of the BLSD. From 2009 to 2012, all plantations have shown over 8 standing leaves, the minimum required for proper filling of the bunch of banana regime at the time of flowering

Évaluation de la sensibilité de sept clones de palmier à huile (Elaeis guineensis Jacq.) à Coelaenomenodera lameensis Berti et Mariau (Coleoptera, Chrysomelidae) Konan J.

Objectifs : Évaluer la sensibilité de 7 clones d’Elaeis guineensis à Coelaenomenodera lameensis (Coleoptera : Hispinae) et estimer les dégâts occasionnés par l’insecte au terme d’un cycle de développement complet sur chaque type de matériel clonal.Méthodologies et Résultats : des insectes adultes de C. lameensis ont été transposés sur des folioles de clones d’Elaeis guineensis isolés dans des manchons. L’évolution des insectes a été ensuite observée à chaque étape du cycle normal de développement de C. lameensis. Les dégâts provoqués par l’insecte ont été estimés par le rapport entre la surface de foliole attaquée et la surface totale de foliole. Les résultats ont montré que certains clones étaient moins favorables au développement de l’insecte que d’autres. Le clone LMC247, avec 53,80 % ± 2,56 de surface foliaire attaquée, a été plus sensible à l’insecte que les autres clones LMC159, LMC161, LMC022, LMC010, LMC270 et LMC291 où les dégâts observés ont été en dessous de 25%..Conclusion et Application : au regard des résultats, il ressort que le développement de C. lameensis est influencé par le type de matériel clonal. Les dégâts sur les clones testés ont été généralement de faible intensité. Cette approche expérimentale, laisse présager de bonnes perspectives pour la lutte génétique contre C. lameensis.. En effet, plus de 300 clones de palmier ont déjà été crées en Côte d’Ivoire. Un criblage élargi à l’ensemble de ce matériel va permettre d’identifier à terme des clones performants pour contrôler le ravageur, au regard de l’homogénéité de ce type de matériel végétal.Mots clés : clone, palmier à huile, lutte génétique, Coelænomenodera lameensisEvaluation of seven oil palm clones (Elaeis guineensis Jacq.) sensibility to Coelaenomenodera lameensis Berti and Mariau (Coleoptera, Chrysomelidae)Objective: this study aims to evaluate seven oil palm clones sensibility to Coelaenomenodera lameensis (Coleoptera: Hispinae) and to estimate the damage caused by this insect on each type of clonal material.Methods and results: adult insects of C. lameensis were transposed on Elaeis guineensis clones leaflets isolated in canvas bags. Insect evolution was observed at each stage of normal development cycle of C. lameensis. The damage caused by the insect was estimated using the ratio of the surface of leaflet attacked and the total surface of leaflet. The results showed that some clones were less favorable to the development of C. lameensis than others. The clone LMC247, with 53.80 ± 2.56% of leaf surface attacked was more susceptible to C. lameensis than the other clones LMC159, LMC161, LMC022, LMC010, LMC270 and LMC291. For these clones, the damages noted were below 25% of leaf area attacked.Conclusion and application: the results showed that C. lameensis development depended of the clones. Overall, a low intensity of damage was observed on the leaflet of the clones. This experimental approach suggests good projection for genetic control of C. lameensis with oil palm clone material. Indeed, more than 300 oil palm clones have already been established in Côte d'Ivoire. The screening of this material can help selecting performing material to control the pest due to the homogeneity of this type of plant material. Key words: clone, oil palm, genetic control, Coelænomenodera lameensi

Impact of newly constructed primary healthcare centres on antenatal care attendance, facility delivery and all-cause mortality: quasi-experimental evidence from Taabo health and demographic surveillance system, Côte d'Ivoire

OBJECTIVES: Access to quality care remains limited, particularly in low-income and middle-income countries. Although better health outcomes for families living in close proximity to healthcare facilities have been documented in cross-sectional studies, evidence on the extent to which additional health facilities can contribute to improved population health remains scanty. We aimed to estimate the causal impact of newly constructed primary healthcare facilities within a health and demographic surveillance (HDSS) site in Cote d'Ivoire. DESIGN: We conducted a quasi-experimental study. Logistic and Cox proportional hazards regression models were used to estimate the impact of new healthcare facilities on healthcare-seeking behaviour and all-cause mortality. SETTING: Data were collected prospectively through the Taabo HDSS located in south-central Cote d'Ivoire between 2010 and 2018. PARTICIPANTS: We analysed 2957 deaths across 440 973 person-year observations as well as 14 132 live births. PRIMARY OUTCOME MEASURES: The primary outcomes were antenatal care (ANC) attendance, facility delivery and mortality. Logistic and Cox proportional hazards models were employed to estimate the impact of the new health facilities on ANC attendance, facility delivery and child as well as adult mortality. RESULTS: Average distance to the nearest healthcare facility declined from 5.5 km before to 2.8 km after opening of four new healthcare facilities in targeted villages. No improvement was observed for ANC attendance, institutional deliveries and adult mortality. New facilities reduced the risk of post-neonatal infant mortality by 46% (HR 0.54, 95% CI 0.31 to 0.94, p<0.05), suggesting a mortality gradient of 2 deaths per 1000 for each additional km (Coef=0.002, 95% CI 0.000 to 0.004, p<0.05). CONCLUSIONS: Our results suggest that new facilities do not necessarily improve healthcare utilisation and health outcomes. Further research is needed to identify the best ways to ensure access to quality care in resource-constrained settings