Connaissances des Anomalies du Tube Neural, Attitudes et Pratiques de Prévention chez les Femmes vues en Consultation prénatale, Région de Niamey-Niger, 2017: Knowledge, Attitudes and Prevention Practices of Neural Tube Anomalies in Women attending Prenatal Consultation in the Niamey-Niger Region 2017

Introduction: Les anomalies congénitales sont des anomalies fonctionnelles, structurelles ou métaboliques se produisant en intra-utérin et identifiables avant ou après la naissance. Au Niger, le domaine des anomalies congénitales n'a pas été suffisamment exploré. Notre objectif était de décrire les connaissances des anomalies du tube neural (ATN), les attitudes et les pratiques de prévention chez les femmes vues en consultation prénatale (CPN). Méthodes: Nous avons mené une enquête transversale de Février â Mars 2017 chez les femmes enceintes vues en CPN1 dans les maternités de Niamey. L'échantillon, calculé avec Open Epi était de 421. Les femmes enceintes ont été interviewées sur leurs connaissances des ATN, leurs attitudes et pratiques de prévention devant ces anomalies. Les données ont été collectées avec un questionnaire à travers les 5 districts sanitaires de la region de Niamey. Le nombre de femmes à enquêter par district a été alloué en tenant compte de l'importance relative des femmes en age de procréer (FAP) selon le district. Dans chaque district, il a été choisi par commodité, l'hôpital de district (HD), 2 maternités urbaines et 2 maternités rurales. Le nombre de femme par maternité a été déterminé selon le même procédé que dans les districts. A la maternité, les participantes ont été choisi de manière aléatoire. Des analyses univariées, bivariées et multivariées ont été réalisées. Des ratios de prévalence (RP), OR de prévalence (POR) à 95% ont été calculés. Les variables avec p<0,25 en analyse bivariée, ont été intégrées dans le modèle logistique multiple. Résultats: L'âge médian des enquêtées était de 25 ans. Il y avait 60,81% de scolarisées et 24,33% de primigestes. Environ 30,65% connaissaient les ATN ; 15,92% avaient de bonnes attitudes ; 41,81% avaient utilisées l'acide folique (AF). La tranche d'êge de 25-49ans a été un facteur indépendant de la connaissance des ATN (p=0,0008) ; pour les attitudes : il s'agit de l'âge (25-49ans) (p=0,03), la prise d'AF (p=0,0002) ; pour la pratique : le niveau d'instruction (p=0,01), l'information par les agents de santé (p< 0,0001), la connaissance d'autres sources d'AF (p=0,04). Conclusion: Il y avait une insuffisance de connaissances, d'attitudes et de pratiques de prévention devant les ATN chez les femmes enceintes. L'éducation continue, une politique d'enrichissement en AF de certains aliments s'impose. Background: Congenital anomalies are functional, structural or metabolic abnormalities occurring in the uterus and identifiable before or after birth. In Niger, the field of congenital anomalies has not been sufficiently explored. Our objective was to describe the knowledge of neural tube defects (NTDs), attitudes and prevention practices in women seen in antenatal care (ANC). Methods: We conducted a cross-sectional survey from February to March 2017 among pregnant women seen in CPN1 in maternity hospitals in Niamey. The sample, calculated with Open Epi, was 421. Pregnant women were interviewed on their knowledge of NTDs, their attitudes and prevention practices in the face of these anomalies. The data were collected with a questionnaire across the 5 health districts of the Niamey region. The number of women to be surveyed by district was allocated taking into account the relative importance of women of reproductive age (FAP) by district. In each district, it was chosen by convenience, the district hospital (HD), 2 urban maternities and 2 rural maternities. The number of women per maternity unit was determined using the same procedure as in the districts. In the maternity ward, the participants were chosen at random. Univariate, bivariate and multivariate analyzes were performed. 95% prevalence (PR), OR prevalence (POR) ratios were calculated. Variables with p <0.25 in bivariate analysis were included in the multiple logistic model. Results: The median age of the respondents was 25 years. There were 60.81% of school children and 24.33% of primigravidae. About 30.65% were familiar with ATNs; 15.92% had good attitudes; 41.81% had used folic acid (FA). The age group of 25-49 years was an independent factor of knowledge of NTDs (p = 0.0008); for attitudes: it is about age (25-49 years) (p = 0.03), AF intake (p = 0.0002); for practice: level of education (p = 0.01), information by health workers (p <0.0001), knowledge of other sources of FA (p = 0.04). Conclusion: There was a lack of knowledge, attitudes and prevention practices towards NTDs among pregnant women. Education continues, a policy of fortifying certain foods with AF is required

Etiology and risk factors for meningitis during an outbreak in Batié Health District, Burkina Faso, January-March 2016

Introduction: On 16 March 2016, Batié Health District notified the Burkina Faso Ministry of Health Surveillance unit of 12 suspected cases of meningitis. During the same period, Batié´s neighboring districts in Côte d'Ivoire and Ghana were experiencing a meningitis epidemic. We investigated to establish the etiology and risk factors for the disease and to recommend prevention and control measures. Methods: We conducted unmatched case control study. A case was any person living in Batié with fever (temp. ≥ 38.5°C) and any of the following: neck stiffness, neurological disorder, bulging fontanelle, convulsion during January to April 2016 with cerebrospinal fluid (CSF) positive to PCR. Controls were non sick household members, neighbors or friends to the cases. We analyzed the investigation and laboratory records. We included all confirmed cases and two neighborhood controls per case. We used a standard questionnaire to collect data. We analyzed data by Epi info 7 and calculated odds ratio (ORs),adjusted odds ratios (AOR) and 95% confidence interval. We proceeded to univariate, bivariate, multivariate and logistic regression analysis. Results: We interviewed 93 participants including 31 meningitis cases and 62 controls. The median age of cases was 8 years old [2 months-55 years] and 6.5 years old [5 months-51 years] for controls. Streptococcus pneumoniae 16(51.61%), Neisseria meningitidis W 14(45.16%) and Haemophilus influenzae b 1(3.23%) were the identified germs. The independent risk factors identified were travel to meningitis affected areas (Adjusted odd ratio(AOR)=12[2.3-60],p=0.0029); >5 persons sharing bedroom (AOR=5.7[1.5-22],p=0.012) and rhinopharyngitis (AOR=26[1.8-380],p=0.017). Conclusion: Streptococcus pneumoniae and Neisseria meningitidis W caused the outbreak in Batié. The risk factors were overcrowding, travel to affected areas, and rhinopharyngitis. We recommended reactive vaccination against Neisseria meningitidis W, limited travel to affected areas and ventilation of rooms