Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study

Background The 2014 west African epidemic of Ebola virus disease posed a major threat to the health systems of the countries affected. We sought to quantify the consequences of Ebola virus disease on maternal and child health services in the highly-affected Forest region of Guinea. Methods We did a retrospective, observational cohort study of women and children attending public health facilities for antenatal care, institutional delivery, and immunisation services in six of seven health districts in the Forest region (Beyla, Guéckédou, Kissidougou, Lola, Macenta, and N’Zérékoré). We examined monthly service use data for eight maternal and child health services indicators: antenatal care (≥1 antenatal care visit and ≥3 antenatal care visits), institutional delivery, and receipt of five infant vaccines: polio, pentavalent (diphtheria, tetanus, pertussis, hepatitis B virus, and Haemophilus influenzae type b), yellow fever, measles, and tuberculosis. We used interrupted time series models to estimate trends in each indicator across three time periods: pre-Ebola virus disease epidemic (January, 2013, to February, 2014), during-epidemic (March, 2014, to February, 2015) and postepidemic (March, 2015, to Feb, 2016). We used segmented ordinary least-squares (OLS) regression using Newey- West standard errors to accommodate for serial autocorrelation, and adjusted for any potential effect of birth seasonality on our outcomes. Findings In the months before the Ebola virus disease outbreak, all three maternal indicators showed a significantly positive change in trend, ranging from a monthly average increase of 61 (95% CI 38–84) institutional deliveries to 119 (95% CI 79–158) women achieving at least three antenatal care visits. These increasing trends were reversed during the epidemic: fewer institutional deliveries occurred (–240, 95% CI –293 to –187), and fewer women achieved at least one antenatal care visit (–418, 95% CI –535 to –300) or at least three antenatal care visits (–363, 95% CI –485 to –242) per month (p<0·0001 for all). Compared with the negative trend during the outbreak, the change in trend during the post-outbreak period showed that 173 more women per month (95% CI 51–294; p=0·0074) had at least one antenatal care visit, 257 more (95% CI 117–398; p=0·0010) had at least three antenatal care visits and 149 more (95% CI 91–206; p<0·0001) had institutional deliveries. However, although the numbers for these indicators increased in the post-epidemic period, the trends for all stagnated. Similarly, the increasing trend in child vaccination completion during the pre-epidemic period was followed by significant immediate and trend reductions across most vaccine types. Before the outbreak, the number of children younger than 12 months who had completed each vaccination ranged from 5752 (95% CI 2821–8682) for tuberculosis to 8043 (95% CI 7621–8464) for yellow fever. Immediately after the outbreak, significant reductions occurred in the level of all vaccinations except for yellow fever for which the reduction was marginal. The greatest reductions were noted for polio and tuberculosis at –3594 (95% CI –4811 to –2377; p<0·0001) and –3048 (95% CI –5879 to –216; p=0·0362) fewer vaccines administered, respectively. Compared with pre-Ebola virus disease outbreak trends, significant decreases occurred for all vaccines except polio, with the trend of monthly decreases in the number of children vaccinated ranging from –419 (95% CI –683 to –155; p=0·0034) fewer for BCG to –313 (95% CI–446 to –179; p<0·0001) fewer for pentavalent during the outbreak. In the post-Ebola virus disease outbreak period, vaccination coverage for polio, measles, and yellow fever continued to decrease, whereas the trend in coverage for tuberculosis and pentavalent did not significantly differ from zero. Interpretation Most maternal and child health indicators significantly declined during the Ebola virus disease outbreak in 2014. Despite a reduction in this negative trend in the post-outbreak period, the use of essential maternal and child health services have not recovered to their pre-outbreak levels, nor are they all on a course that suggests that they will recover without targeted interventions

Séroprévalence de la co-infection VIH /virus de l’hépatite B à l’Hôpital de l’Amitié sino-guinéenne (HASIGUI) Kipé/Conakry (Guinée)

Objectif: L’objectif de cette étude était de déterminer la séroprévalence de la co-infection Virus de l’immunodéficience humaine et Virus de l’hépatite B (VIH/VHB) et les facteurs associés chez les patients reçus au laboratoire biomédical de l’Hôpital de l’Amitié Sino-guinéenne (HASIGUI).Méthodologie et Résultats: Il s’agit d’une étude prospective qui a été menée du 18 juillet 2016 au 18 Avril 2017 sur 525 patients reçus au laboratoire biomédical de HASIGUI pour des examens biologiques. La détection du VIH et le typage ont été faits par immuno-chromatographie à l’aide des Kits spécifiques. La recherche de l’hépatite B a été réalisée par la détection de l’AgHBs par immuno-chromatographie à l’aide de kits spécifiques et par méthode ELISA. Les résultats obtenus ont montré que la prévalence de la coinfection VIH/VHB était de 2,3%. L’âge moyen des patients était de 37 ans avec des extrêmes de 1 et 83 ans. Le sexe masculin était le plus représenté (71,2%) avec une sex-ratio (H/F) égal 2,47. La tranche d’âge la plus représentée était celle des 25 à 34 ans (37,7%). Les prévalences du VIH et de l’hépatite B étaient respectivement de 10,5 et 17,9%. La prévalence du VIH était plus élevée chez le sexe féminins (P=0,05). Tous les cas de VIH détectés étaient du type 1 (VIH1).Conclusion et application: Il ressort de cette étude que la séroprévalence du VIH et du virus de l’hépatite B sont élevées à Conakry. En revanche, celle de la co-infection VIH/VHB est relativement faible par rapport à la plupart des données rapportées dans d’autres pays d’Afrique Sub-saharienne. Cependant, la coinfection VIH/VHB pourrait être considérée comme un problème de santé publique non négligeable en Guinée, nécessitant ainsi son diagnostic précoce en organisant des campagnes de sensibilisation et de  dépistage dans la population, permettant ainsi une meilleure prise en charge des patients co-infectés (VIH/VHB) par un double traitement antirétrovirales et anti-hépatites B.Mots clés: Co-infection, VIH, AgHBs (VHB), HASIGUI, Kipé/ConakryEnglish Title:  Seroprevalence of Hepatitis B Virus and Human Immunodeficiency Virus Coinfection at the Chinese and Guinean Friendships Hospital (HASIGUI) of Kipé Conakry/ GuineaEnglish AbstractObjective: The aim of this study was to determine the seroprevalence of Hepatitis B virus (HBV) and Human Immunodeficiency virus (HIV) coinfection at the Chinese and Guinean friendships hospital of Kipé/Conakry.Methodology and Results: This prospective study was carried out on 525 patients attending to the biomedical laboratory of Kipé/Conakry (HASIGUI) from July 18th, 2016 to April 18th, 2017. HIV and HBV detection assays were done in the sera of all patients by immunochromatographic methods and ELISA. HIV detection and serotyping were processed in sera by immunochromatographic methods. Hepatitis B virus surface Antigen (HBsAg) was detected by immune-chromatographic methods and confirmed by ELISA. The seroprevalence of HIV/HBV coinfection was 2.3%. The mean age was 37 years, ranging from 1 to 83 years. Males were more represented than females and the sex-ratio (M/F) was 2.47%. HIV seroprevalence was 10,5%, while HBV seroprevalence was 17,9%. The HIV prevalence was high in females than males (P=0.05). HIV1 was the only type screened.Conclusion and application of results: This study findings showed that the seroprevalence of HIV/HBV coinfection rate was lower than that reported in other sub-Saharan Africa countries. HBV and HIV infections were similar to some reported prevalence in other sub-Saharan African countries. Then HIV/HBV coinfection must be considered as an important health problems in Guinea. Then, early diagnosis of HIV/HBV co-infected patients must be done to reduce its evolution and to improve its management practices by organizing awarenes and screening campaigns and treatment for both infections, using molecules against HBV and HIV infections.Keywords: HIV, HBV/HBsAg, Co-infection; HASIGUI; Kipé/Conakr

Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study.

BackgroundThe 2014 west African epidemic of Ebola virus disease posed a major threat to the health systems of the countries affected. We sought to quantify the consequences of Ebola virus disease on maternal and child health services in the highly-affected Forest region of Guinea.MethodsWe did a retrospective, observational cohort study of women and children attending public health facilities for antenatal care, institutional delivery, and immunisation services in six of seven health districts in the Forest region (Beyla, Guéckédou, Kissidougou, Lola, Macenta, and N'Zérékoré). We examined monthly service use data for eight maternal and child health services indicators: antenatal care (≥1 antenatal care visit and ≥3 antenatal care visits), institutional delivery, and receipt of five infant vaccines: polio, pentavalent (diphtheria, tetanus, pertussis, hepatitis B virus, and Haemophilus influenzae type b), yellow fever, measles, and tuberculosis. We used interrupted time series models to estimate trends in each indicator across three time periods: pre-Ebola virus disease epidemic (January, 2013, to February, 2014), during-epidemic (March, 2014, to February, 2015) and post-epidemic (March, 2015, to Feb, 2016). We used segmented ordinary least-squares (OLS) regression using Newey-West standard errors to accommodate for serial autocorrelation, and adjusted for any potential effect of birth seasonality on our outcomes.FindingsIn the months before the Ebola virus disease outbreak, all three maternal indicators showed a significantly positive change in trend, ranging from a monthly average increase of 61 (95% CI 38-84) institutional deliveries to 119 (95% CI 79-158) women achieving at least three antenatal care visits. These increasing trends were reversed during the epidemic: fewer institutional deliveries occurred (-240, 95% CI -293 to -187), and fewer women achieved at least one antenatal care visit (-418, 95% CI -535 to -300) or at least three antenatal care visits (-363, 95% CI -485 to -242) per month (p&lt;0·0001 for all). Compared with the negative trend during the outbreak, the change in trend during the post-outbreak period showed that 173 more women per month (95% CI 51-294; p=0·0074) had at least one antenatal care visit, 257 more (95% CI 117-398; p=0·0010) had at least three antenatal care visits and 149 more (95% CI 91-206; p&lt;0·0001) had institutional deliveries. However, although the numbers for these indicators increased in the post-epidemic period, the trends for all stagnated. Similarly, the increasing trend in child vaccination completion during the pre-epidemic period was followed by significant immediate and trend reductions across most vaccine types. Before the outbreak, the number of children younger than 12 months who had completed each vaccination ranged from 5752 (95% CI 2821-8682) for tuberculosis to 8043 (95% CI 7621-8464) for yellow fever. Immediately after the outbreak, significant reductions occurred in the level of all vaccinations except for yellow fever for which the reduction was marginal. The greatest reductions were noted for polio and tuberculosis at -3594 (95% CI -4811 to -2377; p&lt;0·0001) and -3048 (95% CI -5879 to -216; p=0·0362) fewer vaccines administered, respectively. Compared with pre-Ebola virus disease outbreak trends, significant decreases occurred for all vaccines except polio, with the trend of monthly decreases in the number of children vaccinated ranging from -419 (95% CI -683 to -155; p=0·0034) fewer for BCG to -313 (95% CI-446 to -179; p&lt;0·0001) fewer for pentavalent during the outbreak. In the post-Ebola virus disease outbreak period, vaccination coverage for polio, measles, and yellow fever continued to decrease, whereas the trend in coverage for tuberculosis and pentavalent did not significantly differ from zero.InterpretationMost maternal and child health indicators significantly declined during the Ebola virus disease outbreak in 2014. Despite a reduction in this negative trend in the post-outbreak period, the use of essential maternal and child health services have not recovered to their pre-outbreak levels, nor are they all on a course that suggests that they will recover without targeted interventions.FundingUniversity of Conakry and Centre National de Formation et Recherche de Maferinyah (Guinea)

Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study

Summary: Background: The 2014 west African epidemic of Ebola virus disease posed a major threat to the health systems of the countries affected. We sought to quantify the consequences of Ebola virus disease on maternal and child health services in the highly-affected Forest region of Guinea. Methods: We did a retrospective, observational cohort study of women and children attending public health facilities for antenatal care, institutional delivery, and immunisation services in six of seven health districts in the Forest region (Beyla, Guéckédou, Kissidougou, Lola, Macenta, and N'Zérékoré). We examined monthly service use data for eight maternal and child health services indicators: antenatal care (≥1 antenatal care visit and ≥3 antenatal care visits), institutional delivery, and receipt of five infant vaccines: polio, pentavalent (diphtheria, tetanus, pertussis, hepatitis B virus, and Haemophilus influenzae type b), yellow fever, measles, and tuberculosis. We used interrupted time series models to estimate trends in each indicator across three time periods: pre-Ebola virus disease epidemic (January, 2013, to February, 2014), during-epidemic (March, 2014, to February, 2015) and post-epidemic (March, 2015, to Feb, 2016). We used segmented ordinary least-squares (OLS) regression using Newey-West standard errors to accommodate for serial autocorrelation, and adjusted for any potential effect of birth seasonality on our outcomes. Findings: In the months before the Ebola virus disease outbreak, all three maternal indicators showed a significantly positive change in trend, ranging from a monthly average increase of 61 (95% CI 38–84) institutional deliveries to 119 (95% CI 79–158) women achieving at least three antenatal care visits. These increasing trends were reversed during the epidemic: fewer institutional deliveries occurred (–240, 95% CI −293 to −187), and fewer women achieved at least one antenatal care visit (–418, 95% CI −535 to −300) or at least three antenatal care visits (–363, 95% CI −485 to −242) per month (p<0·0001 for all). Compared with the negative trend during the outbreak, the change in trend during the post-outbreak period showed that 173 more women per month (95% CI 51–294; p=0·0074) had at least one antenatal care visit, 257 more (95% CI 117–398; p=0·0010) had at least three antenatal care visits and 149 more (95% CI 91–206; p<0·0001) had institutional deliveries. However, although the numbers for these indicators increased in the post-epidemic period, the trends for all stagnated. Similarly, the increasing trend in child vaccination completion during the pre-epidemic period was followed by significant immediate and trend reductions across most vaccine types. Before the outbreak, the number of children younger than 12 months who had completed each vaccination ranged from 5752 (95% CI 2821–8682) for tuberculosis to 8043 (95% CI 7621–8464) for yellow fever. Immediately after the outbreak, significant reductions occurred in the level of all vaccinations except for yellow fever for which the reduction was marginal. The greatest reductions were noted for polio and tuberculosis at −3594 (95% CI −4811 to −2377; p<0·0001) and −3048 (95% CI −5879 to −216; p=0·0362) fewer vaccines administered, respectively. Compared with pre-Ebola virus disease outbreak trends, significant decreases occurred for all vaccines except polio, with the trend of monthly decreases in the number of children vaccinated ranging from −419 (95% CI −683 to −155; p=0·0034) fewer for BCG to −313 (95% CI–446 to −179; p<0·0001) fewer for pentavalent during the outbreak. In the post-Ebola virus disease outbreak period, vaccination coverage for polio, measles, and yellow fever continued to decrease, whereas the trend in coverage for tuberculosis and pentavalent did not significantly differ from zero. Interpretation: Most maternal and child health indicators significantly declined during the Ebola virus disease outbreak in 2014. Despite a reduction in this negative trend in the post-outbreak period, the use of essential maternal and child health services have not recovered to their pre-outbreak levels, nor are they all on a course that suggests that they will recover without targeted interventions. Funding: University of Conakry and Centre National de Formation et Recherche de Maferinyah (Guinea

Abstracts of the 1st International Colloquium in Mine & Society

This book presents the abstracts of the selected contributions to the First International Colloquium on Mines and Society (CIMS) organized by The Higher Institute of Mining and Geology of Boke. The theme of this colloquium was "Mining and Sustainable Development, a major challenge for an Emerging Africa" which aims to bring together teachers, researchers, and Professionals from different backgrounds in order to exchange the results of their research work, share their points of view on the issue of mining and sustainable development. It also aims to define, in a collaborative and inclusive manner, research prospects or future projects between all the actors involved in this field. Colloquium Title: 1st International Colloquium in Mine &amp; SocietyTheme: Mining and Sustainable Development, A Major Challenge for an Emerging AfricaColloquium Date: 20-22 May 2022Colloquium Location: A L’Hôtel Rio Nunez de BokeColloquium Organizer: The Higher Institute of Mining and Geology of Bok