Impact of an Antenatal Counseling on Use of Modern Family Planning Methods in the Postpartum in Rural Guinea

In Guinea, family planning (FP) uptake remains low. The objective of this study was to compare the impact of two types of antenatal counseling on modern FP uptake in the postpartum in rural Guinea. This was a two-group non-equivalent study comparing the impact of a reinforced antenatal counseling (intervention) to the routine antenatal counseling (control). The study included 404 pregnant women at five rural health centres in Forécariah district, Western Guinea. Each woman was followed up until the ninth month postpartum. The study was conducted from October 12, 2013 to December 30, 2014. Findings showed that at the ninth month postpartum, use of modern FP was significantly higher in the intervention group than in the control group (5.7% and 1.1%, respectively; p=0.024). However, 67.6% and 65.7% of women in the intervention group and the control group, respectively, abstained from sexual intercourse at the sixth month postpartum and had the intention to do so until the child walks. At the ninth month postpartum such women represented 70.5% and 59.5%, respectively. Therefore, a longer study period is recommended to assess the effect of antenatal counseling on use of modern FP in the postpartum in Guinea. Keywords: Antenatal counseling; Family planning; Postpartum; Rural; Guine

Level of viral load and antiretroviral resistance after 6 months of non-nucleoside reverse transcriptase inhibitor first-line treatment in HIV-1-infected children in Mali

International audienc

Risques climatiques et agriculture en Afrique de l’Ouest

Le futur de l’Afrique de l’Ouest dépend de la capacité du secteur de l’agriculture à s’adapter pour garantir la sécurité alimentaire dans un contexte de changement climatique et de croissance démographique. Pour faciliter cette adaptation, la recherche a déployé d’importants efforts pour améliorer les connaissances sur les mécanismes climatiques et leurs impacts sur les systèmes agropastoraux. Or, ces avancées issues de la recherche ne sont que rarement prises en compte dans la planification et la prise de décision. Partant de ce constat, un projet de recherche « Agriculture et gestion des risques climatiques : outils et recherches en Afrique », soutenu par le ministère français des Affaires étrangères et du Développement international est mené entre 2016 et 2018 dans plusieurs pays d’Afrique de l’Ouest. Il a pour objectif d’élaborer des outils efficaces de gestion du risque climatique pour les agriculteurs, en co-construisant avec des réseaux de chercheurs et d’acteurs directement impliqués dans l’accompagnement de l’agriculture des stratégies innovantes basées sur les résultats de la recherche. Cet ouvrage restitue les principales avancées de cette recherche-action sur trois thématiques prioritaires : les services climatiques pour l’agriculture, la gestion des ressources en eau et l’intensification écologique. Il permet aux acteurs du secteur agricole (organisations paysannes, filières, secteur privé agricole, banques de développement agricole, fournisseurs d’intrants, services agricoles et de météorologie) de s’approprier de nouvelles connaissances et de nouveaux outils pour une meilleure prise en compte des risques climatiques dans la gestion des systèmes de production

Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study.

HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region.Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3).This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population