Assessment of Post-abortion Care Services in Two Health Facilities in Conakry, Guinea

High quality post-abortion care (PAC) is needed to curb maternal deaths by providing effective treatment and preventing future unintended pregnancies through PAC family planning. This study aimed at assessing PAC services with a focus on women‘s satisfaction with care they received in two health facilities in Conakry. We conducted a cross-sectional mixed method study with 426 PAC clients from March 1st to August 31st, 2014. Data analyses were performed using Stata software version 14 for quantitative data and using a thematic approach for qualitative data. Overall, 92.5% of women were satisfied with PAC services they received. The short waiting time (< 30 min), the appropriate management of pain during the treatment, the affordable cost of the treatment, the confidentiality of services, the good patient-provider interaction and the cleanliness of the premises were factors statistically significantly associated with the satisfaction of women (P-value ˂ 0.001). This study showed a high rate ofwomen‘s satisfaction. Nevertheless, health authorities should assure a regular follow-up on the application of official prices for the treatment of PAC patients; and providers should further consider aspects such as pain management during treatment, confidentiality of services, patient-provider interaction for optimal satisfaction of clients with PAC services. Keywords: Assessment, Post-abortion care, Health facilities, GuineaDes soins post-avortement (SAA) de haute qualité sont nécessaires pour réduire les décès maternels en fournissant un traitement efficace et en prévenant les futures grossesses non désirées grâce à la planification familiale après-avortement. Cette étude visait à évaluer les services de SAA en mettant l'accent sur la satisfaction des femmes à l'égard des soins qu'elles ont reçus dans deux établissements de santé à Conakry. Nous avons mené une étude transversale à méthodes mixtes auprès de 426 clientes de SAA du 1er mars au 31 août 2014. Les analyses de données ont été réalisées à l'aide du logiciel Stata version 14 pour les données quantitatives et en utilisant une approche thématique pour les données qualitatives. Dans l'ensemble, 92,5% des femmes étaient satisfaites des services de SAA qu'elles ont reçus. Le temps d'attente court (<30 min), la gestion appropriée de la douleur pendant le traitement, le coût abordable du traitement, la confidentialité des services, la bonne interaction patiente -prestataire et la propreté des locaux étaient des facteurs statistiquement significativement associés à la satisfaction des femmes (valeur P ˂0,001). Cette étude a montré un taux élevé de satisfaction des femmes. Néanmoins, les autorités sanitaires devraient assurer un suivi régulier de l'application des prix officiels pour le traitement des patientes de SAA; et les prestataires devraient en outre prendre en compte des aspects tels que la gestion de la douleur pendant le traitement, la confidentialité des services, l'interaction patiente-prestataire pour une satisfaction optimale des clientes à l‘égard des services de SAA. Mots-clés: Évaluation, Soins post-avortement, Établissements de santé, Guiné

Evaluation of caesarean section practices according to Robson's 10-group classification at a level two maternity ward in Conakry, Guinea

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea

High prevalence of asymptomatic malaria in Forest Guinea: Results from a rapid community survey.

Malaria is endemic in Guinea, however, the extent and role in transmission of asymptomatic malaria are not well understood. In May 2023, we conducted a rapid community survey to determine Plasmodium falciparum prevalence among asymptomatic individuals in Middle Guinea (prefecture Dalaba) and Forest Guinea (prefecture Guéckédou). In Dalaba, 6/239 (2.1%, CI 0.9-4.8%) individuals tested positive for P. falciparum by rapid diagnostic test while in Guéckédou, 147/235 (60.9%, CI 54.5-66.9%) of participants tested positive. Asymptomatic malaria needs to be considered more strongly as a driver for transmission when designing control strategies, especially in Forest Guinea and potentially other hyper-endemic settings

Sampling locations depicting the caves where PCR-positive MARV bats were caught.

Map A shows the sampling locations in Guéckédou prefecture (Guinea) indicating the Koema cave in Sierra Leone where MARV-positive bats were previously found [2]. Map B shows an overview of the sampling area and Guinea. Map C focuses on the area around Legon Tyo Cave and Temessadou M’bokét village. Map D zooms on the area around the Kokongoa cave. Elevation contours on maps C and D are shown for altitudes over 440 m with an interval of 20 m. The base vector layer of the map was downloaded from Natural Earth (https://www.naturalearthdata.com/downloads/10m-physical-vectors/).</p

Phylogenetic tree, distances, and alignment comparing the relationship of the MARV sequence of sample ERB-79 to other marburgviruses.

The sequences from Guinea generated during this study are indicated with asterisks. A: Maximum-likelihood tree (Tamura 3-parameter model with 1000 pseudoreplicates) of partial marburgvirus nucleoprotein gene fragments (92 bp). Scale bar indicates the mean number of nucleotide substitutions per site. The sequences in bold were used in the alignment presented below. The tree is midpoint rooted and the root position is verified by the Ravn virus (DQ447649) outgroup. B: Phylogenetic distances between sample ERB-79 and MARV sequences of different phylogenetic groups that were available in GenBank (35 sequences of Ozolin group, 8 sequences of Musoke group, 6 sequences of Angola-like ERB group, and 13 sequences of Angola human group). Distance is shown as the number of substitutions (on the 92 bp fragment of the NP gene). Solid line represents the median, box shows interquartile range (IQR), whiskers represent 1.5 × IQR, and the circles indicate outliers (values exceeded 1.5 × IQR). C: Aligned fragments (92 bp) of the MARV nucleoprotein gene with highlighted variable sites.</p

Maximum-likelihood phylogeny of 64 partial Marburg virus polymerase gene (L gene) fragments with a total length of 1262 bp.

Tree was constructed using the best-fit nucleotide substitution model (T93+G). Sequences in brown were obtained from ERB, and sequences in black come from human and nonhuman primate samples. The sequence from R. aegyptiacus ID ERB-452 generated in this study is indicated with an asterisk and bold text. Scale bar indicates the mean number of nucleotide substitutions per site. The filled circles on branches indicate bootstrap values greater than 0.9.</p

<i>Rousettus aegyptiacus</i> trapping data with the results of PCR screening on MARV.

Rousettus aegyptiacus trapping data with the results of PCR screening on MARV.</p

Phylogenetic trees of four different fragments of Marburg virus.

Phylogenetic trees of four different fragments of Marburg virus.</p

The Legon Tyo cave.

Panel A: The entrance to the Legon Tyo cave (view from below). The cave is located on a wooded slope surrounded with tall trees that block the view and prevent taking a general view photo. Therefore, the picture of the cave entrance was taken at close range. The entrance to the cave hangs from above with a cornice (The growth direction of the tree in the right corner of the photo helps to understand the orientation of the photo). Panel B: General view of a similar cave located on the opposite (southern) slope of Mount Legon Tyo. This cave has a similar entrance structure, but unlike the Legon Tyo cave, here the slope is not covered with trees and therefore it is clearly visible that the entrance is located high on a steep slope and a person cannot get inside without special equipment.</p

Primers used for sequencing of qRT-PCR positive samples.

Primers used for sequencing of qRT-PCR positive samples.</p