Mixed methods study evaluating the implementation of the WHO hand hygiene strategy focusing on alcohol based handrub and training among health care workers in Faranah, Guinea

Introduction The most frequent adverse health events in healthcare worldwide are healthcare-associated infection. Despite ongoing implementation of the WHO multimodal Hand Hygiene (HH) Improvement Strategy, healthcare-associated infection rate continues to be twofold higher in low- than in high-income countries. This study focused on continued evaluation of HH compliance and knowledge. The mixed method approach, with inclusion of patients and care-givers, provided insight into challenges and facilitators of the WHO HH Improvement Strategy, and highlighted improvement points. Methods An uncontrolled, before-and–after intervention, mixed methods study in Faranah Regional Hospital was conducted from December 2017 to August 2019. The intervention implemented the WHO HH Strategy including HH training for healthcare workers (HCWs), and the relaunch of the local production of alcohol-based handrub (ABHR). A baseline assessment of HH knowledge, perception and compliance of HCWs was done prior to the intervention and compared to two follow-up assessments. The second follow-up assessment was complemented by a qualitative component. Results Overall compliance six months post-intervention was 45.1% and significantly higher than baseline but significantly lower than in first follow-up. Knowledge showed similar patterns of improvement and waning. The perception survey demonstrated high appreciation of the intervention, such as local production of ABHR. HCW’s were concerned about overconsuming of ABHR, however simultaneous quantitative measurements showed that consumption in fact was 36% of the estimated amount needed for sufficient HH compliance. Potential fields for improvement identified by HCWs to enhance sustainability were permanent ABHR availability, having a dedicated person with ownership over continuous simulation HH trainings including simulations to improve technique. Conclusion The study shows that the WHO multimodal HH strategy has a positive effect on HCW compliance and knowledge. Improvement points identified by local staff like sensitization on appropriate ABHR amount per HH action should be considered for sustainable HH improvement.Peer Reviewe

Health significance and risk factors for childhood intestinal parasitic infections in Guinea, Africa

A cross-sectional study was conducted among children 1 to 18 years of age in Konindou, Guinea. The study investigated the risk factors for childhood intestinal parasitic infections and malnutrition, and the relationship between childhood intestinal parasitic infection and malnutrition. Households were stratified within districts and one child was randomly selected from each household. The study included a total of 293 children, 153 (52.2%) males and 140 (47.8%) females. All children underwent parasitological, anthropometric, laboratory, and clinical examinations and were interviewed regarding demographic factors, sanitation, personal hygiene, housing, socio-economic status and medical history. Five intestinal parasites were detected in children on fecal examination including hookworm (35.7%), Ascaris lumbricoides (18.5%), Trichuris trichiura (12.2%), Trichomonas intestinalis (7.7%), and Strongyloides stercoralis (10.1%). Moreover, Schistosoma mansoni (6.3%) was detected in children. Examination of thick blood films revealed that 52.9% of children were infected with malaria. Prevalence of intestinal parasitic infection did not differ by district and sex of children, but the prevalence of A. lumbricoides infection was significantly different between females and males 1 to 5 years of age (\chi\sp2 = 4.59; p = 0.03) and 11 to 18 years of age (\chi\sp2 = 5.57; p = 0.01). After controlling for age, males were found to be at higher risk for A. lumbricoides infection compared with females (odds ratio (OR) = 2.29; 95% confidence interval (CI) 1.12-4.71). The absence of a barrel latrine in the household was significantly associated with A. lumbricoides infection in children (OR = 2.81; CI 1.35-5.78). A strong association was found between A. lumbricoides infection and pica (OR = 3.36; CI 1.83-6.92). Fifty-six percent of A. lumbricoides infections that occurred in children were attributed to pica (attributable risk (AR) = 0.56; CI 0.31-0.75). Hookworm infection in children was significantly associated with the absence of a barrel latrine in the household (OR = 1.92; CI 1.12-3.25). Children living in homes with a soil floor had a higher risk (OR = 3.07; CI 1.54-6.08) of hookworm infection than children living in homes with a cement floor. Fifty-six percent of hookworm infections that occurred in children were attributed to living in a house with a soil floor (AR = 0.56; CI 0.32-0.72). Anemia was significantly associated (OR = 4.22; CI 2.34-7.62) with hookworm infection. Anemia and eosinophilia were not associated with A. lumbricoides infection. The risk of clinical signs including anemia, anorexia, diarrhea, elevated eosiphils count, nausea, and vomiting increased with an increase in the number of species of intestinal parasites harbored by children. The results of this study indicate that pica has a negative impact on the health of children in Guinea. Moreover, these results indicate that pica, poor sanitation, poor housing conditions, poor hygiene, and a large number of small children in a household are significantly associated with the likelihood of childhood intestinal parasitic infections and the growth of children in Guinea. The importance of these findings for the planning of parasite control measures is discussed

The protection of international organizations’ financial interests

Les pertes financières dues à la faiblesse ou à l’insuffisance des moyens de contrôle en leur sein ont contraint les organisations internationales à se doter de mécanismes de contrôle capables de contrôler suffisamment leurs ressources financières et d’assurer efficacement la protection de leurs intérêts financiers contre les atteintes qui leurs faites. Car, la réussite de leurs missions dépend dans une large mesure de la bonne utilisation de leurs ressources financières. Les mécanismes juridiques ainsi mis en place, dans le cadre de cette protection, permettent d’effectuer des contrôles financiers aux moyens d’audits et d’appliquer des sanctions contre les infractions qui portent atteinte à leurs intérêts financiers. C’est dans cette perspective que les Etats membres sont mis à contribution. Mais, la participation des Etats à cette protection varie en fonction des organisations internationales (OI). En s’appuyant sur l’exemple de l’Union européenne (UE), qui a su très tôt concevoir un ensemble d’instruments juridiques efficaces, la présente thèse aborde le cadre juridique et les difficultés de la protection des intérêts financiers des OI. Pour cela, outre l’UE, deux autres OI, à savoir l’Organisation des Nations Unies (ONU) et l’Union Economique et Monétaire Ouest Africaine (UEMOA) sont prises en exemple pour analyser les mécanismes de protection des intérêts financiers des OI à la lumière de quelques scandales financiers qui ont permis de mettre à jour l’inefficacité de leurs mécanismes de protection.Financial losses caused by lack of appropriate means of control has led international organizations to implement some mechanism that help them to protect their financial resources from diversion. Indeed, in order to reach their goals, international organizations need a good financial management. Legal mechanisms put in place to protect financial assets of international organizations allow them to oversee their financial management and help them prosecute those who commit financial crimes against international organizations. In doing so, international organization need cooperation from Member States. But this cooperation depends on each international organizations. This dissertation aims to show how, within the European Union (EU), the United Nations (UN) and the West African Economic and Monetary Union (WAEMU), what are the legal mechanisms that enable international organizations to prevent and to prosecute those who commit financial crimes against them

La protection des intérêts financiers des organisations internationales

Financial losses caused by lack of appropriate means of control has led international organizations to implement some mechanism that help them to protect their financial resources from diversion. Indeed, in order to reach their goals, international organizations need a good financial management. Legal mechanisms put in place to protect financial assets of international organizations allow them to oversee their financial management and help them prosecute those who commit financial crimes against international organizations. In doing so, international organization need cooperation from Member States. But this cooperation depends on each international organizations. This dissertation aims to show how, within the European Union (EU), the United Nations (UN) and the West African Economic and Monetary Union (WAEMU), what are the legal mechanisms that enable international organizations to prevent and to prosecute those who commit financial crimes against them.Les pertes financières dues à la faiblesse ou à l’insuffisance des moyens de contrôle en leur sein ont contraint les organisations internationales à se doter de mécanismes de contrôle capables de contrôler suffisamment leurs ressources financières et d’assurer efficacement la protection de leurs intérêts financiers contre les atteintes qui leurs faites. Car, la réussite de leurs missions dépend dans une large mesure de la bonne utilisation de leurs ressources financières. Les mécanismes juridiques ainsi mis en place, dans le cadre de cette protection, permettent d’effectuer des contrôles financiers aux moyens d’audits et d’appliquer des sanctions contre les infractions qui portent atteinte à leurs intérêts financiers. C’est dans cette perspective que les Etats membres sont mis à contribution. Mais, la participation des Etats à cette protection varie en fonction des organisations internationales (OI). En s’appuyant sur l’exemple de l’Union européenne (UE), qui a su très tôt concevoir un ensemble d’instruments juridiques efficaces, la présente thèse aborde le cadre juridique et les difficultés de la protection des intérêts financiers des OI. Pour cela, outre l’UE, deux autres OI, à savoir l’Organisation des Nations Unies (ONU) et l’Union Economique et Monétaire Ouest Africaine (UEMOA) sont prises en exemple pour analyser les mécanismes de protection des intérêts financiers des OI à la lumière de quelques scandales financiers qui ont permis de mettre à jour l’inefficacité de leurs mécanismes de protection

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

Psychosocial impacts of COVID-19 in the Guinean population. An online cross-sectional survey.

Guinea, like many other African countries, has been facing an unprecedented COVID-19 outbreak, since March 2020. In April 2020, Guinean National agency for health security recorded 1351 confirmed cases of COVID-19, including 313 recoveries and 07 deaths. To address this health crisis, some drastic measures were implemented to prevent the spread of COVID-19. Those measures might potentially cause some psychological problems among Guineans. Thus, we conducted this study to assess the psychosocial impacts of COVID-19 in the Guinean population. We carried out an online cross-sectional survey among internet users in Guinea. A free e-survey platform was used, and questionnaires were sent to internet users. The study ran from May 1 through May 10 2020. Participation in the study was voluntary. Data collection was based on sociodemographic information and self-reported questionnaires: Impact of Event Scale-Revised (IES-R) for stress evaluation, Penn state worry questionnaire (PSWQ), and an adapted Social Psychological Measurements of COVID-19. A total of 280 participants took part in the study; responses from 5 participants were deleted because of incompleteness. The average age of participants was 28.9 [95% CI: 28.1;29.6]. Most of participants were male 65.5% [95% CI: 59.5%;71.1%]. Unemployed participants stood for 48.7% [95% CI: 42.7%;54.8%]. IES-R scale for stress evaluation yielded the following findings: 19.6% (mild), 5.23% (moderate) and 9.15% (severe); 82.8% and 17.2% of participants had respectively reported low and moderate worry. No significant statistical association was found between sociodemographic variables and traumatic events (IES-R and PSWQ). However, 82% of our participants had to cope with the negative impacts of COVID-19. Although there were few cases of traumatic events, negative impacts of COVID-19 on study participants deserve to be underlined. So, further investigations are necessary to identify and disentangle specific psychosocial problems in different Guinean socio-cultural contexts

Seroprevalence and Risk Factors of Toxoplasmosis in Cats and Women Undergoing Prenatal Consultation in Coyah, Guinea

The objective of this study is to describe the epidemiological situation of toxoplasmosis in cats and women undergoing prenatal consultation in the city of Coyah (Guinea). During the study, 100 cat sera and 100 sera from women in prenatal consultation were analyzed with a Toxo-Screen DA (Modified Antigen Agglutination Test) kit. The results indicated prevalences of 73%±8.7 in antenatal women and 51%±9.8 in cats. There was no association found between the variables and Toxoplasma gondii seroprevalence in prenatal females and cats. Keywords: Cat; women in prenatal consultation; Toxoplasma gondii; Coyah; Guinea

Impliquer le secteur de la santé dans la prévention et la prise en charge des mutilations génitales féminines: résultats d'une recherche formative en Guinée

Background: Despite efforts to reduce the burden of female genital mutilation (FGM) in Guinea, the practice remains prevalent, and health care providers are increasingly being implicated in its medicalization. This formative study was conducted to understand the factors that facilitate or impede the health sector in providing FGM prevention and care services to inform the development of health sector-based interventions. Methods: Between April and May 2018, a mixed methods formative study was carried out using a rapid assessment methodology in three regions of Guinea—Faranah, Labe and Conakry. A structured questionnaire was completed by one hundred and fifty health care providers of different cadres and 37 semi-structured interviews were conducted with health care providers, women seeking services at public health clinics and key stakeholders, including health systems managers, heads of professional associations and schools of nursing, midwifery, and medicine as well as representatives of the Ministry of Health. Eleven focus group discussions were conducted with female and male community members. Results: This study revealed health systems factors, attitudinal factors held by health care providers, and other factors, that may not only promote FGM medicalization but also impede a comprehensive health sector response. Our findings confirm that there is currently no standardized pre-service training on how to assess, document and manage complications of FGM nor are there interventions to promote the prevention of the practice within the health sector. This research also demonstrates the deeply held beliefs of health care providers and community members that perpetuate this practice, and which need to be addressed as part of a health sector approach to FGM prevention. Conclusion: As integral members of FGM practicing communities, health care providers understand community beliefs and norms, making them potential change agents. The health sector can support them by incorporating FGM content into their clinical training, ensuring accountability to legal and policy standards, and promoting FGM abandonment as part of a multi-sectoral approach. The findings from this formative research have informed the development of a health sector intervention that is being field tested as part of a multi-country implementation research study in Guinea, Kenya, and Somalia.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Outils technologiques de gestion dans les officines de Bamako au Mali

La pharmacie joue un rôle important dans la continuité de la prise en charge des patients. Elle développe des stratégies d’optimisation de son travail avec des logiciels de gestion. L’objectif de cette recherche était d’étudier les outils technologiques de gestion pharmaceutique dans les officines de Bamako. Notre étude était transversale descriptive auprès de 93 officines tirés au sort. Les pharmaciens ou assistant –pharmaciens ont été interrogés pour collecter les informations sur les logiciels utilisés, leurs fonctionnalités et le niveau de satisfaction des utilisateurs. Nous avons utilisé un questionnaire pour collecter les données. La saisie et l’analyse ont été faites sur le logiciel SPSS18. Le score des fonctionnalités était le rapport du nombre de fonctionnalités disponibles sur le total identifiées. L’échantillon comportait 62,4% d’hommes et 50,5% de pharmaciens. Les logiciels recensés étaient au nombre de neuf. WIN PHARMA était utilisé par 77,4% des officines. Il avait un score de fonctionnalité de 0,9 sur 1. La satisfaction moyenne globale des utilisateurs était d’environ 37%. L’approvisionnement (53%) et la clôture de la session (62%) étaient les fonctionnalités beaucoup appréciées. WIN PHARMA était le logiciel le plus utilisé. Il avait un bon score de fonctionnalités et une satisfaction d’environ deux fois le niveau moyen.Mots-clés: Logiciel de gestion, officines, Bamako, MaliEnglish Title: Pharmacies management technology tools in Bamako in MaliEnglish AbstractPharmacy plays an important role in the continuity of patient care. It develops strategies to optimize its work with management software. The objective of this study was to assess the technological tools of pharmaceutical management in the pharmacies in Bamako. A descriptive cross sectional survey involving 93 randomly selected pharmacies was carried out in Bamako, Mali. A questionnaire was used to collect the data. Data entry and analysis were done using SPSS (version 18) software. The functionality score was calculated as the ratio of the number of available functionalities to the total number of functionalities identified. The sample interviewed was 62.4% male and 50.5% were pharmacists. A total of nine software was identified. WIN PHARMA was used by 77.4% of pharmacies. Its functionality score was 0.9 for a maximum of 1. Overall average user satisfaction was about 37%. Supplying (53%) and closing of the session (62%) were the most appreciated features. WIN PHARMA was the software the most commonly used. It had a good score and approximately twice the average level of satisfaction.Keywords: Management software, pharmacies, Bamako, Mal

Laboratory Evaluation and Field Testing of Dengue NS1 and IgM/IgG Rapid Diagnostic Tests in an Epidemic Context in Senegal

In Senegal, the burden of dengue is increasing and expanding. As case management and traditional diagnostic techniques can be difficult to implement, rapid diagnostic tests (RDTs) deployed at point of care are ideal for investigating active outbreaks. The aim of this study was to evaluate the diagnostic performance of the Dengue NS1 and Dengue IgM/IgG RDTs on the serum/plasma samples in a laboratory setting and in the field. During laboratory evaluation, performance of the NS1 RDT was assessed using NS1 ELISA as the gold standard. Sensitivity and specificity were 88% [75–95%] and 100% [97–100%], respectively. Performance of the IgM/IG RDT was assessed using the IgM Antibody Capture (MAC) ELISA, indirect IgG, and PRNT as gold standards. The IgM and IgG test lines respectively displayed sensitivities of 94% [83–99%] and 70% [59–79%] and specificities of 91% [84–95%] and 91% [79–98%]. In the field, the Dengue NS1 RDT sensitivity and specificity was 82% [60–95%] and 75% [53–90%], respectively. The IgM and IgG test lines displayed sensitivities of 86% [42–100%] and 78% [64–88%], specificities of 85% [76–92%] and 55% [36–73%], respectively. These results demonstrate that RDTs are ideal for use in a context of high prevalence or outbreak setting and can be implemented in the absence of a confirmatory test for acute and convalescent patients