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[Seroprevalence of HIV among pregnant women in the ten regions of the Ivory Coast].

UNLABELLED: Ivory Coast, a sub-Saharan African country, has 14 million inhabitants. Two AIDS cases were reported to the WHO in 1985. By December 31st 1996, there were a total of 37,878 AIDS cases in Ivory Coast, 6,727 of which were new cases reported in 1996. Heterosexual transmission is the predominant means of HIV infection in Africa and women of childbearing age account for a substantial proportion of the individuals infected. The aim of this study was to follow the progression of infection in the various regions of the country by comparing data from two time periods: Period I: 1986 to 1989; Period II: 1994 to 1996. MATERIALS AND METHODS LOCATION: Samples were taken in regional maternal and child protection centers. Recruitment method: Women were recruited anonymously, during their antenatal care. BIOLOGICAL ANALYSIS: Period I (1986 to 1989), 2,604 pregnant women. Anti-HIV antibodies were detected with: Abbott HIV-1 EIA Recombinant (Chicago) used initially, for 1,200 sera; Abbott HIV-1/HIV-2 Recombinant (Chicago) used later for the remaining sera. There was no commercially available test for HIV-2 during this first period, so all samples with Rm0.8 (R = optical density/cut-off) were also tested by western blotting. Period II (1994 to 1996), 2,935 pregnant women. All sera were tested with Enzygnost HIV-1-2 and Enzygnost HIV-1-2 Plus, produced by Behring (Germany). All sera testing positive in EIA were also tested by western blotting. RESULTS: The prevalence of HIV infection was 4.23% for Period I and 12.53% for Period II. No region of Ivory Coast was completely free of these 2 viruses after the mid-1980s. Women aged 20 to 29 years of age were the most likely to be infected, for both periods. The highest prevalence of HIV-2 was that for women aged between 20 and 29 years and HIV-2 infection occurred mostly in the South, Southwest and West regions. DISCUSSION: The prevalence of HIV infection is now at least 10% in each region of the country. Abidjan is no longer the city with the highest levels of infection, as shown by the results for Period II. The East and West have the highest levels of HIV infection, and the prevalence of HIV in these areas is significantly higher than that for Abidjan (p = 0.007 for the East and p = 0.009 for the West).

Adult↗

Conditions of anesthesia practice on the Ivory Coast.

The Ivory Coast is one of the most developed countries in Africa, but conditions of practice of anesthesia are difficult. From anesthesia equipment to medications that are available, all resources are limited, and nurse anesthetists as well as sole anesthesia providers, have to manage with isolation and lack of information in uncomfortable situations.

Anesthesia↗

[Waterworks and public health in Ivory Coast].

In Ivory Coast, the provision for good drinking water has received priority attention since 1973. The National Water-works Programme which started in 1975, is progressing satisfactorily. All over the country, villages and towns are being equipped with hydraulic machines and other structures for the production and distribution of good drinking water. This has contributed in no small way to the control of certain diseases related to water pollution. The authors think however that a lot still needs to be done especially to inform and to educate the village communities and to control the quality of the drinking water. These actions should check water pollution and encourage people in the rural areas to drink portable pipe-borne water.

Cote d'Ivoire↗

[Human African trypanosomiasis in Ivory Coast: biological characteristics after treatment. 812 cases treated in the Daloa focus (Ivory Coast)].

The treatment and post therapeutic follow up of patients diagnosed with HAT are important for HAT control. A longitudinal survey was implemented in the focus of Daloa (Côte d'Ivoire). A total of 812 patients infected with Trypanosoma brucei gambiense in meningoencephalitic stage and treated with melarsoprol were included, this study pointed out the biological characteristics of patients after treatment. The relapse occurs between 1 and 24 months after treatment. It is essentially neurological, and characterised by the presence in the CSF of antibodies, by the increase of cell count compared with value immediately after treatment, or by the presence of trypanosomes. The cure can be confirmed from 18 months after treatment, and is characterised by the absence of antibodies and trypanosomes in the CSF, by a normal cell count and a normal proteinorachy. Biological scares were recorded on some of the patients after 18 months of follow up, but no relapse occurred among them.

Animals↗

Analgesic and antiinflammatory activities of an extract from Parkia biglobosa used in traditional medicine in the Ivory Coast.

In the Ivory coast, Parkia biglobosa (Mimosaceae) is used in traditional medicine as an analgesic drug, especially against dental pain. Of the three extracts obtained from the plant bark, the hexane fraction was studied to determine its analgesic and/or antiinflammatory activities. The results show that this extract possesses a marked analgesic activity when evaluated with the abdominal writhing test in mice, but, like paracetamol, was ineffective with the hot-plate method, a feature suggesting a peripheral mechanism of action. This activity was accompanied by an antiinflammatory effect, somewhat weaker than the analgesic one.

Analgesics↗

Prevalence of human T-lymphotropic retroviruses type III (HIV) and type IV in Ivory Coast.

Serological investigations in the Ivory Coast indicate that, despite the rarity of overt acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV) is widely prevalent. So also is human T-lymphotropic virus type IV (HTLV-IV). The highest rates of HIV and HTLV-IV seropositivity were observed in female prostitutes. These findings suggest that, like HIV, HTLV-IV can be transmitted by heterosexual contact, and that the mobility of prostitutes may be an important factor in spread of the retroviruses in Africa. The incidence of HIV-associated AIDS in the Ivory Coast is likely to rise sharply in the next few years.

Acquired Immunodeficiency Syndrome↗

[Influence of social perceptions and practices on the use of bednets in the malaria control programme in Ivory Coast (West Africa)].

The National Malaria Programme in Ivory Coast has encountered difficulty in winning public acceptance of insecticide-treated bednets. We speculate that resistance to the use of bednets could be rooted in social perceptions, beliefs and practices in the communities. The purpose of this study was to identify sociocultural and environmental factors that could be used to support promotion strategies and acceptance of impregnated bednets in Ivory Coast. Survey findings confirmed that bednets were not in widespread use among the population (25%). The most widely used methods were burning mosquito coils (50%) and indoor spraying (31%). Use of impregnated bednets was low (6%). Most survey respondents (73%) indicated initial appreciation for the effectiveness of bednets in protecting against mosquitoes as a nuisance. However only 9% of respondents thought that impregnated bednets provided protection against malaria although they did not necessarily use them. Design was a determinant factor for the use, and even acceptance, of bednets. The population want rectangular, permanently impregnated bednets large enough to accommodate at least 2 persons. Cost was a major obstacle to wider use by the population. According to our data the best price for the population would be between 2000 and 2500 FCFA as compared to the current price of 3500 FCFA in Ivory Coast.

Bedding and Linens↗

[Malaria in military personnel: the case of the Ivory Coast in 2002-2003].

French troops were sent to the Ivory Coast on September 22, 2002 within the framework of Operation Unicorn in response to the political unrest. From September 22 to October 20, a total of 37 cases of malaria were reported, i.e., 35.7 cases per 1000 man-months. As of October 11, the central headquarters of the Armed Services Health Corps decided to use doxycycline as the exclusive agent for drug prophylaxis in military personnel on duty in the Ivory Coast and to enhance vector control measures. The incidence of malaria decreased to 2 cases per 1000 man-months at the sixth month. A recrudescence of malaria to 15 cases per 1000 man-months was observed with the rainy season in April. During this period one person presenting severe malaria with coma required emergency evacuation to France. In May 2003, several studies were undertaken to determine the factors that caused this recrudescence. These studies included surveys to evaluate awareness concerning malaria and monitor compliance with drug prophylaxis and tolerance of doxycycline, a case-control study to identify factors related to malarious episodes and an entomological study. Awareness of malaria was high with 75% of the 477 respondents stating that malaria could be transmitted by single mosquito bite. The case-control study showed a correlation between occurrence of malarious bouts and non-compliance with drug prophylaxis (p < 10(-5)). The odds-ratio was 3.05 (95% confidence interval, 1.52-6.14) for subjects claiming zero to one incident of non-compliance per week and 7.51 (IC95%, 3.24-17.40) for those claiming more than one incident of non-compliance per week. Tolerance of doxycyline was good since 72% of respondents reported no adverse effects. The main vector was Anopheles gambiae. The number of bites per man per night ranged from 25 to 2 and the number of infected bites ranged from 2 to 3 per week. Treatment was initiated promptly using quinine at a total dose of 25 mg/kg in 3 daily doses for 7 days by the intravenous then oral route. This experience shows that malaria remains a major concern for military forces, that standardization of preventive measures in emergency situations is needed, and that enhanced vector control, verification of compliance with drug prophylaxis and prompt treatment based on the presence of a physician in each emergency outpost is crucial. These recommendation must be applied to all French military personnel in the Ivory Coast.

Adult↗

[Prevalence and risk factors for otomycosis treated in the hospital setting in Abidjan (Ivory Coast)].

Otomycosis is frequently encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence, predisposing factors, and etiologic agents associated with otomycosis at the Treichville University Hospital Center in Abidjan, Ivory Coast. Mycological examinations were performed on specimens obtained from 115 patients presenting with external otitis at the d'Oto-Rhino-Laryngology Department. Fungi-positive cultures were obtained in 49 patients for an overall otomycosis prevalence of 42.6 (95% Confidence Interval (CI), 34.4-52.2). Univariate analysis showed that the predisposing factors for otomycosis were frequent swimming in natural or artificial pools (Relative Risk (RR) 3.7; CI 1.7-8.1), daily ear cleaning (RR 3.5; CI 1.8-6.8) and excessive use of eardrops containing antibiotics and corticoids (RR = 9.3; IC95% = 4.3-20.1). The most common etiologic agents were Aspergillus flavus (20.4%), Candida albicans (16.3%), Candida parapsilosis (14.3%), and Aspergillus niger (12.2%). A combination of two agents was found in five cases. These data show that otomycosis is endemic in Ivory Coast. Management of otomycosis must include mycological examination for diagnosis as well as changing behavior patterns leading to infection.

Adolescent↗

[From Ivory Coast to Italy. Burkina Faso migration patterns and national interests].

"Ivory Coast represents nowadays the first immigration country of West Africa.... The movement of Burkinabe migrants [from Burkina Faso], Bissa in particular, from Ivory Coast to Italy does not improve the fundamental instability.... Italian restrictive immigration policy, at the beginning of the 1990s, in accordance with [the] Schengen agreement, has progressively prevented Burkinabe immigrants from obtaining a regular status, which would assure them of basic rights.... New Italian laws, like the French immigration policy of the mid 1970s, are in fact discouraging return migration and fostering stable migration with the relevant integration policy for those, a small number indeed, who are granted a residence permit." (SUMMARY IN ENG)

Acculturation↗

[Epidemiological study of pulmonary hydatid cyst in the Ivory Coast. 3 cases].

No cases of echinococcus have been reported up to this time in Ivory Coast, where it has been considered non-existant in either pulmonary or hepatic form. The three cases of pulmonary echinococcus reported here show the classic paucity of clinical symptoms associated with classical radiological findings. The epidemiological research confirms in one case definite infection occurring in Ivory Coast and the other two either in the Ivory Coast or in closely neighbouring areas.

Adult↗

[Epidemiological aspects of meningitis in the north of the Ivory Coast].

Classically, the North of Ivory Coast is not part of the "meningitis belt". However, recent health statistics put in light some recent outbreaks in this part of the country, the last one in the years 1983-1985. The authors have studied this last outbreak and it can be foreseen that these epidemics will appear again as in the more Northern countries. Therefore it is desirable to set up a monitoring system to better organize the fight against this disease.

Adolescent↗

Smear positive pulmonary tuberculosis in a prison setting: experience in the penal camp of Bouaké, Ivory Coast.

SETTING: Bouaké prison camp, Ivory Coast. OBJECTIVE: To determine the clinical, radiographic and therapeutic characteristics of smear-positive pulmonary tuberculosis in the prison camp of Bouaké. METHODS: The study included 108 cases of smear positive pulmonary tuberculosis who had never been treated previously. Triple chemotherapy of 6 months' duration was recommended for all of the patients. RESULTS: The incidence of smear positive tuberculosis in the prison population under study was very high (5.8%). In the majority of cases tuberculosis infection is associated with other conditions: here they were malnutrition (75%), anaemia (70%) and dermatoses (64%). Human immunodeficiency virus (HIV) infection was observed in 30% of the cases, and alcohol and tobacco dependence in 50%. Radiographic lesions were extensive in 70% of the cases. The 6-month treatment regimen is still effective: 80 of the 108 (74.1%) were cured, i.e. 97.6% of those who completed their treatment. The death rate, however, was alarming at 24% (one patient in four). The main reason for incarceration was theft (73%). CONCLUSION: Other epidemiological studies are needed urgently in order to pin-point those factors that favour the progression from tuberculous infection to disease in this very specific setting, and to improve socio-sanitary conditions for prison inmates.

AIDS-Related Opportunistic Infections↗

Genetic analysis of human immunodeficiency virus in Abidjan, Ivory Coast reveals predominance of HIV type 1 subtype A and introduction of subtype G.

To better understand the molecular epidemiology of HIV genetic diversity in Abidjan, Ivory Coast, we performed a genetic analysis of 170 HIV-1-seropositive specimens representing newly diagnosed tuberculosis patients (n = 143) and women monitored in a mother-to-child transmission cohort study (n = 27). Preliminary screening with RFLP presumptively classified 162 (95.3%) of these as subtype A. The envelope region of 108 specimens was subtyped by sequence analysis: 102 (94.4%) were subtype A, 2 (1.9%) were subtype D, and 4 (3.7%) were subtype G. Subtyping gag and env regions of the genome suggested that five of the six nonsubtype A isolates exhibited a potentially mosaic structure. A comparative phylogenetic analysis of HIV-1 subtype A C2V3 from 27 Ivory Coast and 21 Ugandan sequences revealed a striking clustering among Ivory Coast variants, and an independent segregation from Ugandan subtype A. Despite independent clustering with other subtype A specimens, limited variability of the V3 loop apex was observed; the globally predominant V3 motif, GPGQ, represented 90.1% of the HIV-1 strains. This study demonstrates that clade A is the predominant HIV-1 subtype in HIV-seropositive individuals in Abidjan, Ivory Coast and that these strains are phylogenetically distinct from other subtype A strains observed in East Africa.

Amino Acid Sequence↗