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At least 19 recordsLinked to original sources
PubMed1996

Maternal and perinatal health in Mali, Togo and Nigeria.

OBJECTIVE: The health care system in many developing countries is less efficient compared with that in the industrialized world. The aim of the present study was to investigate the differences of the efficiency of the health care in obstetrics in Nigeria, Mali and Togo. STUDY DESIGN: The data were collected in African district hospitals from Lomé/Togo (n = 1002), Bamako/Mali (n = 1462) and Kaduna/Nigeria (n = 1055) with a routinely applied questionnaire analyzed at the University Giessen and compared with the data from the Department of Obstetrics and Gynaecology Giessen (Germany) (referral hospital) (n = 1313) and the total data pool of the perinatal survey 1993 in Hesse (n = 58430). RESULTS: The medical history indicates important differences: the incidence of young mothers below 18 is highest in Mali (9.8%) compared with Nigeria (2.7%) and Togo (2.6%) (Hesse 0.6%). In general there is an increased rate of previous pregnancies of more than five: 13-28% (Hesse 2.1%). The rate of prenatal visits is also reduced: more than ten visits have 2% in Togo, 10.6% in Mali and 15.5% in Nigeria (Hesse 72%). Ultrasound examinations are very rare (1-12%) and tocolysis is nearly unknown. As a result the incidence of dead infants in the medical history is high: Mali 28%, Togo 18%, Nigeria 10.8% (Hesse 1.7%), as well as the rate of low birth weight infants. This is also reflected in the perinatal mortality which ranged from 115/1000 in Mali, 77/1000 in Togo and 68/1000 in Nigeria (Hesse 5.3/1000, Ob/Gyn Giessen 16.4/1000). CONCLUSION: The improvement of perinatal and maternal health in the developing world can only be achieved if family planning, prenatal care, selection of high risk pregnancies goes in parallel with a sound organization implemented and supported by the government.

Birth Weight↗
PubMed1994

[Vaccination in Togo].

The author describes her participation in an immunization project in Togo, one of many such projects supported by Canada's International Immunization Program. The Togo project was run by CUSO in partnership with the Canadian Public Health Association. In Togo, the infant mortality rate is significant. Thus the institution of an immunization program against major childhood illness (diphtheria, polio, tetanus, pertussis, measles and tuberculosis) was of paramount importance. Based in the maritime region of Togo, the project the author worked on helped 60,000 children and 200,000 women of childbearing age. The health team didn't attempt to change the behavior of the people of Togo since their cultural health care beliefs have existed for centuries and differ significantly from those of North Americans. Rather, efforts centered on health teaching, which increased the immunization rate from 16 to 63 per cent and decreased the incidence of disease.

Humans↗
PubMed2000

[Clinical and epidemiological aspects of traditional therapeutic scarification in epilepsy in Togo].

One of the major problems of epilepsy in Africa are its social implications. Prejudice against the disease is common and epileptics are marginalised. Epilepsy is concealed from all non-family members. The very pronunciation of the word "falling disease" (as epilepsy is called) is taboo, the disease being regarded as supernatural. This unfavourable context introduces considerable bias in hospital and population-based studies. Traditional doctors are consulted by patients especially when they have such a "supernatural" disease. Traditional scarifications are used for the treatment of epileptics in Togo. We examined the skin of 36,000 patients in the neurological department of Lomé's teaching hospital between 1985 and 1995 and conducted a similar, population-based study on about 20,000 inhabitants in the Kloto district of south-western Togo and on 10,000 inhabitants in the Tone district of northern Togo. Interviews with 40,000 traditional doctors revealed that forehead scarifications are characteristic of epilepsy treatment. More than 80% of epileptics have forehead scarifications. When the seizures are rare, scarifications are slim, short (1-3 mm), near the roots of hair on the forehead and concealed; but when they are frequent, known by many people, scarifications are large, long, visible on forehead, the patient showing the sign of his social sentence.. On the skin of epileptics in Togo, is written the diagnosis of his affection. It only needs to look at it.

Adult↗
PubMed1988

Detection of haemoglobinopathies at birth in Togo.

The incidence and nature of haemoglobinopathies were investigated at birth in Togo, using isoelectric focussing on 385 samples of umbilical cord blood. Abnormalities were found in 37.6% of blood samples: Hb A/S, 18.7% (0.5% with Hb Bart's); Hb A/C, 8.9% (0.3% with Hb Bart's); Hb S/C, 1.3% (0.3% with Hb Bart's); Hb S/S, 1%; Hb C/C, 0.3%; isolated Hb Bart's, 5.7%; gamma chain variants 0.8%; acetyl Hb F greater than Hb A, 1%. To date now, no systematic screening of Hb abnormalities has been performed in Togo. Our results showed that Hb S is the principal abnormal Hb found in the population which we studied, with a sickle cell gene frequency of qs = 0.110 and an Hb C gene frequency of qc = 0.053. Our work also confirmed the presence of alpha and beta + thalassaemias (acetyl Hb F greater than Hb A) in Togo. One of the advantages of investigating umbilical cord blood by isoelectric focusing is that detection of Hb S/S and Hb S/C (which had an incidence of 2.3% in our study) can be carried out at birth, allowing the children to be taken care of as soon as possible. About 150,000 children are born each year in Togo, and the infant mortality is estimated at 5 per 100 live births in Lomé and at 10 per 100 live births outside the capital.

Hemoglobin C↗
PubMed1999

Geographic distribution and epidemiology of Oesophagostomum bifurcum and hookworm infections in humans in Togo.

In contrast to the rest of the world, infections with Oesophagostomum bifurcum are commonly found in humans in northern Togo and Ghana. In addition, infections with hookworm are endemic in this region. In the present study, a detailed map of the geographic distribution of O. bifurcum and hookworm infections in northern Togo was made. There were a number of foci with high prevalence of infection with O. bifurcum. All the villages examined were infected with hookworm, and the distribution was quite patchy. Women were infected with O. bifurcum more often than men, while infections with hookworm were more prevalent in men than in women. The prevalence and intensity of infection with both parasites were clearly age-dependent. We estimate that more than a 100,000 people in Togo are infected with O. bifurcum and more than 230,000 are infected with hookworm.

Adolescent↗
PubMed1989

Home treatment of febrile children with antimalarial drugs in Togo.

In Togo, the principal strategy for preventing death from malaria in children is prompt treatment of fever with antimalarial drugs. A household survey was conducted in a rural area of south-central Togo in which information was collected from mothers on the treatment received by 507 children under 5 years of age who, according to their mothers, had recently had fever. Altogether, 20% of the children (95% confidence interval (Cl): 15-25%) were seen at a health centre during their illness, while 83% (95% Cl: 76-90%) were treated at home with an antimalarial drug. Of the children in the latter group, 97% received the drug on the first day of fever. In contrast, only 17% of children who attended a health centre were seen on the first day of their fever. Chloroquine, usually obtained from a street or market vendor, was used for 94% of the treatments given at home. Based on children's weights and treatment histories provided by their mothers, the median total dosage of chloroquine given at home was 12.8 mg per kg body weight--more than that recommended and known to be fully effective in Togo at the time of the survey (10 mg per kg) and less than the total dosage recommended at present (25 mg per kg). The dosage administered was considered to be inadequate for 70% of home treatments, because less than 10 mg per kg was given during the first 24 hours of treatment. In the study area, parents were the main providers of antimalarial drug treatment to children with fever and need guidance on the correct dosage of chloroquine.

Child↗
PubMed1988

[Emergence of chloroquine-resistant malaria in West Africa: the case of Sokode (Togo)].

Within the framework of its surveillance of Plasmodium falciparum chloroquine sensitivity in eight West African countries (Benin, Burkina Faso, Côte d'lvoire, Mali, Mauritany, Niger, Senegal, and Togo) the Reference Centre for Chemoresistant Malaria (CRCP) at the Organization for Coordination and Cooperation to Control Major Endemic Diseases (O.C.C.G.E.) conducted an in vivo survey in February, 1987, in Sokodé (Togo). Two groups of 67 children, aged 2 to 9, received, for the first group a single 10 mg/kg dose of chloroquine; for the second group a 3-day 25 mg/kg dose, according to the WHO methodology. Thick and thin blood smears were examined on D0, D2, D3 when necessary, D4 and D7. Within the 23 children who received the 10 mg/kg dose, seven (30.4%) presented a "resistance", of which six were early RI type and 1 was RII type. Out of 44 children who received the standard dose of 25 mg/kg, two (4.6%) were resistant (early RI type resistance). These data show for the first time the appearance of in vivo chloroquine resistance in this country, and call for a withdrawal of the 10 mg/kg dose of chloroquine in the treatment of fever attacks to the benefit of a 25 mg/kg dose. Thorough studies, using in vivo and in vitro techniques, should be undertaken as soon as possible, not only in Togo but in other West African countries too, to take the exact measure of the issue.

Animals↗
PubMed1992

Distribution and severity of onchocerciasis in southern Benin, Ghana and Togo.

The Onchocerciasis Control Programme in West Africa has recently extended its operation in southern Benin, Ghana and Togo. To estimate the number of people infected and blinded by onchocerciasis and to describe the distribution and severity of the disease in the extension area, 99 villages were selected, using a stratified random sampling procedure, and surveyed. All the ecological and entomological information available was used in the sampling procedure and in the selection of 87 non-representative villages surveyed to confirm the findings. The study estimated that 590,468 people are infected and 11,715 blind from onchocerciasis out of a rural population of 1,878,234. The Pru, Asukawkaw and Mono river basins were areas with high risk of onchocercal blindness. The Oueme and Zou river basins in Benin and the mountainous areas between Ghana and Togo were classified as areas with medium risk of onchocercal blindness. The other parts of the study area presented low or no risk of onchocercal blindness. By detecting the river basins where villagers are at risk of onchocercal disease this study permits the selection of populations for disease control based on mass distribution of ivermectin, a microfilaricide.

Animals↗
PubMed2000

Current status of some zoonoses in Togo.

In Togo, livestock represent an important part of the national and subsistence economies. The most prevalent zoonoses documented in Toga are brucellosis, tuberculosis, cysticercosis and rabies. The status of other zoonoses such as toxoplasmosis, giardiasis, cryptosporidiosis and salmonellosis is not known. A national eradication programme has been instigated to reduce the transmission of rabies. Good relations exist between veterinary and health personnel in the field but this level of interaction is absent at district and national level. This has resulted in information not being transferred between the two disciplines and the lack of a national strategy for the eradication of zoonoses in Togo.

Animals↗
PubMed1984

Comparative studies on nutritional and physiological characteristics of Vibrio parahaemolyticus originating from Germany, Togo and Peru.

During monitoring of bathing areas on the German North Sea coast, 24 strains of V. parahaemolyticus were obtained from 32 water samples. The similarity of these strains to 80 V. parahaemolyticus strains isolated in Togo (patients and environment) and Peru (environment), respectively, was studied using 53 tests (fermentation of carbohydrates, decarboxylation of amino acids and utilisation of different C-sources). The results show a high degree of similarity among all strains with regard to fermentation properties (except fermentation of arabinose and decarboxylation of ornithine). Pronounced differences were found by tests for utilisation of different C-sources. A statistical computerized evaluation of the results revealed a closer relatedness of the German strains to isolates from Togo than to those from environmental sources of Peru. Additional tests for determination of the minimal inhibitory concentration of 11 antibiotics resulted in a high degree of similarity, too. Examination of 3014 faeces specimens from patients with acute enteric disease for V. parahaemolyticus were negative.

Bacteriological Techniques↗
PubMed1999

The area-wide epidemiology of bovine trypanosomosis and its impact on mixed farming in subhumid West Africa; a case study in Togo.

This paper reports on an area wide study of all major variables determining the expression of trypanosomosis in cattle in the subhumid eco-zone of West Africa, taking Togo as an example. To enable systematic area-wide sampling, the country was divided in 311 grid-squares of 0.125 x 0.125 sides. Cross-sectional surveys were then conducted to generate maps or digital layers on cattle density, herd structure, ownership and breed. These data layers, except for the breed data, were subjected to a cluster analysis in order to define spatial patterns in animal husbandry systems. This analysis revealed two main systems: one is oriented towards integration with crop-agriculture and a second towards investment in cattle. These two systems could be further characterised by incorporating breed data. Zebu cattle and their crossbreeds are more favoured in the second system. The breed distribution map shows the actual situation but also serves to predict the outcome of progressive crossbreeding. An area wide trypanosomosis survey allowed the production of prevalence maps for Trypanosoma congolense, T. vivax and the associated packed cell volume (PCV) values. A simple curvi-linear relationship was established between vector density and disease prevalence. The regression between disease prevalence and PCV for taurine and zebu plus crossbreeds separately, revealed that taurine cattle maintain a comparatively high PCV level particularly in high prevalence scenarios. The relationship between the average herd PCV and cattle density suggests that herd PCV value may provide a mirror for the number of animals not kept because of the prevailing risk. The regression between agricultural intensity and cattle density subsequently in areas with decreasing herd PCV values reveals that the level of integration of cattle in crop production decreases with a decreasing PCV. Thus, despite the presence of taurine animals in Togo, the omnipresence of tsetse in particular Glossina tachinoides, remains a major obstacle to cattle raising and indirectly mixed farming development and intensification. It is argued that only with the present type of wide scale, spatial studies it becomes possible to clarify all the major variables influencing the expression of trypanosomosis. Spatial epidemiological studies at a macro level may form the basis for area wide trypanosomosis control in West Africa.

Agriculture↗
PubMed1997

Evaluation of invermectin distribution in Benin, Côte d'Ivoire, Ghana and Togo: estimation of coverage of treatment and operational aspects of the distribution system.

Invermectin distribution by the Onchocerciasis Control Programme (OCP) was assessed in Benin, Côte d'Ivoire, Ghana and Togo, in terms of the proportion of villages which had been treated and the proportion of villagers in each village treated in the last round who had actually received treatment. These proportions were evaluated both for treatment in the last round of ivermectin distribution and for treatment since the beginning of the drug's distribution in each country. During the last treatment round, 97 (74.6%) of the 130 selected villages investigated in the four countries had received ivermectin treatment, and 67.2% of the members of these 97 treated communities had taken ivermectin. In general, higher percentages of the members of treated villages in Côte d'Ivoire and Ghana had been treated [with mean (S.D.) percentage values of 72.0 (5.2) and 71.6 (4.6), respectively] than in those of Togo [61.8 (5.6)] or Benin [64.2 (4.6)]. Overall, 893 (26.1%) of those interviewed had never received treatment since the beginning of ivermectin distribution but 29.4% had received all the annual treatments. The main reason for non-treatment during the last treatment round was absence from village (54.5% of those not treated), followed by non-eligibility (i.e. pregnant women and young children; 12.2%), refusal to take treatment (2.6%), and shortage of drugs (1.9%). Community approval for the programme was demonstrated when all treated individuals, including those who were absent at the last treatment round, said they would take the ivermectin during the next treatment. During the last treatment round, members of the community assisted in the distribution of the ivermectin tablets in 69 (71.1%) of the 97 treated villages which were investigated. Although only 26 (26.8%) of these 97 villages preferred community-based distribution of ivermectin to the 'mobile' method, it is believed that, with good education and efficient organization, the communities could be encouraged to undertake community distribution.

Antimalarials↗
PubMedDate not supplied

Endemic treponematoses in Togo and other west African states.

In 1970 an alarming increase in the number of cases of treponematoses in general and yaws in particular began to be apparent in sub-Saharan Africa, yet official reports usually underestimate the extent of these diseases. Thus, a clinical and serologic investigation of the prevalence of yaws was conducted in May 1981 in Togo. The proportion of examined persons found to have clinical yaws lesions varied from 1% to 3.9%; all of the four cantons with a prevalence of greater than or equal to 3% are located near Ghana, where the disease is endemic. Children one to 14 years old (and especially those five to 14) were most frequently affected by yaws. The results confirm that yaws is underreported and that it persists and is even resurgent in many areas of Togo and in other French-speaking countries in West Africa. Because of the prevalence of migration and nomadism, a regional (as opposed to national) effort to combat the treponematoses is essential.

Adolescent↗
PubMed2000

Effectiveness of incidence thresholds for detection and control of meningococcal meningitis epidemics in northern Togo.

BACKGROUND: Early outbreak detection is necessary for control of meningococcal meningitis epidemics. A weekly incidence of 15 cases per 100 000 inhabitants averaged over 2 consecutive weeks is recommended by the World Health Organization (WHO) for detection of meningitis epidemics in Africa. This and other thresholds are tested for ability to predict outbreaks and timeliness for control measures. METHODS: Meningitis cases recorded for 1990-1997 in health centres of northern Togo were reviewed. Weekly and annual incidences were determined for each district. Ability of different weekly incidence thresholds to detect outbreaks was assessed according to sensitivity, specificity, and positive and negative predictive values. The number of cases potentially prevented by reactive vaccination in 1997 was calculated for each threshold. RESULTS: Outbreaks occurred in 1995-1996 and in 1996-1997. The WHO-recommended threshold had good specificity but low sensitivity. Thresholds of 10 and 7 cases per 100,000 inhabitants in one week had sensitivity and specificity of 100% and increased the time available for intervention by more than one or two weeks, respectively. A maximum of 65% of cases could have been prevented during the 1997 epidemic, with up to 8% fewer cases prevented for each week of delay in achieving vaccine coverage. CONCLUSIONS: In northern Togo, thresholds of 7 or 10 cases per 100,000 inhabitants per week were excellent predictors of meningitis epidemics and allowed more time for a reactive vaccination strategy than current recommendations.

Disease Outbreaks↗
PubMed1987

The Beffa form of Simulium soubrense of the S. damnosum complex in Togo and Benin.

The Beffa form of Simulium soubrense Vajime & Dunbar, a member of the S. sanctipauli sub-complex of the S. damnosum complex, was found breeding throughout rivers in the Togo-Benin Gap, as far north as 9 degrees 30'N. Its distribution changed with the season. In southern Togo there were seasonal fluctuations in the relative abundancies of the Beffa form and of S. damnosum/S.sirbanum. There was considerable temporal and regional variation in the frequencies of different colour morphs of adult flies. The flies in Benin tended to be darker. Infections with Onchocerca volvulus (Leuckart) appeared to be independent of the host's colour morph category. Larger flies harboured significantly more first stage Onchocerca larvae but no significant relations with fly size were found for second and third stage larvae.

Animals↗
PubMed1999

[The prevalence of schistosomiasis in Togo. A cross-sectional study conducted in a school setting].

As a prelude to a national campaign to control schistosomiasis in Togo, mass screening of school children in 22 prefectures was undertaken to determine the extent of endemic schistosomiasis. Children were randomly selected for testing. In each case, stool examinations using by the Kato-Katz method and urine tests (centrifugation of 10 ml) were performed to detect Schistosome eggs. A total of 2511 children were tested. The sex ratio was 1.7 and mean age 10.4 years (range: 5 to 20 years). The incidence of schistosomiasis was 26.7 p. 100. Schistosoma haematobium was the most widespread and active Schistosome species, being endemic in all locations studied. The incidence of Schistosoma haematobium ranged from 0.6 to 72 p. 100 (national mean: 25.5 p. 100). Schistosoma mansoni was prevalent in only 12 prefectures (range 0.6 to 10 p. 100; national average 2.2 p. 100). The rate of infection was highest in the age group between 10 and 20 years and the risk appeared to be significantly higher in males than in females (p < 0.05). This study confirmed the high incidence of schistosomiasis infection in Togo and identified hyperendemic areas in which control measures should be programmed first.

Adolescent↗
PubMed1999

[Health care seeking behavior of children in Togo].

Epidemiological and anthropological studies were carried out in Togo on health seeking behavior for under 5 children to determine causes of dysfunctions in health services. This article reports on the main findings of the anthropological study. Anthropological literature on health seeking behavior has identified labeling and associated explanatory models of illness as important factors for making choices in the use of health services. This study, carried out among 100 families in Togo on health seeking behavior for under-five children, found little difference in the signs and symptoms of illness recalled and the health resources used. Different causal explanations similarly showed little variation in signs and symptoms of illness. The only causal explanation for illness which appeared to correspond to place of recourse was related to social causes, where traditional practitioners were more often consulted. Families explained choices more on the basis of the accessibility and quality of health services (geographical and financial accessibility, reception by health personnel, organization of services, drug availability) than on the basis of the particular signs and symptoms of the illness. Improving the organization and functioning of health services should contribute more to appropriate use of the modern health care sector than interventions targeting user populations, since the latter appear to be aware of the advantages of modern medicine, but find financial, social and organizational features of services unsatisfactory.

Adult↗
PubMed1975

Serotypes of Vibrio parahaemolyticus from clinical and environmental sources in Togo (West Africa).

Serological analysis of O and K antigens was performed on 343 strains of Vibro parahaemolyticus isolated from clinical and environmental sources in Togo. Only two strains were not typable by the available O antisera. K untypable strains were found in 4.8% of isolates from gastroenteritis patients, in 11% from healthy carriers, and in 47% and 46% of isolates, respectively, from water and fish samples. Thirteen serotypes identified in Togo are not considered in the Japanese antigenic scheme. The suitability of the Japanese typing scheme for geographic areas outside of Japan is discussed and its extension is suggested.

Animals↗