Knowledge, Attitudes and Practices of the Health Personnel of the Pediatric and Gynecology-Obstetrics Departments of the BouakéUniversity Hospital Center (CHU) regarding the Intestinal Microbiota and the First 1000 Days of Life

Introduction: The harmonious development of the intestinal microbiota during the first 1000 days of life promotes the child’s immediate and future good health. The objective of the study was to evaluate the knowledge and practices of health personnel on the intestinal microbiota and the first 1000 days of life for the improvement of child health. Methods: Knowledge, attitudes and practices (KAP) type survey conducted among health personnel of the pediatric and gynecology-obstetrics departments of the Bouaké University Hospital from July 1 to 31, 2017. All consenting agents working in the said services and present at the time of the study were included. The parameters studied concerned socio-professional characteristics, knowledge of the intestinal microbiota, and knowledge and practice of the first 1000 days. The data analysis was descriptive and analytical with a significance threshold p ≤ 0.05. Results: Out of 224 active agents, 76 (30 men, 46 women) participated in the survey, i.e. 33.9%. The respondent came from the gynecology-obstetrics (54%) and pediatrics (46%) departments and had professional experience >5 years in 38%. Thirty-eight percent of the respondents had a good knowledge of the intestinal microbiota. Concerning the first 1000 days of life, 64.5% of the respondents had a good knowledge of the first 1000 days overall. They advised exclusive breastfeeding for up to 6 months in 95% of cases. When breastfeeding was not feasible, the main criterion for choosing the infant formula was the composition (57.1%). They proposed a standard infant formula (43%), enriched with prebiotic (29.4%), enriched with probiotic (21.6%), a symbiotic (6%). Good knowledge of the intestinal microbiota was associated with belonging to the paediatric service (p = 0.013), socio-professional category (p = 0.031), year of experience >5 years (p = 0.032) and the first 1000 days of life to year of experience >5 years (p < 0.01). Conclusion: The health personnel interviewed did not have a good knowledge of the intestinal microbiota and the first 1000 days. Capacity building is needed.

Factors Associated with the Unsuppressed Viral Load of Children on Antiretroviral Therapy Followed Up in the GbêkêRegion (Côte d’Ivoire)

Introduction: Unsuppressed viral load (VL) in immunocompromised children on antiretroviral therapy (ART) increases the risk of child morbidity and death. The aim of the study was to identify factors associated with unsuppressed viral load in children on ART for the improvement of prognosis. Patients and Methods: this is a retrospective, descriptive and analytical study carried out from July 2015 to December 2019 in the 28 pediatric HIV/AIDS treatment centers supervised by the NGO IRAA in the region of Gbêkê. It Included children from 0 to 15 years who were HIV positive, on ART for at least 6 months with at least one viral load. The variables studied were socio-demographic, diagnostic and evolutionary. Data analysis was descriptive and analytical with a significance level of p < 0.05. Results: out of 329 children included, 118 (62 boys, 53 girls) had a non-suppressed VL, i.e. a prevalence of 36%. The mean age at diagnosis was 61 months. The mother was a small trader (36.4%), illiterate (45.8%). Unsuppressed viral load was significantly associated with poor nutritional status at the start of treatment (p < 0.001), non-compliance with treatment (p < 0.001), poor maternal education (p = 0.011) and the lack of follow-up of the mother in the context of PMTCT (p = 0.03). Conclusion: Unsuppressed viral load is common in children on ART in the Gbêkê region. It mainly concerns the child who did not comply with ART, and whose mother was not followed within the framework of PMTCT. Strengthening early detection, early initiation of ART, PMTCT and increased therapeutic education strategies would improve the prognosis of children infected with HIV.