Eco-Epidemiological Characteristics of Human Rabies in Côte d’Ivoire, 2012-2017

Introduction: Human rabies is a major public health problem in many African countries, including Côte d’Ivoire. The present work aims at describing the eco-epidemiological characteristics of human rabies cases recorded in Côte d’Ivoire. Methods: This was a retrospective and prospective cross-sectional descriptive study based on epidemiological surveillance data that ran from september 2014 to december 2017. The clinical data were extracted from the database of the human rabies epidemiological surveillance management service of the National Institute of Public Hygiene’s rabies centre. These data cover the period from 1 January 2012 to 31 December 2017. Results: Human rabies is endemic in Côte d’Ivoire, with most people exposed in the south and especially in the west of the country. There was no association between any of the climatological parameters (temperature, humidity, rainfall) and the occurrence of human rabies during the months of exposure to rabies infection. Conclusion: Ultimately, effective prevention and control of human rabies requires a thorough understanding of the links between climatological parameters and rabies. Health authorities must take ownership of these results if we are to achieve our goal of eliminating rabies by 2030.

Prevalence of Work-Aggravated Asthma among Bakery Workers in Abidjan (Cote d’Ivoire)

Introduction: Work-aggravated asthma is pre-existing or concomitant asthma whose symptoms are aggravated by the work environment. The aim of this study was to determine the prevalence of this pathology and its associated factors among bakery workers in Abidjan. Materials and Methods: This descriptive and analytical cross-sectional study was conducted over a period of four (4) months from 18 December 2019 to 18 April 2020. Two questionnaires were used, one on employees and the other on the indoor environment of bakeries. In addition, a spirometry test was performed on all bakery workers. Statistical analysis was performed using stata 15.1 software. Results: A total of 599 bakery employees, including bakers (59.73%), sales assistants/ cashiers (23.52%), cleaners (6.34%) and administrative staff (10.18%), were investigated. The mean age was 30.8 ± 8 years, with a sex ratio (M/F) = 2.2. Asthma symptoms were found in 95 (15.86%) employees, of whom 74 (77.9%) had work-related asthma and 11 (14.9%) had asthma aggravated by work. The factors associated with work-aggravated asthma were personal or family history of allergy or atopy [ORa = 3.75;CI95%: 1.56 - 8.93;p = 0.003], exposure to dust [ORa = 5.01;CI95%: 1.43 - 7.50;p = 0.011] and humidity level (60% - 70%) [ORa = 1.80;CI 95%: 0.99 - 3.28;p = 0.05]. Conclusion: Work-aggravated asthma is a reality in bakeries in Abidjan, with an estimated prevalence of 14.9%. Two of the three factors associated with this condition suggest a link with indoor air pollution. Combating air pollution in these establishments must therefore be a priority for the relevant authorities, in order to provide employees with a working environment that protects their health.

Evaluation of the Use of Long-Lasting Impregnated Mosquito Nets (LLINs) in the Health District of Dimbokro (Center of Côte d’Ivoire)

The Dimbokro health district has one of the highest incidences of malaria in Côte d’Ivoire, despite numerous campaigns to distribute Long-Acting Impregnated Mosquito Nets (LLINs). Given this observation, what are the population’s attitudes towards LLINs that could explain the high endemicity of malaria in Dimbokro? The aim of this study is to assess the knowledge, attitudes and practices of people in the health area of Nofou, one of the villages in the Dimbokro health district where malaria is most prevalent, with a view to strengthening malaria control strategies. A collection of historical health data (malaria cases and LLIN usage rates) and a cross-sectional questionnaire survey was carried out from July 20 to August 03, 2022 in 400 households selected by systematic random sampling. Data were entered using Epi Info 7 and multivariate statistical analyses were performed using IBM SPSS 22 software. In the Dimbokro health district, the rate of LLIN use was negatively correlated (r = -0.771) with malaria incidence over the six years of historical data collection. Households had an average of 53% good knowledge, 68.6% good practices and 28.4% good attitudes towards LLINs. The study also revealed that the main factors explaining LLIN use in the Nofou health area are mosquito bite (ORa = 5.29 (1.12 - 25.04)), age of household members (ORa = 1.07 (1.01 - 1.14)) and marital status (ORa = 8.45 (1.70 - 45.02)). Awareness-raising on the use of LLINs should be intensified in the Dimbokro health district. Other control strategies, such as vector control and environmental sanitation, should be considered to combat malaria.

Prevalence of Ventilatory Function Abnormalities in Residents of Attecoube Lagune, Abidjan (Côte d’Ivoire)

Introduction: Studies of abnormal ventilatory function in Côte d’Ivoire have been carried out in the workplace and in schools. The objective of this study was to determine the prevalence of respiratory symptoms and ventilatory function abnormalities in the population of the lagoon district of Attécoubé in Abidjan. Material and Methods: A cross-sectional study was carried out on 170 people in the municipality of Attécoubé Lagune. A questionnaire was used to collect information on sociodemographic, clinical, and environmental characteristics. A basic spirometry and a beta mimetic test were carried out on all the subjects surveyed. Data analysis was done with the stata 15.1 software. Results: The study population was composed of 103 women and 67 men with a sex ratio (M/F) of 0.65. The average age was 35.92 ± 15.28 years. The most frequent respiratory symptoms were chest tightness (29.41%), dyspnea (28.82%), sneezing (22.94%) and cough (22.35%). The prevalence of ventilatory function abnormalities was 43.24% among residents of Attécoubé Lagune and the most frequent abnormality was ventilatory restriction (35.15%) followed by obstruction (4.85%). The risk factor for ventilatory function abnormalities was heavy pollution [OR = 2.66;IC: 1.053 - 6.743;P = 0.038]. Conclusion: Residents of the Attécoubé Lagune district had many respiratory symptoms and a high prevalence of ventilatory function abnormalities. Improving air quality is urgently needed in this municipality.

Epidemiological Facies of Human Rabies Deaths in Côte d’Ivoire from 2016 to 2022

Introduction: Rabies is a highly fatal viral disease outside the post-exposure prophylaxis (PEP). Data from previous studies and reports from the rabies center show that cases of death from human rabies are regularly reported, despite training measures for health workers, awareness-raising and communities, and the availability of vaccines. Objectives: The aim of this study was to analyse the determinants of human rabies deaths in Côte d’Ivoire from 2016 to 2022. Method: A retrospective cross-sectional qualitative study was carried out from January to August 2023 on all the records of patients who died of human rabies at the Treichville Rabies Center from 2016 to 2022. An analysis of the rabies center’s annual activity reports from 2016 to 2022 was also carried out in order to complete the information gathered from the files. Results: The socio-demographic characteristics showed that out of 148 deaths, children accounted for 47.97% (71) and 66.22% (98) of rabies deaths were male, with an M/F sex ratio of 1.96. In terms of clinical characteristics, in 97.30% (144) of cases, the deceased had presented with furious rabies, and analysis by the Pasteur Institute of Côte d’Ivoire laboratory confirmed 101 cases (92.66%) of human rabies. Geographical distribution showed that cases of human rabies were recorded in 56 health district, and 64% (94) of the deceased lived in rural areas. The main causes of the occurrence of rabies were essentially non-use of post-exposure prophylaxis (PEP) and missed vaccination due to ignorance. Conclusion: In view of these results, control strategies and interventions need to be adapted to the epidemiological characteristics of the disease, using a community-based approach with a view to eliminating dog-transmitted rabies by 2030.

Contribution to the Improvement of Transfusion Safety: Assessment of the Pre-Donation Hemoglobin Level at the Yamoussoukro Blood Transfusion Center in Cote d’Ivoire

Introduction: Despite the progress recorded at the level of transfusion safety in Côte d’Ivoire, much remains to be done, particularly at the level of the medical selection of blood donors. The objective of the study was to make an assessment of the pre-donation capillary hemoglobin dosage for the year 2020 of the fixed collection, of the Blood Transfusion Center of Yamoussoukro. Method: This is a retrospective study that took place at the Yamoussoukro Blood Transfusion Center. The data collection related to all old and new blood donors were deemed suitable for the fixed collection of the year 2020. The method chosen for the pre-donation control is that of the portable hemoglobinometer of the HémoCue® type, more precisely 201+. Results: Of the 1160 blood donors in the study, the pre-donation hemoglobin level was not measured in 787 (67.8%) subjects of either sex. Of the subjects who had a pre-donation hemoglobin level performed, 97 (26%) blood donors had a sub-standard hemoglobin level, including 15 females and 82 males. Conclusion: Pre-donation hemoglobin testing of blood donors is effective in Yamoussoukro. However, efforts must still be made to improve the quality of the blood collected and to protect blood donors.

Practice of Controlled Temperature Chain (CTC) Technique during a Mass Vaccination Campaign in Côte d’Ivoire

Background: MenAfriVacTM is the first of the World Health Organization (WHO)’s pre-qualified vaccines to be allowed to mass vaccination campaign at a temperature below or equal to 40°C during 4 days. This new vaccination practice has already been used in some African countries. This article described the opinion and use of this new technique by actors on the field, during a mass vaccination campaign in Côte d’Ivoire, in December 2014. Methods: We conducted a crosssectional study on the practice of CTC by actors on the field and their perception on the new practice, during a mass vaccination campaign in 2 of 25 health districts in Côte d’Ivoire, in December 2014. Findings: As results, in Séguéla 98.25% of respondents expressed a favourable opinion of CTC, citing advantages such as vaccine carriers requiring no ice packs (29.2%), financial benefit (12.28%) and lighter vaccine carriers (5.26%). In Bouna, respondents gave the same advantages in, respectively, 34%, 2% and 8% of cases. The peak of the total of vials used for immunization sessions reached 376 vials at day one, then dropped to 235 vials at day three and 220 vials at day six. Discussion: Vaccinators found some benefits related to CTC practice, but on the field, they were cautious in using CTC technique.

Involvement of Healthcare Staff from First Contact Health Establishments in the Elimination of Human Rabies in the Health Districts of Ferkessedougou and Kong in Ivory Coast, 2020

Introduction: Rabies is endemic and constitutes a public health problem in Côte d’Ivoire. In the health districts of Kong and Ferkessedougou, exposure to rabies infection reported by the National Institute of Public Hygiene of Ferkessedougou averages 200 cases per year. However, in the involvement of health workers from First Contact Health Establishments (FCHE) of the 2 Districts, the management of exposed persons is unknown. This study aimed to determine the involvement of healthcare personnel in FCHE in the health districts of Ferkessedougou and Kong in the elimination of human rabies. Material and Methods: This was a prospective cross-sectional study with a descriptive aim which took place from October 21, 2020 to November 20, 2020. The data were collected using a questionnaire and then analyzed with the software EXCEL and Epi Info 3.5.3. Principle Results: It emerged from this study that the average age of the participants was 36.8 years with an average professional seniority of 5.07 years. The majority (73.90%) of healthcare staff have not received training on rabies. However, plenty of healthcare personnel respectively experienced the transmission of the rabies virus from animals to humans (98.60%), with dogs (97.10%) as the main animal vector of rabies to man, the bite (100%) as the way of contamination of rabies, the immediate washing with water and soap (66.70%), the administration of the anti-rabies vaccine (75.4%), the National Institute of Public Hygiene as a reference structure (63.8%). At the level of practices after exposure to rabies infection, the majority (65.2%) of the healthcare staff consulted the patients, of whom 84.4% and 95.6% of these consultants respectively carried out communication for social change and behavior and referred patients to the National Institute of Public Hygiene (p Conclusion: Some health workers did not have the necessary knowledge to care for people exposed to rabies infection. Thus, they were not all involved in post-exposure prophylaxis against rabies. It would therefore be desirable for the National Institute of Public Hygiene to strengthen the capacities for the prevention of rabies for all human health workers, particularly those in first contact health establishments with a view to eliminating this disease from here in 2030.

Mapping of Malaria Risk Related to Climatic and Environmental Factors by Multicriteria Analysis in the MarahouéRegion of Côte d’Ivoire

Malaria, a febrile human disease transmitted by female anopheles whose ecology is linked to water, is a major public health problem in Côte d’Ivoire, more precisely in the Marahoué region located in the southwest of the country. In order to effectively control this disease, it is necessary to understand the etiology and the diffusion pattern of the vectors. This justifies this study, which proposes to determine the areas at risk of malaria transmission in order to carry out an effective fight against this disease in this region of Côte d’Ivoire. To achieve this, a combined approach of geographic information systems and multicriteria analysis was adopted. The analysis reveals that the south and northwest of the Marahoué region present a high risk for malaria transmission. This risk is linked to indicators such as climatic factors that cover 48.36% of the study area, environmental factors such as vegetation cover (NDVI), soil moisture (NDWI), altitude, hydrography (water point) and population that covers 55.29% of the area and land use. Also, the results indicated that 50.70% of the region has favorable conditions for malaria transmission. Overall, climatic and environmental indicators are the risk factors associated with the resurgence of malaria.