Building the Capacity of Health Professionals in Monitoring and Evaluation in a Public Health Institution: Experience of the National Institute of Public Health (NIPH) of Côte d’Ivoire

Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.

Factors Associated with Overweight among Workers of the Ministry of Labor and Public Service in Benin in 2023

Introduction: The problem of excess weight is pandemic and affects the majority of nations, regardless of their level of development. However, the prevalence of overweight among workers in Benin is very poorly documented. To fill this gap, the present study aimed to determine the prevalence and factors associated with overweight among workers of the Ministry of Labor and Public Service (MTFP) in 2023 in Benin. Materials and Methods: This is a descriptive cross-sectional study with analytical purposes carried out from August 16 to December 17, 2023, among MINISTRY OF LABOR AND PUBLIC SERVICE staff. The variables studied were overweight, sociodemographic, occupational and dietary characteristics, lifestyle, anthropometric factors and family history of obesity. An exhaustive recruitment of workers meeting our inclusion criteria and a questionnaire survey was carried out. Data were analyzed using R 4.0.4 software. A bivariate analysis followed by a multivariable analysis made it possible to identify the factors associated with overweight at the p Results: In total, 379 workers were included in our study. The average age of the surveyed workers was 44.86 years ± 7.67 years, with 202 (53.30%) workers at least 45 years old. Men predominated with a number of 228 (60.16%). The prevalence of overweight was 63.32% (95% CI: [58.23 - 68.15]) and the associated factors after multivariate analysis were: female sex (ORa = 4.00;95% CI [2.11 - 7.76];p Conclusion: The prevalence of overweight is high among ministry of labor and public service workers. Education and awareness in the professional environment on the prevention and management of risk factors are essential for a long-term impact on a notable regression of this public health phenomenon.

Epidemiology of Low Birth Weight in the Lake Areas of Cotonou (Benin Republic)

Introduction: Low birth weight is a significant public health problem worldwide, particularly in low-and-middle-income countries. This study aimed to investigate the epidemiology of low birth weight in the lake areas of Cotonou. Methods: A cross-sectional analytical study included 931 records of women who gave birth in 2022 in the Cotonou 1-4 health zone. Completed maternity records were included in this study, except for premature births and congenital malformations. Birth weight was the dependent variable. Sociodemographic, obstetrical, preventive care and child-related data were collected using a digitized form. These data were analyzed using SPSS software to determine the prevalence and factors associated with low birth weight using multiple logistic regression analysis. Results: The prevalence of low birth weight was 16.30%. Factors related to this prevalence were non-use of mosquito nets during pregnancy (OR = 2.72;CI: 1.275 - 5.805), twin pregnancy (OR = 9.97;CI: 3.869 - 25.696), previous abortion (OR = 1.61;CI: 1.034 - 2.515), low number of pregnancy (OR = 3.97;CI: 1.276 - 12.393), trimester of first antenatal visit (OR = 3.47;CI: 1.821 - 6.638) and birth size less than 45 cm (OR = 5.98;CI: 2.965 - 12.083). Conclusion: The prevalence obtained from this study justifies the need to support pregnant women in this health zone. It is, therefore, essential to strengthen communication and health promotion strategies for women before, during, and after pregnancy.

Contributions of the Measles Follow-Up Vaccination Campaign to Improving the Vaccination Coverage of Children Aged 6 - 59 Months in the Democratic Republic of the Congo in 2019

Background: In accordance with its measles elimination strategic plan 2012-2020, the Democratic Republic of the Congo (DRC) organized a follow-up vaccination campaign against measles from October to December 2019 in 26 provinces. This study aims to establish the contribution of this supplementary vaccination campaign to protecting children against measles. Methods: The survey was carried out in November 2020 among households of the DRC, according to the 2018 revised version of the World Health Organization’s stratified cluster sampling method, using multiple stage sampling. It targeted 280 children aged 6 - 59 months per stratum or province, with 10 children in each of the 28 selected clusters. Data collection using tablets with centralized and real-time data processing was preceded by enumeration to refine the household sampling frame. Clusters and households were selected by random draw. Data collected with CS Pro 7 software were analyzed with SPSS, Epi info 7 and Excel software to determine indicators and make before-after comparisons using the McNemar test, at a precision threshold of 5%. Results: Of the 8535 surveyed children, 89.5% were vaccinatedduring the follow-up campaign and 81.6% were vaccinated before. Only 3.7% had correctly completed campaign vaccination cards. Estimated vaccination coverage increased from 80.8% before the campaign to 92.6% after the campaign (p 0.001). Vaccination coverage after campaign against measles improved in all provinces (p < 0.001) except Bas-Uele and Maniema. Thirteen provinces reached the national coverage target of 95%, compared to five before the campaign. The proportion of zero-dose children dropped significantly after this campaign from 19.2% to 7.4% (p 0.001), and even fell below 1% in six provinces. Conclusion: This measles vaccination campaign improved overall vaccination coverage by 10% and reached more unvaccinated children. Efforts must continue to improve the retention of vaccination card, the adherence of unvaccinated children and the effectiveness of routine vaccination.

Leisure-time physical activity and all-cause mortality and cardiovascular disease in adults with type 2 diabetes:Cross-country comparison of cohort studies

Purpose:This study aimed to quantify the dose-response association and the minimal effective dose of leisure-time physical activity(PA)to prevent mortality and cardiovascular disease in adults with type 2 diabetes.Methods:Cross-country comparison of 2 prospective cohort studies including 14,913 and 17,457 population-based adults with type 2 diabetes from the UK and China.Baseline leisure-time PA was self-reported and categorized by metabolic equivalent hours per week(MET-h/week)according to World Health Organization recommendations:none,below recommendation(>0-7.49 MET-h/week);at recommended level(7.5-14.9 MET-h/week);above recommendation(>15 MET-h/week).Mortality and cardiovascular disease data were obtained from national registries.Results:During a median follow-up of 12.4 and 9.7 years,in the UK and China cohorts,repectively,higher levels of leisure-time PA were inversely associated with all-cause(1571 and 2351 events)and cardiovascular mortality(392 and 1060 events),mostly consistent with a linear dose-response relationship.PA below,at,and above recommendations,compared with no activity,yielded all-cause mortality hazard ratios of0.94(95%confidence interval(95%CI):0.79-1.12),0.90(95%CI:0.74-1.10),and 0.85(95%CI:0.70-1.02)in British adults and 0.87(95%CI:0.68-1.10),0.88(95%CI:0.74-1.03),and 0.77(95%CI:0.70-0.85)in Chinese adults.Associations with cardiovascular mortality were more pronounced in British adults(0.80(95%CI:0.58-1.11),0.75(95%CI:0.52-1.09),and 0.69(95%CI:0.48-0.97))but less pronounced in Chinese adults(1.06(95%CI:0.76-1.47),1.01(95%CI:0.80-1.28),and 0.79(95%CI:0.69-0.92)).PA at recommended levels was not associated with lower rates of major adverse cardiovascular events(2345 and 4458 events).Conclusion:Leisure-time PA at the recommended levels was not convincingly associated with lower mortality and had no association with risk of major adverse cardiovascular events in British or Chinese adults with type 2 diabetes.Leisure-time PA above current recommendations may be needed to prevent cardiovascular disease and premature mortality in adults with type 2 diabetes.

An extended social force model on unidirectional flow considering psychological and behavioral impacts of hazard source

An accurate assessment of the evacuation efficiency in case of disasters is of vital importance to the safety design of buildings and street blocks.Hazard sources not only physically but psychologically affect the pedestrians,which may further alter their behavioral patterns.This effect is especially significant in narrow spaces,such as corridors and alleys.This study aims to integrate a non-spreading hazard source into the social force model following the results from a previous experiment and simulation,and to simulate unidirectional pedestrian flows over various crowd densities and clarity–intensity properties of the hazard source.The integration include a virtual repulsion force from the hazard source and a decay on the social force term.The simulations reveal(i)that the hazard source creates virtual bottlenecks that suppress the flow,(ii)that the inter-pedestrian push forms a stabilisation phase on the flow-density curve within medium-to-high densities,and(iii)that the pedestrians are prone to a less orderly and stable pattern of movement in low clarity–intensity scenarios,possibly with lateral collisions passing the hazard source.

Epidemiology of Low Birth Weight in the Lake Areas of Cotonou (Benin Republic)

Introduction: Low birth weight is a significant public health problem worldwide, particularly in low-and-middle-income countries. This study aimed to investigate the epidemiology of low birth weight in the lake areas of Cotonou. Methods: A cross-sectional analytical study included 931 records of women who gave birth in 2022 in the Cotonou 1-4 health zone. Completed maternity records were included in this study, except for premature births and congenital malformations. Birth weight was the dependent variable. Sociodemographic, obstetrical, preventive care and child-related data were collected using a digitized form. These data were analyzed using SPSS software to determine the prevalence and factors associated with low birth weight using multiple logistic regression analysis. Results: The prevalence of low birth weight was 16.30%. Factors related to this prevalence were non-use of mosquito nets during pregnancy (OR = 2.72;CI: 1.275 - 5.805), twin pregnancy (OR = 9.97;CI: 3.869 - 25.696), previous abortion (OR = 1.61;CI: 1.034 - 2.515), low number of pregnancy (OR = 3.97;CI: 1.276 - 12.393), trimester of first antenatal visit (OR = 3.47;CI: 1.821 - 6.638) and birth size less than 45 cm (OR = 5.98;CI: 2.965 - 12.083). Conclusion: The prevalence obtained from this study justifies the need to support pregnant women in this health zone. It is, therefore, essential to strengthen communication and health promotion strategies for women before, during, and after pregnancy.

From London buses to activity trackers:A reflection of 70 years of physical activity research

In 1953,Morris et al.^(1)published their ground-breaking findings among London bus drivers and conductors,linking physical activity to a major chronic disease for the first time.This seminal paper marked the birth of a new field—physical activity epidemiology.^(1)Since then,the field has flourished,evidenced by mounting scientific publications.^(2)Our knowledge about the role of physical activity in disease prevention has expanded from coronary heart disease in Morris et al.’s^(1)initial study to dozens of additional diseases and conditions,such as diabetes,cancers,and dementia.^(3)More than 7 decades and thousands of publications later,we critically reflect on several aspects of the progress in physical activity epidemiology.

Correlation between genotypes of Orientia tsutsugamushi and clinical characteristics of patients with scrub typhus in Guangzhou,China

Objective:To explore the correlation between genotypes of Orientia(O.)tsutsugamushi and clinical characteristics of scrub typhus patients.Methods:Clinical data of patients with scrub typhus admitted to different types of medical institutions in Guangzhou from September 2012 to December 2016 were collected using medical records.Demographic data,clinical manifestations,as well as hematological and biochemical indicators of patients infected with different genotypes were analyzed and compared.Results:A total of 192 patients were included in this study,including 121 patients with Karp genotype of O.tsutsugamushi infection(63.0%),36 patients with Gilliam genotype(19.0%),23 patients with Kato genotype(12.0%),and 12 patients with TA763 genotype(6.0%)infection.The median value of albumin in patients with Karp genotype infection was significantly lower than that of Gilliam-infected patients(P=0.032).Patients with Karp genotype infection had a significantly longer hospital stay(9 days)than those with Gilliam genotype(7 days)(P=0.009)and Kato genotype infection(6 days)(P=0.005).Karp-infected patients also represented for the largest number of patients with complicated organ involvement(88/133,66.2%).Furthermore,Karp-infected patients had higher risk of developing multiple organ dysfunction syndrome(18.2%)and requiring intensive care unit treatment(15.9%).Besides,patients with Gilliam genotype(8 days)and TA763 genotype infection(7.5 days)had shorter fever duration than those with Karp genotype(9 days)and Kato genotype(9 days)infection,respectively.Conclusions:Genotypes of Orientia tsutsugamushi were associated with varying clinical manifestations,organ involvement,and treatment outcomes,suggesting that genotypes ranged in virulence.

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.

A Problem Not to Be Ignored: The Influencing Factors of Mobile Phone Addiction and Its Influence on Sleep Quality

Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attention. The present study aims to analyze the current state of mobile phone addiction and its impact on sleep quality within the population, while also exploring the influence of related factors on sleep quality. Ultimately, this research will provide a scientific foundation for targeted intervention measures and strategies. Methods: A total of 253 permanent residents in Nanjing were randomly selected as study subjects. The Mobile Phone Addiction Index (MPAI) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the degree of smartphone addiction and sleep quality of the study subjects. Body mass index (BMI) was measured according to standardized procedures. Independent sample t-test, Chi-square test, rank sum test and multiple linear regression were used to analyze the correlation between mobile phone addiction and sleep quality, and P Results: 117 people (46.2%) were addicted to mobile phones. Chi-square test showed that the rate of mobile phone addiction in drinking group was significantly higher than that in non-drinking group (P P P P P P P P P P Conclusion: Mobile phone addiction may lead to shorter sleep duration and reduce sleep efficiency. The withdrawal of mobile phone addiction may have a negative impact on sleep quality. According to the characteristics of the population, appropriate comprehensive intervention measures should be taken to build an effective evaluation system, so as to reduce the impact of mobile phone addiction and withdrawal problems on sleep and improve sleep quality.

Women on Boards of Directors

This research aims to measure the current gender representation in membership of boards of directors,and to study the factors affecting the presence of women on boards.The results of the study will support the decision makers and policy makers at all levels by providing knowledge that contributes to bridging the current gap in participation of women boards.The methodology used in this research is the descriptive analytical approach,which relies on quantitative methods in the process of collecting and analyzing data.This study represents the boards of directors in the three sectors(public,private,and non-profit)in the Kingdom of Saudi Arabia,The study sample contained 350 targets,where a random sample of 150 people in the public sector,100 people in the private sector,and 100 people in the non-profit sector were selected.The research result found that the majority of the responses believe that the lack of experience and training,and social factors,are the most impact areas of explaining the reasons for the existence of a gap in women’s membership in boards of directors in the three sectors.And the most important reasons for the existence of a gender gap in board membership are:there is no statutory minimum percentage for women’s representation on boards of directors,and scarcity of female competencies in general,and the lack of women occupying leadership positions.

Assessing healthcare workers’knowledge and confidence in the diagnosis,management and prevention of Monkeypox

BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of Mpox.METHODS We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July 2023.The questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and management.The data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical significance.RESULTS The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a vaccine.The confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among HCWs.The confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent it.There is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi HCWs.We encourage future researchers to assess potential hesitancy toward Mpox vaccination and its associated factors.

Prevalence of obesity,determinants,and its association with hyperglycaemia among community dwelling older adolescents in India

BACKGROUND Globally,obesity and diabetes mellitus(DM)are emergent public health concerns in the adolescent population.India,home to the largest adolescent population and the second largest diabetes cohort is experiencing rapid but unplanned urbanization,with accompanying unhealthy nutritional transition,and sedentary lifestyle.AIM To determine prevalence and determinants of obesity and hyperglycaemia and their association among community-dwelling older adolescents(15-19 years)in India.METHODS This cross-sectional analysis from the national family health survey-5 included data of 258028 adolescents aged 15-19 across India(2019-2021).The survey employed stratified two-stage sampling,with systematic random sampling in rural and urban areas.Statistical analysis included descriptive statistics,bivariate,and multivariable logistic regression,employing generalized linear models.RESULTS The weighted prevalence of DM was 1.09%including 0.77%[95%confidence interval(CI):0.72-0.83]previously diagnosed and 0.32%(95%CI:0.29-0.35)newly diagnosed cases detected on survey screening.On adjusted analysis,increasing age,higher education levels,higher wealth index,and overweight/obesity were the factors significantly associated with presence of DM.Only 61%of the adolescents with previously diagnosed DM were on anti-diabetes treatment.The weighted prevalence of overweight/obesity among older adolescents was 6.9%with significantly higher odds in the male sex,having higher educational levels,urban residence,and those with a higher wealth index.CONCLUSION Nearly one in hundred older adolescents in India have diabetes,with one in three undiagnosed.Strengthening DM screening and treatment access among adolescents through public health programs is urgently warranted.

Frequency of the C677T Polymorphism of MTHFR, G20210A of Prothrombin and R506Q of Factor V Leiden in Type 2 Diabetics in Abidjan

In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.

Arterial Hypertension-Related Factors within Custodial Settings of Southern Benin in 2023

Introduction: Hypertension, a non-communicable disease, is a major public health threat worldwide, accounting for a high level of morbidity and mortality. Although it has been extensively published among the general population, further research is needed to understand the reality of hypertension within the custodial setting. This study aimed to investigate the factors associated with arterial hypertension in custodial settings in southern Benin in 2023. Methods: This was a cross-sectional, descriptive, analytical study held in prisons in southern Benin from March to April 2023, involving inmates selected by two-stage random sampling. In the first stage, four prisons out of the six in the southern region of Benin were selected by simple random sampling. In the second stage, the prisoners were selected by systematic random sampling, with the sampling frame being the numbered list of eligible prisoners in each prison selected. Data collected by observation and questionnaire survey were analyzed using Stata 11 software. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and diastolic blood pressure ≥ 90 mmHg. Overweight was defined by a body mass index (weight/height2 (kg/m2) ≥ 25. Factors associated with hypertension were identified by multiple logistic regression, at a 5% threshold of significance. Results: Altogether 336 inmates aged 37.55 ± 1.72 years were surveyed. The prevalence of hypertension in custodial settings in southern Benin in 2023 was 31.32% (95% CI [17.06;52.57]). Associated factors were inmate age (ORa = 3.36 95% CI: [1.94;5.85]) and abnormal waist circumference (ORa = 2.61 95% CI [1.27;5.40]). Conclusion: The prevalence of arterial hypertension in prisons of southern Benin (31.32%) is high when compared with the national average (25.9% (22.5-29.3)). The ministries of the Interior and Health need to collaborate to involve inmates in preventive strategies for non-communicable diseases, including hypertension.

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.

Extension of Chemoprevention of Seasonal Malaria to Five Cycles and to Children from the Age of 6 to 9 Years in Africa: Analysis of Its Acceptability, Feasibility, Cost and Impact A Systematic Review

Introduction: Seasonal Malaria Chemoprevention (SMC) aims at preventing malaria in children during the high transmission season. It has been recommended by the WHO since 2013 for children from the age of 3-59 months. However, despite the impact of this intervention, a peak in the prevalence and incidence of malaria is observed in children from the age of 5-9 years. The aim of this study is to determine from the current literature the feasibility, impact and cost-effectiveness of extending SMC to five cycles and to older children. Methods: A litterature search of PubMed/Medline, NCBI and Google scholar identified 1333 articles. After reading the titles and abstracts by two authors, 24 articles were selected and submitted for full reading. Random control studies on the extension of SMC, malaria, feasibility of SMC, impact of SMC and cost-effectiveness of SMC were selected. A total of 16 articles were included for the qualitative synthesis after excluding 8 studies. Results: Following the summary of the evidence, we conclude that the extension is feasible but will be confronted with the unavailability of older children. The intervention period coincides with field work. SMC is effective in reducing the prevalence and incidence of malaria and the parasite density in children. The financial cost of administering SMC is lower than that of treating a child suffering from malaria. Conclusion: After analysing the information, it was found that the majority of the African population supports the extension of the SMC to the number of cycles and the age group in order to alleviate the high mortality and morbidity rates among children due to malaria.

Excessive Drowsiness among Truck Drivers in Benin in 2023: Associated Factors and Risk of Crashes Occurrence

Introduction: Over-drowsiness is a condition with serious consequences, including road accidents. The condition, however, is often ignored both by carers as well as victims themselves. The aim of the present study was to investigate the factors associated with excessive drowsiness in Cotonou, Benin 2023, along with its influence on the occurrence of crashes among truck drivers. Methods: This was a descriptive and analytical cross-sectional study, held from March 13 to April 10, 2023, focusing on large truck drivers over 18 years of age, selected by convenience from parking lots in and around the city of Cotonou. Data collected using questionnaires on socio-demographic and behavioral factors, sleeping habits and working conditions were processed using Stata 15.0 software. Excessive drowsiness was defined by a score above 10 on the Epworth scale. Associated factors were found by multiple logistic regression, at a threshold of 0.05. Results: Altogether 304 drivers, all male and aged 35.98 ± 8.42 years, were surveyed. The prevalence of excessive drowsiness was 29.2%. The associated factors identified were not practicing sport OR = 2.27, CI95% = [1.33;3.86], p = 0,002;sleep duration per working day OR = 1.82;CI95% = [1.06;3.11], p = 0,027 and average distance travelled per day OR = 3.40;CI95% = [1.53;7.56], p = 0,003. Excessive drowsiness was associated with a 1.73-fold increased risk of road accidents (CI95% [1.04;2.87];p = 0.03). Conclusion: Communicating excessive drowsiness and its associated factors to all the stakeholders in the haulage chain is essential to help prevent road accidents.

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.