BackgroundIn temperate regions, influenza epidemics occur in the winter and correlate with certain climatological parameters. In African tropical regions, the effects of climatological parameters on influenza epidemics are not well defined. This study aims to identify and model the effects of climatological parameters on seasonal influenza activity in Abidjan, Cote d’Ivoire.MethodsWe studied the effects of weekly rainfall, humidity, and temperature on laboratory-confirmed influenza cases in Abidjan from 2007 to 2010. We used the Box-Jenkins method with the autoregressive integrated moving average (ARIMA) process to create models using data from 2007–2010 and to assess the predictive value of best model on data from 2011 to 2012.ResultsThe weekly number of influenza cases showed significant cross-correlation with certain prior weeks for both rainfall, and relative humidity. The best fitting multivariate model (ARIMAX (2,0,0) _RF) included the number of influenza cases during 1-week and 2-weeks prior, and the rainfall during the current week and 5-weeks prior. The performance of this model showed an increase of >3 % for Akaike Information Criterion (AIC) and 2.5 % for Bayesian Information Criterion (BIC) compared to the reference univariate ARIMA (2,0,0). The prediction of the weekly number of influenza cases during 2011–2012 with the best fitting multivariate model (ARIMAX (2,0,0) _RF), showed that the observed values were within the 95 % confidence interval of the predicted values during 97 of 104 weeks.ConclusionIncluding rainfall increases the performances of fitted and predicted models. The timing of influenza in Abidjan can be partially explained by rainfall influence, in a setting with little change in temperature throughout the year. These findings can help clinicians to anticipate influenza cases during the rainy season by implementing preventive measures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3503-1) contains supplementary material, which is available to authorized users.
Gaps in knowledge about the influenza pandemic and vaccine highlight the challenges of pandemic preparedness in poorer countries, where substantial disparities in education and media access are evident.
Dengue has become a major public health concern in Cote d'Ivoire since 2010. In malaria endemic countries, such as Cote d'Ivoire, healthcare workers often confuse dengue with other tropical fevers, such as malaria. However, to control dengue fever, healthcare workers must be knowledgeable about this disease. A cross-sectional study was conducted on 400 healthcare workers' knowledge, attitude, and practices in relation to dengue from 3 rd September, 2014 to 20 th March, 2015 in Abidjan and its suburbs. Logistic analyses with stepwise selection were performed to explain the relationship between the dependent variable (practices) and the main explicative variable (knowledge). The distribution of participant healthcare workers by health facility showed that 55% worked in reference health facilities. Among the 340 participants, 70 (21%) had a good knowledge of dengue fever, while 71 (21%) had good diagnostic practices. The logistical analysis with stepwise selection showed that practices were explained by knowledge (adjusted OR (aOR) = 2.69; p = 0.004), gender (aOR = 1.88; p = 0.036), occupation (aOR = 0.37; p = 0.003) and epidemic risk perception (aOR = 2.59; p = 0.001). The study shows that nurses had better practices in term of dengue diagnosis compared with medical doctors. Similarly, healthcare workers who had good knowledge of dengue fever also had good practices. However, there is a great need for healthcare workers to be trained on how to detect dengue disease.
Introduction: During the 2009 influenza A(H1N1) pandemic (pH1N1), different methods were promoted to reduce the spread of influenza, including respiratory etiquette and vaccination. To identify knowledge gaps about influenza and to plan the vaccination campaign against the pandemic in Côte d'Ivoire, a survey was conducted among health-care providers (HCPs) to assess their knowledge about influenza and their willingness to be vaccinated. Methodology: A cross-sectional survey was performed in the city of Abidjan on 16-18 February 2010, in the three university teaching hospitals, a randomly selected general hospital, and two randomly selected private clinics. In face-to-face interviews, 383 health-care professionals were asked questions about their knowledge of influenza, means of influenza prevention, and their willingness to be vaccinated. Data analysis, both univariate and multivariate, was performed using SPSS. Results: Willingness to be vaccinated against pH1N1 was 80% (n = 284), and 83% of the HCPs would recommend the vaccine to others. The respiratory mode of transmission of influenza was known by 85% (n = 295) of the participants and 50% (n = 174) believed that seasonal influenza virus and pH1N1 virus were different. In a multivariate model, the factors significantly associated with willingness to receive pH1N1vaccine were fear of pH1N1 disease (OR = 2.1; IC = 1.02-4.35), having only a high school education (OR = 8.28; IC = 2.04-33.60), and feeling at risk to contract pH1N1 (OR = 11.43; IC = 4.77-27.38). Conclusion: The willingness to be vaccinated against influenza A (H1N1) by health professionals is real.
Introduction: Chronic myeloid leukemia (CML) accounts for 7%-15% of all leukemias affecting adults. The incidence in Algeria is 0.4/100,000 inhabitants in 2009. The aim of this study is to establish an Algerian-Tunisian epidemiological approach of CML and to know the characteristics of the disease in both countries. Materials and methods: This is a retrospective, longitudinal and multicenter study, including Algerian and Tunisian patients with CML diagnosed between January 2010 and December 2014. Through a data form distributed to various hematology departments, we collected and analyzed the following information: Patient's general characteristics, profession, circumstances of discovery of the disease, clinical and para-clinical examinations outcomes at the time of diagnosis including blood count, blood smear, bone marrow aspiration, cytogenetics, molecular biology, stages of the disease and the Sokal and Eutos prognostic classification scores. Bio-statistical tests: incidence, prevalence and rate of prevalence or relative prevalence (reported to 100,000 inhabitants / year). The descriptive analysis of quantitative and qualitative variables as percentages and 95% confidence interval. The Chi2 test is used to compare two variables. Results: We collected 1349 cases, including 325 from 06 Tunisian hematology units and 1024 from 18 Algerian units. The incidence in the Algerian-Tunisian population was 0.67/100,000 inhabitants with a prevalence rate of 2.72/100,000 inhabitants. The incidence in Tunisia was 0.50 / 100,000 inhabitants with a prevalence of 227 cases in 2014. In Algeria the incidence was 0.53/100,000 inhabitants with a prevalence of 1030 in 2014. The median age is 48 years (03-90) with a peak incidence in the age group (45-49 ans) and slight male predominance (sex ratio: 1,2). There was any notion of risk exposure. The average time between the start of the unrest and the date of diagnosis is 127 days (1-667). The circumstances of discovery: fortuitous in 30.5% (n = 355), splenomegaly in 39.7% (n = 463), asthenia in 24.6% (n = 287), a complication in 8.4% (n =95). Clinical examination includes general signs in 424 cases (36.4%): Weight loss 22.6% (n = 263), profuse sweating 13.8% (n = 13, 8%), bone pains found in 7.8%, splenomegaly in 81.7% (n = 952) with an overhang splenic average of 11.5 ± 5.3 cm (1-28), cutaneous and subcutaneous bleeding: 13.5% (n = 97), thrombosis 0.9% (n = 09). Biological characteristics: the Complete blood count (n = 1185) shows a white blood cells average rate of 171,223 G/L (34,700-984,800), hemoglobin average rate of 10.2 g/dl (4-17), platelets at 394,070 g/l (85-1340). Blood smear 96.3% (n = 1121): the average myelemia was 43.2% (10-98%). The Myelogram is practiced in 55% (n = 641), the average rate of the granular 76,5% (40-99%), erythroblasts 10.5% (0-82%), average blasts 3.6%. The karyotype 38.1% (n = 444), the Philadelphia chromosome was found in 423 cases (95, 3%); additional abnormalities were found in 17 cases (3.8%). The Fish was practiced in 281 cases (24.1%) and transcribed bcr/abl was found in 257 cases (91.4%). Molecular biology is practiced in 672 cases (57.7%) the transcript bcr/abl is found in 100%, the transcript of the type is specified in 373 cases, it is kind of b2a2 in 159 cases (42.6%), a b3a2 type in 180 cases (48.3%) and other transcribed in 34 cases (9.1%). CML chronic phase is diagnosed in 88.8% (n = 1051), acceleration phase in 9% (n = 107) acutisation phase in 3.1% (= 37). The distribution of pts according to Sokal prognostic classification (n = 948) describes a predominance of intermediate risk in 54% (n = 511), high risk in 30.3% (n = 287) and low risk in 16% (n = 152). The Eutos score is specified in 769 cases (66%), it is less than 87 in 661 cases (86%) and more than 87 in 108 cases (14%). Conclusion: The incidence of CML in the Algerian-Tunisian population is 0.67/100,000 population with a prevalence rate of 2.72/100,000 inhabitants. The young adult is more affected with a peak incidence between 45 and 49. The average time between the onset of the disease and the diagnosis remains long and the delay probably explains the frequency of tumor forms encountered in Algeria and the prevalence of high and intermediate risk, according to Sokal prognostic classification. Disclosures No relevant conflicts of interest to declare.
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