This descriptive retrospective study ran from August 2003 to December 2003 at the Rabies Center of the National Institute of Public Health in Abidjan. It covers subjects at risk of rabies transmission during 2004. Identification of participants in the study was made via a census of patients consulting the rabies clinic: a total of 533 subjects were included, predominantly male (54.6%), without gainful employment (57%), with an average age of 26.7 years. Those who lived outside the city of Abidjan accounted for 21.6%. In 88.2% of cases, they were exposed due to a bite. Dogs (90.8%) represented the main species responsible for this kind of exposure. Only 3.2% of these animals had a current valid rabies vaccine. The owner of the animal was not known in 71% of cases. The observance of the recommended immunization schedule for 4 doses was 53.1%. Of the 533 patients registered in the study, 46.9% had stopped treatment vaccine. Some factors have been identified as adversely affecting adherence, such as the vaccination treatment plan of 5 doses, exposure outside the city of Abidjan, unemployment, incurrence of superficial injuries, exposure from an animal bite and lack of immunization of the animal. The results show that the strategies against rabies must focus increasingly on the importance of adherence to treatment and education of the population vis-à-vis the risk of rabies.
The purpose of this study is to describe the epidemiological profile of subjects exposed to rabies in the anti-rabies center of Abidjan in Ivory Coast. The paper is based on a cross-sectional study conducted among all people exposed to the risk of rabies and followed in the anti-rabies center from January to December 2008. During the study period, 2,673 subjects were exposed, i.e. 5 exposures for every 10,000 persons. 1,534 patients (57.4%) were male. The most exposed age groups were the 0-9 and 10-19 age groups (22.4% and 29.5% respectively). In Abidjan, 608 individuals (22.7%) were exposed in Cocody, 471 individuals (17.6%) in Abobo, and 310 individuals (11.6%) in Yopougon. Exposure occurred in 76.9% of cases (2,055 subjects) at home and exclusively concerned visitors of the family. Exposures by animal bites represented 88.1% (2,354 subjects) of all cases, while 23.2% (620 subjects) of exposures were category III. The average period between exposure and consultation was 10 days. Subjects were exposed as a result of contact with a dog in 92.1 % of cases (2,462 subjects). The animal was found alive in 74.9% (2,002 cases) and was not immunized in 87.2% of cases (2,331). Post-exposure prophylaxis was given up by 1,470 persons (55.2%). 13 subjects were received at the stage of clinical rabies. Increased knowledge of the epidemiological profile of rabies exposure will contribute to improving the management of the disease in Ivory Coast.
Résumé Pour déterminer la fréquence des accouchements à domicile dans deux quartiers précaires de la commune de Yopougon, ainsi que les facteurs favorisant le choix de ce lieu d’accouchement, nous avons mené une enquête de ménages du 13 février au 12 mai 2006. Nous avons interrogé toutes les femmes résidant dans ces quartiers et qui ont accouché durant la période allant de janvier 2005 à la date de notre enquête. Il est ressorti de cette étude que 17 % des accouchements ont eu lieu en dehors d’une maternité ; les femmes interrogées qui sont pour la plupart analphabètes et sans profession, ont en moyenne 26 ans ; 64 % méconnaissaient les risques liés à la grossesse et à l’accouchement à domicile. Par ailleurs, 25 % de ces femmes trouvaient l’accueil à la maternité mauvais et 54 % trouvaient le coût de l’accouchement à la maternité trop élevé. Les facteurs qui ont favorisé ces accouchements sont l’inaccessibilité géographique et financière, l’ignorance des femmes et la mauvaise perception des services de maternité. Pour améliorer le taux de fréquentation des services de maternité et réduire la fréquence des accouchements sans assistance médicale, il conviendrait de tenir compte de toutes les influences qui s’exercent sur les femmes lorsqu’elles doivent choisir le lieu de l’accouchement.
This study shows a good level of knowledge of household heads concerning rabies. However, harmful health practices persist. Public awareness of rabies therefore needs to be reinforced.
Resurgence of yellow fever epidemics in Côted'Ivoire remains a major problem of public health. To describe this disease through the early alarm system of National Institute of Public Hygiene (NIPH) is convenient to us. This is a cross-sectional study with descriptive aiming, which proceeded with epidemiological surveillance service of NIPH. The data were collected over 7 years (from 2001 to 2007), starting from the cards of notification, reports, and registers of the service. The main findings of our study are that: 1) we listed 1468 suspect cases including 41 confirmed and the lethality rate was 17.07% among the confirmed cases; 2) most cases of yellow fever were recorded between the years 2001 and 2007; 3) confirmed cases of yellow fever were above 15 years old in 83% of cases. This could be explained by absence of immunization during this age period; 4) recrudescence of cases was observed during the rainy season (June-July and September-October) and the principal vector was Aedes aegypti; 5) data analysis revealed a mean level of 79% for completude and 57%for promptitude of notification; these rates are inferior to WHO norms and; 6) average time of vaccine response post-epidemic was 31 days. Late response is due to difficulties in supplying vaccines. Reinforcement of epidemiological surveillance, prevention by mass immunization, and measurements of hygiene and cleansing are essential to slow down the evolution of this disease.
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