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Objective: The aim of this study was to determine the prevalence of HBsAg carriage in candidates for gendarmerie recruitment., Methods: This was a prospective cross-sectional study conducted from April 7, 2010 to September 12, 2010 at the Abidjan military hospital. It involved candidates for the national gendarmerie competitive examination who agreed to take part in the study. The parameters studied were socio-demographic characteristics, factors of exposure to the hepatitis B virus and the presence of HBs antigen in the blood. Data were analyzed using EPI INFO software. Proportions were compared using the chi-square test or the chi-square test with Yates correction, or Fischer's exact test when the conditions for applying chi-square were not met. The difference was statistically significant if p ≤ 0.05., Results: During the study period, we included 891 male candidates, whose average age was 22.5 years (18-26 years). The prevalence carriage of HBsAg in the candidates was 15.6%. The prevalence carriage of HBsAg was highest in candidates aged 18 years (24%), in married candidates (33.3%) and in those who had more than three sexual partners 6 months prior to the survey (19.4%).The prevalence carriage of HBsAg was also higher in candidates who had never used condoms (20.6%), in those who were transfused (27%)., Conclusion: The prevalence of HBsAg carriage is high in candidates for gendarmerie recruitment. A policy of vaccination against HBV must be implemented to reduce HBsAg carriage in the army and in the ivorian population., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Background: Travelers may be responsible for the spread of vaccine-preventable diseases upon return. Travel physicians and family physicians may play a role in checking and updating vaccinations before traveling. Our aim was to evaluate the vaccine coverage for mandatory and recommended vaccination in travelers attending a travel medicine clinic (TMC)., Methods: Vaccine coverage was measured using the current French immunization schedule as reference for correct immunization, in travelers providing a vaccination certificate during the TMC visit (university hospital of Saint-Étienne), between August 1, 2013 and July 31, 2014., Results: In total, 2336 travelers came to the TMC during the study period. Among the 2019 study participants, only 1216 (60.3%) provided a vaccination certificate. Travelers who provided a vaccination certificate were significantly younger than travelers who did not (mean age: 34.8±17.8 vs. 46±18.4 years, P<0.005) and were less likely to be Hajj pilgrims. Vaccine coverage against Tetanus, Diphtheria, and Poliomyelitis (Td/IPV vaccine) was 91.8%, 78.6% against Measles, Mumps, and Rubella (MMR), and 59.4% against Viral Hepatitis B (HBV). BCG vaccine coverage was 71.9%. Older travelers were less likely to be correctly vaccinated, except against HBV as vaccinated travelers were significantly older than unvaccinated travelers., Conclusion: Obtaining information about immunization in travelers is difficult. Coverage for routine vaccines should be improved in this population. Travel medicine consultations could be the opportunity to vaccinate against MMR, HBV, and Td/IPV., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

This paper is about a Brugada syndrome (BS) of accidental discovery in a patient from Benin during an intestinal shigellosis episode in the infectiology department of university hospital of Saint-Etienne, France. Authors establish a link between these two diseases. After a literature's review, they underline that BS is under-diagnosed in Africa. Furthermore, they highlight socio-cultural characteristics of sudden deaths in West Africa including BS.

The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.

Blood exposure accidents are the source of major risks of contamination of healthcare personnel. The objective of this study was to describe the knowledge of standard precautions, and the attitudes and practices of nursing and midwifery students in relation to this accidental exposure. This cross-sectional survey, conducted in November 2011, was based on voluntary anonymous questionnaires completed by students working in the medical ward of the Bobo-Dioulasso teaching hospital. Of the 275 students asked to participate, 219 (92.8%) completed the questionnaire: 138 (63,0%) were student nurses and 81 (37.0%) student midwives. Their mean age was 27.9 ± 5 years. Among them, 64 (29.1%) acknowledged accidental exposure to blood during treatment performed as part of their hospital work. Only 30 of these 64 cases were reported at the time. The standard precautions for the prevention of these accidents were known to 131 students (59.8%); 58.4% always wore gloves for invasive procedures; 74.9% reported that the syringe container was "always" or "often" used. The needles used were "always" or "often" recapped before disposal in only 39.1% of cases. Only 11.0% were fully vaccinated against hepatitis B. Blood exposure accidents were not uncommon among these students and their knowledge of the standard precautions and actions to take in case of an accident is insufficient. These data show the need for further training and awareness campaigns to improve these hospital practices.

The objective of this study is to describe the clinical, biological, therapeutic and evolving current profile of hospitalized patients with HIV infection in the cohort of the Infectious and Tropical Diseases Unit (ITDU) in the aim to improve their care management. This is a retrospective study, conducted on medical data of hospitalized cases of patients with HIV infection in the ITDU at the teaching hospital of Treichville (Abidjan) from 2006 to 2007. During the two years, 447 patients were included in the study. Their average age was 39 years [18 years-86 years] and sex ratio was 0.69. Of the 447 patients, 35% were unemployed and 67% were new patients who had never undergone antiretroviral therapy (ART). The duration of drug exposure was less than 6 months in 59% of treated patients. The average time to initiate ART was seven weeks. Among naive patients 41.9% were lost to follow up, 35.9% were waiting for treatment and 22.1% waiting for baseline biological test to initiate ART. At the initiation of ART, 79.6% of patients had a CD4 count less than 200/mm(3). The reasons of hospitalization defining AIDS were dominated by tuberculosis (34.2%), cerebral toxoplasmosis (17.9%) and neuromeningeal cryptococcosis (8%). The main reasons of hospitalization in classifying non-AIDS were pyelonephritis (6.5%), bacterial pneumonia (5.4%) and undetermined infectious encephalitis (4.9%). Hospital mortality was 24.4%. The leading causes of death were tuberculosis (22.9%), cerebral toxoplasmosis (20.2%), undetermined infectious encephalitis (18.3%) and cryptococcal meningitis (13.7%). The profile of PLHIV in hospital is characterized by profound immunosuppression due to late diagnosis and high mortality associated with severe opportunistic infections and late initiation of ART.

Objective: To describe the epidemiological and clinical features and the outcome of tetanus with a surgical wound (open fracture, burn, incision, curettage, etc) as the portal of entry., Methods: Cross-sectional analysis of records of patients hospitalized in the department of infectious and tropical diseases in Abidjan for surgical tetanus from 2003 to 2008., Results: During the 6-year study period, 29 cases were identified. They accounted for 11% of all tetanus cases admitted to the hospital: 8% from 2003 through 2006 and 14% in 2007 and 2008. The patients' average age was 36 years (range: 11-72). Most cases (86%) involved recent surgery, in both public (51%) and private (49%) health facilities. All patients had generalized tetanus at admission, and 24 (86%) paroxysms. Moderate forms predominated (69%). The lethality of tetanus in these surgical wound cases was 45%. The characteristics statistically associated with death were: age >44 years, time of hospitalization >4 days, the presence of paroxysms, and a Dakar prognosis score ≥4., Conclusion: The severity of surgical tetanus remains a concern for practitioners. Its high prevalence in recent years demonstrates the need to increase surgeons' awareness of tetanus prevention.

In 1998 UNAIDS implemented the national drug access initiative (DAI) in Côte d'Ivoire. The Ivorian government took the DAI over in 2000 with the support of the Global Fund and Presidential Emergency Program For AIDS Relief (PEPFAR). The ensuing affordability of antiretroviral therapy (ART), medical staff training, and healthcare equipment allowed Ministry of Health to improve HIV care throughout the country. Since 2008 ART and follow-up monitoring have been free of charge for people living with HIV/AIDS (PLWHA). In January 2009 a total of 57,833 PLWHA received ART and follow-up at 274 HIV care centers. Use of ART has improved the life expectancy of PLWHA. However morbidity and mortality remained high during the first year of ART implementation with respective frequencies of 5-10% person-year (PY) and 2-3% PY. Morbidity was mainly related to infectious disease (tuberculosis and bacteriaemia) and earlier onset of adverse events (AE). In most cases ART has been well tolerated. The main adverse effects have been anemia, neuropathy, skin toxicity and liver enzyme elevation. The incidence of stage 3/4 AE has been low (< 2 %PY). Although overall compliance has been good (<80%), data among children and adults suggest the need for further work to reinforce support mechanisms. Convincing results have been obtained in the management of PLWHA. Nevertheless greater funding and commitment must be given to management of opportunistic infections and side effects and to development of nutrition support services.