Introduction: Les hépatites B (VHB) et C(VHC) sont deux maladies infectieuses virales graves et causes majeures de morbidité et de mortalité. Du fait leur transmission sanguine, les donneurs de sang sont soumis à la recherche de ces virus au Centre National de Transfusion Sanguine de Lomé (CNTS). Néanmoins le CNTS dispose de peu d’étude sur les cas rencontrés lors de ce dépistage. Cette étude a été initiée pour combler le vide d’information sur la prévalence et les facteurs associés aux hépatites B et C parmi les primo-donneurs de sang. Méthodes:Nous avons réalisé une étude transversale, analytique du 1er décembre 2022 au 22 janvier 2023. Une extraction exhaustive de données secondaires a été réalisée à partir de la base de données du CNTS. Les données ont été analysées avec Epi info 7. Nous avons calculé la moyenne d’âge. Les proportions et les rapports de côte ajustés avec IC à 95% par régression logistique ont été utilisés pour déterminer les facteurs associés à la survenue de l’une des hépatites Résultats:De 2020 à 2022, 579 cas ont été confirmés d’hépatites virales dont 212 VHB et 367 VHC chez 19081 primo-donneurs, soit une prévalence globale de 3 % (IC 95% [2,7 ;3,2]). L’âge moyen était de 30,4±9ans pour le VHB et de 28,4±7ans pour le VHC. La tranche d’âge de [20-30 ans] était plus représentée dans les 2 formes. Le sexe masculin (ORa=2,09 ;IC 95% [1,62 ;2,70]), l’âge >30 ans (ORa=1,76 ;IC 95% [1,40 ;2,21]), l’appartenance à la profession enseignante (ORa=2,39 ; IC 95%[1,58 ;3,63]) et élève ou étudiant (ORa=1,49 IC 95%[1,19 ;1,87]) prédisposent plus à la survenue d’une hépatite virale tandis que le statut matrimonial « Marié » (ORa=0,58 ;IC 95% [0,47 ;0,70]) protège contre les hépatites virale B et C parmi les primo-donneurs concernés. Conclusion:Notre étude montre une prédominance du VHC chez les primo-donneurs de sexe masculin, célibataires. Le sexe masculin, l’âge >30 ans, le statut de célibataire, l’appartenance à la profession enseignante et élève/étudiant ont été retrouvés comme facteurs associés à la survenue d’une des hépatites. Un programme de prévention adéquat et une prise en charge appropriée des cas sont recommandés. English Abstract Introduction: Hepatitis B (HBV) and hepatitis C (HCV) are two serious viral infectious diseases and major causes of morbidity and mortality. Because they are transmitted through blood, blood donors are screened for these viruses at the National Blood Transfusion Centre in Lomé (CNTS). However, the CNTS has few studies on the cases encountered during this screening. This study was initiated to fill the information gap on the prevalence and factors associated with hepatitis B and C among first-time blood donors. Methods: We conducted a cross-sectional, analytical study from 1 December 2022 to 22 January 2023. An exhaustive extraction of secondary data was carried out from the CNTS database. The data were analysed using Epi Info 7. We calculated the average age. Proportions and adjusted odds ratios with 95% CI by logistic regression were used to determine the factors associated with the occurrence of one of the hepatitis types. Results: From 2020 to 2022, 579 cases of viral hepatitis were confirmed, including 212 HBV and 367 HCV cases among 19,081 first-time donors, representing an overall prevalence of 3% (95% CI: 2.7 – 3.2). The average age was 30.4±9 years for HBV and 28.4±7 years for HCV. The [20-30 year] age group was more represented in both forms. Male gender (aOR=2.09; 95% CI: 1.62 – 2.70), age >30 years (aOR=1.76; 95% CI:1.40 – 2.21), membership of the teaching profession (aOR=2.39; 95% CI:1.58 – 3.63) and being a pupil or student (aOR=1.49 95% CI: 1.19 – 1.87) predispose individuals to viral hepatitis, while being ‘married’ (aOR=0.58; 95% CI:0.47 – 0.70) protects against viral hepatitis B and C among first-time donors. Conclusion: Our study shows a predominance of HCV among first-time male donors who are single. Male gender, age >30 years, single status, and membership in the teaching profession and pupil/student groups were found to be factors associated with the occurrence of hepatitis. An adequate prevention programme and appropriate case management are recommended. Keywords: Epidemiology, hepatitis B and C, first-time donors, Lomé (Togo)
Introduction: La planification familiale réduit des décès maternels dans les pays pauvres mais l’abandon en constitue un frein. L’objectif principal était d’identifier les facteurs associés à l’abandon des méthodes contraceptives de longue durée d’action dans le district de Kloto. Méthodes: Il s’est agi d’une étude transversale à visée analytique en utilisant une base de données secondaires obtenue à partir des cartes et des registres PF de 2018 à 2023 du district de Kloto. Toute femme ayant fait le retrait de sa méthode contraceptive à moins de 24 mois après insertion était considérée comme un abandon. Nous avons fait une analyse descriptive puis procédé une régression logistique univariée et multivariée. Nous avons les Rapports de prévalence et le seuil α <0,05. Résultats : Au total 1368 utilisatrices ont été incluses dans l’étude. La médiane d’âge était de 26 ans (IIQ 21 à 32). L’abandon global était de 31,48% et a évolué de 68,35% en 2018 à 16,99% en 2023. Les facteurs associés à l’abandon était le niveau d’instruction bas (RP ajusté de 1,5 ; p-value 0,0004) ; la résidence urbaine (RPa de 1,6 ; p-value 0,002) ; l’adoption des implants (RPa de 1,5 ; p-value 0,040) ; l’adoption de la méthode lors JPO (RPa de 2,3 ; p-value <0,001) ; le choix d’une méthode à durée d’action supérieure au souhait des femmes (RPa de 2,4 ; p-value < 0,001) et le désir d’enfants supplémentaires (RPa de 1,3 ; p-value 0,049). Conclusion: Un bon counseling pour adoption de méthodes contraceptives selon les besoins des femmes utilisatrices non instruites et résident en milieu urbain pourrait réduire les abandons. English Abstract Introduction: Family planning reduces maternal deaths in poor countries, but discontinuation is a barrier. The main objective was to identify the factors associated with discontinuation of long-acting contraceptive methods in the Kloto district. Methods: This was a cross-sectional analytical study using a secondary database obtained from FP cards and registers from 2018 to 2023 in the Kloto district. Any woman who discontinued her contraceptive method within 24 months of insertion was considered to have discontinued. We performed a descriptive analysis followed by univariate and multivariate logistic regression. We used prevalence ratios and a threshold of α <0.05. Results: A total of 1,368 users were included in the study. The median age was 26 years (IIQ 21 to 32). The overall discontinuation rate was 31.48% and changed from 68.35% in 2018 to 16.99% in 2023. Factors associated with discontinuation were low educational level (adjusted OR of 1.5; p-value 0.0004); urban residence (OR of 1.6; p-value 0.002); adoption of implants (OR of 1.5; p-value 0.040); adoption of the method during the open day (OR of 2.3; p-value <0.001); choice of a method with a longer duration of action than desired by the women (OR of 2.4; p-value < 0.001); and desire for additional children (OR of 1.3; p-value 0.049). Conclusion: Good counselling on the adoption of contraceptive methods according to the needs of uneducated female users living in urban areas could reduce dropouts. Keywords: Associated factors, dropout, long-acting contraception, Kloto, Togo
Introduction: L’approche World Health Organization Package of Essential Nonconmmunicable (WHOPEN)permet la prévention, la détection précoce et la prise en charge de l’hypertension artérielle (HTA) et diabète. Elle est mise en œuvre dans le district de Golfe depuis 2018. L’objectif de cette étude était d’évaluer le système de surveillance d’HTA et diabète selon l’approche WHOPEN dans le district sanitaire de Golfe au Togo en 2023. Méthodes: Une étude transversale descriptive était réalisée en 2023 dans 8 Centres Médico-sociaux offrant les prestations selon WHOPEN. L’évaluation était faite selon les directives de CDC d’Atlanta et portée sur l’utilité et les attributs simplicité, acceptabilité, représentativité, qualité de données. Résultats: Vingt-quatre prestataires étaient enquêtés, majoritairement formés en WHOPEN/Education thérapeutique (75%) et composés d’infirmiers (62,5%). Les définitions de l’HTA et diabète étaient simples pour 100% des prestataires, affirmant que les outils de rapportage de données étaient inadaptés. Parmi les patients, le sexe féminin était plus représenté pour l’HTA (65,3%) et diabète (52,2%). Le nombre de cas d’HTA a augmenté de 189 à 345 et celui du diabète a diminué de 33 à 11. La promptitude, la complétude, l’exhaustivité et la concordance des données étaient respectivement de 75%, 60%, 50% et 63,9%. Les patients suivis étaient de 50,23%. Conclusion: Le WHOPEN était assuré en majorité par les infirmiers. Il était représentatif et utile. Il permettait la détection, le suivi, le traitement précoce des cas d’HTA et diabète afin d’éviter les complications. Un personnel compétent suffisant et des moyens de collecte adaptés favoriseraient l’amélioration de son système de surveillance. Mots clés : Evaluation, HTA, diabète, WHOPEN, district, sanitaire, Golfe, Togo English Abstracts Introduction: The World Health Organisation Package of Essential Noncommunicable Diseases (WHOPEN) approach enables the prevention, early detection and management of high blood pressure (HBP) and diabetes. It has been implemented in the Golfe district since 2018. The objective of this study was to evaluate the HTN and diabetes surveillance system according to the WHOPEN approach in the Golfe health district in Togo in 2023. Methods: A descriptive cross-sectional study was conducted in 2023 in eight medical-social centres offering services according to WHOPEN. The evaluation was carried out according to the guidelines of the CDC in Atlanta and focused on usefulness and the attributes of simplicity, acceptability, representativeness and data quality. Results: Twenty-four providers were surveyed, most of whom were trained in WHOPEN/Therapeutic Education (75%) and consisted of nurses (62.5%). The definitions of hypertension and diabetes were simple for 100% of providers, who stated that the data reporting tools were inadequate. Among patients, females were more represented for hypertension (65.3%) and diabetes (52.2%). The number of hypertension cases increased from 189 to 345 and the number of diabetes cases decreased from 33 to 11. The promptness, completeness, comprehensiveness and consistency of the data were 75%, 60%, 50% and 63.9% respectively. The proportion of patients followed up was 50.23%. Conclusion: WHOPEN was mainly carried out by nurses. It was representative and useful. It enabled the detection, monitoring and early treatment of cases of hypertension and diabetes in order to avoid complications. Sufficient competent staff and appropriate data collection methods would help to improve the surveillance system. Keywords: Evaluation, hypertension, diabetes, WHOPEN, district, health, Gulf, Togo
Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p < 0.001). In multivariable analysis, administration of less than three doses was associated with LBW (aOR = 9.3; 95% CI [4.2-22.3]). Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.
Abstract Sub-Saharan Africa bears the heaviest burden of malariain the world. Pregnant women and children aged 0–5 years are the most affected. Malaria can cause foetal complications such as intrauterine growth restriction and low birth weight (LBW). Since 2012, WHO has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Objectives: The objective of this study was to estimate the proportion of LBW and its associated factors in Lomé (Togo) in 2021. Methods: A descriptive and analytical cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the gynaecology and obstetrics department of the Sylvanus Olympio University Hospital Center. Data from prenatal consultations of the mothers and clinical information of the newborns were collected. Multivariate logistic regression was used to determine factors associated with LBW. A p-value < 0.05 was considered statistically significant. Results: A total of 252 mother-child pairswere included in this study. The proportion of women who received at least three doses of IPT-SP was 66.7% and 37/252 newborns (14.7%) had LBW. Newborns of mothers who received less than three doses of IPT-SP had a higher risk of LBW (aOR = 9.3; 95%CI [4.2–22.3]). Conclusion: Ten years after WHO recommendations on IPT-Sp, Malaria prevention with IPT-SP is not optimal among pregnant women in Lomé. Interventions to strengthen the three-dose IPT policy are needed for the prevention of malaria and its consequences on the foetus in Lomé, Togo.
