Introduction Health workers (HWs) set an example for vaccine recipients, convey vaccine benefits and risks and interface with patients at increased risk for complications in pandemic settings. We explored HWs' acceptance of and recommendation for COVID-19 vaccine with and without previous receipt of seasonal influenza vaccine (SIV) in nine countries.Methods In 2023-2024, cross-sectional surveys among HW were conducted in Bangladesh, Cote d'Ivoire, Ghana, Laos, Lebanon, Morocco, Philippines, Thailand and Tunisia. Country researchers used a standard protocol and questionnaire to assess beliefs, perceptions and acceptance around SIV and COVID-19 vaccine and likelihood of recommending these vaccines to patients. Pooled findings were stratified by the presence or absence of a national HW SIV recommendation. Generalised mixed effects models were used to characterise the relationship between receipt of SIV and COVID-19 vaccine acceptance and recommendation, adjusting for WHO region, sex and duration of employment.Results Our analysis included 12 296 HWs from nine countries representing four WHO regions: African, Eastern Mediterranean, Southeast Asian and Western Pacific. Five countries had a national HW SIV recommendation (61% of HWs surveyed) prior to COVID-19 vaccine introduction. More than 90% of HWs reported completing the COVID-19 vaccination series, whereas intention to continue receiving annual COVID-19 vaccine was lower (61%). HWs who received SIV in the last season compared with those who did not were more likely to have received one or more COVID-19 booster doses (adjusted OR (aOR) 2.63, 95% CI 2.27 to 3.04) and to have recommended COVID-19 vaccine to patients (aOR 1.53, 95% CI 1.29 to 1.82).Conclusions Prior experience with SIV was associated with HW behaviour and recommendations regarding COVID-19 vaccination. Intention to continue receiving COVID-19 vaccines remains a challenge; ongoing training and education for vaccination staff could be beneficial. HWs play a critical role in the successful delivery of new and existing vaccines, particularly in a pandemic setting.
Few studies have been carried out on personal exposure to fine particles linked to combustion activities in West Africa, despite the high concentrations that have been measured and the health risks they pose. This study is a part of the APIMAMA (Air Pollution Mitigation Action for Megacities in Africa) interdisciplinary research project. We focus on the personal exposure to PM2.5 of three groups of women who are heavily exposed to domestic and commercial combustion pollution through their daily work in Abidjan, C & ocirc;te d'Ivoire, specifically in Yopougon. The groups are composed of 30 housewives using wood or charcoal to cook food for their families or for sale; 29 women and 3 men using wood to produce charcoal; and 28 women using wood to smoke fish. All participants wore real-time PM2.5 monitors during the dry season (November 2022-March 2023 for housewives and charcoal makers) and the wet season (July-September 2023 for fish-smoking women) for 15 to 30 days. This study shows alarming 24-h exposure levels: 224.7 (205-245.9) & micro;g m-3 for housewives, 251.6 (207.9-306.3) & micro;g m-3 for charcoal makers, and 269.2 (191.7-399.8) & micro;g m-3 for fish-smoking women. These results are 15 to 18 times higher than the WHO's 24-hours guideline (15 & micro;g m-3), posing serious health risks. For each group, the PM2.5 concentrations and their diurnal variations are closely associated with the reported sources of exposure identified in the health questionnaires. More specifically, the multivariate analysis highlighted the significant role of road traffic in the personal exposure of housewives to PM2.5, whereas combustion activities were the dominant contributors for the other two groups. This finding is consistent with the quantified impact of combustion activities on daily exposure levels. Cooking activities with wood and charcoal contribute to 29% +/- 10% of the housewives' total daily exposure, while charcoal making and fish smoking account for 31% +/- 8% to 41% +/- 13% and 18% +/- 16% to 71% +/- 18%, respectively, of the total daily exposure of the charcoal makers and fish-smoking women.
Introduction : l'Hypertension Artérielle se positionne incontestablement parmi les principales préoccupations de santé publique à l'échelle mondiale. En Côte d'Ivoire un maigre des patients hypertendus (6 %) parvienne à maintenir leur hypertension sous contrôle. Notre étude se propose donc d’évaluer le niveau d'observance thérapeutique de l'hypertension artérielle à l'Institut de cardiologie d'Abidjan. Méthodes : Il s’est agi d’une étude transversale qui s’est déroulée du 01 février au 31 juillet 2024 soit 6 mois à l'Institut de cardiologie d'Abidjan. Elle a ciblé les patients hypertendus suivis au service de consultation chez qui une prise en charge médicamenteuse a été instaurée. L'observance thérapeutique a été évaluée en utilisant le test d'évaluation de l'observance thérapeutique de Girerd. L’analyse de notre échantillon a été faite à l’aide du logiciel SPSS 20.0. Les variables quantitatives ont été décrites par la moyenne et l’écart type et les variables qualitatives par les proportions. Résultats : Pour cette étude nous avons inclus 865 patients. L’âge moyen des patients interrogés était de 62,69 ±10,214 ans. Les patients non scolarisés représentaient 19 % des enquêtés et la majorité des patients (31,9%) était des retraités. La majorité (81,2%) des patients résidait à Abidjan. Dans 16,4 % des patients avait une mauvaise observance, plus de la moitié des patients (54,2%) avait un problème d’observance contre 29,4% qui avaient une bonne observance. Conclusion : La prévalence des patients non observants reste élevée dans notre population d’étude. Il est donc important de rechercher les causes pouvant expliquer ce phénomène pour venir à bout de l’HTA. AbstractIntroduction: Hypertension is undeniably among the major public health concerns worldwide. In Côte d'Ivoire, only a small percentage of hypertensive patients (6%) manage to keep their hypertension under control. Our study therefore aims to describe the level of therapeutic adherence for hypertension at the Abidjan Cardiology Institute. Methods: This was a cross-sectional study conducted from February 1 to July 31, 2024 (6 months) at the Abidjan Cardiology Institute. It targeted hypertensive patients followed in the outpatient department who had been prescribed medication. Therapeutic adherence was assessed using the Girerd Therapeutic Adherence Assessment Test. Analysis of our sample was performed using SPSS 20.0 software. Quantitative variables were described using the mean and standard deviation, and qualitative variables using proportions. Results: For this study, we included 865 patients. The mean age of the patients interviewed was 62.69 ± 10.214 years. Patients with no formal education represented 19% of the respondents, and the majority (31.9%) were retired. The majority (81.2%) of patients resided in Abidjan. More than half of the patients (54.2%) had a problem with adherence to their treatment, compared to 29.4% who had good adherence. Conclusion: The prevalence of non-adherence remains high in our study population. It is therefore important to investigate the causes that may explain this phenomenon in order to overcome hypertension.
Introduction La mise en place du Dossier Patient Informatisé (DPI) constitue un levier majeur pour le renforcement du Système d’Information Hospitalier et l’amélioration de la prise en charge des patients. Bien que son implémentation eût suscité beaucoup d’engouement, son appropriation était restée un véritable challenge. L’objectif de ce travail était de déterminer les obstacles à cette appropriation à partir d’un cadre simplifié d’évaluation Méthodes A partir d’un cadre simplifié d’évaluation qui était issu des modèles d’Acceptation et d’Adoption des Technologies et Unified Theory of Acceptance and Use of Technology, nous avons réalisé une étude analytique transversale à l’Hôpital Général d’Anyama. Cette étude a été réalisée après quatre mois d’utilisation du DPI (du 1er juillet au 30 novembre 2021) auprès des prestataires de soins au sein de cette structure Elle a concerné 16 prestataires de soins (médecins, infirmier(ère)s, sage-femmes, aides-soignants) qui utilisaient le DPI. Les données ont été recueillies via un questionnaire structuré sur les caractéristiques sociodémographiques et les déterminants d’appropriation du DPI Résultats L’analyse a été réalisée avec SPSS V26. Notre analyse a mis en évidence que 62,5 % jugeaient le réseau Internet satisfaisant et 78,57 % disposait d’un équipement informatique. 81,25 % connaissaient la note de service relative à la sensibilisation du déploiement du DPI ; toutefois, 62,16 % déploraient la lenteur du système. L’acceptation du DPI par les prestataires était de 93,75 %, avec une utilisation quotidienne chez seulement 12,5 %. Les prestataires avaient des compétences informatiques limitées et le temps de formation sur le DPI était estimée insuffisante avec respectivement de 75% et 93%. Discussion/Conclusion Comme le fonctionnement d’un engrenage, déployer un DPI s’appuie sur une contingence de facteur. Chaque facteur est déterminant pour le bon fonctionnent du système. Ainsi, l’évaluation de l’appropriation du DPI par les prestataires à l’HG d’Anyama a mise en évidence une faiblesse dans l’appui nécessaire aux prestataires de soins. Cet état de fait a constitué la source inéluctable de cette l’insuffisance d’appropriation
OBJECTIVE:The objective of this study was to determine the association between viral subtype/clade and disease severity. DESIGN:Multicentre retrospective cohort study. SETTING:This study used data from the Global Influenza Hospital Surveillance Network (GIHSN). The dataset comprised hospitalised influenza patients with viral sequencing data across 14 countries, collected from August 2022 through October 2023. PARTICIPANTS:A total of 761 hospitalised patients were enrolled during the study period, and 745 patients were included in the analysis. We excluded patients with missing data on explanatory or outcome variables, those infected with viral clades represented by fewer than 11 sequences, and those enrolled at study sites contributing fewer than 5 patients. OUTCOME MEASURES:Disease severity was defined by admission to intensive care unit (ICU), receipt of non-invasive oxygen supplementation, 3-variable definition (ICU, mechanical ventilation or death) or 4-variable definition (3-variable plus oxygen supplementation).Outcomes were analysed in association with subtype or clade using the mixed-effects logistic regression models, adjusting for age group, sex, underlying medical conditions, influenza vaccination status, antiviral use, country income level and epidemic period, while study site was included as a random effect. RESULTS:745 patients were included: 263 A(H1N1)pdm09, 380 A(H3N2), 102 B/Victoria. A(H1N1)pdm09 infection was associated with increased odds of ICU admission (adjusted ORs (aORs) 2.5, 95% CI 1.1 to 5.8) compared with A(H3N2). 6B.1A.5a.2a.1 clade of A(H1N1)pdm09 was associated with increased severity compared with 6B.1A.5a.2a clade (aOR 3.0, 95% CI 1.0 to 9.5) and (aOR 5.4, 95% CI 1.6 to 18.3) for the 3-variable and 4-variable definitions respectively. Among A(H3N2), the (3C.2a1b.2a.)2b clade showed a trend toward increased severity using the 4-variable definition compared with the 2a.1b clade (aOR 2.9, 95% CI 0.8 to 10.0). CONCLUSIONS:This analysis highlights the differential impact of influenza subtypes and clades on disease severity in hospitalised patients. Future research should investigate the role of specific viral mutations of these clades in modulating immune evasion or disease severity. These findings reinforce the GIHSN's critical role in global surveillance. Ongoing genomic surveillance is crucial for understanding the clinical impact of emerging influenza variants and informing public health responses.
