Introduction:Vaccination is one of the responses to the ongoing global COVID-19 pandemic. However, it has also sparked controversy, hesitation, and infodemics worldwide. Gabon began vaccinating its population in July 2021. Our study aims to describe the motivations, knowledge, and levels of acceptance of volunteers. Methods:We conducted a descriptive, cross-sectional, "knowledge, attitudes, and practices" study from May 2021 to January 2022 (eight months) at the only COVID-19 vaccination center in Makokou, in Gabon's Eastern Health Region. Volunteers were included during the vaccination process and responded to a questionnaire during a face-to-face interview. We studied their sociodemographic profile, knowledge of the disease and the vaccine, and perceptions and experiences of accessibility. Results:A total of 303 people between 18 and 71 years old, were included in the study. Subjects aged 30 to 40 years old represented 39.6% (n = 120) of those included. The sex ratio was 2.7. Eighty-six point seven percent of participants were of Gabonese nationality, and the median length of stay in the city of Makokou was six years (IQR: 2-15). The most represented professions were health workers (17.8%, n = 54), followed by defense and security forces (15.8%, n = 48), who were the main targets of the program. Forty-two point five percent (n = 129) of participants reported being influenced in their decision to get vaccinated. Globally, 72.6% (n = 220) thought that vaccination was a constraint, either for health reasons (n = 128, 58.2%) or for greater freedom of movement (n = 109, 49.5%). The main sources of information were the media (n = 237, 78.2%) and medical personnel (n = 168, 55.4%). Motivation was associated with compulsion (OR = 2.2), knowledge of certain symptoms (OR = 0.4), perception of the disease as serious (OR = 0.2), and positive media influence (OR = 0.4). Accessibility was associated with previous infection (OR = 11) or employer coercion (OR = 0.2). Conclusion:The decision to get vaccinated against COVID-19 was greatly influenced by the media and socio-professional constraints. Given that access to the vaccine was considered easy, motivation should have been the pursuit of better health.
Introduction:ABO blood typing relies on two complementary tests: the red blood cell test (Beth-Vincent) and the serum test (Simonin-Michon). Concordance between these tests is essential for transfusion safety. Persistent discrepancies, though rare, are critical and require thorough investigation. Methods and case presentation:Thirteen patients (aged 6-73) were examined for persistent ABO discordance. We performed parallel Beth-Vincent and Simonin tests. In the event of discordance, we triple washed the red blood cells in saline solution. Auto-, allo-, and ABO controls were systematically performed. The clinical contexts included trauma, anemia, and preoperative and prenatal assessments. Most patients had no history of previous transfusion. Most cases presented a positive auto control, suggesting the presence of autoantibodies, and/or a positive AB control, indicating polyagglutinability. Discrepancies mainly concerned conflicts between direct and inverse ABO phenotypes (AB/O, A/O, and B/O). These results demonstrate the value of controls in guiding diagnosis and the need for complementary approaches. Conclusion:This series illustrates the decision-making algorithm proposed for cases with persistent discrepancies between red blood cell and serum tests during ABO blood typing.
Introduction:Hemorrhagic syndrome accounts for a significant proportion of the mortality and morbidity associated with snakebites in sub-Saharan Africa. Hyperfibrinolysis, which has been reported in some cases, suggests the potential benefit of antifibrinolytics; however, these have been little studied in this context. This study aimed to evaluate the effectiveness of combining tranexamic acid and antivenom in treating hemorrhagic syndrome and coagulopathy associated with Echis ocellatus (West African Carpet Viper) envenomation. Materials and methods:Patients presenting with hemorrhagic syndrome due to envenomation were prospectively included at the Saint Jean de Dieu Hospital in Tanguiéta, Benin. Patients were randomized into two groups: one receiving antivenom and tranexamic acid (SAV + AT) and one receiving only antivenom (SAV). All patients received two vials of InoserpTM PAN-AFRICA antivenom upon admission. The SAV + AT group received 1 g of tranexamic acid over 30 minutes, followed by an additional 1 g over 8 hours. The occurrence of bleeding and the results of blood coagulation tests (whole blood clotting test or WBCT) were recorded at 2, 4, 6, 8, 12, 24, 48, and 72 hours after the initial antivenom administration. Antivenom administration was repeated if bleeding occurred at any of these times. The INR (International Normalized Ratio) was measured at six and twelve hours. Tolerance was assessed at 1, 2, 4, 6, 8, 12, 24, 48, and 72 hours. Plasma creatinine was measured at 24 and 72 hours. Results:Twenty-five patients were included: Twelve patients were in the SAV + AT group, and thirteen patients were in the SAV group. Six patients in the SAV + AT group and five patients in the SAV group experienced persistent or recurrent bleeding (p = 0.695). There was no significant difference in WBCT at different time points between the two groups, nor in INR at 6 and 12 hours. There were no adverse effects suggesting intolerance to tranexamic acid (e.g., ocular abnormality, convulsions, or thrombosis), and plasma creatinine levels did not differ significantly between the two groups. Conclusion:Systematic use of tranexamic acid showed no benefit for hemorrhagic syndrome and coagulopathy associated with E. ocellatus in Benin. Therefore, the indications for this adjunctive treatment need to be clarified.
Objectives:This study aims to present the epidemiological and clinical characteristics of snakebites treated in Kindia, Guinea, between 2015 and 2019. Materials and methods:We conducted a retrospective descriptive study covering the period from January 2015 to December 2019. The study included all patient records for envenomation from snakebites at the Institut de Recherche en Biologie Appliquée de Guinée in Kindia. Results:A total of 1,420 snakebites were recorded, including 1,008 envenomations (male-to-female ratio = 1.2), over a 60-month period. Most patients (76.9%) came from rural areas and were primarily involved in agriculture and livestock farming. In 85.4% of cases, the bites were to the lower limbs. Viper syndrome was predominant, and 98.5% of patients received antivenom with a 95.9% cure rate. Conclusion:The results of this study demonstrate that snakebite envenomation are common and have a 2.5% case-fatality rate. These results suggest the need for greater consideration of snakebites in Guinea's health policy.
Introduction:Thanks to the effectiveness of antiretroviral treatment (ART), more and more people in Africa are aging with HIV. In Senegal, 34% of people living with HIV (PLHIV) who received ART were 50 years of age or older in 2022. As people age, their medical, psychological, and social needs gradually change and increase. This article presents the results of an anthropological study that aimed to describe and analyze the living conditions and care of PLHIV aged 70 and over in urban areas, in relation to the health and social context. Materials and methods:The ethnographic study was conducted from 2022 to 2023 in the Dakar metropolitan area. The study focused on 31 older people living with HIV (OPLHIV), including 14 women, with an average age of 72 (maximum age 90). The median duration of ART was 16 years (maximum: 22 years). Six family caregivers, four community mediators, one nurse, and five doctors (including a geriatrician) were also interviewed, as well as the main national officials responsible for the fight against AIDS. Results:The OPLHIV who were interviewed reported habituation to HIV and demonstrated excellent adherence to ART. However, persistent social stigma surrounding HIV continues to affect their daily lives, leading to various forms of self-exclusion and strategies to keep their illness secret. Medically, they are all in virological remission; however, they face multiple comorbidities and functional disabilities that lead to increased healthcare costs. Economic insecurity and inadequate social protection systems lead to increased dependence on loved ones. Families are the main providers of care. However, the attention given to the elderly depends on the nature and quality of the relationships they have built throughout their lives. Conclusion:This research contributes to anthropology's analysis of healthcare systems and their capacity to care for specific populations. From a public health perspective, the findings of this analysis call for health facilities, community stakeholders, and health authorities to consider the unique health and social needs of OPLHIV to enable them to age with dignity.
