1
|
Kolié D, Guillard E, Sow A, Manet H, Camara BS, Bigirimana T, Harouna M, Delamou A. Exploring experiences of HIV care to optimize patient-centred care in Conakry, Guinea: a qualitative study. Front Reprod Health 2024; 6:1134404. [PMID: 38655091 PMCID: PMC11035823 DOI: 10.3389/frph.2024.1134404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Studies on the organisation of care and the power dynamic between providers and patients with HIV in sub-Saharan Africa are rare. This study aims to describe the patient-provider relationship and explore the challenges to optimal and patient-centred care for HIV patients. Methods This was a qualitative exploratory descriptive study using in-depth individual interviews and focus group discussions. In total, 17 individual interviews and 5 focus group discussions were conducted. This was conducted in four urban health facilities in Conakry, the capital of Guinea. Three group of participants were included in this study namely patients with HIV; health providers including facilities and services managers; and psychosocial counsellors. Psychosocial counsellors provide emotional and psychosocial support to HIV patients. Their role in the organization care in Guinea is new and they contribute to strengthening adherence of patients with HIV to ARV treatment. Results Patients with HIV, health providers, and psychosocial counsellors have a positive perception of the patient-provider relationship. This relationship was characterized essentially by maintaining confidentiality of HIV status disclosure, caring attitudes towards patients (being available, adjusting locations for accessing ART, based on patients' preferences), and participating in HIV patient's social life. However, scolding and miscommunication about the interpretation of viral load tests were reported. The shortage of human resources, low salaries of health staff, poor infrastructure, and the financial burden borne by patients with HIV impede the implementation of optimal patient-centred care. Conclusion Integrating psychosocial counsellors in HIV care organization, improving access to ARV, infrastructure, increasing human resources, and removing the financial burden for HIV patients are needed to optimal patient-centred care in Guinea.
Collapse
Affiliation(s)
- Delphin Kolié
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | | | | | - Hawa Manet
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Bienvenu Salim Camara
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | | | | | - Alexandre Delamou
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| |
Collapse
|
2
|
Dioubaté N, Diallo MC, Maomou C, Niane H, Millimouno TM, Camara BS, Sy T, Diallo IS, Semaan A, Delvaux T, Beňová L, Béavogui AH, Delamou A. Perspectives and experiences of healthcare providers on the response to the COVID-19 pandemic in three maternal and neonatal referral hospitals in Guinea in 2020: a qualitative study. BMC Health Serv Res 2024; 24:226. [PMID: 38383409 PMCID: PMC10882787 DOI: 10.1186/s12913-024-10670-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has adversely affected access to essential healthcare services. This study aimed to explore healthcare providers' perceptions and experiences of the response to the COVID-19 pandemic in three referral maternal and neonatal hospitals in Guinea. METHODS We conducted a longitudinal qualitative study between June and December 2020 in two maternities and one neonatology referral ward in Conakry and Mamou. Participants were purposively recruited to capture diversity of professional cadres, seniority, and gender. Four rounds of in-depth interviews (46 in-depth interviews with 18 respondents) were conducted in each study site, using a semi-structured interview guide that was iteratively adapted. We used both deductive and inductive approaches and an iterative process for content analysis. RESULTS We identified four themes and related sub-themes presented according to whether they were common or specific to the study sites, namely: 1) coping strategies & care reorganization, which include reducing staffing levels, maintaining essential healthcare services, suspension of staff daily meetings, insertion of a new information system for providers, and co-management with COVID-19 treatment center for caesarean section cases among women who tested positive for COVID-19; 2) healthcare providers' behavior adaptations during the response, including infection prevention and control measures on the wards and how COVID-19-related information influenced providers' daily work; 3) difficulties encountered by providers, in particular unavailability of personal protective equipment (PPE), lack of financial motivation, and difficulties reducing crowding in the wards; 4) providers perceptions of healthcare service use, for instance their fear during COVID-19 response and perceived increase in severity of complications received and COVID-19 cases among providers and parents of newborns. CONCLUSION This study provides insights needed to be considered to improve the preparedness and response of healthcare facilities and care providers to future health emergencies in similar contexts.
Collapse
Affiliation(s)
- Nafissatou Dioubaté
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.
| | | | - Cécé Maomou
- Service de Maternité de l'Hôpital Régional de Mamou, Mamou, Guinea
| | - Harissatou Niane
- Institut de Nutrition et de Santé de l'Enfant, Hôpital National Donka, Conakry, Guinea
| | - Tamba Mina Millimouno
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea; Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Faculté des Sciences et Techniques de la Santé, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Telly Sy
- Service de Maternité de l'Hôpital National Ignace Deen, Conakry, Guinea
| | - Ibrahima Sory Diallo
- Institut de Nutrition et de Santé de l'Enfant, Hôpital National Donka, Conakry, Guinea
| | - Aline Semaan
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thérèse Delvaux
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Abdoul Habib Béavogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea; Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Faculté des Sciences et Techniques de la Santé, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea
| |
Collapse
|
3
|
Traoré FB, Sidibé CS, Diallo EHM, Camara BS, Sidibé S, Diallo A, Diarra NH, Ly BA, Ag Ahmed MA, Kayentao K, Touré A, Camara A, Delamou A, Sangho H, Terera I. Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis. Front Public Health 2024; 12:1272193. [PMID: 38327574 PMCID: PMC10847291 DOI: 10.3389/fpubh.2024.1272193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024] Open
Abstract
Objectives This study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa. Methods This systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger's regression test were used to assess the publication bias. Results A total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46-26.97) and 36.02% (CI: 26.68-45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6-3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8-4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9-4.1), male sex (OR: 1.2, 95% CI: 1.1-1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5-3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4-5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01-10.9), parity (OR: 0.5, 95% CI: 0.3-0.7), prolonged labor (OR: 3.4, 95% CI: 1.6-6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3-14.3) were significantly associated with maternal sepsis. Conclusion The prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data.Systematic review registration: PROSPERO (ID: CRD42022382050).
Collapse
Affiliation(s)
- Fatoumata Bintou Traoré
- National Institute of Public Health, Bamako, Mali
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Cheick Sidya Sidibé
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU Amsterdam, Amsterdam, Netherlands
| | - El Hadj Marouf Diallo
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Bienvenu Salim Camara
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
- Department of Public Health, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Sidikiba Sidibé
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
- Department of Public Health, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Alhassane Diallo
- Université de Montpellier, Montpellier, Languedoc-Roussillon, France
| | - Nielé Hawa Diarra
- Faculté de Médecine et d'Odontostomatologie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Birama Apho Ly
- Faculté de Pharmacie, Université des Sciences, Techniques et Technologies de Bamako, Bamako, Mali
| | - Mohamed Ali Ag Ahmed
- Faculté de Médecine et d'Odontostomatologie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Kassoum Kayentao
- Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Abdoulaye Touré
- Center of Research and Training in Infectious Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Alioune Camara
- National Malaria Control Programme Conakry, Conakry, Guinea
| | - Alexandre Delamou
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Hamadoun Sangho
- Faculté de Médecine et d'Odontostomatologie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | | |
Collapse
|
4
|
Diallo R, Baguiya A, Balde MD, Camara S, Diallo A, Camara BS, Toure AO, Soumah AM, Kouanda S, Compaore E. Prevalence and factors associated with overweight in children under 5 years in West African countries. J Public Health Res 2023; 12:22799036231181845. [PMID: 37465529 PMCID: PMC10350767 DOI: 10.1177/22799036231181845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/24/2023] [Indexed: 07/20/2023] Open
Abstract
Background Overweight is a risk factor for non-communicable diseases and is affecting an increasing number of children worldwide. The objective of this study was to measure the prevalence and related factors to overweight among children under 5 years in five West African countries. Methods This study was a secondary analysis of nationally representative cross-sectional data. These data were drawn from Demographic and Health Surveys (DHS) from five countries in the West African region (Benin, Guinea, Mali, Nigeria, and Togo) from 2015 to 2018.Continuous quantitative data were categorized and all analyses were weighted according to the probability that each participant was selected in the sample. Children under 5 years of age were the study population. Multilevel logistic regression was used with Stata 16.0 software. Results The total sample size for the analysis was 38,657 children. The pooled prevalence of overweight among children under 5 years of age in the five countries was 3%. Guinea had the highest prevalence (6%) compared to the other countries, which had a prevalence of 2%. The likelihood of being overweight was higher among children aged 0-6 months (adjusted odds ratio [AOR] = 3.09; 95% confidence interval [CI] [2.41-3.95]), who had a high birth height (AOR = 1.64; 95% CI [1.29-2.09]), whose mothers were overweight (AOR = 1.35; 95% CI [1.09-1.68]), who lived in households with fewer than five members (AOR = 1.19; 95% CI [1.00-1.46]), or who lived in Guinea (AOR = 2.79; 95% CI [1.62-4.79]). Conclusion This study showed that overweight concerns few children under 5 years of age in West Africa. However, it does exist, and its prevalence could likely increase if its modifiable factors (maternal overweight, household size, and height at birth) are not taken into account in nutritional interventions.
Collapse
Affiliation(s)
- Ramata Diallo
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Adama Baguiya
- African Institute of Public Health, Ouagadougou, Burkina Faso
| | | | - Sadan Camara
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Aissatou Diallo
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Bienvenu Salim Camara
- National Center for Training and Research in Rural Health in Maferinyah, Conakry, Guinea
| | - Amadou Oury Toure
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Anne Marie Soumah
- Center for Research in Reproductive Health in Guinea (CERREGUI), Conakry, Guinea
| | - Seni Kouanda
- African Institute of Public Health, Ouagadougou, Burkina Faso
| | - Ella Compaore
- University Joseph Ki-Zerbo of Ouagadougou, Ouagadougou, Burkina Faso
| |
Collapse
|
5
|
Millimouno TM, Meessen B, Put WVD, Garcia M, Camara BS, Christou A, Delvaux T, Sidibé S, Beavogui AH, Delamou A. How has Guinea learnt from the response to outbreaks? A learning health system analysis. BMJ Glob Health 2023; 8:bmjgh-2022-010996. [PMID: 36854489 PMCID: PMC9980363 DOI: 10.1136/bmjgh-2022-010996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/23/2023] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION Learning is a key attribute of a resilient health system and, therefore, is central to health system strengthening. The main objective of this study was to analyse how Guinea's health system has learnt from the response to outbreaks between 2014 and 2021. METHODS We used a retrospective longitudinal single embedded case study design, applying the framework conceptualised by Sheikh and Abimbola for analysing learning health systems. Data were collected employing a mixed methods systematic review carried out in March 2022 and an online survey conducted in April 2022. RESULTS The 70 reports included in the evidence synthesis were about the 2014-2016 Ebola virus disease (EVD), Measles, Lassa Fever, COVID-19, 2021 EVD and Marburg virus disease. The main lessons were from 2014 to 2016 EVD and included: early community engagement in the response, social mobilisation, prioritising investment in health personnel, early involvement of anthropologists, developing health infrastructure and equipment and ensuring crisis communication. They were learnt through information (research and experts' opinions), action/practice and double-loop and were progressively incorporated in the response to future outbreaks through deliberation, single-loop, double-loop and triple-loop learning. However, advanced learning aspects (learning through action, double-loop and triple-loop) were limited within the health system. Nevertheless, the health system successfully controlled COVID-19, the 2021 EVD and Marburg virus disease. Survey respondents' commonly reported that enablers were the creation of the national agency for health security and support from development partners. Barriers included cultural and political issues and lack of funding. Common recommendations included establishing a knowledge management unit within the Ministry of Health with representatives at regional and district levels, investing in human capacities and improving the governance and management system. CONCLUSION Our study highlights the importance of learning. The health system performed well and achieved encouraging and better outbreak response outcomes over time with learning that occurred.
Collapse
Affiliation(s)
- Tamba Mina Millimouno
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea .,Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Conakry, Guinea
| | - Bruno Meessen
- Health Systems Governance and Financing Department, World Health Organization, Geneva, Switzerland
| | - Willem Van De Put
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Marlon Garcia
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Bienvenu Salim Camara
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Aliki Christou
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Therese Delvaux
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Sidikiba Sidibé
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Conakry, Guinea
| | - Abdoul Habib Beavogui
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Alexandre Delamou
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Conakry, Guinea
| |
Collapse
|
6
|
Delamou A, Tripathi V, Camara BS, Sidibe S, Grovogui FM, Kolie D, Bouedouno P, Kourouma K, Banze DF, Mafu MM. Capacity building in operational research on obstetric fistula: Experience in the Democratic Republic of Congo, 2017-2021. Int J Gynaecol Obstet 2023; 160:459-467. [PMID: 35900176 PMCID: PMC10087752 DOI: 10.1002/ijgo.14377] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/14/2022] [Accepted: 07/25/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To implement a Flexible Operational Research Training (FORT) course within the Fistula Care Plus Project, Democratic Republic of Congo, from 2017 to 2021. METHODS A descriptive study using design and implementation (process and outcome) data. Two to four members of medical teams from three supported sites were selected for the training based on their research interests and level of involvement in the program. RESULTS Two courses (13-14 months each) involving nine facilitators and 17 participants overall were conducted between 2017 and 2021. Most participants in both courses were medical doctors (67% and 71%, respectively) from the supported hospitals (83% and 77%, respectively). About half were women. In addition to classic face-to-face didactic modules, the courses integrated online platforms to cope with the changing contexts (Ebola virus and COVID-19). Most participants reported having gained new skills in developing research protocols, collecting, managing, and analyzing data, and developing research manuscripts. The two courses resulted in six scientific manuscripts and three presentations at international conferences. Participants subsequently published five papers from their research after the first course. The total direct costs for both courses were representing a cost of $3669 per participant trained. CONCLUSION The FORT model proved feasible, efficient, and successful. However, scaling up will require more adaptation efforts from programs and participating sites.
Collapse
Affiliation(s)
- Alexandre Delamou
- Africa Center of Excellence (CEA-PCMT), Faculty of Health Sciences and Techniques, University Gamal Abdel Nasser, Conakry, Guinea.,Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, Forecariah, Guinea
| | | | - Bienvenu Salim Camara
- Africa Center of Excellence (CEA-PCMT), Faculty of Health Sciences and Techniques, University Gamal Abdel Nasser, Conakry, Guinea.,Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, Forecariah, Guinea
| | - Sidikiba Sidibe
- Africa Center of Excellence (CEA-PCMT), Faculty of Health Sciences and Techniques, University Gamal Abdel Nasser, Conakry, Guinea.,Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, Forecariah, Guinea
| | - Fassou Mathias Grovogui
- Africa Center of Excellence (CEA-PCMT), Faculty of Health Sciences and Techniques, University Gamal Abdel Nasser, Conakry, Guinea
| | - Delphin Kolie
- Africa Center of Excellence (CEA-PCMT), Faculty of Health Sciences and Techniques, University Gamal Abdel Nasser, Conakry, Guinea.,Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, Forecariah, Guinea
| | - Patrice Bouedouno
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, Forecariah, Guinea
| | - Karifa Kourouma
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, Forecariah, Guinea
| | | | - Michel M Mafu
- Engenderhealth, Kinshasa, Democratic Republic of Congo
| |
Collapse
|
7
|
Geurts B, Weishaar H, Mari Saez A, Cristea F, Rocha C, Aminu K, Tan MMJ, Salim Camara B, Barry L, Thea P, Boucsein J, Bahr T, Al-Awlaqi S, Pozo-Martin F, Boklage E, Delamou A, Jegede AS, Legido-Quigley H, El Bcheraoui C. Communicating risk during early phases of COVID-19: Comparing governing structures for emergency risk communication across four contexts. Front Public Health 2023; 11:1038989. [PMID: 36778563 PMCID: PMC9911432 DOI: 10.3389/fpubh.2023.1038989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023] Open
Abstract
Background Emergency risk communication (ERC) is key to achieving compliance with public health measures during pandemics. Yet, the factors that facilitated ERC during COVID-19 have not been analyzed. We compare ERC in the early stages of the pandemic across four socio-economic settings to identify how risk communication can be improved in public health emergencies (PHE). Methods To map and assess the content, process, actors, and context of ERC in Germany, Guinea, Nigeria, and Singapore, we performed a qualitative document review, and thematically analyzed semi-structured key informant interviews with 155 stakeholders involved in ERC at national and sub-national levels. We applied Walt and Gilson's health policy triangle as a framework to structure the results. Results We identified distinct ERC strategies in each of the four countries. Various actors, including governmental leads, experts, and organizations with close contact to the public, collaborated closely to implement ERC strategies. Early integration of ERC into preparedness and response plans, lessons from previous experiences, existing structures and networks, and clear leadership were identified as crucial for ensuring message clarity, consistency, relevance, and an efficient use of resources. Areas of improvement primarily included two-way communication, community engagement, and monitoring and evaluation. Countries with recurrent experiences of pandemics appeared to be more prepared and equipped to implement ERC strategies. Conclusion We found that considerable potential exists for countries to improve communication during public health emergencies, particularly in the areas of bilateral communication and community engagement as well as monitoring and evaluation. Building adaptive structures and maintaining long-term relationships with at-risk communities reportedly facilitated suitable communication. The findings suggest considerable potential and transferable learning opportunities exist between countries in the global north and countries in the global south with experience of managing outbreaks.
Collapse
Affiliation(s)
- Brogan Geurts
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Heide Weishaar
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Almudena Mari Saez
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Florin Cristea
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Carlos Rocha
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Kafayat Aminu
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Melisa Mei Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Bienvenu Salim Camara
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Conakry, Guinea,Centre de Formation et de Recherche en Santé Rurale de Maferinyah, Département de Recherche, Unité de Socio-Anthropologie, Conakry, Guinea
| | - Lansana Barry
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Conakry, Guinea
| | - Paul Thea
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Conakry, Guinea
| | - Johannes Boucsein
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany,Postgraduate Training for Applied Epidemiology, Robert Koch Institute, Berlin, Germany,European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Thurid Bahr
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Sameh Al-Awlaqi
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Francisco Pozo-Martin
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Evgeniya Boklage
- Information Center for International Health, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Alexandre Delamou
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Conakry, Guinea,Centre de Formation et de Recherche en Santé Rurale de Maferinyah, Département de Recherche, Unité de Socio-Anthropologie, Conakry, Guinea
| | - Ayodele Samuel Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Charbel El Bcheraoui
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany,*Correspondence: Charbel El Bcheraoui ✉
| |
Collapse
|
8
|
Scott S, Camara BS, Hill M, Lama EK, Barry L, Ogouyemi-Hounto A, Houndjo W, Tougri G, Yacouba N, Achu D, Ateba M, Diar MSI, Malm KL, Adomako K, Djata P, Da Silva W, Cissé I, Sanogo V, Jackou H, Ogbulafor N, Adu BM, Nikau J, Gaye S, Gueye AB, Kandeh B, Kolley O, Atcha-Oubou T, Tchadjobo T, Loua KM, Tchouatieu AM, Mbaye I, Lima-Parra MA, Poku-Awuku A, Ndiaye JL, Merle C, Thomas L, Milligan P. The use of video job-aids to improve the quality of seasonal malaria chemoprevention delivery. PLOS Digit Health 2022; 1:e0000165. [PMID: 36812625 PMCID: PMC9931299 DOI: 10.1371/journal.pdig.0000165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/16/2022] [Indexed: 06/18/2023]
Abstract
Mobile phones are increasingly used in community health programmes, but the use of video job-aids that can be displayed on smart phones has not been widely exploited. We investigated the use of video job-aids to support the delivery of seasonal malaria chemoprevention (SMC) in countries in West and Central Africa. The study was prompted by the need for training tools that could be used in a socially distanced manner during the COVID-19 pandemic. Animated videos were developed in English, French, Portuguese, Fula and Hausa, illustrating key steps for administering SMC safely, including wearing masks, washing hands, and social distancing. Through a consultative process with the national malaria programmes of countries using SMC, successive versions of the script and videos were reviewed to ensure accurate and relevant content. Online workshops were held with programme managers to plan how to use the videos in SMC staff training and supervision, and the use of the videos was evaluated in Guinea through focus groups and in-depth interviews with drug distributors and other staff involved in SMC delivery and through direct observations of SMC administration. Programme managers found the videos useful as they reinforce messages, can be viewed at any time and repeatedly, and when used during training sessions, provide a focus of discussion and support for trainers and help retain messages. Managers requested that local specificities of SMC delivery in their setting be included in tailored versions of the video for their country, and videos were required to be narrated in a variety of local languages. In Guinea, SMC drug distributors found the video covered the all the essential steps and found the video easy to understand. However, not all key messages were followed as some of the safety measures, social distancing and wearing masks, were perceived by some as creating mistrust amongst communities. Video job-aids can potentially provide an efficient means of reaching large numbers of drug distributors with guidance for safe and effective distribution of SMC. Not all distributors use android phones, but SMC programmes are increasingly providing drug distributors with android devices to track delivery, and personal ownership of smartphones in sub-Saharan Africa is growing. The use of video job-aids for community health workers to improve the quality delivery of SMC, or of other primary health care interventions, should be more widely evaluated.
Collapse
Affiliation(s)
- Susana Scott
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Michael Hill
- Centre for Excellence in Learning and Teaching, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Eugène Kaman Lama
- National Control Malaria Programme, Ministry of Health, Conakry, Guinea
| | - Lansana Barry
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | | | - William Houndjo
- National Malaria Control Programme, Ministry of Health, Cotonou, Benin
| | - Gauthier Tougri
- National Malaria Control Programme, Ministry of Health, Ouagadougou, Burkina Faso
| | - Nombre Yacouba
- National Malaria Control Programme, Ministry of Health, Ouagadougou, Burkina Faso
| | - Dorothy Achu
- National Malaria Control Programme, Ministry of Health, Yaoundé, Cameroon
| | - Marcellin Ateba
- National Malaria Control Programme, Ministry of Health, Yaoundé, Cameroon
| | | | - Keziah L. Malm
- National Malaria Control Programme, Ministry of Health, Accra, Ghana
| | - Kofi Adomako
- National Malaria Control Programme, Ministry of Health, Accra, Ghana
| | - Paolo Djata
- National Malaria Control Programme, Ministry of Health, Bissau, Guinea Bissau
| | - Wica Da Silva
- National Malaria Control Programme, Ministry of Health, Bissau, Guinea Bissau
| | - Idrissa Cissé
- National Malaria Control Programme, Ministry of Health, Bamako, Mali
| | - Vincent Sanogo
- National Malaria Control Programme, Ministry of Health, Bamako, Mali
| | - Hadiza Jackou
- National Malaria Control Programme, Ministry of Health, Niamey, Niger
| | - Nnenna Ogbulafor
- National Malaria Elimination Programme, Ministry of Health, Abuja, Nigeria
| | - Bala M. Adu
- National Malaria Elimination Programme, Ministry of Health, Abuja, Nigeria
| | - Jamilu Nikau
- National Malaria Elimination Programme, Ministry of Health, Abuja, Nigeria
| | - Seynabou Gaye
- National Malaria Control Programme, Ministry of Health, Dakar, Senegal
| | | | - Balla Kandeh
- National Malaria Control Programme, Ministry of Health, Banjul, The Gambia
| | - Olimatou Kolley
- National Malaria Control Programme, Ministry of Health, Banjul, The Gambia
| | | | | | | | | | | | | | | | | | - Corinne Merle
- UNDP/UNICEF/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR)/ World Health Organization (WHO), Geneva, Switzerland
| | - Liz Thomas
- University of York, York, United Kingdom
| | - Paul Milligan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
9
|
Sidibé S, Kolié D, Grovogui FM, Kourouma K, Camara BS, Delamou A, Kouanda S. Knowledge, attitudes, and practices of health providers regarding access to and use of contraceptive methods among adolescents and youth in urban Guinea. Front Public Health 2022; 10:953806. [PMID: 36466457 PMCID: PMC9713309 DOI: 10.3389/fpubh.2022.953806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The objective of this study was to analyze providers' knowledge, attitudes, and practices regarding access to and use of contraception by urban adolescents and youth. Methods This is a cross-sectional study of 1,707 health care providers in 173 selected private and public health facilities in the capital city of Conakry and the seven administrative regions of Guinea. Factors associated with health care providers' attitudes and practices were then analyzed using logistic regression. Results Among the 1,707 health providers, 71% had a good level of Knowledge about modern contraceptive use among adolescents and youth. In addition, 62% had positive attitudes, and 41% had good prescribing practices toward using modern contraceptive methods by adolescents and youth. Being a midwife (aOR: 1.39, 95%CI: 1.02-1.89), Being aged 25-34 years (aOR: 1.7, 95%CI: 1.2-2.3), 35-44 years (aOR: 2.1, 95%CI: 1.4-3.0), and 45 years, and older (aOR: 2.4, 95%CI: 1.3-4.2), an increase of years in professional experience (aOR:1.05; 95%CI: 1.02-1.08) were factors significantly associated with provider positive attitudes. However, being a medical doctor (aOR: 2.37, 95%CI: 1.04-4.42), an increase of years in professional experience (aOR: 1.07; 95%CI: 1.04-1.10) and a positive attitude (aOR: 3.16. 95%CI: 2.48-4.01) were factors associated with good practice in delivering modern contraceptive methods to adolescents and youth. Conclusion Positive attitudes and good practices toward the use of contraceptive services by adolescents and youth were found among providers. However, many health care providers still have unfavorable attitudes and practices toward delivering FP services to urban adolescents and youth. Therefore, future intervention programs should focus on training health care providers in youth- and adolescent-friendly reproductive health services and promoting contraception among adolescents.
Collapse
Affiliation(s)
- Sidikiba Sidibé
- Institut Africain de Santé Publique (IASP/USTA) of the University Saint Thomas D'Aquin, Ouagadougou, Burkina Faso,African Centre of Excellence in the Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Conakry, Guinea,National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea,*Correspondence: Sidikiba Sidibé
| | - Delphin Kolié
- African Centre of Excellence in the Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Conakry, Guinea
| | - Fassou Mathias Grovogui
- African Centre of Excellence in the Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Conakry, Guinea
| | - Karifa Kourouma
- National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
| | - Bienvenu Salim Camara
- African Centre of Excellence in the Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Conakry, Guinea,National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
| | - Alexandre Delamou
- African Centre of Excellence in the Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Conakry, Guinea,National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
| | - Seni Kouanda
- Institut Africain de Santé Publique (IASP/USTA) of the University Saint Thomas D'Aquin, Ouagadougou, Burkina Faso
| |
Collapse
|
10
|
Barry L, Kouyaté M, Sow A, De Put WV, De Maesschalck J, Camara BS, Adrianaivo N, Delamou A. Ensuring continuity of care during the COVID-19 pandemic in Guinea: Process evaluation of a health indigent fund. Front Public Health 2022; 10:1018060. [PMID: 36466448 PMCID: PMC9714427 DOI: 10.3389/fpubh.2022.1018060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The emergence of the COVID-19 has disrupted the health and socioeconomic sectors, particularly in resource-poor settings such as Guinea. Like many sub-Saharan countries, Guinea is facing shortcomings related to its fragile health system and is further affected by the passage of the Ebola virus disease. The pandemic has worsened the socio-economic situation of the poorest people, leading to their exclusion from health care. To promote access to care for the most vulnerable populations, a system was set up to provide care for these people who are victims of health marginalization to promote their access to care. This study aimed to analyze access to health services by vulnerable populations during the COVID-19 pandemic in Guinea through the establishment of a health indigent fund (HIF). Methods This was a qualitative study to assess the project implementation process. A total of 73 in-depth individual interviews were conducted with beneficiaries, health workers, community health workers and members of the HIF management committee, and a few informal observations and conversions were also conducted in the project intervention areas. The data collected were transcribed and coded using the deductive and inductive approaches with the Nvivo software before applying the thematic analysis. Results A total of 1,987 indigents were identified, of which 1,005 were cared for and 64 referred to all 38 intervention health facilities within the framework of the HIF. All participants appreciated the project's social action to promote access to equitable and quality health care for this population excluded from health care services. In addition, the project has generated waves of compassion and solidarity toward these "destitute" people whose main barrier to accessing health care remains extreme poverty. A state of poverty that leads some to sell their assets (food or animal reserves) or to go into debt to ensure access to care for their children, considered the most at risk. Conclusion The HIF can be seen as an honest attempt to provide better access to health care for the most vulnerable groups. Some challenges need to be addressed including the current system of acquiring funds before the attempt can be considered scalable.
Collapse
Affiliation(s)
- Lansana Barry
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea,Centre National de Formation et de Recherche en Santé Rurale de Maférinyah, Forécariah, Guinea,*Correspondence: Lansana Barry
| | - Mariama Kouyaté
- Centre National de Formation et de Recherche en Santé Rurale de Maférinyah, Forécariah, Guinea
| | | | - Willem Van De Put
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - John De Maesschalck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bienvenu Salim Camara
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | | | - Alexandre Delamou
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea,Centre National de Formation et de Recherche en Santé Rurale de Maférinyah, Forécariah, Guinea
| |
Collapse
|
11
|
Sidibé S, Grovogui FM, Kourouma K, Kolié D, Camara BS, Delamou A, Kouanda S. Unmet need for contraception and its associated factors among adolescent and young women in Guinea: A multilevel analysis of the 2018 Demographic and Health Surveys. Front Glob Womens Health 2022; 3:932997. [DOI: 10.3389/fgwh.2022.932997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 10/10/2022] [Indexed: 11/18/2022] Open
Abstract
Despite the recent repositioning efforts to increase the use of modern contraceptives, the prevalence of unmet need for contraception remains high among adolescent and young women in Guinea. This study analyzed the individual and contextual factors associated with the unmet need for contraception among adolescent and young women in 2018 in Guinea. We conducted a secondary analysis of the 2018 Demographic and Health Survey data. Multilevel mixed-effects logistic regression models were used to assess the association between individual and contextual characteristics and unmet need for contraception among adolescents and young women. Adjusted odds ratios (AORs) with their 95% confidence intervals (CIs) were calculated, with statistical significance set at p < 0.05. The prevalence of total unmet need for contraception was 22.6% (95% CI, 18.1–27.8). Being an adolescent aged 15–19 years (AOR = 1.44; 95% CI, 1.01–2.05), unmarried (AOR = 5.19; 95% CI, 3.51–7.67), having one or two children (AOR = 3.04; 95% CI, 2.18–4.25), or more than two children (AOR = 4.79; 95% CI, 3.00–7.62) were individual factors associated with the unmet need for contraception. As for community factors, only living in Labé (AOR = 2.54; 95% CI, 1.24–5.18) or Mamou (AOR = 1.73; 95% CI, 1.21–2.48) was significantly associated with the unmet need for contraception. In conclusion, both individual and community characteristics were significantly associated with the unmet need for contraception. This highlights the need to focus and strengthen communication and counseling strategies targeting adolescents and young women and aiming to increase the uptake of family planning in Guinea.
Collapse
|
12
|
Sereti I, Shaw-Saliba K, Dodd LE, Dewar RL, Laverdure S, Brown S, Mbaya OT, Muyembe Tamfum JJ, Mblala-Kingebeni P, Sow Y, Akpa E, Haidara MC, Fouth Tchos K, Beavogui AH, Neal A, Arlinda D, Lokida D, Grue L, Smolskis M, McNay LA, Gayedyu-Dennis D, Ruiz-Palacios GM, Montenegro-Liendo A, Tounkara M, Samake S, Jargalsaikhan G, Zulkhuu D, Weyers S, Bonnett T, Potter GE, Stevens R, Rupert A, Aboulhab J, Biampata JL, Delamo A, Camara BS, Kosasih Indonesia H, Karyana M, Duworko JT, Regalado-Pineda J, Guerra-de-Blas PDC, Doumbia S, Dabitao D, Dashdorj N, Dashdorj N, Newell K, Francis A, Rubenstein K, Bera V, Gulati I, Sardana R, Millard M, Ridzon R, Hunsberger S. Design of an observational multi-country cohort study to assess immunogenicity of multiple vaccine platforms (InVITE). PLoS One 2022; 17:e0273914. [PMID: 36107966 PMCID: PMC9477293 DOI: 10.1371/journal.pone.0273914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
In response to the COVID-19 pandemic, COVID-19 vaccines have been developed, and the World Health Oraganization (WHO) has granted emergency use listing to multiple vaccines. Studies of vaccine immunogenicity data from implementing COVID-19 vaccines by national immunization programs in single studies spanning multiple countries and continents are limited but critically needed to answer public health questions on vaccines, such as comparing immune responses to different vaccines and among different populations.
Collapse
Affiliation(s)
- Irini Sereti
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Kathryn Shaw-Saliba
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Lori E. Dodd
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Robin L. Dewar
- Virus Isolation and Serology Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Sylvain Laverdure
- Laboratory of Human Retrovirology and Immunoinformatics, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Shawn Brown
- AIDS Monitoring Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Olivier Tshiani Mbaya
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | | | | | - Ydrissa Sow
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Esther Akpa
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Mory Cherif Haidara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maférinya, Guinea
| | - Karine Fouth Tchos
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Abdoul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maférinya, Guinea
| | - Aaron Neal
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | | | - Dewi Lokida
- Indonesia Research Partnership on Infectious Diseases National Institute of Health Research and Development, Jakarta, Indonesia
| | - Louis Grue
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Mary Smolskis
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Laura A. McNay
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | | | - Guillermo M. Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | | | - Moctar Tounkara
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Seydou Samake
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | | | - Shera Weyers
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Tyler Bonnett
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Gail E. Potter
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Randy Stevens
- AIDS Monitoring Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Adam Rupert
- AIDS Monitoring Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Jamila Aboulhab
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Jean-Luc Biampata
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of Congo
| | - Alexandre Delamo
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maférinya, Guinea
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maférinya, Guinea
| | - Herman Kosasih Indonesia
- Indonesia Research Partnership on Infectious Diseases National Institute of Health Research and Development, Jakarta, Indonesia
| | | | - James T. Duworko
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | - Justino Regalado-Pineda
- Subdirección de Medicina, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | | | - Seydou Doumbia
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Djeneba Dabitao
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | | | - Kevin Newell
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Alyson Francis
- Systex, Inc, Rockville, Maryland, United States of America
| | - Kevin Rubenstein
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Victoria Bera
- Systex, Inc, Rockville, Maryland, United States of America
| | - Iman Gulati
- Systex, Inc, Rockville, Maryland, United States of America
| | - Ratna Sardana
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Monica Millard
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Renee Ridzon
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Sally Hunsberger
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| |
Collapse
|
13
|
Gindola Y, Getahun D, Mohammed KA, Kamau EM, Camara BS, Wossen M, Demissie K, Abdela S, Gebrewold G, Hailu G, Tegistu M, Okugn A, Gikilo G. Abate application practices in the Guinea worm endemic region of Gambella, Ethiopia: identification of elimination gaps. J Infect Dev Ctries 2022; 16:20S-25S. [PMID: 36156498 DOI: 10.3855/jidc.15972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/26/2022] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Guinea worm disease is caused by Dracunculus medinensis. Transmission of the disease depends on vectors (copepods). Abate applications in targeted water sources to control copepod is the main intervention. The aim of this study was to assess vector control practice in the guinea worm endemic region of Gambela, Ethiopia and to identify elimination gaps. METHODOLOGY Retrospective analysis of routine program data recorded from 2016 to 2020 was performed. Pre-and post-copepod test is conducted on water ponds to determine the density of copepods. Based on the copepod density, the chemical is applied accordingly. The five years data was obtained from Ethiopian public health institute electronic database with permission. RESULTS A total of 22,131 water ponds were treated during the past five years. Out of the total treated in 2020, 4,669/7,266 (64%) were found with > 9 Copepods during pre-copepod test. 130/7,266 (1.79%) of water ponds which were post-tested after Abate application failed the requirement of scoring ≤ 9 copepods. Of the 130 water ponds, 115 (88.5%) were observed during the transmission season (April to November). Abate application trend had increased by 28.9% during the 5 years period. According to the database, some of the largest water sources found in infection reporting villages missed their 28 days regular treatment schedule. CONCLUSIONS A single water source that has not been treated effectively could be a source of infection for both humans and animals. The practice of Abate application should be enhanced and monitored regularly. The documenting system should be improved for quality, timely information and action.
Collapse
Affiliation(s)
- Yamlak Gindola
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - Khogali Ahmed Mohammed
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Edward Mberu Kamau
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | | | - Mesfin Wossen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Girmay Hailu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Tegistu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Akwoma Okugn
- Gambela Regional Health Bureau, Gambela, Ethiopia
| | | |
Collapse
|
14
|
Paluku J, Kitambala E, Furaha CM, Bulu Bobina R, Habamungu P, Camara BS, Sidibe S, Banze Kyongolwa DF, Tripathi V, Delamou A. Integrating Client Tracker Tool Into Fistula Management: Experience From the Fistula Care Plus Project in the Democratic Republic of Congo, 2017 to 2019. Front Public Health 2022; 10:902107. [PMID: 35757601 PMCID: PMC9218534 DOI: 10.3389/fpubh.2022.902107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/16/2022] [Indexed: 11/20/2022] Open
Abstract
This study aimed to document the experience of integration and the contribution of the Client Tracker (CT) to female genital fistula (FGF) management and data quality in sites supported by the Fistula Care+ Project in the Democratic Republic of Congo (DRC), from 2017 to 2019. It was a parallel mixed methods study using routine quantitative data and qualitative data from in-depth interviews with the project staff. Quantitative findings indicated that CT forms were present in the medical records of 63% of patients; of these, 38% were completely filled out, and 29% were correctly filled out. Qualitative findings suggested that the level of use of CT in the management of FGF was associated with staff familiarity with the CT, staff understanding of concepts in the CT forms, and the CT-related additional workload. The CT has mainly contributed to improving data quality and reporting, quality of care, follow-up of fistula patients, and self-supervision of management activities. A possible simplification of the CT and/or harmonization of its content with existing routine forms, coupled with adequate continuous training of staff on record-keeping, would further contribute to maximizing CT effectiveness and sustainability.
Collapse
Affiliation(s)
| | | | | | | | | | - Bienvenu Salim Camara
- Africa Center of Excellence for Communicable Diseases Prevention and Control (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea.,Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Sidikiba Sidibe
- Africa Center of Excellence for Communicable Diseases Prevention and Control (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
| | | | | | - Alexandre Delamou
- Africa Center of Excellence for Communicable Diseases Prevention and Control (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea.,Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| |
Collapse
|
15
|
Nembunzu D, Mayemba N, Sidibé S, Grovogui FM, Aussak BTT, Banze Kyongolwa DF, Camara BS, Tripathi V, Delamou A. Factors Associated With Persistent Urinary Incontinence Among Women Undergoing Female Genital Fistula Surgery in the Democratic Republic of Congo From 2017 to 2019. Front Glob Womens Health 2022; 3:896991. [PMID: 35814834 PMCID: PMC9263387 DOI: 10.3389/fgwh.2022.896991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Despite high closure rates, residual urinary incontinence remains a common problem after successful closure of a vesico-vaginal fistula. The objective of this study was to identify factors associated with residual urinary incontinence in women with successful fistula closure in sites supported by the Fistula Care Plus project in the Democratic Republic of Congo (DRC). Material and Methods This was a retrospective cohort study using routine data extracted from the medical records of women undergoing fistula surgery in three hospitals supported by the Fistula Care Plus project in DRC between 2017 and 2019. We analyzed factors associated with residual urinary incontinence among a subsample of women with closed fistula at discharge. We collected data on sociodemographic, clinical, gynecological-obstetrical characteristics, and case management. Univariate and multivariate analyses were performed to determine the factors associated with residual urinary incontinence. Results Overall, 31 of 718 women discharged with closed fistula after repair (4.3%; 95% CI: 3.1–6.1) had residual incontinence. The leading causes identified in these women with residual incontinence were urethral voiding (6 women), short urethra (6 women), severe fibrosis (3 women) and micro-bladder (2 women). The prevalence of residual incontinence was higher among women who received repair at the Heal Africa (6.6%) and St Joseph's (3.7%) sites compared with the Panzi site (1.7%). Factors associated with increased odds of persistent urinary incontinence were the Heal Africa repair site (aOR: 54.18; 95% CI: 5.33–550.89), any previous surgeries (aOR: 3.17; 95% CI: 1.10–9.14) and vaginal surgical route (aOR: 6.78; 95% CI: 1.02–45.21). Conclusion Prior surgery and repair sites were the main predictors of residual incontinence after fistula closure. Early detection and management of urinary incontinence and further research to understand site contribution to persistent incontinence are needed.
Collapse
Affiliation(s)
- Dolores Nembunzu
- Fistula Clinic, Department of Gynecology and Obstetrics, Saint Joseph Hospital, Kinshasa, Democratic Republic of Congo
| | - Naomie Mayemba
- Fistula Clinic, Department of Gynecology and Obstetrics, Saint Joseph Hospital, Kinshasa, Democratic Republic of Congo
| | - Sidikiba Sidibé
- Africa Center of Excellence (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
- *Correspondence: Sidikiba Sidibé
| | - Fassou Mathias Grovogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | | | | | - Bienvenu Salim Camara
- Africa Center of Excellence (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
| | | | - Alexandre Delamou
- Africa Center of Excellence (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| |
Collapse
|
16
|
Mafu MM, Kyongolwa DFB, Aussak BTT, Kolié D, Camara BS, Nembunzu D, Christine AN, Paluku J, Tripathi V, Delamou A. Factors associated with surgical repair success of female genital fistula in the Democratic Republic of Congo: Experiences of the Fistula Care Plus Project, 2017-2019. Trop Med Int Health 2022; 27:831-839. [PMID: 35749231 PMCID: PMC9541372 DOI: 10.1111/tmi.13794] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Objective We sought to document outcomes and factors associated with surgical success in hospitals supported by the Fistula Care Plus Project in the Democratic Republic of Congo (DRC), 2017–2019. Methods This was a retrospective cohort study analysing routine repair data on women with Female Genital Fistula. Univariate and multivariate analyses were conducted to determine factors associated with successful fistula repair. Results A total of 895 women were included in this study, with a mean age of 34 years (±13 years). The majority were married or in union (57.4%) and living in rural areas (82.0%), while nearly half were farmers (45.9%). The average duration living with fistula was 8 years (±7). Vesicovaginal (70.5%) and complex (59.8%) fistulas were the most common fistula types. Caesarean section (34.7%), obstructed labour (27.0%) and prolonged labour (23.0%) were the main aetiologies, with the causal deliveries resulting in stillbirth in 88% of cases. The vaginal route (74.9%) was the primary route for surgical repair. The median duration of bladder catheterization after surgery was 14 days (interquartile range [IQR] 7–21). Multivariate analysis revealed that Waaldijk type I fistula (adjusted odds ratio [aOR]:2.71, 95% confidence interval [CI]:1.36–5.40), no previous surgery (aOR:2.63, 95% CI:1.43–3.19), repair at Panzi Hospital (aOR: 2.71, 95% CI:1.36–5.40), and bladder catheterization for less than 10 days (aOR:13.94, 95% CI: 4.91–39.55) or 11–14 days (aOR: 6.07, 95% CI: 2.21–15.31) were associated with better repair outcomes. Conclusion The Fistula Care Plus Project in the DRC recorded good fistula repair outcomes. However, further efforts are needed to promote adequate management of fistula cases.
Collapse
Affiliation(s)
| | | | | | - Delphin Kolié
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Africa Center of Excellence, University Gamal Abdel Nasser, Conakry, Guinea
| | - Dolores Nembunzu
- Hôpital Saint Joseph, Kinshasa, République Démocratique du Congo
| | - Amisi Notia Christine
- Hopital Général de Référence de Panzi, Bukavu, République Démocratique du Congo.,Université Evangélique en Afrique, Bukavu, République Démocratique du, Congo Hôpital
| | - Justin Paluku
- Hôpital Heal Africa, Goma, République Démocratique du Congo.,Department of Obstetrics and Gynecology, Université de Goma, Goma, République Démocratique du Congo
| | | | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Africa Center of Excellence, University Gamal Abdel Nasser, Conakry, Guinea
| |
Collapse
|
17
|
Toure AO, Balde MD, Diallo A, Camara S, Soumah AM, Sall AO, Kourouma K, Camara BS, Bocoum FY, Kouanda S. The direct cost of dialysis supported by families for patients with chronic renal failure in Ouagadougou (Burkina Faso). BMC Nephrol 2022; 23:222. [PMID: 35739468 PMCID: PMC9219226 DOI: 10.1186/s12882-022-02847-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic renal failure can lead to dialysis and/or a kidney transplant in the final stage. The number of patients under dialysis has increased considerably in the world and particularly in sub-Saharan Africa. Dialysis is a very expensive care. This is the reason why this study on the costs of dialysis management was initiated in Burkina Faso. The objective of the study is to determine the direct medical and non-medical costs of managing chronic renal failure among dialysis patients in Ouagadougou in 2020. Methods An analytical cross-sectional study was conducted. Data were collected in the hemodialysis department of three public university hospitals in Ouagadougou, Burkina Faso. All dialysis patients with chronic renal failure were included in the study. Linear regression was used to investigate the determinants of the direct medical and non-medical cost of hemodialysis. Results A total of 290 patients participated in this study, including children, adults, and the elderly with extremes of 12 and 82 years. Almost half of the patients (47.5%) had no income. The average monthly total direct cost across all patients was 75842 CFA or US$134.41.The average direct medical cost was 51315 CFA or US$90.94 and the average direct non-medical cost was 24 527 CFA or US$43.47. Most of the patients (45.2%) funded their hemodialysis by their own source. The multivariate analysis showed that the presence of an accompanying person during treatment, residing in a rural area, ambulatory care, use of personal cars, and treatment at the dialysis center of Yalgado Teaching Hospital were associated with higher direct costs. Conclusion The average cost of dialysis services borne by the patient and his family is very high in Burkina Faso, since it is 2.1 times higher than the country's minimum interprofessional wage (34664 CFA or US$61.4). It appears that the precariousness of the means of subsistence increases strongly with the onset of chronic renal failure requiring dialysis. Thus, to alleviate the expenses borne by dialysis patients, it would be important to extend the government subsidy scheme to the cost of drugs and to promote health insurance to ensure equitable care for these patients.
Collapse
Affiliation(s)
- Amadou Oury Toure
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea.
| | - Mamadou Dioulde Balde
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Aissatou Diallo
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Sadan Camara
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Anne Marie Soumah
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Alpha Oumar Sall
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Karifa Kourouma
- National Center for Training and Research in Rural Health in Maferinyah Guinea /Centre national de formation et de recherche en santé rurale à Maferinyah Guinée, Maferinyah, Guinea
| | - Bienvenu Salim Camara
- National Center for Training and Research in Rural Health in Maferinyah Guinea /Centre national de formation et de recherche en santé rurale à Maferinyah Guinée, Maferinyah, Guinea
| | - Fadima Yaya Bocoum
- Institut de Recherche en Sciences de la Santé (IRSS) Burkina Faso, Ouagadougou, Burkina Faso.,African Institute of Public Health (IASP) Burkina Faso/Institut Africaine de Santé Publique Burkina Faso, Ouagadougou, Burkina Faso
| | - Seni Kouanda
- Institut de Recherche en Sciences de la Santé (IRSS) Burkina Faso, Ouagadougou, Burkina Faso.,African Institute of Public Health (IASP) Burkina Faso/Institut Africaine de Santé Publique Burkina Faso, Ouagadougou, Burkina Faso
| |
Collapse
|
18
|
Kamara KN, Squire JS, Kanu JS, Carshon-Marsh R, Koroma Z, Koroma AT, Maruta A, Kallon C, Manzi M, Camara BS, Sargsyan A, Delamou A, Guth JA, Reid A, Khogali MA, Vandi MA. Assessment of Infection Prevention and Control Measures at Points of Entry in Sierra Leone in 2021: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:5936. [PMID: 35627473 PMCID: PMC9140457 DOI: 10.3390/ijerph19105936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/04/2023]
Abstract
Implementing and monitoring infection prevention and control (IPC) measures at immigration points of entry (PoEs) is key to preventing infections, reducing excessive use of antimicrobials, and tackling antimicrobial resistance (AMR). Sierra Leone has been implementing IPC measures at four PoEs (Queen Elizabeth II Quay port, Lungi International Airport, and the Jendema and Gbalamuya ground crossings) since the last Ebola outbreak in 2014-2015. We adapted the World Health Organization IPC Assessment Framework tool to assess these measures and identify any gaps in their components at each PoE through a cross-sectional study in May 2021. IPC measures were Inadequate (0-25%) at Queen Elizabeth II Quay port (21%; 11/53) and Jendema (25%; 13/53) and Basic (26-50%) at Lungi International Airport (40%; 21/53) and Gbalamuya (49%; 26/53). IPC components with the highest scores were: having a referral system (85%; 17/20), cleaning and sanitation (63%; 15/24), and having a screening station (59%; 19/32). The lowest scores (0% each) were reported for the availability of IPC guidelines and monitoring of IPC practices. This was the first study in Sierra Leone highlighting significant gaps in the implementation of IPC measures at PoEs. We call on the AMR multisectoral coordinating committee to enhance IPC measures at all PoEs.
Collapse
Affiliation(s)
- Kadijatu Nabie Kamara
- National Disease Surveillance Programme, Directorate of Health Security and Emergencies (DHSE), Ministry of Health and Sanitation (MoHS), Cockerill, Wilkinson Road, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.); (A.T.K.)
| | - James Sylvester Squire
- National Disease Surveillance Programme, Directorate of Health Security and Emergencies (DHSE), Ministry of Health and Sanitation (MoHS), Cockerill, Wilkinson Road, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.); (A.T.K.)
| | - Joseph Sam Kanu
- National Disease Surveillance Programme, Directorate of Health Security and Emergencies (DHSE), Ministry of Health and Sanitation (MoHS), Cockerill, Wilkinson Road, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.); (A.T.K.)
| | | | - Zikan Koroma
- Clinical Laboratories, Directorate of Laboratory and Blood Services, MoHS, Freetown 00232, Sierra Leone;
| | - Aminata Tigiedankay Koroma
- National Disease Surveillance Programme, Directorate of Health Security and Emergencies (DHSE), Ministry of Health and Sanitation (MoHS), Cockerill, Wilkinson Road, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.); (A.T.K.)
| | - Anna Maruta
- IPC/AMR Team Lead, World Health Organization (WHO) Country Office, 21A/B Riverside Drive, Freetown 00232, Sierra Leone;
| | - Christiana Kallon
- Infection Prevention and Control Unit, DHSE, MoHS, Freetown 00232, Sierra Leone;
| | | | - Bienvenu Salim Camara
- Maferinyah National Research and Training Centre, Ministry of Health, Conakry BP 1147, Guinea;
| | - Aelita Sargsyan
- Tuberculosis Research and Prevention Centre, 6/2 Adonts Str., 100 Apt., Yerevan 0014, Armenia;
| | - Alexandre Delamou
- National Training and Research Centre in Rural Health, 01 Maferinyah, Forecariah BP 2649, Guinea;
| | - Jamie Ann Guth
- Global Health Connections, Center Barnstead, Barnstead, NH 03225, USA;
| | - Anthony Reid
- LuxOR, Operational Research Unit, Médecins Sans Frontières, 68 rue Gasperich, L-1617 Luxembourg, Luxembourg;
| | - Mohamed Ahmed Khogali
- Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva, Switzerland;
| | | |
Collapse
|
19
|
Carshon-Marsh R, Squire JS, Kamara KN, Sargsyan A, Delamou A, Camara BS, Manzi M, Guth JA, Khogali MA, Reid A, Kenneh S. Incidence of Surgical Site Infection and Use of Antibiotics among Patients Who Underwent Caesarean Section and Herniorrhaphy at a Regional Referral Hospital, Sierra Leone. Int J Environ Res Public Health 2022; 19:ijerph19074048. [PMID: 35409731 PMCID: PMC8998544 DOI: 10.3390/ijerph19074048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 12/22/2022]
Abstract
Surgical site infections (SSIs) are common postoperative complications. Surgical antibiotic prophylaxis (SAP) can prevent the occurrence of SSIs if administered appropriately. We carried out a retrospective cohort study to determine the incidence of SSIs and assess whether SAP were administered according to WHO guidelines for Caesarean section (CS) and herniorrhaphy patients in Bo regional government hospital from November 2019 to October 2020. The analysis included 681 patients (599 CSs and 82 herniorrhaphies). Overall, the SSI rate was 6.7% among all patients, and 7.5% and 1.2% among CS patients and herniorrhaphy patients, respectively. SAP was administered preoperatively in 85% of CS and 70% of herniorrhaphy patients. Postoperative antibiotics were prescribed to 85% of CS and 100% of herniorrhaphy patients. Ampicillin, metronidazole, and amoxicillin were the most commonly used antibiotics. The relatively low rate of SSIs observed in this study is probably due to improved infection prevention and control (IPC) measures following the Ebola outbreak and the current COVID-19 pandemic. A good compliance rate with WHO guidelines for preoperative SAP was observed. However, there was a high use of postoperative antibiotics, which is not in line with WHO guidelines. Recommendations were made to ensure the appropriate administration of SAP and reduce unnecessary use of antibiotics.
Collapse
Affiliation(s)
- Ronald Carshon-Marsh
- District Health Management Team, Ministry of Health and Sanitation (MOHS), Bo District, Bo City 00232, Sierra Leone
- Correspondence: ; Tel.: +232-79884881
| | - James Sylvester Squire
- National Disease Surveillance Programme, Directorate of Health Security and Emergencies, MOHS, Cockerill, Wilkinson Road, Freetown 00232, Sierra Leone; (J.S.S.); (K.N.K.)
| | - Kadijatu Nabbie Kamara
- National Disease Surveillance Programme, Directorate of Health Security and Emergencies, MOHS, Cockerill, Wilkinson Road, Freetown 00232, Sierra Leone; (J.S.S.); (K.N.K.)
| | | | - Alexandre Delamou
- Department of Public Health, Gamal University of Conakry, Conakry BP 1147, Guinea;
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maferinyah National Center for Training and Research in Rural Health, Forécariah BP 2649, Guinea;
| | | | - Jamie Ann Guth
- Global Health Connections, Center Barnstead, Barnstead, NH 03225, USA;
| | - Mohamed Ahmed Khogali
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organisation, Avenue Appia 20, 1211 Geneva, Switzerland;
| | - Anthony Reid
- Operational Research Unit Luxembourg, Medecins Sans Frontieres/Doctors without Borders, 68 Rue Gasperich, L-1617 Luxembourg, Luxembourg;
| | - Sartie Kenneh
- Office of the Chief Medical Officer, Ministry of Health and Sanitation, 4th Floor, Youyi Building, Brookfields, Freetown 00232, Sierra Leone;
| |
Collapse
|
20
|
Grovogui FM, Benova L, Manet H, Sidibe S, Dioubate N, Camara BS, Beavogui AH, Delamou A. Determinants of facility-based childbirth among adolescents and young women in Guinea: A secondary analysis of the 2018 Demographic and Health Survey. PLOS Glob Public Health 2022; 2:e0000435. [PMID: 36962523 PMCID: PMC10021764 DOI: 10.1371/journal.pgph.0000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Maternal mortality remains very high in Sub-Saharan African countries and the risk is higher among adolescent girls. Maternal mortality occurs in these settings mainly around the time of childbirth and the first 24 hours after birth. Therefore, skilled attendance in an enabling environment is essential to reduce the occurrence of adverse outcomes for both women and their children. This study aims to analyze the determinants of facility childbirth among adolescents and young women in Guinea. METHODS We used the Guinea Demographic and Health Survey (DHS) conducted in 2018. All females who were adolescents (15-19) or young women (20-24 years) at the time of their most recent live birth in the five years before the survey were included. We examined the use of health facilities for childbirth and its determinants selected through the Andersen health-seeking model using descriptive analysis and multilevel multivariable logistic regression. All descriptive and analytical estimated were produced by adjusting for the survey sampling using the svy option, including adjustment for clustering, stratification and unequal probability of selection and non-response (individual sample weights). The subpopulation option was also used to account for the variance of estimations. RESULTS Overall, 58% of adolescents and 57% of young women gave birth in a health facility. Young women were more likely to have used private sector facilities compared to adolescents (p<0.001). Factors significantly associated with a facility birth in multivariable regression included: secondary or higher educational level (aOR = 1.86; 95%CI:1.24-2.78) compared to no formal education; receipt of 1-3 antenatal visits (aOR = 9.33; 95%CI: 5.07-17.16) and 4+ visits (aOR = 16.67; 95%CI: 8.82-31.48) compared to none; living in urban (aOR = 2.50; 95%CI: 1.57-3,98) compared to rural areas. Women from poorest households had lower odds of facility-based childbirth. There was substantial variation in the likelihood of birth in a health facility by region, with highest odds in N'Zérékoré and lowest in Labé. CONCLUSION The percentage of births in health facilities among adolescents and young women in Guinea was 58%. This remains suboptimal regarding the challenges associated maternal mortality and morbidity issues in Guinea. Socio-economic characteristics, region of residence and antenatal care use were the main determinants of its use. Efforts to improve maternal health among this group should target care discontinuation between antenatal care and childbirth (primarily by removing financial barriers) and increasing the demand for facility-based childbirth services in communities, while paying attention to the quality and respectful nature of healthcare services provided there.
Collapse
Affiliation(s)
- Fassou Mathias Grovogui
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Forécariah, Guinea
- Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Guinea
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Hawa Manet
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Forécariah, Guinea
| | - Sidikiba Sidibe
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Forécariah, Guinea
- Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Guinea
- University Gamal Abdel Nasser, Conakry, Guinea
| | - Nafissatou Dioubate
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Forécariah, Guinea
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Forécariah, Guinea
- Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Guinea
| | - Abdoul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Forécariah, Guinea
- University Gamal Abdel Nasser, Conakry, Guinea
| | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Forécariah, Guinea
- Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Guinea
- University Gamal Abdel Nasser, Conakry, Guinea
| |
Collapse
|
21
|
Bangoura C, Dioubaté N, Manet H, Camara BS, Kouyaté M, Douno M, Tetui M, El Ayadi AM, Delamou A. Experiences, Preferences, and Needs of Adolescents and Urban Youth in Contraceptive Use in Conakry, 2019, Guinea. Front Glob Womens Health 2021; 2:655920. [PMID: 34816211 PMCID: PMC8593994 DOI: 10.3389/fgwh.2021.655920] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: The use of contraceptive methods is very low in Guinea, particularly among adolescents and young people. The purpose of this study is to analyze the experiences and expectations of adolescents and young people regarding the use of contraceptive methods in 2019 in Conakry, Guinea. Methods: We conducted a 6-month qualitative and descriptive study. Data were collected through individual in-depth interviews and focus group discussions with adolescents and young people, health providers and health policy makers. Two approaches of deductive and inductive analysis were used to synthesize the main insights from the data. Findings: Twenty-six participants were included in this study. Adolescents and young people have personal, family and community experiences that positively or negatively influence their contraceptive needs and preferences. Positive experiences include the relative cost of injectable forms, perceived absence of side effects of implants, proven efficacy and duration of action of the modern method used (implants and injectable form). Negative experiences included cost of implants remain high (15 Euros), perceived side effects including weight gain, pill compliance, method indiscretion, and low sensation of sexual pleasure for the condom. The preferences of the young participants were dominated by Implants and injectable forms that better meet their contraceptive needs. In terms of needs, the expectations expressed revolved around needs related to the health system, including sex education, reduction in the cost of some contraceptives (implants), availability of contraceptive methods, and equity in the provision of family planning services to adolescents and young people. Conclusion: Exploring the contraceptive experiences, needs and preferences of adolescents and young people reveals decision-making dilemmas. Adolescents and young people expressed their experiences in terms of the cost of preferred contraceptives (implants), side effects, proven efficacy, and duration of action. However, their decisions are still influenced by availability, equity in service delivery, and the involvement of parents and religious leaders in sex education. Decision-makers should then place particular emphasis on improving health service delivery, adolescent sexual and reproductive health, availability of preferred contraceptive methods at affordable cost, and a program on sexuality education with the involvement of parents and religious leaders and the promotion of condom use.
Collapse
Affiliation(s)
- Charlotte Bangoura
- Maferinyah National Centre for Training and Research in Rural Health (CNFRSR), Forécariah, Guinea
| | - Nafissatou Dioubaté
- Maferinyah National Centre for Training and Research in Rural Health (CNFRSR), Forécariah, Guinea
| | - Hawa Manet
- Maferinyah National Centre for Training and Research in Rural Health (CNFRSR), Forécariah, Guinea
| | - Bienvenu Salim Camara
- Maferinyah National Centre for Training and Research in Rural Health (CNFRSR), Forécariah, Guinea.,Africa Centre of Excellence for Prevention and Control of Transmissible Diseases (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
| | - Mariama Kouyaté
- Africa Centre of Excellence for Prevention and Control of Transmissible Diseases (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
| | - Moussa Douno
- Maferinyah National Centre for Training and Research in Rural Health (CNFRSR), Forécariah, Guinea.,Africa Centre of Excellence for Prevention and Control of Transmissible Diseases (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
| | - Moses Tetui
- School of Pharmacy, Waterloo University, Waterloo, ON, Canada.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Department of Health Policy, Planning, and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Alison M El Ayadi
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Alexandre Delamou
- Maferinyah National Centre for Training and Research in Rural Health (CNFRSR), Forécariah, Guinea.,Africa Centre of Excellence for Prevention and Control of Transmissible Diseases (CEA-PCMT), University Gamal Abdel Nasser, Conakry, Guinea
| |
Collapse
|
22
|
Müller SA, Diallo AOK, Rocha C, Wood R, Landsmann L, Camara BS, Schlindwein L, Tounkara O, Arvand M, Diallo M, Borchert M. Mixed methods study evaluating the implementation of the WHO hand hygiene strategy focusing on alcohol based handrub and training among health care workers in Faranah, Guinea. PLoS One 2021; 16:e0256760. [PMID: 34437634 PMCID: PMC8389517 DOI: 10.1371/journal.pone.0256760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/13/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction The most frequent adverse health events in healthcare worldwide are healthcare-associated infection. Despite ongoing implementation of the WHO multimodal Hand Hygiene (HH) Improvement Strategy, healthcare-associated infection rate continues to be twofold higher in low- than in high-income countries. This study focused on continued evaluation of HH compliance and knowledge. The mixed method approach, with inclusion of patients and care-givers, provided insight into challenges and facilitators of the WHO HH Improvement Strategy, and highlighted improvement points. Methods An uncontrolled, before-and–after intervention, mixed methods study in Faranah Regional Hospital was conducted from December 2017 to August 2019. The intervention implemented the WHO HH Strategy including HH training for healthcare workers (HCWs), and the relaunch of the local production of alcohol-based handrub (ABHR). A baseline assessment of HH knowledge, perception and compliance of HCWs was done prior to the intervention and compared to two follow-up assessments. The second follow-up assessment was complemented by a qualitative component. Results Overall compliance six months post-intervention was 45.1% and significantly higher than baseline but significantly lower than in first follow-up. Knowledge showed similar patterns of improvement and waning. The perception survey demonstrated high appreciation of the intervention, such as local production of ABHR. HCW’s were concerned about overconsuming of ABHR, however simultaneous quantitative measurements showed that consumption in fact was 36% of the estimated amount needed for sufficient HH compliance. Potential fields for improvement identified by HCWs to enhance sustainability were permanent ABHR availability, having a dedicated person with ownership over continuous simulation HH trainings including simulations to improve technique. Conclusion The study shows that the WHO multimodal HH strategy has a positive effect on HCW compliance and knowledge. Improvement points identified by local staff like sensitization on appropriate ABHR amount per HH action should be considered for sustainable HH improvement.
Collapse
Affiliation(s)
- Sophie Alice Müller
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
- * E-mail:
| | | | - Carlos Rocha
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Rebekah Wood
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Lena Landsmann
- Unit for Hospital Hygiene, Infection Prevention and Control, Robert Koch Institute, Berlin, Germany
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maférinya, Guinea
| | | | | | - Mardjan Arvand
- Unit for Hospital Hygiene, Infection Prevention and Control, Robert Koch Institute, Berlin, Germany
| | | | - Matthias Borchert
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
23
|
Camara BS, Benova L, Delvaux T, Sidibé S, El Ayadi AM, Grietens KP, Delamou A. Women's progression through the maternal continuum of care in Guinea: Evidence from the 2018 Guinean Demographic and Health Survey. Trop Med Int Health 2021; 26:1446-1461. [PMID: 34310807 PMCID: PMC9292596 DOI: 10.1111/tmi.13661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective To examine women's progression through the antenatal, birth, and post‐partum maternal care in Guinea in 2018. Methods Using the Guinea Demographic and Health Survey of 2018, we analysed data on most recent live births in the 24 months preceding the survey among women aged 15–49 and the determinants (health system, quality of care, reproductive and sociodemographic factors) of women's progression through three steps of the continuum of care, using multivariable logistic regression. Results In the sample of 3,018 women, 87% reported at least one ANC visit (ANC1) with a health professional and 36% reported ANC4+, at least one of which was with a health professional. In the study, 26% of women reported ANC4+ plus birth in a health facility, and 20% reported ANC4+, birth in a health facility, plus post‐partum check‐up. Predictors of woman's progression from ANC1 to ANC4+ visits included living in the administrative regions of Kindia (AOR: 1.96, 95% CI: 1.23–3.14) and Nzérékoré (AOR: 0.50, 95% CI: 0.32–0.79) vs. Kankan, being aged 15 to 17 (AOR: 0.55, 95% CI: 0.35–0.86) vs. aged 25 to 34, having primary or more education (AOR: 1.37, 95% CI: 1.09–1.72), and being from a middle (AOR: 1.52, 95% CI: 1.18–1.96) or wealthier (AOR: 2.38, 95% CI: 1.67–3.39) household vs. a poor household. Living in the administrative regions of Nzérékoré (AOR: 6.27, 95% CI: 1.57–25.05) vs. Kankan, in a middle (AOR: 1.64, 95% CI: 1.05–2.57) or wealthier (AOR: 3.23, 95% CI: 1.98–5.29) household vs. a poor household, nulliparity (AOR: 1.75, 95% CI: 1.03–2.97) vs. 2–4 previous births, the distance to health facility perceived as not being a problem (AOR: 1.75, 95% CI: 1.23–2.50), and higher ANC content score (AOR: 1.29, 95% CI: 1.10–1.52) remained independently associated with progression from ANC4+ to birth in a health facility. Predictors of progression from birth in the health facility to post‐partum check‐up included residing in the administrative regions of Labé (AOR: 0.22, 95% CI: 0.09–0.51) or Faranah (AOR: 0.43, 95% CI: 0.19–0.96) vs. Kankan, higher ANC content score (AOR: 1.76, 95% CI: 1.36–2.28), skin‐to‐skin contact after birth (AOR: 3.00, 95% CI: 1.70–5.31), and being attended at birth by a health professional (AOR: 17.52, 95% CI: 4.68–65.54). Conclusions Removing financial barriers and improving quality of care appear to be important to increase the percentage of women receiving the full maternal continuum of care.
Collapse
Affiliation(s)
- Bienvenu Salim Camara
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.,Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thérèse Delvaux
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sidikiba Sidibé
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Centre d'Excellence Africain pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Université Gamal Abdel Nasser, Conakry, Guinea
| | - Alison Marie El Ayadi
- Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, California, USA
| | | | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Centre d'Excellence Africain pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Université Gamal Abdel Nasser, Conakry, Guinea
| |
Collapse
|
24
|
Pokhrel B, Koirala T, Gautam D, Kumar A, Camara BS, Saw S, Daha SK, Gurung S, Khulal A, Yadav SK, Baral P, Gurung M, Shrestha S. Antibiotic Use and Treatment Outcomes among Children with Community-Acquired Pneumonia Admitted to a Tertiary Care Public Hospital in Nepal. Trop Med Infect Dis 2021; 6:55. [PMID: 33923973 PMCID: PMC8167730 DOI: 10.3390/tropicalmed6020055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/16/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022] Open
Abstract
In the era of growing antimicrobial resistance, there is a concern about the effectiveness of first-line antibiotics such as ampicillin in children hospitalized with community-acquired pneumonia. In this study, we describe antibiotic use and treatment outcomes among under-five children with community-acquired pneumonia admitted to a tertiary care public hospital in Nepal from 2017 to 2019. In this cross-sectional study involving secondary analysis of hospital data, there were 659 patients and 30% of them had a history of prehospital antibiotic use. Irrespective of prehospital antibiotic use, ampicillin monotherapy (70%) was the most common first-line treatment provided during hospitalization followed by ceftriaxone monotherapy (12%). The remaining children (18%) were treated with various other antibiotics alone or in combination as first-line treatment. Broad-spectrum antibiotics such as linezolid, vancomycin, and meropenem were used in less than 1% of patients. Overall, 66 (10%) children were required to switch to second-line treatment and only 7 (1%) children were required to switch to third-line treatment. Almost all (99%) children recovered without any sequelae. This study highlights the effectiveness of ampicillin monotherapy in the treatment of community-acquired pneumonia in hospitalized children in a non-intensive care unit setting.
Collapse
Affiliation(s)
- Bhishma Pokhrel
- Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal; (S.K.D.); (S.G.); (A.K.); (S.K.Y.); (M.G.); (S.S.)
| | - Tapendra Koirala
- Department of Health Services, Ministry of Health and Population, Kathmandu 44600, Nepal
| | - Dipendra Gautam
- World Health Emergencies Program, WHO Country Office, Kathmandu 44600, Nepal;
| | - Ajay Kumar
- International Union against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi 110016, India;
- International Union against Tuberculosis and Lung Disease, 75006 Paris, France
- Yenepoya Medical College, Yenepoya, Mangaluru 575018, India
| | - Bienvenu Salim Camara
- Central National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah 4090, Guinea;
| | - Saw Saw
- Department of Medical Research, Ministry of Health and Sports, Yangon 05081, Myanmar;
| | - Sunil Kumar Daha
- Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal; (S.K.D.); (S.G.); (A.K.); (S.K.Y.); (M.G.); (S.S.)
| | - Sunaina Gurung
- Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal; (S.K.D.); (S.G.); (A.K.); (S.K.Y.); (M.G.); (S.S.)
| | - Animesh Khulal
- Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal; (S.K.D.); (S.G.); (A.K.); (S.K.Y.); (M.G.); (S.S.)
| | - Sonu Kumar Yadav
- Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal; (S.K.D.); (S.G.); (A.K.); (S.K.Y.); (M.G.); (S.S.)
| | - Pinky Baral
- Modern Technical College, Sanepa, Lalitpur 44700, Nepal;
| | - Meeru Gurung
- Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal; (S.K.D.); (S.G.); (A.K.); (S.K.Y.); (M.G.); (S.S.)
| | - Shrijana Shrestha
- Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal; (S.K.D.); (S.G.); (A.K.); (S.K.Y.); (M.G.); (S.S.)
| |
Collapse
|
25
|
Sidibé S, Delamou A, Kourouma K, Camara BS, Bouédouno P, Camara G, Tounkara AF, Grovogui FM, Millimouno TM. [Frequency of pregnancies within school environment and profile of adolescent girls who have had the experience in Conakry city, Guinea]. Sante Publique 2021; 32:571-582. [PMID: 33723963 DOI: 10.3917/spub.205.0571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Pregnancy in schools is an obstacle to the development and education of young girls, especially in developing countries. The purpose of this study was to assess the frequency of pregnancies within a school setting and the profile of adolescent girls who have had the experience in Conakry, Guinea. METHOD We conducted a cross-sectional study covering the period from January 1 to June 30, 2017 in 16 schools. RESULTS A total of 2,419 adolescent girls consented to participate in the study. The mean age was 16.48±0.04 years with extremes of 10 and 19 years. Students aged 15 to 19 (93.0%), those in college (53.3%) and single (69.8%) were the most likely to have been pregnant in school (P<0.05). The factors statistically significantly associated with the occurrence of teenage pregnancies in a school environment were age (Adjusted odds ratio (AOR)=1.5; 95%CI=1.3-1.7; P<0.001), school level (AOR=0.6; 95%CI=0.4-0.8; P=0.003 for Lycée), the place of residence (AOR=0.5; 95%CI=0.4-0.9; P=0.002 for Matam, AOR=0.4; 95%CI=0.3-0.8; P<0.001 for Dixinn, AOR=0,3; 95%CI=0.2-0.8; P=0.010 for Ratoma), marital status (AOR=8.7; 95%CI=3.4-7.0; P<0.001), information on reproductive health (AOR=2.4; 95%CI=1.1-3.0; P=0.015), knowledge of the benefits of family planning (AOR=2.2; 95%CI=1.0-2.2; P=0.030) and the difficulty of accessing sexual and reproductive health services (AOR=3.4; 95%CI=1.4-3,7; P<0.01). CONCLUSIONS The occurrence of school pregnancies remains a worrying reality among adolescent girls in Guinea. Factors associated with the occurrence of pregnancy in the school are age, school level, place of residence, marital status, knowledge of sexual health information, knowledge of the benefits of family planning, and related difficulties access to sexual and reproductive health services.
Collapse
|
26
|
Camara BS, Delamou A, Grovogui FM, de Kok BC, Benova L, El Ayadi AM, Gerrets R, Grietens KP, Delvaux T. Interventions to increase facility births and provision of postpartum care in sub-Saharan Africa: a scoping review. Reprod Health 2021; 18:16. [PMID: 33478542 PMCID: PMC7819232 DOI: 10.1186/s12978-021-01072-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background Most maternal deaths occur during the intrapartum and peripartum periods in sub-Saharan Africa, emphasizing the importance of timely access to quality health service for childbirth and postpartum care. Increasing facility births and provision of postpartum care has been the focus of numerous interventions globally, including in sub-Saharan Africa. The objective of this scoping review is to synthetize the characteristics and effectiveness of interventions to increase facility births or provision of postpartum care in sub-Saharan Africa. Methods We searched for systematic reviews, scoping reviews, qualitative studies and quantitative studies using experimental, quasi experimental, or observational designs, which reported on interventions for increasing facility birth or provision of postpartum care in sub-Saharan Africa. These studies were published in English or French. The search comprised six scientific literature databases (Pubmed, CAIRN, la Banque de Données en Santé Publique, the Cochrane Library). We also used Google Scholar and snowball or citation tracking. Results Strategies identified in the literature as increasing facility births in the sub-Saharan African context include community awareness raising, health expenses reduction (transportation or user fee), non-monetary incentive programs (baby kits), or a combination of these with improvement of care quality (patient’s privacy, waiting time, training of provider), and or follow-up of pregnant women to use health facility for birth. Strategies that were found to increase provision of postpartum care include improvement of care quality, community-level identification and referrals of postpartum problems and transport voucher program. Conclusions To accelerate achievements in facility birth and provision of postpartum care in sub-Saharan Africa, we recommend strategies that can be implemented sustainably or produce sustainable change. How to sustainably motivate community actors in health interventions may be particularly important in this respect. Furthermore, we recommend that more intervention studies are implemented in West and Central Africa, and focused more on postpartum. Plain English summary In in sub-Saharan Africa, many women die when giving or few days after birth. This happens because they do not have access to good health services in a timely manner during labor and after giving birth. Worldwide, many interventions have been implemented to Increase the number of women giving birth in a health facility or receiving care from health professional after giving birth. The objective of this study is to synthetize the characteristics and effectiveness of interventions that have been implemented in sub-Saharan Africa, aiming to increase the number of women giving birth in a health facility or receiving care from health professional after birth. To proceed with this synthesis, we did a review of studies that have reported on such interventions in sub-Saharan Africa. These studies were published in English or French. The interventions identified to increase the number of women giving birth in a health facility include community awareness raising, reduction of health expenses (transportation or user fee), non-monetary incentive programs (baby kits), or a combination of these with improvement of care quality (patient’s privacy, waiting time, training of provider), and or follow-up of pregnant women to use health facility for birth. Interventions implemented to increase the number women receiving care from a health professional after birth include improvement of care quality, transport voucher program and community-level identification and referrals to the health center of mothers’ health problems. In sub-Saharan Africa, to accelerate increase in the number of women giving birth in a health facility and receiving care from a health professional after, we recommend interventions that can be implemented sustainably or produce sustainable change. How to sustainably motivate community actors in health interventions may be particularly important in this respect. Furthermore, we recommend the conduct in West and Central Africa, of more studies targeting interventions to increase the number of women giving birth in a health facility and or receiving care from a health professional after birth.
Collapse
Affiliation(s)
- Bienvenu Salim Camara
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium. .,Department of Anthropology, Amsterdam Institute of Social Science Research, Amsterdam, The Netherlands. .,Centre National de Formation Et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.
| | - Alexandre Delamou
- Centre National de Formation Et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Centre D'Excellence Africain Pour La Prévention Et Le Contrôle Des Maladies Transmissibles (CEA-PCMT), Conakry, Guinea
| | - Fassou Mathias Grovogui
- Centre National de Formation Et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Bregje Christina de Kok
- Department of Anthropology, Amsterdam Institute of Social Science Research, Amsterdam, The Netherlands
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Alison Marie El Ayadi
- Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, CA, USA
| | - Rene Gerrets
- Department of Anthropology, Amsterdam Institute of Social Science Research, Amsterdam, The Netherlands
| | - Koen Peeters Grietens
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Thérèse Delvaux
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| |
Collapse
|
27
|
Sidibé S, Delamou A, Camara BS, Dioubaté N, Manet H, El Ayadi AM, Benova L, Kouanda S. Trends in contraceptive use, unmet need and associated factors of modern contraceptive use among urban adolescents and young women in Guinea. BMC Public Health 2020; 20:1840. [PMID: 33261605 PMCID: PMC7706031 DOI: 10.1186/s12889-020-09957-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/22/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In Guinea, high fertility among adolescents and young women in urban areas remains a public health concern. This study describes trends in contraceptive use, unmet need, and factors associated with the use of modern family planning (FP) methods among urban adolescents and young women in Guinea. METHODS We used four Guinea Demographic and Health Surveys (DHS) conducted in 1999, 2005, 2012, and 2018. Among urban adolescents and young women (15-24 years), we examined trends over time in three key indicators: 1. Modern Contraceptive use, 2. Unmet need for FP and 3. Modern contraceptive use among those in need of FP (demand satisfied). We used multivariable logistic regression to examine association between socio-demographic factors and modern FP use on the most recent DHS dataset (2018). RESULTS We found statistically significant changes over the time period examined with an increase in modern contraceptive use (8.4% in 1999, 12.8% in 2018, p < 0.01) and demand satisfied (29.0% in 1999, 54.1% in 2018, p < 0.001), and a decrease in unmet need for FP (15.8% in 1999, 8.6% in 2018, p < 0.001). Factors significantly associated with modern FP use were; young women aged 20-24 years (AOR 2.8, 95% CI: 1.9-4.1), living in urban areas of Faranah (AOR: 2.6, 95% CI: 1.1-6.5) and Kankan (AOR: 3.6, 95% CI: 1.7-7.8), living in households in the middle (AOR: 7.7, 95% CI: 1.4-42.2) and richer wealth quintiles (AOR: 6.3, 95% CI: 1.0-38.1). Ever-married women (AOR: 0.5, 95% CI: 0.3-0.9) were less likely to use modern FP methods than never married as were those from the Peulh (0.3, 95% CI: 0.2-0.4) and Malinke (0.5, 95% CI: 0.3-0.8) ethnic groups compared to Soussou ethnic group. CONCLUSION Despite some progress, efforts are still needed to improve FP method use among urban adolescent and young women. Age, administrative region, wealth index, marital status, and ethnic group are significantly associated with modern FP use. Future policies and interventions should place emphasis on improving adolescents' reproductive health knowledge, increasing FP availability and strengthening provision. Efforts should target adolescents aged 15-19 years in particular, and address disparities between administrative regions and ethnic groups, and health-related inequalities.
Collapse
Affiliation(s)
- Sidikiba Sidibé
- Institut Africain de Santé Publique (IASP/USTA) of the University Saint Thomas D’Aquin, Ouagadougou, Burkina Faso
- CEA-PCMT_Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Alexandre Delamou
- CEA-PCMT_Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
- National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
| | - Bienvenu Salim Camara
- CEA-PCMT_Faculty of Sciences and Health Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
- National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
| | - Nafissatou Dioubaté
- National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
| | - Hawa Manet
- National Training and Research Centre in Rural Health of Maferinyah, Forecariah, Guinea
| | - Alison M. El Ayadi
- Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA USA
| | - Lenka Benova
- Sexual and Reproductive Health Group, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Seni Kouanda
- Institut Africain de Santé Publique (IASP), Ouagadougou, Burkina Faso
| |
Collapse
|
28
|
Camara BS, Belaid L, Manet H, Kolie D, Guillard E, Bigirimana T, Delamou A. What do we know about patient-provider interactions in sub-Saharan Africa? a scoping review. Pan Afr Med J 2020; 37:88. [PMID: 33244351 PMCID: PMC7680249 DOI: 10.11604/pamj.2020.37.88.24009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 12/30/2022] Open
Abstract
Introduction patient-centred care has become a rallying call for improving quality and access to care in countries where health system responsiveness and satisfaction with health services remain low. Understanding patient-provider interactions is important to guide implementation of an effective patient-centred care approach in sub-Saharan Africa. This review aims to overcome this knowledge gap by synthesizing the evidence on patient-provider interactions in sub-Saharan Africa. Methods we conducted a scoping review using Arksey and O´Malley´s framework. We searched in eight databases and the grey literature. We conducted a thematic analysis using an inductive approach to assess the studies. Results of the 80 references identified through database searching, nine met the inclusion criteria. Poor communication and several types of mistreatment (service denial, oppressive language, harsh words and rough examination) characterize patient-provider interactions in sub-Saharan Africa. Nevertheless, some health providers offer support to patients who cannot afford their medical expenses, cost of transportation, food or other necessities. Maintaining confidentiality depends on the context of care. Some patients blamed health providers for consulting with the door open or carrying out concomitant activities in the consultation room. However, in the context of HIV care provision, nurses emphasized the importance of keeping their patients´ HIV status confidential. Conclusion this review advocates for more implementation studies on patient-provider interactions in sub-Saharan Africa so as to inform policies and practices for patient-centred health systems. Decision-makers should prioritize training, mentorship and regular supportive supervision of health providers to provide patient-centred care. Patients should be empowered in care processes.
Collapse
Affiliation(s)
- Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Loubna Belaid
- Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Hawa Manet
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Delphin Kolie
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | | | | | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Department of Public Health, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| |
Collapse
|
29
|
Camara BS, Okumura J, Delamou A. Do memories of the Ebola virus disease outbreak influence post-Ebola health seeking behaviour in Guéckédou district (epicentre) in Guinea? A cross-sectional study of children with febrile illness. BMC Public Health 2020; 20:1298. [PMID: 32854668 PMCID: PMC7450797 DOI: 10.1186/s12889-020-09359-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/06/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The 2013-2015 Ebola Virus Disease (EVD) outbreak in Guinea resulted in community mistrust that influenced health care service utilization. This study aimed to assess whether EVD-related memories affect post-outbreak health-seeking behaviours for children under 5 years of age with febrile illnesses in Guéckédou district, Guinea. METHODS This cross-sectional study was conducted by surveying caregivers of children under 5 years of age in the sub-district most affected by the EVD outbreak (Guèndembou) and the least affected sub-district (Bolodou) in Guéckédou district. Memories of the outbreak were referred to as EVD-related fears in the post-EVD period, which was based on a series of questions regarding current feelings. RESULTS While the majority of caregivers sought care for their children with febrile illness in both districts, a statistically significantly higher proportion of caregivers in Guèndembou sought care, compared to caregivers in Bolodou.. More caregivers in Guèndembou (19.9%; n = 39) reported the death of family members or friends due to EVD compared to Bolodou (6.9%; n = 14; P < 0.001). The mean EVD fear score of caregivers was significantly higher in Guèndembou (3.0; SD: 3.0) than in Bolodou (2.0; SD: 1.1) (p < 0.001). Caregivers with a fear score above the median were 1.68 times more likely to seek care than those whose fear score was equal to or below the median; however, this difference was not statistically significant. Caregivers who reported family members' or friends' death due to EVD were also more likely to seek care (AOR = 2.12; 95%CI: 0.91-4.91), however, with no statistical significance. Only residing in the EVD-most affected sub-district of Guèndembou (AOR = 1.74; 95%CI: 1·09-2.79) was positively associated with seeking care. CONCLUSIONS This study reveals that community members in the rural district of Guéckédou still live with fear related to EVD nearly 2 years after the outbreak. It calls for more efforts in the health domain to preserve communities' key values and address the psychosocial effect of EVD in rural Guinea.
Collapse
Affiliation(s)
- Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea. .,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Junko Okumura
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan. .,Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
| | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Department of Public Health, Gamal Abdel Nasser University, Conakry, Guinea
| |
Collapse
|
30
|
Beavogui AH, Delamou A, Camara BS, Camara D, Kourouma K, Camara R, Sagara I, Lama EK, Djimde A. Prevalence of malaria and factors associated with infection in children aged 6 months to 9 years in Guinea: Results from a national cross-sectional study. Parasite Epidemiol Control 2020; 11:e00162. [PMID: 32715113 PMCID: PMC7378695 DOI: 10.1016/j.parepi.2020.e00162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/23/2020] [Accepted: 06/18/2020] [Indexed: 01/03/2023] Open
Abstract
Worldwide, a child dies every two minutes due to malaria with Africa bearing about 90% of all malaria deaths particularly among children. This study aimed to describe malaria prevalence and its associated factors among children aged 6 months to 9 years in Guinea. We conducted a cross-sectional household survey between 02 and 29 August 2014 in children aged 6 months to 9 years in the four natural regions of the country. A five-level cluster sampling using the national database from the national institute of statistics was used to select study participants. A total of 1984 children aged 6 months to 9 years were enrolled. The mean age was 50 months (SD, 27). The rapid diagnostic test showed a high malaria prevalence (44%) countrywide along with regional variation ranging from 38% to 61%. A multivariate analysis showed that living in Forest Guinea (AOR: 2.48; 95% CI: 1.78–3.46), in rural areas (AOR: 1.91; 95% IC: 1.45–2.5) and having a splenomegaly (AOR: 2.66; 95% CI: 1.75–4.04) were highly associated with malaria. This study shows that malaria is still prevalent in Guinea among children aged 6 months to 9 years of age.
Collapse
Affiliation(s)
- Abdoul Habib Beavogui
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
- Department of Bioclinical and Fundamental Sciences, Gamal Abdel Nasser University, Conakry, Guinea
- Centre d'Excellence Africain pour la Prevention des Maladies Transmissibles (CEA-PCMT), Gamal Abdel Nasser University, Conakry, Guinea
- Corresponding author at: Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, PoBox: 2649, Conakry, Guinea.
| | - Alexandre Delamou
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
- Centre d'Excellence Africain pour la Prevention des Maladies Transmissibles (CEA-PCMT), Gamal Abdel Nasser University, Conakry, Guinea
- Department of Public Health, Gamal Abdel Nasser University, Conakry, Guinea
| | - Bienvenu Salim Camara
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
| | - Daouda Camara
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
| | - Karifa Kourouma
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
| | - Robert Camara
- National Institute of Public Health, Conakry, Guinea
| | - Issaka Sagara
- Malaria Research and Training Center, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Abdoulaye Djimde
- Malaria Research and Training Center, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| |
Collapse
|
31
|
Quaglio G, Tognon F, Finos L, Bome D, Sesay S, Kebbie A, Di Gennaro F, Camara BS, Marotta C, Pisani V, Bangura Z, Pizzol D, Saracino A, Mazzucco W, Jones S, Putoto G. Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: a prospective observational study. BMJ Open 2019; 9:e029093. [PMID: 31488479 PMCID: PMC6731846 DOI: 10.1136/bmjopen-2019-029093] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the trends concerning utilisation of maternal and child health (MCH) services before, during and after the Ebola outbreak, quantifying the contribution of a reorganised referral system (RS). DESIGN A prospective observational study of MCH services. SETTING Pujehun district in Sierra Leone, 77 community health facilities and 1 hospital from 2012 to 2017. MAIN OUTCOME MEASURES MCH utililization was evaluated by assessing: (1) institutional deliveries, Cesarean-sections, paediatric and maternity admissions and deaths, and major direct obstetric complications (MDOCs), at hospital level; (2) antenatal care (ANC) 1 and 4, institutional delivery and family planning, at community level. Contribution of a strengthened RS was also measured. RESULTS At hospital level, there is a significant difference between trends Ebola versus pre-Ebola for maternal admissions (7, 95% CI 4 to 11, p<0.001), MDOCs (4, 95% CI 1 to 7, p=0.006) and institutional deliveries (4, 95% CI 2 to 6, p=0.001). There is also a negative trend in the transition from Ebola to post-Ebola for maternal admissions (-7, 95% CI -10 to -4, p<0.001), MDOCs (-4, 95% CI -7 to -1, p=0.009) and institutional deliveries (-3, 95% CI -5 to -1, p=0.001). The differences between trends pre-Ebola versus post-Ebola are only significant for paediatric admissions (3, 95% CI 0 to 5, p=0.035). At community level, the difference between trends Ebola versus pre-Ebola and Ebola versus post-Ebola are not significant for any indicators. The differences between trends pre-Ebola versus post-Ebola show a negative difference for institutional deliveries (-7, 95% CI -10 to -4, p<0.001), ANC 1 (-6, 95% CI -10 to -3, p<0.001), ANC 4 (-8, 95% CI -11 to -5, p<0.001) and family planning (-85, 95% CI -119 to -51, p<0.001). CONCLUSIONS A stronger health system compared with other districts in Sierra Leone and a strengthened RS enabled health facilities in Pujehun to maintain service provision and uptake during and after the Ebola epidemic.
Collapse
Affiliation(s)
- Gianluca Quaglio
- European Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
- Department of International Health/CAPHRI, University of Maastricht, Maastricht, The Netherlands
- Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy
| | - Francesca Tognon
- Department for Woman and Child Health, University of Padua, Padua, Italy
| | - Livio Finos
- Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
| | - David Bome
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Santigie Sesay
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Atiba Kebbie
- Department for Woman and Child Health, Pujehun Hospital, Pujehun, Sierra Leone
| | | | - Bienvenu Salim Camara
- National Centre for Training and Research in Rural Health of Maferinyah, Forécariah, Guinea
| | - Claudia Marotta
- Department of Science for Health Promotion and Mother to Child Care, University of Palermo, Palermo, Italy
| | - Vincenzo Pisani
- Department for Woman and Child Health, Pujehun Hospital, Pujehun, Sierra Leone
| | - Zainab Bangura
- Department for Woman and Child Health, Pujehun Hospital, Pujehun, Sierra Leone
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy
| | | | - Walter Mazzucco
- Department of Science for Health Promotion and Mother to Child Care, University of Palermo, Palermo, Italy
| | - Susan Jones
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, London, UK
| | - Giovanni Putoto
- Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy
| |
Collapse
|
32
|
Kourouma K, Delamou A, Lamah L, Camara BS, Kolie D, Sidibé S, Béavogui AH, Owiti P, Manzi M, Ade S, Harries AD. Frequency, characteristics and hospital outcomes of road traffic accidents and their victims in Guinea: a three-year retrospective study from 2015 to 2017. BMC Public Health 2019; 19:1022. [PMID: 31366335 PMCID: PMC6668061 DOI: 10.1186/s12889-019-7341-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/19/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Road traffic accidents (RTA) remain a global public health concern in developing countries. The aim of the study was to document the frequency, characteristics and hospital outcomes of road traffic accidents in Guinea from 2015 to 2017. METHODS We conducted a retrospective cohort study using medical records of RTA victims from 20 hospitals and a cross-sectional study of RTA cases from eight police stations in eight districts in Guinea, West Africa. Data analysis included descriptive statistics, trends of RTA, a sequence of interrupted time-series models and a segmented ordinary least-squares (OLS) regression. RESULTS Police stations recorded 3,140 RTA over 3 years with an overall annual increase in RTA rates from 14.0 per 100,000 population in 2015, to 19.2 per 100,000 population in 2016 (37.1% annual increase), to 28.7 per 100,000 population in 2017 (49.5% annual increase). Overall, the injury rates in 2016 and 2017 were .05 per 100,000 population higher on average per month (95% CI: .03-.07). Deaths from RTA showed no statistical differences over the 3 years and no association of RTA trends with season was found. Overall, 27,751 RTA victims were admitted to emergency units, representing 22% of all hospitals admissions. Most victims were males (71%) and young (33%). Deaths represented 1.4% of all RTA victims. 90% of deaths occurred before or within 24 h of hospital admission. Factors associated with death were being male (p = .04), being a child under 15 years (p = .045) or an elderly person aged ≥65 years (p < .001), and having head injury or coma (p < .001). CONCLUSIONS RTA rates in Guinea are increasing. There is a need for implementing multisectoral RTA prevention measures in Guinea.
Collapse
Affiliation(s)
- Karifa Kourouma
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, PB: 4099, Maferinyah, Forécariah, Guinea.
| | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, PB: 4099, Maferinyah, Forécariah, Guinea.,Department of Public Health, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Léopold Lamah
- Department of Traumatology and Orthopedics, University Teaching Hospital of Donka, Conakry, Guinea
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, PB: 4099, Maferinyah, Forécariah, Guinea
| | - Delphin Kolie
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, PB: 4099, Maferinyah, Forécariah, Guinea
| | - Sidikiba Sidibé
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, PB: 4099, Maferinyah, Forécariah, Guinea.,Department of Public Health, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Abdoul Habib Béavogui
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maferinyah, PB: 4099, Maferinyah, Forécariah, Guinea
| | - Philip Owiti
- International Union Against Tuberculosis and Lung Disease, Paris, France.,The National Tuberculosis, Leprosy and Lung Disease Program, Ministry of Health, Nairobi, Kenya
| | - Marcel Manzi
- Medical Department, Médecins Sans Frontière Bruxelles, Bruxelles, Belgium
| | - Serge Ade
- International Union Against Tuberculosis and Lung Disease, Paris, France.,Faculté de Médecine, Université de Parakou, Parakou, Benin
| | - Anthony D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France.,London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
33
|
Delamou A, Camara BS, Sidibé S, Camara A, Dioubaté N, Ayadi AME, Tayler-Smith K, Beavogui AH, Baldé MD, Zachariah R. Trends of and factors associated with cesarean section related surgical site infections in Guinea. J Public Health Afr 2019; 10:818. [PMID: 31214304 PMCID: PMC6548997 DOI: 10.4081/jphia.2019.818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 07/19/2018] [Indexed: 11/23/2022] Open
Abstract
Since the adoption of free obstetric care policy in Guinea in 2011, no study has examined the surgical site infections in maternity facilities. The objective of this study was to assess the trends of and factors associated with surgical site infection following cesarean section in Guinean maternity facilities from 2013 to 2015. This was a retrospective cohort study using routine medical data from ten facilities. Overall, the incidence of surgical site infections following cesarean section showed a declining trend across the three periods (10% in 2013, 7% in 2014 and 5% in 2015, P<0.001). Women who underwent cesarean section in 2014 (AOR: 0.70; 95%CI: 0.57-0.84) and 2015 (AOR: 0.43; 95%CI: 0.34-0.55) were less likely to develop surgical site infections during hospital stay than women operated in 2013. In the contrary, women with comorbidities were more likely to experience surgical site infection (AOR: 1.54; 95% CI: 1.25-1.90) than those who did not have comorbidities. The reductions achieved in 2014 and 2015 (during the Ebola outbreak) should be sustained in the post-Ebola context.
Collapse
Affiliation(s)
- Alexandre Delamou
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
- Woman and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maferinyah, Guinea
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maferinyah, Guinea
| | - Sidikiba Sidibé
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
- Woman and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maferinyah, Guinea
| | - Alioune Camara
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
| | - Nafissatou Dioubaté
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maferinyah, Guinea
| | - Alison Marie El Ayadi
- University of California, Bixby Center for Global Reproductive Health, San Francisco, CA, USA
| | - Katy Tayler-Smith
- Médecins sans Frontières, Medical Department, Operational Centre Brussels, MSFLuxembourg, Luxembourg
| | - Abdoul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Maferinyah, Guinea
| | - Mamadou Dioulde Baldé
- Department of Gynecology and Obstetrics, Gamal University of Conakry, Conakry, Guinea
| | - Rony Zachariah
- Médecins sans Frontières, Medical Department, Operational Centre Brussels, MSFLuxembourg, Luxembourg
| |
Collapse
|
34
|
van Griensven J, Bah EI, Haba N, Delamou A, Camara BS, Olivier KJJ, De Clerck H, Nordenstedt H, Semple MG, Van Herp M, Buyze J, De Crop M, Van Den Broucke S, Lynen L, De Weggheleire A. Electrolyte and Metabolic Disturbances in Ebola Patients during a Clinical Trial, Guinea, 2015. Emerg Infect Dis 2018; 22. [PMID: 27869610 PMCID: PMC5189166 DOI: 10.3201/eid2212.161136] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Such abnormalities were common during infection and enabled accurate stratification of the risk for death. Electrolyte and Metabolic Disturbances in Ebola By using data from a 2015 clinical trial on Ebola convalescent-phase plasma in Guinea, we assessed the prevalence of electrolyte and metabolic abnormalities at admission and their predictive value to stratify patients into risk groups. Patients underwent testing with a point-of-care device. We used logistic regression to construct a prognostic model and summarized the predictive value with the area under the receiver operating curve. Abnormalities were common among patients, particularly hypokalemia, hypocalcemia, hyponatremia, raised creatinine, high anion gap, and anemia. Besides age and PCR cycle threshold value, renal dysfunction, low calcium levels, and low hemoglobin levels were independently associated with increased risk for death. A prognostic model using all 5 factors was highly discriminatory (area under the receiver operating curve 0.95; 95% CI 0.90–0.99) and enabled the definition of risk criteria to guide targeted care. Most patients had a very low (<5%) or very high (>80%) risk for death.
Collapse
|
35
|
Camara BS, Delamou AM, Diro E, El Ayadi A, Béavogui AH, Sidibé S, Grovogui FM, Takarinda KC, Kolié D, Sandouno SD, Okumura J, Baldé MD, Van Griensven J, Zachariah R. Influence of the 2014-2015 Ebola outbreak on the vaccination of children in a rural district of Guinea. Public Health Action 2017; 7:161-167. [PMID: 28695091 DOI: 10.5588/pha.16.0120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/24/2017] [Indexed: 12/24/2022] Open
Abstract
Setting: All health centres in Macenta District, rural Guinea. Objective: To compare stock-outs of vaccines, vaccine stock cards and the administration of various childhood vaccines across the pre-Ebola, Ebola and post-Ebola virus disease periods. Design: This was an ecological study. Results: Similar levels of stock-outs were observed for all vaccines (bacille Calmette-Guérin [BCG], pentavalent, polio, measles, yellow fever) in the pre-Ebola and Ebola periods (respectively 2760 and 2706 facility days of stock-outs), with some variation by vaccine. Post-Ebola, there was a 65-fold reduction in stock-outs compared to pre-Ebola. Overall, 24 facility-months of vaccine stock card stock-outs were observed during the pre-Ebola period, which increased to 65 facility-months of stock-outs during the Ebola outbreak period; no such stock-out occurred in the post-Ebola period. Apart from yellow fever and measles, vaccine administration declined universally during the peak outbreak period (August-November 2014). Complete cessation of vaccine administration for BCG and a prominent low for polio (86% decrease) were observed in April 2014, corresponding to vaccine stock-outs. Post-Ebola, overall vaccine administration did not recover to pre-Ebola levels, with the highest gaps seen in polio and pentavalent vaccines, which had shortages of respectively 40% and 38%. Conclusion: These findings highlight the need to sustain vaccination activities in Guinea so that they remain resilient and responsive, irrespective of disease outbreaks.
Collapse
Affiliation(s)
- B S Camara
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
| | - A M Delamou
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea.,Woman and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
| | - E Diro
- University of Gondar, Gondar, Ethiopia
| | - A El Ayadi
- Bixby Center for Global Reproductive Health, University of California, San Francisco, California, USA
| | - A H Béavogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea
| | - S Sidibé
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
| | - F M Grovogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea
| | - K C Takarinda
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - D Kolié
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea
| | - S D Sandouno
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
| | - J Okumura
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - M D Baldé
- Department of Gynecology-Obstetrics, Gamal University of Conakry, Conakry, Guinea
| | - J Van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - R Zachariah
- Médecins Sans Frontières, Brussels Operational Centre (LuxOR), Luxembourg
| |
Collapse
|
36
|
Delamou A, Camara BS, Kolie JP, Guemou AD, Haba NY, Marquez S, Beavogui AH, Delvaux T, van Griensven J. Profile and reintegration experience of Ebola survivors in Guinea: a cross-sectional study. Trop Med Int Health 2017; 22:254-260. [DOI: 10.1111/tmi.12825] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Alexandre Delamou
- Department of Public Health; Faculty of Medicine; Gamal University of Conakry; Conakry Guinea
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah; Forecariah Guinea
- Institute of Tropical Medicine; Antwerp Belgium
| | - Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah; Forecariah Guinea
| | - Jean Pe Kolie
- Réseau National des Associations de Survivants d'Ebola de Guinée; Conakry Guinea
| | - Achille Diona Guemou
- Réseau National des Associations de Survivants d'Ebola de Guinée; Conakry Guinea
| | | | - Shannon Marquez
- Department of Public Health; Drexel University; Philadelphia PA USA
| | - Abdoul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah; Forecariah Guinea
| | | | | |
Collapse
|
37
|
Delamou A, El Ayadi AM, Sidibe S, Delvaux T, Camara BS, Sandouno SD, Beavogui AH, Okumura J, Zhang WH, De Brouwere V. The effect of the Ebola Virus Disease on Maternal and Infant Healthcare utilization in Guinea. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw165.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
38
|
Delamou A, Haba NY, Mari-Saez A, Gallian P, Ronse M, Jacobs J, Camara BS, Kadio KJJO, Guemou A, Kolie JP, De Crop M, Chavarin P, Jacquot C, Lazaygues C, De Weggheleire A, Lynen L, van Griensven J. Organizing the Donation of Convalescent Plasma for a Therapeutic Clinical Trial on Ebola Virus Disease: The Experience in Guinea. Am J Trop Med Hyg 2016; 95:647-653. [PMID: 27430546 PMCID: PMC5014273 DOI: 10.4269/ajtmh.15-0890] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 05/06/2016] [Indexed: 11/07/2022] Open
Abstract
Although convalescent plasma (CP) transfusion was prioritized among potential Ebola treatments by the World Health Organization, there were concerns on the feasibility of its implementation. We report on the successful organization of donor mobilization and plasma collection as part of the Ebola-Tx clinical trial from November 2014 to July 2015 in Conakry, Guinea. Project implementation registers, tools and reports, mission reports, and minutes of research team meetings were used to reconstruct the sequence of events on how donor mobilization was organized, plasmapheresis was set up, and how effective this approach was in collecting CP. An initial needs assessment of the Guinean National Blood Transfusion Center resulted in targeted training of staff on site, resulting in autonomy and independent production of CP within 3 months. The Conakry Ebola Survivors Association played a direct role in donor mobilization and organization of CP donations. A total of 98 Ebola survivors were screened for plasma donation, of which 84 were found eligible for plasmapheresis. Of these, 26 (30.9%) were excluded. The remaining 58 donors made a total of 90 donations, corresponding to 50.9 L of CP. This sufficed to treat the 99 eligible patients enrolled in the trial. Within a poor resource emergency context, transfusion capacity could be rapidly improved through the strengthening of local capacities and gradual transfer of skills coupled with active involvement of Ebola survivors. However, large-scale plasma collection or multisite studies may require further adaptations of both strategy and logistics. The Ebola-Tx trial was funded by the European Union and others.
Collapse
Affiliation(s)
- Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Pierre Gallian
- Etablissement Français du Sang, La Plaine Stade de France, France
| | - Maya Ronse
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Jan Jacobs
- Institute of Tropical Medicine, Antwerp, Belgium
- Department of Microbiology and Immunology, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | - Achille Guemou
- Association des Personnes Guéries et Affectées d'Ebola en Guinée, Conakry, Guinea
| | - Jean Pe Kolie
- Association des Personnes Guéries et Affectées d'Ebola en Guinée, Conakry, Guinea
| | | | | | - Chantal Jacquot
- Etablissement Français du Sang, La Plaine Stade de France, France
| | | | | | | | | | | |
Collapse
|
39
|
Samandari G, Delamou A, Traore P, Guilinty Diallo F, Millimono S, Salim Camara B, Laffe K, Verani F, Tolliver M. Integrating Intimate Partner Violence Screening and Counseling in a Family Planning Clinic: Evaluation of a Pilot Project in Conakry, Guinea. Afr J Reprod Health 2016; 20:86-93. [PMID: 29553167 DOI: 10.29063/ajrh2016/v20i2.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Few programs exist to address Intimate Partner Violence (IPV) in Guinea. In 2014, Engender Health, in partnership with the local health authorities in Conakry, Guinea, piloted an integrated approach to IPV screening and counseling, within an existing family planning clinic. This article describes both the process of formulating and implementing this approach, as well as the results of an evaluation of the program. From January to June of 2014, Engender Health staff trained midwives at the Conakry International Planned Parenthood Federation family planning clinic staff in screening and counseling client for IPV. Program evaluators used project records, interview with program staff (n=3), midwives (n=3) and client exit interviews (n=53) to measure the outcomes of this pilot project. Regardless of their IPV status, clients appreciated having a venue in which to discuss IPV. Program staff also felt empowered by the additional training and support for IPV screening. The evaluation yielded valuable suggestions for improvement, including more time for staff training and mock client interview practice, additional skills in counseling, and stronger referral links for women who screen positive for IPV. Integrating IPV screening into family planning services is an important and feasible method for reaching vulnerable women with IPV services.
Collapse
|
40
|
Delamou A, Samandari G, Camara BS, Traore P, Diallo FG, Millimono S, Wane D, Toliver M, Laffe K, Verani F. Prevalence and correlates of intimate partner violence among family planning clients in Conakry, Guinea. BMC Res Notes 2015; 8:814. [PMID: 26697849 PMCID: PMC4690260 DOI: 10.1186/s13104-015-1811-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 12/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a global public health problem that affects women's physical, mental, sexual and reproductive health. Very little data on IPV experience and FP use is available in resource-poor settings, such as in West Africa. The aim of this study was to describe the prevalence, patterns and correlates of IPV among clients of an adult Family Planning clinic in Conakry, Guinea. METHODS The study data was collected for four months (March to June 2014) from women's family planning charts and from an IPV screening form at the Adult Family Planning and Reproductive Health Clinic of "Association Guinéenne pour le Bien-Etre Familial", a non-profit organization in Conakry, Guinea. 232 women out of 245 women who attended the clinic for services during the study period were screened for IPV and were included in this study. RESULTS Of the 232 women screened, 213 (92%) experienced IPV in one form or another at some point in their lifetime. 169 women reported psychological violence (79.3%), 145 reported sexual violence (68.1%) and 103 reported physical violence (48.4%). Nearly a quarter of women reported joint occurrence of the three forms of violence(24%).Half of the IPV positive women were current users of family planning (51.2%) and of these, 77.9% preferred injectable contraceptives. The odds of experiencing IPV was higher in women with secondary or vocational level of education than those with higher level of education (AOR: 8.4; 95% CI 1.2-58.5). Women residing in other communes of Conakry (AOR: 5.6; 95% CI 1.4-22.9) and those preferring injectable FP methods (AOR: 4.5; 95% CI 1.2-16.8) were more likely to experience lifetime IPV. CONCLUSIONS IPV is prevalent among family planning clients in Conakry, Guinea where nine out of ten women screened in the AGBEF adult clinic reported having experienced one or another type of IPV. A holistic approach that includes promotion of women's rights and gender equality, existence of laws and policies is needed to prevent and respond to IPV, effective implementation of policies and laws, and access to quality IPV services in Guinea and countries with higher rates of IPV.
Collapse
Affiliation(s)
- Alexandre Delamou
- Centre National de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea.
- Department of Public Health, Faculty of Medicine, University of Conakry, Conakry, Guinea.
| | | | - Bienvenu Salim Camara
- Department of Public Health, Faculty of Medicine, University of Conakry, Conakry, Guinea.
| | - Pernamou Traore
- Association Guinéenne pour le Bien-Etre Familial, Conakry, Guinea.
| | | | | | | | | | | | | |
Collapse
|
41
|
Delamou A, Delvaux T, Utz B, Camara BS, Beavogui AH, Cole B, Levin K, Diallo M, Millimono S, Barry TH, El Ayadi AM, Zhang WH, De Brouwere V. Factors associated with loss to follow-up in women undergoing repair for obstetric fistula in Guinea. Trop Med Int Health 2015; 20:1454-1461. [PMID: 26250875 DOI: 10.1111/tmi.12584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To analyse the trend of loss to follow-up over time and identify factors associated with women being lost to follow-up after discharge in three fistula repair hospitals in Guinea. METHODS This retrospective cohort study used data extracted from medical records of fistula repairs conducted from 1 January 2007 to 30 September 2013. A woman was considered lost to follow-up if she did not return within 4 months post-discharge. Factors associated with loss to follow-up were identified using a subsample of the data covering the period 2010-2013. RESULTS Over the study period, the proportion of loss to follow-up was 21.5% (448/2080) and varied across repair hospitals and over time with an increase from 2% in 2009 to 52% in 2013. After adjusting for other variables in a multivariate logistic regression model, women who underwent surgery at Labe hospital and at Kissidougou hospital were more likely to be lost to follow-up than women operated at Jean Paul II hospital (OR: 50.6; 95% CI: 24.9-102.8) and (OR: 11.5; 95% CI: 6.1-22.0), respectively. Women with their fistula closed at hospital discharge (OR: 3.2; 95% CI: 2.1-4.8) and women admitted for repair in years 2011-2013 showed higher loss to follow-up as compared to 2010. Finally, loss to follow-up increased by 2‰ for each additional kilometre of distance a client lived from the repair hospital (OR: 1.002; 95% CI: 1.001-1.003). CONCLUSION Reimbursement of transport was the likely reason for change over time of LTFU. Reducing geographical barriers to care for women with fistula could sustain fistula care positive outcomes.
Collapse
Affiliation(s)
- Alexandre Delamou
- Ecole de Santé Publique, Université Libre de Bruxelles (ULB), Bruxelles, Belgium.,Centre national de formation et de recherche en santé rurale de Maferinyah, Maferinyah, Guinea.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thérèse Delvaux
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bettina Utz
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bienvenu Salim Camara
- Centre national de formation et de recherche en santé rurale de Maferinyah, Maferinyah, Guinea
| | - Abdoul Habib Beavogui
- Centre national de formation et de recherche en santé rurale de Maferinyah, Maferinyah, Guinea
| | | | | | | | | | | | - Alison Marie El Ayadi
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Wei-Hong Zhang
- Ecole de Santé Publique, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Vincent De Brouwere
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|
42
|
Delamou A, Dubourg D, Beavogui AH, Delvaux T, Kolié JS, Barry TH, Camara BS, Edginton M, Hinderaker S, De Brouwere V. How Has the Free Obstetric Care Policy Impacted Unmet Obstetric Need in a Rural Health District in Guinea? PLoS One 2015; 10:e0129162. [PMID: 26047472 PMCID: PMC4457830 DOI: 10.1371/journal.pone.0129162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/05/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction In 2010, the Ministry of Health (MoH) of Guinea introduced a free emergency obstetric care policy in all the public health facilities of the country. This included antenatal checks, normal delivery and Caesarean section. Objective This study aims at assessing the changes in coverage of obstetric care according to the Unmet Obstetric Need concept before (2008) and after (2012) the implementation of the free emergency obstetric care policy in a rural health district in Guinea. Methods We carried out a descriptive cross-sectional study involving the retrospective review of routine programme data during the period April to June 2014. Results No statistical difference was observed in women’s sociodemographic characteristics and indications (absolute maternal indications versus non-absolute maternal indications) before and after the implementation of the policy. Compared to referrals from health centers of patients, direct admissions at hospital significantly increased from 49% to 66% between 2008 and 2012 (p = 0.001). In rural areas, this increase concerned all maternal complications regardless of their severity, while in urban areas it mainly affected very severe complications. Compared to 2008, there were significantly more Major Obstetric Interventions for Maternal Absolute Indications in 2012 (p<0.001). Maternal deaths decreased between 2008 and 2012 from 1.5% to 1.1% while neonatal death increased from 12% in 2008 to 15% in 2012. Conclusion The implementation of the free obstetric care policy led to a significant decrease in unmet obstetric need between 2008 and 2012 in the health district of Kissidougou. However, more research is needed to allow comparisons with other health districts in the country and to analyse the trends.
Collapse
Affiliation(s)
- Alexandre Delamou
- Centre national de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea
- Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
- Women and Child Health Research Center, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | | | - Abdoul Habib Beavogui
- Centre national de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea
| | - Thérèse Delvaux
- Women and Child Health Research Center, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Bienvenu Salim Camara
- Centre national de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea
| | - Mary Edginton
- The International Union Against Tuberculosis and Lung Disease, Paris, France
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Vincent De Brouwere
- Women and Child Health Research Center, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|