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Bitty-Anderson AM, Gbeasor-Komlanvi FA, Johnson P, Sewu EK, Dagnra CA, Salou M, Blatome TJ, Jaquet A, Coffie PA, Ekouevi DK. Prevalence and correlates of alcohol and tobacco use among key populations in Togo in 2017: a cross-sectional study. BMJ Open 2019; 9:e028934. [PMID: 31685493 PMCID: PMC6858156 DOI: 10.1136/bmjopen-2019-028934] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES The aim of this study was to estimate alcohol and tobacco use prevalence and their correlates among female sex workers (FSW), men who have sex with men (MSM) and drug users (DU) in Togo. DESIGN, SETTING AND PARTICIPANTS A cross-sectional bio-behavioural study was conducted among 2115 MSM, FSW and DU in 2017 using a respondent-driven sampling method, in the eight biggest towns of Togo. Selection criteria for the MSM were being male and having had oral or anal intercourse with a man in the previous 12 months; for FSW, being a female and having exchanged sex for money in the previous 12 months; and for DU, consuming heroin, cocaine or hashish for MSM, FSW and DU, respectively. All participants had to be at least 18 years old and residing in the territory for the past 3 months. RESULTS The prevalence of alcohol consumption, hazardous/harmful consumption and binge drinking was 64.8%, 38.4% and 45.5%, respectively. Current tobacco use was reported by 30.6% of participants and HIV prevalence was estimated at 12.5%. DU were more likely to engage in binge drinking compared with other key populations (adjusted odds ratio (aOR)=2.0; 95% CI 1.4 to 2.8; p=0.001). Participants who were identified as having hazardous/harmful alcohol consumption had almost three times the odds of tobacco consumption than those with no risky consumption (aOR=2.6; 95% CI 2.0 to 3.4; p=0.001). Hazardous/harmful alcohol consumption was three times more likely among participants with severe psychological distress compared with those with no psychological distress (aOR=3.3, 95% CI 2.2 to 5.1; p=0.001). CONCLUSION Findings from this study demonstrate the need for the integration of mental health and substance abuse reduction interventions into HIV prevention programme, particularly those geared towards key populations.
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Affiliation(s)
| | - Fifonsi Adjidossi Gbeasor-Komlanvi
- Department of Public Health, Faculty of Health Sciences, University of Lomé, Lomé, Togo
- Centre Africain de Recherches en Epidemiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Pascal Johnson
- Centre Africain de Recherches en Epidemiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Essèboè K Sewu
- Centre Africain de Recherches en Epidemiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Claver A Dagnra
- Faculty of Health Sciences, Molecular Biology Laboratory, University of Lomé, Lomé, Togo
| | - Mounerou Salou
- Faculty of Health Sciences, Molecular Biology Laboratory, University of Lomé, Lomé, Togo
| | - Tetouyaba J Blatome
- Centre Africain de Recherches en Epidemiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Antoine Jaquet
- Department of Public Health, INSERM U1219, Bordeaux Population Health Research, University of Bordeaux, Bordeaux, France
- Department of Public Health, Institut de Santé Publique Epidémiologie et Développement, University of Bordeaux, Bordeaux, France
| | - Patrick Ahuatchi Coffie
- PACCI Research Center-Site ANRS Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Department of Public Health, Institut de Santé Publique Epidémiologie et Développement, University of Bordeaux, Bordeaux, France
- Dermatologie et Infectiologie, Unite de Formation et de Recherche des Sciences Medicales, Universite Felix Houphouet-Boigny, Abidjan, Côte d'Ivoire
| | - Didier Koumavi Ekouevi
- PACCI Research Center-Site ANRS Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Department of Public Health, Faculty of Health Sciences, University of Lomé, Lomé, Togo
- Centre Africain de Recherches en Epidemiologie et en Santé Publique (CARESP), Lomé, Togo
- Department of Public Health, INSERM U1219, Bordeaux Population Health Research, University of Bordeaux, Bordeaux, France
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Mama Djima M, Ekouevi DK, Gregoire JP, Tchounga B, Coffie PA, Tran VT, Touré FY, Moisan J. Use of non-HIV medication among people living with HIV and receiving antiretroviral treatment in Côte d'Ivoire, West Africa: A cross-sectional study. PLoS One 2019; 14:e0221335. [PMID: 31525222 PMCID: PMC6746366 DOI: 10.1371/journal.pone.0221335] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 08/06/2019] [Indexed: 11/18/2022] Open
Abstract
Background In Côte d’Ivoire, people living with HIV (PLHIV) have free access to antiretroviral therapy (ART) and cotrimoxazole. Yet, they may use other medications to treat non-HIV diseases. Scarce data are available regarding the use of non-HIV medications in Africa. This study describes the use of non-HIV medications and identifies the factors associated with their use by PLHIV on ART in Côte d’Ivoire. Methods A cross-sectional study was conducted in six HIV clinics in 2016. HIV-1-infected adults receiving ART for at least one year were eligible. A standardized questionnaire was used to collect demographics, HIV characteristics and medication use data. Associated factors were identified using a multivariate adjusted Poisson regression. Results A total of 1,458 participants (74% women) were enrolled. The median age was 44 years, and the median duration of ART was 81 months. A total of 696 (48%) participants reported having used at least one non-HIV medication. Among the 1,519 non-HIV medications used, 550 (36%) had not been prescribed and 397 (26%) were from the nervous system class. Individuals who were more likely to report the use of at least one non-HIV medication included those who had been treated in an Abidjan HIV clinic, had a high school education level, had a monthly income between 152 and 304 euros, had a poor perceived health status, had WHO advanced clinical stage, had used traditional medicine products and had not used cotrimoxazole. Conclusion Almost half PLHIV on ART reported using non-HIV medication. Further research is needed to assess whether the use of non-HIV medication is appropriate given about a third of those medications are not being prescribed.
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Affiliation(s)
- Mariam Mama Djima
- PACCI, CHU Treichville, Abidjan, Côte d’Ivoire
- Institut Pasteur de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Faculté de pharmacie, Université Laval, Québec, Canada
- * E-mail:
| | - Didier Koumavi Ekouevi
- PACCI, CHU Treichville, Abidjan, Côte d’Ivoire
- Centre Inserm U 1219, ISPED, Université Victor Segalen, Bordeaux, France
- Université de Lomé, Département de Santé Publique, Lomé, Togo
| | - Jean-Pierre Gregoire
- Faculté de pharmacie, Université Laval, Québec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
| | | | | | | | | | - Jocelyne Moisan
- Faculté de pharmacie, Université Laval, Québec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec–Université Laval, Québec, Canada
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Coffie PA, Patassi A, Doumbia A, Bado G, Messou E, Minga A, Allah-Kouadio E, Zannou DM, Seydi M, Kakou AR, Dabis F, Wandeler G. Changes in viral hepatitis B screening practices over time in West African HIV clinics. Med Mal Infect 2017; 47:394-400. [PMID: 28545675 DOI: 10.1016/j.medmal.2017.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/08/2016] [Revised: 09/30/2016] [Accepted: 04/18/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND We aimed to describe changes in hepatitis B screening practices over a 3-year period among HIV-infected patients in West Africa. METHODS A medical chart review was conducted in urban HIV treatment centers in Ivory Coast (3 sites), Benin, Burkina Faso, Senegal, and Togo (1 site each). Among patients who started antiretroviral treatment between 2010 and 2012, 100 per year were randomly selected from each clinic. Demographic, clinical, and laboratory data was collected using a standardized questionnaire. We assessed changes in the proportion of patients screened over time and identified predictors of screening in a multivariable logistic regression. RESULTS A total of 2097 patients were included (median age: 37 years, 65.4% of women). Overall, 313 (14.9%) patients had been screened for hepatitis B, with an increase from 10.6% in 2010 to 18.9% in 2012 (P<0.001) and substantial differences across countries. In multivariable analysis, being aged over 45 years (adjusted odds ratio: 1.34 [1.01-1.77]) and having an income-generating activity (adjusted odds ratio: 1.82 [1.09-3.03]) were associated with screening for hepatitis B infection. Overall, 62 HIV-infected patients (19.8%, 95% confidence interval: 15.5-24.7) were HBsAg-positive and 82.3% of them received a tenofovir-containing drug regimen. CONCLUSION Hepatitis B screening among HIV-infected patients was low between 2010 and 2012. The increasing availability of HBsAg rapid tests and tenofovir in first-line antiretroviral regimen should improve the rates of hepatitis B screening.
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Affiliation(s)
- P A Coffie
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire; Programme PACCI, site ANRS Côte d'Ivoire, Abidjan, Cote d'Ivoire.
| | - A Patassi
- Service des maladies infectieuses et de pneumologie, CHU Sylvanus-Olympio, Lomé, Togo
| | - A Doumbia
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire
| | - G Bado
- Service des maladies infectieuses et tropicales, hôpital de Jour, CHU Souro Sanou, Bobo Dioulasso, Burkina-Faso
| | - E Messou
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire; Centre de prise en charge de recherche et de formation, CePReF-Aconda-VS, Cote d'Ivoire
| | - A Minga
- Centre médical de suivi de donneurs de sang/CNTS/PRIMO-CI, Abidjan, Cote d'Ivoire
| | - E Allah-Kouadio
- Département d'hépato-gastro-entérologie, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire
| | - D M Zannou
- Service de médecine interne, CNHU Hubert-Maga, Cotonou, Benin
| | - M Seydi
- Service des maladies infectieuses et tropicales, CHU de Fann, Dakar, Senegal
| | - A R Kakou
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire
| | - F Dabis
- ISPED, centre Inserm U1219-Bordeaux Population Health, université de Bordeaux, Bordeaux, France
| | - G Wandeler
- Service des maladies infectieuses et tropicales, CHU de Fann, Dakar, Senegal; Département des maladies infectieuses et institut de médecine sociale et préventive, université de Berne, Berne, Switzerland
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Arikawa S, Eboua T, Kouakou K, N'Gbeche MS, Amorissani-Folquet M, Moh C, Amoussou-Bouah UB, Coffie PA, Becquet R, Leroy V. Pregnancy incidence and associated factors among HIV-infected female adolescents in HIV care in urban Côte d'Ivoire, 2009-2013. Glob Health Action 2016; 9:31622. [PMID: 27527503 PMCID: PMC4985616 DOI: 10.3402/gha.v9.31622] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 03/15/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Adolescents living with HIV are sexually active and engaged in risky sexual behaviors. Knowledge on how and to what extent adolescents in HIV care are affected by pregnancy is needed so as to adopt better preventive services. We estimated 4-year pregnancy incidence and correlates among HIV-infected female adolescents in HIV care in urban Côte d'Ivoire. DESIGN We conducted retrospective analysis of a pediatric prospective cohort of the International epidemiological Databases to Evaluate AIDS (IeDEA) West Africa Collaboration. Female patients with confirmed HIV infection aged 10-19 years, having at least one clinical visit in 2009 to health facilities participating in the pediatric IeDEA West African cohort in Abidjan, Côte d'Ivoire, were included. Data on incident pregnancies were obtained through medical records and interviews with health professionals. Pregnancy incidence rate was estimated per 100 person-years (PY). Poisson regression models were used to identify factors associated with the first pregnancy and provided incidence rate ratios (IRR) with 95% confidence intervals (CI). RESULTS In 2009, 266 female adolescents were included, with a median age of 12.8 years (interquartile range, IQR: 10.0-15.0), CD4 cell counts of 506 cells/mm(3) (IQR: 302-737), and 80% on antiretroviral treatment. At the 48th month, 17 new pregnancies were reported after 938 PY of follow-up: 13 girls had one pregnancy while 2 had two pregnancies. Overall incidence rate of pregnancy was 1.8/100 PY (95% CI: 1.1-2.9). High incidence was observed among those aged 15-19 years: 3.6/100 PY (95% CI: 2.2-5.9). Role of maternal death in the risk of pregnancy was at the limit of statistical significance (adjusted IRR: 3.1, 95% CI: 0.9-11.0; ref. non-maternal orphans). CONCLUSIONS Incidence of pregnancy among HIV-infected adolescents in care aged 15-19 years reached a level observed in adult cohorts in Sub-Saharan Africa. Health personnel in pediatric care have to intensify their efforts to provide more realistic and age-adapted reproductive health services to meet the needs of adolescent patients already confronting issues of sexuality. Vulnerability of maternal orphans merits further investigation.
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Affiliation(s)
- Shino Arikawa
- Inserm, Centre de recherche Inserm U1219, Bordeaux, France.,Institut de Santé Publique Epidémiologie Développement (ISPED), Université Bordeaux, Bordeaux, France;
| | - Tanoh Eboua
- Centre Hospitalier Universitaire Yopougon, Abidjan, Côte d'Ivoire
| | - Kouadio Kouakou
- Centre Intégré de Recherches Biocliniques, Abidjan, Côte d'Ivoire
| | | | | | - Corinne Moh
- Centre de Prise en charge de Recherche et de Formation, Abidjan, Côte d'Ivoire
| | | | - Patrick Ahuatchi Coffie
- Programme PACCI, Abidjan, Côte d'Ivoire.,Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - Renaud Becquet
- Inserm, Centre de recherche Inserm U1219, Bordeaux, France.,Institut de Santé Publique Epidémiologie Développement (ISPED), Université Bordeaux, Bordeaux, France
| | - Valériane Leroy
- Inserm, Centre de recherche Inserm U1027, Université Paul Sabatier Toulouse 3, Toulouse, France
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Harouna AM, Amorissani-Folquet M, Eboua FT, Desmonde S, N'Gbeche S, Aka EA, Kouadio K, Kouacou B, Malateste K, Bosse-Amani C, Ahuatchi Coffie P, Leroy V. Effect of cotrimoxazole prophylaxis on the incidence of malaria in HIV-infected children in 2012, in Abidjan, Côte d'Ivoire: a prospective cohort study. BMC Infect Dis 2015; 15:317. [PMID: 26248711 PMCID: PMC4527248 DOI: 10.1186/s12879-015-1009-6] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 07/06/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cotrimoxazole prophylaxis has an antimalarial effect which could have an additional protective effect against malaria in HIV-infected children on antiretroviral therapy (ART). We measured the incidence and associated factors of malaria in HIV-infected children on ART and/or cotrimoxazole in Abidjan, Côte d'Ivoire. METHODS All HIV-infected children <16 years, followed-up in the IeDEA West-African paediatric cohort (pWADA) in Abidjan, were prospectively included from May to August 2012, the rainy season. Children presenting signs suggesting malaria had a thick blood smear and were classified as confirmed or probable malaria. We calculated incidence density rates (IR) per 100 child-years (CY). Risk factors were assessed using a Poisson regression model. RESULTS Overall, 1117 children were included, of whom 89 % were ART-treated and 67 % received cotrimoxazole. Overall, there were 51 malaria events occurring in 48 children: 28 confirmed and 23 probable; 94 % were uncomplicated malaria. The overall IR of malaria (confirmed and probable) was 18.3/100 CY (95 % CI: 13.3-23.4), varying from 4.2/100 CY (95 % CI: 1.1-7.3) in children on ART and cotrimoxazole to 57.3/100 CY (95 % CI: 7.1-107.6) for those receiving no treatment at all. In univariate analysis, age < 5 years was significantly associated with a 2-fold IR of malaria compared to age >10 years (incidence rate ratio [IRR] = 2.18, 95 % CI: 1.04-4.58). Adjusted for severe immunodeficiency, cotrimoxazole reduced significantly the IR of first malarial episode (adjusted IRR [aIRR] = 0.13, 95 % CI: 0.02-0.69 and aIRR = 0.05, 95 % CI:0.02-0.18 in those off and on ART respectively). Severe immunodeficiency increased significantly the malaria IR (aIRR = 4.03, 95 % CI: 1.55-10.47). When considering the IR of confirmed malaria only, this varied from 2.4/100 CY (95 % CI: 0.0-4.8) in children on ART and cotrimoxazole to 34.4/100 CY (95 % CI: 0.0-73.3) for those receiving no treatment at all. In adjusted analyses, the IR of malaria in children on both cotrimoxazole and ART was significantly reduced (aIRR = 0.05, 95 % CI: 0.01-0.24) compared to those receiving no treatment at all. CONCLUSIONS Cotrimoxazole prophylaxis was strongly protective against the incidence of malaria when associated with ART in HIV-infected children. Thus, these drugs should be provided as widely and durably as possible in all HIV-infected children <5 years of age.
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Affiliation(s)
- Aïda Mounkaila Harouna
- Inserm U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
- University Bordeaux, ISPED, Centre Inserm, U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
| | - Madeleine Amorissani-Folquet
- University Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.
- Paediatrics, Félix Houphouët Boigny University Hospital, Abidjan, Côte d'Ivoire.
| | | | - Sophie Desmonde
- Inserm U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
- University Bordeaux, ISPED, Centre Inserm, U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
| | | | | | | | | | - Karen Malateste
- Inserm U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
- University Bordeaux, ISPED, Centre Inserm, U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
| | | | - Patrick Ahuatchi Coffie
- University Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.
- Département de Dermatologie et d'Infectiologie, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.
| | - Valeriane Leroy
- Inserm U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
- University Bordeaux, ISPED, Centre Inserm, U897 - Epidémiologie - Biostatistiques, F-33000, Bordeaux, France.
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