Publications (2)1.43 Total impact
Article: Effectiveness of hepatitis-B vaccination in Ivory Coast: the case of the Grand Bassam health district.[show abstract] [hide abstract]
ABSTRACT: Ivory Coast has a high prevalence of infection with hepatitis B virus (HBV). The effects of a control programme based on the anti-HBV vaccine, which has formed part of the national Expanded Programme on Immunization (EPI) since 2000, have recently been evaluated in the country, for the first time. In this, cross-sectional investigation, two-stage cluster sampling stratified by age was used to assess the impact of the programme of universal childhood HBV vaccination in the Grand Bassam health district. The seroprevalences of carriage of the HBV surface antigen (HBsAg) and of antibodies to this antigen (HBsAb) and to the core antigen of HBV (HBcAb) were estimated among children aged 12-59 months and their mothers. Serology was successful for 1038 children (of 1172 in the original sample) and 836 mothers. Of the children enrolled, 46.8% had had a standard vaccination (completed before the age of 6 months, with the correct schedule), 4.6% had had no vaccination against HBV, and the rest had received incomplete or incorrectly timed vaccination. The prevalence of HBsAg carriage was 0.7% among the tested children and 9.9% among the tested mothers. The prevalence of seroprotection (i.e. an HBsAb titre of >10 mIU/ml), which was 74.2% overall, was strongly correlated with the number of vaccination doses, ranging from 16.7% in the unvaccinated infants to 85.5% in the children who had each received four doses. Circulation of the virus (indicated by seropositivity for HBcAb) was much higher among the unvaccinated children (10.4%) than the fully vaccinated ones (2.9%). The prevalences of both HBsAg and HBcAb were higher in rural areas, where vaccine coverage was relatively low, than in the urban areas. It appears that HBV vaccine is highly effective within the framework of the EPI in Ivory Coast, where it has already had a positive impact in reducing HBsAg carriage among children under 5 years of age. Improving vaccination coverage in the rural areas of the country is now a public-health priority.Annals of Tropical Medicine and Parasitology 09/2009; 103(6):519-27. · 1.43 Impact Factor
Article: [Five years of cholera surveillance in Ivory Coast during social and political crisis, 2001 to 2005].[show abstract] [hide abstract]
ABSTRACT: For an efficient struggle against infectious diseases with epidemic potential, the Cdte d'Ivoire set up a precocious alert system in 2001 with a main objective: to detect epidemics of cholera, measles, yellow fever and meningitis and to provide necessary information for their control and their prevention. During the 2001 to 2005 period, the country was marked by military and political crisis which occurred in 2002; the country had to face up to a reappearance of cholera. How did it evolve in such a context? The question was to describe the performances of the system and the evolution of cholera from weekly data collected by the centers of epidemiological monitoring in health districts. The cases and declared deaths were compiled and the indicators of morbidity and mortality were then studied according to time site and individual features on the period of 2001 to 2005. From 2001 to 2005, 11,874 cases were notified with 564 deaths and a lethal rate of 4.7%. In 2001, from the initial source of infection, the civil jail, the epidemic of cholera disseminated itself through visitors in the whole city of Abidjan where 3250 cases were notified. Out of city, 20 outbreaks have been declared with a total of 3010 cases. The yearly highest impact, 37 living cases/100,000 inhabitants recorded in 2001, decreased regularly until 2005 with 0.2 living cases/100,000. After 2002, outbreaks were located mainly in the half south of the country which welcomed displaced populations from the north, preferably in transition or settling zones near the front line. The lethal rate in Abidjan (2.3%) was less important than that of other health districts (8.6%). The lethal rate globally increased as the impact decreased. Vibrio cholerae was responsible for the epidemics. The group of 15 years old and over was the most affected (12.69 living cases/100,000) whereas the highest lethal rate appeared in the group under 5 years old (6.6%). The reappearance and constant cholera epidemics in Côte d'Ivoire are due to bad general hygiene conditions, insufficient supply of drinking water from wells or packaged, concentration of populations in the south of the country due to war and uncontrolled development of the poor and unsanitary precarious boroughs. Outburst during the dry season is a warning signal of an important epidemic during the raining season especially in poor urban areas. The precocious alert system has permitted to detect the epidemics, to follow up their evolution and to orientate the struggle against cholera in Côte d'Ivoire.Bulletin de la Société de pathologie exotique 06/2009; 102(2):107-9.