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Background: In temperate regions, influenza epidemics occur in the winter and correlate with certain climatological parameters. In African tropical regions, the effects of climatological parameters on influenza epidemics are not well defined. This study aims to identify and model the effects of climatological parameters on seasonal influenza activity in Abidjan, Cote d'Ivoire.Methods: We studied the effects of weekly rainfall, humidity, and temperature on laboratory-confirmed influenza cases in Abidjan from 2007 to 2010. We used the Box-Jenkins method with the autoregressive integrated moving average (ARIMA) process to create models using data from 2007-2010 and to assess the predictive value of best model on data from 2011 to 2012.Results: The weekly number of influenza cases showed significant cross-correlation with certain prior weeks for both rainfall, and relative humidity. The best fitting multivariate model (ARIMAX (2,0,0) _RF) included the number of influenza cases during 1-week and 2-weeks prior, and the rainfall during the current week and 5-weeks prior. The performance of this model showed an increase of >3 % for Akaike Information Criterion (AIC) and 2.5 % for Bayesian Information Criterion (BIC) compared to the reference univariate ARIMA (2,0,0). The prediction of the weekly number of influenza cases during 2011-2012 with the best fitting multivariate model (ARIMAX (2,0,0) _RF), showed that the observed values were within the 95 % confidence interval of the predicted values during 97 of 104 weeks.Conclusion: Including rainfall increases the performances of fitted and predicted models. The timing of influenza in Abidjan can be partially explained by rainfall influence, in a setting with little change in temperature throughout the year. These findings can help clinicians to anticipate influenza cases during the rainy season by implementing preventive measures. [ABSTRACT FROM AUTHOR]

Objectives: To generate evidence on willingness to use HIV self-test kits and willingness to pay among antenatal care clients in public and private facilities in Cote d'Ivoire and Tanzania., Methods: Cross-sectional survey data were collected from 414 clients recruited from 35 high-volume facilities in Cote d'Ivoire and from 385 clients in 33 high-volume facilities in Tanzania. Surveys covered willingness to use HIV self-test kits, prices clients were willing to pay, advantages and disadvantages and views on specific qualities of HIV self-tests. Market data on availability of proxy self-testing products (e.g. pregnancy and malaria tests) and attitudes of pharmacists towards HIV self-test kits were collected from 51 pharmacies in Cote d'Ivoire and 59 in Tanzania., Results: Willingness to use HIV self-test kits was 65% in Cote d'Ivoire and 69% in Tanzania. Median ideal prices women would pay ranged from USD 1.77 in Cote d'Ivoire to USD 0.87 in Tanzania. Proxy self-test kits were available in pharmacies, and interest was high in stocking HIV self-test kits., Conclusions: Implications for national HIV self-test policy and planning include keeping prices low, providing psychological and HIV counselling, and ensuring linkage to HIV care and treatment services. Private pharmacies will play a key role in providing access to HIV self-test kits., (© 2020 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)

Introduction: The diagnosis of chronic myeloid leukemia is based on the presence of translocation t(9,22). Additional cytogenetic abnormalities may exist at diagnosis and have prognostic value. The authors evaluated the relationship between these additional chromosomal abnormalities, clinical presentation, and therapeutic response., Method: In a retrospective and comparative study from 2005 to 2015, at Yopougon university hospital, 51 cases of myeloid leukemia were selected, including 22 cases with additional chromosomal abnormalities., Results: Thirteen types of additional Ph1 abnormalities were detected in one group, with a median age of 39years (13-73); a sex ratio of 1.4 and a low social class (49%). The median consultation time is 13months (2-29). Hepatomegaly (54%, P=0.05); fever (81.8%, P=0.0017); bone pain (63.6%, P=0.0001); lymphadenopathies (27.3% P=0.014); poor general condition [WHO>1 (77.3%, P=0.001)], high Sokal index (63.6%, P=0.0019), eosinophilia>5% (72.7, P=0.02) and circulating blastosis were found more frequent in the group with additional abnormalities treated with imatinib mesylate. We obtained 13.6% hematologic remission and 22.7% cytogenetic remission (P=0.02). The average survival was relatively short (20months vs. 76.4months, Log-rank<0.0001). We deplored a high death rate (59.1%)., Conclusion: The presence of an additional anomaly constitutes a pejorative element refractory to imatinib., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Context: The maxillo-facial attack was the first described in the Burkitt lymphoma in 1958 by Denis Pearsons Burkitt. Abdominopelvic disorders, particularly ovarian localization are observed more and more by the developments of imagery technics. Our study aimed to describe the epidemiologic, clinical, therapeutic and evolutive aspects of ovarian localization in the endemic Burkitt lymphoma., Methodology: Twenty files of ovarian Burkitt lymphoma diagnosed in the clinical service of hematology TH of Yopougon during the period August 1995-March 2015 (19 years) were retrospectively analyzed. The epidemiologic, clinical, therapeutic and evolutive parameters were studied., Results: Ovarian Burkitt lymphoma accounted for 20.41% of the population with Burkitt lymphoma and 38.46% for patients with Burkitt lymphoma. The average age was 20.4 years with extremes of 6 and 38 years. The main reasons for consultation were general impairment (85%) and pelvic mass (80%). 75% were in group B clinical scalability. The ovarian mass was bilateral in 60% of cases, heterogeneous in 75% of cases. There was a clear predominance of stage III of Murphy (55%). On the evolutionary level all the patients treated by chemotherapy were in incomplete remission (100%). 10% were alive. 83.33% of the deceased patients had received less than 6 courses of chemotherapy., Conclusion: The diagnosis of ovarian endemic Burkitt lymphoma is most often delayed diagnosis and poor prognosis. Improving its management requires early diagnosis., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Background: Many countries in Africa have lacked sentinel surveillance systems for influenza and are under-represented in data used for global vaccine strain selection., Objectives: We describe 8 years of sentinel surveillance data and the contribution of influenza and other viruses to medically attended influenza-like illness (ILI) in Côte d'Ivoire., Methods: Sentinel surveillance was established in 2003. Nasopharyngeal (NP) specimens and epidemiologic data are collected from persons of all ages presenting with ILI at sentinel sites. Respiratory specimens have been tested for influenza using various viral and molecular diagnostic methods. A subset of 470 specimens collected from children aged 0-5 years were tested for multiple respiratory viruses using RT-PCR., Results: From 2003 to 2010, 5074 NP specimens were collected from patients with ILI. Overall, 969/5074 (19%) of these specimens tested positive for influenza. Seasonal influenza A(H1N1) viruses predominated during 5 years and influenza A(H3N2) viruses predominated during 3 years. Influenza B viruses cocirculated with influenza A viruses during each year from 2004 to 2010. Seasonal peaks in influenza circulation were observed during the months of May, June, and October, with the largest peak corresponding with the primary rainfall season. Of 470 specimens collected from children under aged 5 who were tested for multiple respiratory viruses, a viral respiratory pathogen was detected in 401/470 (85%) of specimens. Commonly detected viruses were RSV (113 of 470 specimens, 24%), rhinoviruses (85/470, 18%), influenza (77/470, 16%), and parainfluenza (75/470, 16%)., Conclusion: In Côte d'Ivoire, there is a significant annual contribution of influenza and other respiratory viruses to medically attended ILI., (© 2012 Blackwell Publishing Ltd.)

African Burkitt lymphomas (BL) are highly aggressive lymphomas mainly affecting children and young adults in Africa. This lymphoma was marked by its high sensitivity to chemotherapy in comparison to Sporadic Burkitt lymphoma. In this study, we evaluated the treatment response and survival of patients with CMA protocol. Eighty-five of the 105 children registered were evaluated for response; there were 46 boys and 39 girls, whose age at diagnosis ranged from 3 to 18 years (median 11 years), admitted to the Hematology National Teaching Hospital of Abidjan in the period 1998-2008 with a diagnosis of BL on histological review and who were given CMA chemotherapy with curative intent are included in this analysis. CMA protocol is a low intermediate regimen of 3 drugs [Cytarabin (ara-C), Methotrexate (MTX), and Cyclophosphamide] with CNS-directed treatment by intrathecal MTX, ara-C and corticosteroid. Fifty-five of 85 patients obtained CR after induction therapy and 10 after 3 supplementary cycle because of partial response. The overall complete remission was 76%. Fifty-three of patients were alive in first CR at a median survival rate period of 2 years (range 82 days to 9 years) and are continuously disease free from Burkitt lymphomas. Twelve patients relapse after CR and died of lymphoma progression. More than 32 patients died, as a result of lymphoma progression. Among the 32 dead, 10 were in Murphy stage IV and all the patients who presented bone marrow involvement died. The projected 5-year overall survival rate was 62%. In conclusion, CMA protocol shows the high sensitivity of African Burkitt lymphoma. This can be considered as a successful result for people living in poor socio-economic conditions with no health insurance.

We report the results of the protocol CMA (cyclophosphamide, methotrexate, Aracytine) reinforced of 26 patients affected by Burkitt lymphoma in facial-maxillary localisation, in a retrospective study from January 2000 till December 2007 and prospective from January till September 2008. Their average age was 7.89 years, with a sex ratio of 2.71. The global response to the treatment was 92.3% with 57.7% of complete remission and 34.6% of incomplete remission. The morbidity related to treatment was essentially a haematological complication (84.6%) and hydroelectrolytic complication (84.6%). Evolution was made towards death in 30.8 and 15.4% were lost of view. The median monitoring was 18.2 months. Treatment response was linked to the therapeutic compliance (P < 0.001), and the delay of consultation (P = 0.01).

Sickle cell disease is a genetic disease characterized by the synthesis of an abnormal haemoglobin called haemoglobin S. It is the most frequent of the hereditary anomalies of haemoglobin and occurs most commonly in individuals of African descent. Various treatments have considerably improved its prognosis, prolonging the survival of patients, especially those with the most severe, homozygous form. The objective of thisstudy is to describe the epidemiologic, clinical, and laboratory characteristics as well as the disease course and available treatments in adults (aged 21 years or older). This retrospective, descriptive, analytic and non-comparative study included 48 adults of both sexes with homozygous sickle cell disease. Their mean age was 26.1 years (range: 21 to 56 years, and sex ratio 1.3. In all, 70.8% had clinical anaemia, 83.3% were subicteric or icteric and 8.3% had hepatomegaly. Spleen size was normal in 41.7% of patients, and atrophic in 37.5%. No case of splenomegaly was noted and 8.3% had been splenectomised. Haemoglobin rates ranged from 4 g/dL to 12.7 g/dL with an average of 9.5 g/dL, haemoglobin S levels from 83 to 93% with an average of 85.3%, and haemoglobin F levels from 3.5 to 17% with an average of 10.6%. The percentage with fewer than three crises (vasooclusive or haemolytic or both) in a year was 68.7%; 27.1% had from three to five crises, and 4.2% more than five. Disease complications included anaemia in 43.7%, infections in 18.8% and ischaemia in 16.7%; 20.8% had no complications. Age at the beginning of treatment was younger than 5 years in 56.25%, from 5 to 10 years in 29.2%, and older than 10 years in 14.6%. Medical follow-up was regular for 68.7% and irregular for 31.2%. Vaccination was up to date in 58.3. Most patients (83.3%) adhered to their maintenance treatment. In all, 41.7% had not had any blood transfusions, 54.2% had had one or two transfusions, and 4.2% three or more. We compared the patients aged 26 years or younger with those older than 26 and studied the influence of age on different disease variables. Age did not affect the frequency of crises (p = 0.368) or of infections (p = 0.116), the rates of haemoglobin (p = 0.221), haemoglobin S (p = 0.44), or haemoglobin F (p = 0.35), or complications (p = 0.56). Nevertheless, we noted that the frequency of crises, infections, and anaemic complications were higher among the younger patients. Early treatment, regular medical follow-up, maintenance treatment and vaccination have all improved the prognosis of homozygous sickle cell disease considerably. These patients have reached adulthood with relatively few chronic complications.

We reported in this retrospective study the clinical outcome of 56 chronic lymphoïd leukemia of black African in Ivory Coast and the predicting prognosis factors. The mean age was 62 years old with average of 38 to 84 years. According to Binet staging, 29 patients with stage A, and respectively 11 and 16 patient for stage B and C. All patient received chemotherapy protocol regimens (CVP, chlorambucil, CHOP). The global response was 51.78%. The death occurred in 29 patients. The mean survival was 8.22 years. The disease free survival was 58.8% at 5 years. In univariate analysis, factors with high-risk of death are patients age above 60 years, the presence of node, liver involvement, Spleen large IV and V of Hackett classification, WBC superior to 100,000/microL, lymphocytosis superior to 63,000/microL, Anaemia inferior to 10 g/dL, thrombopenia inferior to 100,000/microL, medullar lymphocytosis superior to 73% and Binet Stage B and C. In multivariate analysis, only age, adenopathy, hepatomegaly and lymhocytosis were an independent prognostic factor for predicting survival.

We reported in this study a treatment results about 36 Africans patients with follicular lymphoma. The average age of patients was 18 to 73 years old with a median age at 50.83 years old and a sex ratio of 1. Clinical characteristics of patients are mainly represented by advance stage with 70% of stage III and IV of Ann Arbor classification. Histological, we mainly notified follicular lymphoma constituted of small cells 50%, followed by mixed follicular and large cells lymphomas with respectively 27.78 and 22.22%. Using varieties of therapeutics regiments, we obtained 41.67% of complete remission. There were significant correlations between complete remission and histology subtypes. Indeed, the follicular lymphomas constituted by large cells and mixed cells had higher rate of complete remission with respectively 46.67% and 40% in relation with those of small cells with a higher failure rate. Median follow-up was 24 months, the estimated 5-years overall survival and event-free survival were 22%. After a long period, 25 cases of death have been reported, 5 cases of losing sight and 6 patients are still alive and following treatment. Our results are lowers than the reported case in developing country. This none satisfying was in relation with the lower socio-economical level of the main part of the patients. The short survival delay time of our patients didn't permit time to observe transformation case in diffuse large cell lymphomas.

Influenza (flu) is a seasonal viral disease that may have a favorable outcome or be associated with a high morbidity and mortality rate during epidemics. In view of the lack of epidemiological and virological data about flu in Côte d'Ivoire, a surveillance network was set up in Abidjan to monitor the spread of flu and characterize isolated viruses. Over the 24-month period from January 2003 to December 2004, nasal secretions were collected in patients presenting with flu syndrome at various heath care centers in Abidjan. Laboratory identification of viruses was performed by the ELISA technique using anti-A and anti-B monoclonal antibodies (immunocapture) and by isolation on MDCK cells. A fraction of the original samples and isolates was sent for confirmation to the Pasteur Institute in Paris, France and to the National Institute for Communicable Diseases (NICD) in Johannesburg, South Africa. Amongst the 211 samples analyzed, 30 (12.8%) proved positive for flu virus. Twenty-two isolates were positive for influenza virus A including 21 for A (H3N2) type and one for A (H1N1) type. The remaining 8 isolates were positive for influenza virus B. Most of these strains were isolated from patients in two age ranges, i.e. 0 to 5 years (34%) and 15 to 59 years (47%). More than 60% of the strains were isolated in June and October but the study duration was too short to define a flu season. Further surveillance data will allow better determination of flu season and definition of clinical and biological characteristics as a prerequisite for a preventive immunization program.