Search

Vaccination remains the primary strategy for ending the COVID-19 pandemic. However, vaccination rates are still low in low-income countries. The primary goal of this study was to describe the status of COVID-19 vaccine acceptance and hesitancy among women in Guinea and to identify associated predictors.Weconducted a cross-sectional study in five Guinean cities (Conakry, Mamou, Kindia, Kankan and N’zérékoré) across the four natural regions between Mar 22 and Aug 25 2021. Participants aged 18 were randomly recruited from the healthcare workers (HCWs) and the general population (GP). We used multivariate logistic regression to identify facilitators and barriers to acceptance of COVID-19 vaccination and a classification and regression tree (CART) to extract the profile of predictors.We included2,208 women among the HCWs and 1,121 in the GP. Most HCWs (63%) were already vaccinated, compared to only 28% of GP. The main factors associated with acceptance of a COVID-19 vaccine in the HCWs were an absence of pregnancy ORA = 4.46 [CI95%: 3.08, 6.52] and positive subjective norms ORA = 2.34 [CI95%: 1.92, 2.84].Regarding the GP, the main factors were the ability to receive the vaccine ORA = 5.20 [CI95%: 3.45, 8.01] and being adult ORA = 2.25 [CI95%: 1.34, 3.79] associated with acceptance of vaccination. Vaccination rates were higher in the HCWs. Favourable subjective norms and ability to receive the vaccine were facilitators of acceptance of COVID-19 vaccination, while youth and pregnancy were barriers to the approval of the COVID-19 vaccine.

Introduction The composite coverage index (CCI) is the weighted average coverage of eight preventive and curative interventions received along the maternal and child care continuum. We analysed maternally and child health indicators using CCI.Methods We performed a secondary analysis of demographic and health surveys (DHS) focused on women aged 15 to 49 and children aged 1 to 4. The CCI is optimal if the weighted proportion of interventions is less than 50%; otherwise, it is partial. We identified the factors associated with CCI using the following statistics: the Wilcoxon rank-sum test for complex survey samples, the chi-squared tests of Rao & Scott’s second-order correction, and the spatial autocorrelation statistic and the multivariate logistic regression.Results The optimal coverage of the ICC has increased from 43% in 2012 to 61% in 2018. In multivariate analysis, in 2012: the poor had a lower probability of having an optimal CCI than the richest; OR=0.11 [95% CI; 0.07, 0.18]. Those who had done four antenatal care visits (ANC) were 2.78 times more likely to have an optimal CCI than those with less OR=2.78 [95% CI;2.24, 3.45]. In 2018: the poor had a lower probability of having an optimal CCI than the richest OR=0.27 [95% CI; 0.19, 0.38]. Women who planned their pregnancies were 28% more likely to have an optimal CCI than those who had not planned OR= 1.28 [95% CI;1.05, 1.56]. Finally, women with more than 4 ANC were 2.43 times more likely to have an optimal CCI than those with the least OR = 2.43 [95% CI; 2.03, 2.90]. The spatial analysis reveals significant disparities with an aggregation of high partial ICC in Labé between 2012 and 2018.ConclusionThis study showed an increase in CCI between 2012 and 2018. Policies should improve access to care and information for poor women. Besides, strengthening ANC visits and reducing regional inequalities will increase optimal CCI.

Background Most countries in Subsaharan Africa have well-established National Tuberculosis Control Programs with relatively stable routine performances. However, major epidemiological events may result in significant disruptions. In March 2014, the World Health Organization announced the outbreak of Ebola virus disease in Guinea, a country with a high incidence of TB and HIV. Our study aimed to assess the impact of the Ebola virus disease outbreak on TB notification, treatment, and surveillance, using main indicators. Methods This is a retrospective cohort study that compared TB trends using surveillance data from the periods before (2011–2013), during (2014–2016), and after (2017–2018) Ebola virus disease outbreak. A time-series analysis was conducted to investigate the linkages between the decline in TB notification and the Ebola virus disease outbreak through cross-correlation. The lag in the cross-correlation test was evaluated using ANCOVA type II delayed variable dependent model. The surveillance system was assessed using TB surveillance standards and benchmarks and vital registration systems recommended by WHO, compared with those of 2015 during the Ebola virus disease. Results The rate of reporting of TB declined from 120 cases per 100,000 in 2011 to 100 cases per 100,000 in 2014, at the peak of the Ebola virus disease outbreak. The time-series cross-correlation test of all notified cases of TB and Ebola showed a significant lag of − 0.4 (40%), reflecting a drop in the rate of notification (F-value = 5.7 [95% CI: 0.2–21.3]). The Ebola virus disease had no negative impact on patient treatment outcomes (F-value = 1.3 [95% CI: 0.0–8.8]). Regarding the surveillance system, five out of 13 WHO standards and benchmarks were met following their evaluation in 2019, after the Ebola virus disease outbreak, compared to three in 2015. Conclusion Major epidemics such as the Ebola virus disease outbreak may have a significant impact on well-established TB control programs as shown in the example of Guinea. Sudden disruptions of routine performance may lead programs to improve their surveillance system. The experience acquired in the fight against EVD and the investments made should make it possible to prepare the health system in a coherent manner for the other probable episodes.

Background. Malaria control interventions have been scaled up, particularly those in pregnant women in Guinea. Despite that, coverage of key malaria preventive measure (MPM) indicators remains low. Therefore, it is vital to understand the reasons behind that, especially for the low coverage of sulfadoxine-pyrimethamine (SP) and long-lasting insecticide-treated bed nets (LLIN). Methods. We conducted a cross-sectional survey in nine district hospitals in Guinea. Pregnant women received for delivery were interviewed to collect sociodemographic and obstetrical parameters. Associated factors with MPMs were investigated through univariate analysis and classification and regression tree (CART). Results. A total of 2248 parturients participated in this study. Among pregnant women using mosquito nets (63.5% (61.4%, 65.5%)), only 41.2% (39.1%, 43.3%) had used it regularly during the last two weeks preceding delivery. Similarly, most pregnant women (57.9% (55.8%, 59.9%)) had received less than three doses of SP, and only a few pregnant women (23.9% (22.1%, 25.7%)) have benefited from full MPMs. Parturient’s age, marital status, time spent in residence, place of residence, level of education, distance from home to the health centre, health conditions, occupation, head of the household’s occupation, the presence of garbage and stagnant water in the neighbourhood, source of running water, and the number of pregnancies were significantly statistically associated with MPMs in pregnant women. However, the number of antenatal care visits (ANC), means of transportation used by the pregnant woman to accomplish ANCs, and stagnant water in the neighbourhood were the three preponderant factors. Conclusion. The low coverage of SP and LLINs among pregnant women requires revitalising some strategies, especially improving ANC coverage and more efforts to reduce inequalities in access to those services due to sociodemographic status. Education on the benefits of these MPMs should also be emphasised.

Guinea, like many other African countries, has been facing an unprecedented COVID-19 outbreak, since March 2020. In April 2020, Guinean National agency for health security recorded 1351 confirmed cases of COVID-19, including 313 recoveries and 07 deaths. To address this health crisis, some drastic measures were implemented to prevent the spread of COVID-19. Those measures might potentially cause some psychological problems among Guineans. Thus, we conducted this study to assess the psychosocial impacts of COVID-19 in the Guinean population. We carried out an online cross-sectional survey among internet users in Guinea. A free e-survey platform was used, and questionnaires were sent to internet users. The study ran from May 1 through May 10 2020. Participation in the study was voluntary. Data collection was based on sociodemographic information and self-reported questionnaires: Impact of Event Scale-Revised (IES-R) for stress evaluation, Penn state worry questionnaire (PSWQ), and an adapted Social Psychological Measurements of COVID-19. A total of 280 participants took part in the study; responses from 5 participants were deleted because of incompleteness. The average age of participants was 28.9 [95% CI: 28.1;29.6]. Most of participants were male 65.5% [95% CI: 59.5%;71.1%]. Unemployed participants stood for 48.7% [95% CI: 42.7%;54.8%]. IES-R scale for stress evaluation yielded the following findings: 19.6% (mild), 5.23% (moderate) and 9.15% (severe); 82.8% and 17.2% of participants had respectively reported low and moderate worry. No significant statistical association was found between sociodemographic variables and traumatic events (IES-R and PSWQ). However, 82% of our participants had to cope with the negative impacts of COVID-19. Although there were few cases of traumatic events, negative impacts of COVID-19 on study participants deserve to be underlined. So, further investigations are necessary to identify and disentangle specific psychosocial problems in different Guinean socio-cultural contexts.

Introduction:drug-resistant tuberculosis is a major global health problem and a threat to health security given the increase in the number of cases and the challenges associated with care. Besides, the relationship between poor nutritional status and tuberculosis is clearly established. For relevant and evidence-based public health decision-making regarding the management of malnutrition in patients with drug-resistant tuberculosis in the initial phase, it is essential to estimate the prevalence of malnutrition and understand the risk factors associated with it. Methods:we performed a retrospective cohort study in drug-resistant tuberculosis patients aged 18 years and older, among which the nutritional status was assessed through BMI. All predictors were included in a prediction model using the multivariate logistic model according to the lowest Akaike criterion. Discrimination and model calibration was evaluated using receiver performance analysis, and the Hosmer and Lemeshow test. Results:this study revealed a prevalence of malnutrition of 64.7% in drug-resistant tuberculosis patients in our 218-patient series. The factors associated with malnutrition were: unsuccessful treatment, the active presence of mycobacterium tuberculosis, increased bacteriological conversion time, increased serum creatinine, increased transaminase SGPT of the liver, and anaemia. Some of the factors not associated with malnutrition included the history of anti-tuberculosis treatment, vomiting, hepatic SGPT, initial AFB count, smear and culture conversion time, depression, and chest x-ray. Conclusion:malnutrition remains a concern among drug-resistant tuberculosis patients in Guinea as it affects more than half of them with a negative impact on the outcome of treatment. Implementing specific interventions for these high-risk patients, including nutritional supplementation, psychosocial support, and treatment for tuberculosis, can improve management for better treatment outcomes.

Introduction Pregnancy, apart from any external events, is subject to psychological changes. The COVID-19 pandemic in Guinea led to the implementation of restrictive measures followed by the mitigating ones, but few of them have targeted stress and anxiety management in pregnant women. This study aimed to assess the psychological impact and its associated factors in pregnant women. Methods We conducted a cross-sectional study in three health centres in Conakry capital city. Pregnant women were interviewed during antenatal care visits. We used two tools for stress and anxiety assessment: Impact of Event Scale-Revised (IES-R) and Penn State Worry Questionnaire (PSWQ), and followed three steps to seeking for factors associated with stress and anxiety: univariate analysis, regression tree (CART), and logistic regression. Results We surveyed a total of 649 pregnant women. Most of them presented a state of stress (97.7%) and anxiety (52.7%). Gestational age was the main factor associated with stress and anxiety. Pregnant women with a gestational age ≤ 34 weeks had an odd of 0.09 times lower of being stressed compared to those with a gestational age greater than 34 weeks. Pregnant women living in Ratoma and Kaloum with a gestational age was ≤ 9 weeks had an odds of 15.1 times [95% CI: 8.76, 27.4] higher of being worried compared to those from Matoto, Matam and Dixinn with a gestational age greater than 9 weeks. Similarly, pregnant women living in Matoto, Matam and Dixinn with a gestational age ≤ 9 weeks had an odds of 4.48 times [95% CI: 2.59, 8.12] higher of being worried compared to other women from the same localities. Conclusion Most of our participants were at a higher risk of stress and anxiety caused by COVID-19; women in their earlier stage of pregnancy tended to be more vulnerable to these psychological problems. Therefore, it is vital to implement an appropriate management plan which should prioritise those vulnerable pregnant women.

Introduction L'objectif de ce travail était d'étudier les facteurs associés à la pratique des rapports sexuels chez les élèves adolescents de la commune de Matoto à Conakry. Méthodes Il s'agissait d'une étude transversale, descriptive et analytique étendue sur 3 mois (1er mars - 31 mai 2018) ayant concerné les élèves âgés de 10 à 19 ans fréquentant les collèges et lycées de la commune de Matoto à Conakry. Résultats Parmi les 500 élèves interrogés, 226 (162 filles et 64 garçons) déclarent avoir eu des rapports sexuels soit une fréquence de 45,2%. Le préservatif n'était utilisé que par 16,4% des élèves et les contraceptifs par 35,4%. La fréquence des infections sexuellement transmissibles était de 23,5%. Parmi les filles ayant eu des rapports sexuels, 32,1% ont eu au moins une grossesse et celle-ci s'est soldée par un avortement clandestin dans 30,8% des cas. Le facteur associé à la réalisation des rapports sexuels chez les adolescents était les sorties nocturnes (p = 0,000). Conclusion Les rapports sexuels sont fréquents chez les élèves adolescents de la commune de Matoto. Le préservatif et les contraceptifs sont peu utilisés. Il ressort aussi de notre étude que les sorties nocturnes étaient le facteur le plus associé à la pratique.

Abstract Background: Despite the availability of the drug treatment for tuberculosis (TB) more than 75 years, mortality and drug resistance are increasing. Therefore, little data is available in Guinea. We aimed to develop and validate a prognosis nomogram of MDR-TB treatment outcomes. Methods:A retrospective cohort study was conducted among men and women, aged 18 years or older, with MDR-TB, from three major drug-resistance TB centres in Guinea. We used the logistic regression to analyse treatment outcomes. Prognostic factors with a p value less than 0.05 from a multivariate model were used to build nomogram and assessed their performance based on discriminative c-index, and calibration using the Hosmer-Lemeshow (H-L) test. To derive the optimal cut-off point score, the Youden’s index method was used. Results:Among 232 patients with MDR-TBenrolled and followed between June 07, 2016 and June 22, 2018, 218 were analyzed. All patients were resistant to rifampicin, which diagnosed by the Xpert MTB/RIF. The overall rate of success was 73%.Factors associated with successful treatment in drug-resistant TB patients were higher BMI more than 18.5 kg/m2(p = 0.0253; aOR = 2.94), good adherence to treatment (p = < 0.0001; aOR = 33.92), normal platelets count (p = 0.0053; OR = 1.004), and the absence of clinical symptoms such as chest pain (p = 0.0083; aOR = 3.19) and depression (p = 0.0308; aOR = 8.62). The discrimination (c-index= 0.848 [95% bootstrap CI, 0.780 – 0.916] in the derivation sample and 0.803 after correction for optimism) and calibration (H-LX2= 2.91 [p = 0.94]) were good. The optimal absolute risk threshold was 20%, corresponding to a sensibility of 95% and specificity of 58%. Conclusion:Treatment success outcomes was lower than those recommended by the World Health Organization (75%). We recommend to improve the MDR-TB patient monitoring during treatment, nutritional status, and considering the psychological state. Our prognosis nomogram needs to be validated in an external population before it can be used in clinical practice. Keywords:Nomogram, Multidrug-resistant, Tuberculosis, Guinea.

Introduction: The use of modern contraceptives by married women remains a challenge in Guinea despite ongoing efforts. The objective of this study was to analyse the factors associated with the use of modern methods of contraception by married women in Guinea. Methods: This paper carried out a cross-sectional study with married women aged 19 to 49 in two communes of the Republic of Guinea. Data were collected using a structured questionnaire and analysed using Stata SE 16.1 software. This paper performed univariate and multivariate analyses to identify factors that independently influence contraceptive method use by women. Results: This paper interviewed a total of 567 married women living as a couple who agreed to participate in the study. Modern contraceptive prevalence among married women was 20% (112/567). The average age of women was 37, 3±4.6. The women had discussed family planning (71.1%) for birth spacing (86.6%). Factors significantly associated with the use of modern contraceptive methods (p

Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

Background: Benign ovarian tumors are a common reason for consultation and intervention in gynecology. The objective of this was to describe the clinical, ultrasonographic, histological and therapeutic aspects of benign ovarian tumors in the department.Methods: This is a retrospective and descriptive study of three years and six months from January 1, 2016, to June 30, 2019, which focused on the records of women-operated during this period of benign ovarian tumors.Results: The incidence of benign ovarian tumors was 12.58%. The circumstances of discovery were dominated by disorders of the menstrual cycle (35.05%) followed by infertility (20.78%), the sensation of a pelvic mass (19.48%), and pelvic pain. (15.58%). The ultrasound report was in favor of a serous cyst in 74% of cases, a mucoid cyst in 14% of cases, a 9% dermoid cyst, and a 3% endometriotic cyst. Histology revealed serous cystadenoma in 54% of cases, mucinous cystadenoma in 13% of cases, mature poly tissue teratoma in 7% of cases, and endometrial cyst in 3% of cases. Cystectomy was the most performed surgical procedure (71%).Conclusions: Benign ovarian tumors are common in our practice. The most common histological forms were serous and mucinous cystadenomas. Conservative treatment has been practiced in the majority of cases.

Whereas the HIV prevalence in Guinea is among the lowest in Africa, many PLHIV in Guinea are malnourished. This study assessed the effect of a nutritional supplementation program on body mass index and CD4 count among adult PLHIV on ART. Study participants were PLHIV who came for consultation in the study sites between May and July 2016. The data came from two sources: retrospectively from participants’ medical records and interviews at the time of recruitment into the study. About six months before they were recruited into the study, some of the PLHIV started to receive a monthly nutritional supplementation consisting of Corn-Soy Blend and oil. Analytic methods included bivariate and multivariable methods. The intervention increased the mean BMI by 7.4% and the average current CD4 count by 4.7% compared to nonintervention (P

Mucinous cystadenocarcinoma in men is very rare; we reported 1 case of mucinous cystadenocarcinoma in the pancreatic disease institute of Wuhan union hospital in China. The aim of the study was to focus our attention on the gender of this patient. The mucinous cystadenocarcinoma is a pathology frequently seen among women. The clinical presentation of this patient is a characteristic which deserves to be described.