Search

Introduction: The composite coverage index (CCI) is the weighted average coverage of eight preventive and curative interventions received along the maternal and childcare continuum. This study aimed to analyse maternal 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 their children aged 1 to 4. This study took place in Guinea. The CCI (meeting the need for planning, childbirth assisted by qualified healthcare workers, antenatal care assisted by qualified healthcare workers, vaccination against diphtheria, pertussis, tetanus, measles and Bacillus Calmette-Guérin, taking oral rehydration salts during diarrhoea and seeking care for pneumonia) is optimal if the weighted proportion of interventions is > 50%; otherwise, it is partial. We identified the factors associated with CCI using the descriptive association tests, the spatial autocorrelation statistic and multivariate logistic regression., Results: The analyses involved two DHS surveys, with 3034 included in 2012 and 4212 in 2018. The optimal coverage of the CCI 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 CCI in Labé between 2012 and 2018., Conclusion: This 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 increases optimal CCI., (© 2023. The Author(s).)

Background: Despite its effectiveness, the optimal use of the combination of insecticide-treated nets (ITN) and intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) remains low in malaria-endemic areas. Therefore, this study analyzed its variations and predictors in Guinea., Methods: This study was a secondary analysis of the 2012 and 2018 Guinea Demographic and Health Surveys (DHS). It included women who had given birth 3 years before each DHS, slept on ITN and took at least one dose of SP. Use was complete if a pregnant woman slept on ITNs and took SP (at least two doses in 2012; at least three doses in 2018). Moran indices were used to determine spatial autocorrelation and classification methods to identify malaria preventive measures (MPM) predictors., Results: In 2012, 60.88% of pregnant women had incomplete use of MPMs compared with 79.11% in 2018. Associated factors with incomplete MPMs in 2012 were as follows: having an indirect link with the head of household (AOR = 2.23, 95% CI 1.08-4.61) and performing at least 4 ANC visits (AOR = 0.66, 95% CI 0.44-0.99). In 2018: Living in households of 2 to 5 people (AOR = 0.54, 95% CI 0.36-0.80), have a man as the head of the household (AOR = 0.56, 95% CI 0.35-0.89), perform the first ANC in the second trimester of pregnancy (AOR = 0.74, 95% CI 0.54-0.99), perform at least 4 ANC visits (AOR = 0.47, 95% CI 0.36-0.62), have a job (AOR = 0. 67, 95% CI 0.50-0.88), give birth in a public health facility (AOR = 0.53, 95% CI 0.39-0.72) and the middle wealth quintile (AOR = 1.56, 95% CI 1.07-2.26). Analyses revealed a global autocorrelation (Moran index = 0.0009, p = 0.2349) and high-high clusters in Mamou in 2012. In 2018, autocorrelation was found (I Moran = 0.0169, p ≤ 0.05), with spatial clusters in 4 regions., Conclusion: The link with the head of household and the number of ANC visits were the main factors in MPMs. It is essential to implement strategies at the household level and health system level and monitor them to reduce inequality across regions., (© 2022. The Author(s).)

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., Competing Interests: The authors state that there are no conflicts between the parties cited in this study., (Copyright © 2021 Abdourahamane Diallo et al.)

Introduction: the objective was to identify the predictive factors contributing to COVID-related deaths in Intensive Care Unit., Methods: this was a 4-month (12 th March to 12 th July 2020) cross sectional study carried out in the intensive care unit of the COVID treatment center of Donka National Hospital, the only hospital with a COVID intensive care unit in Guinea., Results: during our period of study 140 patients were hospitalized in the COVID intensive care unit and 35 patients died (25%). In univariate analysis, the occurrence of death was associated with: confusional syndrome (p<0.001), time to admission (p<0.001), use of an inotropic or vasopressor (p<0.001), Brescia score ≥ 2 (p=0.004), non-invasive ventilation (p=0.011), stroke (p=0.014), Acute Respiratory Distress Syndrome (ARDS) (p=0.015), male (p=0.021), provenance (p=0.021), acute renal failure (p=0.022), pulmonary embolism (p=0.022), invasive ventilation (p=0.022), and age > 60 years (p=0.047). In multivariate analysis, the factors predictive of mortality were: Acute Respiratory Distress Syndrome (ARDS) (OR= 6.33, 95% CI [1.66-29]; p=0.007), a Brescia score ≥ 2 (OR =5.8, 95% CI [1.7-19.2]; p=0.004) and admission delay (OR =5.6, 95% CI [1.8-17.5]; p=0.003)., Conclusion: our study shows that the acute respiratory distress syndrome, then the Brescia score ≥ 2, and finally the time to admission to intensive care were all associated with an increased risk of death for patients. These results are different from those reported in Asia, Europe and North America., Competing Interests: The authors declare no competing interests., (Copyright: Joseph Donamou et al.)

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., Competing Interests: The authors have declared that no competing interests exist.

Arsenic (As) and selenium (Se) are two metalloids found in the environment. As it poses a significant threat to human health and plant growth due to its prevalence and toxicity, however Se is a required micronutrient for human health. In this study hydroponic experiments were performed to investigate whether endogenous Se can mitigate As toxicity in rice ( Oryza sativa L.). We found that As uptake by rice roots increased by pretreatment with selenateSe(VI) or selenite Se(IV). However, co-application of arsenate As(V) or arsenite As(III) with selenate markedly reduced the uptake of As by roots. Co- or pretreatment with Se with five µM of As(V) or one µM of As(III) significantly decreased shoot As content. Conversely, Se pretreatment before the addition of five µM of As(III) or one µM of As(V) resulted in As accumulation in the shoot compared to As and Se co-application. As translocation to the shoot was lower whereas the transfer factor was higher upon the simultaneous application of Se and As compared to Se pretreatment. Se supplementation with As(III) or pretreatment increased antioxidant enzymes: Superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD) increased in the root and shoot, but decreased glutathione (GSH) and malondialdehyde (MDA) contents in the shoot. Plants under As(V) treatment showed the same trend except that CAT content decreased in the root and shoot, while MDA content increased in the shoot. These results suggest that cultivating rice in the presence of Se can reduce the accumulation of toxic As in seedlings, thus ensuring the safety of this important crop for human consumption.

Agricultural soil contaminated with heavy metals and the subsequent heavy metals uptake by rice have increasingly been reported in the last few decades. In this study, pot experiments with two contaminated soils (acidic soil from Jiangxi Province and slightly alkaline soil from Hunan Province) were conducted to investigate the effects of water management (flooding and aerobic treatment) on the uptake of cadmium (Cd), lead (Pb), arsenic (As), and chromium (Cr) by rice (Oryza sativa L.). The pore water contents of these heavy metals were determined during the growing season. Flooding the soil decreased Cd, Pb, and Cr in soil pore water, but increased As in the soil solution. Relative to the aerobic treatment, flooding decreased the Cd in the soil solution by 17.3-94.5% and 54.7-88.3% in acidic and slightly alkaline soils, respectively. The total As in the soil solutions increased by 0.2-20.9 and 0.1-15.2 times throughout the growing season in acidic and slightly alkaline soils, respectively. In acidic soil, flooding significantly decreased the Cd contents in iron plaque and rice tissues, significantly increased the Cr content in iron plaque, slightly decreased the Cr uptake by rice, and decreased the Pb content in the aboveground parts of rice, and increased the Pb content in rice roots and iron plaque. Relatively fewer changes were observed in rice grown in slightly alkaline soil. Results suggested that flooding the acidic soil had mixed results on heavy metal bioavailability, and the bioavailability in slightly alkaline soil was not notably impacted by flooding., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: the aim of this study was to evaluate Target the effect of the addition of clonidine or magnesium sulfate of morphine, administered through IT on the duration of analgesia after spinal anesthesia for cesarean section., Patients and Methods: 75 women in labor, ASA I or II, proposed programmed or semi-urgent caesarean section, were included in this study. They were randomized into three groups: Group morphine or witness (GM), Magnesium Group (GMg), clonidine group (CG). The primary endpoint was the time between the completion of spinal anesthesia and the first analgesic request., Results: The time to first analgesic request was superior, 286.76 (52.25) mn in the GC and 237.40 (73.67) mnin GMg against 209.68 (36.09)mn GM (p <0.001) in connection with the literature data. The EVA average scores at rest and during exercise in the first 24 postoperative hours were lower in groups and GC GMg compared to GM. Overall satisfaction was good in parturients with no significant difference in the groups. The duration of motor block was 193.68 (33.37) min in the GC against 141.76 (29.80) min in GM and 135.92 (23.14) min in the GMg (p <0.001). We noted a significant incidence of somnolence. Hemodynamic parameters were similar between the three groups., Conclusion: In parturients operated on by cesarean section under spinal anesthesia, the addition of 75 mg magnesium sulfate or 75µg clonidine 100 µg of morphine in IT prolongs significantly the duration of the first analgesic postoperatively demand and reduced scores pain 24 hours without increasing the incidence of adverse effects., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Cadmium (Cd) in rice grains is a potential threat to human health. This study investigated the effects of selenite fertilisation (0 mg kg -1 , 0.5 mg kg -1 , and 1.0 mg kg -1 ) on soil solution Cd dynamics and rice uptake. Rice was grown in two Cd-contaminated soils in Jiangxi and Hunan Provinces under two different sets of conditions: aerobic and flooded. The experiments were conducted in pots. The plants were harvested at the seedling stage and at maturity to determine their Cd levels. Soil solutions were also extracted during the growing season to monitor Cd dynamics. The results showed that in the Jiangxi soil (pH 5.25), Cd concentrations in the soil solutions, seedlings, and mature rice plants were higher under aerobic than under flooded water management conditions. In the Hunan soil (pH 7.26), however, flooding decreased Cd levels in the rice seedlings but not in mature plants. Selenite additions to the Hunan soil decreased Cd concentrations in the soil solutions and in the mature rice plants. These effects were not observed for the solutions or the plants from Jiangxi soil amended with selenite. Relative to the control treatment, 0.5 mg kg -1 selenite decreased the rice grain Cd content by 45.2% and 67.7% under aerobic and flooding conditions, respectively. The results demonstrated that water management regimes affected rice Cd uptake more effectively in Jiangxi than in Hunan soil, whereas selenite addition was more effective in Hunan than in Jiangxi soil. Selenite addition was also more effective at reducing rice grain Cd levels when it was applied under flooding than under aerobic conditions., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The accumulation of arsenic (As) in rice grain is a potential threat to human health. Our study investigated the possible mediatory role of selenite fertilization on As uptake and accumulation by rice (Oryza sativa L.) under different water management regimes (aerobic or flooded) in a pot experiment. Soil solutions were also extracted during the growing season to monitor As dynamics. Results showed that As contents in the soil solutions, seedlings, and mature rice were higher under flooded than under aerobic water management. Under aerobic conditions, selenite additions slightly increased As concentrations in soil solutions (in the last two samplings), but decreased As levels in rice plants. Relative to the control, 0.5 mg kg -1 selenite decreased rice grain As by 27.5%. Under flooded conditions, however, selenite additions decreased As in soil solutions, while increased As in rice grain. Tendencies also showed that selenite additions decreased the proportion of As in rice shoots both at the seedling stage and maturity, and were more effective in aerobic soil. Our results demonstrate that the effect of selenite fertilizer on As accumulation by rice is related to water management., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: In 2014-2016, West Africa faced the most deadly Ebola Virus Disease (EVD) outbreak in history. A key strategy to overcome this outbreak was continual staff training in Infection Prevention and Control (IPC), with a focus on Ebola. This research aimed to evaluate the impact of IPC training and the quality of IPC performance in health care facilities of one municipality of Conakry, Guinea., Methods: This study was conducted in February 2016. All health facilities within Ratoma municipality, Conakry, Guinea, were evaluated based on IPC performance standards developed by the Guinean Ministry of Health. The IPC performance of healthcare facilities was categorised into high or low IPC scores based on the median IPC score of the sample. The Mantel-Haenzsel method and logistic regression were used for statistical analysis., Results: Twenty-five percent of health centres had one IPC-trained worker, 53% had at least two IPC-trained workers, and 22% of health centres had no IPC-trained workers. An IPC score above median was positively associated with the number of trained staff; health centres with two or more IPC-trained workers were eight times as likely to have an IPC score above median, while those with one IPC-trained worker were four times as likely, compared to centres with no trained workers. Health centres that implemented IPC cascade training to untrained medical staff were five times as likely to have an IPC score above median., Conclusions: This research highlights the importance of training healthcare staff in IPC and organising regular cascade trainings. IPC strategies implemented during the outbreak should continue to be reinforced for the better health of patients and medical staff, and be considered a key factor in any outbreak response.

Humic substances can reduce mobility and bio-accessibility of Cd in soil and therefore inhibit its uptake by rice, which is a major source of human Cd intake. Yet, the effects of aging humic substances are not fully understood. A rice pot experiment was conducted to evaluate the effects of humic acid-based amendments on the mobility of Cd in soil solution and its uptake by rice when amendments were freshly added or aged for 130 d. The results showed that the aged and the unaged amendments generally decreased Cd concentration in soil solution, but the effect declined with time. Unaged HA-K (humic-potassium) reduced Cd concentration by 88% for the first sampling, but this dropped to 46% for the last sampling, compared to that of the control. All amendments, whether aged or not, reduced the content of Cd in rice seedlings, as well as in mature plants. Aged and unaged woody peat reduced the Cd content in seedlings by 79% and in grains by 70%, respectively. Aging of amendments caused lower pH and higher Cd concentration in the soil solution for all amendments and accordingly, the Cd content in rice seedlings or each part of mature plants in the aged group was higher than that of the unaged group. The applied amendments might reduce the solubility of Cd through the alteration in soil pH, and thus inhibit the uptake of Cd by rice, but the effects diminished with aging., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: Reduce morbidity and death rates of women with cervical cancer in Guinea., Methodology: This was a five-day cross-sectional study carried out in two successive years (2012 and 2013) at the CERFFO-PCG in Conakry. The target population was women aged 25-49. Approximately 500 women for 2012 and 900 women were expected in these cervical screening campaigns by visual methods (IVA and IVL) with immediate treatment of precancerous lesions. After histologic confirmation of the cancer lesions, the management was carried out according to the protocols in force in the country. We performed a simple descriptive analysis and the results expressed as a percentage and on average., Results: The target population represented 60.4% in 2012 and 76.2% in 2013, of the total number of women received. The incidence rate of high-grade intraepithelial lesions and cancers increased from 2.6% in 2012 to 0.9% in 2013. In 2012, the 57 precancerous lesions were treated with immediate treatment and 10 cases of cancers out of the 16 had a surgical treatment. Also in 2013, all precancerous lesions were treated immediately and 2 cancers out of the 4 benefited from surgery., Conclusion: Our research shows that, with creativity, flexibility, good organization and efficient use of resources, morbidity and death rates of women with cervical cancer in a very resources can be significantly reduced., (Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Diabetic foot is a major complication of diabetes due to its frequency and its high risk of evolution to amputation. We report 105 cases recruited at the diabetes centre Marc Sankale., Method: It's a prospective study including all diabetic patients who attended the diabetes centre for any foot lesion during a one year period. Besides clinical examination data, results of glycaemia, foot X-ray Doppler and bacteriological analysis of the pus were collected., Results: foot lesion represented 2.8% of diabetologist causes of consultation. Mean age of occurrence was 55 +/- 14 years in 63% women and 37% men. Diabetes was type 2 in 90% cases, poorly controlled in 63.92 % cases. Foot lesion was dominated by infection (97%), isolated or associated to peripheral vascular disease (32.4%) or neuropathy (13.3%). 67 patients had medical treatment and healed their wounds in 3 months in 76% cases. 38 other cases needed surgery : major amputation (15%), minor amputation (13%) debridment (9%) and revascularization (1%)., Conclusion: Diabetic foot is a frequent reason for consultation at the National diabetes centre. Despite all the improvements made after the implementation of the patient's educational program, treatment starts late because of economical and cultural reasons that increase morbidity.

Our intentions were to determine the incidence of the association of anemia and pregnancy, to evaluate maternal and fetal prognosis and to offer some recommendations regarding national health care policies. This prospective study lasting 30 months included all cases of anemia and pregnancy detected by clinical and laboratory examinations. Thus 13,191 women were enrolled in the study but only 1408 cases of anemia and pregnancy (10.67%). Primipara and grand multipara were particularly at risk. Severe forms of anemia and pregnancy were encountered often (51.71%). Maternal and fetal prognoses were very poor. Maternal mortality was 852/100,000, accounting for 65% of the maternal mortality of the department. The stillborn rate was 50 per thousand. This is a serious health problem which needs to be dealt with by a national health education programme.