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1. Workplace violence against female healthcare workers: a systematic review and meta-analysis

Author

Issifou Yaya, Fabienne Marcellin, Olivier Chassany, Martin Duracinsky, May-Elizabeth Pere-ere Ajuwa, Clair-Antoine Veyrier, and Lorraine Cousin Cabrolier

Subjects
Medicine
Abstract

Background Workplace violence (WPV) is highly prevalent in the health sector and remains a major occupational issue causing significant harm, ranging from bodily and psychological harm to death. Female healthcare workers (HCWs) are at high risk of WPV.Objectives Identify risk factors of WPV among different professional categories of female HCWs.Data sources PubMed, EMBASE and Web of Science, along with their references lists January 2010 and March 2022.Eligibility criteria English language observational studies focusing on WPV among HCWs evaluating the risk factors, impacts and consequences of WPV in female HCWs.Method Risk of bias was assessed for all studies by Joanna Briggs Institute critical appraisal checklists. We estimated the pooled prevalence of WPV and the associated 95% CI using a random-effects meta-analysis model. We then described the associated factors and effects of WPV.Results 28 reviewed studies (24 quantitative, 4 qualitative and 1 mixed-method) from 20 countries were selected. From the available results of 16 studies, the pooled prevalence of WPV was estimated at 45.0% (95% CI 32% to 58%). Types of violence included verbal abuse, verbal threats, physical assaults, sexual harassment, mobbing, bullying and discrimination. Perpetrators were patients, patients’ relatives, colleagues and supervisors. Nurses were the most studied HCWs category. WPV was found to affect both mental and physical health. Age, marital status, lower occupational position, substance abuse, shorter work experience and low support at work were the main socio-demographic and organisational factors associated with higher risk of WPV.Conclusion WPV prevalence is high among female HCWs, warranting a multilevel intervention approach to address and mitigate its impact. This approach should include targeted policies and individual-level strategies to create a safer work environment and prevent adverse effects on both HCWs and the broader healthcare system. Further research is needed to better document WPV in categories of HCWs other than nurses.PROSPERO registration number CRD42022329574.

Published
2024
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2. Development of a risk prediction score for screening for HBV, HCV and HIV among migrants in France: results from a multicentre observational study (STRADA study)

Author

Issifou Yaya, France Lert, Françoise Roudot-Thoraval, Olivier Chassany, David Zucman, Frédérique Thonon, Martin Duracinsky, Lisa Yombo-Kokule, Pascal Bessonneau, and Olivia Rousset-Torrente

Subjects
Medicine
Abstract

Objectives Migrants from high HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV) endemicity regions have a great burden of these infections and related diseases in the host countries. This study aimed to assess the predictive capacity of the Test Rapide d'Orientation Diagnostique (TROD) Screen questionnaire for HIV, HBV and HCV infections among migrants arriving in France.Design An observational and multicentre study was conducted among migrants. A self-questionnaire on demographic characteristics, personal medical history and sexual behaviours was completed.Setting The study was conducted in the centres of the French Office for Immigration and Integration (OFII).Participants Convenience sampling was used to select and recruit adult migrants between January 2017 and March 2020.Outcome measures Participants were tested for HIV, HBV and HCV with rapid tests. For each infection, the test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy.Results Among 21 133 regular migrants seen in OFII centres, 15 343 were included in the study. The participants’ mean age was 35.6 years (SD±11.1). The prevalence (95% CI) of HBV, HCV and HIV was 2.0% (1.8% to 2.2%), 0.3% (0.2% to 0.4%) and 0.3% (0.2% to 0.4%), respectively. Based on the sensitivity–specificity curve analysis, the cut-off points (95% CI) chosen for the risk score were: 2.5 (2.5 to 7.5) for HBV infection in men; 6.5 (0.5 to 6.5) for HBV infection in women; 9.5 (9.5 to 12.5) for HCV infection; and 10.5 (10.0 to 18.5) for HIV infection. Test performance was highest for HIV (AUC=82.15% (95% CI 74.54% to 87.99%)), followed by that for HBV in men (AUC=79.22%, (95% CI 76.18% to 82.26%)), for HBV in women (AUC=78.83 (95% CI 74.54% to 82.10%)) and that for HCV (AUC=75.95% (95% CI 68.58% to 83.32%)).Conclusion The TROD screen questionnaire showed good overall performance for predicting HIV, HBV and HCV infections among migrants in OFII centres. It could be used to optimise screening for these infections and to propose rapid screening tests to those who are at high risk.Trial registration number NCT02959684.

Published
2024
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3. Predictors of health-related quality of life in a large cohort of adult patients living with sickle cell disease in France: the DREPAtient study

Author

Issifou Yaya, Adrien Pourageaud, Benjamin Derbez, Marie-Hélène Odièvre, Damien Oudin Doglioni, Marieke Podevin, Gaëlle Thomas, Lisa Yombo-Kokule, Christian Godart, Maryannick Lepetit, Tania Cassubie-Mercier, Frederic Galacteros, Olivier Chassany, DREPAtient study group, Frédéric Galactéros, Odièvre-Montanié Marie-Hélène, Sonia Pavan, Patricia Aguilar-Martinez, Jean-Benoït Arlet, Giovanna Cannas, Abdourahim Chamouine, Maryse Etienne-Julan, Corinne Guitton, Sylvain Le Jeune, Gylna Loko, and Corinne Pondarre

Subjects
health-related quality of life, sickle cell disease, SF-36, France, DREPAtient study, Public aspects of medicine, RA1-1270
Abstract

BackgroundSickle cell disease (SCD) is an inherited autosomal recessive disorder exhibiting a range of symptoms and acute and/or chronic complications that affect the quality of life. This study aimed to assess health-related quality of life (HRQoL) and to identify the associated factors in adult patients with SCD in France.MethodsDREPAtient is a cross-sectional, multicenter study conducted from June 2020 to April 2021 in France and in certain French overseas territories where SCD is highly prevalent. Sociodemographic and clinical data were collected online. HRQoL was assessed by the French version of the 36-Item Short Form Survey (SF-36) questionnaire. HRQoL determinants were identified using multivariable linear regression analysis.ResultsIn total, 570 participants were included, mostly women (68.9%), with a mean age of 33.3 (±10.7) years. The highest mean score HRQoL was found in the Physical functioning domain (67.5 ± 21.8) and the lowest mean score in the General Health perception domain (37.7 ± 20.3). The mean score of the physical composite (PCS) and mental composite (MCS) of SF-36 summary scores was 40.6 ± 8.9 and 45.3 ± 9.8, respectively. Participants receiving oxygen therapy (β = −3.20 [95%CI: −5.56; −0.85]), those with a history of femoral osteonecrosis (−3.09 [−4.64; −1.53]), those hospitalized for vaso-occlusive crisis (VOC) or acute chest syndrome (ACS) (−2.58 [−3.93; −1.22]), those with chronic complications (−2.33 [−4.04; −0.62]), female participants (−2.17 [−3.65; −0.69]), those with psychological follow-up (−2.13 [−3.59; −0.67]), older participants (−1.69 [−3.28; −0.09]), and those receiving painkillers (−1.61 [−3.16; −0.06]) reported worse PCS score. By contrast, those who had completed secondary or high school (4.36 [2.41; 6.31]) and those with stable financial situation (2.85 [0.94, 4.76]) reported better PCS scores. Worse MCS scores were reported among participants with psychological follow-up (−2.54 [−4.28; −0.80]) and those hospitalized for VOC/ACS in the last 12 months (−2.38 [−3.99; −0.77]), while those who had relatives’ support (5.27 [1.92; 8.62]) and those with stable financial situation (4.95 [2.65; 7.26]) reported better MCS scores.ConclusionAdults with major SCD reported poor physical and mental HRQoL scores. Hospitalization for VOC/ACS, chronic complications, use of painkillers, perceived financial situation, and support from relatives are important predictors of HRQoL in SCD patients. Interventions to improve HRQoL outcomes SCD should be considered.

Published
2024
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4. Socio-behavioral correlates of pre-exposure prophylaxis use and correct adherence in men who have sex with men in West Africa

Author

August Eubanks, Bakary Coulibaly, Bintou Dembélé Keita, Camille Anoma, Ter Tiero Elias Dah, Ephrem Mensah, Sékou Kaba, Kpassou Julien Lokrou, Faïçal Rodrigue Ouedraogo, Alèda M. Fidèle Badjassim, Gwenaëlle Maradan, Michel Bourrelly, Marion Mora, Lucas Riegel, Daniela Rojas Castro, Issifou Yaya, Bruno Spire, Christian Laurent, Luis Sagaon-Teyssier, and on behalf of the CohMSM-PrEP Study Group

Subjects
MSM, HIV, PrEP, Community-based research, West Africa, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Multiple barriers compromise pre-exposure prophylaxis (PrEP) engagement (i.e., use and adherence) in men who have sex with men (MSM). In low/middle-income countries, little is known about PrEP engagement in this population. In West Africa, the CohMSM-PrEP study was one of the rare interventions providing PrEP to MSM. We estimated PrEP use and correct adherence rates in CohMSM-PrEP, together with associated factors over time. Methods CohMSM-PrEP recruited MSM in four community-based clinics in Mali, Côte d’Ivoire, Burkina Faso, and Togo. Quarterly follow-up included collecting socio-behavioral data, and providing a comprehensive HIV prevention package, PrEP (daily or event-driven), and peer educator (PE)-led counselling. Using repeated measures, multivariate generalized estimating equations models were used to identify factors associated with self-reported i) PrEP use and ii) correct PrEP adherence during participants’ most recent anal intercourse (defined as four pills/week for daily users and 2 + 1 + 1 for event-driven users). Results Five hundred twenty participants were included with a median follow-up time of 12 months (IQR 6–21). Of the 2839 intercourses declared over the follow-up period, PrEP use was self-reported for 1996 (70%), and correct PrEP adherence for 1461 (73%) of the latter. PrEP use was higher in participants who also attended participating clinics outside of scheduled visits (adjusted odds ratio (aOR) [95% Confidence Interval, CI], p-value; 1.32[1.01–1.71], 0.040), and in those who practiced condomless anal sex (1.86[1.54–2.24],

Published
2022
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5. Disseminated Nocardia transvalensis complex and farcinica: First case in an immunocompetent

Author

Abdoulahy Diallo, Yacouba Dembele, Issifou Yaya, Mohamadou Niang, Thierry Benoit-Cattin, Pascal Meliani, and Sarah Permal

Subjects
Nocardia transvalensis, Wallacei and farcinica, Immunocompetent, Disseminated, Community-acquired pneumonia, Infectious and parasitic diseases, RC109-216
Abstract

Background: Nocardiae is an opportunistic infection mainly of the immunocompromised patient without sparing the immunocompetent subject or without any identified risk factors. They can be localized or disseminated. The extreme rarity of this infection often results in a deleterious diagnostic delay. Case presentation: We report a first case of community acquired pneumonia with asymptomatic disseminated brain abscess due to Nocardia transvalensis/wallacei and farcinica in an immunocompetent man. The patient fully recovered after receiving optimized antimicrobial therapy. Conclusions: This case suggests that health care professionals should always evoke this diagnosis when confronted to atypical community-acquired pneumonia, even in immunocompetent patients.

Published
2023
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6. Positive relations between sexual quality of life and satisfaction with healthcare in women living with HIV and/or HCV: Results from a multicountry study.

Author

Sara Rodriguez, Issifou Yaya, Ben Huntingdon, Ilona Juraskova, Marie Preau, Fatima Etemadi, Svetlane Dimi, Maria Patrizia Carrieri, Pascal Bessonneau, Olivier Chassany, and Martin Duracinsky

Subjects
Medicine, Science
Abstract

IntroductionThe sexual quality of life is a neglected concern in women living with HIV (WHIV) or with HCV (WHCV), which can further be affected by their experience with stigma, social instability, fear of transmission and reduced access to treatment. The objective of this study was to identify sociodemographic, psychosocial, and behavioural factors associated with sexual quality of life (SQoL) in this study group.MethodsBetween December 2017 and December 2018, PROQoL-Sex Life questionnaire was administered to 404 WHIV and WHCV in five countries. PROQoL-SQoL consists of four dimensions: positive sexual perception (Psp), stigma and social distress (Sti), soft sexual practices (Sof), sexual practices with a partner (Sp), all of which were scored from 0 to 100 and considered as main outcomes, lower scores mean better sexual quality of life. Linear mixed effects models were used to evaluate the association with sociodemographic and psychosocial factors.ResultsOf the participants analyzed, 191 were living with HCV, 180 with HIV and 33 with HIV and HCV, median age was 48. Among WHIV, a higher satisfaction with health care, and talking about sexuality with healthcare workers were associated with lower scores in all the dimensions of the SQoL, while psychoactive substance use was associated with lower scores of Sti and Sof. Moreover, higher satisfaction with health care, talking about sexuality with healthcare workers, and psychoactive substance use (except cocaine use) in WHCV were associated with lower scores in Psp, Sti, and Sof. Besides, cocaine use was associated with higher scores of Sof.ConclusionThis study highlighted strong relationship between the quality of health care, and psychoactive substance use (except cocaine) and the sexual quality of life in WHIV and WHCV in these five countries. These findings draw attention to the different interventions that can be proposed for improving the sexual quality of life.

Published
2023
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7. A fatal case coronavirus disease 2019 – Associated acute hemorrhagic necrotizing encephalopathy

Author

Abdoulahy Diallo, Yacouba Dembele, Mohamadou Niang, Lucas Balloy, François Pousset, Issifou Yaya, and Sarah Permal

Subjects
acute hemorrhagic necrotizing encephalopathy, covid-19, death, sars-cov-2, Infectious and parasitic diseases, RC109-216
Abstract

Coronavirus disease 2019 (COVID-19) has been reported in association with a variety of brain imaging findings such as acute hemorrhagic necrotizing encephalopathy. To the best of our knowledge, we are reporting a second case of acute necrotizing hemorrhagic encephalopathy associated with COVID-19, which was fatal in a few hours in a 56-year-old male without a specific history. We claim that this case is important because this case shows that the unconscious patients are potentially infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and might cause the horizontal infection. In order to end the pandemic of SARS-CoV-2 diseases, the diagnosis of the disease must be prompt and not overlook any findings. We think that diffusion magnetic resonance imaging is a promising and useful sequence to evaluate the changes in brain tissue in the acute necrotizing encephalopathy.

Published
2022
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8. Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)

Author

Ter Tiero Elias Dah, Issifou Yaya, Luis Sagaon-Teyssier, Alou Coulibaly, Malan Jean-Baptiste Kouamé, Mawuényégan Kouamivi Agboyibor, Kader Maiga, Issa Traoré, Marion Mora, Paméla Palvadeau, Daniela Rojas-Castro, Fodié Diallo, Ephrem Mensah, Camille Anoma, Bintou Dembélé Keita, Bruno Spire, Christian Laurent, and on behalf of the CohMSM Study Group

Subjects
HIV, Prevention, Incidence, MSM, Africa, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Access to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d’Ivoire, Mali, and Togo. Methods We performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively. Results 618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2–26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1–77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p

Published
2021
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9. Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach

Author

Marie Costa, Tangui Barré, Marion Coste, Issifou Yaya, Cyril Berenger, Marc Tanti, Christophe Cutarella, Marion Mora, Pierre Poloméni, Marianne Maynard, Danielle Teuma, Michaël Bazin, Gwenaelle Maradan, Perrine Roux, and Patrizia Maria Carrieri

Subjects
Alcohol use disorder, Access to care, Mixed-methods, Survey, Semi-structured interviews, Textual analysis, Public aspects of medicine, RA1-1270
Abstract

Abstract Background The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care. Methods Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification. Results Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66–8.85]), regular smoking (9.72[3.91–24.15]) and feeling discriminated against (2.35[1.10–5.05]) were independent levers to having sought/received care for AUD, while being aged

Published
2020
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10. Loss to Follow-Up from HIV Pre-Exposure Prophylaxis Care in Men Who Have Sex with Men in West Africa

Author

August Eubanks, Bakary Coulibaly, Bintou Dembélé Keita, Camille Anoma, Ter Tiero Elias Dah, Ephrem Mensah, Gwenaëlle Maradan, Michel Bourrelly, Marion Mora, Lucas Riegel, Daniela Rojas Castro, Issifou Yaya, Bruno Spire, Christian Laurent, Luis Sagaon-Teyssier, and the CohMSM-PrEP Study Group

Subjects
HIV/AIDS, key populations, MSM, pre-exposure prophylaxis, PrEP, West Africa, Microbiology, QR1-502
Abstract

Loss to follow-up (LTFU) from HIV pre-exposure prophylaxis (PrEP) care compromises the goal of HIV elimination. We investigated the proportion of LTFU and associated risk factors among men who have sex with men (MSM) enrolled in a PrEP demonstration project in Burkina Faso, Côte d’Ivoire, Mali, and Togo. CohMSM-PrEP, a prospective cohort study, was conducted between November 2017 and June 2021 in community-based clinics. MSM aged 18 years or older at substantial risk of HIV infection received a comprehensive prevention package, including PrEP and peer education. LTFU was defined as not returning to the clinic for six months. Associated risk factors were investigated using a time-varying Cox’s model. Of 647 participants followed up for a median time of 15 months, 372 were LTFU (57.5%). LTFU was associated with younger age (adjusted hazard ratio [95% Confidence Interval]; 1.50 [1.17–1.94]), unemployment (1.33 [1.03–1.71]), depression (1.63 [1.12–2.38]), and perceiving no HIV risk with stable male partners (1.61 [1.23–2.10]). Contacting peer educators outside of scheduled visits was protective (0.74 [0.56–0.97]). Our findings show that LTFU from PrEP care in West African MSM is a major challenge to achieving HIV elimination, but that the involvement of peer educators in PrEP delivery helps to limit LTFU by providing users with adequate support.

Published
2022
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11. Health-related quality of life among people living with HIV/AIDS in Togo: individuals and contextual effects

Author

Issifou Yaya, Lihanimpo Djalogue, Akouda Akessiwè Patassi, Dadja Essoya Landoh, Ayélé Assindo, Aboubakari Nambiema, Kanfitine Kolani, P’Niwè Massoubayo Patchali, Essodjèlouna Manani Bignandi, Abdoulahy Diallo, Didier Koumavi Ekouévi, and Bayaki Saka

Subjects
Quality of life, PLWHA, Togo, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Objective The objective of this study is to assess the quality of life and to identify factors associated with good global quality of life among people living with HIV/AIDS (PLWHA) in Togo. Results In total, 880 PLWHA with mean age (standard deviation) of 39.6 (10.1) years, were interviewed. Most of them (78.4%) were female. The global score of quality of life was ranged from 42.6 to 112, with a mean (standard deviation) estimated at 86.3 ± (13.3). More than the three-quarters (76.2%) of the participants had a good global quality of life. In multivariate analysis, secondary education level or higher (adjusted odds ratio = 1.78, 95% confident interval (CI) [1.10–2.85]), living in Kara health region (adjusted odds ratio = 4.39, 95% CI [2.94–6.57]), being on antiretroviral therapy (adjusted odds ratio = 6.99, 95% CI [4.11–11.9]) and HIV sero-status disclosure (adjusted odds ratio = 1.83, 95% CI [1.28–2.61]) were associated with a better overall quality of life (score ≥ 77.3).

Published
2019
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12. Prevalence and risk factors of anemia in children aged from 6 to 59 months in Togo: analysis from Togo demographic and health survey data, 2013–2014

Author

Aboubakari Nambiema, Alexie Robert, and Issifou Yaya

Subjects
Anemia, Prevalence, Risk factors, Children, Togo, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Anemia in children continues to be a major public health challenge in developing countries and particularly in Sub-Saharan Africa. Anemia has serious consequences on the growth and development of the children in the early stages of life. This study aimed to determine the prevalence and associated factors of anemia among children from 6 to 59 months in Togo. Methods Data from the Togo Demographic and Health Survey 2013–2014 were used for this study. This nationally representative survey provided data on a wide range of indicators such as mother and child health, nutrition and other characteristics. Anemia status was determined using hemoglobin level (Hb

Published
2019
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13. Acute disseminated encephalomyelitis after dengue

Author

Abdoulahy Diallo, Yacouba Dembele, Céline Michaud, Maxime Jean, Mohamadou Niang, Pascal Meliani, Issifou Yaya, and Sarah Permal

Subjects
Dengue infection, Acute disseminated encephalomyelitis, Mayotte, Infectious and parasitic diseases, RC109-216
Abstract

Dengue fever, transmitted by Aedes aegypti mosquitoes, is one of the most common vector-borne disease. Its incidence is increasing steadily worldwide, becoming a major public health problem in the tropical and subtropical zone. Neurological manifestations after dengue are not very common and acute disseminated encephalomyelitis (ADEM) following dengue infections is rare with a few cases documented in literature. Clinical characteristics and typical lesions of ADEM on magnetic resonance imaging (MRI) of brain along with serologic positivity for dengue usually confirm the diagnosis. We report a case of ADEM which developed as a neurological complication of dengue during an epidemic in a 39-year-old woman.

Published
2020
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14. Factors associated with unmet need for limiting childbirth among women living with HIV in Togo: An averaging approach.

Author

Issifou Yaya, Aboubakari Nambiema, Sokhna Dieng, Lihanimpo Djalogue, Mawuényégan Kouamivi Agboyibor, Mathias Kouamé N'Dri, Takiyatou Baba-Toherou, Akouda Akessiwe Patassi, Dadja Essoya Landoh, Kanfitine Kolani, Abdoul-Samadou Aboubakari, and Bayaki Saka

Subjects
Medicine, Science
Abstract

BACKGROUND:Access to antiretroviral treatment has improved the life expectancy of HIV-positive patients, most often associated with a desire to limit childbearing. Women living with HIV (WLHIV) commonly have unmet need for contraception and could be at risk of unintended pregnancy. Preventing unintended pregnancies among women living with HIV are effective strategies to eliminate mother-to-child transmission of HIV. OBJECTIVE:The aim of this study was to assess unmet need for limiting childbirth and its associated factors among women living with HIV in Togo. METHODS:This facility based cross-sectional study was conducted, between June and August 2016, among WLHIV in their reproductive age (15-49 years) in HIV-care settings in Centrale and Kara regions Data was collected using a structured and pretested questionnaire. WLHIV who desired to limit childbirth but not using contraception were considered to have unmet need of birth limitations. Univariate and multivariate Poisson regression models with robust variance were performed to identify associated factors with unmet needs. A multi-model averaging approach was used to estimate the degree of the association between these factors and the unmet need of birth limitations. RESULTS:A total of 443 WLHIV were enrolled, with mean age of 34.5 years (standard deviation [SD] = 7.0). Among them 244 (55.1%) were in couple and 200 (45.1%) had at least the secondary level of education. 39.1% were followed-up in a private healthcare facility. At the time of the survey, 40.0% did not desire childbearing but only 9.0% (95% CI [6.7-12.1]) of them expressed unmet needs for limiting childbirth. In multivariable analysis, associated factors with unmet needs of birth limitations were: being aged 35 years or more (adjusted prevalence ratio (aPR) = 3.11, 95% confidence intervals (95% CI) [1.52-6.38]), living in couple (aPR = 2.32 [1.15-4.65]), living in Kara region (aPR = 0.10 [0.01-0.76]), being followed in a private healthcare facility (aPR = 0.08[0.01-0.53]) and having severe HIV symptoms (aPR = 3.50 [1.31-9.37]). CONCLUSION:Even though the unmet need for births limitation was relatively low among WLHIV in Togo, interventions to improve more access to contraceptive methods, and targeting 35 to 49 years old women, those in couple or followed in the public healthcare facilities would contribute to the eradication of mother-to-child transmission of HIV.

Published
2020
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15. Incomplete immunization among children aged 12–23 months in Togo: a multilevel analysis of individual and contextual factors

Author

Didier K. Ekouevi, Fifonsi A. Gbeasor-Komlanvi, Issifou Yaya, Wendpouiré I. Zida-Compaore, Amevegbé Boko, Essèboe Sewu, Anani Lacle, Nicolas Ndibu, Yaovi Toke, and Dadja E. Landoh

Subjects
Incomplete immunization coverage, Children, Obstacles, Associated factors, Togo, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Inadequate immunization coverage remains a public health problem in Africa. In Togo, only 62% of children under one year of age were fully immunized in 2013. This study aimed to estimate the immunization coverage among children aged 12–23 months, and to identify factors associated with incomplete immunization status in Togo. Methods A cross-sectional survey was conducted in the six health regions of Togo. Children aged 12 to 23 months who were living with one of their parents or guardians from selected households were recruited for the study. Data was collected using a pre-tested questionnaire through face-to-face interviews. Multilevel logistic regression analyses were performed to assess factors associated with incomplete immunization coverage. Results A total of 1261 households were included. Respondents were predominantly women (91.9%) and 22.8% had secondary or higher education level. Immunization cards were available for 85.3% of children. Complete immunization coverage was 72.3%, 95% confidence interval (CI): [69.7–74.8]). After controlling for both individual and contextual level variables, children whose mothers attended secondary school or above were 33% (adjusted Odds Ratio (aOR) = 0.67, CI [0.47–0.94]) less likely to have an incomplete immunization coverage compared to those with no education. The likelihood of incomplete immunization in children decreased with the increase in household’s income (aOR = 0.73, 95% CI [0.58–0.93]), children who did not have an immunization card (aOR = 13.41, 95% CI [9.19–19.57]) and those whose parents did not know that children immunization was free of charge (aOR = 1.82, 95% CI [1.00–3.30]) were more likely to have an incomplete immunization. Finally, children whose parents had to walk half an hour to one hour to reach a healthcare center were 57% (aOR = 1.57, 95% CI [1.15–2.13]) more likely to have an incomplete immunization coverage than those whose parents had to walk less than half an hour. Conclusion The goal of 90% coverage at the national level has not been achieved in 2017. Innovative strategies such as using electronic cards and strengthening sensitization activities must be initiated in order to attain a complete immunization coverage in Togo.

Published
2018
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16. Prevalence of syphilis among female sex workers and their clients in Togo in 2011

Author

Wemboo Afiwa Halatoko, Dadja Essoya Landoh, Bayaki Saka, Koffi Akolly, Yao Layibo, Issifou Yaya, Dodji Gbetoglo, Abiba Kere Banla, and Palokinam Pitché

Subjects
Female sex workers, Clients, Syphilis, HIV, Togo, Public aspects of medicine, RA1-1270
Abstract

Abstract Background During the last ten years, a resurgence of syphilis has occurred in many countries worldwide, including Togo. Previous studies have shown a wide range of syphilis infection among the female sex workers (FSWs), from 1.5 to 42.1%. In Togo, Key populations, including FSWs, are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the prevalence of syphilis among female sex workers (FSWs) and their clients in Togo. Methods We conducted a cross-sectional study in December 2011 targeting FSWs and their clients in Togo. Among participant who consented, we collected blood samples for syphilis and HIV testing. Results In total, 1,836 participants (1,106 FSWs and 730 clients) were included in the survey. Their mean age was 28.6 ± 9 years. The prevalence of syphilis was 2.2% (2.2% among FSWs compare to 2.3% among their clients, p = 0.82). This prevalence was higher among FSWs over 30 years old compare to those less than 30 years old (Odd Ratio (OR) =5.03; 95% CI [1.95-13.49]). Single FSWs were three times less likely to have syphilis than those living in couple or married (OR = 3.11; CI 95% [1.16-8.83]). Brothel based or declared FSWs were 4 times more likely to be infected by syphilis than secret ones (OR = 3.89; CI 95% [1.60-9.54]). Out of the 1,836 participants of the survey, 165 (8.9%) were HIV positive. Having syphilis was associated with HIV infection (OR = 3.41; IC 95% [1.53-7.41]). Conclusion This study showed that: i) the prevalence of syphilis among FSWs and their clients was high; ii) syphilis was significantly associated with HIV infection. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.

Published
2017
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17. Predictors of incomplete immunization coverage among one to five years old children in Togo

Author

Dadja Essoya Landoh, Farihétou Ouro-kavalah, Issifou Yaya, Anna-Lea Kahn, Peter Wasswa, Anani Lacle, Danladi Ibrahim Nassoury, Sheba Nakacubo Gitta, and Abdramane Bassiahi Soura

Subjects
Immunization, Children, Vaccine coverage, Togo, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Incompleteness of vaccination coverage among children is a major public health concern because itcontinues to sustain a high prevalence of vaccine-preventable diseases in some countries. In Togo, very few data on the factors associated with incomplete vaccination coverage among children have been published. We determined the prevalence of incomplete immunization coverage in children aged one to five years in Togo and associated factors. Methods This was a cross-sectional study using secondary data from the 2010 Multiple Indicator Cluster Surveys (MICS4) conducted in 2010 among children aged 1 to 5 years in Togo. This survey was conducted over a period of two months from September to November, 2010. Results During Togo’sMICS4 survey, 2067 children met the inclusion criteria for our study. Female children accounted for 50.9 % (1051/2067) of the sample and 1372 (66.4 %) lived in rural areas. The majority of children (92.2 %; 1905/2067) lived with both parents and 30 % of the head of households interviewed were not schooled (620/2067). At the time of the survey, 36.2 % (750/2067) of the children had not received all vaccines recommended by Expanded Program on Immunization (EPI). In multivariate analysis, factors associated with incompleteness of immunization at 1 year were: health region of residences (Maritime aOR = 0.650; p = 0.043; Savanes: aOR = 0.324; p

Published
2016
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18. Evolution of patients' socio-behavioral characteristics in the context of DAA: Results from the French ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients.

Author

Issifou Yaya, Perrine Roux, Fabienne Marcellin, Linda Wittkop, Laure Esterle, Bruno Spire, Stéphanie Dominguez, Boni Armand Elegbe, Lionel Piroth, Philippe Sogni, Dominique Salmon-Ceron, Maria Patrizia Carrieri, and ANRS CO13 HEPAVIH Study Group

Subjects
Medicine, Science
Abstract

BACKGROUND:Direct-acting antivirals (DAA) have dramatically increased HCV cure rates with minimal toxicity in HIV-HCV co-infected patients. This study aimed to compare the socio-behavioral characteristics of patients initiating pegylated-interferon (PEG-IFN)-based HCV treatment with those of patients initiating DAA-based treatment. METHODS:ANRS CO13 HEPAVIH is a national multicenter prospective cohort started in 2005, which enrolled 1,859 HIV-HCV co-infected patients followed up in French hospital outpatient units. Both clinical/biological and socio-behavioral data were collected during follow-up. We selected patients with socio-behavioral data available before HCV treatment initiation. RESULTS:A total of 580 patients were included in this analysis. Of these, 347 initiated PEG-IFN-based treatment, and 233 DAA-based treatment. There were significant differences regarding patient mean age (45 years±6 for the PEG-IFN group vs. 52 years±8 for the DAA group, p

Published
2018
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19. Emergence of Lassa Fever Disease in Northern Togo: Report of Two Cases in Oti District in 2016

Author

Akouda Akessiwe Patassi, Dadja Essoya Landoh, Agballa Mebiny-Essoh Tchalla, Wemboo Afiwa Halatoko, Hamadi Assane, Bayaki Saka, Mouchedou Abdoukarim Naba, Issifou Yaya, Kossi Atsissinta Edou, Tsidi Agbeko Tamekloe, Abiba Kere Banla, Kokou Mawule Davi, Magloire Manga, Yao Kassankogno, and Dominique Salmon-Ceron

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Background. Lassa fever belongs to the group of potentially fatal hemorrhagic fevers, never reported in Togo. The aim of this paper is to report the first two cases of Lassa fever infection in Togo. Case Presentation. The two first Lassa fever cases occurred in two expatriate’s health professionals working in Togo for more than two years. The symptoms appeared among two health professionals of a clinic located in Oti district in the north of the country. The absence of clinical improvement after antimalarial treatment and the worsening of clinical symptoms led to the medical evacuation. The delayed diagnosis of the first case led to a fatal outcome. The second case recovered under ribavirin treatment. Conclusion. The emergence of this hemorrhagic fever confirms the existence of Lassa fever virus in Togo. After a period of intensive Ebola virus transmission from 2013 to 2015, this is an additional call for the establishment and enhancement of infection prevention and control measures in the health care setting in West Africa.

Published
2017
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20. Consistent Condom Use during Casual Sex among Long-Truck Drivers in Togo.

Author

Issifou Yaya, Dadja Essoya Landoh, Bayaki Saka, Kokou Vignikin, Abdoul-Samadou Aboubakari, Kouamé Mathias N'dri, Kodjo Dodji Gbetoglo, Atavi-Mensah Edorh, Komla Ahlegnan, Holali Comlan Yenkey, Ayawavi Sitsopé Toudeka, and Palokinam Pitché

Subjects
Medicine, Science
Abstract

In 2008, the proportion of truck drivers who were not systematically protected during sex was 63% with casual partners and 60% with sex workers. Despite the high level of knowledge on HIV/AIDS and the growing awareness of the existence of the risk of HIV infection, condom use always encounters resistance among truck drivers in Togo. We sought to document the factors associated with condom use during casual sex among trucks' drivers in Togo.This was an analytical cross-sectional study conducted in 2010 and targeted truckers at truck station on the two main roads of Togo, Lomé-Cinkassé and Kodjoviakopé-Sanvee Condji.In this study, 1,782 trucks' drivers and their helpers were interviewed. All were men, and their mean age was 28.8 ± 8.8 years. Trucks' drivers were doing an average of 3 stops on their journeys and 1,229 (69%) of them had at least two years of experience in the work. Of the 1,782 trucks' drivers, only 620 (34.8%) had consistently used condoms during casual sex in the last three months. In multivariate analysis, predictors were: education level (primary schooling: OR = 1.54; p = 0.002; Secondary schooling and higher OR = 1.38; p = 0.036), good knowledge of ways of HIV transmission (OR = 1.53; p = 0.000), tested for HIV (OR = 1.67, p = 0.000), duration in the profession (2-5 years: OR = 1.43, p = 0.008; more than 5 years: OR = 1.38, p = 0.027), and HIV risk's perception (OR = 1.44, p = 0.000).These results highlight factors associated with consistent condom use during casual sex by truck drivers in Togo. This is a key population group at high risk of HIV transmission toward which the national HIV/AIDS control program should strengthen the HIV prevention strategies.

Published
2016
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21. HIV status disclosure to sexual partners, among people living with HIV and AIDS on antiretroviral therapy at Sokodé regional hospital, Togo.

Author

Issifou Yaya, Bayaki Saka, Dadja Essoya Landoh, P'Niwè Massoubayo Patchali, Akouda Akessiwè Patassi, Abdoul-Samadou Aboubakari, Makawa-Sy Makawa, Mathias Kouamé N'Dri, Sékandé Senanou, Bassan Lamboni, Daoudou Idrissou, Kao Tanang Salaka, and Palokinam Pitché

Subjects
Medicine, Science
Abstract

BACKGROUND:Many studies have reported factors associated with HIV status disclosure among People Living With HIV and AIDS (PLWHA) but very few were conducted among PLWHA receiving ART. In Togo, no study on HIV status disclosure to sexual partners has been conducted among PLWHA on ART yet. We sought to document factors associated with HIV status disclosure among PLWHA receiving ART at Sokodé regional hospital in Togo. METHOD:This was a cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months. RESULTS:A total of 291 PLWHA on ART were enrolled in this study. Their mean age (± SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 215 (74.6%) completed the questionnaire on HIV sero-status disclosure. We found that 131 PLWHA (60.9%) had disclosed their HIV sero-status to their sexual partners; 130 (60.5%) were aware of the HIV status of their sexual partners. In the multivariate analysis, the factors associated with HIV status disclosure to sexual partners were: adherence to ART (aOR = 4.89; 95%CI = [1.52; 15.78]), sexual partner awareness of HIV sero-status (aOR = 52.73; 95%CI = [14.76; 188.36]) and marital status of PLWHA (aOR = 6.10; 95%CI = [1.74; 21.37]). CONCLUSION:This study allowed us to note that the disclosure of HIV status to sexual partners is relatively low and to document the associated factors such as adherence to ART, sexual partner awareness of HIV sero-status and marital status.

Published
2015
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22. HIV pre-exposure prophylaxis for men who have sex with men in west Africa: a multicountry demonstration study

Author

Christian Laurent, Bintou Dembélé Keita, Issifou Yaya, Gwenvael Le Guicher, Luis Sagaon-Teyssier, Mawuényégan K Agboyibor, Alou Coulibaly, Issa Traoré, Jean-Baptiste Malan, Irith De Baetselier, August Eubanks, Lucas Riegel, Daniela Rojas Castro, Hortense Fayé-Ketté, Amadou Koné, Souba Diandé, Claver A Dagnra, Laetitia Serrano, Fodié Diallo, Ephrem Mensah, Ter Tiero E Dah, Camille Anoma, Bea Vuylsteke, Bruno Spire, Sayouba Ouedraogo, Bruno Granouillac, Martine Peeters, Clotilde Couderc, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Paméla Palvadeau, Thijs Reyniers, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Ekissi Jean Armel Koffi, Dibi Frédéric N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Dagnra, Kokou Dominique Tegueni, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), ARCAD Santé PLUS [Bamako, Mali], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Espoir Vie Togo [Lomé, Togo], Association African Solidarité [Ouagadougou, Burkina Faso], Espace Confiance [Abidjan, Côte d’Ivoire], Institute of Tropical Medicine [Antwerp] (ITM), Coalition PLUS [Pantin, France], Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), Université des sciences, des techniques et des technologies de Bamako (USTTB), Laboratoire National de Référence de la Tuberculose [Ouagadougou, Burkina Faso] (LNRT), Laboratoire National de Référence de la tuberculose [Lomé, Togo] (LNRT/CHU Lomé), CohMSM-PrEP Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bea Vuylsteke, Irith De Baetselier, Thijs Reyniers, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Jean-Baptiste Malan, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Ekissi Jean Armel Koffi, Dibi Frédéric N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Dagnra, Kokou Dominique Tegueni, Malbec, Odile, Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)

Subjects
Adult, Male, 0301 basic medicine, Anti-HIV Agents, Epidemiology, Sexual Behavior, [SDV]Life Sciences [q-bio], Immunology, HIV Infections, Pilot Projects, Emtricitabine, Men who have sex with men, West africa, Young Adult, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Virology, parasitic diseases, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Dosing, Homosexuality, Male, Tenofovir, Prospective cohort study, business.industry, 1. No poverty, 030112 virology, 3. Good health, [SDV] Life Sciences [q-bio], Africa, Western, Regimen, Infectious Diseases, Cohort, Pre-Exposure Prophylaxis, business, Demography, medicine.drug
Abstract

International audience; Background HIV pre-exposure prophylaxis (PrEP) data in men who have sex with men (MSM) in west Africa are essential to guide its large-scale implementation. We assessed the uptake of event-driven and daily PrEP, HIV incidence, and changes over time in sexual behaviours and prevalence of bacterial sexually transmitted infections (STIs) in MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo. Methods We did a prospective cohort study from Nov 20, 2017, to April 14, 2020, in four community-based clinics in Abidjan (Côte d'Ivoire), Bamako (Mali), Lomé (Togo), and Ouagadougou (Burkina Faso). Participants were MSM aged 18 years or older at substantial risk of HIV infection. Participants could choose between event-driven (2+1+1 dosing) and daily oral PrEP (tenofovir disoproxil fumarate 300 mg plus emtricitabine 200 mg), switch regimen, and discontinue or restart PrEP. We compared HIV incidence in this study with that of the same cohort before the availability of PrEP (CohMSM). Statistical analysis included the Kaplan-Meier method and mixed-effects regression models. This study is registered with ClinicalTrials.gov, NCT03459157. Findings We followed up 598 participants for a total of 743•6 person-years. At enrolment, 445 (74%) of 598 participants chose event-driven PrEP and 153 (26%) of 598 chose daily PrEP. 60 (13%) of 445 and 65 (42%) of 153 partici pants switched PrEP regimen at least once (p

Published
2021
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23. Heterogeneity in the Prevalence of High-Risk Human Papillomavirus Infection in Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Men Who Have Sex With Men in West Africa

Author

Issifou, Yaya, Véronique, Boyer, Phyllis Amivi, Ehlan, Alou, Coulibaly, Mawuényégan Kouamivi, Agboyibor, Issa, Traoré, Malan Jean-Baptiste, Kouamé, Alassane Kader, Maiga, Ochoh Rachelle, Kotchi, Yawo Tufa, Nyasenu, Gwenaëlle, Maradan, Daniela, Rojas-Castro, Fodié, Diallo, Camille, Anoma, Ter Tiero Elias, Dah, Ephrem, Mensah, Bintou, Dembélé Keita, Bruno, Spire, Claver Anoumou, Dagnra, Christian, Laurent, Kokou Dominique, Tegueni, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Lomé [Togo], ARCAD Santé PLUS [Bamako, Mali], Espoir Vie Togo [Lomé, Togo], Association African Solidarité [Ouagadougou, Burkina Faso], Espace Confiance [Abidjan, Côte d’Ivoire], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], CohMSM Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Yaotsè Dagnra, Phyllis Amivi Ehlan, Xavier Yawo Tufa Nyasenu, Kokou Dominique Tegueni., Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), and Dupuis, Christine

Subjects
Male, Microbiology (medical), HPV, Multivariate analysis, Adolescent, [SDV]Life Sciences [q-bio], MSM, Human immunodeficiency virus (HIV), Anal Canal, HIV Infections, Logistic regression, medicine.disease_cause, Men who have sex with men, Sexual and Gender Minorities, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Burkina Faso, Prevalence, medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, Papillomaviridae, business.industry, Papillomavirus Infections, HPV infection, HIV, virus diseases, Odds ratio, medicine.disease, Confidence interval, [SDV] Life Sciences [q-bio], Vaccination, Cross-Sectional Studies, Infectious Diseases, 030220 oncology & carcinogenesis, Africa, Female, business, Demography
Abstract

Background Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection. We assessed (i) the prevalence of high-risk HPV (HR-HPV) infection and associated factors, and (ii) the prevalence of vaccine-preventable HPV infections in MSM in Burkina Faso, Côte d’Ivoire, Mali, and Togo. Methods A cross-sectional study was conducted in 2017–2018 among MSM ≥18 years old followed in community-based clinics. HPV infection was investigated in oral and anal samples using the e-BRID system. Factors associated with HR-HPV infection were identified using multivariate logistic regressions. Results Among 631 participants, 425 were HIV-negative and 206 HIV-positive. HR-HPV prevalence ranged from 9.2% to 34.8% in the former, and 33.3% to 71.0% in the latter, according to the study country. In multivariate analysis, HIV infection (adjusted odds ratio (aOR) 3.61, 95% confidence interval (CI) 2.48–5.27) and study country (4.73, 2.66–8.43 for Mali; 3.12, 1.68–5.80 for Burkina Faso; 3.51, 1.92–6.42 for Togo) were associated with HR-HPV infection. Other associated factors were low educational level, self-defined homosexual identity, and condomless anal sex. The prevalence of infections which can be prevented with bivalent, quadrivalent, and nonavalent vaccines was 5.9, 27.1, and 34.6% in HIV-negative participants, and 18.9, 43.7, and 54.9% in HIV-positive participants, respectively. Conclusions HR-HPV prevalence was very heterogeneous between the study countries in both HIV-negative and HIV-positive MSM. Vaccine-preventable HPV infections predominated. Vaccination should be proposed to young MSM to reduce the burden of HPV infection in this vulnerable population and their female partners in West Africa.

Published
2021
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24. Risk Prediction Score for Screening Asymptomatic Sexually Transmitted Infections in HIV-positive French Men Who Have Sex with Men (ANRS 9520 DRIVER)

Author

Martin, Duracinsky, Svetlane, Dimi, Maria Patrizia, Carrieri, Issifou, Yaya, Virginie, Villes, Nadia, Valin, Eric, Farfour, Olivier, Chassany, David, Zucman, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Unité de recherche clinique en économie de la santé [Paris] (URC Eco), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Patient-Centered Outcomes Research [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service de Médecine Interne [Hôpital Foch, Suresnes] (SMI), Hôpital Foch [Suresnes], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Male, MESH: Sexual Behavior, Health (social science), MESH: Humans, MESH: Middle Aged, Social Psychology, Sexual Behavior, [SDV]Life Sciences [q-bio], Sexually Transmitted Diseases, Public Health, Environmental and Occupational Health, HIV Infections, MESH: HIV Infections, Middle Aged, MESH: Male, MESH: Homosexuality, Male, MESH: Sexual and Gender Minorities, Sexual and Gender Minorities, MESH: HIV Seropositivity, HIV Seropositivity, Humans, Homosexuality, Male, MESH: Sexually Transmitted Diseases
Abstract

International audience; Objectives: Asymptomatic sexually transmitted infections (STI) are frequent among men who have sex with men (MSM). Identifying asymptomatic STIs is a crucial issue, not only for secondary but also for primary prevention, as early treatment can reduce transmission risk. We aimed to develop a self-reported predictive score for early identification of asymptomatic STIs. Methods: Participants provided clinical data and completed a self-administered questionnaire including sociodemographic variables and behaviors during the 6 previous months. We used multivariable logistic regression to identify factors associated with asymptomatic STIs. We calculated the accuracy of the model by the non-parametric area (AUC) under the receiver-operating-characteristic (ROC) curve to find the optimal discriminant threshold for screening. Results:A total of 781 HIV-positive MSM were included with a mean age of 46.8 years. Asymptomatic STI prevalence was 13.2%. Detectable plasma HIV RNA (adjusted odds ratio (aOR [95% CI): 2.54 [1.23;5.25]), inconsistent condom use during anal sex (2.20 [1.36;3.56]), group sex (2.00 [1.15;3.45]), during or-genital practices (1.83 [1.12;3.01]), not being in stable relationship (1.70 [1.01;2.66] and an item from a sensation-seeking behavioral scale "I don't like watching porn videos" (1.61 [1.01;2.59] were associated with asymptomatic STI. AUC was 0.7 and with optimal threshold of 0.1082 for this model; sensitivity was 80.4%. Self-reported asymptomatic STI predictive score was built with this threshold according to the 6 factors in the final model. Conclusions: As this predictive score is not designed to be diagnostic, but to provide indications for diagnostic tests, its ease of administration and sensitivity remain the most important features. Its use in clinical practice for early detection of asymptomatic STIs potentially can reinforce STI primary and secondary prevention.

Published
2022
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25. Decrease in incidence of sexually transmitted infections symptoms in men who have sex with men enrolled in a quarterly HIV prevention and care programme in West Africa (CohMSM ANRS 12324—Expertise France)

Author

Ephrem Mensah, Marion Mora, Bruno Spire, Issa Traoré, Malan Jean-Baptiste Kouamé, Issifou Yaya, Camille Anoma, Alou Coulibaly, Bintou Dembélé Keita, Paméla Palvadeau, Christian Laurent, Mawuényégan Kouamivi Agboyibor, Elias Ter Tiero Dah, Fodié Diallo, Kader Maiga, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), ARCAD Santé PLUS [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Espoir Vie Togo [Lomé, Togo], Association African Solidarité [Ouagadougou, Burkina Faso], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Muraz [Bobo-Dioulasso, Burkina Faso], Malbec, Odile, and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI)

Subjects
Adult, [SDV]Life Sciences [q-bio], Population, Sexually Transmitted Diseases, sexual health, HIV Infections, Dermatology, Mali, Rate ratio, Men who have sex with men, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, male, Burkina Faso, Health care, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Poisson regression, Homosexuality, Male, Prospective cohort study, education, Reproductive health, education.field_of_study, 030505 public health, business.industry, Incidence, Incidence (epidemiology), virus diseases, homosexuality, [SDV] Life Sciences [q-bio], preventive health services, Cote d'Ivoire, Infectious Diseases, Togo, Africa, symbols, Pre-Exposure Prophylaxis, 0305 other medical science, business, Demography
Abstract

ObjectiveAlthough men who have sex with men (MSM) are at high risk of STI, their access to tailored healthcare services remains limited in West Africa. We assessed the change in STI symptoms incidence over time among MSM enrolled in a quarterly HIV prevention and care programme in four cities in Burkina Faso, Côte d’Ivoire, Mali and Togo.MethodsWe performed a prospective cohort study in MSM followed up between 2015 and 2019. Men aged over 18 who reported anal sex with another man within the previous 3 months were offered quarterly syndromic diagnosis and treatment for STI, as well as HIV testing, peer-led counselling and support. Condoms and lubricants were also provided. The change in STI symptoms incidence during follow-up was investigated using a non-parametric trend test and mixed-effect Poisson regression models.Results816 participants were followed for a total duration of 1479 person-years. 198 participants (24.3%) had at least one STI symptom during follow-up. Overall, STI symptoms incidence was 20.4 per 100 person-years (95% CI 18.4 to 22.6), ranging from 15.3 in Abidjan to 33.1 in Ouagadougou (adjusted incidence rate ratio (aIRR) 2.39, 95% CI 1.55 to 3.69, pConclusionSTI symptoms incidence decreased over time but the overall burden of STI appeared to be very high in MSM followed up in West Africa. STI services including counselling, diagnosis and treatment should be reinforced. Laboratory tests that allow accurate diagnosis of STI are required. Strengthening STI services will be critical for controlling the HIV and STI epidemics in this vulnerable population and in the general population.Trial registration numberNCT02626286.

Published
2021
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26. Modifiable risk factors for Hepatitis C virus coinfection among HIV-positive men who have sex men at Île-de-France: need for innovative harm reduction micro-elimination strategies (ANRS 9520 DRIVER)

Author

Martin Duracinsky, Svetlane Dimi, Maria Patrizia Carrieri, Issifou Yaya, Julie Timsit, Farfour Eric, Sebastien Fouéré, Olivier Chassany, and David Zucman

Abstract

Background Since the last decade, prevalence of hepatitis C virus (HCV)-infection has increased among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). We aimed to assess the prevalence of HCV coinfection in HIV-positive MSM and identify associated factors in Île-de-France Method This was a multicentric study conducted among HIV-positive MSM seen at least once between 2015 and 2017 HIV clinics of Ile-de-France. Clinical data using CRF, sociodemographic and behavioral data including sexual practices using self-administered questionnaire were collected. All the participants were screened for viral hepatitis including HCV infection. Multivariable logistic regression was used to identify factors associated with HCV co-infection Result In this study, 781 HIV-positive MSM were included with a mean age of 46.76 years (Standard Deviation [SD] = 10.94) and the mean time since HIV diagnosis was 13.93 ± 9.43 years. Of them, 77 participants were infected with HCV with a prevalence of 9.9%; (95% confidence intervals (CI) 7.9% – 12.2%). In multivariable analysis, after adjustment for time since HIV diagnosis and history of anal proctitis, history of GHB (aOR 3.53 [95%CI] [1.89;6.58], p

Published
2022
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27. Rapid antiretroviral therapy initiation and its effect on treatment response in MSM in West Africa

Author

Paméla Palvadeau, Bintou Dembélé Keita, Camille Anoma, Marion Mora, Christian Laurent, Jean-Baptiste Malan Kouamé, Issa Traoré, Ephrem Mensah, Issifou Yaya, Alou Coulibaly, Bruno Spire, Ter Tiero Elias Dah, Association African Solidarité [Ouagadougou, Burkina Faso], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], ARCAD Santé PLUS [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition Internationale Sida [Pantin, France] (Programme Recherche Communautaire), CohMSM Study Group, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), and Malbec, Odile

Subjects
attrition, Male, medicine.medical_specialty, viral suppression, [SDV]Life Sciences [q-bio], Immunology, Population, antiretroviral, antiretroviral therapy, MEDLINE, men, HIV Infections, law.invention, Men who have sex with men, West africa, Sexual and Gender Minorities, Randomized controlled trial, law, Burkina Faso, West Africa, medicine, Immunology and Allergy, Humans, MSM, Prospective Studies, Homosexuality, Male, education, Editorial Comments, education.field_of_study, business.industry, HIV, Antiretroviral therapy, [SDV] Life Sciences [q-bio], Infectious Diseases, Family medicine, Africa, Observational study, business, Viral load
Abstract

Early antiretroviral therapy (ART) initiation reduces HIV-related morbidity and mortality, and contributes to HIV transmission prevention by rapidly suppressing HIV viral load [1–4]. It can also help to control the RNA reservoir when treatment is initiated during the acute HIV infection [5–7]. Since September 2015, the WHO has recommended ART for all adults and adolescents living with HIV, irrespective of WHO clinical stage and CD4+ cell count [8]. In July 2017, WHO updated its treatment guidelines by recommending rapid ART initiation – defined as commencing ART within 7 days of HIV diagnosis – for the above groups, including same-day initiation for people ready to start treatment [9,10]. A systematic review of seven randomized controlled trials in adults aged 18 years or older, showed that rapid ART initiation improved ART uptake, viral load suppression and retention in care at 12 months [11–18]. However, the authors concluded that pragmatic research is needed to validate the effects observed in trials when rapid ART initiation is implemented in health systems. In contrast to trials, recent observational studies in Southern Africa found that same-day ART initiation was associated with lower retention in care [19–21]. In West Africa, the HIV epidemic is concentrated in key populations – including MSM – which together with their sexual partners represented 69% of all new HIV infections in 2019 [22]. Unfortunately, access to and retention in HIV prevention and care services for West African MSM are particularly low [23,24], due in part to social and legal barriers (homophobia, stigmatization, discrimination, violence and criminalization of same-sex relationships) [25,26]. Therefore, studies on the effects of care strategies in this population are needed to improve their management by informing policy. In particular, data on rapid ART initiation and its effect on treatment outcomes are lacking. The CohMSM study was designed to assess the feasibility and benefit of implementing quarterly HIV prevention and care services for MSM in Burkina Faso, Cote d’Ivoire, Mali, and Togo. One of its features was to propose ART initiation to MSM as soon as possible after HIV diagnosis, irrespective of their clinical stage and CD4+ cell count. As the study began in June 2015, rapid ART initiation was not considered, as the latter practice was only recommended by the WHO in 2017. National guidelines in all four study countries adopted the universal treatment strategy in 2018–2019 but rapid ART initiation was included only in Mali's guidelines (the other countries did not specify a specific time for initiation) [27–30]. In the present analysis, we assessed the time from HIV diagnosis to ART initiation and the effect of rapid ART initiation on attrition and virologic and immunologic responses among MSM participating in CohMSM. In addition, we assessed the effect of same-day ART initiation on the same treatment outcomes.

Published
2021
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28. O11.5 Heterogeneity of Mycoplasma genitalium resistance to macrolides and fluoroquinolones among men who have sex with men initiating PrEP in West-Africa

Author

Issifou Yaya, Anoumou Dagnra, Bea Vuylsteke, C Vicky, Amadou Koné, I De Baetselier, Camille Anoma, T Crucitti, Ephrem Mensah, Christian Laurent, Bintou Dembele, S Hilde, Souba Diandé, Hortense Faye-Kette, and Elias Ter Tiero Dah

Subjects
biology, Resistance (ecology), business.industry, Medicine, Mycoplasma genitalium, biology.organism_classification, business, Men who have sex with men, West africa, Demography
Published
2021
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29. Low Seroprevalence of Hepatitis C Among Men Who Have Sex With Men in West Africa

Author

Mahamadou Diarra, Oumar Cissé, Mamadou Ouedraogo, Niamkey Thomas Aka, Kossi Jeff Yaka, Ter Tiero Elias Dah, Stéphane-Alain Babo Yoro, Honoré Comsiambo, Martine Peeters, Kpassou Julien Lokrou, Daniela Rojas Castro, Bréhima Abdrahamane Ouary, Cyril Berenger, Kokou Dominique Tegueni, Michel Bourrelly, Frédéric Dibi N’guessan, Bintou Dembélé Keita, Ousseni Ilboudo, Adama Cissé, Naboh Sangaré, Aly Ouologuem, Fodié Diallo, Marion Mora, Aléda Mawuli Badjassim, Julien Bimba, Kouakou Kokouvi Selom Agbomadji, Ibrahima Kanta, Gwenvael Le Guicher, Camille Rajaonarivelo, Camille Anoma, Laetitia Serrano, Messan Attiogbe, Luis Sagaon-Teyssier, Alassane Kader Maïga, Clotilde Couderc, Gwenaëlle Maradan, Abdoulazziz Traoré, Issifou Yaya, Bruno Granouillac, Drissa Camara, Anani Attisso, Alou Coulibaly, Jean Armel Ekessi Koffi, Phyllis Amivi Ehlan, Claver Anoumou Yaotsè Dagnra, Anouwarsadat Kokouba, Sayouba Ouedraogo, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Joseph Ouedraogo, Agbégnigan Lorette Ekon, Fodé Traoré, Christian Coulibaly, Abdoul Aziz Keita, Richard Mawuényégan Kouamivi Agboyibor, Ephrem Mensah, Lucas Riegel, Mohamed Mimi, Paméla Palvadeau, Noufo Hamed Coulibaly, Christian Laurent, Fayçal Rodrique Ouedraogo, Issa Traoré, Bruno Spire, Sylvie Boyer, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), ARCAD Santé PLUS [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CohMSM Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Yaotsè Dagnra, Phyllis Amivi Ehlan, Kokou Dominique Tegueni, Malbec, Odile, and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)

Subjects
Male, Microbiology (medical), [SDV]Life Sciences [q-bio], MEDLINE, West africa, Men who have sex with men, MESH: Homosexuality, Male, Sexual and Gender Minorities, Seroepidemiologic Studies, MESH: Africa, Western, medicine, Humans, Seroprevalence, Homosexuality, Male, Online Only Articles, ComputingMilieux_MISCELLANEOUS, MESH: Hepatitis C, MESH: Humans, MESH: Seroepidemiologic Studies, business.industry, virus diseases, Hepatitis C, medicine.disease, MESH: Male, MESH: Sexual and Gender Minorities, [SDV] Life Sciences [q-bio], Africa, Western, Infectious Diseases, business, Demography
Abstract

BACKGROUND: Sexual transmission of hepatitis C virus (HCV) is uncommon, yet documented among men who have sex with men (MSM), primarily among those with human immunodeficiency virus (HIV). METHODS: In the HIV Prevention Trials Network 078 study (HPTN 078), which assessed an integrated strategy to achieve HIV viral suppression, 1305 MSM were screened across 4 geographically diverse US cities. At screening, demographic/behavioral/psychosocial questionnaires were completed, along with HIV and HCV testing. Multivariable logistic regression was used to evaluate associations with HCV antibody positivity. RESULTS: Among the 1287 (99%) of the MSM with HCV antibody results, the median age was 41, 69% were black, 85% had a high school education or more, 35% were employed, 70% had HIV, and 21% had undergone substance use counseling. The median lifetime number of male sexual partners was 17 (interquartile range, 6–50), and 246 (19%) were HCV antibody positive. HCV antibody positivity was high in MSM with HIV (20%) and MSM without HIV (17%) (P = .12) and was higher in those receiving substance use counseling (36%) than in those who had not (15%) (P ≤ .01). Substance use counseling (odds ratio, 2.51; 95% confidence interval, 1.80–3.51) and unstable housing (2.16; 1.40–3.33) were associated with HCV antibody positivity. CONCLUSIONS: Nearly 1 in 5 MSM screened for HPTN 078 have been infected with HCV. The prevalence is high regardless of HIV status and is high even in those who did not undergo substance use counseling. In HIV burden networks, high HCV infection prevalence may occur in MSM without HIV. As implementation of preexposure prophylaxis expands and condom use declines, routine HCV counseling and screening among MSM are important.

Published
2021
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30. Homonegativity, sexual violence and condom use with women in men who have sex with men and women in West Africa (CohMSM)

Author

Bintou Dembélé Keita, Lucas Riegel, Michel Bourrelly, Luis Sagaon-Teyssier, Clotilde Couderc, August Eubanks, Issifou Yaya, Pierre-Julien Coulaud, Marion Fiorentino, Ephrem Mensah, Christian Laurent, Gwenaëlle Maradan, Elias Ter Tiero Dah, Bruno Spire, Daniela Rojas-Castro, Camille Anoma, Dupuis, Christine, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), ARCAD-SIDA [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), CohMSM Study Group, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)

Subjects
Male, 0301 basic medicine, MESH: Sexual Behavior, [SDV]Life Sciences [q-bio], HIV Infections, West africa, law.invention, Men who have sex with men, Condoms, Sexual and Gender Minorities, 0302 clinical medicine, 5. Gender equality, law, Immunology and Allergy, Medicine, MESH: Sexual Partners, 030212 general & internal medicine, Sexual violence, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], MESH: Sexual and Gender Minorities, Sexual Partners, Infectious Diseases, Sexual behavior, Togo, Cohort, Female, France, Design support, Psychosocial, MESH: Sex Offenses, MESH: Cote d'Ivoire, Sexual Behavior, Immunology, MESH: Homosexuality, Male, 03 medical and health sciences, MESH: Condoms, Condom, Burkina Faso, Humans, MESH: Burkina Faso, Homosexuality, Male, MESH: Humans, business.industry, Sex Offenses, MESH: Male, MESH: France, Cote d'Ivoire, 030104 developmental biology, MESH: Togo, business, MESH: Female, Demography
Abstract

International audience; Objective: The study aimed to explore longitudinal interactions between homonegativity and sexual behaviors with female partners among HIV-negative West African men who have sex with men and women (MSMW).Design and method: The community-based cohort CohMSM ANRS 12324 - Expertise France enrolled MSM in Togo, Burkina Faso, Côte d'Ivoire and Mali. Sociobehavioral data were collected every 6 months. Using 30-month follow-up data, a multiprobit analysis was performed to investigate the relationship between psychosocial and behavioral variables ex-ante (t - 1) and ex-post (t).Results: MSMW (n = 326) accounted for half of all participants in CohMSM. They reported inconsistent condom use with women in 39% of visits. Perceived and internalized homonegativity at t - 1 tended to lead to sexual violence toward women at t (P < 0.1), which was associated with inconsistent condom use with them at t (P < 0.05).Conclusion: Given the high HIV prevalence in West African MSM, widespread condom-less sex with women in MSMW, and the aggravating effect of social and internalized homonegativity, more research in the MSMW subpopulation is needed to assess the risk of HIV bridging to women and to design support activities.

Published
2021
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31. Population attributable fractions of mortality in people living with HIV: roles of delayed antiretroviral therapy, hepatitis coinfections and social factors

Author

Camelia Protopopescu, Melina Erica Santos, Issifou Yaya, Patrizia Carrieri, Rachel A Ribero, Gerson Fernando Mendes Pereira, Antony Stevens, Adele Schwartz Benzaken, Marie Libérée Nishimwe, Wildo Navegantes de Araújo, University of Brasilia [Brazil] (UnB), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Ministry of Health [Brasília, Brazil], Aids Healthcare Foundation [São Paulo, Brazil] (Global Program), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Dupuis, Christine

Subjects
0301 basic medicine, Adult, Male, [SDV]Life Sciences [q-bio], Hepatitis C virus, Immunology, Population, HIV Infections, medicine.disease_cause, Hepatitis, 03 medical and health sciences, 0302 clinical medicine, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, education, Social Factors, Hepatitis B virus, education.field_of_study, business.industry, Coinfection, Mortality rate, medicine.disease, 3. Good health, CD4 Lymphocyte Count, [SDV] Life Sciences [q-bio], 030104 developmental biology, Infectious Diseases, Anti-Retroviral Agents, Attributable risk, Population study, Female, business, Brazil, Demography
Abstract

OBJECTIVES Despite free access to antiretroviral therapy (ART) from 1996 onward, and treatment for all people living with HIV (PLWHIV) from 2013, mortality in Brazil has not homogeneously decreased. We investigated to what extent delayed ART, hepatitis coinfections and sociodemographic factors predict all-cause mortality in Brazilian PLWHIV. DESIGN We included PLWHIV at least 18 years, with complete CD4 cell count data, followed up between 2007 and 2015 in Brazil. METHODS After multiple imputation, an extended Cox model helped estimate the effects of fixed and time-varying covariates on mortality. RESULTS The study population (n = 411 028) were mainly male (61%), white (55%), 40 years or less (61%), heterosexually HIV infected (71%), living in the Southeast region (48%) and had basic education (79%). Hepatitis C virus and hepatitis B virus coinfection prevalences were 2.5 and 1.4%, respectively. During a 4-year median follow-up, 61 630 deaths occurred and the mortality rate was 3.45 (95% confidence interval: 3.42-3.47) per 100 person-years. Older age, male sex, non-white ethnicity, illiteracy/basic education and living outside the Southeast and Central-West regions were independently associated with increased mortality. The main modifiable predictors of mortality were delayed ART (i.e. CD4 cell count

Published
2020
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32. To Pool or Not to Pool Samples for Sexually Transmitted Infections Detection in Men Who Have Sex With Men? An Evaluation of a New Pooling Method Using the GeneXpert Instrument in West Africa

Author

Bea Vuylsteke, Alain Yeo, Amadou Koné, Camille Anoma, Tania Crucitti, Anoumou Dagnra, Elias Ter Tiero Dah, Bintou Dembélé Keita, Irith De Baetselier, Hortense Faye-Kette, Issifou Yaya, Christian Laurent, Ephrem Mensah, and Souba Diandé

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Gonorrhea, Pooling, Sexually Transmitted Diseases, Chlamydia trachomatis, Dermatology, urologic and male genital diseases, medicine.disease_cause, Asymptomatic, Men who have sex with men, 03 medical and health sciences, Sexual and Gender Minorities, 0302 clinical medicine, medicine, Prevalence, Humans, 030212 general & internal medicine, Homosexuality, Male, 030505 public health, GeneXpert MTB/RIF, Chlamydia, business.industry, Obstetrics, Public Health, Environmental and Occupational Health, Chlamydia Infections, medicine.disease, Neisseria gonorrhoeae, Africa, Western, Infectious Diseases, Africa, medicine.symptom, 0305 other medical science, business
Abstract

Background Men who have sex with men (MSM) using preexposure prophylaxis (PrEP) are at risk for sexually transmitted infections (STIs). Therefore, PrEP services should include regular screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at urethra, anorectum, and pharynx. However, financial and logistic challenges arise in low-resource settings. We assessed a new STI sample pooling method using the GeneXpert instrument among MSM initiating PrEP in West Africa. Methods Urine, anorectal, and pharyngeal samples were pooled per individual for analysis. In case of an invalid result only (strategy 1) or a positive result of the pool (strategy 2), samples were analyzed individually to identify the infection's biological location. The results of 2 different pooling strategies were compared against the individual results obtained by a criterion standard. Results We found a prevalence of 14.5% for chlamydia and 11.5% for gonorrhea, with a predominance of infections being extragenital (77.6%). The majority of infections were asymptomatic (88.2%). The pooling strategy 1, had a sensitivity, specificity and agreement for CT of 95.4%, 98.7%, and 0.93, respectively; and 92.3%, 99.2%, and 0.93 for pooling strategy 2. For NG, these figures were 88.9%, 97.7%, and 0.85 for strategy 1, and 88.9%, 96.7%, and 0.81 for strategy 2. Conclusions West African MSM have a high prevalence of extragenital and asymptomatic STIs. The GeneXpert method provides an opportunity to move from syndromic toward etiological STI diagnosis in low-income countries, as the platform is available in African countries for tuberculosis testing. Pooling will reduce costs of triple site testing.

Published
2020

33. HCV-Related Mortality Among HIV/HCV Co-infected Patients: The Importance of Behaviors in the HCV Cure Era (ANRS CO13 HEPAVIH Cohort)

Author

Perrine Roux, Camelia Protopopescu, Issifou Yaya, Dominique Salmon-Ceron, Lionel Piroth, Eric Rosenthal, Wildo Navegantes de Araújo, Fabienne Marcellin, Melina Erica Santos, Philippe Sogni, Philippe Morlat, Laure Esterle, Maria Patrizia Carrieri, François Bailly, Linda Wittkop, Universidade de Brasilia [Brasília] (UnB), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Département d'hépatologie [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Sorbonne Paris Cité (USPC), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d’information Médicale [CHU de Bordeaux] (Pôle de Santé Publique), CHU Bordeaux [Bordeaux], Hôpital l'Archet, Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université de Toulon (UTLN)-Université Côte d'Azur (UCA), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), ANRS CO13 HEPAVIH Study Group: D Salmon, L Wittkop, P Sogni, L Esterle, P Trimoulet, J Izopet, L Serfaty, V Paradis, B Spire, P Carrieri, M A Valantin, G Pialoux, J Chas, I Poizot-Martin, K Barange, A Naqvi, E Rosenthal, A Bicart-See, O Bouchaud, A Gervais, C Lascoux-Combe, C Goujard, K Lacombe, C Duvivier, D Vittecoq, D Neau, P Morlat, F Bani-Sadr, L Meyer, F Boufassa, S Dominguez, B Autran, A M Roque, C Solas, H Fontaine, D Costagliola, L Piroth, A Simon, D Zucman, F Boué, P Miailhes, E Billaud, H Aumaître, D Rey, G Peytavin, V Petrov-Sanchez, A Pailhé, D Salmon, R Usubillaga, P Sogni, B Terris, P Tremeaux, C Katlama, H Stitou, Y Benhamou, F Charlotte, S Fourati, A Simon, P Cacoub, S Nafissa, I Poizot-Martin, O Zaegel, H Laroche, C Tamalet, G Pialoux, J Chas, P Callard, F Bendjaballah, C Le Pendeven, B Marchou, L Alric, S Metivier, J Selves, F Larroquette, E Rosenthal, A Naqvi, V Rio, J Haudebourg, M C Saint-Paul, C Partouche, O Bouchaud, M Ziol, Y Baazia, M Uzan, D Garipuy, M J Ferro-Collados, F Nicot, Y Yazdanpanah, H Adle-Biassette, G Alexandre, C Lascoux-Combe, J M Molina, P Bertheau, M L Chaix, C Delaugerre, S Maylin, J Bottero, J Krause, P M Girard, D Wendum, P Cervera, J Adam, C Viala, C Goujard, Y Quertainmont, E Teicher, C Pallier, D Vittecoq, O Lortholary, C Rouzaud, J Lourenco, F Touam, C Louisin, V Avettand-Fenoel, A Mélard, D Neau, A Ochoa, E Blanchard, S Castet-Lafarie, C Cazanave, D Malvy, M Dupon, H Dutronc, F Dauchy, L Lacaze-Buzy, P Bioulac-Sage, S Reigadas, P Morlat, D Lacoste, F Bonnet, N Bernard, M Hessamfar, F Paccalin, C Martell, M C Pertusa, M Vandenhende, P Merciéer, T Pistone, M C Receveur, M Méchain, P Duffau, C Rivoisy, I Faure, S Caldato, J L Pellegrin, J F Viallard, E Lazzaro, C Greib, D Zucman, C Majerholc, E Farfour, F Boué, J Polo Devoto, I Kansau, V Chambrin, C Pignon, L Berroukeche, R Fior, V Martinez, C Deback, Y Lévy, J D Lelièvre, A S Lascaux, G Melica, E Billaud, F Raffi, C Allavena, V Reliquet, D Boutoille, C Biron, A Rodallec, L Le Guen, P Miailhes, D Peyramond, C Chidiac, F Ader, F Biron, A Boibieux, L Cotte, T Ferry, T Perpoint, J Koffi, F Zoulim, F Bailly, P Lack, M Maynard, S Radenne, M Amiri, C Scholtes, T T Le-Thi, P Chavanet, M Duong Van Huyen, M Buisson, A Waldner-Combernoux, S Mahy, R Binois, A L Simonet-Lann, D Croisier-Bertin, H Aumaître, F Bani-Sadr, D Lambert, Y Nguyen, J L Berger, D Rey, M Partisani, M L Batard, C Cheneau, M Priester, C Bernard-Henry, E de Mautort, P Gantner, S Fafi-Kremer, G Peytavin, F Roustant, I Kmiec, L Traore, S Lepuil, S Parlier, V Sicart-Payssan, E Bedel, C Louisin, M Mole, C Bolliot, M Mebarki, A Adda-Lievin, F Z Makhoukhi, O Braik, R Bayoud, M P Pietri, V Le Baut, D Bornarel, C Chesnel, D Beniken, M Pauchard, S Akel, S Caldato, C Lions, L Chalal, Z Julia, H Hue, A Soria, M Cavellec, S Breau, A Joulie, P Fisher, C Ondo Eyene, S Ogoudjobi, C Brochier, V Thoirain-Galvan, E Boerg, V Conte, L Dequae-Merchadou, M Desvallees, N Douiri, L Esterle, C Gilbert, S Gillet, R Knight, F Marcellin, L Michel, M Mora, C Protopopescu, P Roux, S Tezkratt, I Yaya, T Barré, T Rojas Rojas, V Villes, M Baudoin, M Santos, Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris], Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Côte d'Azur (UCA)-Université de Toulon (UTLN)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), and Dupuis, Christine

Subjects
Male, Marijuana Abuse, [SDV]Life Sciences [q-bio], HIV Infections, Hepacivirus, Substance use, medicine.disease_cause, Coffee, MESH: Antiretroviral Therapy, Highly Active, Cohort Studies, MESH: Proportional Hazards Models, MESH: HIV-1, 0302 clinical medicine, Alcohol and weight, Antiretroviral Therapy, Highly Active, MORPH3Eus, MESH: Obesity, MESH: Hepacivirus, 030212 general & internal medicine, MESH: Anti-HIV Agents, MESH: Cohort Studies, MESH: Middle Aged, biology, Coinfection, Confounding, virus diseases, Hepatitis C, MESH: HIV Infections, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Infectious Diseases, Cohort, Female, France, 0305 other medical science, Adult, medicine.medical_specialty, Social Psychology, Anti-HIV Agents, Hepatitis C virus, MESH: Marijuana Abuse, Binge drinking, Marijuana Smoking, 03 medical and health sciences, Thinness, Internal medicine, medicine, Humans, Obesity, Mortality, Proportional Hazards Models, MESH: Hepatitis C, Behavior, 030505 public health, MESH: Thinness, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, HIV, MESH: Coffee, MESH: Marijuana Smoking, MESH: Adult, biology.organism_classification, medicine.disease, MESH: Male, MESH: Coinfection, MESH: France, HIV-1, Cannabis, business, MESH: Female
Abstract

International audience; Mortality among individuals co-infected with HIV and hepatitis C virus (HCV) is relatively high. We evaluated the association between psychoactive substance use and both HCV and non-HCV mortality in HIV/HCV co-infected patients in France, using Fine and Gray's competing-risk model adjusted for socio-demographic, clinical predictors and confounding factors, while accounting for competing causes of death. Over a 5-year median follow-up period, 77 deaths occurred among 1028 patients. Regular/daily cannabis use, elevated coffee intake, and not currently smoking were independently associated with reduced HCV-mortality (adjusted sub-hazard ratio [95% CI] 0.28 [0.10-0.83], 0.38 [0.15-0.95], and 0.28 [0.10-0.79], respectively). Obesity and severe thinness were associated with increased HCV-mortality (2.44 [1.00-5.93] and 7.25 [2.22-23.6] versus normal weight, respectively). Regular binge drinking was associated with increased non-HCV-mortality (2.19 [1.10-4.37]). Further research is needed to understand the causal mechanisms involved. People living with HIV/HCV co-infection should be referred for tobacco, alcohol and weight control interventions and potential benefits of cannabis-based therapies investigated.

Published
2020
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34. To pool or not to pool samples for Sexually Transmitted Infections detection in Men who have Sex with Men? An evaluation of a new pooling method using the GeneXpert instrument in West-Africa

Author

Bintou Dembélé Keita, Irith De Baetselier, Christian Laurent, Souba Diandé, Vicky Cuylaerts, Tania Crucitti, Issifou Yaya, Issa Traoré, Hortense Faye-Kette, Anoumou Dagnra, Bea Vuylsteke, Hilde Smet, Diallo Dramane, Camille Anoma, Elias Ter Tiero Dah, Jeff Yaka, Amadou Koné, Ephrem Mensah, Gérard Kadanga, and Alain Yeo

Subjects
medicine.medical_specialty, GeneXpert MTB/RIF, Chlamydia, business.industry, Obstetrics, Pooling, Gonorrhea, urologic and male genital diseases, medicine.disease, medicine.disease_cause, Asymptomatic, Men who have sex with men, Neisseria gonorrhoeae, Medicine, medicine.symptom, business, Chlamydia trachomatis
Abstract

BackgroundMen who have sex with Men (MSM) using Pre-exposure prophylaxis (PrEP) are at risk for Sexually Transmitted Infections (STIs). Therefore, PrEP services should include regular screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at urethra, anorectum and pharynx. However, financial and logistic challenges arise in low resource settings. We assessed a new STI sample pooling method using the GeneXpert instrument among MSM initiating PrEP in West-Africa.MethodsUrine, anorectal and pharyngeal samples were pooled per individual for analysis. Unpooled samples were analyzed in case of an invalid or positive result of the pool, to identify the infection’s biological location. The results of two different pooling strategies were compared against a gold standard.ResultsWe found a prevalence of 14.5% for chlamydia and 11.5% for gonorrhea, with a predominance of infections being extra-genital (77.6%). The majority of infections were asymptomatic (88.2%). The pooling strategy with unpooling of invalid results only, had a sensitivity, specificity and agreement for CT of 95.4%, 98.7% and 0.93, respectively; and 92.3%, 99.2% and 0.93 with additional unpooling of positive results. For NG, these figures were 88.9%, 97.7% and 0.85 for testing of invalid results, and 88.9%, 96.7% and 0.81 with unpooling of positive results.ConclusionWest-African MSM have a high prevalence of extra-genital and asymptomatic STIs. The GeneXpert method provides an opportunity to move from syndromic towards etiological STI diagnosis in low income countries, as the platform is available in all African countries for tuberculosis testing. Pooling will reduce costs of triple site testing.

Published
2020
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35. Factors associated with unmet need for limiting childbirth among women living with HIV in Togo: An averaging approach

Author

Bayaki Saka, Kanfitine Kolani, Mathias Kouamé N’dri, Abdoul-samadou Aboubakari, Aboubakari Nambiema, Akouda Patassi, Mawuényégan Kouamivi Agboyibor, Lihanimpo Djalogue, Takiyatou Baba-Toherou, Issifou Yaya, Sokhna Dieng, Dadja Essoya Landoh, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), CHR Tomdè, Université de Lomé [Togo], World Health Organisation (WHO), country office of Togo, Clinique Biasa, Nambiema, Aboubakari, Épidémiologie en Santé au Travail et Ergonomie (IRSET-ESTER), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
RNA viruses, Epidemiology, Cross-sectional study, Maternal Health, Psychological intervention, HIV Infections, Pathology and Laboratory Medicine, Geographical Locations, Labor and Delivery, 0302 clinical medicine, Immunodeficiency Viruses, 5. Gender equality, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Medicine and Health Sciences, Medicine, Childbirth, 030212 general & internal medicine, Contraception Behavior, Multidisciplinary, 030503 health policy & services, Pregnancy, Unplanned, Obstetrics and Gynecology, Middle Aged, 3. Good health, Contraception, Medical Microbiology, HIV epidemiology, HIV-positive women, Viral Pathogens, Togo, Viruses, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, symbols, Female, HIV clinical manifestations, Pathogens, 0305 other medical science, Research Article, Adult, Adolescent, Science, HIV prevention, unmet needs, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Microbiology, 03 medical and health sciences, symbols.namesake, Retroviruses, Humans, Female Contraception, Poisson regression, Family planning, Microbial Pathogens, Preventive medicine, business.industry, Lentivirus, Parturition, Organisms, Biology and Life Sciences, HIV, medicine.disease, Diagnostic medicine, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Cross-Sectional Studies, Public and occupational health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, People and Places, Africa, Birth, Life expectancy, Women's Health, Private healthcare, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Unintended pregnancy, Follow-Up Studies, Demography
Abstract

International audience; Background: Access to antiretroviral treatment has improved the life expectancy of HIV-positive patients, most often associated with a desire to limit childbearing. Women living with HIV (WLHIV) commonly have unmet need for contraception and could be at risk of unintended pregnancy. Preventing unintended pregnancies among women living with HIV are effective strategies to eliminate mother-to-child transmission of HIV. Objective: The aim of this study was to assess unmet need for limiting childbirth and its associated factors among women living with HIV in Togo. Methods: This facility based cross-sectional study was conducted, between June and August 2016, among WLHIV in their reproductive age (15–49 years) in HIV-care settings in Centrale and Kara regions Data was collected using a structured and pretested questionnaire. WLHIV who desired to limit childbirth but not using contraception were considered to have unmet need of birth limitations. Univariate and multivariate Poisson regression models with robust variance were performed to identify associated factors with unmet needs. A multi-model averaging approach was used to estimate the degree of the association between these factors and the unmet need of birth limitations. Results: A total of 443 WLHIV were enrolled, with mean age of 34.5 years (standard deviation [SD] = 7.0). Among them 244 (55.1%) were in couple and 200 (45.1%) had at least the secondary level of education. 39.1% were followed-up in a private healthcare facility. At the time of the survey, 40.0% did not desire childbearing but only 9.0% (95% CI [6.7–12.1]) of them expressed unmet needs for limiting childbirth. In multivariable analysis, associated factors with unmet needs of birth limitations were: being aged 35 years or more (adjusted prevalence ratio (aPR) = 3.11, 95% confidence intervals (95% CI) [1.52–6.38]), living in couple (aPR = 2.32 [1.15–4.65]), living in Kara region (aPR = 0.10 [0.01–0.76]), being followed in a private healthcare facility (aPR = 0.08[0.01–0.53]) and having severe HIV symptoms (aPR = 3.50 [1.31–9.37]). Conclusion: Even though the unmet need for births limitation was relatively low among WLHIV in Togo, interventions to improve more access to contraceptive methods, and targeting 35 to 49 years old women, those in couple or followed in the public healthcare facilities would contribute to the eradication of mother-to-child transmission of HIV.

Published
2020
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36. Screening and care for alcohol use disorder in France : expectations, barriers and levers using a mixed-methods approach

Author

Danielle Teuma, Perrine Roux, Tangui Barré, Marc Tanti, Pierre Polomeni, Gwenaëlle Maradan, Cyril Berenger, Michaël Bazin, Issifou Yaya, Marie Costa, Marianne Maynard, Patrizia Carrieri, Marion Mora, Marion Coste, Christophe Cutarella, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Centre d'épidémiologie et de santé publique des armées [Marseille] (CESPA), Service de Santé des Armées, Clinique Saint Barnabé - Ramsay Santé [Marseille] (CSB-RS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpitaux du Bassin de Thau, Centre Hospitalier d'Allauch, Hôpitaux du Bassin de Thau (Sète), and Dupuis, Christine

Subjects
Adult, Male, medicine.medical_specialty, Family support, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Psychological intervention, 030508 substance abuse, Context (language use), Access to care, Alcohol use disorder, Semi-structured interviews, Health Services Accessibility, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, mental disorders, medicine, Humans, Mass Screening, Textual analysis, 030212 general & internal medicine, Psychiatry, Survey, Qualitative Research, media_common, Motivation, Mixed-methods, business.industry, Public health, Addiction, lcsh:Public aspects of medicine, Alcohol dependence, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Alcoholism, Socioeconomic Factors, Female, France, Biostatistics, 0305 other medical science, business, Research Article
Abstract

BackgroundThe widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care.MethodsIndividuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification.ResultsNot socializing with heavy drinkers (AOR [95%CI]:3.84[1.66–8.85]), regular smoking (9.72[3.91–24.15]) and feeling discriminated against (2.35[1.10–5.05]) were independent levers to having sought/received care for AUD, while being aged ConclusionThese results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD.

Published
2020
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37. Reaching a Different Population of MSM in West Africa With the Integration of PrEP Into a Comprehensive Prevention Package (CohMSM-PrEP ANRS 12369—Expertise France)

Author

Camille Anoma, Daniela Rojas Castro, Luis Sagaon-Teyssier, Gwenaëlle Maradan, Bintou Dembélé Keita, Michel Bourrelly, August Eubanks, Marion Mora, Ephrem Mensah, Issifou Yaya, Ter Tiero Elias Dah, Bruno Spire, Christian Laurent, Lucas Riegel, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), ARCAD-SIDA [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CohMSM-PrEP Study Group, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Dupuis, Christine

Subjects
Male, medicine.medical_specialty, Anti-HIV Agents, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Population, Psychological intervention, HIV Infections, 030312 virology, Men who have sex with men, 03 medical and health sciences, Pre-exposure prophylaxis, Risk Factors, Odds Ratio, Medicine, Humans, Pharmacology (medical), Homosexuality, Homosexuality, Male, 10. No inequality, education, media_common, 0303 health sciences, education.field_of_study, Unsafe Sex, business.industry, 1. No poverty, virus diseases, 16. Peace & justice, 3. Good health, [SDV] Life Sciences [q-bio], Outreach, Africa, Western, Infectious Diseases, Family medicine, Cohort, Pre-Exposure Prophylaxis, business, Peer education
Abstract

International audience; Background: In West Africa, few HIV services target men who have sex with men (MSM). In 2015, the interventional cohort CohMSM started offering a community-based prevention package for MSM. Participants expressed interest in pre-exposure prophylaxis (PrEP) and their eligibility was demonstrated. In 2017, PrEP was added to services already offered as part of a new program, CohMSM-PrEP, which recruited CohMSM participants and new participants. We aimed to determine whether the introduction of PrEP as an additional prevention tool influenced the type of participant signing up for CohMSM-PrEP.Methods: CohMSM-PrEP recruited HIV-negative MSM in community-based clinics in Mali, Cote d'Ivoire, Burkina Faso, and Togo. Quarterly follow-up included free clinical examinations, PrEP, HIV/sexually transmitted infection screening, peer education, condoms, and lubricants. Sociobehavioral data were collected every 3 months using face-to-face questionnaires. Our outcome was participant type: new participants vs CohMSM participants. Logistic regression was performed to identify the factors associated with being a new participant.Results: Of the 524 MSM included in CohMSM-PrEP, 41% were new participants. After adjustment, multivariate analysis showed they were more socioeconomically disadvantaged with financial insecurity, social isolation-including isolation within the MSM community-and riskier sexual practices.Conclusion: The introduction of PrEP as an additional prevention tool and the use of peer-based outreach services over time influenced the type of participant signing up for a community-based HIV prevention cohort in West Africa. Adding these elements to existing interventions in Sub-Saharan Africa could be the key to reaching MSM marginalized from HIV prevention and care programs.

Published
2020
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38. Acute disseminated encephalomyelitis after dengue

Author

Issifou Yaya, Yacouba Dembele, Abdoulahy Diallo, Céline Michaud, Maxime Jean, Sarah Permal, Mohamadou Niang, and Pascal Meliani

Subjects
0301 basic medicine, Pediatrics, medicine.medical_specialty, Neurological complication, 030106 microbiology, EEG, Electroencephalography, Mayotte, Disease, Aedes aegypti, Infectious and parasitic diseases, RC109-216, Article, ADEM, Acute Disseminated Encephalomyelitis, MRI, Magnetic Resonance Imaging, Dengue fever, Serology, 03 medical and health sciences, 0302 clinical medicine, Acute disseminated encephalomyelitis, medicine, 030212 general & internal medicine, PCR, Polymerase Chain Reaction, ADEM - Acute disseminated encephalomyelitis, biology, business.industry, Incidence (epidemiology), medicine.disease, biology.organism_classification, Infectious Diseases, Dengue infection, business, CSF, Cerebrospinal Fluid
Abstract

Dengue fever, transmitted by Aedes aegypti mosquitoes, is one of the most common vector-borne disease. Its incidence is increasing steadily worldwide, becoming a major public health problem in the tropical and subtropical zone. Neurological manifestations after dengue are not very common and acute disseminated encephalomyelitis (ADEM) following dengue infections is rare with a few cases documented in literature. Clinical characteristics and typical lesions of ADEM on magnetic resonance imaging (MRI) of brain along with serologic positivity for dengue usually confirm the diagnosis. We report a case of ADEM which developed as a neurological complication of dengue during an epidemic in a 39-year-old woman.

Published
2020

40. Health-related quality of life among people living with HIV/AIDS in Togo: individuals and contextual effects

Author

Kanfitine Kolani, P’Niwè Massoubayo Patchali, Essodjèlouna Manani Bignandi, Didier K. Ekouevi, Ayélé Assindo, Akouda Patassi, Aboubakari Nambiema, Abdoulahy Diallo, Bayaki Saka, Lihanimpo Djalogue, Dadja Essoya Landoh, Issifou Yaya, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHR Tomdè, Université de Lomé [Togo], UNICEF, country office of Togo, Clinique Biasa, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, and Nambiema, Aboubakari

Subjects
0301 basic medicine, Quality of life, Adult, Male, Multivariate analysis, Secondary education, Contextual effects, lcsh:Medicine, HIV Infections, General Biochemistry, Genetics and Molecular Biology, Odds, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, PLWHA, Acquired immunodeficiency syndrome (AIDS), Risk Factors, medicine, Humans, 030212 general & internal medicine, 10. No inequality, lcsh:Science (General), lcsh:QH301-705.5, Health related quality of life, Acquired Immunodeficiency Syndrome, business.industry, lcsh:R, HIV, General Medicine, Middle Aged, medicine.disease, Antiretroviral therapy, Health Surveys, Research Note, 030104 developmental biology, Cross-Sectional Studies, lcsh:Biology (General), Anti-Retroviral Agents, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Togo, Multivariate Analysis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography, lcsh:Q1-390
Abstract

International audience; ObjectiveThe objective of this study is to assess the quality of life and to identify factors associated with good global quality of life among people living with HIV/AIDS (PLWHA) in Togo.ResultsIn total, 880 PLWHA with mean age (standard deviation) of 39.6 (10.1) years, were interviewed. Most of them (78.4%) were female. The global score of quality of life was ranged from 42.6 to 112, with a mean (standard deviation) estimated at 86.3 ± (13.3). More than the three-quarters (76.2%) of the participants had a good global quality of life. In multivariate analysis, secondary education level or higher (adjusted odds ratio = 1.78, 95% confident interval (CI) [1.10–2.85]), living in Kara health region (adjusted odds ratio = 4.39, 95% CI [2.94–6.57]), being on antiretroviral therapy (adjusted odds ratio = 6.99, 95% CI [4.11–11.9]) and HIV sero-status disclosure (adjusted odds ratio = 1.83, 95% CI [1.28–2.61]) were associated with a better overall quality of life (score ≥ 77.3).Keywords: Quality of life, PLWHA, Togo

Published
2019
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41. Prevalence and risk factors of anemia in children aged from 6 to 59 months in Togo: analysis from Togo demographic and health survey data, 2013–2014

Author

Alexie Robert, Issifou Yaya, Aboubakari Nambiema, Centre Africain de Recherche en Epidémiologie et en Santé Publique [Lomé, Togo] (CARESP), Aix Marseille Université (AMU), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Nambiema, Aboubakari

Subjects
Male, medicine.medical_specialty, Anemia, Nutritional Status, 030209 endocrinology & metabolism, Logistic regression, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, hemic and lymphatic diseases, Epidemiology, Odds Ratio, medicine, Prevalence, Humans, 030212 general & internal medicine, Developing Countries, Children, Africa South of the Sahara, 2. Zero hunger, business.industry, Public health, lcsh:Public aspects of medicine, Age Factors, 1. No poverty, Public Health, Environmental and Occupational Health, Infant, lcsh:RA1-1270, Odds ratio, medicine.disease, Health Surveys, Confidence interval, Malaria, 3. Good health, Logistic Models, Socioeconomic Factors, Risk factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Child, Preschool, Togo, Multivariate Analysis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Biostatistics, business, Research Article, Demography
Abstract

International audience; BackgroundAnemia in children continues to be a major public health challenge in developing countries and particularly in Sub-Saharan Africa. Anemia has serious consequences on the growth and development of the children in the early stages of life. This study aimed to determine the prevalence and associated factors of anemia among children from 6 to 59 months in Togo.MethodsData from the Togo Demographic and Health Survey 2013–2014 were used for this study. This nationally representative survey provided data on a wide range of indicators such as mother and child health, nutrition and other characteristics. Anemia status was determined using hemoglobin level (Hb

Published
2019
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42. Predictors of overall mortality among people living with HIV/AIDS in Brazil, 2007-2015

Author

Wildo Navegantes de Araújo, Melina Erica Santos, M P Carrieri, Rachel Abrahão Ribeiro, Marie Libérée Nishimwe, Camelia Protopopescu, and Issifou Yaya

Subjects
HIV/AIDS in Brazil, business.industry, Environmental health, Public Health, Environmental and Occupational Health, Medicine, business
Abstract

Background In Brazil there are 926,742 people living with HIV/AIDS (PLWHA). Despite the introduction of antiretroviral therapy (ART) in 1996 and treatment for all in 2014, mortality has increased in some regions. This study aimed to estimate the factors associated with overall mortality in PLWHA to recommend public health actions. Methods We studied PLWHA aged ≥18 years old, followed-up from 2007 to 2015 in the universal health system in Brazil. We used a national database (disease reporting, laboratory tests, ART and death notifications). Kaplan-Meier method and Cox model were used in survival analysis. The outcome was all-cause deaths. The explanatory variables measured at baseline were sociodemographic characteristics, HIV transmission mode and coinfections by hepatitis B (HBV) and C (HCV). The time-varying variables were CD4 cell count, viral load (VL) and ART status. Results Study population (n = 411,281) was mainly male (61%), under 40 years old (61%), Caucasian (37%), with basic education (43%), heterosexual HIV-infection mode (41%), resident in Southeast region (48%). The co-infection rate was 2.5% for HCV, and 1.4% for HBV. Median time to ART initiation was 83 days. During the follow-up period (median: 4 years), 61,757 deaths occurred (6% HCV-coinfected and 2% HBV-coinfected). The global mortality rate was 3.44 [95% confidence interval: 3.42-3.47] per 100 person-years (PY) during 1,793,417 PY. The factors associated with increased mortality in multivariable analyses were male gender, age over 40, non-Caucasian race, HIV infection by drug use, resident in North, Northeast and South regions, HCV and HBV coinfection, VL ≥ 200 copies/mL and starting ART with CD4 Conclusions Although PLWHA start ART in less than 3 months after the beginning of follow-up, there is still late treatment (at CD4 Key messages The results of our study show that all populations should be target for HIV screening regardless of risk group. PLWHA coinfected with hepatitis B and hepatitis C should be also early treated for hepatitis coinfections.

Published
2019
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43. P541 To pool or not to pool STI samples in MSM using PrEP? Results of the CohMSM-PrEP Study (ANRS 12369 – expertise france)

Author

Tania Crucitti, Issifou Yaya, Irith De Baetselier, Hilde Smet, Jeff Yaka, Ephrem Mensah, Anoumou Dagnra, Vicky Cuylaerts, Christian Laurent, Bea Vuylsteke, Souba Diandé, Issa Traoré, Elias Ter Tiero Dah, Bintou Dembele, and Gérard Kadanga

Subjects
Gynecology, medicine.medical_specialty, GeneXpert MTB/RIF, business.industry, medicine, Neisseria gonorrhoeae, Urine, Molecular Technique, medicine.symptom, business, Chlamydia trachomatis, medicine.disease_cause, Asymptomatic
Abstract

Background Syndromic diagnosis of sexually transmitted infections (STIs) has shown its limits among MSM using PrEP due to the many asymptomatic infections. However, testing three biological sites (urethra, pharynx and anorectum) is expensive. Our objective was to implement and to evaluate a pooling method using the locally available GeneXpert instrument to test for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in the framework of the West-African CohMSM-PrEP study (Togo and Burkina Faso). Methods Duplicate pharyngeal (P) and anorectal (A) e-swabs and first-void urine (U) samples were taken from every participant (n=192 in total). A specimen pool per participant (400 µL of each sample) was made and tested using the Xpert CT/NG kit. If positive, the individual samples were tested to confirm the site of infection. Duplicate individual samples were also tested for evaluation purposes using the Abbott CT/NG molecular technique and in-house qPCR. Results A total of 32 CT infections (10U-20A-2P) and 34 NG infections (5U-19A-10P) were found. Twelve results obtained by testing of the pools were discordant from the individual testing using Abbott CT/NG. When unpooling the samples, one discordant result was solved. Three CT infections (1 in each samplingsite) and four NG infections (2A and 2P) were missed; one CT (P) and three NG (A) infection were found to be false positive (one in each sampling site). This converts into a respective sensitivity and specificity of 91.2% (95%CI: 76.3–98.1%) and 99.8% (95%CI: 99.0–100.0%) for CT and 88.6% (95%CI: 73.3–96.8%) and 99.4% (95%: 98.3–99.9%) for NG of the pooling strategy. Cohen’s Kappa agreement was 0.94 for CT and 0.89 for NG which is an almost perfect agreement. Conclusion We showed that this pooling strategy performs well using the FDA approved point-of-care assay GeneXpert. This may be a very cost-effective strategy and also feasible, as the assay is widespread throughout the African continent for tuberculosis testing. Disclosure No significant relationships.

Published
2019
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44. P542 Prevalence of STIs among MSM initiating PrEP in west-africa (CohMSM-PrEP ANRS 12369 – expertise france)

Author

Anoumou Dagnra, Christian Laurent, Alain Yeo, Hortense Faye-Kette, Bea Vuylsteke, Bintou Dembele, Issifou Yaya, Souba Diandé, Elias Ter Tiero Dah, Amadou Koné, Irith De Baetselier, T Crucitti, and Ephrem Mensah

Subjects
medicine.medical_specialty, education.field_of_study, GeneXpert MTB/RIF, biology, business.industry, Obstetrics, Transmission (medicine), Population, biology.organism_classification, medicine.disease_cause, Men who have sex with men, parasitic diseases, Neisseria gonorrhoeae, Medicine, Trichomonas vaginalis, business, Mycoplasma genitalium, education, Chlamydia trachomatis
Abstract

Background Men who have sex with men (MSM) coming forward for Pre-Exposure Prophylaxis (PrEP) are at high risk for HIV and other Sexually Transmitted Infections (STIs). However, little is known about the prevalence of STIs among MSM in West-Africa. Yet, understanding the STI epidemic among MSM will improve STI management. In the framework of a PrEP demonstration study in West-Africa (CohMSM-PrEP), we tested all participants for STIs at enrollment. Methods The study was conducted in Abidjan-Cote d’Ivoire, Bamako-Mali, Lome-Togo and Ouagadougou-Burkina Faso. Participants (n=507) were tested for the following STIs using the GeneXpert instrument: Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG) in Anorectum (A), Urine (U) and Pharynx (P), and Trichomonas vaginalis (TV) in urine. Mycoplasma genitalium (MG) was tested using the S-DiagMGTV multiplex assay in A-U-P samples. Results The overall prevalence of CT was 17.9% (19.4%, 22.0% 16.4%, and 13.6% in Lome, Abidjan, Bamako and Ouagadougou, respectively). Most CT infections were anorectal (12.3%, followed by urethral (5.7%). In Bamako, the second most infected sample type was pharyngeal (6.0%) instead of urine (5.0%). Overall prevalence of NG was 15.8% (9.7%; 25.0%; 6.0%, 22.3% in Lome, Abidjan, Bamako and Burkina, respectively). Most NG infections were found in the anorectum (10.7%), followed by the pharynx (5.7%). In Mali, no pharyngeal NG infections were detected. MG infection was 26.0% for Lome and 27.6% for Ouagadougou (results for other sites not yet available). The majority of MG infections were found in the anorectum (15.4%). Among all participants, only one urine sample with TV has been found in Bamako. Conclusion We showed a very high prevalence of extra-genital STIs among PrEP users in West-Africa. We also detected infections which would not have been treated if a syndromic management approach would have been applied (87.9%). In order to limit transmission of infections we recommend to test also extra-genital sites for STIs in this population. Disclosure No significant relationships.

Published
2019
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45. Sleep disturbances in HIV-HCV coinfected patients: indications for clinical management in the HCV cure era (ANRS CO13 HEPAVIH cohort)

Author

Dominique Salmon-Ceron, Maria Patrizia Carrieri, Fabienne Marcellin, Linda Wittkop, Marie Costa, Philippe Sogni, Issifou Yaya, Denis Lacoste, Hugues Aumaitre, Jessica Krause, Virginie Villes, Teresa Rojas Rojas, Camelia Protopopescu, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Coordination Régionale de la lutte contre l'infection à VIH (COREVIH Aquitaine), CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin-Hôpital du Tondu, Service des maladies infectieuses [CH Perpignan], Centre Hospitalier Saint Jean de Perpignan, Team MORPH3EUS (INSERM U1219 - UB - ISPED), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d’information Médicale [CHU de Bordeaux] (Pôle de Santé Publique), CHU Bordeaux [Bordeaux], Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Paris Descartes - Paris 5 (UPD5), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie du système immunitaire (Inserm U1223), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris], Service d'hépatologie médicale [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), This work was supported by the French National Agency for Research on Aids and Viral Hepatitis (ANRS: France Recherche Nord & sud Sida-hiv Hépatites), with the participation of Abbott France, Glaxo-Smith-Kline, Roche, Schering-Plough, BMS, Merck-Serono., ANRS CO13 HEPAVIH Study Group : Scientific Committee of the ANRS CO13 HEPAVIH Study Group: D. Salmon (co-Principal investigator), L. Wittkop (co- Principal Investigator), P. Sogni (co-Principal Investigator), L. Esterle (project manager), P. Trimoulet, J. Izopet, L. Serfaty, V. Paradis, B. Spire, P. Carrieri, M.A. Valantin, G. Pialoux, J. Chas, I. Poizot-Martin, K. Barange, A. Naqvi, E. Rosenthal, A. Bicart-See, O. Bouchaud, A. Gervais, C. Lascoux-Combe, C. Goujard, K. Lacombe, C. Duvivier, D. Vittecoq, D. Neau, P. Morlat, F. Bani-Sadr, L. Meyer, F. Boufassa, B. Autran, A.M. Roque, C. Solas, H. Fontaine, D. Costagliola, L. Piroth, A. Simon, D. Zucman, F. Boué, P. Miailhes, E. Billaud, H. Aumaître, D. Rey, G. Peytavin, V. Petrov-Sanchez, A. Pailhé. Clinical Centres (ward/participating physicians): APHP Cochin, Paris (Médecine Interne et Maladies Infectieuses: D. Salmon, R. Usubillaga, Hépato-gastro-entérologie: P. Sogni, Anatomo-pathologie: B. Terris, Virologie: P. Tremeaux), APHP Pitié-Salpétrière, Paris (Maladies Infectieuses et Tropicales: C. Katlama, M.A. Valantin, H. Stitou, Hépato-gastro-entérologie: Y. Benhamou, Anatomo-pathologie: F. Charlotte, Virologie: S. Fourati), APHP Pitié-Salpétrière, Paris (Médecine Interne: A. Simon, P. Cacoub, S. Nafissa), APHM Sainte- Marguerite, Marseille (Service d’Immuno-Hématologie Clinique: I. Poizot-Martin, O. Zaegel, H. Laroche, Virologie: C. Tamalet), APHP Tenon, Paris (Maladies Infectieuses et Tropicales: G. Pialoux, J. Chas, Anatomo-pathologie: P. Callard, F. Bendjaballah, Virologie: C. Le Pendeven), CHU Purpan, Toulouse (Maladies Infectieuses et Tropicales: B. Marchou, Hépato-gastro-entérologie: L. Alric, K. Barange, S. Metivier, Anatomo-pathologie: J. Selves, Virologie: F. Larroquette), CHU Archet, Nice (Médecine Interne: E. Rosenthal, Infectiologie: A. Naqvi, V. Rio, Anatomo-pathologie: J. Haudebourg, M.C. Saint-Paul, Virologie: C. Partouche), APHP Avicenne, Bobigny (Médecine Interne – Unité VIH: O. Bouchaud, Anatomo-pathologie: M. Ziol, Virologie: Y. Baazia), Hôpital Joseph Ducuing, Toulouse (Médecine Interne: M. Uzan, A. Bicart-See, D. Garipuy, M.J. Ferro-Collados, Virologie: F. Nicot), APHP Bichat-Claude Bernard, Paris (Maladies Infectieuses:, A. Gervais, Y. Yazdanpanah, Anatomo-pathologie: H. Adle- Biassette, Virologie: G. Alexandre), APHP Saint-Louis, Paris (Maladies infectieuses: C. Lascoux-Combe, J.M. Molina, Anatomo-pathologie: P. Bertheau, Virologie: M.L. Chaix, C. Delaugerre, S. Maylin), APHP Saint-Antoine (Maladies Infectieuses et Tropicales:, K. Lacombe, J. Bottero, J. Krause P.M. Girard, Anatomo-pathologie: D. Wendum, P. Cervera, J. Adam, Virologie: C. Viala), APHP Bicêtre, Paris (Médecine Interne: C. Goujard, Y. Quertainmont, E. Teicher, Virologie: C. Pallier, Maladies Infectieuses: D. Vittecoq), APHP Necker, Paris (Maladies Infectieuses et Tropicales: O. Lortholary, C. Duvivier, C. Rouzaud, J. Lourenco, F. Touam, C. Louisin: Virologie: V. Avettand-Fenoel, A. Mélard), CHU Pellegrin, Bordeaux (Maladies Infectieuses et Tropicales: D. Neau, A. Ochoa, E. Blanchard, S. Castet-Lafarie, C. Cazanave, D. Malvy, M. Dupon, H. Dutronc, F. Dauchy, L. Lacaze-Buzy, Anatomopathologie: P. Bioulac-Sage, Virologie: P. Trimoulet, S. Reigadas), Hôpital Saint-André, Bordeaux (Médecine Interne et Maladies Infectieuses: Médecine Interne et Maladies Infectieuses: P. Morlat, D. Lacoste, F. Bonnet, N. Bernard, M. Hessamfar, J.F. Paccalin, C. Martell, M.C. Pertusa, M. Vandenhende, P. Merciéer, D. Malvy, T. Pistone, M.C. Receveur, M. Méchain, P. Duffau, C Rivoisy, I. Faure, S. Caldato, Anatomo-pathologie: P. Bioulac-Sage, Hôpital du Haut-Levêque, Bordeaux (Médecine Interne: J.L. Pellegrin, J.F. Viallard, E. Lazzaro, C. Greib, Hôpital FOCH, Suresnes (Médecine Interne: D. Zucman, C. Majerholc, Virologie: E. Farfour), APHP Antoine Béclère, Clamart (Médecine Interne: F. Boué, J. Polo Devoto, I. Kansau, V. Chambrin, C. Pignon, L. Berroukeche, R. Fior, V. Martinez, Virologie: C. Deback), CHU Henri Mondor, Créteil (Immunologie Clinique: Y. Lévy, S. Dominguez, J.D. Lelièvre, A.S. Lascaux, G. Melica), CHU Hôtel Dieu, Nantes (Maladies Infectieuses et Tropicales: E. Billaud, F. Raffi, C. Allavena , V. Reliquet, D. Boutoille, C. Biron, Virologie: A. Rodallec, L. Le Guen), Hôpital de la Croix Rousse, Lyon (Maladies Infectieuses et Tropicales: P. Miailhes, D. Peyramond, C. Chidiac, F. Ader, F. Biron, A. Boibieux, L. Cotte, T. Ferry, T. Perpoint, J. Koffi, F. Zoulim, F. Bailly, P. Lack, M. Maynard, S. Radenne, M. Amiri, Virologie: C. Scholtes, T.T. Le-Thi), CHU Dijon, Dijon (Département d’infectiologie: L. Piroth, P. Chavanet M. Duong Van Huyen, M. Buisson, A. Waldner-Combernoux, S. Mahy, R. Binois, A.L. Simonet-Lann, D. Croisier-Bertin), CH Perpignan, Perpignan (Maladies infectieuses et tropicales: H. Aumaître), CHU Robert Debré, Reims (Médecine interne, maladies infectieuses et immunologie clinique: F. Bani-Sadr, D. Lambert, Y. Nguyen, J.L. Berger), CHRU Strasbourg (Le Trait d’Union: D. Rey, M. Partisani, M.L. Batard, C. Cheneau, M. Priester, C. Bernard- Henry, E. de Mautort, Virologie: P. Gantner et S. Fafi-Kremer), APHP Bichat-Claude Bernard (Pharmacologie: G. Peytavin). Data collection: F. Roustant, I. Kmiec, L. Traore, S. Lepuil, S. Parlier, V. Sicart-Payssan, E. Bedel, F. Touam, C. Louisin, M. Mole, C. Bolliot, M. Mebarki, A. Adda-Lievin, F.Z. Makhoukhi, O. Braik, R. Bayoud, M.P. Pietri, V. Le Baut, D. Bornarel, C. Chesnel, D. Beniken, M. Pauchard, S. Akel, S. Caldato, C. Lions, L. Chalal, Z. Julia, H. Hue, A. Soria, M. Cavellec, S. Breau, A. Joulie, P. Fisher, C. Ondo Eyene, S. Ogoudjobi, C. Brochier, V. Thoirain-Galvan. Management, statistical analyses: E. Boerg, P. Carrieri, V. Conte, L. Dequae- Merchadou,M.Desvallees, N. Douiri, L. Esterle, C. Gilbert, S. Gillet, R. Knight, F. Marcellin, L. Michel, M. Mora, C. Protopopescu, P. Roux, B. Spire, S. Tezkratt, I. Yaya, T. Barré, T. Rojas, V. Villes, M. Baudoin, M. Santos., Dupuis, Christine, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Adult, Male, Sleep Wake Disorders, medicine.medical_specialty, Longitudinal study, Time Factors, Hepatitis C virus, Population, Human immunodeficiency virus (HIV), HIV Infections, Hepacivirus, medicine.disease_cause, Antiviral Agents, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Medicine, Humans, 030212 general & internal medicine, education, Retrospective Studies, education.field_of_study, Hepatology, Cognitive Behavioral Therapy, business.industry, Gastroenterology, virus diseases, HIV, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatitis C, Chronic, Middle Aged, Sleep in non-human animals, digestive system diseases, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Quality of Life, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

International audience; OBJECTIVES:Although common among patients coinfected with HIV and hepatitis C virus (HCV), sleep disturbances (SD) are still poorly documented in this population in the HCV cure era. This longitudinal study aimed at analysing SD in HIV-HCV coinfected patients and identifying their clinical and sociobehavioural correlates.METHODS:We used 5-year annual follow-up data from 1047 participants in the French National Agency for Research on Aids and Viral Hepatitis Cohort 13 'Hépatite et VIH' (ANRS CO13 HEPAVIH) cohort of HIV-HCV coinfected patients to identify clinical (medical records) and behavioural (self-administered questionnaires) correlates of SD (mixed-effects logistic regression). SD were identified using one item documenting the occurrence of insomnia or difficulty falling asleep (ANRS 'Action Coordonnée 24' self-reported symptoms checklist), and two items documenting perceived sleep quality (Center for Epidemiologic Studies Depression and WHO Quality of Life HIV-specific brief scales).RESULTS:Seven hundred and sixteen (68.4%) patients with completed self-administered questionnaires reported SD at their most recent follow-up visit. In the multivariable model, hazardous alcohol consumption (Alcohol Use Disorders Identification Test-Consumption score≥4 for men, ≥3 for women) (adjusted odds ratio=1.61; 95% confidence interval: 1.09-2.36), depressive symptoms (6.78; 4.36-10.55) and the number of other physical and psychological self-reported symptoms (1.10; 1.07-1.13) were associated independently with SD after adjustment for sex, age and employment status. HCV cure was not associated significantly with SD.CONCLUSION:SD remain frequent in HIV-HCV coinfected patients and are associated with a series of modifiable behavioural risk factors. Independent of HCV cure, improved screening and comprehensive management of alcohol use, physical and psychological self-reported symptoms and depression are essential in this population. Closer investigation of these risk factors of SDs may both increase sleep quality and indirectly improve patients' clinical outcomes.

Published
2019
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46. INTEREST 2019 Poster I.Yaya

Author

Issifou YAYA, Aboubakari Nambiema, Sokhna Dieng, Nassakou Amadou, Baba-Toherou Takiyatou, Akouda Patassi, Dadja Essoya Landoh, Essodjèlouna Manani Bignandi, Kanfitine Kolani, P'Niwè Massoubayo Patchali, Ekouevi, Didier Koumavi, and Bayaki Saka

Published
2019
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47. [Impact of children with multiple disabilities on families in Abidjan]

Author

Koumé Mathias, N Dri, Issifou, Yaya, Robertine, Zigoli, François, Endemel Ayabakan, Stéphane Yves, Ipou, and Botty, Lambert Moke

Subjects
Family Health, Male, Cote d'Ivoire, Adolescent, Cost of Illness, Child, Preschool, Humans, Female, Child, Disabled Children, Stress, Psychological
Abstract

A child's multiple disabilities have a major impact on families in both developed and developing countries. In Côte d'Ivoire, very few data are available concerning the real experiences of families of children with multiple disabilities. The objective of this study was to improve our knowledge of the impact of children with multiple disabilities on families in Côte d'Ivoire.A qualitative study was conducted among the families consulting the Child Guidance Centre of the National Institute of Public Health in Abidjan. Data were collected in May 2015 by semi-structured individual interviews with mothers of children with multiple disabilities.Twenty mothers of multiply disabled children between the ages of 2 and 14 years were interviewed. The child's multiple disability was found to have a negative impact on finances, health, and social life. Health check-ups, treatment and transport are the main additional costs. Mothers suffer from insomnia, fatigue, back pain and anxiety and were often held responsible for their child's disability. A disabled child was a source of discord in several couples and a cause of school drop-out in some families.This study partially addresses the experiences of families with children with multiple disabilities. It confirms the results of several other studies, highlighting the vulnerability and social dysfunction of these families.The presence of a child with multiple disabilities in a family is a source of psychological, financial and social upheaval. This study raises questions about the impact of multiple disabilities on the whole family and a more detailed analysis of economic aspects.

Published
2018

48. Impact du polyhandicap de l’enfant sur les familles à Abidjan

Author

Botty Lambert Moke, Stéphane Yves Ipou, Robertine Zigoli, François Endemel Ayabakan, Koumé Mathias N’Dri, Issifou Yaya, Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), ORS PACA, Institut National de Santé Publique de Côte d'Ivoire (INSP), Etablissement Public de Santé Mentale Départemental de l'Aisne [Prémontré] (EPSM), and Malbec, Odile

Subjects
Family health, 050103 clinical psychology, [SDV]Life Sciences [q-bio], 05 social sciences, Public Health, Environmental and Occupational Health, Cote d ivoire, 030227 psychiatry, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Political science, Cost of illness, 0501 psychology and cognitive sciences, Humanities
Abstract

Introduction : Le polyhandicap d’un enfant a un impact manifeste sur les familles aussi bien dans les pays developpes que dans ceux en developpement. En Cote d’Ivoire, tres peu de donnees traitent du vecu reel des familles d’enfants polyhandicapes. L’objectif de cette etude etait d’ameliorer les connaissances sur l’impact du polyhandicap des enfants sur les familles en Cote d’Ivoire.Methodes : Une etude qualitative a ete realisee aupres des familles consultant le Centre de Guidance Infantile de l’Institut national de sante publique a Abidjan. La collecte des donnees a ete realisee en mai 2015 a travers d’entretiens individuels semi-directifs aupres de meres d’enfant polyhandicape.Resultats : Vingt meres d’enfants polyhandicapes âges de 2 ans a 14 ans ont ete interrogees. Il ressort que le polyhandicap de l’enfant a un impact negatif sur les finances, la sante et la vie sociale. Les bilans de sante, les traitements et le transport sont les principaux surcouts. Les meres sont victimes d’insomnie, de fatigue, de douleurs de dos et d’anxiete et souvent tenues responsables du polyhandicap de leur enfant. L’enfant handicape est source de discorde dans plusieurs couples et constitue la cause de descolarisation de la fratrie dans certaines familles.Cette etude traite de facon partielle le vecu des familles des enfants polyhandicapes. Cependant, elle s’accorde avec plusieurs autres etudes pour mettre en exergue la vulnerabilite et le dysfonctionnement social des familles.Conclusion : La presence d’un enfant polyhandicape dans une famille est un bouleversement a la fois psychique, financier et social. L’impact du polyhandicap sur toute la famille et l’approfondissement de l’aspect economique sont autant de questions que suscite cette etude.

Published
2018
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49. Impact of elevated coffee intake on the risk of advanced liver fibrosis in HIV-HCV co-infected patients of the French ANRS CO13 HEPAVIH cohort: a sex-based analysis

Author

Issifou Yaya, Lionel Piroth, Fabienne Marcellin, Maria Patrizia Carrieri, Philippe Sogni, Claudine Duvivier, Camelia Protopopescu, Dominique Salmon-Ceron, Linda Wittkop, Laure Esterle, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and DUFOUR, Jean-Charles

Subjects
0303 health sciences, medicine.medical_specialty, Hepatology, business.industry, Liver fibrosis, [SDV]Life Sciences [q-bio], Gastroenterology, 3. Good health, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Coffee intake, Cohort, medicine, 030211 gastroenterology & hepatology, business, 030304 developmental biology
Abstract

International Liver Congress (ILC), Paris, FRANCE, APR 11-15, 2018

Published
2018
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50. Modern contraceptive use among HIV-infected women attending HIV care centres in Togo: a cross-sectional study

Author

Lihanimpo Djalogue, Kanfitine Kolani, Dadja Essoya Landoh, Issifou Yaya, Didier K. Ekouevi, Akouda Patassi, P’Niwè Massoubayo Patchali, Bayaki Saka, Abdel-Daim Daou Namoro, Essodjèlouna Manani Bignandi, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lomé [Togo], UNICEF, country office of Togo, CHR Tomdè, Clinique Biasa, AUTRES, Programme Elargi de Vaccination, Ministère de la Santé et de la Protection Sociale, Lomé, and DUFOUR, Jean-Charles

Subjects
Adult, Multivariate analysis, Adolescent, Cross-sectional study, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), Psychological intervention, HIV Infections, medicine.disease_cause, law.invention, 03 medical and health sciences, Young Adult, 0302 clinical medicine, 5. Gender equality, Condom, Contraceptive Agents, law, Hiv infected, medicine, Humans, 030212 general & internal medicine, Contraception Behavior, 030219 obstetrics & reproductive medicine, business.industry, Research, HIV-infected women, General Medicine, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Contraceptive use, Contraception, Cross-Sectional Studies, Togo, contraception use, Marital status, HIV/AIDS, Female, business, Demography
Abstract

International audience; Introduction Contraceptive use among HIV-infected women in Togo is poorly documented. We aim at assessing the prevalence of modern contraceptive use and associated factors among HIV-infected women in Togo. Design Cross-sectional study. Setting The study was conducted in five HIV care centres in the Centrale and Kara regions in Togo. Participants We included 461 HIV-positive women aged between 15 and 49 years and who were sexually active. Main outcome measure The outcome variable was HIV-infected women who were using modern contraceptive methods. Results A total of 461 HIV-infected women were interviewed, with an average age of 34.3 (+/- 7.1). Among them, 332 (73.1%) women reported using contraceptive methods, mostly condom alone (74.7%) or in combination with hormonal contraceptive (16.9%). In multivariate analysis, education level (primary: adjusted OR (aOR)=1.99, 95% CI (1.05 to 3.76); secondary level and higher: aOR=3.95, 95% CI (2.03 to 7.67)), WHO clinical stage (stage II: aOR=0.7, 95% CI (0.37 to 1.33)), follow-up in private care facilities (aOR=2.54, 95% CI (1.22 to 5.29)) and having a child (aOR=2.51, 95% CI (1.41 to 4.5)) were associated with higher contraceptive use, while marital status (living in union: aOR=0.45, 95% CI (0.28 to 0.74)) and WHO stages III and IV (aOR=0.47, 95% CI (0.24 to 0.94)) were associated with lower contraceptive use. Conclusion About three-quarters of sexually active HIV-infected women in Togo were using contraceptive methods, and private health facilities favoured this contraceptive use. It is important to strengthen the implementation of interventions to increase the incentives for HIV-infected women to use contraception in Togo.

Published
2018
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