Challenges in integrating cervical cancer screening in HIV care clinics in West Africa: a pilot study in Abidjan, Côte d’Ivoire

ObjectivesDespite the increasing number of interventions aiming to integrate cervical cancer screening into HIV clinics in sub-Saharan Africa, Women living with HIV (WLHIV) still have a high risk of developing cervical cancer. The aim of this study was to estimate the coverage of cervical cancer screening and associated factors among WLHIV in Abidjan, Côte d’Ivoire.DesignCross-sectional survey conducted from May to August 2017.SettingsOutpatient setting in the four highest volume urban HIV clinics of government’s or non-governmental organisation’s sector in Côte d’Ivoire.ParticipantsAll WLHIV, aged 25–55 years, followed since at least 1 year, selected through a systematic sampling procedure.InterventionA standardised questionnaire administered to each participant by trained healthcare workers.OutcomeCervical cancer screening uptake.ResultsA total of 1991 WLHIV were included in the study, aged in median 42 years (IQR 37–47), and a median CD4 count (last known) of 563 (378-773) cells/mm3. Among the participants, 1913 (96.1%) had ever heard about cervical cancer, 1444 (72.5%) had been offered cervical cancer screening, mainly in the HIV clinic for 1284 (88.9%), and 1188 reported a personal history of cervical cancer screening for an overall coverage of 59.7% (95% CI 57.6 to 62.0). In multivariable analysis, university level (adjusted OR (aOR) 2.1; 95% CI 1.4 to 3.1, p<0.001), being informed on cervical cancer at the HIV clinic (aOR 1.5; 95% CI 1.1 to 2.0, p=0.017), receiving information self-perceived as ‘clear and understood’ on cervical cancer (aOR 1.7; 95% CI 1.4 to 2.2, p<0.001), identifying HIV as a risk factor for cervical cancer (aOR 1.4; 95% CI 1.1 to 1.8, p=0.002) and being proposed cervical cancer screening in the HIV clinic (aOR 10.1; 95% CI 7.6 to 13.5, p<0.001), were associated with cervical cancer screening uptake.ConclusionInitiatives to support cervical cancer screening in HIV care programmes resulted in effective access to more than half of the WLHIV in Abidjan. Efforts are still needed to provide universal access to cervical cancer screening, especially among socioeconomically disadvantaged WLHIV.

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Barriers and facilitators on cervical cancer screening among HIV women in Cote d’Ivoire

European Journal of Public Health ◽

10.1093/eurpub/ckz185.055 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

K Mensah ◽

D Pourette ◽

V Duschene ◽

P DeBeaudrap ◽

A Dumont

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Hiv Positive ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Hiv Positive Women ◽

Hiv Women

Abstract Background With 50,000 death every year, cervical cancer is the fourth most common cause of death by cancer in sub-Saharan countries. Due to high risk human papilloma virus (hr-HPV) persistence on the cervix, leading to pre-malignous lesions, the disease is more frequent among HIV-positive women. In low- and middle-income countries, cervical cancer screening strategy relies on visual inspection with acetic acid, an operator-associated technic. As an alternative, HPV-based detection and its better performances are considered as it could lead to a potential screening uptake and women empowerment through self-sampling. Côte d’Ivoire, with a high HIV prevalence, is considering this innovative strategy. Yet, few studies analyzed the potential socio-cultural factors associated with cervical cancer screening in this context. Our study aims to assess beliefs and perceptions toward cervical cancer among HIV positive women in Abidjan, Côte d’Ivoire. Methods We performed in-depth interviews with 21 HIV positive women randomly attending a health center or member of a women’s association, in November 2018. All interviews were recorded and transcribed. A theoretical framework with the Health Belief Model and the PEN-3 was used to categorize women’s perceptions, enablers, nurturers, perceived gravity and self-efficacy about cervical cancer, screening and self-sampling technique introduction. Results Positive findings were knowledge about cervical cancer, awareness about women’s vulnerability and HIV status role on it and relationship to caregivers. Fear appeared as a barrier to screening but also a facilitator among women with health awareness. Negative findings were reluctance for HIV-associated diseases, poor screening knowledge and lack of resources to get treated. Self-sampling introduction was disregarded due to lack of self-confidence. Conclusions This study provides useful information for counselling and opens the door to HPV-based screening implementation. Key messages Beliefs and perceptions about cervical cancer screening among HIV women need to be assess before implementing a new strategy. Cervical cancer screening uptake will need to address fear, self-confidence and stigma.

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Describing, analysing and understanding the effects of the introduction of HIV self-testing in West Africa through the ATLAS programme in Côte d’Ivoire, Mali and Senegal

BMC Public Health ◽

10.1186/s12889-021-10212-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nicolas Rouveau ◽

◽

Odette Ky-Zerbo ◽

Sokhna Boye ◽

Arlette Simo Fotso ◽

...

Keyword(s):

West Africa ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

West African ◽

Hiv Care ◽

Key Populations ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Self Testing ◽

Secondary Distribution

Abstract Background The ATLAS programme aims to promote and implement HIV self-testing (HIVST) in three West African countries: Côte d’Ivoire, Mali, and Senegal. During 2019–2021, in close collaboration with the national AIDS implementing partners and communities, ATLAS plans to distribute 500,000 HIVST kits through eight delivery channels, combining facility-based, community-based strategies, primary and secondary distribution of HIVST. Considering the characteristics of West African HIV epidemics, the targets of the ATLAS programme are hard-to-reach populations: key populations (female sex workers, men who have sex with men, and drug users), their clients or sexual partners, partners of people living with HIV and patients diagnosed with sexually transmitted infections and their partners. The ATLAS programme includes research support implementation to generate evidence for HIVST scale-up in West Africa. The main objective is to describe, analyse and understand the social, health, epidemiological effects and cost-effectiveness of HIVST introduction in Côte d’Ivoire, Mali and Senegal to improve the overall HIV testing strategy (accessibility, efficacy, ethics). Methods ATLAS research is organised into five multidisciplinary workpackages (WPs): Key Populations WP: qualitative surveys (individual in-depth interviews, focus group discussions) conducted with key actors, key populations, and HIVST users. Index testing WP: ethnographic observation of three HIV care services introducing HIVST for partner testing. Coupons survey WP: an anonymous telephone survey of HIVST users. Cost study WP: incremental economic cost analysis of each delivery model using a top-down costing with programmatic data, complemented by a bottom-up costing of a representative sample of HIVST distribution sites, and a time-motion study for health professionals providing HIVST. Modelling WP: Adaptation, parameterisation and calibration of a dynamic compartmental model that considers the varied populations targeted by the ATLAS programme and the different testing modalities and strategies. Discussion ATLAS is the first comprehensive study on HIV self-testing in West Africa. The ATLAS programme focuses particularly on the secondary distribution of HIVST. This protocol was approved by three national ethic committees and the WHO’s Ethical Research Committee.

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Exploration targets in the Côte d'Ivoire-Ghana transform margin in Equatorial West Africa

Petroleum Exploration and Development ◽

10.1016/s1876-3804(10)60013-4 ◽

2010 ◽

Vol 37 (1) ◽

pp. 43-50 ◽

Cited By ~ 5

Author(s):

Liu Jianping ◽

Pan Xiaohua ◽

Ma Jun ◽

Tian Zuoji ◽

Wan Lunkun

Keyword(s):

West Africa ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Transform Margin

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Newborn hearing screening in a developing country: Results of a pilot study in Abidjan, Côte d’ivoire

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2009.11.008 ◽

2010 ◽

Vol 74 (2) ◽

pp. 188-191 ◽

Cited By ~ 7

Author(s):

M.J. Tanon-Anoh ◽

D. Sanogo-Gone ◽

K.B. Kouassi

Keyword(s):

Pilot Study ◽

Developing Country ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Hearing Screening ◽

Newborn Hearing Screening ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Newborn Hearing

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Tinea Capitis Caused by Microsporum audouninii: A Report of Two Cases from Côte D’Ivoire, West Africa

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010009 ◽

2021 ◽

Vol 6 (1) ◽

pp. 9

Author(s):

Rie Roselyne Yotsu ◽

Kouamé Kouadio ◽

Aubin Yao ◽

Bamba Vagamon ◽

Motoi Takenaka ◽

...

Keyword(s):

West Africa ◽

Dna Sequencing ◽

Cote D'ivoire ◽

Tinea Capitis ◽

Sampling Method ◽

Côte D’Ivoire ◽

Adhesive Tape ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Epidemiological Surveys

We report here two cases of tinea capitis caused by Microsporum (M.) audouinii in Côte d’Ivoire, West Africa. The patients were a three-year-old boy and a six-year-old girl who presented with scaly patches on the scalp. The causative fungus was isolated using an adhesive tape-sampling method and cultured on Sabouraud dextrose agar plates. It was identified as M. audouinii both by its macroscopic and microscopic features, confirmed by DNA sequencing. These are the first documented cases of M. audouinii infections confirmed with DNA sequencing to be reported from Côte d’Ivoire. The practicality of the tape-sampling method makes it possible to carry out epidemiological surveys evaluating the distribution of these dermatophytic infections in remote, resource-limited settings.

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Transboundary river water pesticide pollution in historical agriculture areas in West Africa: a case study in the Comoe, Bia, and Tanoe rivers (Cote d’Ivoire)

Arabian Journal of Geosciences ◽

10.1007/s12517-021-08294-7 ◽

2021 ◽

Vol 14 (20) ◽

Author(s):

Kone Siriki ◽

Koffi Marcellin Yao ◽

Urbain Paul Gnonsoro ◽

Albert Trokourey

Keyword(s):

West Africa ◽

River Water ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Cote D’Ivoire ◽

Transboundary River ◽

Pesticide Pollution ◽

Côte D'ivoire ◽

Historical Agriculture

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Assessment of dietary diversity and nutritional support for children living with HIV in the IeDEA pediatric West African cohort: a non-comparative, feasibility study

BMC Nutrition ◽

10.1186/s40795-021-00486-4 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Julie Jesson ◽

Ayoko Ephoevi-Ga ◽

Marie-Hélène Aké-Assi ◽

Sikiratou Koumakpai ◽

Sylvie N’Gbeche ◽

...

Keyword(s):

Cote D'ivoire ◽

Nutritional Support ◽

Côte D’Ivoire ◽

Dietary Diversity ◽

Hiv Care ◽

Z Score ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Moderate Malnutrition ◽

Living With Hiv

Abstract Background Nutritional care is not optimally integrated into pediatric HIV care in sub-Saharan Africa. We assessed the 6-month effect of a nutritional support provided to children living with HIV, followed in a multicentric cohort in West Africa. Methods In 2014-2016, a nutritional intervention was carried out for children living with HIV, aged under 10 years, receiving antiretroviral therapy (ART) or not, in five HIV pediatric cohorts, in Benin, Togo and Côte d’Ivoire. Weight deficiency was assessed using two definitions: wasting (Weight for Height Z-score [WHZ] for children<5 years old or Body-Mass-Index for Age [BAZ] for ≥5 years) and underweight (Weight for Age Z-score [WAZ]) (WHO child growth standards). Combining these indicators, three categories of nutritional support were defined: 1/ children with severe malnutrition (WAZ and/or WHZ/BAZ <-3 Standard Deviations [SD]) were supported with Ready-To-Use Therapeutic Food (RUTF), 2/ those with moderate malnutrition (WAZ and/or WHZ/BAZ = [-3;-2[ SD) were supported with fortified blended flours produced locally in each country, 3/ those non malnourished (WAZ and WHZ/BAZ ≥-2 SD) received nutritional counselling only. Children were followed monthly over 6 months. Dietary Diversity Score (DDS) using a 24h recall was measured at the first and last visit of the intervention. Results Overall, 326 children were included, 48% were girls. At baseline, 66% were aged 5-10 years, 91% were on ART, and 17% were severely immunodeficient (CD4 <250 cells/mL or CD4%<15). Twenty-nine (9%) were severely malnourished, 63 (19%) moderately malnourished and 234 (72%) non-malnourished. After 6 months, 9/29 (31%) and 31/63 (48%) recovered from severe and moderate malnutrition respectively. The median DDS was 8 (IQR 7-9) in Côte d’Ivoire and Togo, 6 (IQR 6-7) in Benin. Mean DDS was 4.3/9 (sd 1.2) at first visit, with a lower score in Benin, but with no difference between first and last visit (p=0.907), nor by intervention groups (p-value=0.767). Conclusions This intervention had a limited effect on nutritional recovery and dietary diversity improvement. Questions remain on determining appropriate nutritional products, in terms of adherence, proper use for families and adequate energy needs coverage for children living with HIV. Trial registration PACTR202001816232398, June 01, 2020, retrospectively registered.

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