scholarly journals 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

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.

scholarly journals Enthusiasm for Introducing and Integrating HIV Self-Testing but Doubts About Users: A Baseline Qualitative Analysis of Key Stakeholders' Attitudes and Perceptions in Côte d'Ivoire, Mali and Senegal

2021 ◽  
Vol 9 ◽  
Author(s):  
Odette Ky-Zerbo ◽  
Alice Desclaux ◽  
Alexis Brou Kouadio ◽  
Nicolas Rouveau ◽  
Anthony Vautier ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Sex Workers ◽  
Côte D’Ivoire ◽  
Key Populations ◽  
Structured Interviews ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Perceptions And Attitudes ◽  
Key Stakeholders ◽  
Self Testing

Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Côte d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted. The study was conducted from September to November 2019 within 3 months of the initiation of HIVST distribution. Individual interviews were conducted with 60 key informants involved in the project or in providing support and care to key populations: members of health ministries, national AIDS councils, international organizations, national and international non-governmental organizations, and peer educators. Semi structured interviews were recorded, translated when necessary, and transcribed. Data were coded using Dedoose© software for thematic analyses. We found that stakeholders' perceptions and attitudes are favorable to the introduction and integration of HIVST for several reasons. Some of these reasons are held in common, and some are specific to each key population and country. Overall, HIVST is considered able to reduce stigma; preserve anonymity and confidentiality; reach key populations that do not access testing via the usual strategies; remove spatial barriers; save time for users and providers; and empower users with autonomy and responsibility. It is non-invasive and easy to use. However, participants also fear, question and doubt users' autonomy regarding their ability to use HIVST kits correctly; to ensure quality secondary distribution; to accept a reactive test result; and to use confirmation testing and care services. For stakeholders, HIVST is considered an attractive strategy to improve access to HIV testing for key populations. Their doubts about users' capacities could be a matter for reflective communication with stakeholders and local adaptation before the implementation of HIVST in new countries. Those perceptions may reflect the West African HIV situation through the emphasis they place on the roles of HIV stigma and disclosure in HIVST efficiency.

scholarly journals Primary Biodiversity Data Gaps Assessment and Data Use for Decision-making: A West African Experience

2019 ◽  
Vol 3 ◽  
Author(s):  
Benedictus Freeman ◽  
A. Townsend Peterson
Keyword(s):  
Climate Change ◽  
West Africa ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Ecological Niche Modeling ◽  
West African ◽  
Biodiversity Data ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Global Biodiversity

Primary biodiversity data, data documenting presences of particular species at particular sites at a point in time, available in standard digital formats, provide the basis for many quantitative studies that can inform effective and reliable national, regional, and global biodiversity conservation decisions. However, these datasets are often unavailable, incomplete, or unevenly distributed across regions and landscapes. We assessed the survey completeness and gaps in current knowledge of birds of West Africa, using digital, accessible primary biodiversity data, obtained from the Global Biodiversity Information Facility and eBird. Additionally, using ecological niche modeling approaches, we modeled the current and potential future geographic distributions of a diverse suite of range-restricted and ecologically important bird species, and used the resulting models to identify priority areas for conservation and future surveys (Fig. 1). The survey completeness and gap analyses revealed marked spatial, seasonal, and temporal (historical) gaps and biases in the coverage of bird records across the region (Fig. 1). Well-surveyed sites were clustered around points of access such as major cities, roads, and national reserves or parks, mainly in Ghana, The Gambia, Senegal, Côte d’Ivoire, and Cameroon (Fig. 1). For our distributional analysis, we found broad present-day potential distributions with respect to climate. Future potential distributions, taking into account climate change processes, tended to be still-broader and more inclusive than present-day distributions, so climate-change-driven range losses and gains were minimal. Our models identified Liberia, southeastern Sierra Leone, southwestern Côte d’Ivoire, and southwestern Ghana to have high climate suitability in the present and in the future for most species. These results illustrate the spatial and temporal biases and gaps in West African bird data, and emphasize the need to promote high-quality biodiversity data mobilization and publication in West Africa and by extension the developing world. To address these biases at the regional level, research institutions and individuals need to engage in more systematic planning and biodiversity research, taking into account the potential for spatial, temporal, and seasonal biases.

scholarly journals Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali

2021 ◽  
Vol 9 ◽  
Author(s):  
Marc d'Elbée ◽  
Métogara Mohamed Traore ◽  
Kéba Badiane ◽  
Anthony Vautier ◽  
Arlette Simo Fotso ◽  
...  
Keyword(s):  
Civil Society ◽  
Cote D'ivoire ◽  
Economies Of Scale ◽  
Côte D’Ivoire ◽  
Scale Up ◽  
Vulnerable Groups ◽  
Key Populations ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Self Testing

Despite significant progress on the proportion of individuals who know their HIV status in 2020, Côte d'Ivoire (76%), Senegal (78%), and Mali (48%) remain far below, and key populations (KP) including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are the most vulnerable groups with a HIV prevalence at 5–30%. HIV self-testing (HIVST), a process where a person collects his/her own specimen, performs a test, and interprets the result, was introduced in 2019 as a new testing modality through the ATLAS project coordinated by the international partner organisation Solthis (IPO). We estimate the costs of implementing HIVST through 23 civil society organisations (CSO)-led models for KP in Côte d'Ivoire (N = 7), Senegal (N = 11), and Mali (N = 5). We modelled costs for programme transition (2021) and early scale-up (2022–2023). Between July 2019 and September 2020, a total of 51,028, 14,472, and 34,353 HIVST kits were distributed in Côte d'Ivoire, Senegal, and Mali, respectively. Across countries, 64–80% of HIVST kits were distributed to FSW, 20–31% to MSM, and 5–8% to PWUD. Average costs per HIVST kit distributed were $15 for FSW (Côte d'Ivoire: $13, Senegal: $17, Mali: $16), $23 for MSM (Côte d'Ivoire: $15, Senegal: $27, Mali: $28), and $80 for PWUD (Côte d'Ivoire: $16, Senegal: $144), driven by personnel costs (47–78% of total costs), and HIVST kits costs (2–20%). Average costs at scale-up were $11 for FSW (Côte d'Ivoire: $9, Senegal: $13, Mali: $10), $16 for MSM (Côte d'Ivoire: $9, Senegal: $23, Mali: $17), and $32 for PWUD (Côte d'Ivoire: $14, Senegal: $50). Cost reductions were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes and progressive IPO withdrawal at scale-up. In all countries, CSO-led HIVST kit provision to KP showed relatively high costs during the study period related to the progressive integration of the programme to CSO activities and contextual challenges (COVID-19 pandemic, country safety concerns). In transition to scale-up and integration of the HIVST programme into CSO activities, this model shows large potential for substantial economies of scale. Further research will assess the overall cost-effectiveness of this model.

scholarly journals Is it possible to recruit HIV self-test users for an anonymous phone-based survey using passive recruitment without financial incentives? Lessons learned from a pilot study in Côte d’Ivoire

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Arlette Simo Fotso ◽  
Arsène Kouassi Kra ◽  
Mathieu Maheu-Giroux ◽  
Sokhna Boye ◽  
Marc d’Elbée ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Financial Incentives ◽  
Côte D’Ivoire ◽  
Lessons Learned ◽  
Recruitment Strategy ◽  
Cote D’Ivoire ◽  
Partner Testing ◽  
Côte D'ivoire ◽  
Self Testing ◽  
Secondary Distribution

Abstract Background Due to the discreet and private nature of HIV self-testing (HIVST), it is particularly challenging to monitor and assess the impacts of this testing strategy. To overcome this challenge, we conducted a study in Côte d’Ivoire to characterize the profile of end users of HIVST kits distributed through the ATLAS project (AutoTest VIH, Libre d’Accéder à la connaissance de son Statut). Feasibility was assessed using a pilot phone-based survey. Methods The ATLAS project aims to distribute 221300 HIVST kits in Côte d’Ivoire from 2019 to 2021 through both primary (e.g., direct distribution to primary users) and secondary distribution (e.g., for partner testing). The pilot survey used a passive recruitment strategy—whereby participants voluntarily called a toll-free survey phone number—to enrol participants. The survey was promoted through a sticker on the HIVST instruction leaflet and hotline invitations and informal promotion by HIVST kit-dispensing agents. Importantly, participation was not financially incentivized, even though surveys focussed on key populations usually use incentives in this context. Results After a 7-month period in which 25,000 HIVST kits were distributed, only 42 questionnaires were completed. Nevertheless, the survey collected data from users receiving HIVST kits via both primary and secondary distribution (69% and 31%, respectively). Conclusion This paper provides guidance on how to improve the design of future surveys of this type. It discusses the need to financial incentivize participation, to reorganize the questionnaire, the importance of better informing and training stakeholders involved in the distribution of HIVST, and the use of flyers to increase the enrolment of users reached through secondary distribution.

Political Stability in West African States: Problems and Solutions. (Case Studies of Côte d’Ivoire and Senegal)

2018 ◽  
pp. 75-88
Author(s):  
Lyubov Sadovskaya
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Political Stability ◽  
West African ◽  
The Political ◽  
Political Systems ◽  
African Countries ◽  
Cote D’Ivoire ◽  
External Threats ◽  
Côte D'ivoire

The article presents a new view on the problems of political stability in West African countries. For the first time was carried out a comparative analysis of the sustainability of the political systems of the two Francophone fastest growing countries in West Africa, Côte d’Ivoire and Senegal. The author analyzes the factors negatively influencing political stability social order, and those that reduce conflict potencial in these States. Internal and external threats to the political systems of Senegal and Сôte d’Ivoire are examined. The response of both countries to internal and external challenges is shown. The study proves that while external threats indanger Senegal’s political stability, such as the penetration of religious extremism, the crisis in Casamance, maritime piracy, drug traffic, for Côte d’Ivoire, on the contrary, main risks are internal: electoral, socio-political crises, the split of elites, arms smuggling, banditry. The study demonstrates that the level of social governance in Senegal is higher than in other West African countries, including Сôte d’Ivoire, due to the dualism of the political system: the coexistence of Western-style political institutions with local faiths (tariqas), as well as policy pursued by President M. Sall. aimed at achieving mutual compromise that ensure the peaceful settlement of conflicts and contradictions. The author concludes that a new approach to the development of a security strategy is required.

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

2010 ◽  
Vol 37 (1) ◽  
pp. 43-50 ◽  
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

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

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.

scholarly journals 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 ◽  
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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