scholarly journals Evaluating point-of-care nucleic acid tests in adult HIV diagnostic strategies: a Côte d’Ivoire modeling analysis

2021 ◽  
Author(s):  
Anne M Neilan ◽  
Jennifer Cohn ◽  
Emma Sacks ◽  
Aditya R Gandhi ◽  
Patricia Fassinou ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Life Expectancy ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Point Of Care ◽  
World Health ◽  
Cote D’Ivoire ◽  
High Performing ◽  
Côte D'ivoire ◽  
Nucleic Acid Tests

Abstract Introduction The World Health Organization (WHO) HIV diagnostic strategy requires six rapid diagnostic tests (RDTs). Point-of-care nucleic acid tests (POC NATs) are costlier, less sensitive, but more specific than RDTs. Methods We simulated a one-time screening process in Côte d’Ivoire (CI; undiagnosed prevalence: 1.8%), comparing WHO- and CI-recommended RDT-based strategies (RDT-WHO, RDT-CI) and an alternative: POC NAT to resolve RDT discordancy (NAT-Resolve). Costs included assays (RDT: $1.47; POC NAT: $27.92); ART ($6–22/month); HIV care ($27–38/month). We modeled two sensitivity/specificity scenarios: high-performing (RDT: 99.9%/99.1%; POC NAT: 95.0%/100.0%) and low-performing (RDT: 91.1%/82.9%; POC NAT: 93.3%/99.5%). Outcomes included true/false positive/negative (TP, TN, FP, FN) results, life expectancy, costs, and incremental cost-effectiveness ratios (ICERs: $/year-of-life saved [YLS]; threshold ≤$1,720/YLS [per-capita GDP]). Results Model-projected impacts of misdiagnoses were: 4.4y lost (FN versus TP; range: 3.0–13.0y) and a $5,800 lifetime cost increase (FP versus TN; range: $590–$14,680). In the high-performing scenario, misdiagnoses/10,000,000 tested were lowest for NAT-Resolve versus RDT-based strategies (FN: 409 versus 413–429; FP: 14 versus 21–28). Strategies had similar life expectancy (228 months) and lifetime costs ($220/person) among all tested; ICERs were $3,450/YLS (RDT-CI versus RDT-WHO) and $120,910/YLS (NAT-Resolve versus RDT-CI). In the low-performing scenario, misdiagnoses were higher (FN: 22,845–30,357; FP: 83,724–112,702) and NAT-Resolve was cost-saving. Conclusions We projected substantial clinical and economic impacts of misdiagnoses. Using POC NAT to resolve RDT discordancy generated the fewest misdiagnoses, was not cost-effective in high-performing scenarios, but may be an important adjunct to existing RDT-based strategies in low-performing scenarios.

scholarly journals Accuracy of Two Circulating Antigen Tests for the Diagnosis and Surveillance of Schistosoma mansoni Infection in Low-Endemicity Settings of Côte d’Ivoire

2021 ◽  
Author(s):  
Rufin K. Assaré ◽  
Mathieu I. Tra-Bi ◽  
Jean T. Coulibaly ◽  
Paul L. A. M. Corstjens ◽  
Mamadou Ouattara ◽  
...  
Keyword(s):  
Schistosoma Mansoni ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Point Of Care ◽  
Urine Specimen ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Circulating Antigen ◽  
Antigen Tests ◽  
True Infection

In low-endemicity settings, current tools for diagnosis and surveillance of schistosomiasis are often inaccurate in detecting true infection. We assessed the accuracy of an up-converting phosphor lateral flow circulating anodic antigen (UCP-LF CAA) test and a point-of-care circulating cathodic antigen (POC-CCA) urine cassette test for the diagnosis of Schistosoma mansoni. Our study was conducted in eight schools of western Côte d’Ivoire. Fifty children, aged 9 to 12 years, were enrolled per school. From each child, a single urine specimen and two stool specimens were collected over consecutive days for diagnostic workup. Urine samples were subjected to UCP-LF CAA and POC-CCA tests. From each stool sample, triplicate Kato-Katz thick smears were examined. Overall, 378 children had complete data records. The prevalence of S. mansoni, as assessed by six Kato-Katz thick smears, was 4.0%. The UCP-LF CAA and POC-CCA tests revealed S. mansoni prevalence of 25.4% and 30.7%, respectively, when considering trace results as positive, and prevalence of 23.3% and 10.9% when considering trace results as negative. In the latter case, based on a composite gold standard, the sensitivity of UCP-LF CAA (80.7%) was considerably higher than that of POC-CCA (37.6%) and six Kato-Katz thick smears (13.8%). The negative predictive value of UCP-LF CAA, POC-CCA, and six Kato-Katz thick smears was 92.8%, 79.8%, and 74.1%, respectively. Our results confirm that UCP-LF CAA is more accurate than Kato-Katz and POC-CCA for the diagnosis of S. mansoni in low-endemicity settings.

scholarly journals Les Représentations De La Beauté Féminine: Une Lecture Des Fondements Socioculturels Du Teint Clair Chez Les Bété De Côte d’Ivoire

2017 ◽  
Vol 13 (23) ◽  
pp. 39
Author(s):  
Yoro Blé Marcel
Keyword(s):  
Life Expectancy ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Field Survey ◽  
Social Categories ◽  
Cote D’Ivoire ◽  
Young Girls ◽  
Female Beauty ◽  
Côte D'ivoire

This study proposes an analysis of the representation of the female beauty whose clear complexion is one of the illustrations in the bété. In Côte d’Ivoire, the bété shows that there was a development of the beauty through the worship of the bagnon. However, in the representation of the male beauty through the bagnon, there is no fixed color complexion. It is not the same for the beauty of the woman whose clear complexion is of significant importance. This is why this study proposes the canons of the female beauty and to question the sociocultural bases which specifically underlie the preference of the clear complexion to the black complexion of the bété woman. However, this is in a bid to understand the cultural anchoring of the female depigmentation in bété country. From a field survey of people of all social categories, the study shows that the preference of the clear complexion is explained by the fact that it would carry virtues of rejuvenation and longevity for the man. In other words, the beauty of the woman aims at developing the man by rejuvenating him and by lengthening his life expectancy. These imaginations results to the depigmentation of the young girls and women bété in their search for beauty. This they do via the clear complexion to make them more attractive to men.

scholarly journals Self-Assessed Life Expectancy Among Older Adults in Côte D’Ivoire

2020 ◽  
Author(s):  
Richard K Moussa ◽  
Vakaramoko Diaby
Keyword(s):  
Older Adults ◽  
Life Expectancy ◽  
Cote D'ivoire ◽  
Regression Models ◽  
Côte D’Ivoire ◽  
Finite Mixture ◽  
Cote D’Ivoire ◽  
Survival Probabilities ◽  
Côte D'ivoire ◽  
Fourth Component

Abstract Background The purpose of this study was to estimate individuals’ expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life expectancy in a sample of elderly people (50 years and older) in Côte d’Ivoire. Methods Paper-based questionnaires were administered to a sample (n=267) of older adults residing in the city of Dabou, Côte d’Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities were collected. We estimated self-assessed life expectancy and its determinants using a two-pronged approach by: (i) estimating individuals’ life expectancy using the self-assessed survival probabilities (SSPs), and (ii) applying a finite mixture of regression models to form homogenous groups of individuals (clusters/components) and investigate the determinants. A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify homogeneous groups of individuals (i.e. clusters/components) of the overall subjective life expectancy distribution of the study participants. Results The mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02 and 77.79 years in the first, second, third and fourth component of the subjects' overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component. Conclusions We extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly’s perception of aging, which could be used to forecast the demand for health services and long-term care needs.

scholarly journals A Study on Self-Assessed Life Expectancy Among Older Adults in Côte d’Ivoire

2020 ◽  
Author(s):  
Richard K Moussa ◽  
Vakaramoko Diaby
Keyword(s):  
Older Adults ◽  
Life Expectancy ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Term Care ◽  
Cote D’Ivoire ◽  
Subjective Expectations ◽  
Survival Probabilities ◽  
Côte D'ivoire ◽  
Fourth Component

Abstract Background: The purpose of this study was to estimate individuals’ expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life expectancy in a sample of elderly people in Côte d’Ivoire.Methods: Paper-based questionnaires were administered to a sample (n=267) of older adults residing in the city of Dabou, Côte d’Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities were collected. The subjective expectations were related to sociodemographic, health and lifestyle indicators. A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify clusters/components of the overall subjective life expectancy distribution of the study participants. Results: The mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02 and 77.79 years in the first, second, third and fourth component of the subjects' overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component.Conclusion: We extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly’s perception of aging, which could be used to forecast the demand for health services and long-term care needs.

scholarly journals Feasibility study on the adoption of the WHO safe childbirth checklist by front-line healthcare providers and managers in Burkina Faso and Côte d’Ivoire

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kadidiatou Raissa Kourouma ◽  
Wambi Maurice Evariste Yaméogo ◽  
Daouda Doukouré ◽  
Marie Laurette Agbré Yacé ◽  
Akoua Tano Kamelan ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Healthcare Providers ◽  
Real Life ◽  
World Health ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background The World Health Organization Safe Childbirth Checklist tool was specifically designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth. However, the implementation of the Safe Childbirth Checklist tool requires a good knowledge of the context setting to face challenges. Our study objectives were (1) to assess the acceptability of the WHO SCC tool and (2) to identify conditions and strategies for a better introduction and use of the WHO SSC tool. Methods This was a pilot multi-country study conducted from January to March 2019 in Burkina Faso and Côte d’Ivoire, respectively, in the health regions of central-North and Agnéby-Tiassa-Mé. In each health region, 5 health facilities of different levels within the health system pyramid were selected through a purposive sampling. The study was conducted in 2 phases: 38 healthcare providers and 15 managers were first trained to use the Safe Childbirth Checklist tool; secondly, the trained providers were allowed to use the tool in real-life conditions for 2 weeks. Then, semi-structured interviews were conducted among healthcare providers and managers. The topics covered by the interview guides were acceptability of the tool, barriers and facilitators to its use, as well as strategies for better introduction and use within the healthcare system. Analysis was carried out using the Nvivo 12 software. Results Respondents reported an overall good acceptance of using the tool. However, they suggested minor content adaptation. The design of the tool and increased workload were the main barriers to its use. Potential facilitators to its introduction were managers’ commitment, healthcare providers’ motivation, and the availability of supplies. The best strategies for optimal use were its attachment to existing tool such as partograph or/and its display in the maternity ward. Conclusions The findings showed that the implementation of the Safe Childbirth Checklist tool is acceptable in Burkina Faso and Côte d’Ivoire. These findings are important and will help to design a trial aiming at assessing the effectiveness of the tool WHO SCC tool in these two countries.

scholarly journals Organochlorine Residues Levels in Some Selected Kolanuts (Cola nitida Schott & Endl.) in Côte d’Ivoire

2020 ◽  
pp. 24-35
Author(s):  
Deigna-Mockey Viviane ◽  
Biego Henri ◽  
Nyamien Yves ◽  
Konan Ysidor ◽  
Coulibaly Adama ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Health Department ◽  
Research Unit ◽  
World Health ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Significant Difference ◽  
Adults And Children ◽  
Health Organization

Aims: The aim of this study was to assess the level of organochlorine pesticide (OCPs) residues in some selected kolanuts in Côte d’Ivoire. Study Design: Kolanuts samples were collected from farmers, collectors and urban stores in 3 regions, in particular western, southwestern and eastern of Côte d’Ivoire. Place and Duration of Study: Health Department of Hydrology Health and Toxicology, Training and Research Unit of Pharmaceutical and Biological Sciences, Abidjan, Côte d’Ivoire, running 2017-2018. Methodology: A total of 225 samples were analyzed using a gas chromatograph equipped with an electron capture detector. Results: Data showed that all 17 pesticides analyzed were detected in kolanuts samples. Statistical analysis indicated no significant difference in OCPs sub-group used by farmers and traders in all producing region. The mean levels of HCHs, DDTs and cyclodienes were ranged from 0.07± 0.01– 0.91± 0.05 mg/kg, 0.15±0.01 – 0.61±0.12 mg/kg and 0.12±0.03 - 0.84±0.46 mg/kg, respectively. Otherwise, farmer’s levels of OCPs were lower than those detected in kolanuts from collectors and urban stores samples. Thus, compared to the MRL set by the World Health Organization/Food and Agricultural Organization, the farmer’s samples are lower than limits fixed, unlike the contents registered with collectors and urban stores. Conclusion: There is the need to keep monitoring ecotoxicological chemical substances in kolanuts produced in Côte d’Ivoire and take steps that ensure health safety of end users. Care should be taken since residues could pose chronic health risk for adults and children.

scholarly journals Sensitivity of the Point-of-Care Circulating Cathodic Antigen Urine Cassette Test for Diagnosis of Schistosoma mansoni in Low-Endemicity Settings in Côte d’Ivoire

2018 ◽  
Vol 99 (6) ◽  
pp. 1567-1572 ◽  
Author(s):  
Rufin K. Assaré ◽  
Mathieu B. I. Tra ◽  
Mamadou Ouattara ◽  
Eveline Hürlimann ◽  
Jean T. Coulibaly ◽  
...  
Keyword(s):  
Schistosoma Mansoni ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Point Of Care ◽  
Cote D’Ivoire ◽  
Côte D'ivoire
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