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Rabies is a neglected zoonotic disease with a global burden of approximately 59,000 human deaths a year. Once clinical symptoms appear, rabies is almost invariably fatal; however, with timely and appropriate post-exposure prophylaxis (PEP) consisting of wound washing, vaccine, and in some cases rabies immunoglobulin (RIG), the disease is almost entirely preventable. Access to PEP is limited in many countries, and when available, is often very expensive. We distributed a standardized assessment tool electronically to a convenience sample of 25 low- and middle-income countries in Asia and Africa to collect information on rabies PEP procurement, forecasting, distribution, monitoring and reporting. Information was collected from national rabies focal points, focal points at the World Health Organization (WHO) country offices, and others involved in procurement, logistics and distribution of PEP. Because RIG was limited in availability or unavailable in many countries, the assessment focused on vaccine. Data were collected between January 2017 and May 2018. We received responses from key informants in 23 countries: 11 countries in Asia and 12 countries in Africa. In 9 of 23 (39%) countries, rabies vaccine was provided for free in the public sector and was consistently available. In 10 (43%) countries, all or some patients were required to pay for the vaccine in the public sector, with the cost of a single dose ranging from US$ 6.60 to US$ 20/dose. The primary reason for the high cost of the vaccine for patients was a lack of funding at the central level to subsidize vaccine costs. In the remaining 4 (17%) countries, vaccine was provided for free but was often unavailable so patients were required to purchase it instead. The majority of countries used the intramuscular route for vaccine administration and only 5 countries exclusively used the dose-sparing intradermal (ID) route. Half (11/22; 50%) of all countries assessed had a standardized distribution system for PEP, separate from the systems used for routine childhood vaccines, and almost half used separate storage facilities at both central and health facility levels. Approximately half (9/22; 41%) of all countries assessed reported having regular weekly, monthly or quarterly reporting on rabies vaccination. While all countries in our assessment had rabies vaccines available in the public sector to some extent, barriers to access include the high cost of the vaccine to the government as well as to patients. Countries should be encouraged to use ID administration as this would provide access to rabies vaccine for many more people with the same number of vaccine vials. In addition, standardized monitoring and reporting of vaccine utilization should be encouraged, in order to improve data on PEP needs.

The aim of this study was to identify the encephalic lesions in the eclampsia occurrences. Within a period of 18 months, computed tomography (CT) of the brain was performed in all patients admitted in intensive care for eclampsia. These CTs were analyzed and intracerebral lesions were identified. Thirty-nine patients were included. We noted 10 cases of ischemic stroke, 9 cases of cerebral edema, and 3 cases of hemorrhagic stroke and subarachnoid hemorrhage. The CT scan came back to normal in 20 eclamptic patients. Overall, delays in obstetric and intensive care and time of completion of the CT were long. CT has allowed highlighting in patients with eclampsia varied intracerebral lesions. The early performance of the CT is therefore essential for a better support of patients.

Leprosy epidemiology in Daoukro health district (Côte d’Ivoire) from 1999 to 2017Introduction. Leprosy is a real problem in the Daoukro health district despite the actions of the National programme for elimination.Objective. To describe the epidemiological and clinical profile of new leprosy cases in the Daoukro health district from 1999 to 2017.Method. Descriptive survey including leprosy patients admitted to the dermato-leprology de-partment from 1999 to 2017.Results. From 1999 to 2017, the incidence of leprosy fluctuated from 4.4 to 0 per 100,000 with a peak of 14.2 in 2003. In 2016 and 2017 no cases of leprosy were reported. The mean age was 36.8 years (SD=20). A majority of cases were uneducated and living in rural areas. Females and children under 15 years of age accounted for 53% and 16% of cases respectively.Clinically, cutaneous signs were predominant in the patients. The multibacillary form accounted for 82%. Nearly 1 out of 4 patients had a grade 2 disability (24%). All patients received treatment (multidrug therapy). Among them, 83.8% were cured, while 0.5% were not cured. In addition, regarding 29 patients (15.7%) details of how their disease progressed were not available. Among the patients declared cured, 26% had sequels.Conclusion. Leprosy control activities must be strengthened in order to maintain the achieve-ments in this non-endemic district.Épidémiologie de la lèpre dans le district sanitaire de Daoukro (Côte d’Ivoire) de 1999 à 2017Introduction. La lèpre est une réalité dans le district sanitaire de Daoukro malgré les actions du Programme national d’élimination.Objectif. L’objectif de cette étude est de décrire les aspects épidémiologiques et cliniques des nouveaux cas de lèpre dans le district sanitaire de Daoukro de 1999 à 2017.Méthode. Étude descriptive portant sur les patients lépreux reçus au service de dermato-léprologie de 1999 à 2017.Résultats. De 1999 à 2017, l’incidence annuelle de la lèpre fluctuait de 4,4 à 0 pour 100 000 avec un maximum de 14,2 pour 100 000 en 2003. À partir de 2004, elle est passée à moins de 1 cas pour 10 000 habitants (recommandations de l’OMS) pour se maintenir à 0 cas en 2016 et 2017. Avec un âge moyen de 36,8 ans (écart type = 20), la majorité des cas étaient sans instruction et vivaient en milieu rural. Les sujets de sexe féminin et les enfants de moins de 15 ans représentaient respectivement 53 % et 16 % des cas. Sur le plan clinique, les signes cutanés prédominaient chez les patients. La forme multibacillaire représentait 82 %. Près de 1 malade sur 4 présentait une invalidité de degré 2 (24 %). Tous les patients reçus ont été mis sous traitement (polychimiothérapie). Parmi eux, 83,8 % ont guéri, 0,5 % étaient non guéris. Par ailleurs, les modalités évolutives n’étaient pas précisées chez 29 patients soit 15,7 %. Parmi les patients déclarés guéris, 26 % présentaient des séquelles.Conclusion. Les actions de lutte contre la lèpre doivent être renforcées en vue de maintenir les acquis dans ce district non endémique.

This study highlighted the symbiosis between Anabaena-azollae cyanobacteria and Azolla aquatic fern in the production of Azolla filiculoides and its use as a biofertilizer. His trial of vegetative production using ordinary water + dung, carried out in 14 days of culture, showed a significant amount (6473g). Then, the use of this one as an amendment for the growth of CB-one rice, showed its positive impact on soil fertility thus translating high yields of CB-one rice contrary to the unamended witness. Indeed, with this treatment, the average number of tillers observed after 56 days of culture, was 18.1 ± 4.23 tillers contrary to the NPK (15.83 ± 4.98) and the control (10, 4 ± 3.27). The average number of leaves was significant in Azolla (57.20 ± 13.45), average for the NPK fertilizer (48.86 ± 15.79) and low for the control (34.83 ± 14, 52). In sum, the trays treated with Azolla filiculoides produced many more panicles and grains compared to treatments. As a result, Azolla is likely to restore soil fertility by providing the soil with the nutrients needed for crop productivity.

To palliate the problems of energy and service woods shortage and decrease of soils fertility, studies are taken up in forest transition zone of Côte d'Ivoire on 20 species of dry zones arborescent leguminous. Two important objectives were defined. It is to first, identify leguminous adapted to dry areas of Côte d'Ivoire; then set pulses management technics for their use in reforestation. To do this, plants from nurseries were planted and monitored by periodic inventories. The survival, the adaptability, the vigor and the volume of wood leguminous species were evaluated. A coppice was made after coppicing trees at 30 cm from the ground at the beginning of the rainy season. Seven years after planting, 18 species have survived. Leucaena leucocephala, Leucaena shannonii, Albizia guachepele and Enterolobium cyclocarpum present high potentialities for reafforestation with a plantation strike root rate superior to 65 p. c., a middle diameter between 9.7 and 16.3 cm and woods productivity superior to 10 m^sup 3^.ha^sup -1^.year^sup -1^. Cubage equations have been established for 11 arborescent leguminous species to estimate the production of wood in the transition zone. The wood technical exploitability ages of species plants are situated between 4 and 7 years. Some species react favorably to the treatment of coppicing.

Résumé Objectif: Analyser les aspects thérapeutiques et évolutifs de l’éclampsie en milieu de réanimation en Côte d’Ivoire. Méthode: Étude rétrospective réalisée au sein des services de réanimation des Centres Hospitaliers Universitaires (CHU) de Cocody et de Yopougon de 2001 à 2006. Les patientes admises en réanimation pour éclampsie ont été incluses dans l’étude. Les aspects thérapeutique et évolutif (état clinique à l’admission, médicaments utilisés, mode d’accouchement, type d’anesthésie, létalité, séquelles, l’évolution du tableau clinique) ont été étudiés. Les facteurs prédictifs de décès étaient recherchés par le calcul du risque relatif assorti de son intervalle de confiance. Le Chi carré de Mantel Haenszel a été utilisé avec une erreur α=0,05. Résultats: L’étude a porté sur 313 patientes dont l’âge moyen était de 22,7±6,1 ans. Le diazépam était l’anticonvulsivant le plus utilisé (50,5 % des cas) et la dihydralazine l’hypertenseur le plus fréquemment employé (50,2 %). L’accouchement a été réalisé par césarienne dans 58,5 % des cas et par voie vaginale dans 41,5 % des cas. Pour la césarienne, l’anesthésie générale avec intubation a été réalisée dans 79 % des cas et la rachianesthésie utilisant la bupivacaïne 0,5 % (dose: 10 à 12,5 mg) dans 21 % des cas. Le traitement n’a pas été régulièrement suivi dans 31,3 % des cas. La mortalité maternelle s’élevait à 16 % et la mortalité périnatale à 16,1 %. La provenance hors du CHU, le délai d’admission >12 h, le score de Glasgow ≤ à 8 à l’admission, l’état de mal éclamptique et le suivi irrégulier du traitement étaient les facteurs prédictifs de mortalité. Conclusion: La mortalité maternelle est encore élevée dans notre contexte. Une action énergique sur les facteurs de mauvais pronostics permettra de réduire la mortalité.

The aim of this study was to identify the encephalic lesions in the eclampsia occurrences. Within a period of 18 months, computed tomography (CT) of the brain was performed in all patients admitted in intensive care for eclampsia. These CTs were analyzed and intracerebral lesions were identified. Thirty-nine patients were included. We noted 10 cases of ischemic stroke, 9 cases of cerebral edema, and 3 cases of hemorrhagic stroke and subarachnoid hemorrhage. The CT scan came back to normal in 20 eclamptic patients. Overall, delays in obstetric and intensive care and time of completion of the CT were long. CT has allowed highlighting in patients with eclampsia varied intracerebral lesions. The early performance of the CT is therefore essential for a better support of patients.