Suchergebnisse

Dans les villes secondaires d'Afrique soudano-sahélienne, la proximité du milieu rural permet encore la collecte du lait auprès des producteurs situés en zone périurbaine et sa distribution auprès des consommateurs urbains. De nombreux acteurs transportent et commercialisent de petites quantités. Des minilaiteries prennent parfois une place majeure en tant que relais. En revanche, le fossé se creuse dans les capitales tant que le réseau de collecte et de distribution ne s'adapte pas aux exigences du marché. Les minilaiteries, en dépit de leur dynamisme, ne répondent que très partiellement à cette nécessité d'adaptation. La croissance démographique, l'expansion urbaine en périphérie au détriment des pâturages ou encore l'éloignement progressif de la production par rapport aux lieux de consommation rendent caduques les systèmes traditionnels de transport. Pour que la production laitière locale garde une place significative sur un marché urbain porteur, la collecte " industrielle " dans les lieux de production devrait être promue en dépit de leur éloignement, à l'instar de la laiterie Tiviski en Mauritanie. Mais les conditions de l'industrialisation ne sont pas évidentes à réunir. En outre, les réseaux de distribution du lait en poudre importé et de ses produits dérivés suivent efficacement les transformations récentes des marchés urbains (multiplication des boutiquiers, diversification des produits, présence croissante de la chaîne du froid, prix attractifs, qualité sanitaire correcte.), rendant encore plus rude, voire illusoire la compétition. Les politiques publiques doivent tenir compte de cet état de fait. L'appui aux unités de collecte et de distribution du lait local est une priorité, sous réserve que le développement de la production locale en soit une aux yeux des dirigeants.

Poor wastewater management that results from a lack of appropriate sanitation infrastructure contributes to increasing health risks in urban areas in Côte d'Ivoire. We assessed the health risks associated with the use of wastewater for watering salad destined for human consumption, to help local authorities in developing appropriate risk mitigation measures for Yamoussoukro, the political capital of Côte d'Ivoire. We applied a stochastic approach based on quantitative microbiological risk assessment (QMRA), focusing on wastewater for farming activities and salad consumption at the household level. Farming activities rely on a large degree on contaminated water and are conducted without any protection. The QMRA highlights that the poor quality of watering water increased the microbiological risk of the two assessed groups of urban farmers and individual households. The annual risk of infection due to watering wastewater in the city is estimated at 0.01 per person per year (pppy) for Giardia lamblia and 0.2 pppy for Escherichia coli O157:H7. The annual risk from salad consumption is 0.01 pppy for G. lamblia and 0.9 pppy for E. coli O157:H7. Both the annual risks from farming activities and salad consumption were higher than the tolerable standard of risk of 10−4 pppy as defined by the World Health Organization. There is a need to conduct a risk analysis and a cost-effectiveness study on intervention to improve public health and the livelihoods of the producers which are women in majority in Yamoussoukro. ; Programme d'Appui Stratégique à la Recherche Scientifique, Côte d'Ivoire ; National Centre for Competence in Research North-South, Switzerland ; Peer Review

The authors acknowledge support from the DELTAS Africa Initiative [Afrique One-ASPIRE /DEL-15-008]. Afrique One-ASPIRE is funded by a consortium of donor including the African Academy of Sciences (AAS) Alliance for Accelerating Excellence in Science in Africa (AESA), the New Partnership for Africa's Development Planning and Coordinating (NEPAD) Agency, the Wellcome Trust [107753/A/15/Z] and the UK government. ; Background: Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. Methods: Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatmentseeking actions. Results: Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatmentseeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the ...

There is increasing policy demand for real-time evaluations of research and capacity-building programmes reflecting a recognition of the management, governance and impact gains that can result. However, the evidence base on how to successfully implement real-time evaluations of complex interventions in international development efforts is scarce. There is therefore a need for reflective work that considers methodologies in context. This article shares learning from the experience of conducting a participatory, real-time, 'theory driven' evaluation of the African Institutions Initiative, a Wellcome Trust-funded programme that aimed to build sustainable health research capacity in Africa at institutional and network levels, across seven research consortia. We reflect on the key challenges experienced and ways of managing them, highlight opportunities and critical success factors associated with this evaluation approach, compared with alternative evaluation approaches.

Poor waste management is a key driver of ill-health in urban settlements of developing countries. The current study aimed at assessing environmental and human health risks related to urban waste management in Yamoussoukro, the political capital of Côte d'Ivoire. We undertook trans-disciplinary research within an Ecohealth approach, comprised of a participatory workshop with stakeholders and mapping of exposure patterns. A total of 492 randomly selected households participated in a cross-sectional survey. Waste deposit sites were characterised and 108 wastewater samples were subjected to laboratory examinations. The physico-chemical parameters of the surface water (temperature, pH, conductivity, potential oxidise reduction, BOD5, COD, dissolved oxygen, nitrates, ammonia and total Kendal nitrogen) did not comply with World Health Organization standards of surface water quality. Questionnaire results showed that malaria was the most commonly reported disease. Diarrhoea and malaria were associated with poor sanitation. Households having dry latrines had a higher risk of diarrhoea (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.2–2.7) compared to latrines with septic tanks and also a higher risk for malaria (OR = 1.9, 95% (CI) 1.1–3.3). Our research showed that combining health and environmental assessments enables a deeper understanding of environmental threats and disease burdens linked to poor waste management. Further study should investigate the sanitation strategy aspects that could reduce the environmental and health risks in the study area.

AbstractBuruli ulcer (BU) belongs to the group of neglected tropical diseases and constitutes a public health problem in many rural communities in Côte d'Ivoire. The transmission patterns of this skin infection are poorly defined, hence the current study aimed to contribute to the understanding, perceptions and interpretations of its mode of transmission using a socio-environmental approach. Social and environmental risk factors that may expose people to infection, and the dynamics of local transfer of knowledge and practices related to BU, were assessed in two endemic locations in southern Côte d'Ivoire, i.e. Taabo and Daloa. Data were generated by the administration of a household questionnaire (N=500) between February and June 2012 to assess how the population perceived transmission of BU, focus group discussions with local communities (N=8) to analyse ideologies regarding transmission patterns and semi-structured interviews with patients or their parents, former BU patients and traditional healers (N=30). The interviewees' empirical knowledge of the disease was found to be close to its biomedical description. Their aetiological perception of the disease was linked to natural (e.g. dirty water, insects) and supernatural (e.g. witchcraft, fate) causes. Some informants attributed the spread of the disease to recently immigrated neighbouring communities whose arrival coincided with an increase in reported BU cases. However, the general consensus seemed to be that the main mode of transmission was contact with infested soil or ulcerated wounds. The participants were aware that BU was a socio-environmental problem in these endemic areas, offering a good starting point for educational campaigns for at-risk communities. Buruli ulcer control programmes should therefore include educational campaigns and Water, Sanitation and Hygiene (WASH) interventions for those at risk in affected communities.

Poor waste management is a key driver of ill-health in urban settlements of developing countries. The current study aimed at assessing environmental and human health risks related to urban waste management in Yamoussoukro, the political capital of Côte d'Ivoire. We undertook trans-disciplinary research within an Ecohealth approach, comprised of a participatory workshop with stakeholders and mapping of exposure patterns. A total of 492 randomly selected households participated in a cross-sectional survey. Waste deposit sites were characterised and 108 wastewater samples were subjected to laboratory examinations. The physico-chemical parameters of the surface water (temperature, pH, conductivity, potential oxidise reduction, BOD5, COD, dissolved oxygen, nitrates, ammonia and total Kendal nitrogen) did not comply with World Health Organization standards of surface water quality. Questionnaire results showed that malaria was the most commonly reported disease. Diarrhoea and malaria were associated with poor sanitation. Households having dry latrines had a higher risk of diarrhoea (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.2–2.7) compared to latrines with septic tanks and also a higher risk for malaria (OR = 1.9, 95% (CI) 1.1–3.3). Our research showed that combining health and environmental assessments enables a deeper understanding of environmental threats and disease burdens linked to poor waste management. Further study should investigate the sanitation strategy aspects that could reduce the environmental and health risks in the study area.

Despite considerable improvement of food security in low- and middle-income countries over the last decades, food shortages remain persistent in sub-Saharan Africa. The driving forces are often related not only to climate change and other environmental hazards but also to socioeconomic and political factors. In Africa, food security has also assumed a strong urban dimension, raising new issues of physical and financial access to food. However, beyond the conjunctural rhetoric around unregulated food policies, social unrest, socio-economic difficulties, and environmental stresses, an emphasis should be put on socio-cultural aspects of food security. This would be possible through an analysis of "connectivities" between various stages and actors, i.e., food exchange practices between various socioecological spaces, and governance coordination in food security strategies. Based on a study on cassava shortage in Cote d'Ivoire in 2015-2016, this paper explores sociocultural factors associated with food shortage in urban settings. Findings from a qualitative research approach comprising key-informant interviews and focus group discussion with various stakeholders in the cassava value chain revealed that food shortage cannot always be explained by supply/demand narratives. The study shows that cassava supply mechanisms in the Abidjan area are not sustainable as the main producers of cassava for sale are migrant workers employed in rubber plantations and whose stability in the region depends on prices of this cash crop on the international market. Regions at the vicinity of Abidjan are supplying the city with cassava but the offer does not meet the requirements of cassava-based food processors who need specific types of the product. Moreover, strategies from the municipal and government authorities to circumvent the shortage often face resistance of populations if local norms and values are not considered. In food strategies, sociocultural dynamics should be considered alongside the complex socioeconomic and environmental factors shaping the social geography of food supply in African cities.

At the beginning of the COVID-19 outbreak, preventive measures seemed the most appropriate method to control its spread. We assessed the knowledge, attitudes, and practices of the Ivorian public regarding preventive measures, conducting a hybrid survey across the country. Participants were invited to complete a questionnaire online, by phone, or face-to-face. Chi-squared, Fisher's exact, and Kruskal–Wallis tests were used to compare the frequency of responses regarding compliance with preventive measures. Data were validated for 564 individuals. Over one-third of respondents believed that COVID-19 was related to non-natural causes. Though the disease was perceived as severe, respondents did not consider it to be highly infectious. Overall, 35.6% of respondents fully trust health officials in the management of the pandemic, and 34.6% trusted them moderately. Individuals who believed COVID-19 was a disease caused by a pathogen and the well-educated were likely to comply with preventive measures. About 70% of respondents stated that their daily expenses had increased due to preventive measures. The study concludes that beyond unfavorable socioeconomic conditions, the level of knowledge regarding COVID-19 and trust in the government/health system are more likely to influence compliance with preventive measures such as self-reporting, physical distancing, the use of face masks, and eventually the acceptability of vaccines.