Yopougon University Hospital Research Articles

Impact of Hydroxyurea on Clinical and Biological Parameters of Sickle Cell Anemia in Children in Abidjan.

Background: The lives of individuals affected by sickle cell disease are marked by painful crises sometimes accompanied by complications. Curative treatments such as bone marrow transplantation or gene therapy exist, but are not currently performed in Côte d'Ivoire. Treatment with hydroxyurea remains an effective alternative. The aim of our study is to contribute to improving the management of children with sickle cell disease.
 Methods: We conducted a prospective observational study from November 2017 to April 2019 at the at the Yopougon University Hospital. Children aged 5 to 15 years experiencing at least 3 vaso-occlusive crises (VOC) per year were included in the study after obtaining informed and written consent from their parents. Each patient received a daily dose of 15mg/kg of hydroxyurea.
 Results: The mean age of the children was 9 years. More than 75% of patients were homozygous SSFA2 major sickle cell individuals. After 6 months on hydroxyurea, our study observed rates of 84.4%, 100%, and 97.8%, respectively, for the absence of vaso-occlusive crises, hospitalization, and transfusion. Biologically, from M0 to M12 the mean hemoglobin level increased significantly, from 7.24 to 8.55 g/dL; white blood cell (WBC) and platelet counts decreased; Fetal hemoglobin (Hb F) increased significantly from 10.3% to 19.7%. Biochemical parameters within normal ranges, except for a moderate treatment-related increase in transaminases.
 Conclusion: The induction of fetal hemoglobin (Hb F) production through hydroxyurea intake is the primary mechanism by which hydroxyurea modifies the pathogenesis of sickle cell disease

Micropenis Associated or Not with Cryptorchidism in the Endocrinology Department of Yopougon University Hospital in Ivory Coast: Epidemiological, Clinical, Paraclinical and Therapeutic Aspects

Micropenis Associated or Not with Cryptorchidism in the Endocrinology Department of Yopougon University Hospital in Ivory Coast: Epidemiological, Clinical, Paraclinical and Therapeutic Aspects

Epidemioclinical, Therapeutic and Prognostic Features of Tropical Endemic Limbo-Conjunctivitis (TELC) at the Yopougon University Hospital: A Report About 150 Cases Collected

Epidemioclinical, Therapeutic and Prognostic Features of Tropical Endemic Limbo-Conjunctivitis (TELC) at the Yopougon University Hospital: A Report About 150 Cases Collected

Determinants of virological failure in HIV1 infected patients followed in a third-level hospital Abidjan, Cote d’Ivoire

: Côte d'Ivoire has been committed to achieving the UNAIDS 90-90-90 targets of People Living with HIV (PLHIV) follow-up since 2015. The proportion of patients on antiretroviral therapy (ART) was below the desired rates for 2020. The laboratory of the University Hospital Center (CHU) of Yopougon has been equipped with instruments capable of quantifying the plasma viral load (VL) of PLHIV on ART. This quantification allowed for early detection of virological failure in PLHIV. The objective of this study was to determine the rate of virological failure and the epidemiological, immunological and virological determinants of virological failure in patients followed at the Yopougon University Hospital in Abidjan. : This was a retrospective study covering the period from January 1, 2015 to October 31, 2019. It was carried out on data related to blood samples (plasma) of PLHIV (infected with HIV-1) under ART for at least 6 months and who had quantified their viral load.: A total of 52356 PLHIV were included in this study. The age group 40-50 years comprised the majority of the patients (46.7%) with a median age of 40 +/- 0.3 years. The female sex predominated with 72% and a sex ratio of (M/F) = 0.38. The TCD4 cell were between 500 and 350 cells/µL in 57.0% of patients at treatment initiation. The TDF+3TC+EFV treatment regimen was prescribed in the majority of patients (88.62%). The population of patients with virological failure (defined as VL ≥ 1000 copies/ml) was 12924 or a prevalence of 24.7%. The determinants of virological failure were age ≤ 15 years, male sex and CD4+ LT rate below 250 cells/µL (p <0.05).: The virological failure rate was high especially in children and male subjects at the Yopougon University Hospital. It appears therefore important to act on these determinants, by additional efforts through concrete actions such as regular and systematic measurement of CV at the time of rapid change of treatments with effective combinations for this type of PLHIV. The goal is to achieve the objectives of the UNAIDS to eradicate HIV by 2030.

Itinéraire thérapeutique des enfants atteints de paralysie cérébrale admis en médecine physique et de réadaptation (MPR) à Abidjan en 2018

ObjectiveTo analyze the different stages of the medical and rehabilitation follow-up of children with cerebral palsy (CP) before their admission to the PMR department. MethodsCross-sectional study analyzing the care pathway of 58 children with PC before their admission to the MPR department of the Yopougon University Hospital over the period from June to September 2018. ResultsThe majority of children with male CP (58.6%) were the first or second child in the siblings. The parents lived as a couple (84%) and resided in the city of Abidjan (87%) but the children lived with both parents in 77.6%. Diagnosis made in a university hospital (46.5%) or in a clinic private (29.3%) by specialists in pediatrics (53.4%) and neurology (34.5%). The time to diagnosis was more than 6 months in 55.2 %. These parents used several therapies: medical (62.07%), traditional (31.03%) and spiritual (6.90%). The most used therapeutic route was medical-traditional-medical (29.3%). The factors influencing the choice of route were the parents’ culture and beliefs (75.9%) and family and economic factors. ConclusionNeed to develop a precise therapeutic circuit for children with CP.

Evaluation of the knowledge of type 2 diabetic patients on diabetes in the Endocrinology-Diabetology Department of the Yopougon University Hospital, Abidjan

The diabetic patient's knowledge of his pathology is integral to his care, and his training in this area has become a public health priority. The objective of this study was to assess the knowledge of type 2 diabetic patients followed in the Endocrinology Department of the University Hospital of Yopougon. We carried out a cross-sectional and analytical descriptive study in 2019, in type 2 diabetic patients followed for at least one year who consented to participate in the study. Data were collected using a questionnaire designed for the study and administered by the investigators. A total of 137 patients were included, of which 68.7% were women. The overall level of patient knowledge was insufficient at 59%, 53.1% had a blood glucose meter and only 15.7% had already attended at least two therapeutic education sessions (TPE) conducted in the service. The threshold for defining diabetes was known in 17.7% of patients, signs of hyperglycemia were known in 70.6% of patients, and symptoms of hypoglycemia were known in 53.1% of them. Chronic complications were known in 72.8% of patients. After multivariate logistic regression, the factors associated with a good level of knowledge were: possession of a blood glucose meter p<0.01, high school level p<0.01, and duration of diabetes p=0.02. The higher the school level or the older diabetes, the better the level of knowledge was p<0.01.

Evaluation of the knowledge of type 2 diabetic patients on diabetes in the Endocrinology-Diabetology Department of the Yopougon University Hospital, Abidjan

Evaluation of the knowledge of type 2 diabetic patients on diabetes in the Endocrinology-Diabetology Department of the Yopougon University Hospital, Abidjan

Socio-economic aspects of the management of chronic viral hepatitis in Côte-d’Ivoire

Context and objectives. Chronic viral hepatitis is a public health problem in Côte-d’Ivoire. A significant number of patients have little access to treatment due to the high costs of assessment and treatment. The objective of our study was to evaluate the costs of assessments and treatment of chronic viral hepatitis. Methods. This was an analytical cross-sectional observational study from March 1, 2019 to July 31, 2019 in the Hepato- Gastroenterology Consultation Service at the Yopougon University Hospital. The variables studied were socio-demographic and economic parameters. Results. 136 patients (men 53.6 %, average age 42 ± 12.2 years) were included. More than half of the patients (63.3 %) had a monthly income not exceeding 490.39 USD. The cost ofthe initial assessment was 223.13 USD and 351.14 USD for viral hepatitis B and C, respectively. Tenofovir and pegylated interferon were free of charge. Treatment with sofosbuvir + velpastavir cost 593.37 USD. The annual follow-up assessment was estimated at 237.02 USD for viral hepatitis B and 225.58 USD for viral hepatitis C. Conclusion. The assessment and treatment of chronic viral hepatitis have a cost that remains high for patients despite the universal health coverage.

Dissatisfaction of Patients Operated under Rachi Anaesthesia: Study of the Experience of Patients Treated at the Chu De Yopougon (Cote D'ivoire)

Background: To evaluate the satisfaction of patients operated under spinal anaesthesia and to identify its determinants.
 Methods: We conducted a prospective analytical study in the hospital wards of the gynaecology-obstetrics, general surgery and traumatology departments of the Yopougon University Hospital in Abidjan (Côte d'Ivoire) over a period of 5 months from February to June 2019.
 Results: At the end of the study, 156 patients were selected. The mean age was 38.89±14.28 years with extremes of 19 and 72 years and a sex ratio of 0.8. The unemployed represented 20.41% of the total number of patients. The types of intervention were dominated by caesarean sections with 53.21% of patients. All our patients had a pre-anaesthetic consultation which was carried out by an anaesthetist, however 44.23% were dissatisfied due to anxiety. During the operation, nausea and vomiting were the main sources of discomfort for 25% of patients. Thirst, hunger and pain were the most common discomforts encountered in the ICU by 40.38%, 42.31% and 36.52% respectively. The determinants of dissatisfaction were age over 45 years, female gender of patients. Osteosynthesis of the femur and osteotomy of the tibial plateau were significantly associated with a reduction in dissatisfaction.
 Conclusion: Several causes of dissatisfaction remain during spinal anaesthesia. Their management would allow to improve the comfort of our patients, thus the quality of care.

Steady-state indirect bilirubin level in sickle cell anemia: A comparative hospital-based cross-sectional study

Background: The major forms of sickle cell disease are characterized by hemolysis. The extent of this hemolysis may itself depend on the form of the disease even in the steady-state. This study aims to compare the indirect bilirubin level between the homozygous and beta plus sickle cell anemia (SAFA2) in the steady-state conditions. Material and methods: Fifty subjects of each forms, homozygous and beta plus sickle cell anemia were enrolled in a comparative hospital-based cross-sectional study from April 2008 to May 2008 at the laboratory of the university hospital of Yopougon, Ivory Coast. Subjects of each form awaiting their visits were selected from the database of the patients regularly followed in the clinical hematology department of Yopougon University Hospital. During their visits, clinical and socio-demographic data were collected, and a blood sample was also taken to carry out biological examinations. Blood count and bilirubin testing were performed by using Sysmex Kx-21™ and BioMérieux KONELAB-20™, respectively. Data were analysis in the software Statistical Product and Service Solutions version 12.0. Shapiro test was used to verify data normality and Student t-test for the comparison of parametric data means or Mann-Whitney’s independent test for none-parametric data. Pearson Chi square tests or Yate’s correction test for continuity where the first test was not appropriate. The threshold of statistical significance was set at p ≤ 0.05. Results: The median Hb was higher in SAFA2 patients compared to homozygous SSFA2 patients 10.7 g/dL [IQR = 8] vs 7.3 g/dL [IQR = 7]; p < 0.001. In contrast, the median of indirect bilirubin was lower in SAFA2 patients compared to SSFA2 patients 5.6 μmol/L [IQR = 10] vs 15.1 μmol/L [IQR = 13], p < 0.001. The ratio of these two medians shows that subjects SAFA2 hemolysis 2.7 times less than the homozygous subjects SSFA2 in the steady-state. Out of the one hundred subjects, indirect hyperbilirubinemia defined as indirect bilirubin median > 14 μmol/L was higher in men than in women 79.2% vs 20.8%, p = 0.01 whereas patients age groups was not associated to indirect hyperbilirubinemia, p = 0.4. Conclusion: Our data suggest that the hemolysis is higher in subjects SSFA2 than SAFA2 subjects in the steady-state. This marked chronic hemolysis of SSFA2 subjects must be taken into account when it comes to give a comprehensive care to these subjects.

Survival of Acute Myeloid Leukaemia Patients- A Retrospective Study from the Yopougon University Hospital, Abidjan, Ivory Coast

Introduction: The survival of acute leukaemia patients has improved significantly thanks to multidrug chemotherapy and the development of cell therapy and marrow transplantation. However, this is not the case in Middle Income Countries (MICs), particularly in Côte d’Ivoire, West Africa where much efforts are still needed to improve the treatment of these patients.This study raises the issue of the fate and survival of Acute Myeloid Leukaemia (AML) patients in these countries. Aim: To study the overall survival and survival factors of patients with AML under the present practice conditions. Materials and Methods: This retrospective study was conducted in the Department of Haematology of Yopougon University Hospital in Abidjan, Ivory Coast. The data was collected from January 2005-April 2019 and data processing happened over a duration of one year from November 2019-November 2020. The mortality and survival were studied on 75 AML patients.The socio-demographic, pretherapeutic and therapeutic characteristics were recorded. Statistical Package for the Social Sciences (SPSS) statistics version 26 was used for data analysis, comparisons were done using by the Chi-square test and survival through the Kaplan Meier method and the log rank test. Results: The patient’s age ranged from 1 to 74 years, with two peaks (37 and 49 years old) with a sex ratio at 1.03. Majority of patients (50.7%) had a low socio-economic level. Overall, 81.6% of patients started treatment within two weeks. Out of total patients 38 (50.7%) patients received chemotherapy, which was curative for 10 (13.33%) patients and palliative for 28 (37.33%) patients. There was not a single patient of complete remission. A total of 4 (5.3%) were alive, 51 (68%) died, and 10 (26.7%) were lost to follow-up. The average overall survival (OS) was 90 days and the probabilitý of Overall Survival (OS) was 62% at one month, 49% at six months, and 10% at one year. The predictive factors for prolonged survival were high socioeconomic level (p=0.046) - absence of bleeding syndrome (p-0.04) - haemoglobin level ≥10 g/dL (p-0.02) - cytological type different from AML-M0 (p-0.05). Conclusion: The therapeutic results were inferior to those obtained in developed countries where high level diagnostic and therapeutic techniques give very promising results. This study highlighted the difficulties of AML management and identified five prognostic factors of survival in the care conditions of MIC.

Doppler Ultrasound Abnormalities of the Lower Limbs in Patients with Diabetic Foot at the Yopougon University Hospital in Ivory Coast

Doppler Ultrasound Abnormalities of the Lower Limbs in Patients with Diabetic Foot at the Yopougon University Hospital in Ivory Coast

Expérience africaine monocentrique de la prise en charge personnalisée des cancers du sein à Abidjan : défis et perspectives

AimTo present the results of the personalized care of Ivorian women suffering from breast cancer since the advent of immunohistochemistry in Côte d’Ivoire. MethodsWe carried out a single-center retrospective study at the Yopougon university hospital from January 2014 to December 2018. All women's breast cancer with complementary immunohistochemistry and treated at the Yopougon hospital center were selected. Standard descriptive statistical tests were used to describe patient and tumor characteristics, and univariate and multivariate analyzes were performed with a statistical significance set at a P-value of 0.05 using SPSS version 20.0. ResultsThe mean age of women is 48.27 years, SD (11.92). 50.88 % of the tumors were hormone-dependent. The triple negative subgroup was the most represented (43.28 %) followed by luminal A (35.42 %). Conservative treatment represented 18.51 % of cases. In the univariate analysis, the risk of developing a hormone-dependent cancer is statistically significant respectively in women with an education level removed OR=1.98 (P˂0.015) and with a wealthy salary OR=1.85 (P˂0.009). On the other hand, the high level of education (OR=0.44; P˂0.005), and the well-off salary condition (OR=0.59; P˂0.024) would be protective factors for the development of triple negative breast cancer. All these factors are not significant in multivariate analysis, whether for hormone-dependent or triple negative tumors. ConclusionThe personalized care of breast cancer in our African context remains difficult and must take into account several medical and extra-medical parameters.

Indication for Doppler evaluation in the management of intrauterine growth restriction of vascular origin in Sub-Saharan Africa

Objective: To assess the contribution of Doppler in foetal monitoring and decision-making during delivery in case of in-utero vascular growth retardation.
 Design: We conducted a retrospective cohort study from January 2015 to December 2017 in the Gynaecology and Obstetrics Department of the Yopougon University Hospital (Abidjan, Ivory Coast). It included 130 patients who gave birth in a setting of pre-eclampsia with intrauterine growth restriction (IUGR) from 28 weeks of amenorrhoea.
 Results: The average age of patients was 31years. Nulliparous (33% of our patients) and pauciparous (41% of our patients) women were the group most affected. The mean gestational age at the first Doppler examination was 32 weeks of amenorrhoea. Doppler abnormalities were 65% in uterine Doppler and 90% in umbilical Doppler. The meancerebrovascular ratio was reversed in 90% of the cases. Perinatal mortality was 22.3% (n = 29) with 21 foetal death in utero and 8 neonatal deaths. The time interval between absent end-diastolic or reverse flow velocity and in-utero foetal death was 3.8 days.
 Conclusion: Foetal and umbilical Doppler ultrasound greatly modified the management of intrauterine growth retardation related to hypertension.

Indication for Doppler evaluation in the management of intrauterine growth restriction of vascular origin in Sub-Saharan Africa

Objective: To assess the contribution of Doppler in foetal monitoring and decision-making during delivery in case of in-utero vascular growth retardation.
 Design: We conducted a retrospective cohort study from January 2015 to December 2017 in the Gynaecology and Obstetrics Department of the Yopougon University Hospital (Abidjan, Ivory Coast). It included 130 patients who gave birth in a setting of pre-eclampsia with intrauterine growth restriction (IUGR) from 28 weeks of amenorrhoea.
 Results: The average age of patients was 31years. Nulliparous (33% of our patients) and pauciparous (41% of our patients) women were the group most affected. The mean gestational age at the first Doppler examination was 32 weeks of amenorrhoea. Doppler abnormalities were 65% in uterine Doppler and 90% in umbilical Doppler. The meancerebrovascular ratio was reversed in 90% of the cases. Perinatal mortality was 22.3% (n = 29) with 21 foetal death in utero and 8 neonatal deaths. The time interval between absent end-diastolic or reverse flow velocity and in-utero foetal death was 3.8 days.
 Conclusion: Foetal and umbilical Doppler ultrasound greatly modified the management of intrauterine growth retardation related to hypertension.

Caractéristiques préthérapeutiques et évolutives des patients atteints de la leucémie myéloïde chronique à Abidjan Côte d’Ivoire

The diagnosis of chronic myeloid leukemia is based on the presence of translocation t(9,22). Additional cytogenetic abnormalities may exist at diagnosis and have prognostic value. The authors evaluated the relationship between these additional chromosomal abnormalities, clinical presentation, and therapeutic response. In a retrospective and comparative study from 2005 to 2015, at Yopougon university hospital, 51 cases of myeloid leukemia were selected, including 22 cases with additional chromosomal abnormalities. Thirteen types of additional Ph1 abnormalities were detected in one group, with a median age of 39years (13-73); a sex ratio of 1.4 and a low social class (49%). The median consultation time is 13months (2-29). Hepatomegaly (54%, P=0.05); fever (81.8%, P=0.0017); bone pain (63.6%, P=0.0001); lymphadenopathies (27.3% P=0.014); poor general condition [WHO>1 (77.3%, P=0.001)], high Sokal index (63.6%, P=0.0019), eosinophilia>5% (72.7, P=0.02) and circulating blastosis were found more frequent in the group with additional abnormalities treated with imatinib mesylate. We obtained 13.6% hematologic remission and 22.7% cytogenetic remission (P=0.02). The average survival was relatively short (20months vs. 76.4months, Log-rank<0.0001). We deplored a high death rate (59.1%). The presence of an additional anomaly constitutes a pejorative element refractory to imatinib.

Interest of late cerclage on open cervix with amniotic membrane’s hernia in an African environment. Review of 11 collected cases at Yopougon University hospital in Abidjan (Ivory Coast, West Africa)

Objective: To demonstrate effective strapping emergency in the therapeutic management of threat with opencervix. Methodology: We conducted a descriptive cohort study at Yopougon Abidjan (Cote d'Ivoire) University Hospital. Over a period of two years (February 2015 to January 2017), the study concerned 11 gestantes who presented a severe threat of late miscarriage with the opened cervix, protrusion and intact membranes in the second trimester of Pregnancy. For all pregnant, a strapping of the cervix has been performed according to Mac Donald’s procedure. Results: Mean’s age of patients was 30 years, 27.30% primigravida and 36.40% nulliparous. More than half (55%) had a history of abortion. Symptomatology was dominated by pelvic pain (63.60%). The average gestational age at the time of strapping was 20 weeks. The average duration of the interventions was 12, 27min and hospitalization of pregnant after cerclage was 3 days. Following up was marked by a new hospitalization in 3 patients, because of membrane’s rupture at 31 weeks of pregnancy. Average gestational age for childbirth was 36 weeks, 82% of births by cesarean section. 64% of children were born with a score of APGAR greater than 7 at the first minute. No cases of newborn death have been noted. The average time between strapping and childbirth was 115 days or 15 weeks. Conclusion: Emergency cervical strapping is used to prolong the duration of pregnancy and to reduce the risk of high prematurity, thereby improving fetus viability and prognosis.

Depression in a situation of persistent motor handicap: Case of vascular hemiplegia in an African context

Post-stroke depression is a very common nosological entity and its perception in Africa is sometimes experienced as a stigmatizing situation, often poorly accepted. To specify the incidence of depression after vascular hemiplegia, and also its functional repercussion in rehabilitation in the PMR department at Yopougon's University Hospital. It was an eight-month prospective cross-sectional study from January to August 2016. It involved all cases of patients with hemiplegia following a stroke managed in the PMR service. Patients presenting in addition severe cognitive impairment were excluded. On 49 hemiplegic patients, 19 patients with a mean age of 57.21 years with extremes of 37 and 70 years had post-stroke depression (38.8%), mostly men with a sex ratio of 1, 71. Ischemic stroke represented 89.5% of the PSD; 11 patients (57.9%) had minor depression and 8 patients (42.1%) had severe depression. There was a suicidal risk in 6 patients, 31.6%. Motor handicap was present in all depressed patients with an average Demeurisse's score at 55.16/100 and extremes ranging from 9 up to 80. Post-stroke depression is common in our context despite its debilitating and poorly accepted nature by a segment of the general population. It compromises the functional prognosis, which is a source of demotivation for patients, especially for the execution of the rehabilitation program. Post-stroke depression should be searched systematically in all hemiplegic vascular in our African context, during the decline in performance and achievements during rehabilitation sessions, and during regular meetings with the family.

Liver Transient Elastography Combined to Platelet Count (Baveno VI) Predict High Esophageal Varices in Black African Patient with Compensated Hepatitis B Related Cirrhosis

Aim: To assess the predictive value of the Baveno VI criteria for the diagnosis of large esophageal varices (EV) in Black African patient with compensated hepatitis B related cirrhosis. Methods: We carried out a cross-sectional study from January 2 to July 3 (2016), in Department of Gastroenterology at University Hospitals of Cocody (CHUC) and Yopougon (CHUY). All the black African patients included were more than 15 years old and their liver elasticity score (LES) was carried out at Yopougon University Hospital. Hepatitis B related cirrhosis was defined by LES ≥ 11 kPa (FibroScan® (Echosens, France)) with positive HBs antigen (HBsAg) and anti HBc antibody. All the patients with hepatitis B related cirrhosis performed a gastroscopy at Cocody University Hospital and esophageal varices were ranked according to societe francaise d’endoscopie digestive (SFED) classification. Data analysis was performed by SPSS model 20.0 statistics software (SPSS Inc., Chicago, IL, United States). Diagnostic performance of LES 150,000/mmm3 (Baveno VI criteria) for the diagnosis of large EV by gastroscopy was studied (area under the ROC curve, specificity (Sp), sensitivity (Se), positive predictive value (PPV) and negative predictive value (NPV). Results: During the study period, 720 patients achieved liver FibroScan® at CHUY. Of these, 60 respondents to our inclusion criteria were prospectively included in our study. Twelve (20%) of these 60 patients met the Baveno VI criteria. EV were present in 40% of cases (n = 24) with 6.7% (n = 4), 15% (n = 9) and 18.3% (n = 11) of grade 1, 2 and 3, respectively. (66.7% (n = 40) without EV or with small EV) and 33.3% (n = 20) with large EV. The Baveno VI criteria had a Se, Sp, PPV and NPV of 100%, 41.6%, 30% and 100% respectively for the diagnosis of large EV. The area under the ROC curve of a platelet count greater than 150,000/mm3, a liver elasticity score of less than 20 kPa and combination of both were respectively 0.763 [0.645 - 0.880; P = 0.272]; 0.588 [0.436 - 0.739; P = 0.01] and 0.650 [0.513 - 0.787 P = 0.005]. Conclusion: The combination of liver elasticity score 150,000/mm3, allowed the exclusion of large esophageal varices at gastroscopy with a 100 % NPV in Black African patients with compensated hepatitis B related cirrhosis.

Factors Associated with Non-Adherence to Antiretroviral Therapy among HIV-Infected Adolescents at Pediatric Department of Yopougon University Hospital, C&amp;#244;te d’Ivoire

Context: The consequences of non-adherence to antiretroviral therapy (ART) are harmful in terms of morbidity and mortality among HIV-infected adolescents. There is a little data in this population in West Africa, about non-adherence to ART. Objective: To identify factors associated with non-adherence to ART in adolescents at the Pediatric Ambulatory Treatment Center (PATC) of the pediatric department of Yopougon University Hospital. Materials and Methods: A cross-sectional study was conducted from May to July 2017 among adolescents aged 10 to 19 years old at PATC of pediatrics department of Yopougon University Hospital. We have considered that adolescent was not adherent to ART when he affirm that he have not taking ART at least once in the week before the survey. A logistic regression model was used to identify factors associated with non-adherence to ART. Results: Overall 166 adolescents were included. The median age was 15 years old [IQI = 13 - 17 years]. They had a detectable viral load greater than 1000 copies/ml in 41.8% of cases. The rate of non-adherence to ART was 40.4%. The factors associated with non-adherence to ART were male [OR = 2.5 (CI = 1.1 - 10.0)], having parent widowed [OR = 7.8 (CI = 1.6 - 39.3)] or divorced [RC= 3.7 (IC=1.1 - 13.5)], CD4 inclusion rate ≥ 500 cells/ml [OR = 8.5 (CI = 1.6 - 45.5)] and duration on ART ≥ 10 years [OR = 8.9 (CI = 1.6 - 50)]. Conclusion: A rigorous therapeutic education taking into account associated factors in this study is necessary to reduce the rate of non-adherence among adolescents at PATC.