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D Kerouedan

Publications and source records attributed to D Kerouedan.

10 recordsLinked to original sources
PubMed2004

[Issues on user participation in health care management in Africa].

The 1990s witnessed great progress in increasing community participation in the management of health care services as an objective for reform of healthcare systems especially in urban areas benefiting from funding from the international community. Community participation has taken various forms from one country to another in terms of sources of healthcare training (public, private, or both), organization of management committees (inclusion or not of healthcare personnel), and scope of public service assigned to district health care units (preventive and/or curative care, management of proceeds from provision of health care procedures and/or medication, etc.). These strategies have had variable results and, although some urban programs have been evaluated, no attempt has been made to use this experience as a basis for analyzing the political implications of issues involving citizenship and public health. This report presents some ideas on these issues from the point of view of both governments and citizens and restates the purpose of user participation in healthcare services in Africa. That intent involves the need not only to increase household contributions to the cost of healthcare especially within the uncertain economic environment of urban areas but also to improve access to as well as quality of healthcare services.

Africa↗
PubMed1998

[The campaign against AIDS in west Africa: what perspectives at the end of the century? From the situation of the Cote d'Ivoire as observed from the period 1987-1997].

WHO is commissioned to create the World AIDS Program and to elaborate the strategy for the fight against the AIDS pandemic. The standardised strategy for African countries developed in Geneva in 1987 favours the prevention of sexual transmission of HIV without communicating the methods for such. The external and exclusive nature of the technical intervention of WHO and the lack of its adaptation to the dynamics of the epidemic in the 90s, (increase in seroprevalence among pregnant women, increase in the number of sick and HIV infected children, and economical and social consequences of the disease) explain in part the fact that the objectives haven't been reached on the continent a decade later. It seems important to us that the national authorities take responsibility concerning the development of an integrated strategy for AIDS prevention-care that takes into account the determinants of the propagation of the virus in Africa, advocates widespread access to testing-counselling for the general population and pregnant women, provides training for all health personnel concerning care for infected people, and promotes the implementation of social mechanisms for the future and financing for care, including symptomatic treatment for opportunistic infections.

AIDS Serodiagnosis↗
PubMed1996

Mother-to-child transmission of human T-cell lymphotropic virus types I and II (HTLV-I/II) in Gabon: a prospective follow-up of 4 years.

SUMMARY: For 4 years. we determined the mode and risk of mother-to-child transmission of HTLV-I in a prospective cohort of 34 children born to seropositive mothers in Franceville, Gabon. We also determined the prevalence of antibodies to HTLV-I/II in siblings born to seropositive mothers. Antibodies to HTLV-I/II were detected by Western blot, and the proviral DNA was detected by the polymerase chain reaction (PCR). The risk of seroconversion to anti-HTLV-I for the 4 years of follow-up was 17.5 percent. Anti-HTLV-I/II and proviral DNA were only detected after age 18 months. We observed a seroprevalence rate of 15 percent among the siblings born to HTLV-I/II seropositive mothers. Furthermore, we report a case of mother-to-child transmission of HTLV-II infection in a population of HTLV-II-infected pregnant women that is emerging in Gabon. The lack of detection of HTLV-I/II proviral DNA in cord blood and amniotic fluid and, furthermore, the late seroconversion observed in the children indirectly indicate that mother-to-child transmission occurred postnatally, probably through breast milk.

Amniotic Fluid↗
PubMed1991

Genetic variability affects the detection of HIV by polymerase chain reaction.

Nine isolates of HIV-1 obtained from Congolese AIDS patients were amplified by the polymerase chain reaction (PCR) using primer pairs and oligomer probes derived from the HIV-1 LAV-BRU (BRU) sequence. When compared to BRU, two isolates exhibited a significant decrease of PCR efficiency with a given primer pair. Moreover, the DNA amplified from two other isolates did not hybridize with the corresponding probe despite efficient PCR. Base substitutions were detected in the regions of proviral genomes involved in oligonucleotide annealing and were assumed to be responsible for the failure of both amplification and probing. Our data confirm that the genetic variability of HIV-1 may reduce the efficiency of PCR as a diagnostic procedure, especially in the case of African isolates.

Base Sequence↗
PubMed1989

Interpretation of antibodies reacting solely with human retroviral core proteins in western equatorial Africa.

Out of 4176 sera from asymptomatic adults originating from Chad, equatorial Guinea and Gabon tested for HIV-1 antibodies, 146 (3.5%) were positive by an enzyme immunoassay (EIA). By Western blot (WB), 20 (0.5%) were positive, i.e. with antibodies to the core and the envelope proteins, 96 (2.3%) were indeterminate, i.e. with antibodies to the viral core proteins only and 30 (0.7%) were negative. On testing for HIV-2 by WB, two of the 96 indeterminate sera had antibodies to the HIV-2 envelope glycoproteins. Two complementary tests were used: a radioimmunoprecipitation assay (RIPA) and a HIV EIA recombinant assay (ENVACOR) to check 53 of these indeterminate sera. Forty-one were positive for the p25 protein in RIPA, of which 34 were negative in ENVACOR; six were positive for core proteins only and one was positive for envelope and core proteins using this assay. Twelve of the 53 indeterminate sera were negative in RIPA, of which 11 were negative and one positive for core proteins in ENVACOR. Thus, 42 of these sera remained indeterminate even after the two additional tests which did not allow a distinction between retroviral infection or non-specific reactions. We were able to isolate an unusual HIV-1 virus from lymphocyte cultures of two subjects presenting antibodies directed only against the core proteins.

Africa, Western↗
PubMedDate not supplied

[Blood transfusions in Africa during the AIDS epidemic. Condition of localities and perspectives in the Ivory Coast].

HIV is transmitted essentially by the heterosexual route in Africa. As part of an international mobilization against the Aids epidemic, information, education and communication strategies should continue to reduce the frequency of the infection. In this paper, we underline the high risk of HIV infection from blood transfusion in Africa. Although few epidemiological data are available, we feel that this problem should be made a priority, and that blood transfusion in Africa can be made reasonably safe by rational use of limited resources. We first report how the Ivory Coast health ministry, with funding from the European Community, has organized blood transfusion services in the main urban areas. Despite routine screening tests, the risk of HIV transmission through blood products remains high because of the large number of infected donors who are antibody-negative. The accent must thus be placed on alternatives to blood transfusions, while the use of transfusions must be minimized, especially in pediatric and general medical wards. As malaria, undernutrition and obstetric surgery are leading causes of anemia, health programs should be aimed at controlling these factors with the ultimate goal of limiting the spread of HIV.

Adult↗
PubMedDate not supplied

[One world in hope?].

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Acquired Immunodeficiency Syndrome↗