Uncertainties beyond preparedness: COVID-19 vaccination in Senegal.

Vaccination is one of the most recognised strategies in public health for preventing the spread of epidemics, and the availability of a vaccine is often expected by health actors to be a 'game-changer'. However, the COVID-19 (coronavirus disease 2019) vaccine in Senegal was not the magic bullet that the international community expected. A very low vaccination coverage rate (less than 10% by April 2023) was observed in this country, once considered a model in West Africa for its epidemic response.

[Preparing for epidemics. A strategy for strengthening social science skills in Africa].

The Covid pandemic was a reminder of the need to be prepared for epidemics and pandemics and to take into account their socio-political dimensions by developing socioanthropological and interdisciplinary approaches. In the post-crisis era, the challenge is one of operationality. How can these dimensions be made more visible? How can we develop analyses that can help to humanize institutional responses, make inequalities visible to limit them during the crisis, reveal structural determinants of transmission, and define interventions that are scientifically sound, ethically just and respectful of diversity?Three strategies are relevant to meet these challenges: (1) more social scientists in Frenchspeaking Africa must get expertise on epidemics to investigate associated issues before, during and after epidemic crisis; (2) public health professionals, health and social workers must get informed about social, historical, economic and political aspects of epidemics that shape risk, care and control; (3) collaborations between researchers and those involved in responding to epidemics on the basis of shared knowledge must develop.

"I take it and give it to my partners who will give it to their partners": Secondary distribution of HIV self-tests by key populations in Côte d'Ivoire, Mali, and Senegal.

Introduction: HIV epidemics in Western and Central Africa (WCA) remain concentrated among key populations, who are often unaware of their status. HIV self-testing (HIVST) and its secondary distribution among key populations, and their partners and relatives, could reduce gaps in diagnosis coverage. We aimed to document and understand secondary HIVST distribution practices by men who have sex with men (MSM), female sex workers (FSW), people who use drugs (PWUD); and the use of HIVST by their networks in Côte d'Ivoire, Mali, and Senegal.

Willingness to use and distribute HIV self-test kits to clients and partners: A qualitative analysis of female sex workers' collective opinion and attitude in Côte d'Ivoire, Mali, and Senegal.

Background: In West Africa, female sex workers are at increased risk of HIV acquisition and transmission. HIV self-testing could be an effective tool to improve access to and frequency of HIV testing to female sex workers, their clients and partners. This article explores their perceptions regarding HIV self-testing use and the redistribution of HIV self-testing kits to their partners and clients.

Vaccine anxieties, vaccine preparedness: Perspectives from Africa in a Covid-19 era.

Global debates about vaccines as a key element of pandemic response and future preparedness in the era of Covid-19 currently focus on questions of supply, with attention to global injustice in vaccine distribution and African countries as rightful beneficiaries of international de-regulation and financing initiatives such as COVAX. At the same time, vaccine demand and uptake are seen to be threatened by hesitancy, often attributed to an increasingly globalised anti-vaxx movement and its propagation of misinformation and conspiracy, now reaching African populations through a social media 'infodemic'. Underplayed in these debates are the socio-political contexts through which vaccine technologies enter and are interpreted within African settings, and the crucial intersections between supply and demand.

Negotiating Intersecting Precarities: COVID-19, Pandemic Preparedness and Response in Africa.

This article shares findings on COVID-19 in Africa across 2020 to examine concepts and practices of epidemic preparedness and response. Amidst uncertainties about the trajectory of COVID-19, the stages of emergency response emerge in practice as interconnected. We illustrate how complex dynamics manifest as diverse actors interpret and modify approaches according to contexts and experiences.

Enthusiasm for Introducing and Integrating HIV Self-Testing but Doubts About Users: A Baseline Qualitative Analysis of Key Stakeholders' Attitudes and Perceptions in Côte d'Ivoire, Mali and Senegal.

Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Côte d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted.

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project.

The rate of HIV status disclosure to partners is low in Mali, a West African country with a national HIV prevalence of 1.2%. HIV self-testing (HIVST) could increase testing coverage among partners of people living with HIV (PLHIV).

Describing, analysing and understanding the effects of the introduction of HIV self-testing in West Africa through the ATLAS programme in Côte d'Ivoire, Mali and Senegal.

Background: The ATLAS programme aims to promote and implement HIV self-testing (HIVST) in three West African countries: Côte d'Ivoire, Mali, and Senegal. During 2019-2021, in close collaboration with the national AIDS implementing partners and communities, ATLAS plans to distribute 500,000 HIVST kits through eight delivery channels, combining facility-based, community-based strategies, primary and secondary distribution of HIVST. Considering the characteristics of West African HIV epidemics, the targets of the ATLAS programme are hard-to-reach populations: key populations (female sex workers, men who have sex with men, and drug users), their clients or sexual partners, partners of people living with HIV and patients diagnosed with sexually transmitted infections and their partners.

[Adherence reinforcement for antiretroviral therapy: PLHIV's perceptions and experience in Burkina Faso].

Introduction: Adherence to antiretroviral therapy is a major obstacle to achieving WHO target 3. In West Africa, however, there is a lack of evidence on the most feasible, acceptable and effective adherence reinforcement measures and users' perceptions of these measures. The purpose of this article is to analyze the perceptions of PLHIV (people living with HIV) on ART reinforcement measures in Burkina Faso.

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Introduction: Adherence to antiretroviral therapy is a major obstacle to achieving WHO target 3. In West Africa, however, there is a lack of evidence on the most feasible, acceptable and effective adherence reinforcement measures and users' perceptions of these measures. The purpose of this article is to analyze the perceptions of PLHIV (people living with HIV) on ART reinforcement measures in Burkina Faso.

'They'll inject you and you'll die': from medication non-compliance to acceptance in Guinea's Ebola treatment units.

During the 2013-2016 West African Ebola epidemic, medical emergency response teams negotiated a context marked by public hysteria and fear to prevent the spread of the virus and treat those already infected. However, the presence and work of Ebola response teams added to suspicions provoked by the rapid increase in numbers of dead and dying and by locally unintelligible emergency measures. Based on data collected from 40 young adult 'survivors' between 16 and 29 years of age who were hospitalized for Ebola during the epidemic, this article examines how pharmaceutical treatments were accepted (or not) by patients in ebola treatment units (ETU).

Understanding Ebola virus and other zoonotic transmission risks through human-bat contacts: Exploratory study on knowledge, attitudes and practices in Southern Cameroon.

The ecology of Ebola virus (EBV) remains largely unknown, but the previous detection of viral RNA and anti-EBV antibodies in African bats suggests that they might play a role in the EBV reservoir. Moreover, African bats also carry other potentially zoonotic agents such as Henipah-like viruses, coronaviruses and lyssaviruses. Today only little information is available on interactions between humans and bats.

[Neglected patients, unexpected effects. Ebola virus disease suspected case experience.].

Introduction: In an epidemic context, the identification of suspected cases, among alert or contact cases, leads to caring for persons for whom only a minority will be confirmed cases, with a laboratory diagnosis positive for Ebola. How are suspected cases treated that are not subsequently confirmed and how do they feel about this experience ? What are the medical or social consequences ?

Methods: A qualitative study was conducted in two countries with a high Ebola risk epidemic situation in 2015-2016 (Senegal, Côte d'Ivoire). Based on interviews with suspected cases and caregivers, 12 referral itineraries were identified for 20 people.

[Anthropology engaged against Ebola (2014-2016): approaches, contributions and new questions].

Anthropologists contributed to the response to the 2014-2016 Ebola outbreak in three ways : as Ebola experts, cultural mediators between populations and caregivers, and researchers. This article presents a preliminary review of approaches, contributions and related issues based on a literature review, case studies and debates. The anthropological research discussed in this article concerns four themes : epidemiological contexts of transmission ; cultural interpretation of illness and social responses ; social construction of stakeholders' experience ; critical analysis of public health interventions.

[The silent disappearance of PADHUE doctors: the end of a State injustice or a new form of exclusion?].

Up until recently in France, physicians who obtained their degrees outside the European Union had a specifically disadvantaged status, that was supposed to be eliminated by the end of 2016. Until that date, a selective qualification process authorized foreign physicians to “full practice”. The deadline has been postponed to 2017 to resolve the complicated situations of certain doctors and to avoid tensions in hospital wards.

Accepted monitoring or endured quarantine? Ebola contacts' perceptions in Senegal.

During the 2014-2016 West Africa Ebola epidemic, transmission chains were controlled through contact tracing, i.e., identification and follow-up of people exposed to Ebola cases.

Ethical considerations of providers and clients on HIV testing campaigns in Burkina Faso.

Background: Campaigns have been conducted in a number of low HIV prevalence African settings, as a strategy to expand HIV testing, and it is important to assess the extent to which individual rights and quality of care are protected during campaigns. In this article we investigate provider and client perceptions of ethical issues, including whether they think that accessibility of counseling and testing sites during campaigns may hinder confidentiality.

Methods: To examine how campaigns have functioned in Burkina Faso, we undertook a qualitative study based on individual interviews and focus group discussions with 52 people (providers and clients tested during or outside campaigns and individuals never tested).

[HIV/AIDS stigma in Africa: analysis of its forms and manifestations in Burkina Faso].

Introduction: Negative impact of stigma on HIV care and prevention is documented. Qualitative approaches were used to describe its importance in Burkina Faso (1% of HIV prevalence) and need to be completed by quantitative estimations of the main manifestations and categories of stigma.

Methodology: During the MATCH study (Multi-country African Study on Testing and Counselling for HIV) conducted in 2007-2008, 219 people tested HIV positive (PLWHA) were interviewed by means of a quantitative questionnaire.

Rewards and challenges of providing HIV testing and counselling services: health worker perspectives from Burkina Faso, Kenya and Uganda.

The rapid scale-up of human immunodeficiency virus (HIV) testing, counselling and treatment throughout sub-Saharan Africa has raised questions about how to protect patients' rights to consent, confidentiality, counselling and care in resource-constrained settings. The Multi-country African Testing and Counselling for HIV (MATCH) study investigated client and provider experiences with different modes of testing in sub-Saharan Africa. One component of that study was a survey of 275 HIV service providers in Burkina Faso, Kenya and Uganda that gathered quantifiable indicators and qualitative descriptions using a standardized instrument.