Coupled with poor urban development, the increasing urban population of many Sub-Saharan African countries is subject to recurrent severe flooding episodes. In response to these flood events, while the focus is often put on slums and precarious urban settings, the social implications of these floods affect a variety of social classes. Presenting a case study of Cocody, a district of Abidjan, Côte d’Ivoire, known to have the country’s highest number of flood-impacted people, this paper evaluates the social vulnerability of urban Côte d’Ivoire to flooding using the MOVE framework. The MOVE framework (Method for the Improvement of Vulnerability Assessment in Europe) has successfully been used in European contexts to assess social vulnerability of urban areas to geo-environmental disasters such floods. It helped assess the major factors involved in the social vulnerability to urban flooding and to have a good appreciation of the spatial distribution of areas that are vulnerable to urban flood. By taking this framework to the local context, relevant indicators were developed and GIS applications were used to assess spatially the relative social vulnerability of Cocody sub-districts to urban flooding. The results revealed that many sub-districts of Cocody are highly vulnerable to urban floods. Exposure and susceptibility are components that are found to have high influence on vulnerability to flood hazard in the district of Cocody. Their respective indicators need to be addressed properly in order to increase residents’ resilience to urban flooding. The MOVE theoretical framework can be applied in Africa by contextualizing the vulnerability by using local indicators.

The land use/land cover of the district of Cocody in Abidjan, Côte d’Ivoire, is under substantial pressure associated with ‘fast urbanization. This study conducts a detailed analysis of the impact of the changing land use/land cover in Cocody by assessing inhabitants’ social vulnerability to heat. The approach was based on integrated methods: remote sensing-based analysis of urban land cover helped to analyze the urbanization dynamic, while indicator-based analysis, through the integrated theoretical MOVE framework, helped to define vulnerability and identify indicators. Both methods combined allowed an analysis of the social vulnerability of Cocody inhabitants to extreme heat conditions. The results reveal that Cocody is experiencing rapid land use/land cover change dominated by rapid growth of buildings and a noticeable decrease in the natural environment. Cocody is highly vulnerable to extreme heat conditions, which could be aggravated by its increasing population, with a high percentage of children under five years of age (11.31%). Creating more green spaces is therefore recommended in the more susceptible areas to counter the harmful effects of the changing climate.

The failure of sewage and drainage systems in SubSaharan African cities is frequent and can be considered as a critical issue, both from an environmental standpoint and in terms of associated maintenance costs. This study analyzes the state of the sanitation systems, the elements behind the failures, the environmental concepts used to classify the problems, and the tools and methodological alternatives for ranking the various management solutions. This research illustrates the causes that contribute to the dysfunctions in the sewage systems of Abidjan as a typical example of sewerage systems management challenges in SubSaharan Africa’s large cities. Poor solid waste and wastewater management practices by residents, e.g., illegal dumping of solid waste into the sewers, unauthorized and defective connections to the network, structural dysfunctions related to the age of the network (cracked, denuded, or broken), urban agriculture in the vicinity of the channels, natural phenomena such as erosion, landslides in the undeveloped parts, and the high concentration of vegetation in the network, wholly contribute to the degradation of the network. A variety of decision support systems for the management of the assets of the urban sewage network were presented. The instruments have been categorized based on their capacity and functionality. The operating concept of each of these tools has been outlined, as well as their respective data needs. In addition, the study analyzes challenges related to the usage of existing decision support systems and provides an outlook on future research requirements in this area. This study offers a detailed analysis of the issues of sanitation management and could serve as a reference for other emerging nations in SubSaharan Africa.

The global strategy to control helminthiases (schistosomiasis and soil-transmitted helminthiasis) emphasizes preventive chemotherapy. However, in the absence of access to clean water, improved sanitation, and adequate hygiene, reinfection after treatment can occur rapidly. Integrated approaches might be necessary to sustain the benefits of preventive chemotherapy and make progress toward interruption of helminthiases transmission. The aim of this study was to assess and quantify the effect of an integrated control package that consists of preventive chemotherapy, community-led total sanitation, and health education on soil-transmitted helminthiasis, schistosomiasis, intestinal protozoa infection, and diarrhea in rural Côte d'Ivoire. In a first step, a community health education program was developed that includes an animated cartoon to promote improved hygiene and health targeting school-aged children, coupled with a health education theater for the entire community. In a second step, a cluster randomized trial was implemented in 56 communities of south-central Côte d'Ivoire with 4 intervention arms: (1) preventive chemotherapy; (2) preventive chemotherapy plus community-led total sanitation; (3) preventive chemotherapy plus health education; and (4) all 3 interventions combined. Before implementation of the aforementioned interventions, a baseline parasitologic, anthropometric, and hygiene-related knowledge, attitudes, practices, and beliefs survey was conducted. These surveys were repeated 18 and 39 months after the baseline cross-sectional survey to determine the effect of different interventions on helminth and intestinal protozoa infection, nutritional indicators, and knowledge, attitudes, practices, and beliefs. Monitoring of diarrhea was done over a 24-month period at 2-week intervals, starting right after the baseline survey. Key results from this cluster randomized trial will shed light on the effect of integrated approaches consisting of preventive chemotherapy, community-led total sanitation, and health education against infections with soil-transmitted helminths, schistosomes, an intestinal protozoa and prevention of diarrhea in a rural part of Côte d'Ivoire. The research provided new insights into the acceptability, strengths, and limitations of an integrated community-based control package targeting helminthiases, intestinal protozoa infections, and diarrhea in rural communities of Côte d'Ivoire. In the longer term, the study will allow determining the effect of the integrated control approach on infection patterns with parasitic worms and intestinal protozoa, diarrheal incidence, anthropometric measures, and hygiene-related knowledge, attitudes, practices, and beliefs. International Standard Randomized Controlled Trial Number (ISRCTN): 53102033; http://www.isrctn.com/ISRCTN53102033 (Archived by WebCite at http://www.webcitation.org/6wpnXEiHo). RR1-10.2196/9166.

Parasitic worms (helminths) are common infections in low- and middle-income countries. For most helminth species, school-aged children are at highest risk of infection and morbidity, such as impaired cognitive and physical development. Preventive chemotherapy is the current mainstay for helminthiases control. Sanitation improvement and hygiene-related education are important complementary strategies, which act by altering children’s behaviour. However, little is known about the effect of improved knowledge on the risk of helminth infection. The aim of this study was to assess the potential influence of knowledge that children acquired at home or in school, without any specific health education intervention, on helminth infections. In May 2014, we conducted a cross-sectional survey in western Côte d’Ivoire. A total of 2498 children, aged 9-12 years, were subjected to three consecutive stool examinations using duplicate Kato-Katz thick smears to determine infections with soil-transmitted helminths and Schistosoma mansoni. Additionally, children were interviewed to assess their knowledge about helminth infections. Four knowledge scores were constructed by factor analysis; one, reflecting general knowledge about helminths and three manifesting helminth species-specific knowledge. The effect of general and specific knowledge on children’s helminth infection status was determined using meta-analysis. Children who scored high in the hookworm-specific knowledge were less likely to be infected with hookworm but no association was found for the other helminth species. Moreover, greater general knowledge was not associated with lower odds of being infected with any helminth species. Most of the children interviewed believed that the effect of preventive chemotherapy is permanent, and hence, re-treatment is not necessary. Specific knowledge about different types of helminths might not suffice to induce behavioural change which in turn reduces infection and reinfection with helminths. Health education interventions should strive to strengthen the perception of risk and to clarify the true benefit of preventive chemotherapy.

Les maladies diarrhéiques constituent la deuxième cause de morbidité chez les enfants de moins de 5 ans en Afrique, au sud du Sahara et plus particulièrement en Côte d’Ivoire. Un projet pilote de gestion des diarrhées par l’approche écosanté a été initié en 2006 dans un village périurbain de la commune de Yopougon, à Abidjan. Après plusieurs rencontres d’échange avec les populations et un atelier de lancement participatif incluant toutes les parties prenantes, une enquête ménage transversale par questionnaire (n = 205) adressée aux femmes de ménage, une enquête géographique, l’analyse d’eau de puits, des observations et des groupes de consultations (focus group) ont été réalisés en août 2006 afin de déterminer la prévalence des maladies diarrhéiques et d’identifier les facteurs de risques majeurs.1234 personnes ont été recensées dans les 205 ménages. 7 % de ces personnes (85/1234) avaient vécu un épisode diarrhéique au cours des deux semaines précédant la date d’enquête. La tranche d’âge des moins de 5 ans était la plus affectée avec une prévalence de 14 %, suivie de celle des plus de 15 ans (6 %) et enfin des enfants de 5 à 15 ans (3 %).Les principaux facteurs de risques identifiés dans l’avènement des diarrhées sont, entre autres, le lieu de conservation de l’eau de boisson (P-value = 0,02), le récipient de conservation (p-value = 0,03) et le lieu d’installation des latrines dans les ménages (p-value = 0,02). D’autres facteurs et comportements à risques ont été également identifiés. Il s’agit des enfants qui mangent sans se laver les mains, des mouches qui pullulent et couvrent les repas consommés, des poubelles sans fermeture et couvertes de mouches, de déchets solides et points d’eaux stagnantes qui couvrent toute la surface habitée du village.Ces résultats ont permis, à travers un processus transdisciplinaire et participatif incluant les communautés et autres parties prenantes, la mise en place d’actions de renforcement de capacités des villageois pour faire face aux maladies diarrhéiques.