Snakebite frequencies and envenomation case management in primary health centers of the Bobo-Dioulasso health district (Burkina Faso) from 2014 to 2018.

BACKGROUND: Snakebite envenomation is a significant public health problem in Burkina Faso. Our study describes the epidemiological and therapeutic aspects of snakebite cases at primary health centers in Houet Province, which is located in the western area of Burkina Faso. METHODS: We conducted a retrospective study of 664 snakebite cases occurring at 10 primary health centers in Houet Province from January 2014 to December 2018. Data were collected from the patient consultation recording database registry system. RESULTS: Affected individuals had a male/female ratio of 1.31. The lowest annual incidences (0.02 [95% CI -0.01 to 0.05] and 0.24 [95% CI 0.05 to 0.43]) were observed in the urban primary health centers of Bolomakoté and Sarfalao, respectively. Rural primary health centers in Nasso in 2016 and in Soumousso in 2014 had the highest annual incidence (13.80 [95% CI 7.59 to 20.00] and 3.92 [95% CI 2.99 to 4.86], respectively). Of the 664 registered snakebite victims, none received antivenom immunotherapy treatment. CONCLUSION: Our study shows that snakebite envenomation incidents are common at the 10 primary health centers in Houet Province. Furthermore, despite the lack of antivenom and often inadequate treatment at these primary health centers, they remain the first point of care for snakebite victims.

Short Persistence and Vector Susceptibility to Ficam 80WP (bendiocarb active ingredient) During Pilot Application of Indoor Residual Spraying in Burkina Faso, West Africa.

Indoor residual spraying (IRS) was applied in addition to the use of long-lasting insecticidal nets in the South West in Burkina Faso, where Anopheles gambiae s.l. the major malaria vector was resistant to pyrethroids. This study was designed to evaluate the efficacy and residual life of bendiocarb (active ingredient) used for spraying on different wall surfaces (mud and cement). Cone bioassays were done monthly with the susceptible An. gambiae 'Kisumu' strain and the local wild populations to determine the duration for which insecticide was effective in killing mosquitoes. Cone bioassay data showed low efficacy and short persistence of bendiocarb applied on mud and cement walls, lasting 2 mo with the susceptible insectary strain and less than 1 mo with An. gambiae wild populations. In addition, WHO tube assays confirmed resistance of An. gambiae wild populations to 0.1% bendiocarb with mortality rates less than 80% in both study sites (sprayed and unsprayed sites). The pilot study of IRS with bendiocarb showed that the residual efficacy of bendiocarb was very short, and resistance to bendiocarb was confirmed in wild populations of An. gambiae s.l. Therefore, Ficam 80 WP was not suitable for IRS in this area due to the short residual duration related mainly to vectors resistance to bendiocarb. While waiting for innovative malaria control tool, alternative insecticide (organophosphate or neonicotinoid classes) or combinations of insecticides have to be used for insecticide resistance management in Burkina Faso.

Efficacy of artemether-lumefantrine and artesunate-amodiaquine as first line therapy of uncomplicated malaria in Burkina Faso, 11 years after policy change.

INTRODUCTION: Artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) are the first line therapy of uncomplicated malaria in Burkina Faso. We assessed the treatment efficacy, tolerability of these drugs 11 years following its adoption as first line treatment. METHODS: In this opened randomized controlled trial carried out in 2016, participants with age over 6 months who consented to participate were randomly assigned treatment with artemether-lumefantrine or artesunate-amodiaquine and followed up for 28 days. Primary endpoint was the treatment efficacy over 28 days of follow up unadjusted by Polymerase chain reaction (PCR). RESULTS: Two hundred and eighty-one (281) participants were enrolled and the completion rate was 92.9%. No early treatment failure was found. Adequate clinical and parasitological responses were significantly higher in artesunate-amodiaquine group (97% versus 85.2%, p = 0.0008). On day 28, the risk of failure was 4 times higher in AL group 20.14%, 95% CI (13-30.47) against 5.16%, 95% CI (1.91-13.54) in ASAQ group. All treatments had a similar and good tolerability profile. CONCLUSION: Eleven years following artemether-lumefantrine and artesunate-amodiaquine adoption as first line therapy for uncomplicated malaria in Burkina Faso, artemether-lumefantrine retained fairly good efficacy even though its efficacy fell below WHO threshold of 90% considering uncorrected outcome.