Phytopharmaceutical practices of traditional health practitioners in Burkina Faso: a cross-sectional study.

BACKGROUND: Traditional health practitioners constitute an important part of the health care system in Burkina Faso, particularly in the supply of traditional herbal medicines. Quality and safety of these medicines rely heavily on practices employed during their traditional development. However, traditional phytopharmaceutical practices are poorly described in Burkina Faso. This study aimed to describe the phytopharmaceutical practices of traditional medicine practitioners in Burkina Faso. METHODS: This was a cross-sectional descriptive ethno-pharmaceutical study, conducted from October 1 to November 30, 2020, among traditional practitioners in four randomly selected health districts: Nongr-Massom (Centre region), Tenkodogo (Centre-East region), Diapaga (East region) and Dafra (Hauts-Bassins region). An anonymous semi-structured face-to-face questionnaire was used to collect socio-demographic data and data on raw materials and finished products. RESULTS: Sixty-seven (67) traditional health practitioners, aged 56 years on average, including a majority of men (72%), participated in the study. Gathering of wild medicinal plants was the main source of raw materials acquisition (51.5%), which were usually leaves (32.3%). These raw materials were usually sun-dried (43.9%) and packaged mostly in plastic bags (37.2%). They were derived from 60 plant species belonging to 33 botanical families. Fabaceae was the most represented family (18.7%) and Khaya senegalensis Juss. (Meliaceae) the most cited plant species (5.2%). The finished products had an average shelf life of 17 months and were usually prepared as a decoction (31.7%) and administered most often orally (71.4%). Gastrointestinal disorders were the main predictable adverse events of the finished products (54%). CONCLUSION: This study showed that THPs have important knowledge in the use of medicinal plants, but several shortcomings are observed in their phytopharmaceutical and plant protection practices. Continuous improvement of these practices, through education and training of traditional health practitioners, is essential for the conservation of plant biodiversity and quality assurance of traditional herbal medicines.

Use of traditional medicines among conventional medicine practitioners in Burkina Faso / Utilisation des médicaments traditionnels chez les praticiens de la médecine conventionnelle au Burkina Faso

INTRODUCTION: The integration of traditional medicine into biomedical health care practice is highly dependent on its acceptability by conventional medical practitioners. Its use by conventional practitioners was previously unknown in Burkina Faso. PURPOSE OF RESEARCH: The purpose of this study was to estimate the prevalence of traditional medicine use and the frequency of occurrence of adverse events associated with this use among conventional medical practitioners in Burkina Faso. RESULTS: The majority of the practitioners surveyed were women (56.1%) and the average age was 39.7±7 years. Nurses (56.1%), midwives (31.4%) and physicians (8.2%) were the most represented professions. The prevalence of the use of traditional medicines in the 12 months preceding the survey was 75.6%. Malaria was the main medical reason for using traditional medicines (28%). The frequency of reported adverse events was 10% and mainly concerned gastrointestinal disorders (78.3%). CONCLUSIONS: The majority of conventional medical practitioners in Burkina Faso use traditional medicines for their health problems. This finding suggests the effective integration of traditional medicine into biomedical health care practice which could benefit from good acceptability by these professionals.

Introduction: L'intégration de la médecine traditionnelle dans le système de santé moderne est fortement dépendante de son acceptabilité par les praticiens de ce système. Leur recours à la médecine traditionnelle était jusque-là méconnu au Burkina Faso. But de l'étude: Le but de cette étude était d'estimer la prévalence de l'utilisation des médicaments traditionnels et la fréquence de survenue des événements indésirables parmi les praticiens de santé conventionnels au Burkina Faso. Résultats: La majorité des praticiens enquêtés étaient des femmes (56,1 %) et l'âge moyen s'établissait à 39,7 ±7 ans. Les infirmiers (56,1 %), les sages-femmes (31,4 %) et les médecins (8,2 %) étaient les professions les plus représentées. La prévalence de l'utilisation de médicaments traditionnels durant les douze mois précédant l'enquête était de 75,6 %. Le paludisme apparaissait comme la principale raison médicale du recours aux médicaments traditionnels (28 %). La fréquence des événements indésirables rapportés s'élevait à 10 % et concernaient principalement des troubles gastro-intestinaux (78,3 %). Conclusions: Les praticiens de la médecine conventionnelle ont largement recours aux médicaments traditionnels. Cela suggère l'intégration effective de la médecine traditionnelle dans la pratique biomédicale des soins et la surveillance des risques associés à cette utilisation.

Current Status and Challenges of Pharmacovigilance of Traditional Medicines in French-Speaking West African (UEMOA) Countries.

BACKGROUND: West African Economic and Monetary Union (UEMOA) countries are characterised by a high prevalence of informal use of medicinal plants and traditional medicines by their population for health care, requiring the establishment of pharmacovigilance, in order to monitor the associated health risks. However, the state of implementation of pharmacovigilance for traditional medicines in UEMOA countries is not known. OBJECTIVE: This study aimed to assess the state of implementation of pharmacovigilance for traditional medicines in the eight UEMOA countries, describing the relevant community provisions, assessing the integration of traditional medicines monitoring into national pharmacovigilance systems and identifying related national challenges. METHODS: This was a cross-sectional study using questionnaires, conducted between 1 May and 31 August 2022. A face-to-face questionnaire was administered to officials responsible for the issue within UEMOA and the West African Health Organisation (WAHO). A second online questionnaire was specifically sent to the pharmacovigilance focal points of the eight UEMOA countries. Questionnaires were designed using the WHO indicators for pharmacovigilance. The face-to-face questionnaire collected two types of data, namely community policies and regulations on pharmacovigilance and technical and financial support from sub-regional organisations to countries. The online questionnaire sent to countries collected four categories of data on the study issue: structural data, process data, impact data and data on national challenges. RESULTS: As a community provision, WAHO has a harmonised regulatory framework for phytovigilance. The monitoring of traditional medicines is not effectively implemented in the pharmacovigilance systems of UEMOA countries. Only two reports of adverse events due to traditional medicines have so far been recorded in the Union. The countries have neither funding nor sufficient human resources for pharmacovigilance in general. Monitoring of traditional medicines in the unregulated market, training of stakeholders, risk communication, and integration of traditional health practitioners in reporting systems are the main challenges of countries for the development of pharmacovigilance for traditional medicines. CONCLUSION: The effective compliance of WAHO's harmonised phytovigilance regulatory framework by UEMOA countries and addressing the challenges identified by the countries constitute the basis for the development of pharmacovigilance for traditional medicines within UEMOA.

[Halitosis: multidisciplinary diagnostic and therapeutic approaches]. / Halitose: approches diagnostiques et thérapeutiques pluridisciplinaires.

INTRODUCTION: Halitosis is a morbid condition characterized by bad breath. Sometimes it has pathological and social implications. In the context of daily clinical practice, halitosis poses many diagnostic and therapeutic problems. This study aims to investigate the clinical and therapeutic features of this disorder. METHODS: We conducted a cross-sectional study over a one year period. Patients over the age of 15 years presenting with halitosis at the University Hospital Yalgado Ouedraogo were enrolled in the study. Patients with bad breath but presenting with some other problema were excluded. Patient's breath was assessed by a practitioner on the basis of Rosenberg organoleptic test. RESULTS: A total of 35 patients were included, with a sex ratio of 1.2. The average age of patients was 31.9 years. In 57.1% of cases, complaints were made by patients themselves. The mean duration of halitosis was 4.3 years. Nineteen patients had Mel Rosenberg score ≥ 2. Dental caries (07 cases), sinusitis (07 cases), Helicobacter pylori infection (09 cases) and gastrointestinal ulcer (10 cases) were associated with halitosis. Treatment was based on etiology in 82.9% of cases with satisfactory improvement after two weeks in 71.8% of cases. CONCLUSION: Halitosis is a little studied disorder which poses problem in positive diagnosis as well as etiologic problems in our context. The dentist plays a crucial role in identifying the possible cause of halitosis. However, multidisciplinary approach would enable a more effective response.

[Infectious ENT emergencies]. / Les urgences infectieuses ORL.

Extremely serious diseases associated with very poor prognosis, especially in this context of undermedicalization and poverty. The aim of this case study was to determine the etiologies of these emergencies and to discuss their therapeutic management. Retrospective-descriptive study conducted over a 5-year period, a total of 52 clinical records were included. These infections accounted for 0.33% of our consultations. The average age of our patients was 23 years. Young age, inappropriate treatments and some ENT disorders were found to be contributing factors. The reasons for consultation were varied, depending on the site of infection; however, two clinical signs were constant: pain and fever. Adenophlegmon, peritonsillar phlegmon, cellulitis were our main etiologies together with streptococcus and staphylococcus which were the commonest causative bacteria. Empirical antibiotic therapy was used as first-line therapy, in particular third-generation cephalosporin + aminoglycoside + imidazole combination. Clinical course was marked by local and systemic complications. The evolution of diagnostic and therapeutic ENT emergencies management plans still encounters complications due to patient delay in seeking consultation.

Associated injuries in patients with facial fractures: a review of 604 patients.

Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention.

Endemic Burkitt lymphoma of maxillofacial region: results of induction treatment with cyclophosphamide plus methotrexate in West Africa.

BACKGROUND: Burkitt lymphoma is frequent a cancer in the developing countries where its treatment is based on non-intensive chemotherapy protocols. The purpose of this study was to assess the effectiveness and the toxicity of a non-intensive chemotherapy protocol combining cyclophosphamide and methotrexate in children with Burkitt lymphoma of the maxillofacial region. PROCEDURE: A retrospective descriptive study was carried out in patients with Burkitt lymphoma of maxillofacial region who received at least one weekly treatment with intravenous cyclophosphamide and methotrexate between 1999 and 2006 in a university teaching hospital in Burkina Faso. The demographic characteristics of the patients, the effectiveness and the toxicity of the treatment were recorded. RESULTS: A total of 58 patients were included. The mean age was 7.2 years. According to Murphy's staging, 28 patients (48%) were at stage I, 18 (31%) at stage II, 11 (19%) at stage III and 1 (2%) at stage IV. Among 28 patients who received all the cycles of the protocol, 21 (75%) achieved complete remission, 6 (21%) had partial remission and 1 (4%) had progressive disease. The major complications during the treatment were febrile leucopenia and anemia. The mortality rate was 19% (11/58). CONCLUSION: Non-intensive chemotherapy protocol with cyclophosphamide and methotrexate could be an alternative to intensive chemotherapy protocols for the management of the stage I-III endemic Burkitt lymphoma in developing countries.