[Factors associated with post-term pregnancy at the Yalgado Ouédraogo University Hospital: case-control study]. / Facteurs associés à la grossesse post-terme au Centre Hospitalier Universitaire Yalgado Ouédraogo: étude cas-témoins.

Introduction: post-term pregnancy is a risky situation for the fetus and the mother. In our context, few data exist on the subject. This aims to determine the associated factors of post-term pregnancy in order to contribute to a reduction in maternal and fetal morbidity and mortality. Methods: we conducted a matched case-control study in the department of gynaecology-obstetrics of the Yalgado Ouédraogo University Hospital. Data were collected between 1st January 2014 and 31st August 2014. Cases were patients who delivered at 41 weeks of amenorrhoea and above and controls were those who delivered between 37 and 41 weeks of amenorrhoea. Results: the study included 153 cases and 153 controls. Risk factors with statistically significant association with post-term pregnancy were high maternal socioeconomic status (adjusted odds ratio (AOR)=3.17; 95% CI [1.13; 9.07]) primiparity (AOR=1.45; 95% CI [1.07; 2.51]), and previous post-term pregnancy (AOR=7.02; 95% CI [2.08; 23.79]). Conclusion: early recognition of risk factors for post-term pregnancy will help health workers identify women with high-risk pregnancies.

[Varicella (chickenpox) morbidity and mortality in hospital: about 19 cases collected at the Yalgado Ouedraogo University Hospital, Burkina Faso]. / Morbi-mortalité de la varicelle en milieu hospitalier: à propos de 19 cas colligés au Centre Hospitalier Universitaire Yalgado Ouédraogo, Burkina Faso.

Varicella is a viral disease whose cause is poorly known in Burkina Faso. The aim of this study is to describe varicella features in the department of infectious diseases at the Yalgado Ouedraogo University Hospital. We here report a series of 19 cases of patients hospitalized between the 1stJanuary 2005 and 31st December 2014. The study included all patients with complete and workable medical records who received a positive diagnosis of varicella. The rate of varicella was 6.2%, accounting for 14.6% of febrile rash. It had been more common in 2011, from January to March. The average age was 19 years and half of the patients were aged between 6 and 30 years. Comorbidities were dominated by HIV infection and herpes. Clinically, fever and pruritus were the typical symptoms and vesicles were the most common type of eruption. On admission, the main complications included pulmonary, hematological and cutaneous complications. The median duration of hospitalization was 5 days, ranging between 0 and 13 days. The main treatments were based on antiviral drugs in 9 cases, antipyretic drugs in 19 cases, topic drugs in 17 cases and antihistamines in 11 cases. Out of 19 cases of varicella, 14 were cured and 2 died, including 1 adult out of 10 and 1 child out of 9. Varicella is usually a benign disease. It can be fatal in adults and children with severe complications.

Chronic kidney disease and HIV in the era of antiretroviral treatment: findings from a 10-year cohort study in a west African setting.

BACKGROUND: It has been reported that people living with HIV in West Africa exhibited the highest risks for chronic kidney disease (CKD) in the world. Here, we aimed at determining the CKD frequency and changes in kidney function during antiretroviral treatment (ART) in a large cohort of HIV-patients followed in Burkina Faso. METHODS: We included ART-naive adults who initiated ART at the Day Care Unit of the Souro Sanou University Hospital between 01/01/2007 and 12/31/2016. We assessed the estimated glomerular filtration rate (eGFR) by serum creatinine using the Modification of Diet in Renal Disease (MDRD) equation. Following the K/DOQI recommendations, CKD was defined as eGFR < 60 ml/min/1.73m2 at two consecutive measurements at least 3 months apart. The factors associated with eGFR decline or CKD were identified by mixed linear regression and Cox regression, respectively. RESULTS: Three thousand, one hundred and thirty-eight patients (72% women) were followed for a median (IQR) of 4.5(2.2-6.9) years. At baseline, median eGFR (IQR) was 110.7(94.4-128.4) ml/min/1.73m2 and 93 (3%) patients exhibited eGFR < 60 ml/min/1.73m2. The lowest-performing progressions of eGFR during the first year of ART were observed in patients with 40-49 yr. age range (- 8.3[- 11.7;-5.0] ml/min/1.73m2, p < 0.001), age ≥ 50 yr. (- 6.2[- 10.7;-1.8] ml/min/1.73m2, p = 0.006) and high blood pressure (HBP) (- 28.4[- 46.9;-9.9] ml/min/1.73m2, p = 0.003) at ART initiation. Regarding the ART exposure in patients with normal baseline eGFR, zidovudine (AZT) with protease inhibitor (PI) (- 4.7[- 7.7;-1.6] ml/min/1.73m2, p = 0.002), tenofovir (TDF) + PI (- 13.1[- 17.4;-8.7] ml/min/1.73m2, p < 0.001), TDF without PI (- 3.2[- 5.0;-1.4] ml/min/1.73m2, p < 0.001), stavudine (d4T) + PI (- 8.5[- 14.6-2.4] ml/min/1.73m2, p = 0.006) and d4T without PI (- 5.0[- 7.6-2.4] ml/min/1.73m2, p < 0.001) were associated with poorer eGFR progression. The prevalence of CKD was 0.5% and the incidence was 1.9 [1.3; 2.7] cases/1000 person-years. The risk of CKD was higher in patients with HBP (4.3[1.8;9.9], p = 0.001), 40-49 yr. patients (4.2[1.6;11.2], p = 0.004), ≥50 yr. patients (4.5[1.5;14.1], p = 0.009) and patients exposed to abacavir (ABC) or didanosine (ddI) based ART (13.1[4.0;42.9], p < 0.001). CONCLUSIONS: Our findings do not confirm the high risk of CKD reported in previous studies of West Africans with HIV, but support the recommendations for early initiation of ART and close kidney function monitoring in patients with HBP or aged ≥40 yr.