Incidence and Predictors of Imported Cases of COVID-19 in Burkina Faso.

BACKGROUND: To limit the spread of COVID-19 due to imported cases, Burkina Faso has set up quarantine measures for arriving passengers. We aimed to determine the incidence and predictors of imported cases of COVID-19 in Burkina Faso. METHODS: A prospective cohort study was performed using data from passengers arriving at the airport from April 9 to August 31, 2020. The data was extracted from the District Health Information Software 2 (DHIS2) platform. Cox regression was used to identify predictors of imported cases of COVID-19. RESULTS: Among 6,332 travelers who arrived in the study period, 173 imported cases (2.7%) were recorded. The incidence rate was 1.9 cases per 1,000 traveler-days (95%CI: 1.6-2.2 per 1,000). Passengers arriving in April (Adjusted hazard ratio [aHR] = 3.56; 95%CI: 1.62-7.81) and May (aHR = 1.92; 95% CI: 1.18-3.12) were more at risk of being tested positive compared to those arriving in August, as well as, passengers presenting with one symptom (aHR = 3.71; 95% CI: 1.63-8.43) and at least two symptoms (aHR = 10.82; 95% CI: 5.24-22,30) compared to asymptomatic travelers. CONCLUSIONS: The incidence of imported cases was relatively low in Burkina Faso between April and August 2020. The period of travel and the presence of symptoms at arrival predicted the risk of being tested positive to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This is essential in the context of the high circulation of virus variants worldwide and the low local capacity to perform genotyping tests to strengthen the surveillance and screening capacities at the points of entry into the country.

[Tuberculosis and HIV coinfection complicated by nosocomial infection caused by Klebsiella pneumoniae: about 4 cases in a Department of Infectious diseases in Mali]. / Co-infection tuberculose-VIH compliquée d'une sur infection nosocomiale à Klebsiella pneumoniae: à propos de 4 observations dans un Service de Maladies Infectieuses au Mali.

Nosocomial infections are a real global public health problem. Pulmonary tuberculosis and HIV co-infection increases the incidence of nosocomial infections because of immunosuppression and iterative hospitalizations. We here report four cases of patients aged 28, 36, 42 and 52 years co-infected with HIV and tuberculosis (multifocal tuberculosis in 2 patients, miliary tuberculosis, bacteriologically confirmed tuberculosis), all with CD4 < 100 cells/mm3. During the intensive-phase, patients received antitubercular drugs and antiretroviral therapy (ART). They had been admitted to the Department of Infectious Diseases at the G-Point University Hospital with productive cough and/or hyperthermia following hospital stay greater than 48 hours. Patients' history revealed that one patient had not been compliant with tuberculosis treatment because of adverse reactions classified as minor. There had been no clinical improvement in the three remaining patients despite their optimal compliance to different treatments. Cytobacteriological examination of sputum and/or testing of the feeding tubes, blood cultures and specific samples allowed to identify multidrug-resistant Klebsiella pneumoniae. The clinical course of these patients was favorable under specific antibiotic therapy. Nosocomial infections may be misinterpreted and associated with poor therapeutic response in patients receiving TB treatment. Cytobacteriological examination of the biological fluids should be systematic in patients co-infected with HIV and tuberculosis and hospitalized for at least 48 hours, in whom pulmonary signs and/or fever persist despite their good compliance to treatment.

[Localised tetanus with no obvious entry site: about a case in Bamako (Mali)]. / Tétanos localisé sans porte d´entrée apparente: à propos d´un cas à Bamako (Mali).

Tetanus is a major public health problem in sub-Saharan Africa. Localised tetanus is rare, unlike generalized tetanus which has been sufficiently described in the literature. We report a case of localised tetanus with no obvious entry site managed in the Department of Infectious Diseases in Bamako. The study involved a retired nurse aged 59 years who had not undergone tetanus booster immunisation within the last 10 years, corresponding to the date of her last delivery. She was referred to our Hospital with dysphagia associated with inability to open the buccal cavity. Patient's history was characterized by long-term therapy associated with many specialized consultations without any improvement. The diagnosis of localised tetanus with no obvious entry site was retained after having excluded any other local disorder. Outcome was favorable ten days after adequate management. Underdiagnosed or unknown to health-care providers, localised tetanus may mimic other diseases delaying diagnosis and management. Targeted campaign to build awareness should be implemented in order to improve adherence with immunization schedules.