Cervical cancer prevention in Burkina Faso: a stakeholder's collaboration for the development of awareness messaging.

Background: Cervical Cancer stands as the second leading cause of both incident female cancers and deaths in Burkina Faso. Unfortunately, the prevention, early detection, and care of cervical cancers are suboptimal at individual, institutional, and national levels. In October 2023, we organized a stakeholder's workshop to develop cervical cancer awareness messaging for disease control in the country. Methods: A one-text workshop was organized with stakeholders working toward improving health in general or women's health and well-being. A participatory, learning, and adaptive approach was used to facilitate discussions and activities, ensuring the contribution of all participants. Contextual evidence-based and empirical elements about cervical cancer burden and preventive strategies were presented to the participants by key informants. These served as the foundation for a collaborative formulation of messaging content that aimed at raising awareness about cervical cancer. Results: Sixty-two participants from 28 organizations attended the workshop. They work mainly at local and international non-governmental organizations, civil society organizations, universities, university hospitals, research centers, and the Ministry of Health. During the first and second days of the workshop, the participants explored cervical cancer data, its preventive and treatment options available in Burkina Faso, communication strategies for behavioral change, and determinants of the use of prevention and health promotion services. During the following three days, 3 working groups were formed to define strategies, and key messages adapted to diverse tools and targeted audiences. All information was validated during plenary sessions before the end of the workshop and available to all participants and their organizations for cancer awareness activities. Conclusion: Upon conclusion of the workshop, the participants provided insightful information for the development of cervical awareness messaging in Burkina Faso. They formed the first community of practice to serve as a dynamic platform for implementation, monitoring, evaluation, and continued learning activities.

Antiulcer Effect of Aqueous Ethanolic Extracts of Pseudocedrela kotschyi (Schweinf) Harms (Meliaceae) and Ximenia americana L. (Olacaceae).

Purpose: This study aimed to provide pharmacological evidence of Pseudocedrela kotschyi and Ximenia americana in preventing or healing peptic ulcers claimed by traditional healers in Burkina Faso. Methods: The trunk bark of Pseudocedrela kotschyi and the roots bark of Ximenia americana (Olacaceae) were macerated in mixed ethanol/water (80:20), respectively, to obtain dried extracts. Two models of hydrochloric acid (HCl, 0.3 M/ethanol, 60%) and hypothermic stress-induced peptic ulcer were used. The cytoprotective effect of individual or combined plant extracts was assessed at 1; 10; 30mg/kg. bw. Then, the healing effect of the extracts at 10mg/kg.bw was evaluated within 21 days of treatment on the hydrochloric acid-induced ulcer model. The extracts' antioxidant activity and phenolic content were assessed to support the plant extracts' efficiency. Results: The extracts of P. kotschyi and X. americana at 10 mg/kg.bw reduced ulceration index in hydrochloric acid- and hypothermic stress-ulcer models by more than 83% and 65%, respectively. The extract from X. americana at 10mg/kg.bw allowed complete ulcer healing but not the association of the two plant extracts. The plant extracts had IC50of inhibition of DPPH radical lower than 5µg/mL and total ferric reducing antioxidant power of more than 77 mg EQAA/100mg. The total polyphenolic content was 64.82 ±0.99 and 53.75 ±1.39 mg EGA/g of dried extract of P. kotschyi and X. americana, respectively. Conclusion: X. americana extract is better than the combined two plant extracts in gastric cytoprotection and ulcer healing. Further investigations are needed to highlight mechanism-based effects.

Distribution of high- and low-risk human papillomavirus genotypes and their prophylactic vaccination coverage among West African women: systematic review.

INTRODUCTION: The second most deadly gynecological cancer worldwide, cervical cancer is steadily on the rise in sub-Saharan Africa, while vaccination programs are struggling to get off the ground. This systematic review's aim was to assess the prevalence and distribution of high- and low-risk HPV genotypes in West African women. METHODS: Original studies were retrieved from PubMed/Medline, Embase, Scopus, Google Scholar, and Science Direct. In these studies, Human papillomavirus (HPV) DNA was assessed in cervical samples by polymerase chain reaction (PCR), Hybrid capture, and sequencing. The quality of the articles was assessed and the results were extracted and reviewed. RESULTS: Thirty-nine studies from 10 West African countries were included for the systematic review including 30 for the pooled analysis. From an overall of 17358 participants, 5126 of whom were infected with at least one HPV genotype, the systematic review showed a prevalence varying from 8.9% to 81.8% in the general population. In contrast, the pooled prevalence of infection was 28.6% (n = 3890; 95% CI 27.85-29.38), and HPV-52 (13.3%), HPV-56 (9.3%), and HPV-35 (8.2) were the most frequent. Quadrivalent and nonavalent vaccines covered 18.2% and 55.8% of identified genotypes respectively. CONCLUSION: Faced with this growing public health challenge in West Africa, it would be necessary for all its countries to have reliable data on HPV infection and to introduce the nonavalent vaccine. A study of the genotypic distribution of HPV in high-grade precancerous lesions and cervical cancer would be very useful in West Africa.

Association of HLA-DRB1*11 and HLA-DRB1*12 gene polymorphism with COVID-19 in Burkina Faso.

BACKGROUND: The clinical manifestations of coronavirus disease (COVID-19) can vary widely, ranging from asymptomatic to severe, and may be influenced by the host genetic background. The aim of the present study was to determine the frequencies of HLA-DRB1*11 and HLA-DRB1*12 allele polymorphisms and their associations with COVID-19. METHODS: In this cross-sectional study, 198 subjects were enrolled, including 150 COVID-19 positive cases and 48 subjects who tested negative for COVID-19. Participants were recruited from the emergency, intensive care, and infectious diseases departments of the Bogodogo Centre University Hospital (CHU-B) or the routine laboratory of Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA). Genomic DNA was extracted from nasopharyngeal swabs samples and multiplex PCR-SSP was used to detect the HLA-DRB1*11 and HLA-DRB1*12 alleles. The study was approved by CERS (№ 2021-02-033). RESULTS: The positive cases were categorized into 38 asymptomatic (CC+), 60 symptomatic (NC+), and 52 severe cases (SC+). Females were more frequent in the overall study population (53.0%, 105/198) as well as in the negative group's CC- (68.75%, 33/48) and SC+ (57.69%, 30/52 negative groups, whereas males were more frequent in the CC+ (63.16%, 24/38) and NC+ (53.33%, 32/60) groups. The highest mean age was observed in the SC + group. A frequency of 19.19% (38/198) and 14.65% (29/198) was found for the HLA-DRB1*11 and HLA-DRB1*12 alleles, respectively. Individuals carrying the HLA-DRB1*11 allele had an approximately sixfold higher risk of asymptomatic SARS-CoV-2 infection (OR = 5.72 [1.683-19.442], p = 0.005) based on the association analysis. CONCLUSIONS: Altogether, the present study reports high frequency of HLA-DRB1*11 and HLA-DRB1*12 alleles within a population from Ouagadougou, Burkina Faso. The results suggest that individuals carrying the HLA-DRB1*11 allele are more susceptible to COVID-19 infection but may not display symptoms.

[Cancer of the vulva: Diagnostic stages, treatment and survival in a country with limited resources (Burkina Faso)]. / Cancer de la vulve : stades diagnostiques, traitement et survie dans un pays aux ressources limitées (Burkina Faso).

INTRODUCTION: Vulvar cancer is rare and belatedly diagnosed in Africa. We describe its diagnostic stages, therapeutic and evolution features in a country with limited resources. METHODOLOGY: Forty-seven cases of vulvar cancer diagnosed between 2013 and 2018 in Burkina Faso, were analyzed retrospectively. The diagnostic stages, therapeutic and evolution terms were considered. Survival was calculated through the Kaplan Meier Method and compared using the Logrank technique. RESULTS: Stages IA and IB accounted for 10.6%. Radiotherapy was not available and chemotherapy was done in 9 cases. Full vulvectomy with bilateral inguino-femoral dissection was performed in 11 cases. Average survival was 41 months with a median of 52 months. The difference in survival according to the diagnostic stages were highly significant statistically (P=0.000). DISCUSSION: Cancer of the vulva is rare and raises major therapeutic difficulties in countries with limited resources. Surgery is the only affordable weapon. Evolution would be better if radiochemotherapy was possible. CONCLUSION: Radiochemotherapy cannot be done due to the lack of a radiotherapy unit and the high cost of cytotoxics. Surgery is largely palliative and/or mutilating. Survival is modest. An early diagnosis could help promote conserving treatments.

Giant lipoma of the left mesocolon: Radiological and surgical aspects.

INTRODUCTION: Abdominal masses are common in digestive surgery and gastro-enterology units. However, meso-intestinal lipomas remain rare and lipoma of the left colon uncommon. We report a case of giant lipoma of the left mesocolon whose diagnosis was highly guided by radiological examinations. PRESENTATION OF CASE: A female patient aged 56, consulted for left subcostal abdominal pains. The clinical examination showed an abdominal mass occupying the left hemiabdomen. The abdominal-pelvic CT scan highlighted a large abdominal-pelvic mass in the left abdomen. Abdominal-pelvic MRI revealed a large fatty mass spreading from the front subphrenic space up to the level of the left iliac fossa, non-suspected and compatible with lipoma. FDG-Pet Scan had not revealed pathological fixing. The mass appeared like a total gap space. Exploratory surgery revealed a lipoma mass in the left mesocolon. Hemicolectomy was performed taking away the mass. Histology confirmed the diagnosis of lipoma and the outcome was favourable. DISCUSSION: Our case represents the fourth case of mesocolon lipoma described in the literature. Imaging, especially TDM and MRI are an important step of the preoperative diagnosis. The surgery consists of either a lumpectomy or a colectomy. CONCLUSION: Lipoma of the left mesocolon is exceptional. Radiological examinations provide most arguments to suggest lipoma. However the organ's diagnosis is provided by surgical exploration and the certainty diagnosis by pathological examination. Treatment is surgical.

Identification of BRCA1/2 p.Ser1613Gly, p.Pro871Leu, p.Lys1183Arg, p.Glu1038Gly, p.Ser1140Gly, p.Ala2466Val, p.His2440Arg variants in women under 45 years old with breast nodules suspected of having breast cancer in Burkina Faso.

Breast cancer is the top cause of cancer mortality among women in the world and the second in Africa. The aims of this study were to: i) identify women with breast nodules suspected of having breast cancer ii) sequence the BRCA1 and BRCA2 genes and iii) screen mutations. From 2015 to 2016, 112 women aged from 35 to 44 years, who had come for consultation in the gynecology/obstetrics and the oncology department of the University Hospital Yalgado Ouedraogo, voluntarily agreed to participate to this study. Whole blood was collected from those with mammary nodules. The genomic DNA was extracted using Qiagen kit. FAST KAPA was used for genomic DNA amplification and the purified PCR products were analyzed by direct sequencing using Big Dye v1.1 and ABI 3730 automated sequencer. Nucleotides substitutions were determined. We identified BRCA1 SNPs rs1799966, rs799917, rs16942, rs16941, rs2227945, and BRCA2 SNPs rs169547, rs4986860. These identified variants are found mostly in cases of benign tumors of breast or ovarian cancer with familial history of breast cancer. This study in Burkina-Faso, is the basis for improved and more specific genetic testing, and suggests that additional genes contributing to an increased risk of breast cancer should be analyzed.

Ectopic pheochromocytoma or paraganglioma of the ZUCKERKANDL organ: A case report and review of the literature.

INTRODUCTION: Paraganglioma of the ZUCKERKANDL organ are rare. Diagnosis is based on clinical, radiological and biological arguments. We report a case to describe our surgical procedure and insist on the necessity of preoperative diagnosis. PRESENTATION OF CASE: BA, 52-years-old male patient was seen in consultation for left hypochondrium pains. The clinical examination had revealed a painful tumefaction in the left flank and the left hypochondrium. A deep mass was observed, but was difficult to be assessed, due to pain. Abdominal-pelvic CT scan with contrast injection had revealed a tissue mass, suggesting a tumor of the tail of the pancreas. Laparotomy showed this mass was not attached to the tail of the pancreas, and was along the abdominal aorta up to the aortic bifurcation. Upon touching the mass, blood pressure raised up to 240 mmHg. A least mobilization of the mass and the use of nicardipine helped maintain blood pressure below 180mmhg. Dissection was carried out from the aortic bifurcation to the TREITZ's angle and the mass was removed. The follow-ups were characterized by low blood pressure a few minutes following the resection of the mass. DISCUSSION: Pheochromocytoma is rare. The Clinical signs, Abdominal-pelvic CT scan and biology are the steps of the preoperative diagnosis. The surgery consists a lumpectomy. The resuscitation determines the patient's prognosis. CONCLUSION: Pheochromocytoma is an unusual mass. Preoperative diagnosis can be difficult in pauci-symptomatic cases. One should consider this in the face of any abdominal mass, so as to improve planning of resuscitation which determines the patient's prognosis.