Pulmonary function assessment among conventional and organic cotton farmers exposed to pesticides in the Central-West region of Burkina Faso.

BACKGROUND: Respiratory diseases have been associated with the exposure of populations to some environmental pollutants such as pesticides. To assess effects of pesticides on farmers' respiratory health, this study aimed to evaluate the pulmonary function of cotton farmers exposed to synthetic and natural pesticides in the Central-West region of Burkina Faso. METHODS: A cross-sectional study was conducted from June to July 2022 among 281 conventional and 189 organic cotton farmers. After collecting information on pesticide use conditions, pulmonary function tests (PFTs) were performed on each farmer according to the American Thoracic Society/European Respiratory Society guidelines, in order to assess chronic respiratory effects among cotton producers. Binary logistic regression was used to assess factors associated with the occurrence of ventilatory changes. RESULTS: Both conventional and organic cotton farmers reported similar chronic respiratory symptoms in different proportions. The main reported were rhinitis (54.45% conventional vs. 34.92% organic), chest pains (41.28% conventional vs. 23.81% organic), cough (33.45% conventional, 24.34% organic), breathlessness (31.67% conventional, 4.23% organic) (p<0.05). 16.18% and 27.50% of conventional male and female cotton farmers, respectively, had a restrictive defect. Among organic cotton farmers, 15.85% and 18.69%, respectively, of males and females had a restrictive defect. Furthermore, a significant increase in the predicted average percentage of FEV1/FVC ratio was observed among organic cotton farmers after salbutamol's use (p = 0.039). The type of cultivated cotton was not associated with ventilatory changes neither in the univariate analysis, nor in the multivariate analysis. Other factors such as farmers' age, BMI and insecticides use frequency per year were also important. Farmers who used insecticides more than 6 times per season had an increased risk of developing an obstructive defect (OR = 1.603; 95%CI: 0.484-5.309) compared to those who used them 6 times or less. CONCLUSION: Chronic respiratory signs and ventilatory impairments were found among conventional and, to our knowledge, for the first time among organic cotton producers. However, these health effects were more prevalent among conventional cotton farmers than organic ones.

Chronic respiratory disease observatory for Africa (CHEST-Africa): study protocol for the prevalence, determinants and economic impacts of asthma and COPD in Africa.

INTRODUCTION: Contemporary data on the burden of chronic respiratory diseases in sub-Saharan Africa is limited. More so, their economic burden is not well described. This study aims to establish a chronic respiratory disease observatory for Africa. Specific study aims are (1) to describe the prevalence and determinants of asthma with a target to screen up to 4000 children and adolescents across four African cities; (2) to determine the prevalence and determinants of chronic obstructive pulmonary disease (COPD) with a target to screen up to 3000 adults (≥18 years) across five African cities; (3) to describe the disease burden by assessing the frequency and severity of symptoms and exacerbations, medication use, emergency healthcare utilisation and hospitalisation; and (4) to assess the economic burden and affordability of the medicines for these diseases. METHODS AND ANALYSIS: Surveys will be conducted in schools to identify children and adolescents with asthma using the Global Asthma Network screening questionnaire in Ghana, Nigeria, the Democratic Republic of Congo, and Uganda. Community surveys will be conducted among adults using an adapted version of the Burden of Obstructive Lung Disease Questionnaire to identify persons with COPD symptoms in Nigeria, Burkina Faso, Mozambique, Rwanda, and Sierra Leone. Fractional exhaled nitric oxide and pre-bronchodilator and post-bronchodilator spirometry will be done for children with asthma or asthma symptoms and for all adult participants. Children and adults with respiratory symptoms or diagnoses will complete the health economic questionnaires. Statistical analysis will involve descriptive and analytical statistics to determine outcomes. ETHICS AND DISSEMINATION: Ethical approval has been obtained from participating institutions. This study's results will inform deliberations at the United Nations General Assembly high-level meeting on non-communicable diseases in 2025. The results will be shared through academic conferences and journals and communicated to the schools and the communities.

High prevalence of TB multimorbidity among adults of a tertiary hospital in Sierra Leone: a cross-sectional study.

OBJECTIVE: Tuberculosis (TB) is a leading cause of death globally, with approximately 1.5 million deaths in 2020. TB often coexists with chronic communicable and non-communicable diseases, but data to determine the extent of comorbid diseases are limited. In this study, we aimed to assess the prevalence of TB multimorbidity and its risk factors in a tertiary hospital in Sierra Leone. This is a cross-sectional study of 240 adults with microbiologically-confirmed TB at Connaught Hospital in Freetown, between March and May 2022. Logistic regression analysis was used to identify factors associated with TB multimorbidity. RESULTS: The mean age of the patients was 37 years. More than two-thirds were males and about the same number had two or more chronic diseases. The most common were hypertension (47.9%) and diabetes (24.2%). Patients under 35 years of age were less likely to have TB multimorbidity (< 25 years: adjusted OR 0.07, 95%CI 0.01-0.6; 25-34 years: adjusted OR 0.2, 95%CI 0.01-0.9). We report a high prevalence of comorbid diseases among TB patients in the largest treatment center in Sierra Leone, with hypertension and diabetes being the most common. These findings support the current call for addressing comorbid non-communicable diseases in TB patients through integrated care.

Assessment of Recovery Time, Worsening, and Death among Inpatients and Outpatients with COVID-19, Treated with Hydroxychloroquine or Chloroquine plus Azithromycin Combination in Burkina Faso.

OBJECTIVES: Our study aimed to assess the statistical relationship between the use of chloroquine phosphate or hydroxychloroquine plus azithromycin (CQ/HCQ + AZ) and virological recovery, disease worsening, and death among out- and inpatients with COVID-19 in Burkina Faso. METHODS AND DESIGNS: This was a retrospective observational study that compared outcomes in terms of time to recovery, worsening, and death in patients who received CQ/HCQ + AZ and those who did not using a multivariable Cox or Poisson model before and after propensity matching. RESULTS: Of the 863 patients included in the study, about 50% (432/863) were home-based follow-up patients and 50% were inpatients. Of these, 83.3% (746/863) received at least 1 dose of CQ/HCQ + AZ and 13.7% (118/863) did not. There were no significant differences in associated time to recovery for patients receiving any CQ/HCQ + AZ (adjusted HR 1.44; 95% CI 0.76-2.71). Similarly, there was no significant association between CQ/HCQ + AZ use and worsening (adjusted IRR 0.80; 95% CI 0.50-1.50). However, compared with the untreated group, the treated group had a lower risk of death (adjusted HR 0.20; 95% CI 0.10-0.44). CONCLUSIONS: The study provided valuable additional information on the use of CQ/HCQ in patients with COVID-19 and did not show any harmful outcomes of CQ/HCQ + AZ treatment.

Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low- and Middle-Income Countries.

Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality-over one and a half million children and adolescents develop TB each year. A history of the global public health perspective on child and adolescent TB is followed by 12 narratives detailing challenges and progress in 19 TB endemic low and middle-income countries. Overarching challenges include: under-detection and under-reporting of child and adolescent TB; poor implementation and reporting of contact investigation and TB preventive treatment services; the need for health systems strengthening to deliver effective, decentralized services; and lack of integration between TB programs and child health services. The COVID-19 pandemic has had a significant negative impact on case detection and treatment outcomes. Child and adolescent TB working groups can address country-specific challenges to close the policy-practice gaps by developing and supporting decentral ized models of care, strengthening clinical and laboratory diagnosis, including of multidrug-resistant TB, providing recommended options for treatment of disease and infection, and forging strong collaborations across relevant health sectors.

Predictors of severe hypoxemia among COVID-19 patients in Burkina Faso (West Africa): Findings from hospital based cross-sectional study.

INTRODUCTION: COVID-19 is one of the world's major health crises. The objective of this study was to determine the predictive factors of severe hypoxemia in patients hospitalized in COVID-19 health facilities in Burkina Faso. PATIENTS AND METHOD: This study was a hospital-based cross-sectional study. The data collected relate to the period of the first wave of the epidemic (March 9 to June 30, 2020). All patients hospitalized for COVID-19 in the requisitioned health facilities of Ouagadougou were included in this study. Predictors of severe hypoxemia were identified using a multivariate logistic regression model. RESULTS: During the study period, 442 patients were included, representing 45.7% of the total number of positive patients in the entire country. The most common co-morbidities were diabetes (55; 12.4%) and arterial hypertension (97; 21.9%). Severe hypoxemia (SpO2 < 90%) was observed in 64 patients (14.5%). Age over 65 years (OR = 8.24; 95% CI: 2.83-24.01) and diabetes (OR = 2.43; 95% CI: 1.17-5.06) were the predictors for occurrence of severe hypoxemia in multivariate analysis. CONCLUSION: The predictive factors of COVID-19 are similar in African and Caucasian populations. The surveillance of COVID-19 in risk groups should be strengthened to reduce their morbidity and mortality.