Rotavirus vaccines in Africa and Norovirus genetic diversity in children aged 0 to 5 years old: a systematic review and meta-analysis : Rotavirus vaccines in Africa and Norovirus genetic diversity.

Noroviruses are the second leading cause of death in children under the age of 5 years old. They are responsible for 200 million cases of diarrhoea and 50,000 deaths in children through the word, mainly in low-income countries. The objective of this review was to assess how the prevalence and genetic diversity of noroviruses have been affected by the introduction of rotavirus vaccines in Africa. PubMed, Web of Science and Science Direct databases were searched for articles. All included studies were conducted in Africa in children aged 0 to 5 years old with gastroenteritis. STATA version 16.0 software was used to perform the meta-analysis. The method of Dersimonian and Laird, based on the random effects model, was used for the statistical analyses in order to estimate the pooled prevalence's at a 95% confidence interval (CI). Heterogeneity was assessed by Cochran's Q test using the I2 index. The funnel plot was used to assess study publication bias. A total of 521 studies were retrieved from the databases, and 19 were included in the meta-analysis. The pooled norovirus prevalence's for pre- and post-vaccination rotavirus studies were 15% (95 CI, 15-18) and 13% (95 CI, 09-17) respectively. GII was the predominant genogroup, with prevalence of 87.64% and 91.20% respectively for the pre- and post-vaccination studies. GII.4 was the most frequently detected genotype, with rates of 66.84% and 51.24% respectively for the pre- and post-vaccination studies. This meta-analysis indicates that rotavirus vaccination has not resulted in a decrease in norovirus infections in Africa.

[Preliminary selective laser trabeculoplasty (SLT) intraocular pressure results in glaucoma patients in Burkina Faso]. / Résultats tonométriques préliminaires de la trabéculoplastie sélective au laser (SLT) chez les glaucomateux au Burkina Faso.

INTRODUCTION: Glaucoma is the leading cause of irreversible blindness in the world. The purpose of our study was to evaluate the tonometric results of SLT treatment in patients with glaucoma. MATERIALS AND METHODS: This was a prospective study of patients with glaucoma who were seen from October 1, 2017 to July 31, 2018. All patients underwent SLT of the inferior 180°. Intraocular pressure (IOP) was measured before and then at 1, 15, 30, 60, 90 and 120days after treatment. RESULTS: We studied 35 eyes of 31 patients. The mean age was 59.3 (±8.4years), range 43-77years. The mean IOP prior to SLT was 20.1mmHg (±7mmHg). One day after the laser, this decreased to 17.6mmHg (±8.4), for a percentage of drop of 12.4%. At 30days, it was 15.3mmHg (±5.4mmHg), i.e. a 23.9% decrease. After 60 and 90days, there was a drop of 13.9% and 15.4%, respectively. At 120days, 43.3% of treated eyes had a decrease of at least 20%. The main complication was increased IOP in 14.2% of cases. CONCLUSION: SLT reduces IOP and the number of glaucoma medications in patients. It appears to be a viable alternative in our countries. These results should be confirmed with a larger cohort and longer follow-up.

[Cost Analysis of the Immunization Program Supportive Supervision in Côte-d'Ivoire]. / Analyse des coûts de supervision formative du programme de vaccination en Côte-d'Ivoire.

One of the major obstacles to improve the performance of immunization programs is the lack of competent health personnel. To increase the availability of qualified health personnel, the Agence de Médecine Préventive (Agency of Preventive Medicine) has set up a technical assistance focused on supportive supervision. The objective of this study is to analyze the cost of this supportive supervision in 10 health districts of Côte-d'Ivoire. The data extracted from the financial and technical reports of the supportive supervisions included personnel costs (salary, per diem), transportation, communication, office supplies, vehicle maintenance and depreciation. The analysis consisted of estimating the total cost of the supportive supervision, the total cost per item and the average cost of a supervisory visit. The conduct of 40 supportive supervision visits amounted to 44,675.12 USD. Of this amount, recurring costs were 40,112.12 USD (89.79%) and non-recurring costs were 4,563 USD (10.21%). The unit cost per supervisory visit was 1,116.88 USD. The cost of personnel was the largest cost. The total cost of the formative supervision would be reduced by 58.68% through the resort to local facilities' staff for the supervision, and the review of the useful life of the vehicles. The costs for implementing supportive supervision were acceptable in comparison to the benefits. Mastering personnel costs, optimizing the scheduling of supervision tours and frequency of visits focused on districts with the lowest EPI indicators could lead to cost savings.

Un des obstacles à l'amélioration des performances des programmes de vaccination est l'insuffisance de ressources humaines compétentes. Pour accroître la disponibilité de personnel de santé qualifié, l'Agence de médecine préventive a mis en place une assistance technique centrée sur la supervision formative. L'objectif de cette étude est d'analyser les coûts de cette supervision formative dans dix districts sanitaires de Côte-d'Ivoire à partir des données extraites des rapports techniques et financiers de supervision. L'analyse a consisté en l'estimation du coût total des supervisions, du coût total par poste et du coût moyen par visite de supervision. Les 40 visites de supervision réalisées ont coûté 44 675,12 USD dont 40 112,12 USD de coûts récurrents (89,78 %) et 4 563 USD de coûts non récurrents. Le coût par visite de supervision était de 1 116,87 USD. Le coût du personnel était le poste de coûts le plus important. Le coût total et le coût unitaire de la supervision seraient réduits de 58,68 % par l'utilisation des superviseurs locaux et des recommandations de l'OMS sur la durée de vie utile des véhicules. Les coûts de la supervision formative étaient acceptables au regard des bénéfices obtenus. La maîtrise des coûts du personnel, une programmation optimale des tournées de supervision et une fréquence des visites centrée davantage sur les districts présentant les plus faibles indicateurs du PEV pourraient favoriser des économies.

[Prevalence of Hepatitis C virus infection in pregnant women and mother-child transmission in Ouagadougou, Burkina Faso]. / Portage du virus de l'hépatite C chez les femmes enceintes et transmission mère-enfant à Ouagadougou, Burkina Faso.

The aim of our study was to estimate the prevalence of Hepatitis C virus (HCV) among pregnant women and the rate of mother-child transmission. Over one month (April 26 to May 25, 2002) blood samples of 200 pregnant women who gave birth at the maternity of the university hospital and Gounguin center medical of Ouagadougou were tested for anti-HVC antibodies (Ac HCV) and anti HIV antibodies (Ac HIV). Infants born to mother tested positive for Ac HCV and their mother were tested for HCV-RNA. The prevalence of HCV (positive Ac HCV and HCV-RNA) was 2% in pregnant women (4/200). One case of mother-child transmission was found. The virus transmitted was 2a (A/C) genotype. The mother had a high titre of HCV-ARN, was co-infected by HIV and had had history of blood transfusion, excision and tattoo of the gums.

[Analysis of the results of 1221 colonoscopies in the hospitals of Burkina Faso, 1994-1997]. / Analyse des résultats de 1221 coloscopies en milieu hospitalier au Burkina Faso, 1994-1997.

The authors report the results of 1221 colonoscopies. It appears from their analysis that whereas functional diseases of the colon remain predominant and topical, organic diseases appear to be increasing in frequency (polyps, polyposis, rectocolic cancer, parasitical colitis, diverticulis). Inflammatory bowel diseases are also beginning to be seen. The reported cases of Crohn's disease and ulcerative colitis are, so far as they know, the first in their country.

[Peritoneal tuberculosis and HIV infection. Reflection apropos of 22 cases at the National Hospital of Bobo Dioulasso]. / Tuberculose péritonéale et infection par le VIH. Réflexion à propos de 22 cas à l'Hôpital national de Bobo Dioulasso.

Peritonitis tuberculosis is still a frequently encountered pathology in our hospital. Since the AIDS pandemic, cases of peritonitis tuberculosis present increasingly atypical characteristics, largely diverging from classical descriptions. The authors report on 22 cases of peritonitis tuberculosis associated with HIV infection. The study was carried out from June 1997 to December 1999 in the National Hospital Centre Souro SANOU of the Bobo Dioulasso internal office. It concerned 10 women and 12 men of a mean age of 37.9 years. The sex-ratio was 1.2 in favour of men. Diagnosis was established by laparoscopy. Peritonitis tuberculosis associated with HIV accounted for 78.5% of peritonitis tuberculosis cases. The clinical picture was dominated by isolated ascite (100%) associated with an oscillating high fever in 68.2% of cases. Negative results for IDR seemed to reflect poor prognosis. Response to treatment was slow but acceptable. The general prognosis was poor with a mortality rate of 18%.

[Perihepatitis and HIV/AIDS infection. Apropos of 13 cases at the National Hospital of Bobo-Dioulasso]. / Périhépatite et infection par le VIH/sida. A propos de 13 cas à l'Hôpital national de Bobo-Dioulasso.

Perihepatitis or Fitz-Hugh syndrome, peritonitis located in the right hypochondriasis (RH), is a relatively rare affectation. However, the HIV-AIDS pandemic has brought about the emergence and re-emergence of disease-states either uncommon or formerly on the decline as well as the appearance of opportunistic illness. We report the results of a retrospective study conducted in the National Hospital of Bobo-Dioulasso (Burkina-Faso) between 1 June 1997 and 31 December 1999 in an effort to contribute to a wider vision of diseases associated with HIV-AIDS. We based our study on 130 laparoscopies carried out for unexplained pain linked to RH (with or without fever), as well as abdominal-pelvian or diffuse abdominal pain. Thirteen cases (11 women, 2 men) of perihepatitis were diagnosed. The mean age for women and men was respectively 31.4 and 39.5. HIV serology was systematically carried out for all patients and, in case of perihepatitis, cultures were taken. All patients were infected with HIV and some presented signs of AIDS according to the WHO classification. In clinical terms, a shalking pain for RH was noted for 5 patients, abdominal sensitivity in 8 cases as well as gynaecological anomalies: cul-de-sac moving pain (4 cases), leuchorrea (3 cases) and mucosic vulvovaginitis (1 case). Paraclinical tests revealed a slight hepatic cytolysis for only 3 patients (1.5 N). 6 patients tested positive for Chlamydia trachomatis; the 7 others could not be tested, but this aetiology was assumed for evaluating the efficacy of the treatment under study. The high frequency of perihepatitis in these patients, all of whom were suffering from HIV-AIDS, and its presence in the 2 male cases, suggest that immunodepression is conducive to the appearance of this disease.

[Diabetes mellitus at the National Hospital Center of Ouagadougou (Burkina Faso)]. / Diabète sucré au Centre hospitalier national de Ouagadougou (Burkina Faso). Epidémiologie, types et manifestations cliniques.

The study, conducted over 4 years among 400 diabetic patients, reports the epidemiological and clinical aspects of diabetes mellitus at the National Hospital of Ouagadougou, Burkina Faso. Epidemiologically, diabetes mellitus affects men by 64% and women by 36%. 76% are over 40 y. o., whereas only 2.2% are under 20. Clinically, the classification of diabetic patients shows that 10.7% are insulin-dependent and 76.5% non insulin-dependent. No usual tropical diabetes has been found. The calcifications observed in 2.5% of cases were combined with chronic alcoholic pancreatitis. The classic triad (polyuria, polyphagia, polydipsia) led to diagnostic by 41% of the patients, whereas 27.5% have been identified when having complications, and 23% by a systematic check-up. Cardio-vascular risk factors combined with diabetes have been found: obesity (28%), high blood pressure (20%), hyperuricaemia (14%), addiction to smoking (20%). The epidemiological characteristics, as well as the various clinical aspects, mostly complies with the observations of the african authors.