Extent and patterns of drug use in prison in Burkina Faso: findings from a cross-sectional study in central prison of Ouagadougou.

PURPOSE: Drug use in prisons remains a public health concern because it is often the place of drug initiation. The purpose of this study was to analyze the drug use in prison in Burkina Faso. DESIGN/METHODOLOGY/APPROACH: We conducted cross-sectional study in the prison of Ouagadougou. The adult prisoners (male and female) incarcerated for more than one month at the largest prison of Burkina Faso were included in the study. Participants were selected using a systematic random sampling. Data were collected from October 28 to November 26, 2018. The face-to-face interviews were conducted in the prison grounds. Logistic multivariate regression was used to identify factors associated with in prison drug use. All analysis was done using Stata. FINDINGS: A total of 379 prisoners were included in this study. Approximately one-third inmates (32.71%; n = 124) experienced illicit drug in lifetime. Nearly one-third (28.76%; n = 109) of the prisoners were drug users before incarceration and 11.87% (n = 45) used drug inside the prison, of which 33.33% (n = 15) initiated drug use in the prison. Cannabis was the first drug used by the prisoners (71.11%) followed by tramadol (62.22%), diazepam (13.33%) and cocaine (2.22%). Four prisoners (3.63%) had reported Heroin use before incarceration. Cannabis was mainly smoked. Tramadol, diazepam and amphetamines were swallowed or mixed with food. Cocaine is smoked and snorted. Case of injection of cocaine and heroin was reported before incarceration. Main factors independently associated with drug use in prison is drug use before prison and young age of inmates. Indeed, inmates who had reported drug use before prison had 4.01 time {adjusted odd ratio (AOR: 4.01 [95% CI: 1.91-8.41])} higher odds to use drug in prison. RESEARCH LIMITATIONS/IMPLICATIONS: To conduct the interviews in the prison grounds could be a limitation due to social desirability bias. Indeed, the prisoners may understate drug use in prison for the fear of likely additional sentence. Availability of biological tests for drug markers might help addressed this bias. Nevertheless, the findings of this study should help to plan effective drug use prevention and care programs for prisoners. PRACTICAL IMPLICATIONS: The actions must include the implementation of a medical and psychological care in continuum of healthcare system in Burkina Faso. This system should include screening at entry and adequate health and psychological care in prison for drug users for an effective control of drugs use in prison. SOCIAL IMPLICATIONS: Most of these drug users in prison have a low level of education and are unemployed. Education activities and training on occupational activities to prepare drug users for a successful social reintegration less dependent on drugs is essential. This study can be a basis to explore more possibilities and find out what is available to help those with substance use disorder, manage these cases in prison and prevent relapse on release. ORIGINALITY/VALUE: To the best of the authors' knowledge, this study is the first study on drug use in prison in Burkina Faso. It indicates that the repressive strategy against drug use seems ineffective because former users continue their consumption inside and also new users are initiated to use drugs in prison.

Knowledge, attitudes, and practices of healthcare workers regarding human immunodeficiency virus index testing in 2021, Burkina Faso.

Although knowing one's HIV status is a necessary step in initiating antiretroviral treatment, more than a quarter of Burkinabe who are HIV-positive do not know their status. To reach the target of screening at least 95% of people living with HIV (PLHIV), the country has opted for HIV index testing (screening of sexual partners, children and partners of intravenous drug users). This study assessed the knowledge, attitudes and practices of health workers on HIV index testing. A cross-sectional study was conducted among health workers on index testing pilot sites in Burkina Faso. We constructed scores of health workers' knowledge, attitudes and practices regarding HIV index testing. A total of 132 health workers were surveyed, 62.8% of whom were female. Regarding profiles, 44.7% of the participants were nurses and 5.3% were midwives; physicians and psychosocial counselors accounted for 16.7 and 33.3%, respectively. Most of the participants worked in public health centers (60.6%). Overall, the majority of the participants had poor or average knowledge (85.6%) of the index testing strategy and harmful or inadequate practices (87.1%). Less than half (40.9%) had favorable attitudes toward the strategy. Our study showed that the knowledge of health workers was generally average, their attitudes were not very favorable and their practices were mostly inadequate with regard to HIV index testing. In order to increase the chances of reaching the first 95% of UNAIDS, trainings on the topic must be designed for health workers.

HIV viral load measurement: knowledge, attitudes and practices of health workers, Burkina Faso / Mesure de la charge virale VIH : connaissances, attitudes et pratiques des agents de santé, Burkina Faso

Introduction: Approximately a quarter of people living with HIV (PLHIV) had their plasma viral load (PVL) measured in 2020 in Burkina Faso. The purpose of this study was to assess the knowledge, attitudes, and practices (KAP) of health workers regarding HIV PVL measurement. Methods: A cross-sectional study was conducted among health workers involved in the care of PLHIV in the 13 regions of Burkina Faso in 2021. Scores were constructed to assess their KAP on PVL measurement. Factors associated with knowledge and practices were identified by logistic regression. Results: A total of 255 health workers were surveyed. The majority had good knowledge (73%) and favorable attitudes (93%). However, 40% had inadequate practices. Taking into account the availability of a laboratory to carry out PVL tests within the health center, having a coordinating role increased the likelihood of having good knowledge, while not having a medical qualification reduced this likelihood. Good practices were more common among health workers working at the second level of the health pyramid. Conclusions: Interventions to increase the demand for a measurement of PVL are essential to improve the care of PLHIV. For example, future investigations could explore the role of mediators in increasing the demand for PVL among PLHIV and their caregivers.

Introduction: Environ un quart des personnes vivant avec le virus de l'immunodéficience humaine (PVVIH) avait réalisé une charge virale plasmatique (CVP) en 2020 au Burkina Faso. Le but de cette étude était d'évaluer les connaissances, les attitudes et les pratiques (CAP) des agents de santé en matière de mesure de la CVP du VIH. Méthodes: Une étude transversale a été conduite auprès des agents de santé impliqués dans la prise en charge des PVVIH dans les 13 régions du Burkina Faso en 2021. Des scores ont été construits pour évaluer leurs CAP sur la mesure de la CVP. Les facteurs associés aux connaissances et pratiques ont été identifiés par une régression logistique. Résultats: Au total, 255 agents de santé ont été inclus dans l'étude. La majorité avait de bonnes connaissances (73 %) et des attitudes favorables (93 %). Cependant, 40 % avaient des pratiques inadéquates. Tenant compte de la disponibilité d'un laboratoire de réalisation de la CVP au sein du centre de santé, occuper un rôle de coordonnateur augmentait la probabilité d'avoir de bonnes connaissances, tandis que ne pas avoir une qualification médicale réduisait cette probabilité. Les bonnes pratiques étaient plus courantes chez les agents santé travaillant au deuxième niveau de la pyramide sanitaire. Conclusions: Des interventions pour accroître la réalisation de la CVP sont indispensables pour améliorer la prise en charge des PVVIH. Par exemple, des investigations futures pourraient étudier le rôle des médiateurs dans l'accroissement de la demande de la CVP auprès des PVIHH et de leur soignant.

Risk Prediction Models for Cardiotoxicity of Chemotherapy Among Patients With Breast Cancer: A Systematic Review.

Importance: Cardiotoxicity is a serious adverse effect that can occur in women undergoing treatment for breast cancer. Identifying patients who will develop cardiotoxicity remains challenging. Objective: To identify, describe, and evaluate all prognostic models developed to predict cardiotoxicity following treatment in women with breast cancer. Evidence Review: This systematic review searched the Medline, Embase, and Cochrane databases up to September 22, 2021, to include studies developing or validating a prediction model for cardiotoxicity in women with breast cancer. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess both the risk of bias and the applicability of the prediction modeling studies. Transparency reporting was assessed with the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) tool. Findings: After screening 590 publications, we identified 7 prognostic model studies for this review. Six were model development studies and 1 was an external validation study. Outcomes included occurrence of cardiac dysfunction (echocardiographic parameters), heart failure, and composite clinical outcomes. Model discrimination, measured by the area under receiver operating curves or C statistic, ranged from 0.70 (95% IC, 0.62-0.77) to 0.87 (95% IC, 0.77-0.96). The most common predictors identified in final prediction models included age, baseline left ventricular ejection fraction, hypertension, and diabetes. Four of the developed models were deemed to be at high risk of bias due to analysis concerns, particularly for sample size, handling of missing data, and not presenting appropriate performance statistics. None of the included studies examined the clinical utility of the developed model. All studies met more than 80% of the items in TRIPOD checklist. Conclusions and Relevance: In this systematic review of the 6 predictive models identified, only 1 had undergone external validation. Most of the studies were assessed as being at high overall risk of bias. Application of the reporting guidelines may help future research and improve the reproducibility and applicability of prediction models for cardiotoxicity following breast cancer treatment.

Survival of patients operated on for breast cancer in Ouagadougou/Burkina Faso.

BACKGROUND AND OBJECTIVES: Breast cancer is the most common cancer in women. The objective is to study the survival of patients operated on for breast cancer. METHODS: Descriptive and analytical study of the survival of patients operated on for breast cancer between January 1, 2013 and December 31, 2020 in Ouagadougou. Survival was assessed by the Kaplan-Meier method and comparisons by the log-rank test. Prognostic factors were determined using the Cox model. RESULTS: We collected 550 cases. Overall survival at 5 years was 66.2%. Those under 30 years of age had a low 5-year overall survival (53%). The 5-year overall survival was poor in rural patients (63.5%), triple-negative patients (77.2%), HER2+ patients (50.5%) and stage IV patients (29.8%). In multivariate analysis, higher education (p < 0.001) and higher socioeconomic level (p < 0.001) were associated with better prognoses. CONCLUSIONS: The survival of patients operated on for breast cancer remains to be improved. It is influenced by multiple factors especially the socio-economic and educational level of the patients.

Factors associated with unmet need for birth spacing among Angolan women.

Unmet need for family planning (UNFP) remains a public health concern in Angola. The objective of this study was to analyze the factors associated with UNFP among Angolan women aged 15-49 years in 2015-2016. This was an analytical cross-sectional study. A multiple logistic regression model using data from the Angola Demographic and Health Survey 2015-2016 was performed to determine the associated factors. In total, the study involved 8033 women, 22% of whom were between 25-29 years of age. A large number (65%) lived in urban areas and 39% had primary education. About 1/4 of the women (26%) had UNFP for birth spacing. Associated factors were multiple. Age, credible source of information on family planning were protective factors against UNFP for birth spacing while economic level, the woman's level of education were risk factors for NFP.

[Causes of stress in the workplace: survey of 223 formal private sector employees in the city of Ouagadougou]. / Facteurs de stress en entreprise: cas de 223 salariés des entreprises privées formelles (EPF) de la ville de Ouagadougou.

INTRODUCTION: in Burkina Faso, work-related stress is a public health problem. The purpose of this study is to evaluate factors of stress among formal private sector employees in the city of Ouagadougou. METHODS: we conducted a survey using the 26-item scale derived from Karasek and the 23-item scale derived from Siegrist. Validated Karasek and Siegrist´s models as well as SPSS software were used to analyze data. RESULTS: we surveyed 223 employees (186 men and 37 women) with an average age of 36.70 years ± δ = 33.25. In addition, 70,40% of employees had job strain; 50,22% iso strain and 52,02% effort-reward imbalance. Post-hoc analyses showed the following stress factors: great efforts and poor decision-making ability. CONCLUSION: this study confirms the presence of stress among private sector employees and highlights the importance of combining Karasek and Siegrist's questionnaires in the study of stress factors.

[The challenge of intersectorality in the formulation of policies favourable to the health of older persons in west africa: the case of Burkina Faso]. / Le defi de l'intersectorialite dans la formulation des politiques favorables a la sante des personnes agees en afrique de l'ouest : cas du Burkina Faso.

AIM: The aim of this study was to contribute to a better development of health policies for the elderly in Burkina Faso. MATERIAL AND METHODS: We have done a qualitative cross-sectional study from February to September 2018 in 4 ministerial departments of Burkina Faso (health, human rights, public service and national solidarity). The interviews included non-governmental organisations, associations, technical and financial partners. Inductive approach has used to produce results. RESULTS: A total of 24 key informants were included in the study. Various interventions were implemented differently by the departmental departments. The study identified non-functional interdepartmental consultation frameworks as mechanisms for consultation. These frameworks have not been used in the formulation or implementation of policies for the elderly. CONCLUSION: National coordination of public policies for the elderly in high level of decision-making is important. The activation of interdepartmental consultation frameworks is a necessity for formulating holistic and complementary interventions for the elderly and even beyond this target group.

BUT: Le but de cette étude était de contribuer à une meilleure élaboration des politiques publiques de santé en faveur des personnes âgées au Burkina Faso. MATÉRIELS ET MÉTHODES: il s'est agi d'une étude transversale qualitative de Février à Septembre 2018 dans 4 départements ministériels du Burkina Faso (la santé, les droits humains, la fonction publique et la solidarité nationale). Les entretiens ont inclus des organisations non gouvernementales, des associations, des partenaires au développement. L'approche inductive a été utilisée pour produire les résultats. RÉSULTATS: Au total 24 informateurs clés étaient inclus dans l'étude. Diverses interventions étaient mises en œuvre différemment par les départements ministériels. L'étude a mis en évidence des cadres de concertations interministériels non fonctionnels. Ces cadres n'ont pas été utilisés ni dans la formulation, ni dans la mise en œuvre des politiques en faveur des personnes âgées dans les différents ministères. CONCLUSION: L'absence de coordination interministérielle entre les ministères chargés des politiques publiques en faveur de la santé des personnes âgées et le faible engagement de l'Etat et des partenaires au développement étaient des limites relevées dans cette étude. La définition d'une politique publique de santé des personnes âgées à dimension intersectorielle s'avère nécessaire au Burkina Faso.

[Prevalence and factors associated with missed opportunities for vaccination at Niamey, Niger]. / Prevalence et facteurs associes aux occasions manquees de vaccination (OMV) a Niamey au Niger.

AIM: determine the prevalence and factors associated with missed opportunities for vaccination of children 0-23 months old in the health district Niamey 2 (Niger) in 2018. MATERIALS AND METHODS: It was a cross - sectional study conducted in the health district of Niamey 2 in 2018. All children aged of 0 - 23 months which had parents aged more than 15 years old, who accepted to answer our questions were included. RESULTS: The prevalence of the missed opportunities immunization was 42.8%. Parent's perception on health services, the long waiting time, the refusal of immunization, the date of next appointment were the factors associated with the missed opportunities immunization. CONCLUSION: Taking into consideration the results of this study, the missed opportunities immunization remain important public health problems in Niger. Some actions need to be taken to improve the sensitization of communities about children immunization completeness.

BUT: déterminer la prévalence et les facteurs associés aux occasions manquées de vaccination selon la communauté (OMV) chez les enfants de 0 - 23 mois. MATÉRIELS ET MÉTHODES: Il s'est agi d'une étude descriptive transversale à visée analytique chez les enfants de 0 à 23 mois et leurs parents dans le district sanitaire Niamey 2 du 01 juin au 31 août 2018. Etaient inclus tous les enfants de 0 - 23 mois et leurs parents âgés de plus de 15 ans, acceptant de répondre à nos questions. RÉSULTATS: La prévalence des OMV était de 42,8%. Les perceptions des parents vis-à-vis des services de vaccination, le long temps d'attente, le refus de vaccination, la courtoisie des agents en demandant le carnet de vaccination des enfants, la date du prochain rendez ­ vous de même que la satisfaction des parents des services de vaccination étaient statistiquement liés aux occasions manquées de vaccination. CONCLUSION: Au regard de nos résultats, les occasions manquées de vaccination demeurent un problème de santé publique au Niger. Il revient donc aux autorités sanitaires la mise en œuvre des programmes d'intensification de sensibilisations communautaires pour assurer aux enfants une bonne complétude vaccinale.

Dengue virus infection and pregnancy outcomes during the 2017 outbreak in Ouagadougou, Burkina Faso: A retrospective cohort study.

INTRODUCTION: Dengue fever is a re-emerging pathology in Burkina Faso. It affects everyone and pregnant women are not left out. The objective of this study was to estimate the burden of dengue fever and to assess its effects on pregnancy outcomes in hospitalized pregnant women during the 2017 outbreak in Ouagadougou, Burkina Faso. METHOD: This was a retrospective cohort study including febrile pregnant women from five health facilities in Ouagadougou. The study was carried out from July 1st to December 31st, 2017. A logistic stepwise regression was performed to identify the pregnancy adverse outcomes risk factors. RESULTS: Our study included 424 pregnant women at a mean age of 27.1 years old (Standard deviation: 6.23 years). Overall 28.54% (121/424) were infected with dengue virus. During follow-up, 29.01% (123/424) presented an adverse pregnancy outcome. Adjusted for gestational age and clinical symptoms, the risk of adverse pregnancy outcome was twice as high among dengue infected women as compared to uninfected women with an adjusted Odds Ratio (aOR) = 2.09 (1.08-4.05). The risk of the adverse pregnancy outcome was higher in the third trimester of pregnancy with aOR = 1.66 (1.02-2.72) in dengue fever infected women. CONCLUSION: Dengue fever is a risk factor for adverse pregnancy outcomes, especially in the third trimester in Burkina Faso. The implementation of effective anti-vectorial control interventions and better management of dengue fever during pregnancy are needed to improve pregnancy outcomes.

Smokeless tobacco use: its prevalence and relationships with dental symptoms, nutritional status and blood pressure among rural women in Burkina Faso.

BACKGROUND: Sub-Saharan women use smokeless tobacco (SLT) more than smoked tobacco. Among Western African countries, the estimated weighted prevalence of SLT use in rural women was found to be the highest in Burkina Faso (after Sierra Leone). This study aimed to assess the prevalence of SLT use and its associated factors among rural women in Burkina Faso by using nationally representative data. METHODS: We used data from the 2013 STEPwise approach to Surveillance (STEPS) study, which provided sociodemographic, clinical (anthropometric, systolic blood pressure [SBP], diastolic blood pressure [DBP] and dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and tobacco and alcohol consumption data. Data for 1730 rural women were used, and we performed Student's chi-squared and logistic regression analyses. RESULTS: The prevalence of current SLT use was 13.8% (95% CI: 12.2-15.5). Significant risks for SLT use were the presence of dental symptoms (adjusted odds ratio [aOR] = 2.59; p < 0.001), undernourishment (aOR = 1.78; p < 0.01), decreased waist circumference (aOR = 0.98; p < 0.05), decreased DBP (aOR = 0.97; p < 0.01), increased SBP (aOR = 1.01; p < 0.05), and increased differential blood pressure (aOR = 1.01; p < 0.05). The co-use of alcohol was also a significant risk factor (aOR = 2.80; p < 0.001). CONCLUSION: The prevalence of current SLT use was high among rural women in Burkina Faso, and significant concerns for users included alcohol co-use, the occurrence of dental symptoms, undernourishment, and an increase in differential blood pressure. National Public Health interventions are needed to reduce SLT use and its health-related concerns.

Prevalence of wasting and associated factors among 6 to 23 months old children in the Sahel Region of Burkina Faso.

INTRODUCTION: Despite the efforts of nutrition stakeholders in Burkina Faso to improve infant and young child feeding (IYCF) practices, the country is still struggling to stem undernutrition. Wasting, or acute malnutrition, is the form of malnutrition that has the most harmful short-term consequences for children. The objective of our study was to estimate the prevalence of wasting in children aged 6-23 months in the Sahel region of Burkina Faso and to identify its associated factors. METHODS: We conducted a secondary analysis of data from the 2015 National Nutrition Survey. The factors associated with wasting in the studied population were identified using a logistic regression. RESULTS: A total of 956 children participated in the study. The prevalence of wasting was 25% (95% CI [22.28, 27.87]) in the Sahel region. Only 24.37% of children received a minimum meal frequency and 13.38% received a minimum dietary diversification the day before the survey. In the multivariate analysis, being male (aOR = 1.99; 95% CI [1.46, 2.72]), breastfeeding the day before the survey (aOR = 2.43; 95% CI [1.13, 5.22]), and having a history of illness (aOR = 2.32; 95% CI [1.67, 3.21]) significantly increased the risk of acute malnutrition. CONCLUSION: In 2015, the prevalence of wasting among children was high in the Sahel region and good IYCF practices were still inadequate. There is an urgent need to implement good IYCF practices and strengthen interventions to improve infant health in this region.

[Study considering the use of medicines in children receiving free care]. / Etude de l'utilisation des médicaments chez les enfants dans un contexte de gratuité des soins.

INTRODUCTION: Rational medical prescription is a concern for the health systems and policies of African countries. The purpose of this study was to analyze the use of medicines in children aged 0 to 5 years receiving free care. METHODS: We conducted a cross-sectional study considering the use of medicines in 20 randomly selected health facilities level 1 in Ouagadougou. The reference of the World Health Organization and of the International Network for the Rational Use of Drugs (WHO/INRUD) was used to analyze data. Descriptive statistics were used as the average and standard deviation. Differences were measured using ANOVA test. RESULTS: In total, 1.206 prescriptions were reviewed between April 2016 and March 2017. The number of medicines issued on prescription was 2.9, the percentage of generic medicines prescribed was 88.7% and 97.7% of medicines prescribed were registered on the National List of Essential Medicines. The percentage of consultations during which antibiotics were prescribed was 83.2%, and 9.3% of prescriptions contained at least one injectable product. CONCLUSION: Irrational prescription is mainly relates to the use of antibiotics. Essential alertness should be given to the treatment of children less than 5 years to avoid an excessive consumption of medicines and the emergence of antibiotic resistance.

Social ecological factors affecting substance abuse in Ghana (West Africa) using photovoice.

INTRODUCTION: Substance abuse is an important public health issue affecting West Africa; however, there is currently a dearth of literature on the actions needed to address it. The aim of this study was to assess the risks and protective factors of substance abuse in Ghana, West Africa, using the photovoice method. METHODS: This study recruited and trained 10 participants in recovery from substance abuse and undergoing treatment in the greater Accra region of Ghana on the photovoice methodology. Each participant received a disposable camera to take pictures that represented the risk and protective factors pertinent to substance abuse in their communities. They were also given the opportunity to provide narratives of the pictures using pre-identified themes and the different levels of the social-ecological model and participatory action research (PAR). RESULTS: Participants identified at the individual level: ignorance; interpersonal level: family and peer pressure; organizational level: lack of regulation; community level: media, availability of drugs, cost of drugs, urbanization, slum communities and cultural factors; and policy level: lack of regulations and their enforcement. Education and beliefs were cited at the individual level; family at the interpersonal level; religion at the organizational level; organizing youth, media and narcotics anonymous at the community level; and nothing at the policy level. CONCLUSION: This is an exploratory study that will add to the limited body of knowledge in the scientific literature with respect to substance abuse in the country and also help develop interventions to address the respective needs of several communities in Ghana.

Perception or reality of body weight: which matters to the depressive symptoms.

BACKGROUND: Failure to control for the confounding effects from body perceptions may contribute to the inconsistency of literature on the relationship between body weight and depression. The aim was to determine if perception mediates the associations between measured weight and depression. METHODS: We analyzed the data of 13,548 adults age 18 or older, collected in the National Health and Nutrition Examination Survey, 2005-2008. Depression status was ascertained using the Patient Health Questionnaire; and the BMI was calculated from measured height and weight. RESULTS: Among women, adjusting for perception weakened the relationship between measured weight and depression. The odds ratios (OR) of depression for being obese and overweight were 2.26 [95% confidence interval (1.50-3.40)] and 1.92 (1.29-2.85) before being adjusted for perception and 1.72 (1.01-2.92) and 1.62 (1.01-2.60) when perception was adjusted for. Independent from measured weight, women who perceived themselves as underweight [OR=2.95(1.47-5.14)] or overweight [1.73 (1.14-2.61)] had an increased odds of depression compared with women who perceived themselves as about the right weight. Among men, measured weight, neither overweight nor underweight, was associated with depression, perceiving oneself as underweight [OR=2.80 (1.42-5.54)] was associated with depression. LIMITATION: The inherent limitation of the study's cross-sectional design prevented the authors from investigating causality. CONCLUSION: Perception may be more important than measured weight in the relationship with depression. Independent from measured weight either perceived under or overweight among women, or underweight among men, appear to be significantly associated with depression.