Extended red blood cell antigens and phenotypes in Burkina Faso: potential issues to design local population-sourced red blood cell reagent panels.

To date, 43 blood group systems with 349 red blood cell (RBC) antigens have been recognized. The study of their distribution is useful for blood services to improve their supply strategies for providing blood of rare phenotypes, but also to design indigenous RBC panels for alloantibody screening and identification. In Burkina Faso, the distribution of extended blood group antigens is not known. This study aimed to investigate the extended profiles of blood group antigens and phenotypes of this population and to raise limitations and potential strategies for the design of local RBC panels. We conducted a cross-sectional study that included group O blood donors. Extended phenotyping for antigens in the Rh, Kell, Kidd, Duffy, Lewis, MNS, and P1PK systems was performed using the conventional serologic tube technique. The prevalence of each antigen and phenotype combination was determined. A total of 763 blood donors were included. The majority were positive for D, c, e, and k and negative for Fya and Fyb. The prevalence of K, Fya, Fyb, and Cw was less than 5 percent. The most frequent Rh phenotype was Dce, and the most common probable haplotype was R0R0 (69.5%). For the other blood group systems, the K-k+ (99.4%), M+N+S+s- (43.4%), and Fy(a-b-) (98.8%) phenotypes were the most frequent. Antigenic polymorphism of blood group systems by ethnicity and geography argues for the design and evaluation of population-sourced RBC panels to meet specific antibody profiles. However, some of the specificities identified in our study, such as the rarity of double-dose antigen profiles for certain antigens and the cost of antigen phenotyping tests, are major challenges to overcome.

Feasibility and performance of in-house red blood cell reagents to detect unexpected antibodies in immunized patients in Burkina Faso.

In sub-Saharan Africa, antibody detection tests remain inaccessible because of the high cost and limited shelf life of red blood cell (RBC) reagents. This study aimed at investigating the feasibility and performance of locally prepared RBC reagents for antibody detection in Burkina Faso. We conducted an experimental study comparing commercial RBC panels and a local panel prepared from phenotyped blood donors in Ouagadougou, Burkina Faso. Antibody detection testing was performed by the indirect antiglobulin test using a gel card filtration column in a low-ionic-strength solution. Judgment criteria were the concordance rate and the kappa agreement coefficient of results generated by the two panels. A total of 302 blood donors were phenotyped for the major antigens of the RH, KEL, MNS, FY, JK, LE, and P1PK blood group systems. From this pool of donors, we designed an RBC detection panel that was used to screen for unexpected antibodies in 1096 plasma samples from 832 patients with a history of transfusion and 264 recently delivered or pregnant women with no history of blood transfusion. A positive antibody detection test was observed in 8.1 percent of the samples using the local panel versus 6.4 percent with the commercial panels. A total of 23 samples were negative with the commercial panels and positive with the local panel, while the findings were reversed for four samples. The concordance rate was 97.5 percent, and the kappa agreement coefficient was 0.815. Our results suggest that the development of local RBC panels can be an alternative to commercial panels in countries with limited resources. It could also be a cost-effective intervention, mainly for children under 5 years of age, women of childbearing age, and pregnant women, all of whom are most at risk for malaria and sickle cell disease complications. Blood services could develop and implement appropriate strategies to make phenotyped donor pools available for the design of suitable RBC panels.

[Protection of caregivers in a university hospital at the time of Covid-19: Between overprotection and underprotection or between abandonment and weakening of the vital forces?] / Protection des soignants dans un CHU au temps du Covid-19 : entre surprotection et sous-protection ou entre abandon et affaiblissement des forces vives ?

During the first months of the Sars-Cov-2 pandemic, French caregivers faced difficult situations, organizational changes, and rapidly changing recommendations. The occupational physicians of the hospital staff had to accompany the caregivers, both to answer their questions, both to better prevent the risks to their health in connection with the pandemic. Recommendations were quickly issued by the Société française de médecine du travail (French Society of Occupational Medicine). In our CHU, an evaluation of exposures was made by department. Occupational physicians advised agents and the institution to limit the risks to the health of agents. However, faced with the uncertainties linked to ignorance of the virus, how can we play both the role of protection of each agent, and that of a doctor registered in a health war? This article revisits from a distance the ethical tensions of the hospital occupational physician and the qualities necessary for the accomplishment of these missions.

A 2020 baseline assessment for the monitoring of the End TB indicator of catastrophic costs in Burkina Faso.

BACKGROUND Prior assessment of the economic burden of TB showed high risk of catastrophic costs in Burkina Faso. A decade later, the National TB Programme conducted the first national patient cost survey, establishing a baseline for future policymaking.METHODS A national TB patient cost survey was conducted early 2020. Following WHO methods, a structured questionnaire was administered to 465 patients (20 clusters) to report on the direct and indirect costs of TB, household income and coping strategies adopted by the TB-affected families. The share of households facing catastrophic costs was assessed. Multiple logistic regression was performed to identify factors associated with catastrophic costs due to TB.RESULTS One in two (54.4%) TB-affected households in Burkina Faso faced catastrophic costs, resulting in major improvements over the past decade. On average, households incurred in US$962.64 per episode of care (respectively US$741.7, US$122.3 and US$98.6 for indirect, direct medical and non-medical costs), leaving substantial costs requiring mitigation strategies (39.8%). Major risk factors were associated with hospitalisation and wealth-related variables. Job loss, food insecurity and other social consequences were also experienced.CONCLUSION Despite progress, reducing the End TB indicator of catastrophic costs remains central to policymaking to ensure effective financial protection in Burkina Faso.

[Recurrence of dengue epidemics in Burkina Faso: Community preference for an intervention to prevent the disease]. / Épidémies récurrentes de la dengue au Burkina Faso : préférences communautaires pour une intervention de prévention de la maladie.

BACKGROUND: Community-based interventions have proven effective in several Latin American countries in controlling dengue vector Aedes aegypti and reducing the burden of the disease. However, we did not find any study reporting the assessment or implementation of such interventions in Sub-Saharan Africa. This article presents local communities' preferences for activities as part of the implementation of a community-based intervention for dengue prevention in Ouagadougou (Burkina Faso) where dengue epidemics are recurrent during the rainy season. METHODS: A mixed-method study combining qualitative and quantitative data collection was conducted. Information from 983 households and their preferences for community-based activities for dengue prevention were collected in five neighborhoods of the city using a quantitative questionnaire. Then, 15 qualitative focus groups were organized in one of the neighborhoods that was randomly selected to receive a community-based intervention for dengue prevention. These groups were made up of 216 people representing the different socio-cultural categories: community leaders, men, women, young girls and boys. RESULTS: More than 95% of household respondents to the quantitative questionnaire found community-based interventions acceptable and/or useful: to raise awareness of mosquito-borne disease transmission, to identify and remove the mosquito breeding sites and areas favorable to the development of the adult vectors. Most participants in the focus groups, preferred outreach activities such as video/debate sessions, school and home education sessions, focus groups. They also preferred the implementation of community working groups, responsible for identifying and eliminating mosquito breeding sites in the neighborhood. However, many participants had reservations about sending preventive text messages to residents. They found it feasible but not useful since most people cannot read. CONCLUSION: This study shows that it is important to get the local communities involved in the formulation of health prevention activities in sub-Saharan Africa where some interventions are often implemented using strategies from other continents.

Mucosal lactoferrin response to genital tract infections is associated with iron and nutritional biomarkers in young Burkinabé women.

BACKGROUND/OBJECTIVES: The iron-binding affinity of vaginal lactoferrin (Lf) reduces iron available to genital pathogens. We describe host reproductive, nutritional, infection and iron biomarker profiles affecting vaginal Lf concentration in young nulliparous and primigravid women in Burkina Faso. SUBJECTS/METHODS: Vaginal eluates from women who had participated in a randomized, controlled periconceptional iron supplementation trial were used to measure Lf using a competitive double-sandwich ELISA. For this analysis samples from both trial arms were combined and pregnant and non-pregnant cohorts compared. Following randomization Lf was measured after 18 months (end assessment) for women remaining non-pregnant, and at two antenatal visits for those becoming pregnant. Associations between log Lf levels and demographic, anthropometric, infection and iron biomarker variables were assessed using linear mixed models. RESULTS: Lf samples were available for 712 non-pregnant women at end assessment and for 303 women seen at an antenatal visit. Lf concentrations of pregnant women were comparable to those of non-pregnant, sexually active women. Lf concentration increased with mid-upper-arm circumference, (P = 0.047), body mass index (P = 0.018), Trichomonas vaginalis (P < 0.001) infection, bacterial vaginosis (P < 0.001), serum C-reactive protein (P = 0.048) and microbiota community state types III/IV. Adjusted Lf concentration was positively associated with serum hepcidin (P = 0.047), serum ferritin (P = 0.018) and total body iron stores (P = 0.042). There was evidence that some women maintained persistently high or low Lf concentrations from before, and through, pregnancy. CONCLUSION: Lf concentrations increased with genital infection, higher BMI, MUAC, body iron stores and hepcidin, suggesting nutritional and iron status influence homeostatic mechanisms controlling vaginal Lf responses.

Area-level income disparities in colorectal screening in Canada: evidence to inform future surveillance.

Background: Participation in colorectal screening remains low even in countries with universal health coverage. Area-level determinants of low screening participation in Canada remain poorly understood. Methods: We assessed the association between area-level income and two indicators of colorectal screening (having never been screened, having not been screened recently) by linking census-derived local area-level income data with self-reported screening data from urban-dwelling respondents to the Canadian Community Health Survey (50-75 years of age, cycles 2005 and 2007, n = 18,362) who reported no known risk factors for colorectal cancer. Generalized estimating equation Poisson models estimated the prevalence ratios and differences for having never been screened and having not been screened recently, adjusting for individual-level income, education, marital status, having a regular physician, age, and sex. Results: About 53% of the study population had never been screened. Among individuals who had ever been screened, 35% had been screened recently. Adjusting for covariates, lower area-level income was associated with having never been screened [covariate-adjusted prevalence ratios: 1.24 for quartile 1; 95% confidence limits (cl): 1.16, 1.34; 1.25 for quartile 2; 95% cl: 1.15, 1.33; 1.15 for quartile 3; 95% cl: 1.08, 1.23]. Among individuals who had been screened in their lifetime, area-level income was not associated with having not been screened recently. Conclusions: Lower area-level income is associated with having never been screened for colorectal cancer even after adjusting for individual socioeconomic factors. Those findings highlight the potential importance of socioeconomic contexts for colorectal screening initiation and merit attention in both future research and surveillance efforts.

Management of necrotizing and non-necrotic bacterial erysipelas of the face in tropical areas: a series of four cases and a review of the literature.

The necrotizing and not necrotizing acute bacterial dermohypodermitis (DHD) are acute bacterial infections of tissues situated between the skin and the muscles. The localizations of the face are infrequent, and sometimes put diagnostic difficulties with other current facial dermatosis. We report in this article 4 cases of DHD of the face with skin source, hospitalized in the service of the Infectious and Tropical Diseases of the Teaching Hospital Yalgado Ouédraogo of Ouagadougou (Burkina Faso). The objective is to make a current situation of their etiologies and complications, and to look for the difficulties to take care of them in a country with limited resources. The patient's care journey for this disease is long while it constitutes a medical or medical-surgical emergency. Imaging, which is essential for the diagnosis of heart valve disease and the daunting complications of necrotizing fasciitis and mediastinitis, is generally available only in tertiary hospitals. Antibiotic therapy is most often inadequate or insufficient. Anti-inflammatories, widely used, according to several authors contribute to serious forms and excess mortality. Health workers in resource-limited settings need to be better educated and guidelines issued to recognize the signs of this condition in order to enable early referral of patients in specialized settings. In addition, education of the population and hygiene awareness of skin lesions should be a priority to reduce complications.

Reconstruction of a Traumatic Bone Defect from Distal Femur.

INTRODUCTION: Bone defect is a difficult problem in orthopedics. The treatment conventionally relies on techniques such as induced membrane, grafts, and elongations. The reintegration of an externalized osseous fragment involves significant infectious risks but is essential in certain situations. CASE REPORT: We report the case of a 10 cm traumatic bone loss of the right distal femur in a 35-year-old woman. Treatment consisted of paring, reintegration and stabilization by the external fixative. The 5-year follow-up was satisfactory with good consolidation and good function of the limb. CONCLUSION: The reintegration of a bone fragment of limb expelled onto the soil is rare. We tried it because the response time was very short, but also and especially because the fragment was expelled on very hot bitumen. These two elements limited the risk of infection and favored the osseointegration of the fragment. We have not found a similar case reported in the literature allowing comparisons and recommendations.

Challenges of cold chain quality for routine EPI in south-west Burkina-Faso: An assessment using automated temperature recording devices.

BACKGROUND: Abnormal temperatures are a major issue for vaccines within the Expanded Program of Immunization in tropical climates. Prolonged exposure to temperatures outside the standard +2 °C/+8 °C range can impact vaccine potency. METHODS: The current study used automatic temperature recording devices (Testostore 171-1©) to monitor cold chain in remote areas of Western Burkina Faso. A series of 25 randomly selected health centers representing 33% of the existing 176 EPI facilities in Western Burkina Faso were prospectively assessed for eight months in 2015. Automatic measurements were compared to routine temperature loggers and vaccine vial monitors (VVM). RESULTS: The median age for all refrigerators was 9 years with 10/25 (42%) older than 10 years. Adverse temperatures were recorded in 20/24 (83%) refrigerators and ranged from -18.5 °C to +34.2 °C with 12,958/128,905 (10%) abnormal hourly records below +2 °C and 7357/128,905 (5.7%) above +8 °C. Time of day significantly affected the rate of temperature excursions, with higher rates from 00 am to 06 am (p < 0.001) for low temperatures and 10-12 am (p < 0.001) and 13-16 pm (p < 0.001) for high temperatures. Abnormal temperatures lasted from 1 h to 24 h below +2 °C and 13-24 h above +8 °C. Standard manual registers reported only 182/2761 (7%) inadequate temperatures and VVM color change detected only 133/2465 (5%) disruptions. Reliability of the refrigerators ranged from 48% to 98.7% with a median of 70%. Risk factors for excursions were old age of the refrigerators, the months of April and May, hours of high activity during the day, and health staff-associated factors such as inappropriate actions or insufficient knowledge. CONCLUSION: Important cold chain reliability issues reported in the current study in Western Burkina Faso raise concern about vaccine potency. In the absence of systematic renewal of the cold chain infrastructure or improved staff training and monitoring, antibody response assessment is recommended to study levels of effective immunization coverage.

Etiological, therapeutic and prognostic particularities of primary biliary peritonitis in tropical environments.

To describe the etiological, therapeutic, and prognostic aspects of primary biliary peritonitis in Burkina Faso. This retrospective study reviewed records of all patients admitted for primary biliary peritonitis at Tenkodogo Regional Hospital (Burkina Faso) from 2010 through 2016. Cases of secondary biliary peritonitis have been excluded. Thirty patients were identified. Their average age was 26.5 years. Fourteen patients were under 12 years of age. The reasons for consultation were dominated by abdominal pain (in all cases) and bile-induced vomiting (in 22 cases). Seven patients had a general condition classified in stage 2 of the World Health Organization classification, 18 in stage 3, and 5 in stage 4. The etiologies of peritonitis were acute typhoidal cholecystitis, which predominated (27 cases), and gallstones (3 cases). The surgical approach was a laparotomy in all cases. Intraoperative observation showed an inflamed and perforated gallbladder in 24 cases; gangrene was noted in 6 cases. Treatment consisted of cholecystectomy and peritoneal lavage, associated with antibiotic therapy. The post-operative period was complicated by septicemia in 12 cases. Fourteen patients died, for a mortality rate of 46.7 %. In rural Burkina Faso, primary biliary peritonitis occurs in young subjects. Its cause is most often acute cholecystitis due to Salmonella typhi. Mortality is very high.

[Results after surgical management of ileal perforation due to typhoid fever, about 29 cases in Ouahigouya (Burkina Faso)]. / Résultats de la prise en charge des perforations iléales typhiques : à propos de 29 cas à Ouahigouya (Burkina Faso).

The aim of this study was to determine the results of management of typhoid perforations. This was a descriptive cross-sectional study carried out from January 1, 2016 to December 31, 2016 in the General Surgery Department of the Regional Teaching Hospital Center of Ouahigouya (Burkina Faso). It involved 29 operated patients, in whom the diagnosis of typhoid perforation was confirmed at laparotomy: age, sex, admission time, clinical, therapeutic and prognostic aspects were analyzed. Typhoid perforations accounted for 20% of acute generalized peritonitis and 38.1% of digestive perforations. Twenty-three patients were males and six were females (sex-ratio: 3.8). The average age of patients was 19 years. The mean diagnostic time was 9.8 days. The excision-suture of the perforation was the most used technique with 62% of the cases. The treatment lead to complications in 10 cases with a morbidity of 34.5%. Four deaths were recorded, representing an overall mortality of 13.8%. Prognostic factors were diagnostic delay, age, number of perforations and resection-anastomosis.

Epidemiological, bacteriological and therapeutic aspects of chronic osteomyelitis in a sub-Saharan environment.

The purpose of this study was to describe the epidemiological and bacterial aspects of chronic osteomyelitis at the regional hospital of Tenkodogo, in Burkina Faso. This prospective study took place at the regional hospital in Tenkodogo during the 3 year-period 2011-2013 and included all cases of chronic osteomyelitis diagnosed during those years. The diagnosis was based on clinical and radiological evidence. In all, 86 patients were identified, with a mean age of 18.5 years, and predominantly male (73 %). The mean time to consultation was 18 months. The most common sites of chronic osteomyelitis were the tibia and femur. Bacteriologically, the pathogen most frequently isolated was Staphylococcus (75.6 %). The pathogens isolated were mostly responsive to gentamicin (75 % of pathogens) and ciprofloxacin (56.2 % of pathogens). Resistance to the combination amoxicillin + clavulanic acid was observed frequently. The treatment included a sequestrectomy and additional long-term antibiotic therapy based on susceptibility testing. The recurrence rate was 5.8 % over a one-year follow-up. Encouraging results can be obtained in chronic osteomyelitis with proper treatment. In this perspective, the isolation of the causative organism and knowledge of its sensitivity to antibiotics are essential information.

Epidemiological, clinical, and therapeutic features of typhoid intestinal perforation in a rural environment of Burkina Faso.

The aim of this study was to describe the epidemiological, clinical, and therapeutic features of ileal perforation due to typhoid fever at the regional hospital of Tenkodogo (Burkina Faso). This cross-sectional study examined the records over a 5-year period of all patients treated for typhoid ileal perforation. Ileal perforation was diagnosed intraoperatively, and its typhoid origin determined according to the following criteria : background signs of typhoid fever, location of the perforation on the antimesenteric edge of the terminal ileum, and a positive Widal-Felix serology. The study included 216  patients. Their mean age was 13.8 years, and 63.4% were male. The average time to consultation was 11 days. Clinical signs were mainly abdominal pain, vomiting, and abdominal tenderness. Anemia was observed in 135 patients (62.5%). All patients underwent laparotomy. Three procedures for treating surgical perforation were used : excision and suture of the perforation in 86 patients (39.8%), ileal resection with anastomosis in 98 (45.4%), and ileostomy with subsequent recovery in 32 (14.8%). The average length of hospital stay was 16.1 days. Postoperative complications occurred in 156 patients (72.2%). Thirty-seven patients died, for a mortality rate of 17.1 %. Ileal perforations due to typhoid fever are the main cause of peritonitis in rural areas of Burkina Faso. Patients are relatively young, and most are anemic at admission. Morbidity and mortality are significant.

[Bochdalek's posterior-lateral right hernia: a case report]. / Hernie postero-laterale droite de Bochdalek a propos d'un cas.

INTRODUCTION: Congenital diaphragmatic hernias are embryopathies; they represent 8% of congenital malformations. There are several types: hiatal hernia, retro-costo-xiphoid hernia and posterior-lateral hernia called Bochdalek. Its incidence is estimated at 1/3200 live births, which represents 0.06% to 6% of cases of diaphragmatic hernias; it is predominant on the left in 85%. It may be in the neonatal period or late and the clinical signs are polymorphic. The purpose of this study is to recall the clinical and radiological aspects of this disease and discuss its treatment. RESULT: We report a case of a 3-year-old child with a history of recurrent broncho- pneumopathy since the age of one month admitted to the pediatric emergency department in an acute respiratory distress, radiography revealed a congenital diaphragmatic hernia operated. CONCLUSION: Bochdalek hernia of right seat is rare; it may be neonatal revelation or later revelation; its symptomatology is dominated by respiratory signs and imaging is indispensable in the diagnostic procedure. His treatment is surgical and the prognosis is generally good in the absence of major malformations associated.

INTRODUCTION: Les hernies diaphragmatiques congénitales sont des embryopathies; elles représentent 8% des malformations congénitales. Il en existe plusieurs types: la hernie hiatale, la hernie rétro-costo-xiphoïdienne et la hernie postéro-latérale dite de Bochdalek. Son incidence est estimée à 1/3200 naissances vivantes, ce qui représente 0,06% à 6% des cas de hernies diaphragmatiques; elle est prédominante à gauche dans 85%. Elle peut se révéler à la période néonatale ou tardivement et les signes cliniques sont polymorphes. Le but de la présente étude est de rappeler les aspects cliniques et radiologiques de cette pathologie et discuter son traitement. RÉSULTAT: Nous rapportons le cas d'un petit enfant de 3 ans, avec des antécédents de broncho-pneumopathies à répétition depuis l'âge d'un mois, admis au service des urgences pédiatriques dans un tableau de détresse respiratoire aiguë, chez qui l'exploration radiologique a révélé une hernie diaphragmatique congénitale prise en charge. CONCLUSION: La hernie de Bochdalek de siège droit est rare; elle peut être de révélation néonatale ou de révélation plus tardive; sa symptomatologie est dominée par les signes respiratoires et l'imagerie est indispensable dans la démarche diagnostique. Son traitement est chirurgical et le pronostic est en général bon en l'absence de malformations majeures associées.

[Survival of malignant and paramalignant pleural effusions in Ouagadougou]. / Survie des pleurésies malignes et paramalignes à Ouagadougou.

This study aimed to present the survival of patients with malignant and paramalignant pleural effusion (MPE) in a context of resource-limited countries. We retrospectively studied patients received for malignant and paramalignant pleural effusion in three health facilities in Ouagadougou from 1st August 2009 to 30 July 2015. Survival was analyzed according to various characteristics related to patients and disease. Eighty patients with a mean age of 54 years were selected. The sex-ratio was 0.9. Sixteen patients had comorbidities. Pleural effusion was revealing, synchronous and metachronous in respectively 55 %, 26.3 % and 17.5 % of cases. Lung cancer was the most common cause of MPE (27.5 %), followed by breast cancer (18.7 %). The median overall survival was 3 months; it varied between primary cancers: 5 months for primary cancer unknown, 4 months for lung cancers and 2 months for breast cancers. Sex and the presence of comorbidities were independent factors influencing survival of patients. In this study, patient survival length is strongly compromised by inadequacies of medical technical equipment.

Penetrating chest wound of the foetus.

Traumas of the foetus caused by stabbings are rare but actually life-threatening for both the foetus and the mother. We report a case of penetrating chest wound on a baby taken from the obstetrics unit to the paediatric surgical department. His mother was assaulted by his father, a mentally sick person with no appropriate follow-up. The foetus did not show any sign of vital distress. Surgical exploration of the wound has revealed a section of the 10 th rib, a laceration of the pleura and a tearing of the diaphragm. A phrenorraphy and a pleural drainage were performed. The new-born and its mother were released from hospital after 5 days and the clinical control and X-ray checks 6 months later showed nothing abnormal. We insisted a medical, psychiatric follow-up be initiated for the father. As regards pregnant women with penetrating wounds, the mortality rate of the foetus is 80%. The odds are good for our newborn due to the mild injuries and good professional collaboration of the medical staff. Penetrating transuterine wounds of the foetus can be very serious. The health care needed should include many fields due to the mother and the foetus' lesions extreme polymorphism. In our case, it could have prevented by a good psychiatric followed up of the offender.

[Newborn and infant fractures secondary to traditional massage]. / Fractures du nouveau-né et du nourrisson secondaires au massage traditionnel.

The traditional massage of the newborn and young infant is an ancient practice in Africa and other regions. It has many benefits that are currently recognized, even in Western societies. However, it can be dangerous. We report two cases of fractures of the femur and clavicle that occurred in a 17-day-old newborn and a 1-month-old infant secondary to a traditional massage. In both cases, there was no concept of trauma or a history of osteogenesis imperfecta in the family or the presence of other fractures suggesting abuse. We concluded in a fracture caused by traditional massage in both cases. Given its many benefits as described in the literature, the traditional massage of young infants cannot be considered a harmful practice. However, it should be practiced with care to prevent the occurrence of such complications.

[Knowledge, attitudes and practices of healthcare professionals at the Souro Sanou university hospital of Bobo Dioulasso regarding Mellitus diabetes]. / Connaissances, attitudes et pratiques des professionnels de Sante du centre hospitalier universitaire Souro Sanou de Bobo Dioulasso en Matiere de diabete sucre.

INTRODUCTION: In Burkina Faso, the insufficiency of doctoral interns, of endocrinologists, and medical services specialized in the coverage of the diabetes, means that these cases are relegated to general practitioners and the paramedical staff. OBJECTIVES: To study the level of knowledge, attitudes and practices of the medical and paramedical staff on the coverage of sugar diabetes in the Souro Sanou University Hospital of Bobo Dioulasso. METHOD: A cross-sectional study of descriptive type was conducted over a 3 month period, from March 1st to May 31st, 2013. The investigated population was constituted of healthcare professionals represented by general practitioners, female nurses, State-certified male nurses, and patented male nurses of the Souro Sanou University Hospital of Bobo Dioulasso. A questionnaire, adapted for each professional category, was administered to the participants. A notation grid enabled us to record the level of knowledge, attitude and practice of the staff regarding sugar induced diabetes. RESULTS: Three hundred four (304) healthcare professionals, 187 men and 117 women (sex ratio of 1.59) were investigated. The average age was of 40.84 years with extremes of 26 and 60 years. Their level of knowledge, attitude and practice on sugar induced diabetes varied from one professional category to another. Clinical signs of the disease, as well as its physiopathology were well known by healthcare providers. However, the definition of the disease, its diagnostic criteria, its classification by cause, were little known general practitioners. The general practitioners, had a good attitude and practice in front of a case of diabetes compared to other professional categories. CONCLUSION: Adapted staff recycling is essential across the professional categories for healthcare providers of the university hospital.

INTRODUCTION: Au Burkina Faso, l'insuffisance de médecins internistes, d'endocrinologues, et des services médicaux spécialisés dans la prise en charge du diabète sucré, font que les médecins généralistes et le personnel paramédical sont relégués au premier. OBJECTIFS: Etudier le niveau de connaissances, attitudes et pratiques du personnel médical et paramédical sur la prise en charge du diabète sucré au CHU SS de Bobo Dioulasso. MÉTHODE: Il s'est agi d'une étude transversale de type descriptif, déroulée sur trois (03) mois, du 1er mars au 31 mai 2013. La population enquêtée était constituée de professionnels de santé représentés par les médecins généralistes, les attachés de santé, les infirmiers diplômés d'état, les sages-femmes/maïeuticiens d'état, les infirmiers brevetés du CHU SS de Bobo Dioulasso. Un questionnaire a été administré au personnel consentant adaptée à la catégorie professionnelle. Une grille de notation a permis d'apprécier le niveau de connaissance, d'attitude et de pratique du personnel en matière de diabète sucré. RÉSULTATS: Trois cent quatre (304) agents de santé dont 187 hommes (sex ratio = 1,59) ont été enquêtés. Leur moyenne d'âge était de 40,84 ans avec des extrêmes de 26 et 60 ans. Leur niveau de connaissance, d'attitude et de pratique sur le diabète sucré était variable d'une catégorie professionnelle à une autre. Ainsi, les signes cliniques de la maladie, ainsi que sa physiopathologie étaient bien connus par les agents de santé. Cependant, la définition de la maladie, ses critères diagnostiques, sa classification étiologique, étaient peu connus des médecins généralistes. Les médecins généralistes, avaient une bonne attitude et pratique devant un cas de diabète sucré par rapport aux autres catégories professionnelles. CONCLUSION: Des besoins de recyclage du personnel adapté aux catégories professionneles s'avèrent indispensables pour les agents de santé du CHU SS.

[Inventory of fixtures on the tolerance of the treatment) of the resistant multi-tuberculosis (Burkina Faso)]. / Etat des lieux sur la tolerance du traitement de la tuberculose multi resistante (Burkina Faso).

OBJECTIVES: Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo. PATIENTS AND METHODS: It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included. RESULTS: 71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness. CONCLUSION: The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

OBJECTIFS: Apprécier la tolérance des antituberculeux prescrits dans le traitement de la tuberculose multi résistante chez les patients suivis dans le service de Pneumologie du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU YO). PATIENTS ET MÉTHODES: Il s'est agi d'une enquête longitudinale rétrospective et prospective. Les dossiers des patients ont permis de renseigner le questionnaire pour la phase rétrospective (2010­2011), le suivi des patients durant la phase prospective (2011­2013) a permis la collecte des données. Etaient inclus tous les patients sous traitement antituberculeux de 2ème ligne entre le 1er Janvier 2010 et le 31 Aout 2013. RÉSULTATS: Au total 71 cas de tuberculose multi résistante (TB-MDR) ont été recrutés. Le sex- ratio était 3,4. La tranche d'âge de 30 à 39 était la plus représentée (39,4%). Une notion de contage tuberculeux a été retrouvée chez 18 (25,3%) des patients. Tous les patients TB-MR avaient des antécédents de traitement incluant des aminosides de durée supérieure à 2 mois. L'intolérance au traitement a été rapportée chez 57 patients. Elle prédominait chez les 30 à 39 ans et chez les sujets co-infectés Tuberculose/VIH. Les atteintes neurologiques (47,9%) et psychiatriques (47,9%) étaient les plus représentées. L'atteinte vestibulo-cochléaire était de 42,3% avec 18,3% de surdité totale. CONCLUSION: L'intolérance du traitement antituberculeux de deuxième ligne est un véritable hantise pour le clinicien. Des régimes plus courts éviteraient certainement des modifications thérapeutiques à l'origine de survenue d'échecs.