Inequalities and Trends in Under-Five Mortality Between Formal and Informal Areas in Ouagadougou, Burkina Faso.

The physical expansion of the city of Ouagadougou, the capital and largest city of Burkina Faso, subsided in 2015 after the government banned land speculation that contributed to the growth and entrenchment of informal areas. The government subsequently implemented social policies such as free health care for pregnant women and children under 5 years of age. Against this background, we tested the convergence of under-5 mortality trends between formal and informal areas in the city between 2010 and 2019; data covering that period came from the Ouagadougou Health and Demographic Surveillance System (HDSS). The analyses included the calculation of all-cause and cause-specific mortality rates, the implementation of a Poisson regression model, and competing risk models. Over the study period, children in formal areas had lower mortality than those in informal areas. However, the inequality gap decreased over time due to a faster mortality decline in informal areas. This decline was explained by a rapid decline in deaths from malaria and other causes including sepsis, HIV/AIDS, measles, meningitis, and encephalitis. The pursuit of upgrading informal areas and the implementation of social policies targeting the poorest are likely to accelerate the mortality decline in Ouagadougou overall.

Toxic potential evaluation of liquid effluents discharged into nature by the university hospital centers (UHC) and mixed wastewater treatment station (WWTS) at Ouagadougou-Burkina Faso.

In Burkina Faso, several investigations have raised suspicions that hospital liquid effluents are the source of contaminants in porbeagle-culture products and surface water in urban and peri-urban areas. This study aimed to evaluate the hygienic quality of hospital liquid effluents discharged into nature by the UHC Bogodogo (UHC-BOG), Yalgado Ouédraogo (UHC-YO), and the WWTS of Kossodo (WWTS-KOS). Thus, 15 samples of liquid effluents (five per site) discharged into nature were collected. Within the physicochemical parameters, the pH, chemical oxygen demand (COD), biochemical oxygen demand (BOD5), suspended solids (TSS), conductivity, copper, iron, hafnium, silver, mercury, lead, and cadmium of these samples were determined using standard methods. The mean values of pH were 8.84 ± 0.42,8.06 ± 0.54, and 8.55 ± 0.53 for WWTS-KOS, UHC-BOG, and UHC-YO, respectively. Conductivity values were 1956.80 ± 81.30, 812.80 ± 45.22, and 956.00 ± 39.96 µS/cm, respectively. TSS were 338.20 ± 38.80, 45.00 ± 5.79, and 187.80 ± 27.58 mg/L, respectively. COD were 274.80 ± 20.46, 35.00 ± 5.52, and 139.80 ± 25.53 mg/L, respectively. BOD5 were 186.40 ± 68.68, 26.20 ± 4.82, and 81.80 ± 15.63 mg/L, respectively. Mercury values were 1.93 ± 0.38, 4.04 ± 0.38, and 14.37 ± 1.65 µg/L, respectively. Lead values were 434.70 ± 202.42, 310.50 ± 4.09, and 367.43 ± 94.01 µg/L, respectively. Cadmium values were 79.59 ± 19.48, 109.94 ± 8.43, and 80.26 ± 7.85 µg/L, respectively. Copper values were 27.66 ± 3.33, 30.84 ± 1.65, and 28.32 ± 2.36 mg/L, respectively. Iron was detected only on the STEP-KOS with an average of 71.01 ± 37.83 mg/L. Hafnium values were 50.27 ± 4.49 and 51.58 ± 4.61 mg/L for WWTS-KOS and UHC-BOG, respectively. Silver values were 34.26 ± 3.06 for WWTS-KOS. On the three sites, the differences found were significant (p < 0.05). Liquid hospital effluents from Ouagadougou discharged into nature on the whole do not compile with the Burkinabè normative values for the discharge of wastewater into the environment.

Isolation and Characterization of Environmental Extended Spectrum ß-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae from Ouagadougou, Burkina Faso.

Antimicrobial resistance (AMR) is a global public health threat. Quality data are needed to address the rise of multidrug-resistant clones, particularly in sub-Saharan Africa. In this study, we analysed the prevalence, antimicrobial resistance profile, and presence of genes encoding extended-spectrum ß-lactamase-producing Escherichia coli (ESBL-Ec) and Klebsiella pneumoniae (ESBL-Kp) in environmental samples from Ouagadougou, Burkina Faso. Of 264 samples collected, 95 (36%) and 74 (28%) contained ESBL-Kp and ESBL-Ec, respectively. ESBL-Kp was more prevalent in runoff water and in treated and untreated wastewater, while ESBL-Ec was more prevalent in manure. Interestingly, wastewater treatment did not significantly reduce the recovery of ESBL bacteria. As expected, resistance to third- and fourth-generation cephalosporins was predominant, and rare for second generation cefoxitin. Interestingly, all the isolates from treated wastewater were susceptible to ampicillin and piperacillin, while all the other clones were resistant to these antibiotics. Regarding the ESBL-encoding genes, the blaCTX-M family was the most abundant, with the blaCTX-M1 subfamily being the most prevalent. Carriage of combinations of ESBL genes was common, with the majority of the isolates harbouring 2-4 different genes. This study highlights the need for active surveillance to manage the risk of exposure to ESBL bacteria in Burkina Faso.

Effets identitaires de la socialisation différentielle de genre sur les aspirations au premier enfant et au mariage des jeunes adolescent(e)s à Ouagadougou: une étude mixte.

Studies show that gender socialisation shapes differently the gendered identity, self-esteem, and sexual behaviours of girls and boys. While pre-adolescence is viewed as a pivotal period for gendered socialisation, few studies in francophone Africa investigate the role of gender identity effects on aspirations and sexual and reproductive behaviours at this life stage. This article explores how the internalisation of gender stereotypes during socialisation is linked to the aspirations of girls and boys for certain life events, such as having their first child or getting married. A survey was conducted in 10 primary schools in Ouagadougou, among pupils aged between 9 and 16 years, as well as seven focus group discussions with their parents. The findings indicate a gender-based variation in the effects of adherence to unequal gender norms among young adolescents. As a result, girls tend to have earlier aspirations towards marriage and later aspirations for childbearing, while boys show earlier aspirations for childbearing and later ones for marriage. These effects may expose both girls and boys to risks of poor sexual and reproductive health. Interventions promoting egalitarian gender norms could boost girls' self-esteem as well as mutual respect among young adolescents of both genders, aiming to improve their sexual and reproductive health during adolescence and into adulthood.

RésuméDes études montrent que la socialisation de genre développe différemment chez les filles et les garçons leur identité sexuée, leur estime de soi et leurs comportements sexuels. Alors que la préadolescence est considérée comme une période charnière de la socialisation genrée, peu d'études en Afrique francophone questionnent le rôle des effets identitaires de genre sur les aspirations et les comportements sexuels et reproductifs à cette étape de vie. Cet article examine la manière dont l'intériorisation des stéréotypes de genre au cours de la socialisation est associée aux aspirations qu'ont les filles et les garçons pour certains événements de leurs vies comme avoir un premier enfant ou se marier. Une enquête a été réalisée dans 10 écoles primaires de Ouagadougou, auprès d'élèves âgé(e)s entre 9 et 16 ans, ainsi que sept discussions de groupes avec leurs parents. Les résultats montrent une variation selon le sexe des effets de l'adhésion aux normes de genre inégalitaires chez les jeunes adolescent(e)s. Cela a pour conséquence de développer des aspirations, chez les filles plus précoces au mariage et plus tardives à l'enfantement, et chez les garçons, plus précoces à l'enfantement et plus tardives au mariage. Ces effets peuvent exposer les filles et les garçons à des risques de mauvaise santé sexuelle et reproductive. Des interventions promouvant des normes égalitaires de genre pourraient renforcer l'estime de soi des filles ainsi que le respect mutuel entre les jeunes adolescent(e)s des deux sexes afin d'améliorer leur santé sexuelle et reproductive à l'adolescence et à l'âge adulte.

[Tuberculosis of the palatine tonsil mimicking a malignant lesion and associating pulmonary tuberculous miliaria: about a case in Ouagadougou, Burkina Faso]. / Tuberculose de l'amygdale palatine simulant une lésion maligne et associant une miliaire tuberculeuse pulmonaire : à propos d'un cas à Ouagadougou, Burkina Faso.

Tonsillar tuberculosis is the infectious localization of Koch's bacillus in the palatine tonsils. It is rare. Tonsillar tuberculosis associated with miliary tuberculosis is even more exceptional. Objective: The aim of our work is to report a rare case of tuberculous tonsillitis associated with miliary tuberculosis. Patient and methods: This was a case of tonsillar tuberculosis associated with miliary tuberculosis. The main complaint was chronic odynophagia, which had been present for 7 months and was associated with weight loss. Questioning also revealed alcohol, tobacco and marijuana consumption. Results: Oropharyngoscopy revealed an enlarged, ulcerated and hemorrhagic right tonsil, suggesting a malignant lesion. Diagnostic tonsillectomy with anatomopathological examination of the surgical specimen led to the diagnosis of tonsillar tuberculosis. A postoperative chest X-ray revealed tuberculous miliaria. No other tuberculosis site was identified. No other confirmatory biological tests were carried out. The patient was treated with 4 anti-tuberculosis drugs (rifampicin, isoniazid, pyrazinamide, ethambutol) during 2 months and 2 anti-tuberculosis drugs (Rifampicin, Isoniazid) during 4 months. The evolution was favorable and the patient was declared cured at the end of treatment. There was no recurrence after 5 years. Conclusion: Tonsillar tuberculosis is rare. Tonsillar tuberculosis associated with pulmonary miliaria is even more exceptional. Tonsil biopsy for anatomopathological examination is sufficient for diagnosis. A chest X-ray should be requested as part of the preoperative workup prior to any tonsillar biopsy or tonsillectomy. GeneXpert (MTB/RIF) should be carried out if possible, not only for its value in the biological confirmation of tuberculosis but also to identify rifampicin resistance. Antibacillary treatment often leads to a favorable outcome.

Detection and Characterization of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae from Hospital Effluents of Ouagadougou, Burkina Faso.

Hospital wastewater is a recognized reservoir for resistant Gram-negative bacteria. This study aimed to screen for carbapenemase-producing Escherichia coli and Klebsiella pneumoniae and their resistance determinants in two hospital effluents of Ouagadougou. Carbapenem-resistant E. coli and K. pneumoniae were selectively isolated from wastewater collected from two public hospitals in Ouagadougou, Burkina Faso. Bacterial species were identified via MALDI-TOF mass spectrometry. Carbapenemase production was studied phenotypically using antibiotic susceptibility testing via the disk diffusion method. The presence of carbapenemases was further characterized by PCR. A total of 14 E. coli (13.59%) and 19 K. pneumoniae (17.92%) carbapenemase-producing isolates were identified with different distributions. They were, respectively, blaNDM (71.43%), blaVIM (42.86%), blaIMP (28.57%), blaKPC (14.29%), blaOXA-48 (14.29%); and blaKPC (68.42%), blaNDM (68.42%), blaIMP (10.53%), blaVIM (10.53%), and blaOXA-48 (5.26%). In addition, eight (57.14%) E. coli and eleven (57.89%) K. pneumoniae isolates exhibited more than one carbapenemase, KPC and NDM being the most prevalent combination. Our results highlight the presence of clinically relevant carbapenemase-producing isolates in hospital effluents, suggesting their presence also in hospitals. Their spread into the environment via hospital effluents calls for intensive antimicrobial resistance (AMR) surveillance.

Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross­sectional study.

Background: The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries. Objectives: To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects. Methods: A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ² test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking. Results: Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent's father (p=0.0001) and mother (p=0.0004). Conclusion: We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority. Study synopsis: What the study adds. The study provides additional data from resource-poor settings such as Burkia Faso, where there is an overall high prevalence of Sisha smoking, and also among students who are poorly informed about the health effects of smoking. Implications of the findings. The data informs advocacy and intervention strategies to combat smoking and decrease overall tobacco use in an African setting.

COVID-19, food coping strategies and households resilience: the case of informal sector in Burkina Faso.

The closure of markets in the city of Ouagadougou due to COVID-19 pandemic has had consequences on the food security status of households, in particular households of informal sector. The objective of this paper is to analyze the effect of COVID-19 on households' likelihood to resort to food coping strategies taking into account their resilience capacities. A survey was carried out among 503 households of small traders in five markets in the city of Ouagadougou. This survey identified seven mutually inclusive food coping strategies which are endogenous and exogenous to households. Thus, the multivariate probit model was used to identify the factors explaining the adoption of these strategies. The results indicate that the COVID-19 pandemic has had an impact on households' likelihood to use certain food coping strategies. Furthermore, the results show that assets and access to basic services is the main pillar of household resilience that reduces how likely a household resort to coping strategies due to COVID-19. Therefore, strengthening adaptive capacity and improving social security of households of informal sector are relevant.

Research of Antibiotic Residues and Bacterial Strain's Antibiotic Resistance Profile in the Liquid Effluents Evacuated in Nature by Two CHUs and a Mixed WWTP of Ouagadougou (Burkina Faso).

Background: In Burkina Faso, suspicions have been raised that hospital liquid effluents are a source of microbiological contaminants in surface waters of urban and peri-urban areas. This study aimed to determine the antibiotic residues and the antibiotic resistance phenotype of potential pathogenic bacteria in the hospital liquid effluents discharged into nature by the CHUs Bogodogo, Yalgado Ouédraogo and the WWTS of Kossodo. Methods: Fifteen samples of liquid effluents discharged into nature were collected. Antibiotic residues were identified by HPLC. A wavelength of 254 nm for the UV detector was set. Antibiotic testing was realized according to CASFM 2019 recommendations. Results: Three molecules including Amoxicillin, Chloramphenicol and Ceftriaxone were detected in 13 samples. The strains characterized were 06 E. coli, 09 Pseudomonas spp, 05 Staphylococcus aureus and 04 Salmonella spp. Thus, none of the strains was resistant to Imipenem, but they were resistant to Amoxiclav with rates of 83.33% (E. coli), 88.88% (Pseudomonas spp) and 100% (Staphylococcus aureus and Salmonella spp). Conclusion: Ouagadougou hospital liquid effluents discharged into nature are contaminated with antibiotic residues and potential pathogenic bacteria.

[Availability and affordability of diagnosis and treatment for asthma and COPD in Ouagadougou, Burkina Faso]. / Disponibilité et accessibilité financière aux moyens diagnostiques et thérapeutiques de l'asthme et de la bronchopneumopathie chronique obstructive dans la ville de Ouagadougou, Burkina Faso.

INTRODUCTION: Chronic respiratory diseases, particularly asthma and Chronic Obstructive Pulmonary Disease (COPD), pose a significant threat to public health. This study aims to determine the accessibility and affordability of means of diagnosis and treatment. METHODS: This was a cross-sectional study covering the period from August to December 2021 in Ouagadougou, Burkina Faso. This study involved 107 health centers and 135 pharmacies. The World Health Organization/Health Action International definition was used as a benchmark for accessibility to medicines. RESULTS: Out of 107 health centers, 29 (27.1%) had a spirometer. The average cost of spirometry represented 19.88 days of salary for a patient paid at the minimum wage. The most widely available drugs were salbutamol in a pressurized metered dose inhaler (pMDI) (88.1%) and prednisone 20mg tablet (87.4%). No disease-modifying drug was available in public pharmacies. Affordable drugs were salbutamol 4mg tablet and aminophylline 100mg tablet. CONCLUSION: The means of diagnosis and treatment of asthma and COPD are insufficiently available, especially in the public sector, which is characterized by a nearly total absence of basic treatment.

Socio-cultural influences on children's feeding habits and feeding frequencies in Ouagadougou, Burkina Faso: a retrospective survey.

BACKGROUND: From 6 months of age, children need, in addition to breast milk, a complementary food whose nutritional composition meets their needs. However, low consumption of child-specific foods in favor of adult foods has been documented. Thus, the lack of adaptation of children to family feeding conditions has been the source of frequent malnutrition in some low-income countries. In Burkina Faso, little data is available on family-type food consumption by children. The objective was to describe the socio-cultural influences on feeding habits and food consumption frequencies of infants aged 6-23 months in Ouagadougou. METHODS: The study was conducted from March to June 2022 using a structured questionnaire. A reminder of the previous 24 h' meals was used to assess 618 children's food consumption. Mother-child pairs were selected using the simple random sampling method, and data collection was done by the interview method. Sphinx V5, IBM SPSS Statistics 20.0 and XLSTAT 2016 software were used to process data. RESULTS: Influences between the consumption of certain foods and the mother's social status were observed. The most consumed foods are simple porridges (67.48%), Tô/rice (65.70%), cookies and cakes (62.94%), juices and sweetened drinks (62.94%). Cowpeas (17.31%), improved porridge (13.92%) and eggs (6.63%) are the least consumed. The most meals frequency was three meals daily (33.98%), and children with the minimum daily meal frequency were 86.41%. Principal component analysis showed that the mother's social status influenced the consumption of imported infant flours, fish soups, fruits, juices and sweetened drinks, cookies and cakes, simple porridge, and tô/rice. Concerning the consumption of local infant porridges, 55.72% of the children who consumed them appreciated positively. However, for 57.75% of the parents, the lack of information limits the consumption rate of this type of flour. CONCLUSION: High consumption of family-type meals was observed and was influenced by parental social status. In addition, the rate of acceptable meal frequencies was generally high.

Aspects scanographiques de la pneumopathie à COVID-19 à Ouagadougou: Étude multicentrique à propos de 1017 cas.

OBJECTIVE: To study the chest CT profile of SARS-CoV-2 pneumonia in patients in the city of Ouagadougou. PATIENTS AND METHODS: descriptive cross-sectional study with retrospective collection of 1017 patients of both sexes. Included were patients aged 15 and over who had performed a chest CT scan without or with injection of contrast product, suspected or positive for COVID -19. The variables analyzed were: the history, the nature of the examination, the socio-demographic, clinical, CT data including the description of the tomodensitometric lesions and their characteristics, the extent of the parenchymal lesions according to the visual estimate of the French thoracic Imaging Society, complications, other lesions on the chest CT scan and CORADS classification. All parameters (age, sex on the one hand and clinical and CT findings on the other) were subjected to statistical analysis. RESULTS: The mean age of the patients was 56.95 years, predominantly male (1.47). Dyspnea was the most frequent symptomatology, at 46.26% (n = 506). Diabetes was the most common comorbidity with 29.37% (n = 94). Frosted glass opacity accounted for 90.95% of elementary lesions which were predominantly in plaque in 44.35% (n = 451), bilateral in (82.79%) and peripheral subpleural in (81.51%). The lower lobes were the most affected and postero-basal involvement predominant with greater involvement in the right lung. The extent was severe in 28.42% (n = 289). Thirty-nine point twenty-three (39.23)% or 399 of cases presented with complications dominated by pleural effusion at 56.39% (n = 225) and pulmonary embolism at 34.08% (n = 136 ). The lesions were classified as CORADS type in 815 CT reports. CORADS 5 type lesions were found in 47% of patients. Five hundred and ninety-two (592) PCRs of our patients were undetermined, in 58.21%. The PCR was positive in 342 cases or 33.63%. The bi- and multivariate analysis noted: a statistically significant link between the age and the extent of the lesions, between the extent of the lesions and the clinical context, between the extent of the lesions and comorbidities such as diabetes, Hypertension and renal failure. There was also a link between the PCR result and basic lesions such as ground glass and crazy paving and between the occurrence of pulmonary embolism and the presence of hypertension. DISCUSSION: The scanographic profile corresponded to that described in the literature. Frosted glass was the most common elementary lesion. The impairment was severe to critical in patients over 65 with comorbidity. CT angiography was the most requested in front of signs such as dyspnea and desaturation CONCLUSION: A study on CT specificities with precision on the onset of symptoms and the notion of vaccination would complement these results.

[Giant cervical lipoma: Report on one case in Ouagadougou, Burkina Faso]. / Lipome cervical géant : À propos d'un cas à Ouagadougou, Burkina Faso.

Objective: To report on a case of rare giant anterior cervical lipoma. Patients and methods: This was a 60-year-old male patient received in March 2020 for an anterior cervical swelling in progressive evolution since 20 years. The condition was negatively impacting the patient's quality of life with a feeling of cervical heaviness, discomfort, head movement limitations, with no sign of compression. Despite this significant discomfort, the patient first consulted several traditional practitioners with different traditional treatments without success, the mass having been taken for a goiter. It is in the face of the failure of traditherapeuts that the patient finally decided to consult in our care structure. Results: Physical examination found a large left paramedian formation which appeared soft, mobile vis-a-vis the two plans, and sensitive; it measured 13 cm on its longer axis, and surrounding skin showed scarifications, witness to previous traditional treatments. Cervical CT eliminated goiter and made it possible to diagnose a giant cervical lipoma. A cervicotomy was performed under general anesthesia with a total one-block excision of an encapsulated mass. The evolution was favorable with a good healing. The histological examination of the mass identified a well-differentiated lipoma. There was no relapse up until 24 months later. Conclusion: The giant anterior cervical lipoma is rare. The differential diagnosis is mainly posed with a large goiter or liposarcoma. CT or MRI make it possible to confirm the diagnosis. Its treatment is exclusively surgical and the examination of the operative piece by the pathologist confirms the diagnosis. An extended post-operative monitoring is recommended given the risks of relapse and of malignant degeneration.

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.

Total, Patient and System Diagnostic Delays for Pulmonary Bacilliferous Tuberculosis in the Six Diagnostic and Treatment Centers in the Five Health Districts of the Central Region, Burkina Faso, 2018.

INTRODUCTION: Long diagnosis delay contributes significantly to the failure to eradicate tuberculosis. The objective of this study was to evaluate the total, patient and system delays in diagnosis of pulmonary bacilliferous in the six tuberculosis Diagnostic and Treatment Centers in the five health districts of the central region in Burkina Faso. METHODS: A descriptive cross-sectional study was conducted among 384 microscopy-positive pulmonary tuberculosis patients in 2018 to address this objective. It concerned the socio-demographic, clinical, microbiological characteristics, and referral location/pathway characteristics of the patients. We then calculated the different delays. The "patient" (time from first symptoms to first consultation), "system" (time from first consultation to first diagnosis) and total (time from first symptoms to diagnosis) median diagnostic delay were estimated. RESULTS: The median "total", "patient" and "system" diagnostic times were 37, 21 and 7 days, respectively. Of the 384 patients surveyed, 158 patients or 41.25% of patients had a long total diagnostic delay (> 45 days). The number of patients with a long system diagnostic delay was 125 patients (32.55%; p < 0.001) and those with a long patient diagnostic delay were 105 patients (27.34%; p < 0.001). CONCLUSION: The total diagnosis delay of pulmonary tuberculosis was long for almost half of the patients. Awareness of the signs of tuberculosis among patients and caregivers, and consultation in a health center must be intensified to help considerably reduce these delays.

[Prevalence and risk factors associated with intradialytic hypotension in Sub-Saharan Africa: The case of Burkina Faso]. / Prévalence et facteurs de risque associés à l'hypotension intradialytique en Afrique subsaharienne : cas du Burkina Faso.

AIM: The aim of our study was to determine the prevalence and factors associated with intradialytic hypotension in our cohort of chronic hemodialysis patients. METHODS: This was a prospective monocentric study over a six-month period. Intradialytic hypotension was defined as a decrease in systolic blood pressure ≥ 20mmHg or a decrease in mean arterial pressure of 10mmHg associated with clinical events and the need for nursing interventions. The groups were compared using univariate analysis of variance. RESULTS: We included 48 patients and counted 3014 hemodialysis sessions. The mean age was 44.7±15 years. The prevalence of intradialytic hypotension was 12.4%, with cramps 20 (41.7%) as the main symptom. Factors associated with frequent intradialytic hypotension compared to the groups without intradialytic hypotension and with infrequent intradialytic hypotension were age (61±13 years, p=0.018), diabetes (33.3%, p=0.019), high body mass index (27, 3±7.8kg/m2, p=0.002), interdialytic weight gain ≥ 5% of baseline weight (66.7%, p=0.033), hourly ultrafiltration (800±275ml/h, p=0.037) and perdialytic feeding (33.3%, p=0.016). Low pre-dialysis diastolic blood pressure (72±13mmHg, p=0.012) and high baseline weight (73.9±17.5kg, p=0.028) were associated with frequent versus infrequent intradialytic hypotension. CONCLUSION: Intradialytic hypotension is common in our context. Its prevention in at-risk patients is critical to reducing morbidity and mortality and improving quality of life.

Retroperitoneal GIST: An exceptional location of a rare tumour. A case report from Ouagadougou and review of the literature.

INTRODUCTION: GIST can occur in all segments of the gastrointestinal tract with a predilection for the stomach. Retroperitoneal localization remains exceptional. We report a case to describe our diagnostic and therapeutic approach. CASE PRESENTATION: A 55-year-old patient was admitted with borborygms and a sensation of lumbar swelling for 6 months. He was diabetic and hypertensive. The clinical examination noted a right lumbar mass with perception of bowel sound anterior to the mass, with minimal discomfort and mobility. Ultrasound revealed a hypervascularised, encapsulated, well-limited retroperitoneal tissue mass in contact with the right psoas muscle. Abdomino-pelvic CT scan showed a large, hypervascularized, encapsulated, calcified tissue mass measuring 147 × 106 mm in close contact with the outer edge of the right psoas muscle, suspected of being malignant. MRI noted a suspicious process developed at the expense of the right psoas muscle in its lumbar and iliac portion suggestive of a psoas rhabdomyosarcoma. The patient underwent laparotomy with a retroperitoneal approach by lumbar incision. Histology and immunohistochemistry revealed a GIST expressing CD117. The patient was put on imatinib for 6 months. He is complaint-free after 4 months. DISCUSSION: Despite the rarity of retroperitoneal GIST, it should be considered in the presence of any retroperitoneal mass. This will allow for early management. CONCLUSION: Retroperitoneum is an exceptional location for GIST. Surgery remains the mainstay of curative treatment. Adjuvant imatinib reduces the risk of recurrence. The prognosis is usually good.

[Central Post-Stroke Pain at the Tingandogo University Teaching Hospital of Ouagadougou (Burkina Faso): Frequency, Clinical Profile, Quality of Life of Patients and Associated Factors]. / La Douleur Centrale Post Accident Vasculaire Cérébral au Chu Tingandogo de Ouagadougou (Burkina Faso): Fréquence, Profil Clinique, Qualité de Vie des Patients et Facteurs Associés.

Objective: Few studies have been done on central post-stroke pain (CPSP) in Sub-Saharan Africa, while taking it into account would improve the quality of life of stroke survivors. The purpose of this study was to determine the prevalence of CPSP, to describe its clinical profile, to assess the quality of life of patients and to identify the factors associated with its occurrence, from a prospective hospital series in Ouagadougou, Burkina Faso. Methodology: It was a prospective, descriptive and analytical longitudinal follow-up study, conducted from January 2015 to March 2020, at the Tingandogo University Hospital, in Ouagadougou, Burkina Faso. The study involved all patients over the age of 16, consecutively hospitalized for stroke confirmed by CT and / or brain MRI, then reviewed every three months in outpatient Neurology, during at least 9 months after their stroke. The sociodemographic and clinical characteristics of the patients, the nature of the stroke, the existence of CPSP and, if applicable, its clinical characteristics, its treatment and its impact on the quality of life of the patients were recorded; a bivariate then multivariate analysis with logistic regression step by step, made it possible to search for the factors associated with the occurrence of CPSP. The significance threshold used was p < 0.05. Results: A total of 236 patients were collected, out of which 28 patients presented a CPSP (11.9%), after a mean duration of post-stroke follow-up of 12.9 months. Cerebral infarction, intracerebral hemorrhage and cerebral venous thrombosis accounted for 69.5%, 29.7% and 0.8% respectively. The mean age of patients with CPSP was 54.6 years, with a male predominance (53.6%). The mean time to onset for CPSP was 3.8 months after stroke. Pains such as burning (75%) and allodynia (67.8%) were the most common. The average CPSP intensity was 7.6 / 10 on the visual analog scale. Hypoaesthesia (96.4%) and paraesthesia (71.4%) were the signs or symptoms most commonly associated with CPSP. CPSP had a moderate to severe negative impact on usual work, general activity and mood of patients in 60.7%, 50% and 46.4% of patients, respectively. Amitriptyline (75%) and / or level II analgesics (60.7%,) were the most used molecules, and effective in 57% of cases. Only age ≤ 50 years was independently associated with the occurrence of CPSP (OR 2.86; p = 0.03). Conclusion: CPSP affects more than 1 in 10 stroke patients and moderately to severely affects the quality of life for most of these patients. Screening and adequate management of CPSP as part of multidisciplinary post-stroke follow-up will contribute to improve the quality of life of stroke patients and will facilitate their social and professional reintegration.

[Clinical and paraclinical profile of autoimmune myasthenia gravis in Ouagadougou, Burkina Faso]. / Profil clinique et paraclinique de la myasthénie auto-immune à Ouagadougou au Burkina Faso.

Introduction: Certain differences in the epidemiological, clinical, paraclinical and evolution profiles of autoimmune myasthenia gravis (AIMG) are increasingly described in patients according to geographic origins. The present study was carried out in order to help characterize the socio-demographic, clinical and paraclinical profile of AIMG in Ouagadougou, Burkina Faso. Patients and methods: This was a cross-sectional, descriptive, multicenter, hospital study carried out in Ouagadougou (Burkina Faso), over a period of 5 years 6 months, from March 2015 to September 2019. The study concerned all patients who had a clinical symptomatology suggestive of myasthenia gravis, associated with the presence in the serum of anti-AChR Ab and / or anti-MuSK Ab and / or the presence of a >10% decrement in electroneuromyography and / or a positive therapeutic test for oral anticholinestherasics. Sociodemographic, clinical and paraclinical variables, were analyzed. Results: A total of 25 patients (15 women and 10 men), were included. The young adult form was predominant (20 cases). The median time between the first symptoms and the diagnosis was 28.4 months +/- 44.8 (2 - 217 months). Diplopia and/or ptosis (80%) and dysphonia (72%) were the most frequent revealing clinical presentations. On admission, 7 patients (28%) had a moderate generalized form (MGFA class III) and 9 patients (36%) had a severe to very severe generalized form (MGFA class IV to V). Plasma Ab assays were performed in 17 patients (68%): anti-RACh Ab were positive in 11 patients (64.7%) and anti-MuSK Ab in 3 patients (14.3%). Thoracic CT revealed thymus hyperplasia in 12 patients (48%), thymoma in 5 patients (20%). Hyperthyroidism was associated in 2 patients (8%). Conclusion: AIMG in Ouagadougou, Burkina Faso is marked by delayed diagnosis, a predominance in young women, severe generalized forms and a high frequency of plasma anti-MuSK Ab. This profile appears to be different from that of Caucasian patients. Collaborative studies in the sub-Saharan region on AIMG in general populations are needed.

[Clinical and therapeutic aspects of sexual violence received at CHU Yalgado Ouedraogo, Burkina Faso)]. / Aspects cliniques et therapeutiques des violences sexuelles reçues au centre hospitalier et universitaire (CHU) Yalgado Ouedraogo, Burkina Faso.

INTRODUCTION: Sexual abuse is a health problem that needs to be adequately and comprehensively managed. A preventive strategy must be conducted to deter potential abusers. The purpose of the study was to describe the cases of sexual abuse received in the Department of Gynecology and Obstetrics at Yalgado Ouedraogo University Hospital. PATIENTS AND METHOD: It was a retrospective and descriptive study covering a period from January 1, 2009 to December 31, 2013.The study involved victims of sexual violence received in the obstetrics and gynecology department of Yalgado OUEDRAOGO Hospital and whose files were usable. RESULTS: The average age of alleged victims was 16 years, ranging from 03 years to 32 years. Rape was the most frequent reason for consultation (93.1%). It was practiced nightly, usually in the residences. The most common genital lesion was vulvar lacerations (17.8%). The most frequent of non-gynecological lesion was scratches (10.9%).The victims' support was essentially medical and surgical. The short-term prognosis was favorable (100%). Psychological support was marginal.

INTRODUCTION: Les violences sexuelles constituent un problème de santé dont la prise en charge doit être adéquate et globale. Une stratégie préventive doit être menée afin de dissuader les potentiels agresseurs. Le but de l'étude était de décrire les cas de violences sexuelles reçus dans le Département de gynéco-obstétrique du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHUYO). PATIENTES ET MÉTHODE: Il s'est agi d'une étude rétrospective à visée descriptive couvrant une période allant du 1er janvier 2009 au 31 décembre 2013. L'étude a concerné les présumées victimes de violences sexuelles reçues dans le département de gynécologie obstétrique du CHUYO et dont les dossiers étaient exploitables. RÉSULTATS: La moyenne d'âge des présumées victimes était de 16 ans avec des extrêmes allant de 03 ans à 32 ans. Le viol était le motif de consultation le plus fréquent (93,1%) et se déroulait nuitamment, généralement dans les domiciles. La lésion génitale la plus fréquente était les déchirures vulvaires (17,8%). La lésion non gynécologique la plus fréquente était les égratignures (10,9%).La prise à charge des victimes était essentiellement médico-chirurgicale. Le pronostic à court terme était favorable (100%). La prise en charge psychologique était marginale. CONCLUSION: Les violences sexuelles restent une préoccupation bien que sa fréquence soit faible. Ce fléau touche essentiellement les adolescentes.