Équité d'accès aux services de vaccination dans la région sanitaire du Centre-Est, 2018, Burkina Faso.

INTRODUCTION: The Central East region of Burkina Faso has vaccine coverage which is among the lowest in the country with an epidemiological profile marked by the occurrence of measles or meningitis outbreaks. This study was conducted with the aim of carrying out an equity analysis of the organization of immunization services in this region in order to identify factors that cause potential inequities in vaccination offer. MATERIALS AND METHOD: This descriptive cross-sectional study covered the seven districts in the Central East region. Data collection was done in two weeks combined with observation method, individual interviews and document review. Part of the data was collected using a self-administered questionnaire. The data analysis was performed with the Epi info 7 software using a plan designed for this purpose. RESULTS: A total of 144 health centers in the region (93.0% coverage) were surveyed. The average distance between villages and health facilities was 5.2 km with 16.2% of villages that were located more than 10 km from a health facility. Health centers had an average of four health workers, however the urban health centers had more workers than those in rural areas. About 16% of the villages did not benefit from an on-site vaccination trip due to the unavailability of transport logistics. More than half of the health centers (53.9%) had experienced vaccine shortages in the last six months before the study. More than 5,000 safety boxes containing used syringes were stored in the districts of the region. CONCLUSION: This study identified factors potentially responsible for an inequity in providing vaccination services in the Central East region. These factors include, but are not limited to, the geographical distribution of the health centers, the availability of transport logistics, and the shortage in vaccines and deficiencies in the waste disposal system. Concerted actions should be developed, involving all stakeholders in the health system in order to address these issues.

[Equity of access to immunization services in the Center-East health region in 2018, Burkina Faso] / Équité d'accès aux services de vaccination dans la région sanitaire du Centre-Est, 2018, Burkina Faso.

INTRODUCTION: The Central East region of Burkina Faso has vaccine coverage which is among the lowest in the country with an epidemiological profile marked by the occurrence of measles or meningitis outbreaks. This study was conducted with the aim of carrying out an equity analysis of the organization of immunization services in this region in order to identify factors that cause potential inequities in vaccination offer. MATERIALS AND METHOD: This descriptive cross-sectional study covered the seven districts in the Central East region. Data collection was done in two weeks combined with observation method, individual interviews and document review. Part of the data was collected using a self-administered questionnaire. The data analysis was performed with the Epi info 7 software using a plan designed for this purpose. RESULTS: A total of 144 health centers in the region (93.0% coverage) were surveyed. The average distance between villages and health facilities was 5.2 km with 16.2% of villages that were located more than 10 km from a health facility. Health centers had an average of four health workers, however the urban health centers had more workers than those in rural areas. About 16% of the villages did not benefit from an on-site vaccination trip due to the unavailability of transport logistics. More than half of the health centers (53.9%) had experienced vaccine shortages in the last six months before the study. More than 5,000 safety boxes containing used syringes were stored in the districts of the region. CONCLUSION: This study identified factors potentially responsible for an inequity in providing vaccination services in the Central East region. These factors include, but are not limited to, the geographical distribution of the health centers, the availability of transport logistics, and the shortage in vaccines and deficiencies in the waste disposal system. Concerted actions should be developed, involving all stakeholders in the health system in order to address these issues.

[Equity of access to immunization services in the Center-East health region in 2018, Burkina Faso]. / Équité d'accès aux services de vaccination dans la région sanitaire du Centre-Est, 2018, Burkina Faso.

INTRODUCTION: The Central East region of Burkina Faso has vaccine coverage which is among the lowest in the country with an epidemiological profile marked by the occurrence of measles or meningitis outbreaks. This study was conducted with the aim of carrying out an equity analysis of the organization of immunization services in this region in order to identify factors that cause potential inequities in vaccination offer. MATERIALS AND METHOD: This descriptive cross-sectional study covered the seven districts in the Central East region. Data collection was done in two weeks combined with observation method, individual interviews and document review. Part of the data was collected using a self-administered questionnaire. The data analysis was performed with the Epi info 7 software using a plan designed for this purpose. RESULTS: A total of 144 health centers in the region (93.0% coverage) were surveyed. The average distance between villages and health facilities was 5.2 km with 16.2% of villages that were located more than 10 km from a health facility. Health centers had an average of four health workers, however the urban health centers had more workers than those in rural areas. About 16% of the villages did not benefit from an on-site vaccination trip due to the unavailability of transport logistics. More than half of the health centers (53.9%) had experienced vaccine shortages in the last six months before the study. More than 5,000 safety boxes containing used syringes were stored in the districts of the region. CONCLUSION: This study identified factors potentially responsible for an inequity in providing vaccination services in the Central East region. These factors include, but are not limited to, the geographical distribution of the health centers, the availability of transport logistics, and the shortage in vaccines and deficiencies in the waste disposal system. Concerted actions should be developed, involving all stakeholders in the health system in order to address these issues.

Spatio-Temporal Determinants of Dengue Epidemics in the Central Region of Burkina Faso.

The aim of this study was to analyze the spatio-temporal distribution and determinants of the 2017 dengue epidemic in Burkina Faso. A principal component analysis of meteorological and environmental factors was performed to reduce dimensions and avoid collinearities. An initial generalized additive model assessed the impact of the components derived from this analysis on dengue incidence. Dengue incidence increased mainly with relative humidity, precipitation, normalized difference vegetation index and minimum temperature with an 8-week lag. A Kulldoff Satscan scan was used to identify high-risk dengue clusters, and a second generalized additive model assessed the risk of a health area being at high risk according to land-use factors. The spatio-temporal distribution of dengue fever was heterogeneous and strongly correlated with meteorological factors. The rural communes of Sabaa and Koubri were the areas most at risk. This study provides useful information for planning targeted dengue control strategies in Burkina Faso.

Magnitude and associated factors of latent tuberculosis infection due to Mycobacterium tuberculosis complex among high-risk groups in urban Bobo-Dioulasso, Burkina Faso.

Objectives: To determine the prevalence and risk factors for latent tuberculosis infection (LTBI) among three high-risk groups - household contacts of TB index cases, healthcare workers and slaughterhouse workers - in Bobo-Dioulasso, Burkina Faso. Methods: Participants were recruited to this cross-sectional study from March to July 2020 after giving informed consent. Sociodemographic, clinical and biological data were collected using a structured questionnaire. The QuantiFERON-TB Gold Plus test (QFT-Plus) and the tuberculin skin test (TST) were used for detection of LTBI. Bivariate and multivariate logistic regression analyses were performed to identify risk factors for LTBI. Results: The prevalence of LTBI among 101 participants (age range 15-68 years) was 67.33% [95% confidence interval (CI) 57.27-76.33] and 84.16% (95% CI 75.55-90.66) based on QFT-Plus and TST results, respectively. Compared with healthcare workers and household contacts of TB index cases, the prevalence of LTBI among slaughterhouse workers was significantly higher for both QTF-Plus (96.8%; P<0.001) and TST (100%; P=0.003). Working in a slaughterhouse [adjusted odds ratio (AOR) 1.095, 95% CI 1.00-2.036], smoking (AOR 4.214, 95% CI 1.051-16.899), ≥15 years of exposure (AOR 5.617, 95% CI 1.202-32.198), having an animal at home (AOR 2.735, 95% CI 1.102-6.789) and protozoal infection (AOR 2.591, 95% CI 1.034-6.491) were significantly associated with LTBI on the QFT-Plus assay. Conclusion: The prevalence of LTBI was high in all three groups, particularly slaughterhouse workers. The risk factors identified could form the basis of targeted intervention.

Hepatitis B vaccination in Burkina Faso: prevalence of HBsAg carriage and immune response in children in the western region.

INTRODUCTION: Hepatitis B virus (HBV) infection remains a major health problem in Burkina Faso. To control and prevent HBV infection, Hepatitis B vaccine was introduced in the national expanded program in 2006. In this study, we evaluated the prevalence of HBsAg in children aged under 10 years after one decade of universal hepatitis B vaccination, and the immune response among these children. METHODOLOGY: Between May and October 2015, a cross-sectional study was conducted among children in two primary healthcare centers in the western region of Burkina Faso. Participants were enrolled in Accart-Ville Healthcare Center in Bobo-Dioulasso (urban area) and the Healthcare Center of the village of Djigouera (rural area). Blood samples were collected from all children and analysed for the presence of HBsAg and anti-HBs antibodies (Abs). For HBsAg positive children, blood samples were also taken among their mothers for screening for HBsAg. RESULTS: A total of 265 children were included in this study. The mean age was 4.4 years. HBsAg was found in 3.4% (9/265) of children. Of the 9 HBsAg positive children, 5 had HBsAg positive mothers. From the 265 children tested for quantification of anti-HBs Ab titer, 219 (82.6%) were fully vaccinated and 135 (61.6%) of them had an anti-HBs ≥ 10 mIU/mL. CONCLUSION: Despite a good vaccination coverage (82.6%), a considerable proportion of vaccinated children remains unprotected from HBV infection. That emphasizes the need for further strengthening of the vaccination program through implementing the birth dose of HBV vaccine as recommended by WHO.

[Fight against maternal mortality in rural areas: decentralization of emergency obstetric cares in Burkina Faso]. / Lutte contre la mortalité maternelle en milieu rural: décentralisation de l'offre des soins obstétricaux d'urgence au Burkina Faso.

INTRODUCTION: In order to cover the shortage of midwives (MWs) in the health district of Tougan, Burkina Faso, a strategy for the decentralization of emergency obstetric cares, based on ad hoc interventions undertaken by MW to manage obstetric complications in health centers (HCs), has been developed in rural areas. This study aimed to describe this experience and to analyze the achieved results. METHODS: We conducted a cross-sectional, analytical, intervention study based on a review of routine data from all the parturients treated from 2013 to 2015. Data collection took place from 5 to 20 January 2016. Chi-square Test, odds ratios (ORs) and their 95% confidence intervals were calculated. RESULTS: A total of 416 parturients with obstetric complications were treated by zonal MW. The average age of patients was 26.4 years. The median distance travelled to treat parturients was 15 km, with an average intervention period of 21.1 minutes (standard deviation = 7.13 minutes). Dystocias accounted for half (50.7%, CI95%= 45.8-55.6) of treated complications followed by hemorrhage (26.4%, CI95%= 22.3%-31.0%). More than 77% of interventions resulted in local resolution of obstetric complications. Finally, the intervention outcome was subject to the pathology treated (OR=5.88; p < 0.001). CONCLUSION: This strategy was an answer to the shortage of MWs in the perypheral HCs in the health district of Tougan. In this particular context, this intervention could provide an alternative solution to the shortage of human resources for health in rural areas.