A Qualitative Study of the Experience of COVID-19 Patients in Burkina Faso.

In Burkina Faso, the health system is characterized by systemic insufficient and antiquated health-care infrastructures. Consequently, few health-care establishments have the required resources to diagnose and manage patients with COVID-19, and fewer still have intensive care facilities for severely ill patients with COVID. Furthermore, there is a widespread scarcity of qualified health-care staff. The aim of this study was to explore the experiences of patients with COVID-19 who recovered after being cared for in Bobo Dioulasso and Ouagadougou. Using individual semistructured interviews, we performed a cross-sectional qualitative, descriptive study from June 12 to 30, 2020 with the aid of 13 well-educated patients who had survived COVID-19. The results reveal that prior to hospital admission, the main reason that prompted patients to seek care was onset of symptoms of COVID-19, regardless of whether they had been in contact with suspected or confirmed cases. Transmission was mainly believed to have occurred in the community, in the hospital, and during travel. Patient management was punctuated by frequent self-medication with medicinal plants or pharmaceutical drugs. The participants reported a negative perception of hospitalization or home-based management, with several forms of stigmatization, but a positive perception influenced by the satisfactory quality of management in health-care centers. This report of patient experiences could be helpful in improving the management of COVID-19 in Burkina Faso, both in the health-care setting and in home-based care.

[Traditional enema for newborns and infants in Bobo Dioulasso: health practice or socialisation]. / Hygiène et socialisation du nourrisson: le lavement rectal en milieu urbain à Bobo Dioulasso.

Kanki demonstrated a high prevalence and frequency of enema practised with newborns in the South-West of Burkina Faso. Little is known about the risks on children's health possibly associated with this practice and about its impact on other treatments in paediatrics. In this study, the authors describe daily administered enema (DAE) and analyse local conceptual frameworks underlying this practice through in-depth-interviews and focus group discussions with 30 mothers, 5 traditional healers and 5 health agents. Various medications are used to compose the liquid introduced by the mothers in the child's anus. Many of these substances are prone to irritate intestinal mucus, others are simply toxic. Practically, enema aims at curing or preventing a variety of diseases caused by an accumulation of impurities (nògò) in the intestines due to the consumption of inappropriate food. With newborns, diseases are transmitted by mothers through breastfeeding after eating food which is too sweet or too fat. In addition to provoking diseases, the nògò also "block" the child's physical and psychic development during his/her first year of life. Therefore, as soon as the child has excreted for the first time, most mothers give enema daily both to protect their children from diseases and to speed their development. In fact, beside prophylaxy and therapy lies a "didactic" function of enema as a medication used to help the child to stand up, to get teeth..., to gain independence from his/her mother. DAE therefore plays an important role in the process of acquiring bio-social aptitudes, i.e., important educational virtues to achieve a successful first step in the socialisation process. Exploring more deeply local perceptions explaining the origin of the n g , the authors found an interesting relationship with religious taboos. Beside prohibited food, the n g are also due to transgression of various taboos surrounding birth and breastfeeding and even suggest a religious, rather than hygienic, explanation for the food prohibited. DAE ultimately consists in re-adjusting the child and his mother according to moral and cultural rules, avoiding the negative consequences of transgression. Consistently, DAE also facilitates the process of acquiring bio-social aptitudes for the child and therefore help him to enter his/her family as a fully accepted member. Moreover, religious prohibitions surrounding birth end as soon as the child is able to eat solid food and free him/herself. Therefore, DAE also helps the parents to get back to their normal life conditions. In conclusion, in addition to prophylactic and therapeutic explanations, the DAE participates in a general process of socialisation of newborns. To a certain extent, the child's health depends on the respect of the social and religious system and rules. The study reveals the important conceptual gap that may exist between two different logical frameworks--biomedical and popular--prone to explain health risk for newborns. The authors then reflect on the possible impact of health education programmes seeking to intervene at the hygienic level and ultimately facing an important set of cultural values aiming at keeping the social and cultural organisation coherent.