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.

[Prognostic factors for neonatal mortality at the Souro Sanou University Hospital in Bobo-Dioulasso, Burkina Faso: a cross-sectional study]. / Facteurs pronostiques de la mortalité néonatale au CHU Sourô Sanou de Bobo-Dioulasso, Burkina Faso: une étude transversale.

Introduction: to help reduce neonatal mortality in Burkina Faso, we identified the prognostic factors for neonatal mortality at the Sourô Sanou University Hospital. Methods: we conducted a cross-sectional and analytical study in the neonatal department from July 25, 2019 to June 25, 2020. Patients' medical records, consultation and hospital records were reviewed. Prognostic factors for neonatal mortality were identified using a Cox model. Results: data from 1128 newborn babies were analysed. Neonatal mortality was 29.8%. Most of these deaths (89%) occurred in the early neonatal period. The mean weight of newborns at the admission was 2,285.8 ± 878.7 and 43.6%. They were at a healthy weight. Four out of five newborns had been hospitalized for infection or prematurity. The place of delivery (HR weight <1000g = 5.45[3.81 -7.79]) and the principal diagnosis (HR asphyxiation= 1.64[1.30-2.08]) were prognostic factors for neonatal mortality. Conclusion: improving technical facilities for the etiological investigation of infections and an efficient management of low-weight newborns suffering from respiratory distress would considerably reduce in-hospital neonatal mortality in Bobo-Dioulasso.

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

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

Genetic diversity of enteric viruses responsible of gastroenteritis in urban and rural Burkina Faso.

BACKGROUND: Viral gastrointestinal infections remain a major public health concern in developing countries. In Burkina Faso, there are very limited updated data on the circulating viruses and their genetic diversity. OBJECTIVES: This study investigates the detection rates and characteristics of rotavirus A (RVA), norovirus (NoV), sapovirus (SaV) and human astrovirus (HAstV) in patients of all ages with acute gastrointestinal infection in urban and rural areas. STUDY DESIGN & METHODS: From 2018 to 2021, stool samples from 1,295 patients with acute gastroenteritis were collected and screened for RVA, NoV, SaV and HAstV. Genotyping and phylogenetic analyses were performed on a subset of samples. RESULTS: At least one virus was detected in 34.1% of samples. NoV and SaV were predominant with detection rates of respectively 10.5 and 8.8%. We identified rare genotypes of NoV GII, RVA and HAstV, recombinant HAstV strains and a potential zoonotic RVA transmission event. CONCLUSIONS: We give an up-to-date epidemiological picture of enteric viruses in Burkina Faso, showing a decrease in prevalence but a high diversity of circulating strains. However, viral gastroenteritis remains a public health burden, particularly in pediatric settings. Our data advocate for the implementation of routine viral surveillance and updated management algorithms for diarrheal disease.

Co-circulation of two Alphaviruses in Burkina Faso: Chikungunya and O'nyong nyong viruses.

BACKGROUND: Chikungunya virus (CHIKV) and O'nyong nyong virus (ONNV) are phylogenetically related alphaviruses in the Semliki Forest Virus (SFV) antigenic complex of the Togaviridae family. There are limited data on the circulation of these two viruses in Burkina Faso. The aim of our study was to assess their circulation in the country by determining seroprevalence to each of the viruses in blood donor samples and by retrospective molecular and serological testing of samples collected as part of national measles and rubella surveillance. METHODOLOGY/PRINCIPAL FINDINGS: All blood donor samples were analyzed on the Luminex platform using CHIKV and ONNV E2 antigens. Patient samples collected during national measles-rubella surveillance were screened by an initial ELISA for CHIKV IgM (CHIKjj Detect IgM ELISA) at the national laboratory. The positive samples were then analyzed by a second ELISA test for CHIKV IgM (CDC MAC-ELISA) at the reference laboratory. Finally, samples that had IgM positive results for both ELISA tests and had sufficient residual volume were tested by plaque reduction neutralization testing (PRNT) for CHIKV and ONNV. These same patient samples were also analyzed by rRT-PCR for CHIKV. Among the blood donor specimens, 55.49% of the samples were positive for alphaviruses including both CHIKV and ONNV positive samples. Among patient samples collected as part of national measles and rubella surveillance, 3.09% were IgM positive for CHIKV, including 2.5% confirmed by PRNT. PRNT failed to demonstrate any ONNV infections in these samples. No samples tested by RT-qPCR. had detectable CHIKV RNA. CONCLUSIONS/SIGNIFICANCE: Our results suggest that CHIKV and ONNV have been circulating in the population of Burkina Faso and may have been confused with malaria, dengue fever or other febrile diseases such as measles or rubella. Our study underscores the necessity to enhance arbovirus surveillance systems in Burkina Faso.

Frailty progression in adults aged 40 years and older in rural Burkina Faso: a longitudinal, population-based study.

BACKGROUND: Little is known about ageing and frailty progression in low-income settings. We aimed to describe frailty changes over time in individuals living in rural Burkina Faso and to assess which sociodemographic, disability, and multimorbidity factors are associated with frailty progression and mortality. METHODS: This longitudinal, population-based study was conducted at the Nouna Health and Demographic Surveillance Systems (HDSS) site in northwestern Burkina Faso. Eligible participants were aged 40 years or older and had been primarily resident in a household within the HDSS area for at least the past 6 months before the baseline survey and were selected from the 2015 HDSS household census using a stratified random sample of adults living in unique households within the area. Participants were interviewed in their homes in 2018 (baseline), 2021 (follow-up), or both. We derived the Fried frailty score for each participant at each timepoint using data on grip strength, gait speed, self-reported weight loss, self-reported exhaustion, and physical activity, and described changes in frailty status (no frailty, pre-frailty, or frailty) between 2018 and 2021. We used multivariate regression models to assess factors (ie, sex, age, marital status, educational attainment, wealth quintile, WHO Disability Assessment Schedule (WHODAS) score, and multimorbidity) associated with frailty progression (either worsening frailty status or dying, compared with frailty status remaining the same or improving) and with mortality, and developed sequential models: unadjusted, adjusting for sociodemographic factors (sex, age, marital status, educational attainment, and wealth quintile), and adjusting for sociodemographic factors, disability, and multimorbidity. FINDINGS: Between May 25 and July 19, 2018, and between July 1 and Aug 22, 2021, 5952 individuals were invited to participate: 1709 (28·7%) did not consent, 1054 (17·8%) participated in 2018 only and were lost to follow-up, 1214 (20·4%) participated in 2021 only, and 1975 (33·2%) were included in both years or died between years. Of 1967 participants followed up with complete demographic data, 190 (9·7%) were frail or unable to complete the frailty assessment in 2018, compared with 77 (3·9%) in 2021. Between 2018 and 2021, frailty status improved in 567 (28·8%) participants and worsened in 327 (16·6%), and 101 (5·1%) participants died. The relative risk of frailty status worsening or of dying (compared with frailty impRoving or no change) increased with age and WHODAS score, whereas female sex appeared protective. After controlling for all sociodemographic factors, multimorbidity, and WHODAS score, odds of mortality were 1·07 (odds ratio 2·07, 95% CI 1·05-4·09) times higher among pre-frail individuals and 1·1 (2·21, 0·90-5·41) times higher among frail individuals than among non-frail individuals. INTERPRETATION: Frailty status was highly dynamic in this low-income setting and appears to be modifiable. Given the rapid increase in the numbers of older adults in low-income or middle-income countries, understanding the behaviour of frailty in these settings is of high importance for the development of policies and health systems to ensure the maintenance of health and wellbeing in ageing populations. Future work should focus on designing context-appropriate interventions to improve frailty status. FUNDING: Alexander Von Humboldt Foundation, Institute for Global Innovation, University of Birmingham, and Wellcome Trust.

Facteurs influençant le délai de prise en charge aux urgences chirurgicales du CHU Sourô Sanou.

INTRODUCTION: Assessing patient turnaround times is essential for improving the quality of care in emergency service departments. PURPOSE OF THE RESEARCH: This study looked at waiting and treatment times, and their associated factors, in the surgical emergency service department at the Souro Sanou National Teaching Hospital (SSNTH) in Bobo-Dioulasso, Burkina Faso. RESULTS: This study was carried out on 380 patients with a median age of thirty-eight. The sex ratio was 0.54. In 63.7 percent of cases, the participants lived in urban areas. Most of the patients surveyed were farmers (34.7 percent). The median waiting time for patients was eleven minutes. The nature of the trauma sustained was associated with the waiting time. The median time taken to administer first aid was sixty-three minutes, with the unavailability of medication at the hospital pharmacy cited as a factor contributing to this delay. The median time taken to obtain paraclinical results was 134 minutes and 102 minutes for laboratory tests and scans, respectively. The factor associated with delays in obtaining scan results was the need for surgical intervention. The median waiting time for surgery was 24.3 hours. CONCLUSIONS: The turnaround times in the SSNTH surgical emergency department are long. For the improvement of patient turnaround times to be possible, an overhaul of the department is in order. In particular, a rapid consultation team needs to be established, and essential drugs for emergency care need to be made readily available.

Tuberculose résistante au Burkina Faso : audit organisationnel et enquête de satisfaction.

INTRODUCTION: Drug-resistant tuberculosis is a public health priority and shortcomings in health services can make matters worse. PURPOSE OF THE RESEARCH: The aim of the study was to carry out an organizational audit inspired by the accreditation standards of the Agence nationale d’accréditation et d’évaluation en santé (ANAEH) (French National Agency for Health Accreditation and Assessment) for the management of resistant tuberculosis patients and to determine the level of patient satisfaction in order to identify any failings and possible solutions. RESULTS: The overall audit score was 63.2 percent for the Centre hospitalier universitaire Yalgado Ouédraogo (CHUYO) (Yalgado Ouédraogo University Hospital) and 59.8 percent for the Centre de lutte anti-tuberculose (CLAT) (French Tuberculosis Prevention Center). The problems raised were related to “intake, equipment, and infrastructure,” “patient rights and information,” and “management and administration.” Overall, patients were satisfied with their care. The majority of them noted that the care centers were safe and equipped with toilets that, in addition to improving hygiene, should take account of the specific nature of different illnesses and genders. The patients indicated that their privacy was relatively well respected, but that the quality of the meals provided remains unsatisfactory. Treatment was free, notwithstanding certain paraclinical examinations. Most of the patients and service providers were unaware of the cost of tuberculosis treatment. Non-compliance with treatment, thought to stem from the adverse side effects of anti-tuberculosis drugs, was cited as the main cause of resistance. CONCLUSIONS: A number of operational shortcomings exist in the management of patients with resistant tuberculosis, stemming from unfamiliarity with the treatment protocol. The application of the patient-centered approach could allow for the fight against tuberculosis, especially its resistant form, to be waged more effectively.

Physical and insecticidal durability of Interceptor®, Interceptor® G2, and PermaNet® 3.0 insecticide-treated nets in Burkina Faso: results of durability monitoring in three sites from 2019 to 2022.

BACKGROUND: National Malaria Programmes (NMPs) monitor the durability of insecticide-treated nets (ITNs) to inform procurement and replacement decisions. This is crucial for new dual active ingredients (AI) ITNs, for which less data is available. Pyrethroid-only ITN (Interceptor®) and dual AI (Interceptor® G2, and PermaNet® 3.0) ITNs were assessed across three health districts over 36 months in southern Burkina Faso to estimate median ITN survival, insecticidal efficacy, and to identify factors contributing to field ITN longevity. METHODS: Durability was monitored through a prospective study of a cohort of nets distributed during the 2019 mass campaign. Three health districts were selected for their similar pyrethroid-resistance, environmental, epidemiological, and population profiles. Households were recruited after the mass campaign, with annual household questionnaire follow-ups over three years. Each round, ITNs were withdrawn for bioassays and chemical residue testing. Key measures were the percentage of cohort ITNs in serviceable condition, insecticidal effectiveness, and chemical residue content against target dose. Cox proportional hazard models were used to identify determinants influencing ITN survival. RESULTS: At endline, the median useful life was 3.2 (95% CI 2.5-4.0) years for PermaNet® 3.0 ITNs in Orodara, 2.6 (95% CI 1.9-3.2) years for Interceptor® G2 ITNs in Banfora and 2.4 (95% CI 1.9-2.9) years for Interceptor® ITNs in Gaoua. Factors associated with ITN survival included cohort ITNs from Orodara (adjusted hazard ratio (aHR) = 0.58, p = 0.026), households seeing less rodents (aHR = 0.66, p = 0.005), female-headed households (aHR = 0.66, p = 0.044), exposure to social behavior change (SBC) messages (aHR = 0.52, ≤ 0.001) and folding nets when not in use (aHR = 0.47, p < 0.001). At endline, PermaNet® 3.0 ITN recorded 24-h mortality of 26% against resistant mosquitos on roof panels, with an 84% reduction in PBO content. Interceptor® G2 ITN 72-h mortality was 51%, with a 67% reduction in chlorfenapyr content. Interceptor® ITN 24-h mortality was 71%, with an 84% reduction in alpha-cypermethrin content. CONCLUSION: Only PermaNet® 3.0 ITNs surpassed the standard three-year survival threshold. Identified protective factors should inform SBC messaging. Significant decreases in chemical content and resulting impact on bioefficacy warrant more research in other countries to better understand dual AI ITN insecticidal performance.

A participatory approach to move towards a One Health surveillance system for anthrax in Burkina Faso.

The One Health approach calls for collaboration across various sectors and different scales to improve understanding of complex health issues. Regarding epidemiological surveillance, this implies the development of integrated systems that link several surveillance components operating in different domains (human, domestic animals, environment) and involving several actor networks. However, surveillance continues to operate in a very compartmentalized way, with little interaction between sectoral institutions and with the community for the governance and operation of surveillance activities. This is partly explained by the insufficient consideration of the local context and the late involvement of national stakeholders when developing programmes that aimed at strengthening the integration of surveillance. In low- and middle-income countries in particular, there is a strong influence of external partners on the development of intersectoral programmes, including surveillance systems. In this context, we developed and implemented a participatory planning process to support stakeholders of the surveillance system of anthrax in Burkina Faso, in the definition of the One Health surveillance system they wish for and of the pathway to reach it. The workshop produced an action plan that reflects the views and perspectives of representatives of the different categories of stakeholders and beneficiaries of surveillance. In addition, the participation of stakeholders in this participatory co-construction process has also improved their knowledge and mutual understanding, fostering a climate of trust conducive to further collaboration for surveillance activities. However, the quality of the participation raises some questions over the results, and contextual factors may have influenced the process. This underlines the need to include a monitoring and evaluation plan in the process to assess its implementation and ability to produce One Health surveillance modalities that are appropriate, accepted and applied over the long term.

Modeled impacts of bouillon fortification with micronutrients on child mortality in Senegal, Burkina Faso, and Nigeria.

Micronutrient interventions can reduce child mortality. By applying Micronutrient Intervention Modeling methods in Senegal, Burkina Faso, and Nigeria, we estimated the impacts of bouillon fortification on apparent dietary adequacy of vitamin A and zinc among children and folate among women. We then used the Lives Saved Tool to predict the impacts of bouillon fortification with ranges of vitamin A, zinc, and folic acid concentrations on lives saved among children 6-59 months of age. Fortification at 250 µg vitamin A/g and 120 µg folic acid/g was predicted to substantially reduce vitamin A- and folate-attributable deaths: 65% for vitamin A and 92% for folate (Senegal), 36% for vitamin A and 74% for folate (Burkina Faso), and >95% for both (Nigeria). Zinc fortification at 5 mg/g would avert 48% (Senegal), 31% (Burkina Faso), and 63% (Nigeria) of zinc-attributable deaths. The addition of all three nutrients at 30% of Codex nutrient reference values in 2.5 g bouillon was predicted to save an annual average of 293 child lives in Senegal (3.5% of deaths from all causes among children 6-59 months of age), 933 (2.1%) in Burkina Faso, and 18,362 (3.7%) in Nigeria. These results, along with evidence on program feasibility and costs, can help inform fortification program design discussions.

Coût de la prise en charge des pathologies cardio-vasculaires au Burkina Faso.

INTRODUCTION: The management of cardiovascular pathologies has a high cost for users. PURPOSE OF THE RESEARCH: It is therefore important to assess the costs of hospitalization to gain a better understanding of its impact on care. RESULTS: This was a case series-type, descriptive, observational study with prospective data collection. RESULTS: A total of 103 patients were included, with a mean age of 51 years and extremes ranging from 14 to 86 years. The average length of stay was 7.1 days. Heart failure was the most frequent pathology (61.7%). The average monthly income per patient was 101,360 CFA francs. The average total direct cost during hospitalization was 114,015 CFAF. The average direct cost of drugs and consumables was 60,553.77 CFAF. The average direct cost of paraclinical examinations was 34,360.29 CFAF. Hospitalization costs averaged 16,747.47 CFAF. Total direct costs during hospitalization were 11,737,060 CFAF, dominated by drugs and medical consumables (53.14%), followed by complementary examinations (29.86%) and non-medical expenses (17%). During the study, 13.59% of patients were discharged against medical advice. Expenses were covered by the parents in 71.84% of cases. CONCLUSIONS: The average direct cost of hospitalization is well above the purchasing power of the majority of patients.

Form and functioning: contextualising the start of the global financing facility policy processes in Burkina Faso.

BACKGROUND: Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally. OBJECTIVE: This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso. METHODS: We conducted an exploratory qualitative policy analysis. Data collection included document review (N = 74) and in-depth semi-structured interviews (N = 23). Data were analysed based on the components of the health policy triangle. RESULTS: There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective. CONCLUSIONS: Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.

Main findings: There was a high level of political commitment to the Global Financing Facility in Burkina Faso, but its implementation has been hindered by policy fragmentation, competing interests, weak institutional anchoring, and misunderstandings.Added knowledge: This study documents the initiation of a global health initiative, specifically the Global Financing Facility, including the development and implementation of its planning documents, namely the Investment Case and Project Appraisal Document.Global health impact for policy and action: An understanding of the factors that facilitated or impeded the policy processes of developing and implementing the Global Financing Facility can inform the design and implementation of future initiatives.

The unseen battle: interpreting the 2023 World Malaria Report from Burkina Faso's frontlines.

The recently released 2023 World Malaria Report sheds light on an alarming reality: despite preventive measures, malaria remains a severe issue in Burkina Faso. As researchers in the field working on malaria in Burkina Faso, the assessment suggests significant underreporting, especially in remote areas with limited healthcare access. In addition, the confusion arising from similar diseases, such as dengue, further complicates the situation. Aligning with the 2023 World Health Organization recommendations, it is time to advocate for tailored strategies in high-burden areas by emphasizing community involvement in data collection awareness campaigns for effective disease management to combat the invisible crisis lurking within communities.

Évaluation de l'offre de soins en situation d'urgence basée sur la mise en place des postes de santé avancés dans la ville de Djibo, Burkina Faso, avril 2022.

INTRODUCTION: The town of Djibo in Burkina Faso has been facing a security and humanitarian crisis since 2015. The internally displaced populations who have taken refuge there have several needs, including health care. The establishment of advanced health posts is part of the health-nutrition service delivery strategy adopted to address these needs. We evaluated the contribution of these advanced health posts in terms of availability, access to care, and beneficiary satisfaction. METHODOLOGY: We conducted a mixed descriptive and analytical cross-sectional study from May 1, 2021 to January 30, 2022 on the host population, internally displaced people, health workers, and selected health facilities in Djibo. It involved 422 people for the quantitative component. The quantitative data, including those from 2016 to 2020, were analyzed using Epi Info software, version 7.2.3.1, and completed by a qualitative component. RESULTS: Of the nine peripheral structures studied, seven were advanced health posts offering basic care such as prenatal and postnatal consultations, infant monitoring, and vaccination. Nutritional interventions were inadequate in some of these advanced health posts. Geographic access was satisfactory, but financial access was not. CONCLUSION: The strategy made it possible to meet basic health care needs in this crisis context, but financial access must be improved.

Current status of digital health interventions in the health system in Burkina Faso.

BACKGROUND: Digital health is being used as an accelerator to improve the traditional healthcare system, aiding countries in achieving their sustainable development goals. Burkina Faso aims to harmonize its digital health interventions to guide its digital health strategy for the coming years. The current assessment represents upstream work to steer the development of this strategic plan. METHODS: This was a quantitative, descriptive study conducted between September 2022 and April 2023. It involved a two-part survey: a self-administered questionnaire distributed to healthcare information managers in facilities, and direct interviews conducted with software developers. This was complemented by a documentary review of the country's strategic and standards documents on digital transformation. RESULTS: Burkina Faso possesses a relatively comprehensive collection of governance documents pertaining to digital transformation. The study identified a total of 35 digital health interventions. Analysis showed that 89% of funding originated from technical and financial partners as well as the private sector. While the use of open-source technologies for the development of the applications, software, or platforms used to implement these digital health interventions is well established (77%), there remains a deficiency in the integration of data from different platforms. Furthermore, the classification of digital health interventions revealed an uneven distribution between the different elements across domains: the health system, the classification of digital health interventions (DHI), and the subsystems of the National Health Information System (NHIS). Most digital health intervention projects are still in the pilot phase (66%), with isolated electronic patient record initiatives remaining incomplete. Within the public sector, these records typically take the form of electronic registers or isolated specialty records in a hospital. Within the private sector, tool implementation varies based on expressed needs. Challenges persist in adhering to interoperability norms and standards during tool design, with minimal utilization of the data generated by the implemented tools. CONCLUSION: This study provides an insightful overview of the digital health environment in Burkina Faso and highlights significant challenges regarding intervention strategies. The findings serve as a foundational resource for developing the digital health strategic plan. By addressing the identified shortcomings, this plan will provide a framework for guiding future digital health initiatives effectively.

News sequences types of Staphylococcus aureus isolated from human pathologicals fluids in Burkina Faso.

Staphylococcus aureus is a pathogen with high epidemic potential frequently involved in nosocomials and communities infections. The pathogenicity of Staphylococcus aureus is due to both its ability to resist antibiotics and to Produce toxins. This work aims at studying the resistance and Molecular Epidemiology of Staphylococcus aureus. Antibiotic susceptibility of the 70 strains isolates of Staphylococcus aureus was determined by agar diffusion while Multiplex PCR and MLST were used to search toxin-coding genes and MRSA typing, respectively. 14.28% of isolates were multidrug resistant. Staphylococcus aureus showed high susceptibility to aminoglycoside and Macrolides familly. lukS-PV/lukF-PV and sea genes were detected in 45% and 3% of Staphylococcus aureus respectively. Ten (10) sequence types including ST5710, ST2430, ST5289, ST5786, ST6942, ST6943, ST6944, ST6945, ST6946, ST6947 have been reported. The study showed a diversity of antibiotic resistance phenotypes and a great diversity of MRSA clones causing infections.

Estimating dengue burden among family contacts through cluster investigation around probable cases in 2022 and 2023 in the Central Region, Burkina Faso.

BACKGROUND: In 2023, Burkina Faso experienced the largest dengue epidemic ever in Africa. This study aimed to estimate the prevalence of symptomatic, subclinical, and asymptomatic dengue and determine the associated factors among adult contacts of dengue in the Central Region, Burkina Faso. METHODS: This cross-sectional study included contacts of dengue probable cases through cluster sampling in 2022-2023. These suspected cases that tested positive were identified from the five health facilities (Pissy CMA, Saaba CM, Kossodo CMA, Samandin CM, and Marcoussis CSPS) that reported the highest number of cases in 2021 per district. All participants underwent dengue and malaria rapid diagnostic tests (RDT). Samples positive for non-structural 1 protein antigen (AgNS1) and/or immunoglobulin M (IgM) were tested for serotype detection by reverse transcription polymerase chain reaction (RT-PCR). Binary logistic regression was done to identify the determinants of asymptomatic, subclinical, and symptomatic dengue among contacts of probable dengue cases. RESULTS: A total of 484 contacts were included, mostly in 2023 (75.2%). Most participants were females (58.6%), residing (24.3%) and passing their daytime (23.1%) in Saaba. The overall prevalence of dengue was estimated at 15.1% [95% confidence interval (CI): 12.0-18.6%], representing cases not seeking care in hospitals. Asymptomatic cases represented 2.9% (95% CI: 1.6-4.8%). Subclinical and symptomatic cases accounted for 6.0% (95% CI: 4.1-8.5%) and 6.2% (95% CI: 4.2-8.7%), respectively. Of the 58 samples tested by RT-PCR, 10 were confirmed for serotype 3 in 2023. Malaria cases were estimated at 5.6% (95% CI: 3.7-8.0%). After adjustment, participants claiming that a virus transmits dengue were likelier to have asymptomatic dengue [adjusted odds ratio (aOR) = 7.1, 95% CI: 2.4-21.0]. From the multivariable analysis, subclinical dengue was statistically associated with being included in the study in 2023 (aOR = 30.2, 95% CI: 2.0-455.5) and spending the daytime at Arrondissement 4 (aOR = 11.5, 95% CI: 1.0-131.0). After adjustment, symptomatic dengue was associated with living less than 50 m away from cultivated land (aOR = 2.8, 95% CI: 1.1-6.9) and living less than 50 m from a stretch of water (aOR = 0.1, 95% CI: 0.0-0.6). CONCLUSIONS: The overall burden of dengue among populations not seeking care in hospitals was quite high, with few asymptomatic cases. Efforts to manage dengue cases should also target non-hospital cases and raise population awareness. The 2023 epidemic could be due to dengue virus (DENV)-3.

[Complications of female genital mutilation: epidemiology and management of cases at Ouahigouya regional teaching hospital, Burkina Faso]. / Complications des mutilations génitales féminines : épidémiologie et prise en charge des cas au Centre hospitalier universitaire (CHU) régional de Ouahigouya, Burkina Faso.

Background: Female genital mutilation is still common in Burkina Faso, despite decades of struggle against its practice. The northern region of this country has one of the highest prevalence of this practice at the national level with 76% of women mutilated. The objective of our study was to describe the health complications of female genital mutilation treated in the referral hospital in this region. Patients and methods: This was a descriptive cross-sectional study with retrospective data collection over a 13-year period, from September 15, 2009 to September 14, 2022. Patients admitted for genital or loco-regional complications related to genital mutilation were included. Mutilated parturients without infibulation, victims of vulvar tears or who had undergone episiotomy were not included. Results: We recorded 204 patients, representing 3,1% of consultants, and an annual frequency of 15.7 cases. The ages of the victims ranged from 15 months to 31 years. The 15-20 age group was the most represented (49.3%). Victims were more likely to come from urban than rural areas. The main reasons for consultation were vulvar stricture, dyspareunia, impossibility of sexual intercourse, and dysuria. These were medium- and long-term complications of the mutilation. These complications were related to infibulation in 81.8% of cases and to type II mutilation in 18.2%. Surgery accounted for 89.9% of treatments, with drug treatments alone accounting for 10.1%. Deinfibulation was the most common surgical procedure. No clitoral reconstruction was performed. The outcome was favourable in all cases. Conclusion: There are many local and regional complications of genital mutilation, but fortunately their treatment has a good anatomical prognosis. However, psychological complications remain to be evaluated and managed in our context. The management of these complications should be an opportunity to raise awareness among the patients' family circles to abandon the practice.

[Reduction in malaria case-fatality rate after implementation of an emergency plan for improved case management in the Bittou health district, Burkina Faso]. / Réduction de la létalité du paludisme après la mise en œuvre d'un plan d'urgence pour l'amélioration de la prise en charge des cas dans le district sanitaire de Bittou, Burkina Faso.

Objective: To observe the evolution in malaria case-fatality rate among children under 5 years of age receiving care at the Bittou district hospital (CMA) after an improvement of the care practices. The management team implemented an emergency plan in 2016 with 5 components: i) health facilities staff sensitization to enable rapid referral of severe malaria cases to CMA; ii) reorganization of CMA paediatric emergencies to make a physician as the mainpoint of contact; iii) ensuring availability of supplies for severe malaria case management, including the availability of blood; iv) daily medical check-ups of hospitalized patients; v) reinforcement of clinical staff skills at all peripheral health facilities. At the same time were introduced i) free care for children under 5 years; ii) municipality involvement to finance ambulance fuel for the referrals of patients; iii) free blood collection in professional schools and soldiers; iv) a free telephone line between the health structures; v) presence of 5 medical doctors at the CMA. Material and methods: Analysis of data collected from the statistical yearbooks of the Ministry of Health of Burkina Faso from 2014 to 2021. Results: The malaria case-fatality rate (CFR) in under-five in the Bittou health district (1.39% and 1.52% in 2014 and 2015) was higher than the average for all districts in this region (1.08%). After implementation of the emergency plan, the malaria CFR in Bittou declined to 0% in 2016 and 2017, 0.2% in 2018, 0% in 2019, 0.07% in 2020 and 0.05% in 2021. The same trend was observed at the CMA level with 2.94% and 2.59% in 2014 and 2015, 0% in 2016 and 2017, 0.38% in 2018, 0% in 2019, then 0.17% and 0.47% in 2020 and 2021. Conclusion: Malaria control remains a challenge in Burkina Faso. However, the improved malaria CFRs observed in Bittou show that effective involvement of health district teams could potentially contribute to substantial reductions in malaria case-fatality risk.