[Poliomyelitis case surveillance data management in Burkina Faso]. / Gestion de l’'information au cours de la surveillance des Paralysies Flasques Aiguës au Burkina Faso.

INTRODUCTION: The global initiative for poliomyelitis eradication can only remain relevant if survey systems are regularly assessed. In order to identify shortcomings and to propose improvement, the data collection and transmission during case investigation were assessed in the Banfora health district in Burkina Faso. METHODS: The survey targeted six (6) primary health centres, the district laboratory and the national laboratory, all involved in the poliomyelitis surveillance system. Data from registers, forms documenting suspected cases, stool sample forms and weekly reports were collected by means of a data grid. Data from actors involved in the poliomyelitis case investigation system were collected by means of an individual questionnaire. RESULTS: The reactivity of investigating suspected cases was satisfactory with a median alert questionnaire notification time of 18 hours. The completeness of the reporting system was satisfactory. Nevertheless, the promptness of data management by primary heath centres and the national laboratory remained unsatisfactory. Evaluation of data management revealed logistic and organization shortcomings. CONCLUSION: The overall efficacy of the poliomyelitis surveillance could be improved by using management tools for laboratory supplies, collecting data related to the homes of suspected cases and implementing a cold chain maintenance plan.

[Satisfaction of AIDS patients managed in Dafra district hospital: an overview]. / Satisfaction des malades du sida pris en charge à l’hôpital du district sanitaire de Dafra. État des lieux.

INTRODUCTION: Assessment of patient satisfaction is an essential tool for continuing improvement of health services. OBJECTIVE: In order to more clearly define what has been achieved and what remains to be achieved, from the patient's perspective, the level of satisfaction of AIDS patients managed at Dafra district hospital was assessed. METHODS: This cross-sectional study was based on data from Individual interviews conducted with patients on ARV therapy forat least six months on 1st April2014. Erin's multiattribute modelwas used to identify the content of the data collection. RESULTS: Patients were relatively satisfied with the comfort and the fact that some of their expectations were taken into account, such as nutritional support,free drug prescriptions and measurement of body temperature and blood pressure. However, they expressed complaints concerning the promptness of services, the courtesy of healthcare providers, confidentiality and questioned the skills ofhealthcare providers. CONCLUSION: The provision of good quality health care for AIDS patients in the Dafra health district requires permanent review of healthcare provider practices. Improvements are needed in terms of promptness of services, courtesy and confidentiality. Health care teams must take the sociocultural background of healthcare providers into account in order to develop, test and evaluate appropriate solutions.

[Knowledge and practices of health care workers in the area of healthcare-associated infection risks. A case study in a district hospital in Burkina Faso]. / Connaissances et pratiques des professionnels de santé sur le risque infectieux associé aux soins : étude dans un hôpital de district au Burkina Faso.

INTRODUCTION: Healthcare-associated infections are a common consequence of unsafe health care practices and are a major issue for patient safety. Health care workers play a key role in patient safety and the quality of care, with factors such as poor compliance with hygiene standards and poor knowledge of infection risks having a major impact. However, the role of health care workers in patient safety has been overlooked in the literature. The objectives of this study were i) to examine health care workers' awareness of infection risks and ii) to assess levels of hand hygiene compliance and barriers to patient safety. METHODS: A one-day cross-sectional survey was conducted in June 2011 at the Ziniaré health district hospital. The study focused on the health care workers present on the day of the survey in hospital care units and involved interviews and observations. RESULTS: The study found that 30.04% of the health care workers knew the definition of healthcare-associated infections. Only 44.4% of the health care workers reported that the hands of health care workers (in the event of poor hand hygiene compliance) were the main mode of transmission of germs between patients in a care facility. In addition, only 21.43% (12/56) of the participants were aware of the main factors that increase the risk of health care-associated infections. The level of compliance with hygiene protocols was low (36.85%). CONCLUSION: The promotion of patient safety and quality of care requires a focus on training and behavior change among health care workers.

Healthcare-associated infection in Burkina Faso: an assessment in a district hospital.

In developing countries, few data are available on healthcare-associated infections. In Burkina Faso, there has been a failure to take into account risk management and patient safety in the quality assurance program. The main objective of our study was to carry out an assessment of healthcare-associated infection in a first level hospital. We conducted a cross-sectional study in June 2011 in the care units of Ziniaré District Hospital (Ziniaré, Burkina Faso). The hospital has been divided in three components: i) hospital population (care providers, in-patients and patients' guardians); ii) healthcare and services organization; iii) hospital environment. We included: care providers of the clinical services, hospital in-patients and patients' guardians, hospitalization infrastructure and nursing units, and all the documents relating to standards and protocols. Data collection has been done by direct observation, interviews and biological samples taken at different settings. In hospital population, care providers and patients' guardians represented a high source of infection: adherence to hygiene practice on the part of care providers was low (12/19), and no patients' guardian experienced good conditions of staying in the hospital. In healthcare and services organization, healthcare waste management represented a high-risk source of infection. In hospital environment, hygiene level of the infrastructure in the hospital rooms was low (6.67%). Prevalence of isolated bacteria was 71.8%. Urinary-tract catheters infections were the most significant in our sample, followed by surgical-site infections. In total, 56.26% (9/19) of germs were -Lactamase producers (ESBL). They were represented by Escherichia coli and Klebsiella pneumoniae. Our analysis identified clearly healthcare-associated infection as a problem in Ziniaré district hospital. Hence, a national program of quality assurance in the hospitals should now integrate the risk infectious management of healthcare-associated infections.

Assessment of the health system to support tuberculosis and AIDS care. A study of three rural health districts of Burkina Faso.

There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to develop a comprehensive assessment of the health services capacity to provide tuberculosis (TB) and human immunodeficiency virus (HIV) care but also to enhance patient empowerment, social network and community support. A cross-sectional study was conducted from 1 to 31 of August 2007 in 3 districts of Burkina Faso. We used a step-by-step model and the assessment of chronic illness care (ACIC) scale to assess capacities of 24 first line health centres (FLHC) and 3 district hospitals (DH) for providing TB and HIV/AIDS care. Data for the step-by-step model were extracted from medical records of 75 TB and 66 HIV patients. The ACIC scale was completed by health professionals, 6 medical doctors and 18 nurses, working at the DH level and at the FLHC level, respectively. The biological test for confirmation was free of charge for all the TB patients but only for 10.6% (7/66) HIV cases. Up to the time of the survey, 5 TB (6.6%) and 18 HIV+ patients (27.3%) have been hospitalised for care at least once, 64 TB (85.3%) had been declared cured and 38 HIV (54.5%) were under antiretroviral treatment. Health care process organisation for TB and HIV care had distinct areas of weaknesses. From a maximum ACIC score of 11, the overall score for TB care ranged between 1.9 and 4.9 with a median of 3.7 and for HIV care between 2.1 and 6.7 with a median of 4.1. This study provides an illustration of assessing the HIV and TB care combining data from the routine information system and from the chronic illness care assessment tool, to encompass both disease control and patient health perspective. It provides to health managers arguments for clear conclusions and sufficient data for action.