Enhanced effect of seasonal malaria chemoprevention when coupled with nutrients supplementation for preventing malaria in children under 5 years old in Burkina Faso: a randomized open label trial.

BACKGROUND: In rural African settings, most of the children under the coverage of Seasonal Malaria Chemoprevention (SMC) are also undernourished at the time of SMC delivery, justifying the need for packaging malarial and nutritional interventions. This study aimed at assessing the impact of SMC by coupling the intervention with nutrients supplementation for preventing malaria in children less than 5 years old in Burkina Faso. METHODS: A randomized trial was carried out between July 2020 and June 2021 in the health district of Nanoro, Burkina Faso. Children (n = 1059) under SMC coverage were randomly assigned to one of the three study arms SMC + Vitamin A (SMC-A, n = 353) or SMC + Vitamin A + Zinc (SMC-AZc, n = 353) or SMC + Vitamin A + PlumpyDoz(tm) (SMC-APd, n = 353)-a medium quantity-lipid-based nutrient supplement (MQ-LNS). Children were followed up for one year that included an active follow-up period of 6 months with scheduled monthly home visits followed by 6 months passive follow-up. At each visit, capillary blood sample was collected for malaria diagnosis by rapid diagnosis test (RDT). RESULTS: Adding nutritional supplements to SMC had an effect on the incidence of malaria. A reduction of 23% (adjusted IRR = 0.77 (95%CI 0.61-0.97) in the odds of having uncomplicated malaria in SMC-APd arm but not with SMC-AZc arm adjusted IRR = 0.82 (95%CI 0.65-1.04) compare to control arm was observed. A reduction of 52%, adjusted IRR = 0.48 (95%CI 0.23-0.98) in the odds of having severe malaria was observed in SMC-APd arm compared to control arm. Besides the effect on malaria, this combined strategy had an effect on all-cause morbidity. More specifically, a reduction of morbidity odds of 24%, adjusted IRR = 0.76 (95%CI 0.60-0.94) in SMC-APd arm compared to control arm was observed. Unlike clinical episodes, no effect of nutrient supplementation on cross sectional asymptomatic infections was observed. CONCLUSION: Adding nutritional supplements to SMC significantly increases the impact of this intervention for preventing children from malaria and other childhood infections. TRIAL REGISTRATION: NCT04238845.

[Cutaneous manifestations in patients on chronic hemodialysis in a developing country]. / Les manifestations cutanées chez les patients hémodialysés chroniques dans un pays en voie de développement.

Our study aims to highlight the most common skin disorders in patients on chronic hemodialysis at the University Hospital Yalgado Ouédraogo (CHU-YO) in Ouagadougou. The study, of transverse type descriptive, carried out of September 15 to December 31, 2014, is unrolled with the CHU-YO. This descriptive transversal study was conducted at the CHU-YO from September 15 to December 31, 2014. It involved patients who had been on chronic dialysis for at least 3 months. The frequency of hemodialysis sessions was one every five days. The significance level of statistical tests was defined as the probability p ≤ 0.05. Eighty-five patients (61.1% men and 38.9% women) with an average age of 42.1 years were included in the study. The mean duration of hemodialysis was 31.9 months. The success rate of biological examinations varied from 7,4 to 85,3%. Eighty patients (85,3%) had at least one cutaneous manifestation. Cutaneous xerosis (67.4%), pruritus (45.3%), and hyperpigmentation (23.2%) were the most frequent skin manifestations that may be specific of hemodialysis. Guttate hypomelanosis (11.6%), prurigo (11.6%) and folliculitis (8.4%) were the main non-specific skin manifestations. Skin involvement was frequent but did not seem related to seniority in hemodialysis. In Ouagadougou, bad hemodialysis conditions and a hot, dry environment promote such conditions, especially xerosis and pruritus. A better subvention of health care could help to reduce the prevalence of skin diseases and to improve the quality of life of our patients on chronic hemodialysis.