Nutritional, Microbiological, and Toxicological Quality Assessment of Foods Sold in Urban and Suburban Markets in Burkina Faso.

Food safety risks are becoming a public health problem with important socioeconomic consequences for human wellbeing, especially for pregnant women and infants. In this article, we describe findings from microbiological, toxicological, and nutritional quality assessments of foods from 5 localities in Burkina Faso, with the aim to provide baseline data on the quality of food and the risks to mothers and children. Samples for assessment included food sold in markets, stores, and restaurants (eg, cereals, oilseeds, vegetables, edible oils, powdered milk, dried fish, packaged water, ready-to-eat meals). The research team selected the samples using the random route method and analyzed them at the National Public Health Laboratory in Ouagadougou between January and December 2020. A total of 443 food samples were collected, of which 101 were analyzed for microbial contamination, 360 were analyzed for the presence of toxins, and 59 were analyzed for their nutritional value. The microbiological quality of 11.88% of the food samples was unsatisfactory, and 41.50% were contaminated with aflatoxins. At least 1 pesticide residue and cyfluthrin were detected in 58.10% of samples. The most detected contaminant (cyfluthrin) was found in 79.10% of the analyzed samples. A peroxide index higher than the normal value (10 mEq/kg) was found in 3.38% of the oil samples and 76.27% of the oil samples had a vitamin A content lower than the recommended limit of 11 mg/kg. This study is the first in Burkina Faso that provides baseline data on the quality of food and potential health risks to mothers and children in Burkina Faso. Considering the level of contaminants reported in this article, it is imperative to enhance routine monitoring of foods in the country.

Evaluation of Adherence of Health-Care Workers to Integrated Management of Childhood Illness Guidelines in the Context of the Free Care Program in Burkina Faso.

To reduce child mortality in children younger than 5 years, Burkina Faso has been offering free care to this population of children since 2016. The free care program is aligned with the Integrated Management of Childhood Illness (IMCI) guidelines. Given that the number of studies that evaluated the competence of health-care workers (HCWs) during the free care program was limited, we assessed the adherence level of HCWs to the IMCI guidelines in the context of free care. This was a secondary data analysis. Data were obtained from a cross-sectional study conducted from July to September 2020 in 40 primary health-care centers and two district hospitals in the Hauts-Bassins region in Burkina Faso. Our analysis included 419 children younger than 5 years old who were consulted according to IMCI guidelines. Data were collected through direct observation using a checklist. The overall score of adherence of HCWs to IMCI guidelines was 57.8% (95% CI, 42.6-73.0). The mean adherence score of the evaluation of danger signs was 71.9% (95% CI, 58.7-85.1). The mean adherence score of following IMCI guidelines was significantly greater in boys (54.2%) compared with girls (44.6%; P < 0.001). Adherence scores of the performance of different IMCI tasks were significantly different across HCW categories. The overall adherence of HCWs to IMCI guidelines in the context of free care was greater than the adherence reported before the implementation of free care in Burkina Faso. However, this assessment needs to be performed nationwide to capture the overall adherence of HCWs to IMCI guidelines in the context of the free care program.

[The challenge of intersectorality in the formulation of policies favourable to the health of older persons in west africa: the case of Burkina Faso]. / Le defi de l'intersectorialite dans la formulation des politiques favorables a la sante des personnes agees en afrique de l'ouest : cas du Burkina Faso.

AIM: The aim of this study was to contribute to a better development of health policies for the elderly in Burkina Faso. MATERIAL AND METHODS: We have done a qualitative cross-sectional study from February to September 2018 in 4 ministerial departments of Burkina Faso (health, human rights, public service and national solidarity). The interviews included non-governmental organisations, associations, technical and financial partners. Inductive approach has used to produce results. RESULTS: A total of 24 key informants were included in the study. Various interventions were implemented differently by the departmental departments. The study identified non-functional interdepartmental consultation frameworks as mechanisms for consultation. These frameworks have not been used in the formulation or implementation of policies for the elderly. CONCLUSION: National coordination of public policies for the elderly in high level of decision-making is important. The activation of interdepartmental consultation frameworks is a necessity for formulating holistic and complementary interventions for the elderly and even beyond this target group.

BUT: Le but de cette étude était de contribuer à une meilleure élaboration des politiques publiques de santé en faveur des personnes âgées au Burkina Faso. MATÉRIELS ET MÉTHODES: il s'est agi d'une étude transversale qualitative de Février à Septembre 2018 dans 4 départements ministériels du Burkina Faso (la santé, les droits humains, la fonction publique et la solidarité nationale). Les entretiens ont inclus des organisations non gouvernementales, des associations, des partenaires au développement. L'approche inductive a été utilisée pour produire les résultats. RÉSULTATS: Au total 24 informateurs clés étaient inclus dans l'étude. Diverses interventions étaient mises en œuvre différemment par les départements ministériels. L'étude a mis en évidence des cadres de concertations interministériels non fonctionnels. Ces cadres n'ont pas été utilisés ni dans la formulation, ni dans la mise en œuvre des politiques en faveur des personnes âgées dans les différents ministères. CONCLUSION: L'absence de coordination interministérielle entre les ministères chargés des politiques publiques en faveur de la santé des personnes âgées et le faible engagement de l'Etat et des partenaires au développement étaient des limites relevées dans cette étude. La définition d'une politique publique de santé des personnes âgées à dimension intersectorielle s'avère nécessaire au Burkina Faso.

Design and challenges of a large HIV prevention clinical study on mother-to-child transmission: ANRS 12397 PROMISE-EPI study in Zambia and Burkina Faso.

Post-natal HIV infection through breastfeeding remains a challenge in many low and middle-income countries, particularly due to non-availability of alternative infant feeding options and the suboptimal Prevention of Mother to Child Transmission of HIV-1 (PMTCT) cascade implementation and monitoring. The PROMISE-EPI study aims to address the latter by identifying HIV infected mothers during an almost never-missed visit for their infant, the second extended program on immunization visit at 6-8 weeks of age (EPI-2). The study is divided into 3 components inclusive of an open-label randomized controlled trial aiming to assess the efficacy of a responsive preventive intervention compared to routine intervention based on the national PMTCT guidelines for HIV-1 uninfected exposed breastfeeding infants. The preventive intervention includes: a) Point of care testing for early infant HIV diagnosis and maternal viral load; b) infant, single-drug Pre-Exposure Prophylaxis (PrEP) (lamivudine) if mothers are virally unsuppressed. The primary outcome is HIV-transmission rate from EPI-2 to 12 months. The study targets to screen 37,000 mother/infant pairs in Zambia and Burkina Faso to identify 2000 mother/infant pairs for the clinical trial. The study design and challenges faced during study implementation are described, including the COVID-19 pandemic and the amended HIV guidelines in Zambia in 2020 (triple-drug PrEP in HIV exposed infants guided by quarterly maternal viral load). The changes in the Zambian guidelines raised several questions including the equipoise of PrEP options, the standard of care-triple-drug (control arm in Zambia) versus the study-single-drug (intervention arm). Trial registration number (www.clinicaltrials.gov): NCT03869944. Submission category: Study Design, Statistical Design, Study Protocols.

[Epidemiologic Weight Of Noncommunicable Diseases In Burkina Faso : National STEPS Survey 2013]. / Poids Epidemiologiques Des Maladies Non Transmissibles Au Burkina Faso. Enquete Nationale STEPS 2013.

AIM: This study aimed to analyze the extent of major noncommunicable diseases and their common risk factors in Burkina Faso. MATERIALS AND METHODS: It was an analysis based on secondary data from the 2013 national STEPS survey in Burkina Faso. The analysis conducted in 2018 concerned behavioral risk factors and metabolic factors. A multiple regression model was used to determine the independent factors associated with these diseases. RESULTS: The independent variables associated with behavioral risk factors were 1) young age(OR=0, 4423; p< 0,001) and males(OR=0,0030 ; p< 0,001) for smoking, 2) older age (OR= 2,01 ; p= 0,0066 and OR=2,18 ; p< 0,001) and males(OR=2,18 ; p< 0,001) for drinking and harmful use of alcohol, and 3) young age(OR=0,34 ; p< 0,001) and the urban environment(OR=1,57 ; p= 0,0236) for physical inactivity. The independent variables associated with metabolic risk factors were 1) young age (OR=1,33 ; p= 0,0295) and urban (OR=0,31 ; p<0,001) for overweight, 2) female(OR=2,55 ; p= 0,0010) and urban(OR= 0,13; p< 0,001) for obesity, and 3) advanced age(OR=2,49 ; p< 0,001and OR= 2,12 ; p= 0,0115), and urban setting(OR=0,47 ; p< 0,001 and OR= 0,49 ;p= 0,0320) for high blood pressure and diabetes. CONCLUSION: In Burkina Faso, prevention and health promotion actions to reduce these risk factors need to be stepped up with a multi-sectoral approach.

BUT: L'objectif de cette étude était d'analyser l'ampleur des principales maladies non transmissibles et leurs facteurs de risque communs au Burkina Faso. MATÉRIELS ET MÉTHODES: il s'agissait d'une analyse basée sur des données secondaires de l'enquête par étape (STEPS)au Burkina Faso réalisée en 2013. L'analyse a concerné les facteurs de risques comportementaux et métaboliques. Un modèle de régression multiple a été utilisé pour déterminer les facteurs indépendants associés à ces maladies. RÉSULTATS: Les variables indépendantes associées aux facteurs de risque comportementaux étaient 1) le jeune âge (OR=0,4423 ; p< 0,001) et le sexe masculin (OR=0,0030 ; p< 0,001)pour le tabagisme, 2) l'âge avancé (OR= 2,01 ; p= 0,0066 et OR=2,18 ; p< 0,001) et le sexe masculin (OR=2,18 ; p< 0,001) pour la consommation et l'usage nocif d'alcool et 3) le jeune âge (OR=0,34 ; p< 0,001)et le milieu urbain(OR=1,57 ; p= 0,0236) pour l'inactivité physique. Les variables indépendantes associées aux facteurs de risque métaboliques étaient 1) le jeune âge (OR=1,33 ; p= 0,0295) et le milieu urbain (OR=0,31 ; p< 0,001) pour le surpoids, 2) le sexe féminin (OR=2,55 ; p= 0,0010) et le milieu urbain (OR= 0,13; p< 0,001) pour l'obésité et 3) l'âge avancé (OR=2,49 ; p< 0,001 et OR= 2,12 ; p= 0,0115) et le milieu urbain (OR=0,47 ; p< 0,001 et OR= 0,49 ;p= 0,0320) pour l'hypertension artérielle et le diabète. CONCLUSION: Au Burkina Faso, des actions de prévention et de promotion de la santé doivent être accentuées avec une approche multisectorielle pour lutter contre ces facteurs de risque.