Incidence, prevalence, and mortality of type 1 diabetes in children and youth in Burkina Faso 2013-2022.

AIM: There are no data on type 1 diabetes (T1D) incidence and prevalence in Burkina Faso. We aimed to determine these in persons aged <25 years (y) since the implementation of Life for a Child (LFAC) program in 2013. PATIENTS AND METHODS: Data were collected from the prospective program register. Diagnosis of T1D was clinical, based on presentation, abrupt onset of symptomatic hyperglycemia, need for insulin replacement therapy from diagnosis, and no suggestion of other diabetes types. RESULTS: We diagnosed 312 cases of T1D <25y in 2013-2022. Male-to-female ratio was 1:1. T1D incidence <25y per 100,000 population/year increased from 0.08 (CI 95% 0.07-0.60) in 2013 to 0.34 (CI 95% 0.26-0.45) in 2022 (p=0.002). Incidence <15y/y rose from 0.04 (CI 95% 0.01-0.10) to 0.27 (CI 95% 0.18-0.38) per 100,000/year in 2013 and 2022, respectively (p < 0.002). Prevalence per 100,000 population <25y was 0.27 (CI 95% 0.19-0.37) in 2013 and rose to 1.76 (CI 95% 1.546-1.99) in 2022 (p<0.0001). Mortality rate was 20 (CI 95% 13-29.6) per 1,000-person y. CONCLUSIONS: There is a low but sharply rising T1D incidence and prevalence rates in children and youth in Burkina Faso since LFAC program implementation. It is very likely this is partly due to improved case detection. Mortality remains substantial.

Comparison of regular with NPH insulin vs. premix insulin in children and adolescents with type 1 diabetes in a resources-limited setting: a retrospective data analysis.

OBJECTIVES: Few studies addressed the efficacy of human insulin regimens (mostly premix insulin) used in many low-and-middle income countries on glycemic control of children and adolescents with diabetes. The aim of this study was to assess the efficacy of the premix insulin on the glycated hemoglobin (HbA1c) in comparison to the regular with NPH insulin scheme. METHODS: A retrospective study was carried out from January 2020 to September 2022 on patients with type 1 diabetes aged below 18 years followed in Burkina Life For A Child program. They were categorized into three groups, on regular with NPH insulin (Group A), on premix insulin (Group B) and on regular with premix insulin (Group C). Outcome was analyzed based on HbA1c level. RESULTS: Sixty-eight patients with a mean age of 15.38 ± 2.26 years and the sex ratio (M/W) 0.94 were studied. There were 14 in Group A, 20 in Group B, and 34 patients in Group C. The mean HbA1c value in the corresponding insulin regimen was 12.8 ± 1.39%, 9.87 ± 2.18%, and 10.66 ± 2.1%, respectively. Glycemic control was better in Groups B and C than Group A (p<0.05) but there was no difference between groups B and C. CONCLUSIONS: Our results indicate that the use of premix insulin gives a better glycemic control than NPH insulin. However, further prospective study of these insulin regimens with a strengthening education strategy and glycemic control by continuous glucose monitoring and HbA1c is required to corroborate these preliminary findings.

Otomycosis in Africa: Epidemiology, diagnosis and treatment.

This review sets out to highlighted knowledge gaps regarding the epidemiological, diagnostic (clinical and laboratory) and therapeutic aspects of otomycosis in Africa. A computerized literature search for otomycosis related articles were performed using MEDLINE. The search encompassed articles published in early January 1980 to May 2019 yielded 220 articles. Electronic search on PubMed was performed with the specific keywords. This review shows the higher prevalence rates of otomycosis in Africa. These prevalences varies from one country to the other and also from one population to another within the same country. The main symptoms are otalgia, otorrhea, hearing loss, aural fullness, pruritus, and tinnitus. Otomycosis is due to several predisposing factors, however, use of topical antibiotic/steroid eardrops, trauma to the external ear canal or instrumentation of the ear, being exposed to hot humid atmospheres, and close contact with water are the common risk factors. Aspergillus species are the most commonly identified organisms compared with Candida species. Worldwide, A. niger and C. albicans are the most commonly described agents of otomycosis in Africa. The Laboratory diagnosis of otomycosis is usually confirmed by mycologic tests relied on a set of evidences. Further conventional methods such as Chromagar Candida System, latex agglutination test, Biochemical tests (Api 20C AuxTM and auxanogram), phenotypical tests (Germ-tube and chlamydosporulation), and rRNA gene sequencing (PCR) are performed to improve diagnosis and the management of the disease. Adequate treatment of otomycosis includes microscopic suction clearance of fungal mass, discontinuation of topical antibiotics and treatment with antifungal eardrops for three weeks.

Severe dengue in adults and children, Ouagadougou (Burkina Faso), West Africa, October 2015-January 2017.

Introduction: Although dengue is the most common arbovirus infection worldwide, studies of severe dengue in Africa are lacking, and risk factors for severe dengue have been insufficiently described. This study was conducted in the context of the 2016 dengue epidemic in Burkina Faso to determine the prevalence of severe dengue, identify factors associated with severe dengue, and perform mapping of dengue cases in the country's capital, Ouagadougou. Methods: This cross-sectional study was conducted from November 2015 to January 2017. Data were collected in 15 public and private health centres, and included sociodemographic, clinical and patient outcome variables. Dengue was diagnosed using SD Bioline Dengue Duo rapid diagnostic tests. Data were analysed using Epi-Info Version 7. Logistic regression was used to identify predictors of severe dengue. P<0.05 was considered significant. Dengue case mapping was performed using Geographic Information System software (ArcGIS). Results: Of the 811 patients who tested positive for dengue, 609 (75%) had early dengue (AgNS1 positive) and 272 (33.5%) had severe dengue. Patient age ranged from 1 to 83 years (median 30.5 years) and 393 (48.3%) were female. Renal failure (13.1%) and severe bleeding (10.6%) were the most common signs of severe dengue. Risk factors for severe dengue included age, male sex, haemoglobin S, diabetes, hypertension, and primary dengue. Dengue cases were more concentrated  in sectors located in the centre of the city and close to the health centres. Conclusion: Dengue is increasingly common in Africa and factors associated with severity should be sought systematically as soon as a patient tests positive. Additional studies are needed to determine if the factors found to be associated with severity can be used to identify patients at risk for dengue-related complications, and to provide early and specialized management to reduce morbidity and mortality related to dengue in Africa.

[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.

[Prevalence and factors associated with missed opportunities for vaccination at Niamey, Niger]. / Prevalence et facteurs associes aux occasions manquees de vaccination (OMV) a Niamey au Niger.

AIM: determine the prevalence and factors associated with missed opportunities for vaccination of children 0-23 months old in the health district Niamey 2 (Niger) in 2018. MATERIALS AND METHODS: It was a cross - sectional study conducted in the health district of Niamey 2 in 2018. All children aged of 0 - 23 months which had parents aged more than 15 years old, who accepted to answer our questions were included. RESULTS: The prevalence of the missed opportunities immunization was 42.8%. Parent's perception on health services, the long waiting time, the refusal of immunization, the date of next appointment were the factors associated with the missed opportunities immunization. CONCLUSION: Taking into consideration the results of this study, the missed opportunities immunization remain important public health problems in Niger. Some actions need to be taken to improve the sensitization of communities about children immunization completeness.

BUT: déterminer la prévalence et les facteurs associés aux occasions manquées de vaccination selon la communauté (OMV) chez les enfants de 0 - 23 mois. MATÉRIELS ET MÉTHODES: Il s'est agi d'une étude descriptive transversale à visée analytique chez les enfants de 0 à 23 mois et leurs parents dans le district sanitaire Niamey 2 du 01 juin au 31 août 2018. Etaient inclus tous les enfants de 0 - 23 mois et leurs parents âgés de plus de 15 ans, acceptant de répondre à nos questions. RÉSULTATS: La prévalence des OMV était de 42,8%. Les perceptions des parents vis-à-vis des services de vaccination, le long temps d'attente, le refus de vaccination, la courtoisie des agents en demandant le carnet de vaccination des enfants, la date du prochain rendez ­ vous de même que la satisfaction des parents des services de vaccination étaient statistiquement liés aux occasions manquées de vaccination. CONCLUSION: Au regard de nos résultats, les occasions manquées de vaccination demeurent un problème de santé publique au Niger. Il revient donc aux autorités sanitaires la mise en œuvre des programmes d'intensification de sensibilisations communautaires pour assurer aux enfants une bonne complétude vaccinale.

Dengue infection during pregnancy in Burkina Faso: a cross-sectional study.

BACKGROUND: Dengue fever is prevalent in the world; in recent years, several outbreaks occurred in West Africa. It affects pregnant women. We aimed to assess the consequences of dengue fever on pregnant women and their fetuses during dengue epidemic in Burkina Faso. METHODS: We conducted a cross-sectional study from November 1, 2015 to January 31, 2017 in 15 public and private health facilities in Ouagadougou, using secondary data. Immunochromatographic rapid test Duo detecting specific antibodies, immunoglobin M/G and /or dengue non structural antigen1 virus was used to diagnose dengue cases. RESULTS: Out of 399 (48%) women registered during the study period, 25 (6%) were pregnant. The average age of pregnant women was 30 years, with 18 and 45 years as extremes. The main symptoms were fever (92%) and headache (92%). Nine patients (36%) had severe dengue characterized by bleeding (16%), neurological symptoms (16%) and acute respiratory distress (8%). Eight (32%) of the 25 women had early miscarriage and 8 (32%) women gave birth to viable fetuses. Among those with viable babies, 5 (20%) presented post-partum hemorrhage and 3 (12%) presented early delivery. The main fetal complications included 3 cases of acute fetal distress (12%). One case of maternal death (4%) and 4 cases of neonatal mortality (44.5%) were notified. CONCLUSION: Dengue fever occurring during pregnancy increases maternal and neonatal mortality. Its severe complications require specific monitoring of pregnant women until delivery.

[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.

Poids épidémiologiques des maladies non transmissibles au Burkina Faso. Enquête nationale steps 2013

But : L'objectif de cette étude était d'analyser l'ampleur des principales maladies non transmissibles 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

Epidemiology and molecular characterization of influenza viruses in Burkina Faso, sub-Saharan Africa.

BACKGROUND: The importance of influenza viruses in respiratory infections in sub-Saharan Africa has been historically overlooked, including in Burkina Faso. OBJECTIVES: This study therefore aimed at evaluating the prevalence and seasonal occurrence of influenza viruses in children under 5 years old, at risk of influenza-related complications, presenting with influenza-like illness (ILI) or severe acute respiratory infection (SARI). The study also aimed at identifying the periods with increased influenza transmission for vaccination recommendations in Burkina Faso. METHODS: From January 2014 to December 2015, ILI and SARI (2015 only) patients were recruited in six healthcare centers in Burkina Faso. Influenza A and B molecular detection and subtyping were performed. Clade clustering of a subset of A(H1N1)pdm09 and A(H3N2) strains was deduced by performing phylogenetic analyses on hemagglutinin gene sequences. Weekly surveillance data from FluNet (2011-2013; 2016) and this study (2014-2015) were used to identify periods of increased influenza activity. RESULTS: Influenza A and B viruses were detected in 15.1% (112 of 743) of ILI and 6.6% (12 of 181) of SARI patients. Overall, influenza A viruses were largely predominant (81 of 124, 65.3%), with 69.1% of A(H3N2) and 30.9% of A(H1N1)pdm09 strains. Four waves of increased transmission were identified in 2014-2015, each dominated by different influenza subtypes and clades. Between 2011 and 2016, periods of increased influenza activity varied in their frequency, duration, and timing. CONCLUSION: Influenza A and B viruses were detected in a substantial number of ILI and SARI cases in Burkina Faso. Vaccination in September-October would likely protect the highest number of patients.

[Prevalence and knowledge of arterial hypertension in the elderly: cross-sectional study conducted in Bobo-Dioulasso, Burkina Faso]. / Prévalence et connaissances de l'hypertension artérielle chez les personnes âgées: étude transversale menée à Bobo-Dioulasso, Burkina Faso.

This study aims to determine the prevalence of arterial hypertension (AH) in the elderly people as well as their knowledge of this disease. We conducted a cross-sectional, descriptive study in the town of Bobo-Dioulasso from October to November 2015 at the intervention sites of the Association of Medical Assistance to elderly people "KAFOLI". Patients aged 60 years and more, with or without hypertension, who wished to participate in the study were included. Subjects were considered to be hypertensive when they had systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥90 mmHg or when they were under antihypertensive treatment. Socio-demographic and clinical data as well as the risk factors associated with the disease were collected. Knowledges on arterial hypertension were based on general knowledges about arterial hypertension as sources of information about it. A total of 88 subjects were included in this study. The study involved 56 women and 32 men (sex ratio 0.57). The average age of patients was 71 years (IQR:66-76). The prevalence of arterial hypertension was 61,36% and it was associated with knowledges about AH and with alcohol consumption; 68.18 % of patients had knowledge of AH. The majority of them were followed up in first-level health care nursing centres (64,81%). This study highlighted a high prevalence of hypertension in elderly people living in Bobo-Dioulasso. The majority of these persons were aware of this disease. In the majority of cases follow-up was ensured by nursing staff.

[Electrocardiography coupled with transthoracic echocardiography at rest in the diagnosis of cardiac impairments in type 2 diabetics: lessons learned from a cross-sectional case series in Burkina Faso]. / Electrocardiographie couplé à l'échocardiographie transthoracique de repos dans le diagnostic des atteintes cardiaques chez le diabétique de type 2: les enseignements d'une série transversale au Burkina Faso.

Diabetes is a powerful independent cardiovascular risk factor. The aim of this study is to describe the electrocardiographic and echocardiographic abnormalities observed in patients with type 2 diabetes treated in the Department of Medicine at the University Hospital in Bobo-Dioulasso. We conducted a descriptive cross-sectional study of all patients with type 2 diabetes who gave consent from April to September 2014. We gathered clinical data from all the patients. They, moreover, underwent electrocardiography and doppler echocardiography. A total of 155 diabetics were investigated. The average age of patients was 55 years (IQR: 47-64) with a female predominance (sex ratio 0.5). Electrocardiographic abnormalities included repolarization abnormalities (31%) and atrial rhythm disorders (16,12%). Echocardiographic examination showed left ventricular hypertrophy (LVH) in 20,64% of cases. Left atrium was dilated in 14.19% of cases, LV was dilated in 1.3% of cases. Abnormal left ventricular ejection fraction was detected in 3.87% of cases. Nosological entities included hypertensive heart disease in 27 cases (54%), ischemic heart disease in 19 cases (38%), dilated cardiomyopathy in 2 cases (4%) and diabetic cardiomyopathy in 2 cases (4%). Heart failure was detected in 22 cases (44%) independently from cardiac impairment. Electrocardiographic and echocardiographic abnormalities are frequent in type 2 diabetes population at the University Hospital in Bobo-Dioulasso. Improved cooperation between cardiologists and diabetologists as well as the establishment of adequate technical screening equipment would be prerequisite for better cardiac risk stratification in this population.

[Patient complaints: an opportunity to improve the quality of care of older people with multimorbidity in Burkina Faso]. / Plaintes des patients: une opportunité pour améliorer la qualité des soins des personnes âgées avec des multimorbidités au Burkina Faso.

INTRODUCTION: Little data exist on patient complaints to identify the strategy for the improvement of the quality of care of older people with multimorbidities. The aim of this study was to investigate the complaints of older people with multimorbidities at the health care facilities in Bobo-Dioulasso, Burkina Faso. METHODS: We conducted a cross-sectional study in the health care facilities in Bobo-Dioulasso from November 2013 to February 2014. Older people aged 60 years or more, with at least a chronic disease, examined in ambulatory or in hospital during the study period were included. Qualitative interviews were conducted using a semi-structured questionnaire. A content analysis was performed. RESULTS: We recorded the complaints related to long waiting time for health care, unsuitable hospital transfer service, lack of shared information on diseases and unsuitable hospitality conditions for older patients come to consultation and hospitalization. CONCLUSION: Improvement strategies should include the renovation and extension of the waiting rooms in the health care facilities, the separation of chronic care practice from acute care practice in ambulatory and in hospital, the support to the empowerment through a better communication with the patient, a community mutual assistance group and the involvement of family members.

Pregnancy rate and birth outcomes among women receiving antiretroviral therapy in Burkina Faso: a retrospective cohort study.

INTRODUCTION: In Sub-Saharan Africa, few studies reported pregnancy incidence and outcomes in women taking antiretroviral therapy (ART). This survey aims to estimate the incidence and outcomes of pregnancy in a cohort of HIV positive women initiating ART in Bobo-Dioulasso, Burkina Faso. METHODS: We carried out a retrospective cohort study. We selected women in childbearing age initiating ART and followed up in Bobo-Dioulasso teaching hospital between January 2005 and June 2011. The incidence of pregnancies during follow-up was calculated. Childbirth was defined by the expulsion of a fetus after 22 weeks of amenorrhea. Before this term, it is an abortion. Childbirth is said premature if it occurs before 37 weeks of gestation, to term if it occurs between the 38th and the 42nd week. The annual age-standardized fertility rates were calculated using the baseline population from the 2010 demographic and health survey (DHS) in Burkina Faso. RESULTS: A total of 1,763 women of childbearing age under ART were included in the study. They ranged between 18 and 48 years old with a median of 35 years old. A total of 222 pregnancies were observed during 4639 women-years of follow-up, corresponding to an incidence density of 5 pregnancies for 100 women-years (95% CI: 4.2-5.5). Among the 222 pregnancies recorded, 9(4.0%) ended with abortion, 205(92.4%) with childbirth (including 15 premature childbirths); the outcome of 8(3.6%) pregnancies were unknown abortion. Live birth and stillborn rates were 94.0% (193/205) and 6.0% respectively. The standard fertility rate in our cohort was 45 live births for 1,000 women-years. The general decrease in fertility rates was 66.0% among women infected with HIV compared to the overall population. CONCLUSION: This study shows a low pregnancy incidence among women initiating ART as compared to their peers from the general population. Pregnancies that occurred during ART generally end with live births. Care packages for HIV infected women of childbearing age must include reproductive health services to better address this issue.

[Potentially inappropriate medication use in elderly care in Burkina Faso]. / Utilisation des médicaments potentiellement inappropriés dans les soins gériatriques au Burkina Faso.

These results suggest approaches to encourage the development of care provider skills, standardized practices and rational prescription to help improve medication use in the elderly..

[Quality of chronic patient care according to the Chronic Care Model in Burkina Faso]. / Qualité de la prise en charge des malades chroniques au Burkina Faso selon le Chronic Care Model.

INTRODUCTION: There is a lack of organizational knowledge concerning optimal management by the health care system for patients with chronic health conditions in sub-Saharan Africa. The objective of this study was to describe the quality of chronic patient care at first-line heath facilities in Bobo-Dioulasso, Burkina Faso. METHODS: We conducted a cross-sectional study in six health facilities in Bobo-Dioulasso from October to November 2013. The chronic care model was used as a reference to describe the care of hypertensive patients. A score was calculated for each item in the model, and the strengths and weaknesses of health care organization were identified RESULTS: The overall level of support for the management of hypertensive patients was "basic" for all surveyed structures: median score and IQR 3.7 (3.4, 4.4). The level of support was basic for primary health facilities (median score 4.4), district hospitals (median score 4.1) and the University health center (median score 5.4). The relationship with the community and support to decision-making were identified as weak components of the model. CONCLUSIONS: To improve the quality of chronic patient care in first-line health facilities in Burkina Faso, efforts must be made to strengthen clinical governance and partnership with the community.

Caractéristiques thérapeutiques des diabétiques suivis au chu de Bobo-Dioulasso, Burkina Faso

Objectif. Le diabète est un problème majeur de santé publique, notamment dans les pays à ressources limitées d'Afrique, où sa prévalence ne cesse de croitre. L'objectif de notre étude était de déterminer les caractéristiques thérapeutiques des diabétiques suivis au Centre Hospitalier Universitaire de Bobo-Dioulasso, au Burkina Faso.Méthodes. Nous avons entrepris une étude transversale descriptive de septembre 2010 à juillet 2011, dans le Département de Médecine dudit centre hospitalier, qui a concerné 388 diabétiques consentants, suivis dans le département depuis au moins un an. Les données ont été collectées par revue documentaire, interview, examens physique et complémentaires.Résultats. L'âge moyen des sujets était de 53,5±13,5 ans. Les femmes étaient majoritaires et représentaient 58,0% de l'effectif. Le diabète de type 2 représentait 91,2% des cas, celui de type 1 8,5% des cas. Tous les patients ont déclaré suivre un régime sans sucre d'absorption rapide. Près de sept diabétiques de type 2 sur dix, étaient sous antidiabétiques oraux, à base de biguanides et/ou de sulfamides hypoglycémiants. L'insulinothérapie faisait appel essentiellement aux insulines ordinaire et intermédiaire. L'administration de l'insuline était assurée par le patient lui-même dans environ deux-tiers des cas, cette différence étant statistiquement associée à l'ancienneté du diabète. Seuls 1,5% des diabétiques bénéficiaient d'une assurance-maladie.Conclusion. La prise en charge du diabète est essentiellement assurée par le patient et sa famille au Centre Hospitalier Universitaire de Bobo-Dioulasso. La mise en place de structures de soutien telles l'assurance maladie et les mutuelles de santé, permettrait de soutenir les sujets souffrant de cette pathologie chronique grave

Pneumococci in the African meningitis belt: meningitis incidence and carriage prevalence in children and adults.

BACKGROUND: The development of optimal vaccination strategies for pneumococcal conjugate vaccines requires serotype-specific data on disease incidence and carriage prevalence. This information is lacking for the African meningitis belt. METHODS: We conducted hospital-based surveillance of acute bacterial meningitis in an urban and rural population of Burkina Faso during 2007-09. Cerebrospinal fluid was evaluated by polymerase chain reaction for species and serotype. In 2008, nasopharyngeal swabs were obtained from a representative population sample (1 month to 39 years; N = 519) and additional oropharyngeal swabs from 145 participants. Swabs were evaluated by culture. RESULTS: Annual pneumococcal meningitis incidence rates were highest among <6-month-old (58/100,000) and 15- to 19-year-old persons (15/100,000). Annual serotype 1 incidence was around 5/100,000 in all age groups. Pneumococcal carriage prevalence in nasopharyngeal swabs was 63% among <5-year-old children and 22% among ≥5-year-old persons, but adding oropharyngeal to nasopharyngeal swabs increased the estimated carriage prevalence by 60%. Serotype 1 showed high propensity for invasive disease, particularly among persons aged ≥5 years. CONCLUSIONS: Serotype 1 causes the majority of cases with a relatively constant age-specific incidence. Pneumococcal carriage is common in all age groups including adults. Vaccination programs in this region may need to include older target age groups for optimal impact on disease burden.

Emergence of epidemic Neisseria meningitidis serogroup X meningitis in Togo and Burkina Faso.

Serogroup X meningococci (NmX) historically have caused sporadic and clustered meningitis cases in sub-Saharan Africa. To study recent NmX epidemiology, we analyzed data from population-based, sentinel and passive surveillance, and outbreak investigations of bacterial meningitis in Togo and Burkina Faso during 2006-2010. Cerebrospinal fluid specimens were analyzed by PCR. In Togo during 2006-2009, NmX accounted for 16% of the 702 confirmed bacterial meningitis cases. Kozah district experienced an NmX outbreak in March 2007 with an NmX seasonal cumulative incidence of 33/100,000. In Burkina Faso during 2007-2010, NmX accounted for 7% of the 778 confirmed bacterial meningitis cases, with an increase from 2009 to 2010 (4% to 35% of all confirmed cases, respectively). In 2010, NmX epidemics occurred in northern and central regions of Burkina Faso; the highest district cumulative incidence of NmX was estimated as 130/100,000 during March-April. Although limited to a few districts, we have documented NmX meningitis epidemics occurring with a seasonal incidence previously only reported in the meningitis belt for NmW135 and NmA, which argues for development of an NmX vaccine.