Field sensitivity and specificity of the SD BIOLINE onchocerciasis IgG4 Rapid Diagnostic Test in children <10 years old from endemic areas in Burkina Faso.

Skin biopsies (Skin snips) have historically been the gold standard for the diagnosis of onchocerciasis. However, in low prevalence areas and in areas with successful ivermectin mass drug administration (MDA) programs, skin snips are not sensitive enough to decide when to stop MDA; thus, serological diagnostic tools have been recommended for this purpose. This study assessed the sensitivity and specificity of the Ov16 Rapid Diagnostic Test (SD BIOLINE Onchocerciasis RDT) compared to skin snip in endemic areas undergoing ivermectin mass distribution using Community Directed Treatment with Ivermectin (CDTI) strategy. A cross-sectional study was conducted between September and November 2016 in five endemic villages in the Cascades region in Burkina Faso. Children aged 2 to 9-years were examined during the impact epidemiological survey using both the skin snip and Ov16 Rapid Diagnostic Test. The Ov16 Rapid Diagnostic Test sensitivity and specificity were determined with reference to the skin biopsy. Skin snip positivity was 1.25% in this population, while seroprevalence was 6.5%. When compared to the skin snip as the gold standard, the sensitivity of the Ov16 Rapid Diagnostic Test was 60% and the specificity 94%. When the Ov16 Rapid Diagnostic Test was considered as the gold standard, the skin snip exhibited a sensitivity of 11.5% and a specificity of 99.5%. These results are similar to other studies comparing the performance of the Ov16 ELISA to skin snips, suggesting that the Ov16 RDT may be a useful tool for ivermectin STOP MDA and post transmission surveys, assuming that the prevalence of infection is low or close to zero, and the Ov16 RDT detected also pre patent infections.

Mortalité à long terme des survivants d'accidents vasculaires cérébraux ischémiques à Bobo Dioulasso, Burkina Faso / Long-term mortality of ischaemic stroke survivors in Bobo-Dioulasso, Burkina Faso

Contexte et objectif. La survie à long terme des accidents vasculaires cérébraux ischémiques (AVCI) reste un défi majeur. L'objectif de ce travail était d'analyser la mortalité à long terme des survivants d'AVCI. Méthodes. Il s'est agi d'une cohorte rétrospective portant sur les patients hospitalisés du 1er janvier 2017 au 31 décembre 2019, sortis vivants du service de neurologie au Centre Hospitalier Universitaire Sourô Sanou de Bobo-Dioulasso après un AVCI. Nous avons recouru aux méthodes de Kaplan Meier et la regression de Cox pour décrire respectivement la survie et les prédicteurs de la mortalité. Résultats. Au total, 87 patients dossiers ont été colligés. L'âge moyen était de 61,2 ans (±13,7). Le sex-ratio M/F était de 1,23/1. L'hypertension artérielle était le principal facteur de risque cardiovasculaire (65,5 %). Les antécédents de cardiopathies étaient présents chez 6 patients. La conscience était normale chez 82 patients et les complications de décubitus ont été observées chez 20 patients au cours de l'hospitalisation. La durée moyenne d'hospitalisation était de 15,8 jours. La mortalité cumulée en post hospitalisation était de 40,2 % à 4 ans. Les facteurs prédictifs de la mortalité étaient l'âge > 60 ans (p=0,008; HRa= 3,05 ; IC 95 % : 1,33-6,99), le score de Glasgow>9 (p<0,001; HRa = 0,09; IC 95 % : 0,02-0,31) et l'absence de complication de décubitus (p=0,009; HRa = 0,34; IC95 % : 0,15-0,76). Conclusion. Dans ce contexte, la mortalité à long terme des AVCI est élevée. Le renforcement du suivi vis-à-vis des groupes spécifiques pourrait contribuer à réduire considérablement cette mortalité à long terme.

Context and objective. Long-term survival from ischaemic stroke remains a major challenge. The aim of this study was to analyse the long-term mortality of stroke survivors at the Sourô Sanou University Hospital in Bobo-Dioulasso. Methods. This was a retrospective cohort of hospitalized patients from January 1, 2017 to December 31, 2019, discharged alive from the neurology service after ischaemic stroke. We used Kaplan Meier and Cox regression methods to describe survival and predictors of mortality, respectively. Results. A total of 87 patients were included in this study. The mean age was 61.2 years (±13.7). The sex ratio M/F was 1.23. Hypertension was the main cardiovascular risk factor (65.5%). A history of heart disease was present in 6 patients (6.9%). Consciousness was normal in 82 patients (94.2%) and decubitus complications were observed in 20 patients (23%) during hospitalisation. The average length of hospital stay was 15.8 days. Cumulative post-hospital mortality was 40.2% at 4 years. Factors predictive of mortality were age >60 years (p=0.008; aHR= 3.05; 95%CI: 1.33-6.99), Glasgow score>9 (p<0.001; aHR = 0.09; 95% CI: 0.02-0.31) and absence of decubitus complication (p=0.009; aHR = 0.34; 95%CI: 0.15-0.76). Conclusion. In this context, long-term mortality in ischaemic stroke is high. Closer monitoring of specific groups could help to reduce considerably this long-term mortality.

Geographical and sociodemographic disparities in fruit and vegetables consumption among adults in Burkina Faso: baseline results from the 2013 WHO STEPS survey.

BACKGROUND: Evidence on sociodemographic determinants and spatial variations in the fruit and/or vegetable (FV) consumption was reported. This study aimed to explore geographical and sociodemographic disparities in the level of FV consumption among adults in Burkina Faso, using the national baseline data. METHODS: This was a cross-sectional secondary study of primary data obtained by the 2013 (September to October) World Health Organization Stepwise Approach to Surveillance survey conducted in Burkina Faso. The participants were 4402 women and men aged 25-64 years and living in all 13 Burkinabè Regions. Descriptive and analytical analyses were performed using Student's t test, ANOVA, the chi-square test, Fisher's exact test and logistic regressions. RESULTS: The prevalence of a typical daily consumption of at least three servings was 4.1% (95% CI: 3.6-4.8) for fruits and 6.6% (95% CI: 5.9-7.3) for vegetables. The national prevalence of adequate FV intake was 5.1% (95% CI: 4.4-5.8), and for two Regions ("Centre-Ouest" and "Nord") the pooled prevalence was 22.4%, while in the other eleven Regions its was significantly lower, 2.4% (p = 0.0001). Using quartiles derived from the national level of consumption, each of these two Regions had a higher proportion (about 50%) of their participants in the fourth quartile (the higher level). The associated sociodemographic factors with the adequate intake were being rural residents (aOR = 1.7, p = 0.011) and women (aOR = 1.3; p = 0.03). CONCLUSION: Except for the Regions of "Centre-Ouest" and "Nord" of Burkina Faso, the prevalence of adequate consumption of FV was very low in its other eleven Regions. Measures to increase consumption in urban people are urgent while women should be the key actor in the family-based approaches implementation and the nutrition education promoting FV consumption.

Dietary intake of preformed vitamin A and provitamin A carotenoids are not associated with serum retinol and carotenoid concentrations among children 36-59 months of age in rural Burkina Faso: a cross-sectional study.

PURPOSE: This study aimed to assess the association between dietary intake of preformed vitamin A (VA) and pro-VA carotenoids and serum retinol and carotenoid concentrations among 36-59-month-old children in a rural area in Burkina Faso. METHODS: Two community-based cross-sectional studies were conducted in a rural area of Burkina Faso and included 115 children aged 36-59 months. Dietary intake of preformed VA and pro-VA was assessed directly by 24-h dietary recall. Serum retinol and carotenoid (α- and ß-carotene, and ß-cryptoxanthin) concentrations were measured. The associations between serum retinol and carotenoid concentrations and their respective dietary intake were assessed by multiple linear regression. RESULTS: Geometric mean [95% CI] adjusted serum retinol concentration in children was 0.86 [0.81; 0.92] µmol/L. The prevalence of low adjusted serum retinol concentration (< 0.7 µmol/L) was 26.8%. Geometric mean [95% CI] serum carotenoid concentrations were: α-carotene (0.03 [0.02; 0.03] µmol/L), ß-carotene (0.14 [0.12; 0.16] µmol/L), and ß-cryptoxanthin (0.17 [0.15; 0.21] µmol/L). Dietary intakes of α- and ß-carotene and adjusted serum retinol and α-carotene concentrations were significantly higher during the rainy season. In multiple linear regressions, no associations were found between dietary intakes of preformed VA and pro-VA carotenoids and serum retinol and carotenoid concentrations in children aged 36-59 months in Burkina Faso. There was no effect of season on the associations between preformed VA and pro-VA carotenoids intake and serum retinol and carotenoid concentrations. CONCLUSIONS: This study shows that dietary intakes of preformed VA and pro-VA carotenoids based on 24-h dietary recall method cannot be used as proxy of serum retinol and carotenoid concentrations in this population. TRIAL REGISTRATION: The study was registered retrospectively (22 March 2018) as a clinical trial with the Pan African Clinical Trials Registry (Cochrane South Africa; PACTR201803002999356).

A comparison of unhealthy lifestyle practices among adults with hypertension aware and unaware of their hypertensive status: results from the 2013 WHO STEPS survey in Burkina Faso.

BACKGROUND: We compared the prevalence of unhealthy lifestyle factors between the hypertensive adults who were aware and unaware of their hypertensive status and assessed the factors associated with being aware of one's hypertension among adults in Burkina Faso. METHODS: We conducted a secondary analysis of data from the World Health Organization Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso. Lifestyle factors analysed were fruits and vegetables (FV) consumption, tooth cleaning, alcohol and tobacco use, body mass index and physical activity. RESULTS: Among 774 adults living with hypertension, 84.9% (95% CI: 82.2-87.3) were unaware of their hypertensive status. The frequencies of unhealthy lifestyle practices in those aware vs. unaware were respectively: 92.3% vs. 96.3%, p = 0.07 for not eating, at least, five FV servings daily; 63.2% vs. 70.5%, p = 0.12 for not cleaning the teeth at least twice a day; 35.9% vs. 42.3%, p = 0.19 for tobacco and/or alcohol use; 53.9% vs. 25.4%, p = 0.0001 for overweight/obesity and 17.1% vs, 10.3%, p = 0.04 for physical inactivity. In logistic regression analysis, older age, primary or higher education, being overweight/obese [adjusted odds ratio (aOR) = 3.2; p < 0.0001], intake of adequate FV servings daily (aOR = 2.9; p = 0.023) and non-use of alcohol and tobacco (aOR = 0.6; p = 0.028) were associated with being aware of one's hypertensive status. CONCLUSION: Undiagnosed hypertension was very high among Burkinabè adults living with hypertension. Those aware of their hypertension diagnosis did not necessarily practise healthier lifestyles than those not previously aware of their hypertension. Current control programmes should aim to improve hypertension awareness and promote risk reduction behaviour.

How alcohol and/or tobacco use and raised glycemia are associated with oral hygiene practices among Burkinabè adults: Evidence from the first national non-communicable disease risk factors survey.

Socio-demographic correlates with oral hygiene practices are commonly investigated. The present study aimed to determine whether alcohol and/or tobacco use and hyperglycemia were associated with oral hygiene practices among Burkinabè adults. This descriptive, cross-sectional study included 4550 adults selected through multistage cluster sampling performed during the first WHO STEPS survey conducted in 2013 in Burkina Faso. The practices we considered were the frequencies of tooth cleaning, the fluoridated toothpaste use and the dentist visit within the past-six months. We collected data on self-reported alcohol and tobacco use and measured fasting blood glucose (FBG). About 82.8% of respondent reported they cleaned their teeth at least once a day, 31.5% cleaned them at least twice a day, 25.4% used fluoridated toothpaste, 2.2% had visited a dentist in the past six months, 38.8% used either alcohol or tobacco and 8.4% had raised FBG. After adjusting for socio-demographic factors, alcohol and/or tobacco use was an unfavorable factor for tooth cleaning at least once a day [aOR = 0.7 (0.6-0.8) p < 0.001], or at least twice a day [aOR = 0.6 (0.5-0.7) p < 0.001]. Moreover, raised FBG was negatively associated with cleaning tooth at least twice a day [aOR = 0.7 (0.5-0.9) p < 0.01] or the use of fluoridated toothpaste [aOR = 0.7 (0.6-0.9) p < 0.05]. Oral health education in addition to cardiovascular risk factor reduction should be efficiently integrated in the behavioral lifestyle interventions' strategies for the non-communicable diseases' prevention.

Oral hygiene practices and their sociodemographic correlates among adults in Burkina Faso: results from the First National Survey.

BACKGROUND: Sociodemographic parameters are the driving determinants of oral hygiene practices. This study aims to describe oral hygiene practices and associated sociodemographic factors in the Burkinabè population using the first nationally representative data. METHODS: This descriptive, cross-sectional study included 4677 adults through multistage cluster sampling performed during the first WHO STEPS survey conducted in 2013 in Burkina Faso. The practices we considered were the frequencies of tooth cleaning, fluoridated toothpaste use and dentist visits within the last six months. Sociodemographic variables and oral hygiene practices were described, and the first variables were used as the explanatory variables for the seconds in the multivariable analyses. RESULTS: Individuals who cleaned teeth at least once a day represented 82.8% and at least twice a day represented 31.4%; 25.6% used fluoridated toothpaste and 2.1% visited a dentist. With the highest odds ratio, only being educated was a favourable factor for each oral hygiene practice. Living in an urban area or being a younger adult were favourable factors for cleaning teeth at least twice a day or the use of a fluoridated paste. Female gender applied more to regular tooth cleaning, as well as to dentist visits. CONCLUSION: Cleaning teeth at least once a day was common among Burkinabè, while cleaning at least twice a day, the use of fluoridated paste or dentist visits were infrequent. Education was the key favourable determinant for healthy oral hygiene practices, and improving oral health literacy interventions through basic health education should be promoted.

Mobile Monitoring of Diabetic Patients in the Active File of the Medical Center of Do (Burkina Faso).

The care of diabetic patients in peripheral medical centers in Burkina Faso faces many difficulties. This work, which is a new experience, aimed to set up an information system for the care of diabetic patients in the context of Burkina Faso. The system thus conceived consists of a web application (MedshakeEHR), used by the doctor and a mobile application (Glucosio) for the patient. The system has advantages such as remote appointment scheduling, appointment reminder, patient information sharing. The device also makes it possible to store data for the production of statistics and for scientific research. This experience has enabled us to meet certain challenges related in particular to the problem of HIS such as organizational constraints, the creation of a unique identifier, the modeling of the main business processes, etc.

Aspects épidémiologiques, cliniques et facteurs pronostiques des accidents vasculaires cérébraux ischémiques chez le sujet âgé à Bobo-Dioulasso, Burkina Faso / Epidemiological, clinical and prognosis aspects of ischemic stroke in the elderly in Bobo-Dioulasso, Burkina Faso

Contexte et objectif. Le risque d'accident vasculaire cérébral (AVC) augmente avec l'âge. Notre objectif était d'identifier les caractéristiques épidémiologiques, cliniques et les facteurs liés au pronostic vital des sujets âgés hospitalisés pour AVC ischémique (AVCI) au Centre Hospitalier Universitaire Sourô Sanou de Bobo-Dioulasso. Méthodes. Il s'est agi d'une étude rétrospective portant sur une période allant du 1er janvier 2017 au 31 décembre 2019 et concernant tous les patients âgés de 65 ans et plus hospitalisés pour AVCI. Résultats. Au total, 153 dossiers médicaux ont été colligés. L'âge moyen était de 73,9 ans. Le sex-ratio M/F était de 1,25. Les facteurs de risque cardiovasculaire étaient principalement l'hypertension artérielle chronique (61,4 %), l'alcoolisme (21,5 %), le diabète (14,3 %), et l'antécédent d'AVC (13,7 %). Le déficit moteur était le principal motif de consultation. La pathologie athéromateuse était la principale étiologie. La durée moyenne d'hospitalisation était de 16,2 jours. Le taux de mortalité intrahospitalière était de 16,9 %. La médiane de survie était de 53 jours. Les facteurs prédictifs de la mortalité étaient l'âge (p= 0,017; HR= 2,81; IC 95 %: 1,21-6,54) et le coma (p= 0,010; HR= 4,68; IC 95 %: 2,05- 43,94). Conclusion. L'AVCI chez la personne âgée à BoboDioulasso est marqué par une mortalité intrahospitalière élevée. L'optimisation de la prise en charge des patients âgés pourrait contribuer à la réduction significative de la mortalité des AVC.

Context and objective. Strokes risk increases with age. The most common one is ischemic stroke. Our objective was to identify epidemiological, clinical features and the factors linked to the prognosis for survival of older patients hospitalized for ischemic stroke in Sourô Sanou Teaching Hospital of Bobo-Dioulasso. Methods. This was an analytical historical study on older patients aged ≥ 65 years, hospitalized for ischemic stroke at Sourô Sanou Teaching Hospital of Bobo-Dioulasso during the period from January 1st , 2017 to December 31st, 2019. Results. A total of 153 patients has been involved in this study. The intrahospital ischemic stroke frequency was 68. 61 % of all strokes in elderly. The average age was 73.98 years. The sex ratio M/F was 1.25. Chronic high blood pressure (61.43 %), alcoholism (21.56 %), diabetes (14.37 %), and history of stroke (13.72 %) were the most frequent cerebrovascular risk factors in past medical history. The motor deficit represented the main reason for consultation. Atheromatous pathology was the main etiology. The mean duration of hospitalization was 16.21 days. The intrahospital mortality was 16. 99 %. Median survival was 53 days. The predictive factors of mortality were the age (p= 0.017; HR= 2.81; IC 95 %: 1.21-6.54) and coma (p= 0.010; HR= 4.68; IC95 %: 2.05-43.94). Conclusion. Stroke in the elderly at Bobo-Dioulasso is responsible for a high death rate. Optimization of management for elderly patients could contribute to a significant reduction of stroke mortality

Associations between dental problems and underweight status among rural women in Burkina Faso: results from the first WHO Stepwise Approach to Surveillance (STEPS) survey.

OBJECTIVE: To explore the relationships between dental problems and underweight status among rural women in Burkina Faso by using nationally representative data. DESIGN: This was a cross-sectional secondary study of primary data obtained by the 2013 WHO Stepwise Approach to Surveillance survey conducted in Burkina Faso. Descriptive and analytical analyses were performed using Student's t test, ANOVA, the χ2 test, Fisher's exact test and logistic regression. SETTING: All thirteen Burkinabè regions were categorised using quartiles of urbanisation rates. PARTICIPANTS: The participants were 1730 rural women aged 25-64 years. RESULTS: The prevalence of underweight was 16·0 %, and 24·1 % of participants experienced dental problems during the 12-month period. The women with dental problems were more frequently underweight (19·9 % and 14·7 %; P < 0·05) and had a lower mean BMI (21·1 ± 3·2 and 21·6 ± 3·7 kg/m2, P < 0·01) than those without dental problems. More risk factors for underweight were observed in less urbanised regions among elderly individuals (> 49 years old) and smokeless tobacco users. Age > 49 years, professions with inconsistent income, a lack of education, smokeless tobacco use and low BMI were factors that were significantly associated with dental problems, while residency in a low-urbanisation area was a protective factor. CONCLUSION: The prevalence of underweight in rural Burkinabè women is among the highest in sub-Saharan Africa, and women with dental problems are more frequently affected than those without dental problems. Public health measures for the prevention of these disorders should specifically target women aged over 49 years and smokeless tobacco users.

Post-stroke Complications and Mortality in Burkinabè Hospitals: Relationships with Deglutition Disorders and Nutritional Status.

Stroke frequently causes deglutition disorders, leading to a decline in nutritional status and complications, and increasing mortality. Sub-Saharan data are scarce. The objectives of this study were to assess complications and mortality among hospitalized patients in Burkina Faso during the first two weeks after stroke, and to investigate associated factors. Patients with stroke were followed prospectively in Ouagadougou and Bobo-Dioulasso hospitals. Deglutition disorders and nutritional parameters were assessed at baseline (D0) and on Days 8 (D8) and 14 (D14). Complications and mortality were recorded up to D14. Factors associated with complications and mortality were investigated using multivariate analysis. Of the 222 patients included, 81.5% developed at least one complication, and mortality was 17.1%. At D0, D8, and D14, the rate of deglutition disorders was 37.4%, 28.4%, and 15.8%, respectively, and that of undernourishment 25.2%, 29.4%, and 31.0%, respectively. In multivariate analysis, only the presence of deglutition disorders was a risk factor for developing at least one complication (OR = 5.47, 95% CI 1.81-16.51). Factors predicting death were the presence of deglutition disorders at D0 (OR = 7.19, 95% CI 3.10-16.66), and at least one seizure during follow-up (OR = 3.69, 95% CI 1.63-8.36). After stroke, the rates of complications, death, and undernourishment were high compared to Western countries. Prevention and management of deglutition disorders, and specific follow-up of patients with seizures could reduce post-stroke mortality.

Smokeless tobacco use: its prevalence and relationships with dental symptoms, nutritional status and blood pressure among rural women in Burkina Faso.

BACKGROUND: Sub-Saharan women use smokeless tobacco (SLT) more than smoked tobacco. Among Western African countries, the estimated weighted prevalence of SLT use in rural women was found to be the highest in Burkina Faso (after Sierra Leone). This study aimed to assess the prevalence of SLT use and its associated factors among rural women in Burkina Faso by using nationally representative data. METHODS: We used data from the 2013 STEPwise approach to Surveillance (STEPS) study, which provided sociodemographic, clinical (anthropometric, systolic blood pressure [SBP], diastolic blood pressure [DBP] and dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and tobacco and alcohol consumption data. Data for 1730 rural women were used, and we performed Student's chi-squared and logistic regression analyses. RESULTS: The prevalence of current SLT use was 13.8% (95% CI: 12.2-15.5). Significant risks for SLT use were the presence of dental symptoms (adjusted odds ratio [aOR] = 2.59; p < 0.001), undernourishment (aOR = 1.78; p < 0.01), decreased waist circumference (aOR = 0.98; p < 0.05), decreased DBP (aOR = 0.97; p < 0.01), increased SBP (aOR = 1.01; p < 0.05), and increased differential blood pressure (aOR = 1.01; p < 0.05). The co-use of alcohol was also a significant risk factor (aOR = 2.80; p < 0.001). CONCLUSION: The prevalence of current SLT use was high among rural women in Burkina Faso, and significant concerns for users included alcohol co-use, the occurrence of dental symptoms, undernourishment, and an increase in differential blood pressure. National Public Health interventions are needed to reduce SLT use and its health-related concerns.

Prevalence and factors associated with overweight and obesity among rural and urban women in Burkina Faso.

INTRODUCTION: Low- and middle-income countries, including Burkina Faso, are facing increasing urbanization with health challenges related to nutrition transition that impact body weight change. This study reported the prevalence and factors associated with overweight/obesity among women living in rural and urban Burkina Faso. METHODS: We conducted a secondary analysis using data from the Burkina Faso 2013 WHO STEPwise survey. Data included socio-demographic, clinical (anthropometric, systolic/diastolic blood pressure (SBP/DBP), oral/dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and alcohol and tobacco consumption data. A total of 2191 participants with complete data were considered in the analysis. We categorized the 13 Burkinabe regions by urbanization rate quartiles. We then performed Student's t, chi-squared, and Fisher's exact tests and backward stepwise regressions. RESULTS: The overall prevalence of overweight/obesity was 19.6% (13.1% and 44% in rural and urban women respectively, p=0.0001). Common factors positively associated with overweight/obesity in both rural and urban women were being a resident of a region in the highest urbanization rate quartile, having a high level of total cholesterol (alone or via an interaction with age) and having a high DBP. In urban women only, overweight/obesity was also associated with a high SBP. CONCLUSION: The prevalence of overweight/obesity in urban women in Burkina was among the highest levels in urban sub-Saharan Africa and roughly mimicked the urbanization profile of the country. In overweight/obesity conditions, cardiovascular concerns, such as increase in total cholesterol and blood pressure, were objective, and the blood pressure increase was more severe in urban women than in rural women.

Changes in nutritional state and dysphagia in stroke patients monitored during a 14-d period in a Burkina Faso hospital setting.

INTRODUCTION: Dysphagia and undernourishment are common in cerebrovascular accident (stroke) patients in developed countries. Despite the dietary transition, there is little information available in Africa on this topic. This study aims to assess the prevalence of undernourishment and dysphagia in stroke patients in two Burkina Faso teaching hospitals at a starting point (D0), on the eighth day, and on the 14th (D14) and to specify factors related to undernourishment at day 14. METHODOLOGY: The nutritional state of the patients was assessed using body mass index, triceps skinfold thickness, and mid-upper arm circumference. Dysphagia was identified using the Practical Aspiration Screening Schema. RESULTS: A total of 222 patients were included in the study. From D0 to D14, the prevalence of undernourishment increased from 25.2% to 31.0% and the prevalence of dysphagia decreased from 37.4% to 15.8%. All nutritional criteria worsened. In a multivariate analysis, undernourishment was more present at D14 for women (odds ratio [OR] = 7.01; 95% confidence interval [CI]: 1.51-32.56, P = 0.01) and was less present if weight (OR = 0.69; 95% CI: 0.60-0.79, P = 0.0001) or triceps skinfold thickness (OR = 0.85; 95% CI: 0.74-0.99, P = 0.03) were high at D0. CONCLUSION: The prevalence of undernourishment was high at D0 and increased during the monitoring period. It would be advisable to monitor patients' weight and triceps skinfold thickness, to optimize care for women and patients with low weight or triceps skinfold thickness at D0, to monitor dysphagia, and to inform patients, families, and relevant staff of nutritional concerns after a cerebrovascular accident.

Knowledge and practice concerning swallowing disorders in hemiplegic patients among nurses of Bobo-Dioulasso urban primary health care centers in Burkina Faso.

INTRODUCTION: The quality of management of swallowing disorders (SD) from admission onwards influences the patients' nutritional status and their prognosis. Neurological diseases are the main causes of SD, affecting one in three patients with hemiplegia (Hp). In Burkina Faso (BF), primary health care center (PHCC) nurses are the first to manage these patients, but there are no data related to their management of SD. The study aimed to assess knowledge and practices regarding SD in Hp among PHCC nurses in Bobo-Dioulasso, a main center for care of Hp in BF. METHODS: This cross-sectional study was performed August 1-September 15 2014. Subjects underwent a standardized survey to determine their knowledge and practices concerning SD in Hp. RESULTS: Of 125 nurses surveyed (83.3% of the targeted workers), 82.4% had experience of caring for Hp. The role of the central nervous system in cases of Hp and SD was recognized by 56.8% of nurses; 42.3% knew that SD can cause aspiration, and 36.0% were aware of rescue techniques to use when aspiration occurs; 39.2% correctly assessed the impact on nutritional status of SD. Knowledge in this area was better among respondents who recently completed training school. 65.6% and 1.6% respectively knew about the impact of posture and the texture of food on the ability to swallow. Among the 103 nurses with experience of treating Hp, 68.0% considered clinical interview the best way to detect SD, and 30.1% did not give the patient advice in this area. In multivariate analysis, detection of SD was associated with good knowledge of the value of voice disorders (OR = 3.5, 95% CI = 1.4-8.1; p = 0.005). CONCLUSION: Few nurses had been warned of the connection between Hp and SD, which are classic issues and potential complications. Practices varied, but most were not in accord with what are recognized as good strategies for SD screening and management. In order to improve care of Hp, neurological and nutritional training should be accompanied by specific training in SD, emphasizing screening and simple management.