[Cross-sectional study of iron level during pregnancy at the Mohamed V Military Training Hospital, Rabat]. / Etude transversale du statut martial au cours de la grossesse à l'Hôpital Militaire d'Instruction Mohamed V, Rabat.

Iron deficiency is the most widespread nutritional disorder. Anaemia during pregnancy is common in developing countries. The purpose of this study was to check iron levels during pregnancy by evaluating laboratory indicators of iron deficiency. Our study was conducted in the Department of Obstetrics and Gynaecology of the Mohamed V Military Training Hospital (MVMTH) and included 66 patients monitored during three trimesters of pregnancy. Biochemical tests including ferritin, serum iron, CRP and blood counts were performed. The average age of patients was 28.3 years, with a standard deviation of 5.2. The prevalence of iron deficiency was 15.2% (n = 10), 25.8% (n = 17) and 42.2% (n = 28) in the first, second and third trimester, respectively. Anemia progressed from 10% (n = 7), 24% (n = 16) to 42% (n = 28). ANOVA test was used to compare the means for the parameters serum ferritin and iron, hemoglobin and hematocrit within the three trimesters. This showed a significant difference with p = 0.001. This study highlights a high prevalence of iron deficiency during pregnancy, especially in the third trimester, that would justify a systematic iron supplementation.

Assessment of heterocyclic aromatic amines contents in flamed and braised chicken in Burkina Faso.

The nutritional status of meat is tarnished by its association with the induced cooking contaminants. The aim of this study was to assess the heterocyclic aromatic amines profile and contents in processed chicken in Burkina Faso. Eight polar and apolar heterocyclic aromatic amines (HAAs) including 2-mino-3-methylimidazo[4,5-f]quinolone (IQ), 3-amino-1,4-dimethyl-5H-pyrido[4, 3-b]indole (Trp-P1), 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P2), 2-mino-9H-pyrido-[2,3-b]indole (AαC), 2-amino-1-methyl-6-phenylimidazo[4, 5- ]pyridine (PhIP), 2-amino-3-methyl-9H-pyrido[2,3-b] indole (MeAαC), 2-amino-3,4,8-rimethylimidazo[4,5-f]quinoxaline (4,8-DiMeIQx) and 2-amino-3,8-imethylimidazo[4,5-]quinoxaline (MeIQx) were screened by high performance liquid chromatography from 29 samples of flamed chicken and 66 samples of braised chicken collected in Ouagadougou city. Apolar HAAs and polar HAAs were respectively 12 and 3 times more abundant in flamed chickens (32.66±10 and 3.48±10.39 ng/g, respectively) than in braised chickens (2.70±9.67 and 0.92 ng/g, respectively). The maximum levels of AαC were in the same proportions in flamed (12.01 ng/g) and braised chickens (14.13 ng/g). Flamed chicken had the highest Trp-P1 content (530.31 ng/g). The 4,8-DiMeIQx was not detected in braised chicken. The AαCs were more abundant in flamed than in braised chicken. The profile and the contents of the HAAs in processed chicken are related to cooking methods. Because of the high variability observed on the obtained concentrations, investigations on the contents of precursors in raw chicken, the effect of marinating ingredients on the formation of HAAs are needed.

Pesticide residues in commonly consumed food from five localities of Burkina Faso: occurrence and health risk assessment.

Monitoring data for pesticides are generally scarce in many countries of the world, especially in developing countries. In Burkina Faso, there are few scientific data on the occurrence and concentrations of pesticide residues in staple foods found in local markets. Using QuEChERS extraction method and gas chromatography-mass spectrometry, samples of commonly eaten foods from five localities of Burkina Faso were evaluated by targeting more than 40 pesticides. It appears that 58.1% of all the collected samples exhibited at least one or more pesticide residues. Among those, 36.5% of the samples had at least one pesticide with a concentration above the maximum residue level (MRL) value. Unfortunately, no MRL data was available for dried fish which is a widely consumed food in this part of Africa. Simazine was found in tomatoes, pyrethroids in cereals, while dried fish contained most of the pesticides detected. The assessment of long-term health risks revealed that dieldrin quantified in dried fish showed more than 250% of acceptable daily intake which was then labelled as unacceptable high risk. For hazardous foods, more sampling should be carried out for a better assessment of the health risks involved.

Molecular Characterization and the Antimicrobial Resistance Profile of Salmonella spp. Isolated from Ready-to-Eat Foods in Ouagadougou, Burkina Faso.

The emergence of antimicrobial-resistantfood-borne bacteria is a great challenge to public health. This study was conducted to characterize and determine the resistance profile of Salmonella strains isolated from foods including sesames, ready-to-eat (RTE) salads, mango juices, and lettuce in Burkina Faso. One hundred and forty-eight biochemically identified Salmonella isolates were characterized by molecular amplification of Salmonella marker invA and spiC, misL, orfL, and pipD virulence genes. After that, all confirmed strains were examined for susceptibility to sixteen antimicrobials, and PCR amplifications were used to identify the following resistance genes: bla TEM, temA, temB, StrA, aadA, sul1, sul2, tet(A), and tet(B). One hundred and eight isolates were genetically confirmed as Salmonella spp. Virulence genes were observed in 57.4%, 55.6%, 49.1%, and 38% isolates for pipD, SpiC, misL, and orfL, respectively. Isolates have shown moderate resistance to gentamycin (26.8%), ampicillin (22.2%), cefoxitin (19.4%), and nalidixic acid (18.5%). All isolates were sensitive to six antibiotics, including cefotaxime, ceftazidime, aztreonam, imipenem, meropenem, and ciprofloxacin. Among the 66 isolates resistant to at least one antibiotic, 11 (16.7%) were multidrug resistant. The Multiple Antimicrobial Resistance (MAR) index of Salmonella serovars ranged from 0.06 to 0.53. PCR detected 7 resistance genes (tet(A), tet(B), bla TEM, temB, sul1, sul2, and aadA) in drug-resistant isolates. These findings raise serious concerns because ready-to-eat food in Burkina Faso could serve as a reservoir for spreading antimicrobial resistance genes worldwide.

Aflatoxins contents determination in some foodstuffs in Burkina Faso and human health risk assessment.

Aflatoxins are produced by fungi of the genus Aspergillus that colonize many foodstuffs during agricultural production, harvesting, transportation, storage, and food processing. In view of these aflatoxins toxicity to humans, their presence in foods such as cereals and oilseeds constitutes a major challenge for global food security, health and nutrition. This study was therefore initiated to assess the level of aflatoxin contamination of various foodstuffs sold in urban and semi-urban markets in Burkina Faso, and to evaluate the carcinogenic risk which the consuming population is exposed to. Two hundred and twelve foodstuff samples were collected in two large cities (Ouagadougou and Bobo Dioulasso) and three semi urban localities (Cinkansé, Dakola and Niangoloko). Aflatoxins contents in foodstuffs were determined by immunoaffinity chromatography and human health risk assessment was performed by using the Monte Carlo algorithm. The aflatoxins contents determination showed that 41.50% of studied samples were contaminated with concentrations up to 182.28 µg/kg for AFB1 in peanuts. Chronic Daily Intake, calculated based on the consumption patterns assumed in this study, was estimated to be higher in large cities (CDI = 33.68 µg/kg bw in Ouagadougou and 10.18 µg/kg bw in Bobo Dioulasso) than in semi urban localities (CDI = 4.29 µg/kg bw in Cinkansé, CDI = 0.39 µg/kg bw in Dakola and CDI = 0.18 µg/kg bw in Niangoloko). The MOE determination showed that the sorghum meal and whole grain maize consumption was associated to the carcinogenic risk for public health in large cities (the percentile 95 of MOE = 3316 for rice, 4511 for peanuts, 3334 for sorghum meal and 4530 for whole grain maize). In semi urban localities, no carcinogenic risk was observed to public health. These results should inspire the country's sanitary and agricultural authorities to undertake actions to fight against the agricultural food products contamination by aflatoxins in order to safeguard the population's health.

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.

Microbiological quality assessment of five common foods sold at different points of sale in Burkina-Faso.

The aim of the present study was to assess the microbial quality of five ready-to-eat food such as bread, pasta, rice with sauce, beans and milk sold in five localities of Burkina Faso namely, Ouagadougou, Bobo-Dioulasso, Dakola, Cinkansé and Niangoloko. One hundred and one samples were collected and microbial quality were assessed by evaluating the food hygiene indicators such as total aerobic mesophilic flora, total coliforms, thermotolerant coliforms, yeast and mould. Food safety indicators such as Escherichia coli, Salmonella, coagulase-positive staphylococci, Clostridium perfringens and Bacillus cereus were also tested for contamination. Samples were tested according to ISO guidelines for all parameters. The results showed that 74 (73.27%) of samples were satisfactory while 15 (14.85%) were acceptable and 12 (11.88%) were not satisfactory according to international standards. Among the food safety indicators sought, Escherichia coli was detected in two samples and Bacillus cereus in four samples. Most of the analyzed food exhibited good hygiene behavior within the acceptable limits and the highest of not satisfactory rate was observed in milk powder and rice with sauce. Ouagadougou samples recorded the highest number of not satisfactory samples. Despite the general quality was satisfactory, the presence of specific microorganisms such as coliforms is indicative of the poor hygiene surrounded these foods. It is therefore necessary to train and follow up the vendors in the handling of equipment, hand-washing practices and selling environment hygiene for better improvement of the quality of the street foods.

Evaluation of metallic trace elements contents in some major raw foodstuffs in Burkina Faso and health risk assessment.

Diet based on cereal, vegetables, oleaginous and dried fish are providing essential metallic elements. It can be also a source of exposure to toxic metallic elements. The aims of this study were to evaluate the contents on nine metallic trace elements (Fe, Zn, Mn, Co, Cd, Pb, Cu, Ni, Cr) in some major raw foodstuffs including rice, maize, peanut, tomato and dried fish in Burkina Faso and assess the health risk of these elements. Two hundred twenty-two samples were collected and analyzed by atomic absorption spectrometry. The health risk assessment was based on the United States Environment Protection Agency (USEPA) model. Iron and Zinc were the elements with the highest concentrations in the investigated foodstuffs. The iron highest median value (68.80 mg/kg) was observed in dried fish followed by maize (43.09 mg/kg) and peanuts (28.92 mg/kg). Rates of 77.95%, 66.66% and 32.5% obtained respectively fro tomato, maize and rice samples were above the maximum limit of lead set by Codex Alimentarius while 47.6%, 71.16% and 0% of maize, tomato and rice samples respectively have shown concentration above the maximum limit of cadmium. Chromium had shown higher contribution rate to the maximum daily intake of 167.11%, 34%, 2% and 8.53% for rice, maize and peanut respectively. A non-cancer risk situation has been observed on rice, maize and peanut consumption. None of the index risk values was above the threshold set by USEPA.

Assessment of the sanitary quality of ready to eat sesame, a low moisture street food from Burkina Faso.

BACKGROUND: Microbial contamination of edible low moisture food poses a significant public health risk for human. In this study, the microbial quality of sweet dehulled sesame seed croquettes, salted dehulled sesame seed and the raw sesame seed, sold under ambient conditions were examined. The samples were collected in the cities of Burkina Faso. The first type is sweet dehulled sesame seed croquettes (n1 = 25); the second type is salted dehulled sesame seed (n2 = 25) and the third type is raw sesame seed (n3 = 25). Assessment of the microbial quality was based on the total aerobic mesophilic bacteria, the thermotolerant coliforms, the yeasts and moulds, the E. coli, and the Salmonella spp. using ISO methods. RESULTS: The results showed the presence of microorganisms varying from <1.0 to 1.72 × 105 CFU g- 1 for thermotolerant coliforms, from <1.0 to 6,12 × 106 CFU g- 1 for the total mesophilic aerobic flora and from <1.0 to 8.10 × 105 CFU g- 1 for yeasts and moulds. The higher contaminations rates were mostly observed in raw sesame seed samples. No E coli or Salmonella pathogens were detected. Based on international standards of dehydrated food, 50.67% of the ready to eat sesame are satisficing while 17.33% are acceptable and 32% are not satisficing. CONCLUSION: Attention should be emphasized on the processing practices, especially in crowded places where RTE sesames seeds are mostly sold. The high numbers of all microbial groups in these sesame seed samples suggested that the production of RTE sesame seed should be improved by better hygiene. This study highlights also that RTE sesame seed might harbor a wide range of microorganisms when processes are weak of hygiene.

Polycyclic Aromatic Hydrocarbons Contamination of Flamed and Braised Chickens and Health Risk Assessment in Burkina Faso.

Charcoal- or wood-cooked chicken is a street-vended food in Burkina Faso. In this study, 15 samples of flamed chicken and 13 samples of braised chicken were analyzed for 15 priority polycyclic aromatic hydrocarbons (PAHs) with a high-performance liquid chromatography-fluorescence detector. A face-to-face survey was conducted to assess the consumption profiles of 300 men and 300 women. The health risk was assessed based on the margin of exposure (MOE) principle. BaP (14.95-1.75 µg/kg) and 4PAHs (BaP + Chr + BaA + BbF) (78.46-15.14 µg/kg) were eight and five times more abundant at the median level in flamed chickens than in braised ones, respectively. The contents of BaP and 4PAHs in all flamed chicken samples were above the limits set by the European Commission against 23% for both in braised chickens. Women had the highest maximum daily consumption of both braised (39.65 g/day) and flamed chickens (105.06 g/day). At the estimated maximum level of consumption, women were respectively 3.64 (flamed chicken) and 1.62 (braised chicken) times more exposed to BaP and 4PAHs than men. MOE values ranged between 8140 and 9591 for men and between 2232 and 2629 for women at the maximum level of consumption of flamed chickens, indicating a slight potential carcinogenic risk.

Concentrations and Health Risk Assessment of Metallic Trace Elements in Ready-to-Eat Braised and Flamed Chickens in Burkina Faso.

Braised and flamed chickens known as "poulet bicyclette" are famous and popular street food in Burkina Faso. Although they are important sources of a wide range of essential trace elements for humans, they can also contain toxic metals. The aim of the study was to assess the concentrations and health risk of metallic trace elements (Ag, Cr, Cu, Mn, Fe, Co, Zn, Ni, Cd, Pb) in ready-to-eat braised and flamed chickens in Burkina Faso. The concentrations and health risk assessment were estimated by atomic absorption spectrometry and hazard quotient method, respectively. The concentrations of Cu (3.12 mg kg-1), Fe (20.17 mg kg-1), and Ni (0.22 mg kg-1) were about 2 times higher in flamed chickens than in braised ones. Cd (0.45 mg kg-1) and Cr (2.50 mg kg-1) were 2 to 5 times more concentrated in braised chickens than flamed chickens. Pb was found in 72.72% of braised chicken and 62.06% of flamed chicken samples, above the maximum limit set by the JECFA. The daily intakes of Cu, Mn, Fe, and Zn contributed for less than 2% to the recommended daily intakes set by the Institute of Medicine of USA for both males and females, whereas Cr contributed for more than 20% from braised chicken. The estimated monthly intakes of Cd represented about 1.92-4.06% of the provisional tolerable monthly intake of Cd set by FAO/WHO. A non-cancer risk estimated as hazard index has been recorded at the maximum level of consumption for female consumer group for flamed chicken (HI = 2.14). The estimated cancer index risk in this study is below the reference value (10-4) set by the United States Environmental Protection Agency (US EPA).

Identification of Streptococcus suis Meningitis by Direct Triplex Real-Time PCR, Burkina Faso.

Meningitis confirmation in Burkina Faso uses PCR for detecting Streptococcus pneumoniae, Neisseria meningitidis, or Hemophilus influenzae. We identified 38 cases of meningitis among 590 that were PCR-positive for 3 nonpneumococcal streptococcal pathogens, including 21 cases of Streptococcus suis. Among the country's 13 regions, 10 had S. suis-positive cases.

[Difficult immunofixation electrophoresis interpretation of serum proteins]. / Interprétation délicate de l'immunofixation des protéines sériques.

Immunofixation is currently very used in medical laboratories. The interpretation of the results is usually easy, but some cases raise interpretative problems. We here report two cases difficult to interpret. In the first case, we report a case of nonspecific precipitation of the protein on each track, in the second case we report a case of double monoclonal band on immunofixation electrophoresis. Reducing agent such as ß2-mercaptoethanol used in these two cases allowed to solve the problem and to make a diagnosis. A comparison between clinical radiological and laboratory test data is necessary before making a diagnosis of monoclonal immunoglobulin.

[Evolution of biochemical and hematological parameters in patients living with HIV/AIDS treated with antiretroviral therapy at the Aboubacar Sangoulé Lamizana General Camp Medical Center]. / Evolution des paramètres biochimiques et hématologiques chez les personnes vivant avec le VIH/SIDA sous traitement antirétroviral au Centre Médical du Camp General Aboubacar Sangoule Lamizana.

INTRODUCTION: This study aimed to evaluate the impact of treatment on biochemical and hematological parameters in HIV-positive patients followed up at the Aboubacar Sangoulé Lamizana General Camp Medical Center in Burkina Faso. METHODS: We conducted a retrospective study over the period January 2010-September 2015. The study only included HIV-positive patients treated with ART having undergone laboratory tests at treatment initiation (M0), at sixth month (M6), and at twelfth month (M12). RESULTS: Sex-ratio was 0.88 and the most affected age group was 45-55 years. The most prescribed treatments were triple combination therapies based on 2INTI + 1INNTI (74,5%), 2INTI+1 IP (14,9%). Viral load test was little requested. The rate of patients with normal laboratory tests showed a statistically significant regression between M0 (70%), and M6 (13%) (p<0.05). Severely immunocompromised patients showed a significant increase in average TCD4 lymphocytes value, ranging from 79,22 at M0 to 227.95 cells/mm3 at M12 (p<0.05). Anaemic patients showed a significant increase in the rate of mean haemoglobin levels from 10.5 g/dl at M0 to 12.53 g/dl at M12 (p<0.05). The analysis of biochemical parameters could not be performed because of a lack of data. CONCLUSION: The increase in the rate of TCD4 lymphocytes and in the rate of hemoglobin levels gives an indication of ART effectiveness and of patient's tolerance to treatment. Viral load test accessibility and an improvement in laboratory testing monitoring are essential.

Polymorphisme génétique des cytochromes p450: synthèse méthodiques des études primaires effectuées dans la population Africane

Il existe une grande variabilité interindividuelle de réponse aux médicaments, tant en terme d'efficacité que de toxicité. Pour comprendre cette variabilité, de multiples travaux de recherche sur le polymorphisme génétique des cytochromes P450 ont été menés de par le monde. Notre étude a pour but de faire le point des études réalisées en Afrique ayant porté sur le polymorphisme génétique des cytochromes P450 afin de recenser leurs variants alléliques susceptibles d'entrainer une variabilité interindividuelle de réponse aux médicaments.Il s'agissait d'une revue systématique des travaux de recherche qui ont porté sur le polymorphisme génétique des cytochromes P450. Elle a été réalisée au Burkina Faso à partir des articles publiés dans la base de données Pubmed et a concerné les populations africaines.Parmi les 1625 études primaires collectées dans la base de données Pubmed, 23 se sont intéressées aux populations africaines. Ces études ont été réalisées essentiellement dans la plupart des régions africaines sauf la partie centrale. Ces études primaires ont traité de la distribution des cytochromes P450 1A1, 1B1, 1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6 et 3A4. Les variants alléliques CYP 1A2*2, 1B1 (*2,*6), B6 (*6,*18,*20,*27), 2C8 (*2,*3), 2C9 (*2,*3,*5,*11), 2C19 (*2,*3), 2D6 (*4,*17,*29), 3A4*1B et 3A5*3 sont ceux susceptibles d'entrainer une anomalie de réponse aux médicaments. Cela montre la nécessité d'entreprendre des études spécifiques sur les populations africaines où on retrouve la plus grande variabilité génétique par rapport aux autres continents

Etude des performances de l'analyseur de biochimie le i-smart 30 au laboratoire de biochimie du Centre Hospitalier Universitaire Pédiatrique Charles De Gaulle (CHU-P/CDG)

De façon générale il s'est agi de l'évaluation du niveau de performances du i-Smart 30 pour l'analyse des électrolytes (Na+, K+ et Cl-) et de comparer le i smart 30 versus Micros 60 pour la mesure de l'hématocrite.Nous avons fait une étude analytique et descriptive qui s'est déroulée sur 06 mois au laboratoire du CHU-P/CDG. Pour l'analyse de la performance dans le dosage des électrolytes nous avons utilisé trois sérums de contrôles de niveau différent (bas, moyen et élevé) et la pour l'hématocrite nous avons utilisé du sang de patients en faisant un passage en parallèle sur le i-Smart 30 et le Micros 60 l'automate de référence.Pour les tests de comparaison nous avons eu une bonne concordance entre les résultats fournis par i-Smart30 et le Micros60 avec un biais de Bland-Altman à 1,96. Pour la justesse tous les points des électrolytes se situaient dans les intervalles requis par le fabricant. En ce qui concerne les tests de précision, la répétabilité et la fidélité intermédiaire, la plupart des niveaux de contrôle avaient des CV qui sont conformes aux normes maximales d'acceptabilité établis par la SFBC témoignant d'une bonne précision du i-Smart 30 pour le dosage des ions. Le i-Smart30 a été donc qualifié pour être utilisé lors des gardes et des permanences. La satisfaction a été confirmée par les résultats des contrôles de qualité externes

Reference ranges of cholesterol sub-fractions in random healthy adults in Ouagadougou, Burkina Faso.

In Burkina Faso, the values that serve as clinical chemistry reference ranges are those provided by European manufacturers' insert sheets based on reference of the Western population. However, studies conducted so far in some African countries reported significant differences in normal laboratory ranges compared with those of the industrialized world. The aim of this study was to determine reference values of cholesterol fractions in apparently normal adults in Burkina Faso that could be used to better assess the risks related to cardiovascular diseases. Study population was 279 healthy subjects aged from 15 to 50 years including 139 men and 140 women recruited at the Regional Center of Blood Transfusion of Ouagadougou, capital city of Burkina Faso (West Africa). Exclusion criteria based on history and clinical examination were used for defining reference individuals. The dual-step precipitation of HDL cholesterol sub-fractions using dextran sulfate was performed according to the procedure described by Hirano. The medians were calculated and reference values were determined at 2.5th and 97.5th percentiles. The median and upper ranges for total cholesterol, LDL cholesterol, total HDL cholesterol and HDL2 cholesterol were observed to be higher in women in comparison to men (p <0.05). These reference ranges were similar to those derived from other African countries but lower than those recorded in France and in USA. This underscores the need for such comprehensible establishment of reference values for limited resources countries. Our study provides the first cholesterol sub-fractions (HDL2 and HDL3) reference ranges for interpretation of laboratory results for cardiovascular risk management in Burkina Faso.

Implementation of a national external quality assessment program for medical laboratories in Burkina Faso: challenges, lessons learned, and perspectives.

OBJECTIVES: The National External Quality Assessment (NEQA) program of Burkina Faso is a proficiency testing program mandatory for all laboratories in the country since 2006. The program runs two cycles per year and covers all areas of laboratories. METHODS: All panels were validated by the expert committee before dispatch under optimal storage and transport conditions to participating laboratories along with report forms. RESULTS: Performance in the last 5 years varied by panel, with average annual performance of bacteriology panels for all laboratories rising from 75% in 2006 to 81% in 2010 and with a best average performance of 87% in 2007 and 2008. During the same period, malaria microscopy performance varied from 85% to 94%, with a best average performance of 94% in 2010; chemistry performance increased from 87% to 94%, with a best average annual performance of 97% in 2009. Hematology showed more variation in performance, ranging from 61% to 86%, with a best annual average performance of 90% in 2008. Average annual performance for immunology varied less between 2006 and 2010, recording 97%, 90%, and 95%. Except for malaria microscopy, annual performances for enrolled panels varied substantially from year to year, indicating some difficulty in maintaining consistency in quality. CONCLUSIONS: The main challenges of the NEQA program observed between 2006 to 2010 were funding, sourcing, and safe transportation of quality panels to all laboratories countrywide.

[National External Quality Assessment for medical biology laboratories in Burkina Faso: an overview of three years of activity]. / Contrôle national de qualité des laboratoires d'analyses de biologie médicale du Burkina Faso: bilan de trois années d'activités.

We report results of the National External Quality Assessment for (NEQA) laboratories in Burkina Faso, a country with limited resources located in West Africa whose epidemiology is dominated by infectious diseases. The national laboratory network consists of 160 laboratories including 40 private. The Government of Burkina Faso has adopted a national laboratory policy. One of the objectives of this policy is to improve the quality of laboratory results. One of the strategies to achieve this objective is the establishment of a NEQA. The NEQA is a panel testing also called proficiency testing. It is mandatory for all laboratories to participate to the NEQA. The NEQA is organized twice a year and covers all areas of laboratories (bacteriology-virology, biochemistry, hematology, parasitology and immunology). The review of three years of activity (2006-2008) shows the following results: (1) for microscopic examination of bacteria after Gram staining, the error rate decreased from 24.7% in 2006 to 13.1% in 2007 and 13% in 2008; (2) errors rate in reading slides for the microscopic diagnosis of malaria were 23.4%, 14.6% and 10.2% respectively in 2006, 2007 and 2008; (3) for biochemistry, the percentages of unsatisfactory results were respectively 12.5%, 14.8% and 13.8% in 2006, 2007 and 2008 for the overall parameters assessed. The analysis of the results generated by the laboratories during these three years shows a quality improvement. However, the NEQA should be strengthened through ongoing training and quality control of reagents and equipment.