Estimating dengue burden among family contacts through cluster investigation around probable cases in 2022 and 2023 in the Central Region, Burkina Faso.

BACKGROUND: In 2023, Burkina Faso experienced the largest dengue epidemic ever in Africa. This study aimed to estimate the prevalence of symptomatic, subclinical, and asymptomatic dengue and determine the associated factors among adult contacts of dengue in the Central Region, Burkina Faso. METHODS: This cross-sectional study included contacts of dengue probable cases through cluster sampling in 2022-2023. These suspected cases that tested positive were identified from the five health facilities (Pissy CMA, Saaba CM, Kossodo CMA, Samandin CM, and Marcoussis CSPS) that reported the highest number of cases in 2021 per district. All participants underwent dengue and malaria rapid diagnostic tests (RDT). Samples positive for non-structural 1 protein antigen (AgNS1) and/or immunoglobulin M (IgM) were tested for serotype detection by reverse transcription polymerase chain reaction (RT-PCR). Binary logistic regression was done to identify the determinants of asymptomatic, subclinical, and symptomatic dengue among contacts of probable dengue cases. RESULTS: A total of 484 contacts were included, mostly in 2023 (75.2%). Most participants were females (58.6%), residing (24.3%) and passing their daytime (23.1%) in Saaba. The overall prevalence of dengue was estimated at 15.1% [95% confidence interval (CI): 12.0-18.6%], representing cases not seeking care in hospitals. Asymptomatic cases represented 2.9% (95% CI: 1.6-4.8%). Subclinical and symptomatic cases accounted for 6.0% (95% CI: 4.1-8.5%) and 6.2% (95% CI: 4.2-8.7%), respectively. Of the 58 samples tested by RT-PCR, 10 were confirmed for serotype 3 in 2023. Malaria cases were estimated at 5.6% (95% CI: 3.7-8.0%). After adjustment, participants claiming that a virus transmits dengue were likelier to have asymptomatic dengue [adjusted odds ratio (aOR) = 7.1, 95% CI: 2.4-21.0]. From the multivariable analysis, subclinical dengue was statistically associated with being included in the study in 2023 (aOR = 30.2, 95% CI: 2.0-455.5) and spending the daytime at Arrondissement 4 (aOR = 11.5, 95% CI: 1.0-131.0). After adjustment, symptomatic dengue was associated with living less than 50 m away from cultivated land (aOR = 2.8, 95% CI: 1.1-6.9) and living less than 50 m from a stretch of water (aOR = 0.1, 95% CI: 0.0-0.6). CONCLUSIONS: The overall burden of dengue among populations not seeking care in hospitals was quite high, with few asymptomatic cases. Efforts to manage dengue cases should also target non-hospital cases and raise population awareness. The 2023 epidemic could be due to dengue virus (DENV)-3.

Pulmonary function assessment among conventional and organic cotton farmers exposed to pesticides in the Central-West region of Burkina Faso.

BACKGROUND: Respiratory diseases have been associated with the exposure of populations to some environmental pollutants such as pesticides. To assess effects of pesticides on farmers' respiratory health, this study aimed to evaluate the pulmonary function of cotton farmers exposed to synthetic and natural pesticides in the Central-West region of Burkina Faso. METHODS: A cross-sectional study was conducted from June to July 2022 among 281 conventional and 189 organic cotton farmers. After collecting information on pesticide use conditions, pulmonary function tests (PFTs) were performed on each farmer according to the American Thoracic Society/European Respiratory Society guidelines, in order to assess chronic respiratory effects among cotton producers. Binary logistic regression was used to assess factors associated with the occurrence of ventilatory changes. RESULTS: Both conventional and organic cotton farmers reported similar chronic respiratory symptoms in different proportions. The main reported were rhinitis (54.45% conventional vs. 34.92% organic), chest pains (41.28% conventional vs. 23.81% organic), cough (33.45% conventional, 24.34% organic), breathlessness (31.67% conventional, 4.23% organic) (p<0.05). 16.18% and 27.50% of conventional male and female cotton farmers, respectively, had a restrictive defect. Among organic cotton farmers, 15.85% and 18.69%, respectively, of males and females had a restrictive defect. Furthermore, a significant increase in the predicted average percentage of FEV1/FVC ratio was observed among organic cotton farmers after salbutamol's use (p = 0.039). The type of cultivated cotton was not associated with ventilatory changes neither in the univariate analysis, nor in the multivariate analysis. Other factors such as farmers' age, BMI and insecticides use frequency per year were also important. Farmers who used insecticides more than 6 times per season had an increased risk of developing an obstructive defect (OR = 1.603; 95%CI: 0.484-5.309) compared to those who used them 6 times or less. CONCLUSION: Chronic respiratory signs and ventilatory impairments were found among conventional and, to our knowledge, for the first time among organic cotton producers. However, these health effects were more prevalent among conventional cotton farmers than organic ones.

Determinants and prevalence of symptomatic dengue fever among adults in the Central Region of Burkina Faso: a hospital-based cross-sectional study.

BACKGROUND: Dengue fever (DF) is a significant public health concern in Burkina Faso, particularly in the Central Region, previously endemic for malaria. However, limited research has focused on dengue prevalence and associated factors among adult febrile patients in this region. This study aimed to estimate the prevalence of symptomatic dengue fever among adults and identify the sociodemographic and clinical determinants of the disease. METHODS: A seroepidemiological cross-sectional study was conducted in the Central Region of Burkina Faso, through a three-stage sampling. Five health facilities, one from each of the region five districts, were purposively selected. Febrile patients aged 16 and older, suspected of having dengue, were included in the study, after consenting. Bivariate analyses and multivariate binary logistic regression were done at a 5% confidence level. RESULTS: A total of 637 patients between the ages of 16 and 90 years were included. Most of the participants were females (58.71%). Most dengue cases resided in Arrondissement 4 (59.62%), or were present in the Arrondissement 4 at daytime during the previous days (51.92%). 52.90% of the participants knew of dengue. Dengue prevalence was estimated at 8.16% (95% CI: 6.16%-10.57%). The most frequent markers for dengue were immunoglobulins M detected in 4.40% (2.94%-6.29%), followed by Antigen NS1 at 4.24% (95% CI: 2.81%-6.11%). The Antigen NS1 marker was associated with myalgia (p = 0.024), vomiting (p < 0.001), hemorrhagic manifestations (p = 0.001), and anorexia (p < 0.001). Staying at Arrondissement 4 (vs staying at Saaba) during daytime (aOR = 2.36 95% CI: 1.03-5.45; p = 0.044) significantly increased the odds of dengue. Dengue cases were about 3 times more likely to have vomited (aOR = 2.99 95% CI: 1.58-5.64; p = 0.001). Participants knowing of dengue (aOR = 0.53 95% CI: 0.29-0.98; p = 0.042) and those coinfected with malaria (aOR = 0.28 95% CI: 0.14-0.57; p < 0.001) instead had reduced odds of dengue. CONCLUSION: The study revealed a relatively high prevalence of symptomatic dengue fever among adults in the Central Region of Burkina Faso in 2022. These findings emphasize the need for continuous surveillance and targeted control measures. The low coinfection of dengue and malaria warrants further investigation.

Self-reported health effects of pesticides among cotton farmers from the Central-West region in Burkina Faso.

Pesticides are chemicals used to control pests with sometime harmful effects on human health. This paper presents results of self-reported health effects experienced by cotton farmers in the Central-West region of Burkina Faso. It was a cross-sectional survey conducted from October to December 2021 among 585 consenting conventional and organic cotton farmers. Data collected included pesticides used, they use conditions, farming practices, experienced health effects. Binary logistic regression was used to find relationships between self-reported health effects and the type of cotton produced. Results showed that all conventional cotton farmers (100%) reported using synthetic pesticides compared to organic ones who using only natural insecticides. Both conventional and organic farmers reported health effects that occurred at least once since they started using pesticides, involving skin effects (85.27% conventional, 65.52% organic), nervous (88.95% conventional, 48,71% organic), respiratory (88.10% conventional, 67.67% organic) systems. 99.72% of conventional farmers vs 46.98% of organic ones reported skin irritation following pesticide use. 69.97% of conventional vs 35.34% of organic cotton farmers reported acute signs such as severe headaches. In univariate and multivariate logistic regressions, severe headaches, dizziness, skin, and ocular effects were significantly associated with conventional farmers compared to organic ones (p < 0.05). There was a significant relationship between vomiting (p = 0.014), diarrhea (p = 0.003) and experience in synthetic pesticide use among conventional farmers. Among organic farmers, there was no significant relationship between health effects reported and experience in organic insecticides use. there was a significant relationship between severe headaches (p = 0.01), rhinitis (p = 0.006), cough (p = 0.0001), skin and ocular irritations (p = 0.007) and the frequency of synthetic insecticides use per year by conventional farmers. Study showed that conventional and organic cotton producers experience the same types of health effects. However, these health effects were significantly associated with conventional farmers compared to organic ones.

Setting Dengue Fever Epidemic Thresholds Between 2016 and 2021 in the Central Health Region, Burkina Faso: An Ecological Study.

BACKGROUND: Dengue fever (DF) is endemic in Burkina Faso, with 70% of its burden supported by the Central Health Region. Then, a single confirmed case can no longer mean an epidemic. This study aimed at describing trends and setting epidemic thresholds of DF in the Central Health Region. DATA AND METHODS: An ecological study was conducted using monthly data from DF surveillance between 2016 and 2021. Three methods were applied to set alert and intervention thresholds of DF monthly incidence rate: mean [mean + 2 SD], median [3rd quartile] and cumulative sum (C-sum) [C-sum + 1.96 SD]. These thresholds were plotted with the monthly incidence rates for 2021. RESULTS: In total, 54,429 cases were reported between 2016 and 2021. Dengue cases increased biannually. The median annual incidence rate did not vary significantly across years [Kruskal-Wallis: χ2(5) = 9.825; p = 0.0803]. Within a year, the monthly incidence rate fell under 48.91 cases per 100,000 inhabitants between January and September and peaked in October or November. With the mean and C-sum methods, the 2021 monthly incidence rate remained below the intervention thresholds (Mean + 2 SD and C-sum + 1.96 SD). With the median method, the incidence rate exceeded the alert and intervention thresholds in July-September 2021. CONCLUSIONS: If the DF incidence varied within a year due to the seasons, it was relatively stable between 2016 and 2021. The mean and C-sum methods based on the mean were subject to extreme values, giving high thresholds. The median method seemed better for capturing the abnormal increase in dengue incidence.

Preclinical Evaluation of the Antihypertensive Effect of an Aqueous Extract of Anogeissus leiocarpa (DC) Guill et Perr. Bark of Trunk in L-NAME-Induced Hypertensive Rat.

BACKGROUND: The present study investigates the effect of an aqueous extract of Anogeissus leiocarpa (AEAL) on normotensive Wistar rats and its chronic antihypertensive effects in L-NAME-induced hypertensive rats by using a non-invasive tail-cuff model. METHODS: The effects of AEAL (50mg/kg) and NaCl 0.9% on blood pressure were investigated by daily oral administration in normotensive Wistar rats over four weeks. L-NAME-induced hypertensive rats were produced by L-NAME (40mg/kg) daily oral administration for two weeks. For chronic antihypertensive effects, induced hypertensive rats have received L-NAME in combination with AEAL (10 or 50mg/kg/day) for two following weeks. RESULTS: In normotensive rats, daily administration of AEAL (50mg/kg) has no significant effect on their blood pressure, which was similar to that of the control group. L-NAME's daily oral administration induces a progressive increase in systolic blood pressure (SBP) from 115.8 ± 7.9mmHg to 153.5 ± 4.6mmHg after two weeks, which was maintained to the end of the treatment. In L-NAME-induced hypertensive rats, AEAL (50mg/kg/day) significantly decreases the SPB from 160.0 ± 5.8 mmHg to 108.8 ± 2.7mmHg after only four days of administration. However, the lower dose of AEAL (10mg/kg) also normalized the SBP of L-NAME-induced hypertensive rats but only evident after seven days of administration. Moreover, AEAL does not effect on the serum biochemical parameters (ALAT, ASAT, CREAT, etc.) and any macroscopic adverse effect was detected on the sensible organs involved during hypertension. In the aorta rings from treated rats, AEAL (50mg/kg/day) alone or in combination with L-NAME has enhanced the vasodilation effect of acetylcholine. However, the vasodilation effect of AEAL alone or in association with L-NAME has enhanced the sodium nitroprusside effect in treated rat aorta rings after autopsy. CONCLUSION: These findings suggest that AEAL affords significant antihypertensive effects against L-NAME-induced hypertensive rats without modification of serum parameters and deleterious effects.

Toxicity and bacterial anti-motility activities of the hydroethanolic extract of Acacia senegal (L.) Willd (Fabaceae) leaves.

BACKGROUND: Acacia senegal is a plant traditionally used for its various properties, including the treatment of infectious diseases. Recently, our team has demonstrated the ability of the hydroethanolic extract of the leaves to increase the activity of phenicol antibiotics against multi-resistant bacteria. The aim of this work is to determine the toxicological effects of the extract and its capacity to inhibit the bacterial mobility of Gram-negative bacteria, in order to evaluate the level of safety use of this plant. METHODS: The cytotoxicity test was performed using the neutral red absorption method. Acute and sub-acute oral toxicity were conducted on NMRI mice and Wistar rats. The behaviour and adverse effects were recorded during the 14 days of the acute study. For the subacute test, biochemical parameters, food and water consumption, and morphological parameters were determined. The anti-motility activities were evaluated on Pseudomonas aeruginosa PA01 and Escherichia coli AG100, using specific concentrations of Agar as required by the method. RESULTS: HEASG induced inhibition of keratinocytes cell growth with an IC50 of 1302 ± 60 µg/mL. For the acute toxicity study in mice, the single dose of extract of 2000 mg/kg body weight caused no deaths and no behavioural changes were observed; therefore, the median lethal dose (LD50) of HEASG was calculated to 5000 mg/kg body weight. In Wistar rats, no mortality was observed at 250, 500 and 1000 mg/kg/day during the 28-day subacute oral toxicity study. The weights of both females and males increased globally over time, regardless of the batch. No statistically significant differences were registered for organ weights and biochemical parameters, except for chloride for biochemical parameters. Water and food consumption did not change significantly. Furthermore, no macroscopic changes in organ appearance were observed. Regarding anti-motility activity, the extract has reduced the swarming motility of PA01 and AG100 significantly at the concentration of 32 µg/mL (P < 0.001). The extract has reduced the swimming motility (P < 0.01) of PA01 but not AG100. CONCLUSIONS: The results suggest that hydroethanolic extract of A. senegal leaves has significant activity against bacterial motility and relatively low toxicity.

Pharmacological Evaluation of the Bronchorelaxant Effect of Waltheria indica L. (Malvaceae) Extracts on Rat Trachea.

Waltheria indica L. (Malvaceae) is a plant used in Burkina Faso for the treatment of various ailments including asthma. The aim of the study was to evaluate the pharmacological relaxant effect of the leafy stem extracts of Waltheria indica and thereby verify claim of use in treating asthma. Aqueous decoction and hydroalcoholic extracts obtained from the powdered leafy stems were screened for the presence of some phytoconstituents. The in vitro relaxant effect of the two extracts was evaluated on acetylcholine- (ACh 10-5 M) and potassium chloride- (KCl 6 × 10-2 M) induced contractions on rat-isolated tracheal preparations. To examine whether the potassium (K+) channels are involved in the relaxant effect, glibenclamide, an ATP-sensitive potassium channel inhibitor, was used. Moreover, to assess the safety of the extracts, acute oral toxicity was carried out on mice. The phytochemical screening revealed the presence of alkaloids, flavonoids, saponins, steroids, triterpenoids, tannins, and coumarins in the hydroalcoholic extract. Tannins, steroids, triterpenoids, and coumarins were not detected in the aqueous decoction. With respective EC50 values of 1.517 ± 0.002 mg/mL and 1.433 ± 0.001 mg/mL on ACh-and KCl-provoked contractions, the hydroalcoholic extract was found more potent in relaxing the isolated rat tracheal preparations compared to the aqueous decoction. In the presence of glibenclamide, the relaxant effect of the hydroalcoholic extract (EC50 = 0.191 ± 0.002 mg/mL) increased and was higher than that of the aqueous decoction. At dose of 5000 mg/kg of body weight, the extracts did not produce deaths or any significant changes in the general behavior of mice. The results suggest that different mechanisms including modulation of calcium and potassium channels, particularly the ATP-sensitive K+ channels, could be involved in the relaxation effect. These findings could justify the traditional use of W. indica in the management of asthma.

In vitro impact of five pesticides alone or in combination on human intestinal cell line Caco-2.

In Burkina Faso, as in most Sahelian countries, the failure to follow good agricultural practices coupled with poor soil and climate conditions in the locust control context lead to high environmental contaminations with pesticide residues. Thus, consumers being orally exposed to a combination of multiple pesticide residues through food and water intake, the digestive tract is a tissue susceptible to be directly exposed to these food contaminants. The aim of our work was to compare in vitro the impact of five desert locust control pesticides (Deltamethrin DTM, Fenitrothion FNT, Fipronil FPN, Lambda-cyalothrine LCT, and Teflubenzuron TBZ) alone and in combination on the human intestinal Caco-2 cells viability and function. Cells were exposed to 0.1-100 µM pesticides for 10 days alone or in mixture (MIX). Our results showed a cytotoxic effect of DTM, FNT, FPN, LCT, and TBZ alone or in combination in human intestinal Caco-2 cells. The most efficient were shown to be FPN and FNT impacting the cell layer integrity and/or barrier function, ALP activity, antioxidant enzyme activity, lipid peroxidation, Akt activation, and apoptosis. The presence of antioxidant reduced lipid peroxidation level and attenuated the pesticides-induced cell toxicity, suggesting that key mechanism of pesticides cytotoxicity may be linked to their pro-oxidative potential. A comparative analysis with the predicted cytotoxic effect of pesticides mixture using mathematical modeling shown that the combination of these pesticides led to synergistic effects rather than to a simple independent or dose addition effect.

Pilot study on agricultural pesticide poisoning in Burkina Faso.

Epidemiologic data related to agricultural pesticide poisoning cases in Burkina Faso were collected. The study was carried out using retrospective (from January 2002 to June 2010) surveys conducted among farmers and healthcare centers. One hundred and fifty-three (153) pest control products were recorded during the survey and 56 active ingredients were identified. Out of the 153 pest control products, 49 (i.e. 32%) were authorized for sale in Burkina Faso. The main risk factors are socio-demographic characteristics of farmers, their low education level, and some attitudes and practices on using agricultural pesticides. Pesticide poisonings are relatively frequent and their management was not always efficacious. Actions are needed to reduce pesticide poisoning as a global public health problem and to improve management of pesticide poisoning. To this purpose, advanced investigations should be carried out over a longer period of time to complement the present pilot study.

Biological alterations and self-reported symptoms among insecticides-exposed workers in Burkina Faso.

Occupationally exposed workers, farm workers and plant protection agents in the Sahel region of Burkina Faso were interviewed to assess adverse health effects of insecticides. The subjects were also examined for changes in both hematological and biochemical parameters. The prevalence of liver and kidney dysfunction was found to be quite high among insecticide applicators, especially among plant protection agents. The prevalence of biochemical alterations seems to be correlated to the frequency of insecticide use. However, no significant differences were found between the hematological parameters among farm workers and plant protection agents. The hematological parameters of all the insecticide applicators were normal. The great majority of insecticide applicators (85%) reported symptoms related to insecticide exposure. The use of insecticides in the agriculture of Burkina Faso is threatening to human health.