The effect of medication event reminder monitoring on treatment adherence of TB patients.

BACKGROUND: TB control remains a serious public health problem, compounded by poor treatment adherence, which increases the likelihood of onward transmission. We evaluated the effectiveness of medication event reminder monitoring (MERM) upon treatment adherence in a high TB burden setting.METHODS: We conducted an open-label parallel group randomised controlled trial among pulmonary TB adults. Participants were provided with a MERM device to store their medications. In the intervention arm, the devices were set to provide daily medication intake reminders. Primary outcome was the proportion of patient-months in which at least 6/30 doses were missed. Secondary outcomes included 1) the proportion of patient-months in which at least 14/30 doses were missed, and 2) the proportion of doses missed.RESULTS: Of 2,142 patients screened, 798 (37.3%) met the inclusion criteria and 250 participants were enrolled. The mean ratio (MR) for poor adherence between the intervention and control groups was 0.72 (95% CI 0.55-0.86). The intervention was also associated with a reduction in the proportion of patients missing at least 14/30 doses (MR 0.61, 95% CI 0.54-0.68) and the percentage of total doses missed (MR 0.75, 95% CI 0.68-0.80).CONCLUSION: MERM is effective in improving TB treatment adherence in a resource-limited environment.

Monoclonal antibody based radiopharmaceuticals for imaging and therapy.

The concept of personalized medicine has been steadily growing for the past decades. Monoclonal antibodies (mAbs) are undoubtedly playing an important role in the transition away from conventional medical practice to a more tailored approach to deliver the best therapy with the highest safety margin to a specific patient. In certain instances, mAbs and antibody drug conjugates (ADCs) may represent the preferred therapeutic option for several types of cancers due to their high specificity and affinity to the antigen. Monoclonal antibodies can be labeled with specific radionuclides well-suited for PET (Positron Emission Tomography) or gamma camera scintigraphy. The use of radiolabeled mAbs allows the interrogation of specific biomarkers and assessment of tumor heterogeneity in vivo by a single diagnostic imaging scan that includes the whole-body in the field-of-view. Moreover, the same mAb can then be radiolabeled with an analogous radionuclide for the delivery of beta-minus radiation or alpha-particles as part of a radioimmunotherapy (RIT) approach. However, the path to develop, validate, and implement mAb-based radiopharmaceuticals from bench-to-bedside is complex due to the extensive pre-clinical experiments and toxicological studies required, and the necessity of labor-intensive clinical trials that often require multi-time-point imaging and blood draws for internal radiation dosimetry and pharmacokinetics. As more mAb-based radiopharmaceuticals have been developed and evaluated, the opportunities and limitations offered by mAbs have become better defined. Our aim with this manuscript is therefore to provide an overview of the recent advances in the development of mAb-based radiopharmaceuticals and their clinical applications in Oncology.

Prostate-Specific Membrane Antigen-Targeted Radiopharmaceuticals in Diagnosis and Therapy of Prostate Cancer: Current Status and Future Perspectives.

Prostate cancer is the most common cancer to affect men in the United States and the second most common cancer in men worldwide. Prostate-specific membrane antigen (PSMA)-based positron emission tomography (PET) imaging has become increasingly popular as a novel molecular imaging technique capable of improving the clinical management of patients with prostate cancer. To date, several 68Ga and 18F-labeled PSMA-targeted molecules have shown promising results in imaging patients with recurrent prostate cancer using PET/computed tomography (PET/CT). Studies of involving PSMA-targeted radiopharmaceuticals also suggest a higher sensitivity and specificity, along with an improved detection rate over conventional imaging (CT scan and methylene diphosphonate bone scintigraphy) and 11C/18F-choline PET/CT. In addition, PSMA-617 and PSMA I&T ligands can be labeled with α- and ß-emitters (e.g., 225Ac, 90Y, and 177Lu) and serve as a theranostic tool for patients with metastatic prostate cancer. While the clinical impact of such concept remains to be verified, the preliminary results of PSMA molecular radiotherapy are very encouraging. Herein, we highlighted the current status of development and future perspectives of PSMA-targeted radiopharmaceuticals and their clinical applications.

Fully automated preparation of 68Ga-PSMA-11 at curie level quantity using cyclotron-produced 68Ga for clinical applications.

68Ga-PSMA-11 is currently one of the most investigated PET agents for imaging both recurrent prostate cancer and relevant metastases; however, the production and distribution of 68Ga-PSMA-11 is limited to a supply of only a few daily doses when using a commercially available 68Ge/68Ga generator. 68Ge/68Ga generators deliver only a modest amount of activity, up to 1850 MBq (50 mCi), when new, but it decreases with time. Additionally, the production of 68Ga/68Ge generators has not been able to meet the increasing demand of 68Ga radiotracers. In response to the need for a more economically viable alternative, the focus of this study was to provide a simple and efficient method for producing 68Ga-PSMA-11, using cyclotron-produced 68Ga that is ready for routine clinical practice.

Predicting 3-year mortality based on the tumor necrosis factor alpha concentration in low-flux hemodialysis patients.

Tumor necrosis factor alpha (TNF-α) is an inflammatory cytokine produced during acute inflammation. Few studies have evaluated the association between serum TNF-α and its receptors and their clinical outcomes in hemodialysis patients. However, a study assessing patients using a low-flux dialyzer reuse has not been conducted yet. The serum TNF-α concentrations of 319 prevalent hemodialysis patients (mean age, 45 ± 15 years; median duration of hemodialysis, 48 [interquartile range, 26-79] months; 185 males and 134 females) was examined to predict their 3-year mortality. The patients were divided into tertiles according to their serum TNF-α concentrations: T1 (n = 106; serum TNF-α concentration, <41.22 pg/mL), T2 (n = 106; serum TNF-α level, from 41.22 to 67.28 pg/mL), and T3 (n = 107; serum TNF-α concentration, ≥ 67.29 pg/mL). During the 36-month follow-up period, a total of 50 (15.7%) patients died from all causes. The Kaplan-Meier analysis revealed that the all-cause mortality in T3 was significantly higher compared to that in T1 and T2 (log-rank test, P < .001). The serum TNF-α level was a significant predictor for all-cause mortality (area under the curve = 0.887, P < .001, cutoff value, 89.812 pg/mL, sensitivity = 76%, specificity = 96.3%). The serum TNF-α level was a better predictor of mortality than the duration of hemodialysis and serum albumin, serum high-sensitivity C-reactive protein, and serum beta-2 microglobulin concentrations. The serum TNF-α concentration was a good predictor of the 3-year mortality in low-flux hemodialysis patients.

Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso.

INTRODUCTION: Pregnant women are more susceptible to vaginal colonization and infection by yeast. The role of Candida colonization in the occurrence of preterm birth is well established. The knowledge of local epidemiology and identification of risk factors for preterm birth is important for the prevention and management strategies. The purpose of the study was to determine the prevalence of Candida sp. in vaginal swabs of pregnant women. METHODS: Pregnant women attending routine antenatal visits in three primary health centres in Bobo-Dioulasso (Burkina Faso) were enrolled into a cross-sectional study carried out from February to April 2015. Vaginal swabs samples were taken from participants after obtaining oral consent. The swabs were inoculated into Sabouraud's glucose agar supplemented with chloramphenicol and incubated at 37°C for 24 to 48hours under aerobic conditions in order to perform fungal culture. The identification of the Candida species was done by culture on HiCrome Candida Differential Agar at 35°C for 48h for production of species-specific colors. RESULTS: A total of 229 pregnant women were included. The prevalence of vulvovaginal candidiasis (VVC) was 22.71%, (95% CI [17.45-28.69]). Candida albicans accounted for 40.39% and non-Candida albicans species for 59.61% of the isolates, with mainly C. glabrata (32.69%), C. tropicalis (15.38%) and C. krusei (11.54%). CONCLUSIONS: This study revealed a high prevalence of non-C. albicans species. The syndromic management guidelines for VVC in Burkina Faso will be revised to include a specific protocol for pregnant women.

Assisted vaginal delivery in low and middle income countries: an overview.

OBJECTIVE: To assess the use of assisted vaginal delivery (AVD) in low- and middle-income countries (LMICs), highlighting what level of care procedures were performed and identifying systemic barriers to its use. DESIGN: Cross-sectional health facility assessments. SETTING: Up to 40 countries in Latin America, sub-Saharan Africa and Asia. POPULATION: Assessments tended to be national in scope and included all hospitals and samples of midlevel facilities in public and private sectors. METHODS: Descriptive secondary data analysis. MAIN OUTCOME MEASURES: Percentage of facilities where health workers performed AVD in the 3 months prior to the assessment, instrument preference, which health workers performed the procedure, and reasons AVD was not practiced. RESULTS: Fewer than 20% of facilities in Latin America reported performing AVD in the last 3 months. In sub-Saharan Africa, 53% of 1728 hospitals had performed AVD but only 6% of nearly 10 000 health centres had done so. It was not uncommon to find <1% of institutional births delivered by AVD. Vacuum extraction appears preferred over forceps. Lack of equipment and trained health workers were the most frequent reasons for non-performance. CONCLUSIONS: The low use of AVD in LMICs is in contrast with many high-income countries, where high caesarean rates are also associated with significant rates of AVD. In many LMICs, rising caesarean rates have not been associated with maintenance of skills and practice of AVD. AVD is underused precisely in countries where pregnant women continue to face hardships accessing emergency obstetric care and where caesarean delivery can be relatively unsafe. TWEETABLE ABSTRACT: Many LMICs exhibit low use of assisted vaginal delivery where access to EmONC continues to be a hardship.

[Feasibility and results of at-home follow-up after early postpartum discharge from maternity units in Bobo-Dioulasso, Burkina Faso]. / Faisabilité et résultat d'un suivi à domicile d'accouchées sorties précocement de la maternité à Bobo-Dioulasso, Burkina Faso.

OBJECTIVE: to describe the feasibility and results of at-home follow-up of mothers and newborns discharged early from the maternity ward after normal childbirth. METHOD: This prospective descriptive study took place during a one month period (April 1-30, 2011) in five maternity units in Bobo-Dioulasso, the second largest city in Burkina Faso. Mothers with normal vaginal deliveries and no complications at the sixth hour postpartum were included in the study with their newborns after informed oral consent. The discharge took place between 12 and 48 hours after delivery. The follow-up took place by telephone, home visits, and emergency hospital visits in cases of complications. A postnatal hospital visit was systematically planned for day 7. RESULTS: The study included 630 mothers and their babies. There were 1567 phone calls made: 27 women could not be reached by telephone after discharge, and 140 home visits took place, either at the mother's request or because of the failure to reach her by telephone. Complications were observed in 55 mothers and 135 babies. CONCLUSION: Postnatal follow-up at home is required for mothers and their newborns discharged early from the maternity ward after normal childbirth in view of the possibility of complications. This ensures continuity of care to improve survival of mothers and babies. As cell phones become more and more available, they may play an important role as a tool for such follow up.

Chirurgie des prolapsus genitaux au Centre Hospitalier Universitaire Souro Sanou de Bobo-Dioulasso; Burkina-Faso

Objectifs. Decrire les types de prolapsus genitaux et en analyser les complications post-chirurgicales au Centre Hospitalier Universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso. Methode. Etude prospective et descriptive de 39 patientes operees de prolapsus genital entre le 1er avril 2005 et le 30 septembre 2006. Le follow-up a ete effectue 6 semaines; 3mois; puis 6 mois apres la chirurgie. Un questionnaire ecrit; semi-structure a permis le recueil de donnees cliniques et les protocoles operatoires ont ete revus. Resultats : Trente-neuf patientes; porteuses de 84 types de prolapsus diagnostiques (42;86); ont ete operees; representant pres de 10 de l'ensemble d'interventions gynecologiques programmees. La frequence annuelle des prolapsus genitaux en consultation gynecologique etait de 4;2. Les lesions etaient souvent associees (77) et interessaient les 3 etages dans 49 des cas. La cystocele etait la plus frequente (79;5); suivie de la rectocele (71;8) et des hysteroceles (50). Deux tiers des interventions concernaient les prolapsus de degre 4. Six techniques operatoires ont ete repertoriees; la plus frequente etant la triple operation perineale (51;3). Les complications per operatoires (15;4) ont ete : une plaie vesicale; deux plaies rectales; et trois cas d'hemorragies. Deux patientes ont developpe une retention urinaire aigue en postoperatoire immediat (5;1). A 6 mois de suivi postoperatoire; 7 cas de recidives (15;38) ont ete enregistres : parmi lesquels; 6 cystoceles apparues des la 6eme semaine. Conclusion : La cystocele est le type de prolapsus le plus frequent dans notre service ; elle en represente avec l'hemorragie; les principales complications postchirurgicales; justifiant l'elaboration de lignes directrices pour une prise en charge efficace de cette pathologie

Intégration de l'inspection visuelle du col a l'acide acétique dans les services de soins après avortement et de planification familiale au CHU de Bobo-Dioulasso

Objectif : Evaluer l'intégration du dépistage du cancer du col par IVA dans les services de soins après avortement (SAA) et de planification familiale (PF) dans un hôpital universitaire.Méthodologie : L'étude s'est déroulée dans les unités de Soins Après Avortement (SAA) et de planification familiale (PF) du CHU de Bobo Dioulasso au Burkina Faso. Les données ont été collectées rétrospectivement sur les clientes de PAC et de PF ayant bénéficié du dépistage du cancer du col par IVA pendant la période du 1er janvier 2009 au 31 aout 2010. Le personnel des deux unités a également été interrogé sur son point de vue sur l'intégration des services et les difficultés de sa mise en œuvre.Résultats : Le nombre de femmes ayant consulté dans les deux unités pendant la période de l'étude était de 3161. Leurs caractéristiques sociodémographiques étaient les suivantes : âge moyen de 32,8 ans, mariées dans 93,50% des cas, sans profession dans 78,8% ; gestité et parité moyennes respectives de 3,8 et 2,9 et un taux d'utilisation d'une méthode contraceptive de 66,7%. Au total 460 femmes ont bénéficié du dépistage des lésions précancéreuses par l'IVA soit 14,6% des consultantes et 70,2% de ces femmes ont bénéficié du dépistage en plus des soins pour lesquels elles ont consulté. L'IVA a été normal dans la majorité des cas (426 sur 460), positive chez 12 femmes et une IST a été diagnostiquée dans 54 cas (11,7%). Les principales difficultés évoquées par le personnel sont l'insuffisance de personnel formé et les problèmes logistiques.Conclusion : L'intégration du dépistage du cancer du col dans les services de SAA et de PF n'a pas donné les résultats escomptés dans les deux services à savoir l'augmentation de l'accès au dépistage. La formation du personnel, la résolution des problèmes logistiques dans les deux services ainsi qu'une meilleure organisation des soins doivent permettre d'améliorer le taux de dépistage

[Audit of medical records]. / Audit des dossiers médicaux.

OBJECTIVE: TO assess the quality of medical records in a university teaching hospital in Africa. MATERIAL AND METHODS: We conducted a retrospective study at the Souro Sanou University Teaching Hospital of Bobo Dioulasso in Burkina Faso, by randomly selecting 480 medical records from 4 clinical departments (internal medicine, obstetrics & gynaecology, paediatrics and surgery). Items recorded were based mainly on those used by the French agency for the evaluation of health services (now the HAS). Ten physicians were also interviewed about medical file ergonomics file. Descriptive statistics were compiled from the data collected. RESULTS: Only 368 of the 480 records could be found. Two of the four departments had an adequate record room. Assessment of the overall quality of the files noted that: i) 95 to 100% of the records were in good physical condition; ii) the handwriting in the files was legible in 94 to 100% of the cases; iii) the identity of the staff members making file entries could be determined in 73 to 92% of the cases. A detailed examination of the content of the files revealed that: i) the patient's social and demographic characteristics (name, sex, age, residence, occupation, marital status and religion) were available in 26 to 99% of the cases; ii) the mode of admission was noted in 52 to 88%; iii) the reason for admission was stated in 83 to 100%; iv) the main diagnosis was reported in 68 to 100%; v) surgery notes were found for 93 to 100% of patients who underwent surgery; vi) the disposition on discharge was not found in 31% of the records; vii) the circumstances of death were not recorded for 77% of the patients who died. CONCLUSION: The quality of medical records at Souro University Teaching Hospital must be improved, through improving staff awareness and regular audits.

Clinical efficiency of a natural resin fluoride varnish (Shellac F) in reducing dentin hypersensitivity.

Previous in vitro permeability and scanning electron microscopic studies have demonstrated the effectiveness of a new natural based-resin varnish (Shellac F) in dentin permeability reduction and effective tubule occlusion. The aim of this randomized double-blind, controlled, split mouth 8-week clinical study was to evaluate the efficiency of Shellac F in reducing dentin hypersensitivity. Ten patients (eight women: two men) completed the study. A quadrant including at least one hypersensitive tooth (Visual Analog Scale - VAS = 15 mm to air blast) was considered as a unit and randomly assigned to different groups for Shellac F, Duraphat, Isodan. Three applications of each material were completed at days 0, 1 and 7. The subjective response was assessed by tactile and thermal/evaporative methods. Data were collected at baseline and after the first application, at 15 min, 1, 7, 14, 28 and 56 days. Analysis was based on Kruskall-Wallis test, Wilcoxon signed rank test and the method of the least square means. No statistically significant difference was noted between Shellac F and the two control materials. Regardless of the type of stimulus, Shellac F showed significant immediate and progressive continuous efficiency in reducing dentin hypersensitivity until 56 days (VAS of 14 +/- 12 mm and provoking pain force of 89 +/- 12 cN, respectively, compared with 38 +/- 23 mm and 41 +/- 10 cN at baseline), corresponding to a highly effective relief dentin hypersensitivity. Shellac F reduced dentin hypersensitivity and did not differ from the two desensitizing agents used as controls.

Is misoprostol a safe, effective and acceptable alternative to manual vacuum aspiration for postabortion care? Results from a randomised trial in Burkina Faso, West Africa.

OBJECTIVES: Previous research has demonstrated the effectiveness of misoprostol for treatment of incomplete abortion; however, few studies have systematically compared misoprostol's effectiveness with that of standard surgical care. This study documents the effectiveness of a single 600 micrograms dose of oral misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion in a developing country setting. DESIGN: Open-label randomised controlled trial. SETTING: Two university teaching hospitals in Burkina Faso, West Africa. POPULATION: Women of reproductive age presenting with incomplete abortion. METHODS: From April 2004 through October 2004, 447 consenting women with incomplete abortion were randomised to either a single dose of 600 micrograms oral misoprostol or MVA for treatment of their condition. MAIN OUTCOME MEASURE: Completed abortion following initial treatment. RESULTS: Regardless of treatment assigned, nearly all participants had a complete uterine evacuation (misoprostol = 94.5%, MVA = 99.1%; relative risk [RR] = 0.95 [95% CI 0.92-0.99]). Acceptability and satisfaction ratings were similar and high for both misoprostol and MVA, with three out of four women indicating that the treatment's adverse effects were tolerable (misoprostol = 72.9%, MVA = 75.8%; RR = 0.96 [95% CI 0.86-1.07]). The majority of women were 'satisfied' or 'very satisfied' with the method they received (misoprostol = 96.8%, MVA = 97.7%; RR = 0.99 [95% CI 0.96-1.02]), expressed a desire to choose that method again (misoprostol = 94.5%, MVA = 86.6%; RR = 1.09 [95% CI 1.03-1.16]) and to recommend it to a friend (misoprostol = 94.5%, MVA = 85.2%; RR = 1.11 [95% CI 1.04-1.18]). CONCLUSION: Six hundred micrograms of oral misoprostol is as safe and acceptable as MVA for the treatment of incomplete abortion. Operations research is needed to ascertain the role of misoprostol within postabortion care programmes worldwide.

Etude de l'insuffisance érectile dans une population d'hommes jeunes et sexuellement actifs au Burkina Faso

Objectif: Notre tude avait pour objectif de dterminer la prvalence de l'insuffisance rectile (IE) dans notre environnement et d'valuer les connaissances et les attitudes des sujets qui en souffrent. Mthodologie: Il s'agissait d'une enqute transversale sur six mois concernant des sujets gs de 18 ans et plus du monde de travail, ralise au cours d'une visite annuelle des travailleurs des entreprises de la place et de quelques fonctionnaires. Les sujets ayant accept de participer l'enqute (855 hommes), avaient remplir deux questionnaires: la version 5 items de l'International Iindex of Erectile Function (IIEF5), qui value la fonction rectile et, un questionnaire labor par nous mme, dans le but d'valuer les connaissances et les attitudes des enquts, vis vis de l'IE. Les questionnaires ont ensuite t dpouills et analyss sur micro ordinateur l'aide du logiciel Epi info. Rsultats: Les 855 sujets qui ont particip l'enqute reprsentaient 80% de tous ceux qui ont t sollicits. L'ge moyen des enquts tait de 37,4 ± 9,1; plus des 2/3 (78%) taient maris et monogames dans 69%. La prvalence globale note tait de 47% et on a remarqu que celle-ci augmentait avec l'ge. Trois facteurs de risque ont t mis en exergue: l'ge, l'hypertension artrielle (HTA) et la maladie hmorrodaire. Si l'ge et l'HTA sont des facteurs de risque classiques, la maladie hmorrodaire l'est moins; par contre il a t beaucoup invoqu par de nombreux enquts. 93,2% des sujets interrogs seraient prts consulter pour IE, alors que seulement 3,8% l'avaient effectivement dj fait. Conclusion: L'insuffisance rectile s'est rvl comme un problme rel vcu dans notre environnement. Cependant nos rsultats ne peuvent pas tre gnraliss et nous envisageons d'autres tudes, en population gnrale, qui nous permettraient de tirer des enseignements et de mieux organiser la prise en charge de ces patients

[Transfer of obstetric patients in a pregnant and postpartum condition to an intensive care unit: eighty-two cases in Burkina Faso]. / Transfert de patientes en état gravido-puerpéral en réanimation: à propos de 82 cas au Burkina Faso.

OBJECTIVE: To review all obstetric admissions to an intensive care unit (ICU) of an African hospital. PATIENTS AND METHODS: Retrospective analysis of the records of all obstetric patients admitted to the ICU of Souro Sanou Hospital in Burkina Faso, from January 1st, 1996, to June 30, 1998. RESULTS: Eighty-two patients out of 6119 deliveries were transferred to the ICU, which meant a 1.34% transfer rate. These transfers concerned young patients (mean age of 24 years), coming originally from outlying maternities in 52.4% and having already given birth in 64.63% of the cases. The two main diagnoses at the ICU were: eclampsia and septic shock. The large majority of the patients (73 out of 82) had at least one bad prognosis factor at admission at the ICU. A maternal mortality rate of 60% was noted, the main risk factors for mortality being acute respiratory condition and severe anemia. CONCLUSION: Mortality of obstetric patients admitted to ICUs is very high in our setting. Establishing an ICU within the obstetric unit or early detection of cases to be transferred (scoring system?) should improve the prognosis.

Sexual and reproductive life of women informed of their HIV seropositivity: a prospective cohort study in Burkina Faso.

BACKGROUND: In the context of the DITRAME-ANRS 049 research program that evaluated interventions aimed at reducing mother-to-child transmission of HIV (MTCT) in Bobo-Dioulasso (Burkina Faso), Voluntary HIV counseling and testing (VCT) services were established for pregnant women. HIV-infected women were advised to disclose their HIV serostatus to their male partners who were also offered VCT, to use condoms to reduce sexual transmission, and to choose an effective contraception method to avoid unwanted pregnancies. This study aimed at assessing how HIV test results were shared with male sexual partners, the level of use of modern contraceptive methods, and the pregnancy incidence among these women informed of the risks surrounding sexual and reproductive health during HIV infection. METHODS: From 1995 to 1999, a quarterly prospective follow-up of a cohort of HIV-positive women. RESULTS: Overall, 306 HIV-positive women were monitored over an average period of 13.5 months following childbirth, accounting for a total of 389 person-years. The mean age at enrollment in the cohort was 25.1 (standard deviation, 5.2 years). In all, 18% of women informed their partners, 8% used condoms at each instance of sexual intercourse to avoid HIV transmission, and 39% started using hormonal contraception. A total of 48 pregnancies occurred after HIV infection was diagnosed, an incidence of 12.3 pregnancies per 100 person-years. Pregnancy incidence was 4 per 100 person-years in the first year of monitoring and this rose significantly to 18 per 100 person-years in the third year. The only predictor of the occurrence of a pregnancy after HIV diagnosis was the poor outcome of the previous pregnancy (stillbirth, infant death). Severe immunodeficiency and change in marital status were the only factors that prevented the occurrence of a pregnancy after HIV diagnosis. CONCLUSION: Our study shows a poor rate of HIV test sharing and a poor use of contraceptive methods despite regular advice and counseling. Pregnancy incidence remained comparable with the pregnancy rate in the general population. To improve this situation, approaches for involving husbands or partners in VCT and prevention of MTCT interventions should be developed, evaluated, and implemented.

HBs antigen in children with suspicion of HIV infection.

In order to evaluate the prevalence rate of HBs antigen in children with a suspicion of HIV infection, 103 children were tested for HBs antigen and HIV. The mean age of the children was 2 years. The prevalence of HBs antigen was 39.8 per cent in children and the HIV ELISA test was positive in 57.7 per cent. A correlation was found between carrier of HBs antigen and HIV ELISA positivity (p = 0.04, RR = 1.46; 1.06 < RR < 2.02). There was a high prevalence of HBs antigen in children with a suspicion of HIV infection. This calls for the promotion of antenal screening for HIV and HBV along with immunization against hepatitis B in newborns in our setting.

[HIV infection and hepatitis B co-infection: survey of prevalence in pregnant women in Bobo Dioulasso, Burkina Faso]. / Co-infection hépatite B et VIH: enquête de préevalence chez les femmes enceintes à Bobo Dioulasso, Burkina Faso.

We carried out this study to assess the prevalence of co-infection with hepatitis B and HIV-1 in african pregnant women. Nine hundred and seventeen pregnant women attending two antenatal clinics in Bobo Dioulasso, Burkina Faso, were included. The characteristics of the women were the following: a mean age of 26 years and 83.5% married; a mean gravidity and para of 4 and 3 respectively and a mean gestational age of 27 weeks of amenorrhea. Then sera were drawn to be tested for both hepatitis B and HIV-1. Sera tested positive for HIV-1 at ELISA were confirmed by Western Blot. Ninety eight women (10.7%) were Ag HBs carriers of whose 18.2% were positive for Ag HBe, 66.7% anti-HBe positive and 95.6% anti-HBc positive. The HIV-1 prevalence rate was 5.9%. Eight women were positive for both Ag HBs and HIV-1, giving a co-infection rate of 0.88%. The co-infection rate by hepatitis B and HIV-1 is very low in pregnant women in Bobo Dioulasso despite a high prevalence of these two infections.