Estimation of enteric methane emission factors for Ndama cattle in the Sudanian zone of Senegal.

Methane (CH4) emission estimations for cattle in Sub-Saharan Africa (SSA) reflect limited production levels and diets that are high in cellulose forage. However, data on these livestock systems is lacking for their accurate evaluation. To provide guidance for climate change mitigation strategies in Senegal, it is necessary to obtain reliable estimates of CH4 emissions from Ndama cattle reared in grazing systems, which is the predominant cattle system in the country. The objective of this study was to determine the annual methane emission factor (MEF) for enteric fermentation of Ndama cattle following the IPCC Tier 2 procedure. Our estimated annual MEF at the herd scale was 30.8 kg CH4/TLU (30.7 kg CH4/head/yr for lactating cows and 15.1 kg CH4/head/yr for other cattle). These values are well below the default IPCC emission factor (46 and 31 kg CH4/head/yr for dairy and other cattle, respectively) proposed in the Tier 1 method for Africa. Our study showed that feed digestibility values differ with season (from 46 to 64%). We also showed that cattle lose weight and adapt to lower feed requirements during the long dry season, with a resulting major reduction in methane emissions. The results of this work provide a new framework to re-estimate the contribution of grazing systems to methane emissions in Africa.

Rachianesthésie pour le cerclage du col utérin

Introduction :Notre étude avait pour but d'évaluer la rachianesthésie à faible dose de bupivacaïne et de fentanyl pour le cerclage du col de l'utérus chez des patientes en surpoids ou obèses. Le cerclage du col utérin est indiqué dans le traitement de l'incompétence cervicale, généralement réalisé sous anesthésie générale et en chirurgie ambulatoire. Méthodes : Il s'agissait d'une étude prospective observationnelle et multicentrique réalisée sur une période de 18 mois portant sur la rachianesthésie pour cerclage du col utérin. Etaient inclues les patientes de classes ASA 1 et 2, ayant un indice de masse corporelle supérieur ou égal à 25 Kg/m2. La rachianesthésie était réalisée avec une association de 5 mg de bupivacaïne et de 25 µg de fentanyl. Les principales variables étudiées étaient la qualité du bloc sensitif et moteur, les paramètres hémodynamiques, le délai de sortie de l'hôpital. L'analyse statistique a été faite à l'aide du logiciel SPSS 21.0. Résultats : Cinquante-neuf patientes d'un âge moyen de 27 ± 7 ans avec un âge de grossesse de 16 ± 4 semaines d'aménorrhée (SA) ont été inclues. Le délai d'installation du bloc sensitif était de 3,86±1,06 minutes, pour un niveau d'anesthésie à T11 chez 86,44% des patientes, et un score de Bromage à 1 à la mise en position gynécologique. Aucune plainte douloureuse n'a été exprimée à la préhension du col. La durée moyenne du cerclage était de 22,83 ± 5,04 min. Aucun cas d'hypotension artérielle ou de bradycardie n'a été observé. La récupération postopératoire était complète (score de Bromage 0) à la 2ème heure. La sortie était faite à la fin de la 3ème heure post-opératoire chez toutes les patientes. Conclusion : La rachianesthésie à faible dose de bupivacaïne et de fentanyl est suffisante et efficace pour le cerclage du col, chez des patientes à terrain particulier, permettant ainsi une récupération post interventionnelle précoce

Accès d'euphorie au réveil d'une sédation avec le propofol

L'objectif de cette revue était de rapporter les effets hallucinatoires survenus chez un sujet de 30 ans, au réveil d'une sédation au propofol pour endoscopie digestive. Le propofol est un hypnotique intraveineux d'utilisation courante lors des anesthésies pour gestes de courte durée comme les procédures diagnostiques en radiologie et en endoscopie. Le réveil post-anesthésie est qualifié « de très bonne qualité », cependant des effets hallucinatoires et psychodysleptiques ont fait l'objet de quelques écrits dans la littérature. Nous rapportons un cas d'accès d'euphorie post-anesthésique après sédation au propofol pour une endoscopie digestive

Survey of patient and partner satisfaction following collagenase Clostridium histolyticum treatment for Peyronie's disease.

Intralesional injection of collagenase Clostridium histolyticum (CCH) is a minimally invasive, Food and Drug Administration-approved, effective treatment for Peyronie's disease (PD). To assess the satisfaction of patients and their female sexual partners (FSP) following CCH therapy for PD, we conducted a retrospective review of the records of all patients treated with CCH for PD between 04/2014 and 03/2016. Collected variables included demographics, pre- and post-treatment sexual function, penile curvature, penile vascular findings, and treatment outcomes. Patients and their FSPs were subsequently contacted by telephone and queried regarding their ability to have intercourse and their satisfaction with treatment. A total of 24 couples responded to our questionnaire and constitute the subjects of this analysis. Patient and FSP satisfaction with treatment were 67% and 71%, respectively. Significant predictors of FSP satisfaction with treatment included recall of penile trauma during prior sexual intercourse, improved ability to have sexual intercourse following treatment, and absence of post-procedural glans hypoesthesia. In conclusion, CCH imparts a significant benefit on a couple's sexual health. Partner satisfaction with treatment is correlated with improved ability to have sexual intercourse and absence of patient glans hypoesthesia.

[Surveillance system for adverse events following immunization against yellow fever in Burkina Faso in 2008. Good practice recommendations]. / Dispositif de surveillance des effets indésirables graves lors de la campagne de vaccination preventive contre la fièvre jaune au Burkina Faso en 2008. Recommandations de bonnes pratiques.

Yellow fever (YF) remains a public health problem in Africa. In 2007 and 2008, Togo, Senegal, Mali and Burkina Faso became the first countries to implement mass YF immunization campaigns within the framework of the Yellow Fever Initiative. The goal of this initiative led by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) with the support of The Global Alliance for Vaccines and Immunization (GAVI) is to organize mass YF immunization campaigns in 12 African countries at high risk forYF transmission between 2006 and 2013. A total of 290 million USD have been allocated for vaccination of 180 million people with the highly effective attenuated 17DYF vaccine. Working in partnership with the WHO, the 12 member states are to identify and target high risk areas with the dual aim of preventing epidemics and increasing immunization coverage. Surveillance of adverse events following immunization (AEFI) is a mandatory component for organization of these campaigns. Purpose. The purpose of this article is to describe the AEFI surveillance system implemented in Burkina Faso in 2008. Methods. The strategy used in Burkina Faso was based on a combination of regular passive surveillance and active surveillance. General guidelines and related operational processes were established including reporting forms, investigation forms, and procedures for collection, storage and transport of biological specimens. Classification of cases was based on clearly defined criteria. Any patient meeting the defined criteria and requiring hospitalization was considered as a serious case. In addition to case definition criteria, serious cases were tracked according to presented signs and symptoms using a line-listing form at two university hospital centers in Ouagadougou and one regional hospital center. Emergency room admission records and patient charts were examined during the surveillance period (30 days after the end of the immunization campaign) and on-duty hospital staff were interviewed. The Ministry of Health appointed an 11-member National Expert Committee (NEC) to investigate and judge the status of reported cases. After eliminating coincidental events, program errors, and undetermined cases, vaccination was established as the suspected cause. Suspected cases were classified as viserotrophic or neurotrophic AEFI and recorded as probable cases pending confirmation by virologic studies. An AEFI center with a duly mandated coordinator was designated to coordinate the activities of the different teams involved and to serve as an interface for the expert committee. Detection and investigation teams were formed at each of the hospital locations. A national laboratory as well as an international virology laboratory were designated as reference centers for performance of further testing. Results. Between November 28, 2008, and December 9, 2008, a total 7,566,218 people (aged 9 months and older) excluding pregnant women, critically ill patients, and individuals allergic to eggs, were immunized in 37 of the 63 districts in Burkina Faso. Administrative vaccination coverage was 102.3%. Systematic line-listing at the 3 hospital centers accounted for most of the suspected serious AEFIs identified from reported cases. During the AEFI surveillance period, the NEC met once a week to discuss the suspected serious AEFI. Some cases were excluded and others were designated for further testing. At least one biological specimen was available for all retained cases. Each case benefited from laboratory testing to achieve differential clinical diagnosis as well as from virological testing (results pending). Conclusion. Experiences in Burkina Faso demonstrates the value of active surveillance and of systematic line listing. However, the duration of case investigation and data management was at least six months. To improve AEFI surveillance in future campaigns, several measures can be recommended. Planning should begin well in advance with appropriate funding. Training should be given to raise awareness at all levels of the health system. Mechanisms should be developed for systematic and timely collection and processing of biological samples and data at national level.

Host range of rice yellow mottle virus in Sudano-Sahelian Savannahs.

In the present study, we investigated on the experimental host range of RYMV among plant species most of which are frequently encountered in rice-growing environments of west and central African savannahs. Only seven out of 66 plant species inoculated were infected by RYMV. All susceptible plant species belonged to the Poaceae family and three of them (Chloris prieuri, Eragrostis cilianensis and Shoenefeldia gracilis) were reported for the first time. Symptoms were conspicuous and persistent in most species but disappeared totally in older plants of some host species such as S. gracilis and Eragrostis tenella. Therefore, surveys for identification ofRYMV wild hosts should be conducted before the flowering stage. Virus-host Interactions were studied between 15 RYMV isolates of different strains and 10 wild host species. Differential reactions were obtained in the crow-foot grass Dactyloctenium aegyptium which was susceptible to five of the fifteen isolates. All other plants were susceptible to the whole set of virus isolates. Altogether, this study underlined the narrowness of RYMV host range and pointed out the complexity of interactions between the virus and its hosts, especially the rationale behind overcoming host barriers.

[Sociocultural aspects of epilepsy in secondary school students in Bobo-Dioulasso (Burkina Faso)]. / Aspects socioculturels de l'épilepsie en milieu scolaire à Bobo-Dioulasso (Burkina Faso).

In Black Africa, epilepsy is usually affected by sociocultural attitudes. A school survey concerning epilepsy was conducted in February 1999 in Bobo-Dioulasso, an Islamic region. Knowledge and attitudes towards epilepsy in secondary school students was evaluated through focus group discussions done in secondary schools. Epilepsy was supposed to be a chronic disease attributed to brain damage, or spiritual. The students usually described the "Grand Mal" generalized tonic-clonic form of epilepsy. Epilepsy is believed to have hereditary causes and the students believed it to be contagious through saliva and physical contact. For students, epilepsy cannot be cured. When a treatment was proposed, only traditional medicine was supposed to be competent. If burns occur in the course of the disease, the prognosis is supposed to be bad. Generally fear and mistrust are dominant feelings among students despite the fact they are literate urban population. Their belief in the contagiousness of epilepsy could be a major reason for discriminating against an epileptic person. Our data suggest that there is a need to make additional efforts in order to increase the knowledge of the general population and the level of formal education. Poor knowledge and lack of information explained secondary school students attitudes towards epilepsy in Bobo-Dioulasso.

Potties, pits and pipes: explaining hygiene behaviour in Burkina Faso.

Stool disposal practices have been shown to be associated with childhood diarrhoea. However, efforts to promote improved hygiene behaviour are hampered by a lack of understanding of what determines those behaviours. Data from 2793 household interviews with mothers of children from the town of Bobo-Dioulasso in Burkina Faso were analyzed to examine what differentiated mothers who reported using safer stool disposal practices from those who did not. Three 'outcomes' were considered: where the child was reported to defaecate; where the mother reported disposing of the child stools; and whether excreta were observed in the compound. Regression models were developed to identify those factors with the strongest independent associations with the outcomes. There was a consistent association between the source of water and the outcomes. Mothers with access to a tap in the yard reported using safe hygiene practices three times more often than mothers using wells outside the compound and twice as often as mothers who used public standpipes or wells within the yard. The source of water showed a similar pattern of association with observations of faecal matter in the environment. Improved sources of water may contribute to safer stool hygiene by reducing the time spent on water collection or by encouraging mothers to conform to higher standards of hygiene. Other factors which played a role in predicting the hygiene behaviour of mothers were the husbands' occupation, the number of health education sessions that she had attended, her zone of residence and family ownership of certain valuable objects. These factors are likely to be related and to be, to some extent, proxies for the real determinants of her behaviour. A model of the cultural, psycho-social and infrastructural proximate determinants of hygiene behaviour is proposed. Data from focus group discussions suggested that the main purpose of hygienic behaviour is to conform to existing norms of social etiquette. Trials of interventions based on changing such norms are needed to test whether this is an effective means of promoting of safer hygiene practices.

Child defecation behaviour, stool disposal practices, and childhood diarrhoea in Burkina Faso: results from a case-control study.

OBJECTIVE: To investigate the association between where young children defecate, where stools are disposed of, and the presence of human stools on the ground in the compound and the rate of hospital admission with diarrhoea. DESIGN: This was a case-control study with two control groups. SETTING: The study took place in Bobo-Dioulasso, the second city of Burkina Faso in West Africa. PARTICIPANTS: Three groups of children aged 36 months and under, and living in Bobo-Dioulasso were studied. Cases were 757 children admitted to hospital with symptoms of diarrhoea or dysentery. The first control group comprised 757 neighbourhood control children approximately matched on age and date of recruitment, and the second, 631 children admitted to the same hospital without symptoms of diarrhoea or dysentery. MAIN RESULTS: There was no evidence of any association between where the child was reported to defecate and hospital admission with diarrhoea or dysentery (odds ratio = 1.10; 95% confidence interval (CI) 0.78, 1.57, cases v neighbourhood controls; odds ratio = 0.84; 95% CI 0.60, 1.18, cases v hospital controls). There was evidence of an association between where the mother reported disposing of the child's stools and hospital admission with diarrhoea or dysentery (odds ratio = 1.50; 95% CI 1.09, 2.06, cases v neighbourhood controls; odds ratio = 1.31; 95% CI 0.96, 1.79, cases v hospital controls). Human stools were more frequently observed in the yards of cases than controls (odds ratio = 1.38; 95% CI 0.98, 1.95, cases compared with neighbourhood controls; odds ratio = 1.33; 95% CI 0.96, 1.84, cases compared with hospital controls). CONCLUSIONS: The findings suggest that it is not where the child defecates that matters but how the mother then deals with the child's stools.

[Acute respiratory infections in pediatric hospital at Bobo-Dioulasso (Burkina Faso)]. / Les infections respiratoires aiguës en milieu hospitalier pédiatrique de Bobo-Dioulasso (Burkina Faso).

BACKGROUND: Acute lower respiratory tract infections are the primary cause of morbidity in developing countries. POPULATION AND METHODS: Six hundred and sixty seven children (379 boys, 288 girls, aged 0-30 months) admitted for lower respiratory tract infections from January 1990 to March 1991 were included in the study. Immediate medical history was collected from the mother. The weight, height, temperature and clinical manifestations, plus the results of chest X-rays, parasitologic and bacteriological examination of stools, and blood smear for malaria were recorded for each patient. Sero-immunologic study for HIV infection of 473 of the patients aged 12-36 months and their mothers also took part in a sero-immunological study for HIV infection. RESULTS: Lower respiratory tract infections were the second major cause of admission (16.8%) after malaria (28.7%). Infections peaked between 6 and 11 months of age (29.5%). The main diseases were pneumonia and bronchial pneumonia (54%) followed by bronchiolitis (21.7%). Almost half the patients were admitted during the hot, dry season. Two hundred and eighty seven patients (43.4%) were referred only after they had been suffering from the disease for 3 to 9 days, partly explaining the high level of mortality. One hundred and twenty one patients (20.9%) died; the main cause of death was staphylococcal pneumonia (57.9%), followed by pneumonia and bronchial pneumonia (29.3%). Some criteria for severity could be identified, based on pulmonary signs and symptoms and associated manifestations (dehydration, malnutrition, convulsions, anemia). Twenty two patients were positive for HIV-1 infection. CONCLUSIONS: This study confirms that acute lower respiratory tract infections remain a public health problem. Early diagnosis and treatment are necessary to reduce mortality.

Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility.

The use of observation techniques has been promoted for the study of hygiene practices; however, questions still remain about the validity and repeatability of such techniques. In this article we compare data on hygiene behaviours obtained from questionnaires with data obtained using a structured observation approach and examine the repeatability of structured observations of behaviours and spot observations of environmental conditions. Poor agreement between questionnaire responses and observations was found for child defecation and stool disposal practices (kappa statistic: 0.25 and 0.28, respectively). There was evidence of over-reporting of "good" behaviours (P < 0.0001). Repeated observations of child defecation and stool disposal behaviours showed better agreement (kappa statistic: 0.76 and 0.62, respectively) based on small sample sizes. These findings suggest that our questionnaire data are less valid than data obtained by direct observation. However, different approaches to questioning may be less prone to over-reporting of "good" behaviours than our approach. Further research into the validity of different forms of question is warranted. Behaviours and conditions related to hygiene vary. Observations may be useful in determining the frequency of different behaviours/conditions in the community. However, individual practices may be too variable to assign individuals to exposed and non-exposed groups for the purpose of identifying links with health outcomes. Further studies on the variability of behaviours and the repeatability of observations are therefore needed.

PIP: The measurement of health behavior has included point-in-time structured questionnaires and structured observation. The correlation between these 2 approaches for assessing hygiene practices has not been found to be high. In this study, questionnaire responses, direct observations of behavior, repeated observations of hygiene behavior, and repeated observations of environmental conditions related to hygiene are compared. The unweighted kappa statistic was used to assess the degree of agreement between questionnaire responses and direct observation, and between repeated observations. McNemar's test and chi-square tests were used for examining general associations and trends. The case control study of childhood diarrhea was conducted in Bobo-Dioulasso, Burkina Faso under between January 15, 1990 and March 31, 1991, among a sample of children under 36 months old who had been admitted to Sanou Souro Hospital. Each child upon discharge was visited at home and matched to a control in the same neighborhood. A precoded data collection form was used during the observation to record behaviors. There were 10 households that were observed on 6 separate occasions out of the 57 (10%) households with repeat observations. Home interviews were conducted for 2775 children. 548 households were involved in direct observation. The findings revealed that agreement between questionnaire responses and observations on child defecation and stool disposal practices were very poor when chance agreement was taken into account. "Good practices" were overreported. Repeated observations were in greater agreement. The results were consistent with the hypothesis that questionnaire responses are less valid. One caveat was the way the question was posed; different results might have been achieved had the question been: "What happened the last time the child defecated?" Another difficulty is the assumption that behaviors are habitual as a justification for an initial observation. The suggestion is that hygiene behaviors are variable and the degree of consistency may vary substantially; an example is given to show the consequences of this variability. Measurement may be useful to gauge a general level of incidence, but not behavioral change or assignment into risk or nonrisk groups. Further research is warranted.

Prolonged breast-feeding: no association with increased risk of clinical malnutrition in young children in Burkina Faso.

Reported are our findings from a case-control study of the association between prolonged breast-feeding and clinical malnutrition in an urban setting in West Africa. The cases were children aged 12-36 months who had been hospitalized with a diagnosis of clinical malnutrition. Children of a similar age who lived in neighbouring courtyards were recruited as controls. For 152 case-control pairs in which both children were receiving solid foods, non-breast-feeding was associated with an increased risk of clinical malnutrition (crude odds ratio = 2.37; 95% confidence interval = 1.24, 4.55). This association remained statistically significant after controlling for various potentially confounding variables (P = 0.03). Our findings suggest that either prolonged breast-feeding may offer substantial protection against clinical malnutrition in the study population or malnutrition leads mothers to stop breast-feeding. These results are inconsistent with those of a number of workers who have reported that prolonged breast-feeding is associated with an increased risk of malnutrition. This inconsistency might have arisen because of differences in the definition of malnutrition used or because of variations in the quantity and quality of weaning foods available in different settings. We found no evidence to support the hypothesis that prolonged breast-feeding may be detrimental to children.

PIP: This case control study includes all children aged 12-36 months admitted to the pediatric unit of Sanou Souro Hospital for clinical malnutrition in Bobo-Biolasso, Burkina Faso in 1990 and early 1991. Cases numbered 273 persons, and matched controls numbered 173. 75% of cases have a diagnosis of marasmus, 10% have a diagnosis of kwashiorkor, and 15% have a diagnosis of marasmic kwashiorkor, Mortality includes 50% (14 cases) of the kwashiorkor cases and 30% of each of the other types of malnutrition. All cases show a poor anthropometric status (-4.2 among marasmus cases, -2.75 among kwashiorkor cases, and -3.80 among marasmic kwashiorkor cases). Only 2% show clinical malnutrition. The primary diagnoses are for diarrhea (78%), vomiting (46%), hepatomegaly (25%), dyspnoea (14%). and lymphadenopathy (14%). 35% are aged 12-17 months, 38% are aged 18-23 months, 18% are aged 24-29 months, and 9% are aged 30-36 months. 53% are male. 72% are in receipt of home follow-up visits. Of the 77 not followed up, 30 died. Cases and controls are grouped by feeding patterns (solid foods without breast milk, solid foods and breast milk and without or without porridge, and no solid foods). More malnutrition cases occur among children in the group with no solid food (11 with breast milk and/or other milk or porridge and 7 with porridge only). Those eating solid food with breast milk have a reduced odds of malnutrition. The case-control analysis indicates that more malnutrition occurs among those receiving breast milk or other milk. But with controls for age and supplementation the results indicate that children not receiving breast milk are twice as likely to suffer clinical malnutrition (odds ratio of 2.37), and the occurrence varies with age. Logistic regressions with control for confounding factors indicate that children without breast milk have three times the risk of malnutrition. Prolonged breast feeding and solid food supplements are associated with a 70% reduction in the rate of clinical malnutrition. Caution is urged in accepting wholly the findings due to the potential for reverse causality.

[Diarrheic diseases in children. Rationalization of fecal test]. / Maladies diarrhéiques de l'enfant. Pour une rationalisation des examens de selles.

The level of diarrheic diseases among children in Burkina Faso is very high. The identification of aetiologic agents of diarrhoea in hospitalized children (0-36 months) is one of the objectives of the study. All children less than 37 months old admitted to the Pediatric Unit of the National Hospital Souro Sanou of Bobo-Dioulasso between January 1990 and March 1991, were investigated by a standardized clinical examination, and in addition, we do an analysis of a rectal swab at admission and a stool to identify aetiologic enteric agents. As a conclusion to the study: an agent was isolated in 56% of the children with diarrhoea, and in 40% of the children without diarrhoea; some germs (such Salmonella, Shigella, Entamoeba) are found in children both with and without diarrhoea; also, the total of these examinations comes to 20 US $ per episode, or 100 US $ per children/year in Burkina Faso where the number of bouts reaches 5 times per year per infant who is less than 5 years old. Stool samples are not beneficial for children with diarrhoea, neither for the diagnosis nor for the treatment. There fore these types of routine exams should not be used in Sub-Saharan Africa.

Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility

The use of observation techniques has been promoted for the study of hygiene practices; however, questions still remain about the validity and repeatability of such techniques. In this article we compare data on hygiene behaviours obtained from questionnaires with data obtained using a structured observation approach and examine the repeatability of structured observations of behaviours and spot observations of environmental conditions. Poor agreement between questionnaire responses and observations was found for child defecation and stool disposal practices (kappa statistic: 0.25 and 0.28, respectively). There was evidence of over-reporting of "good" behaviours (P < 0.0001). Repeated observations of child defecation and stool disposal behaviours showed better agreement (kappa statistic: 0.76 and 0.62, respectively) based on small sample sizes. These findings suggest that our questionnaire data are less valid than data obtained by direct observation. However, different approaches to questioning may be less prone to over-reporting of "good" behaviours than our approach. Further research into the validity of different forms of question is warranted. Behaviours and conditions related to hygiene vary. Observations may be useful in determining the frequency of different behaviours/conditions in the community. However, individual practices may be too variable to assign individuals to exposed and non-exposed groups for the purpose of identifying links with health outcomes. Further studies on the variability of behaviours and the repeatability of observations are therefore needed