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1.
Malar J ; 21(1): 143, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524310

RESUMO

BACKGROUND: In 2014, the Burkina Faso government launched the Seasonal Malaria Chemoprevention (SMC) programme. Expected benefit was a 75% reduction of all malaria episodes and a 75% drop of severe malaria episodes. This study assessed SMC efficiency on malaria morbidity in the country after 2 years of implementation. METHODS: Quasi-experimental design comparing changes in outcomes during the high transmission period (August-November) between SMC and non-SMC health districts before (2013-2014) and after intervention (two rounds in 2015 and 2016). Health indicators (number of uncomplicated malaria cases (UM) and severe malaria cases (SM)) from 19 health districts (8 in intervention and 11 in comparison group) were extracted from the District Health Information System (DHIS2)-based platform including health facilities data. Effect on incidence was assessed by fitting difference-in difference mixed-effects negative binomial regression model at a log scale. RESULTS: The two rounds of SMC were associated with a reduction of UM incidence (ratio of incidence rate ratio (IRR) 69% (95% CI 55-86%); p = 0.001) and SM incidence (ratio of IRR = 73% (55-95%), p = 0.018) among under five children. CONCLUSION: The two rounds of SMC had a significant effect on the reduction of malaria cases in under five children. This additional evidence on the effectiveness of SMC, using routine data, support the need to sustain its implementation and consider expansion to eligible areas not yet covered.


Assuntos
Antimaláricos , Malária , Antimaláricos/uso terapêutico , Burkina Faso/epidemiologia , Quimioprevenção , Criança , Pré-Escolar , Humanos , Lactente , Malária/tratamento farmacológico , Malária/epidemiologia , Malária/prevenção & controle , Estações do Ano
2.
BMC Health Serv Res ; 22(1): 536, 2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35459161

RESUMO

BACKGROUND: In many parts of sub-Saharan Africa, access to abortion is legally restricted, which partly contributes to high incidence of unsafe abortion. This may result in unsafe abortion-related complications that demand long hospital stays, treatment and attendance by skilled health providers. There is however, limited knowledge on the capacity of public health facilities to deliver post-abortion care (PAC), and the spread of PAC services in these settings. We describe and discuss the preparedness and capacity of public health facilities to deliver complete and quality PAC services in Burkina Faso, Kenya and Nigeria. METHODS: A cross-sectional survey of primary, secondary and tertiary-level public health facilities was conducted between November 2018 and February 2019 in the three countries. Data on signal functions (including information on essential equipment and supplies, staffing and training among others) for measuring the ability of health facilities to provide post-abortion services were collected and analyzed. RESULTS: Across the three countries, fewer primary health facilities (ranging from 6.3-12.1% in Kenya and Burkina Faso) had the capacity to deliver on all components of basic PAC services. Approximately one-third (26-43%) of referral facilities across Burkina Faso, Kenya and Nigeria could provide comprehensive PAC services. Lack of trained staff, absence of necessary equipment and lack of PAC commodities and supplies were a main reason for inability to deliver specific PAC services (such as surgical procedures for abortion complications, blood transfusion and post-PAC contraceptive counselling). Further, the lack of capacity to refer acute PAC cases to higher-level facilities was identified as a key weakness in provision of post-abortion care services. CONCLUSIONS: Our findings reveal considerable gaps and weaknesses in the delivery of basic and comprehensive PAC within the three countries, linked to both the legal and policy contexts for abortion as well as broad health system challenges in the countries. There is a need for increased investments by governments to strengthen the capacity of primary, secondary and tertiary public health facilities to deliver quality PAC services, in order to increase access to PAC and avert preventable maternal mortalities.


Assuntos
Aborto Induzido , Aborto Espontâneo , Assistência ao Convalescente , Burkina Faso/epidemiologia , Estudos Transversais , Feminino , Instalações de Saúde , Humanos , Quênia/epidemiologia , Nigéria , Gravidez
3.
Bull World Health Organ ; 100(4): 256-267, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35386558

RESUMO

Objective: To evaluate the implementation of a screening strategy for the partners and children of pregnant women with hepatitis B virus (HBV) attending antenatal care. Methods: We identified pregnant women positive for HBV surface antigen (HBsAg) at antenatal consultation in Ouagadougou, Burkina Faso. At post-test counselling, women were advised to disclose their HBV status to partners and to encourage their partner and children to be screened for HBsAg. We used multivariable logistic regression to explore factors associated with uptake of screening and HBsAg positivity among family members. Findings: Of 1000 HBsAg-positive women, 436/1000 partners and 215/1281 children were screened. HBsAg was detected in 55 (12.6%) partners and 24 (11.2%) children. After adjusting for confounders, uptake of screening was higher in partners who were married, who attended the woman's first post-test consultation and to whom the woman had disclosed her HBV status. In children, HBsAg positivity was associated with being born before the introduction of infant hepatitis B vaccination in Burkina Faso (not significant in the multivariable analysis), having a mother positive for HBV e-antigen (adjusted OR: 8.57; 95% CI: 2.49-29.48) or having a mother with HBV DNA level ≥ 200 000 IU/mL (OR: 6.83; 95% CI: 1.61-29.00). Conclusion: In low-income countries, the antenatal consultation provides a cost-effective opportunity to identify HBV-infected household contacts and link them to care. Children born before the introduction of infant hepatitis B vaccination and whose mother has higher viral load or infectivity should be a priority for testing and linkage to care.


Assuntos
Hepatite B , Complicações Infecciosas na Gravidez , Antígenos de Superfície , Burkina Faso/epidemiologia , Criança , Feminino , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle
4.
Antimicrob Resist Infect Control ; 11(1): 59, 2022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35418154

RESUMO

BACKGROUND: In low- and middle-income countries, the prevalence of antimicrobial resistance (AMR) is increasing. To control AMR, WHO recommends monitoring antibiotic use, in particular Watch antibiotics. These are critically important antibiotics, with restricted use because at risk of becoming ineffective due to increasing AMR. We investigated pre-hospital antibiotic use in rural Burkina Faso. METHODS: During 2016-2017, we collected data from patients aged > 3 months presenting with severe acute fever to the rural hospital of Nanoro Health District, Burkina Faso, including antibiotic use in the two weeks prior to consultation or hospitalization. We analysed reported antibiotic use by applying the WHO Access, Watch, Reserve classification. RESULTS: Of 920 febrile participants (63.0% ≤ 14 years), pre-hospital antibiotic use was reported by 363 (39.5%). Among these 363, microbiological diagnoses were available for 275 (75.8%) patients, of whom 162 (58.9%) were non-bacterial infections. Use of more than one antibiotic was reported by 58/363 (16.0%) participants. Of 491 self-referred patients who did not previously visit a primary health care center, 131 (26.7%) reported antibiotic use. Of 424 antibiotics reported, 265 (62.5%) were Access and 159 (37.5%) Watch antibiotics. Watch antibiotic use was more frequent among patients > 14 year olds (51.1%) compared to those 0-14 year old (30.7%, p < 0.001) and among referrals from the primary health care centers (42.2%) compared to self-referred patients (28.1%, p = 0.004). Most frequently reported Watch antibiotics were ceftriaxone (114, 71.7%) and ciprofloxacin (32, 20.1%). CONCLUSION: The reported frequent use of Watch group antibiotics among febrile patients prior to presentation to the hospital in rural Burkina Faso highlights the need to develop targeted interventions to improve antibiotic use in community settings as part of strengthening antibiotic stewardship in low- and middle-income countries. This should include facilitating referral, access to qualified prescribers and diagnostic tools in rural primary health care centers. Trial registration ClinicalTrials.gov identifier: NCT02669823. Registration date was February 1, 2016.


Assuntos
Antibacterianos , Gestão de Antimicrobianos , Adolescente , Antibacterianos/uso terapêutico , Burkina Faso/epidemiologia , Criança , Pré-Escolar , Instalações de Saúde , Hospitais , Humanos , Lactente , Recém-Nascido
5.
Pak J Biol Sci ; 25(3): 254-262, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35234016

RESUMO

<b>Background and Objective:</b> Dengue is a remerging vector-borne viral disease in Burkina Faso since the outbreak of 2013 and requires special attention from health authorities. This study reports the prevalence of dengue fever serological markers (NS1Ag, IgM and IgG) and infection dynamic from January, 2018 to December, 2020 among patients tested for dengue infection at Saint Camille Hospital of Ouagadougou (HOSCO). <b>Materials and Methods:</b> The study population consisted of 6414 patients aged 0-97 years. Dengue virus infection was detected in serum or plasma using the SD bioline dengue duo rapid detection kit. <b>Results:</b> The prevalence of dengue NS1Ag was 2.25% (45/2003), 18.43% (501/2719) and 2.42% (38/1569) in the study population in 2018, 2019 and 2020, respectively. The age groups over 50 years and 15-20 years were significantly more infected compared to the group 21-30 years respectively in 2019 (p = 0.030) and 2020 (p = 0.035). Patients tested positive for at least one of these markers (NSlAg, IgG and IgM) represented 26.01% (521/2003) and 38.98% (1060/2719). The peak of infection during 2018 and 2019 was observed between October and November. The present study reports a high seroprevalence of acute dengue virus infection. The presence of NS1Ag, IgM and IgG in patients suggests an active circulation of the dengue virus in Ouagadougou. <b>Conclusion:</b> Data shows recurrent outbreaks of dengue infection in our country need strong surveillance and a suitable and affordable diagnostic system to clarify the burden, pinpoint the risk factors and for better case management.


Assuntos
Vírus da Dengue , Dengue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Burkina Faso/epidemiologia , Criança , Pré-Escolar , Dengue/diagnóstico , Dengue/epidemiologia , Hospitais , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Adulto Jovem
6.
Malar J ; 21(1): 103, 2022 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-35331248

RESUMO

BACKGROUND: Seasonal malaria chemoprevention (SMC) is a WHO-recommended intervention for children aged 3-59 months living in areas of high malaria transmission to provide protection against malaria during the rainy season. Operational guidelines were developed, based on WHO guidance, to support countries to mitigate the risk of coronavirus disease 2019 (COVID-19) transmission within communities and among community distributors when delivering SMC. METHODS: A cross-sectional study to determine adherence to infection prevention and control (IPC) measures during two distribution cycles of SMC in Nigeria, Chad and Burkina Faso. Community distributors were observed receiving equipment and delivering SMC. Adherence across six domains was calculated as the proportion of indications in which the community distributor performed the correct action. Focus group discussions were conducted with community distributors to understand their perceptions of the IPC measures and barriers and facilitators to adherence. RESULTS: Data collectors observed community distributors in Nigeria (n = 259), Burkina Faso (n = 252) and Chad (n = 266) receiving IPC equipment and delivering SMC. Adherence to IPC indications varied. In all three countries, adherence to mask use was the highest (ranging from 73.3% in Nigeria to 86.9% in Burkina Faso). Adherence to hand hygiene for at least 30 s was low (ranging from 3.6% in Nigeria to 10.3% in Burkina Faso) but increased substantially when excluding the length of time spent hand washing (ranging from 36.7% in Nigeria to 61.4% in Burkina Faso). Adherence to safe distancing in the compound ranged from 5.4% in Chad to 16.4% in Nigeria. In Burkina Faso and Chad, where disinfection wipes widely available compliance with disinfection of blister packs for SMC was low (17.4% in Burkina Faso and 16.9% in Chad). Community distributors generally found the IPC measures acceptable, however there were barriers to optimal hand hygiene practices, cultural norms made social distancing difficult to adhere to and caregivers needed assistance to administer the first dose of SMC. CONCLUSION: Adherence to IPC measures for SMC delivery during the COVID-19 pandemic varied across domains of IPC, but was largely insufficient, particularly for hand hygiene and safe distancing. Improvements in provision of protective equipment, early community engagement and adaptations to make IPC measures more feasible to implement could increase adherence.


Assuntos
Antimaláricos , COVID-19 , Malária , Antimaláricos/uso terapêutico , Burkina Faso/epidemiologia , COVID-19/prevenção & controle , Chade , Quimioprevenção , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Malária/prevenção & controle , Nigéria/epidemiologia , Pandemias/prevenção & controle , Estações do Ano
7.
Parasit Vectors ; 15(1): 72, 2022 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-35246216

RESUMO

BACKGROUND: African animal trypanosomosis (AAT), transmitted by tsetse flies, is arguably the main disease constraint to integrated crop-livestock agriculture in sub-Saharan Africa, and African heads of state and governments adopted a resolution to rid the continent of this scourge. In order to sustainably reduce or eliminate the burden of AAT, a progressive and evidence-based approach is needed, which must hinge on harmonized, spatially explicit information on the occurrence of AAT and its vectors. METHODS: A digital repository was assembled, containing tsetse and AAT data collected in Burkina Faso between 1990 and 2019. Data were collected either in the framework of control activities or for research purposes. Data were systematically verified, harmonized, georeferenced and integrated into a database (PostgreSQL). Entomological data on tsetse were mapped at the level of individual monitoring traps. When this was not possible, mapping was done at the level of site or location. Epidemiological data on AAT were mapped at the level of location or village. RESULTS: Entomological data showed the presence of four tsetse species in Burkina Faso. Glossina tachinoides, present from the eastern to the western part of the country, was the most widespread and abundant species (56.35% of the catches). Glossina palpalis gambiensis was the second most abundant species (35.56%), and it was mainly found in the west. Glossina morsitans submorsitans was found at lower densities (6.51%), with a patchy distribution in the southern parts of the country. A single cluster of G. medicorum was detected (less than 0.25%), located in the south-west. Unidentified tsetse flies accounted for 1.33%. For the AAT component, data for 54,948 animal blood samples were assembled from 218 geographic locations. The samples were tested with a variety of diagnostic methods. AAT was found in all surveyed departments, including the tsetse-free areas in the north. Trypanosoma vivax and T. congolense infections were the dominant ones, with a prevalence of 5.19 ± 18.97% and 6.11 ± 21.56%, respectively. Trypanosoma brucei infections were detected at a much lower rate (0.00 ± 0.10%). CONCLUSIONS: The atlas provides a synoptic view of the available information on tsetse and AAT distribution in Burkina Faso. Data are very scanty for most of the tsetse-free areas in the northern part of the country. Despite this limitation, this study generated a robust tool for targeting future surveillance and control activities. The development of the atlas also strengthened the collaboration between the different institutions involved in tsetse and AAT research and control in Burkina Faso, which will be crucial for future updates and the sustainability of the initiative.


Assuntos
Trypanosoma , Tripanossomíase Africana , Moscas Tsé-Tsé , Animais , Burkina Faso/epidemiologia , Insetos Vetores , Tripanossomíase Africana/epidemiologia , Tripanossomíase Africana/prevenção & controle , Tripanossomíase Africana/veterinária
8.
PLoS Med ; 19(3): e1003943, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35263343

RESUMO

BACKGROUND: Among children with moderate acute malnutrition (MAM) the level of serum cobalamin (SC) and effect of food supplements are unknown. We aimed to assess prevalence and correlates of low SC in children with MAM, associations with hemoglobin and development, and effects of food supplements on SC. METHODS AND FINDINGS: A randomized 2 × 2 × 3 factorial trial was conducted in Burkina Faso. Children aged 6 to 23 months with MAM received 500 kcal/d as lipid-based nutrient supplement (LNS) or corn-soy blend (CSB), containing dehulled soy (DS) or soy isolate (SI) and 0%, 20%, or 50% of total protein from milk for 3 months. Randomization resulted in baseline equivalence between intervention groups. Data on hemoglobin and development were available at baseline. SC was available at baseline and after 3 and 6 months. SC was available from 1,192 (74.1%) of 1,609 children at baseline. The mean (±SD) age was 12.6 (±5.0) months, and 54% were females. Low mid-upper arm circumference (MUAC; <125 mm) was found in 80.4% (958) of the children and low weight-for-length z-score (WLZ; <-2) in 70.6% (841). Stunting was seen in 38.2% (456). Only 5.9% were not breastfed. Median (IQR) SC was 188 (137; 259) pmol/L. Two-thirds had SC ≤222 pmol/L, which was associated with lower hemoglobin. After age and sex adjustments, very low SC (<112 pmol/L) was associated with 0.21 (95% CI: 0.01; 0.41, p = 0.04) and 0.24 (95% CI: 0.06; 0.42, p = 0.01) z-score lower fine and gross motor development, respectively. SC data were available from 1,330 (85.9%) of 1,548 children followed up after 3 months and 398 (26.5%) of the 1,503 children after 6 months. Based on tobit regression, accounting for left censored data, and adjustments for correlates of missing data, the mean (95% CI) increments in SC from baseline to the 3- and 6-month follow-up were 72 (65; 79, p < 0.001) and 26 (16; 37, p < 0.001) pmol/L, respectively. The changes were similar among the 310 children with SC data at all 3 time points. Yet, the increase was 39 (20; 57, p < 0.001) pmol/L larger in children given LNS compared to CSB if based on SI (interaction, p < 0.001). No effect of milk was found. Four children died, and no child developed an allergic reaction to supplements. The main limitation of this study was that only SC was available as a marker of status and was missing from a quarter of the children. CONCLUSIONS: Low SC is prevalent among children with MAM and may contribute to impaired erythropoiesis and child development. The SC increase during supplementation was inadequate. The bioavailability and adequacy of cobalamin in food supplements should be reconsidered. TRIAL REGISTRATION: ISRCTN Registry ISRCTN42569496.


Assuntos
Desnutrição , Burkina Faso/epidemiologia , Criança , Suplementos Nutricionais , Feminino , Hemoglobinas/metabolismo , Humanos , Lactente , Masculino , Desnutrição/epidemiologia , Vitamina B 12 , Zea mays
9.
Cerebrovasc Dis Extra ; 12(1): 36-46, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35235929

RESUMO

INTRODUCTION: Stroke is a major public health concern. It is a frequent pathology, 80% of which is of ischemic origin. Approximately 86% of all stroke deaths worldwide occur in low- and middle-income countries. The objective of this study was to investigate prognostic factors for in hospital lethality of stroke cases admitted in a public university hospital in Burkina Faso. METHODS: This was a retrospective cohort study with a descriptive and analytical aim on adults admitted for a stroke confirmed by a brain scan at the Sourô Sanou University Teaching Hospital (CHUSS) of Bobo-Dioulasso over the period from January 1, 2009, to December 31, 2013. RESULTS: The proportion of cases confirmed by the brain CT scan was 32% of all patients admitted for stroke in the CHUSS. The overall case fatality was 27.6%. This lethality was more pronounced in patients with hemorrhagic stroke (35.8%) compared to patients with ischemic stroke (22.4%). Median survival was higher in patients with ischemic stroke than those with hemorrhagic one (36 and 25 days, respectively) with a statistically significant difference (p value = 0.001). In multivariate analysis and hemorrhagic stroke (hazard ratio [HR]: 2.25; CI 95%: 1.41-3.61), an altered state of consciousness (HR: 1.90; CI 95%: 1.20-2.99) and the presence of central facial paralysis (HR: 1.67; CI 95%: 1.04-2.67) are factors that increased significantly the lethality. CONCLUSION: The study has identified three prognostic factors of lethality that are the hemorrhagic stroke type, the altered state of consciousness, and the central facial paralysis. Given the high case fatality, it is important to develop and implement effective prevention and management strategies adapted to the resources for the optimal control of stroke in Africa.


Assuntos
Paralisia Facial , AVC Hemorrágico , AVC Isquêmico , Adulto , Burkina Faso/epidemiologia , Hospitais de Ensino , Humanos , Prognóstico , Estudos Retrospectivos
10.
Int J Infect Dis ; 118: 224-229, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35227869

RESUMO

OBJECTIVES: Our study aimed to assess the statistical relationship between the use of chloroquine phosphate or hydroxychloroquine plus azithromycin (CQ/HCQ + AZ) and virological recovery, disease worsening, and death among out- and inpatients with COVID-19 in Burkina Faso. METHODS AND DESIGNS: This was a retrospective observational study that compared outcomes in terms of time to recovery, worsening, and death in patients who received CQ/HCQ + AZ and those who did not using a multivariable Cox or Poisson model before and after propensity matching. RESULTS: Of the 863 patients included in the study, about 50% (432/863) were home-based follow-up patients and 50% were inpatients. Of these, 83.3% (746/863) received at least 1 dose of CQ/HCQ + AZ and 13.7% (118/863) did not. There were no significant differences in associated time to recovery for patients receiving any CQ/HCQ + AZ (adjusted HR 1.44; 95% CI 0.76-2.71). Similarly, there was no significant association between CQ/HCQ + AZ use and worsening (adjusted IRR 0.80; 95% CI 0.50-1.50). However, compared with the untreated group, the treated group had a lower risk of death (adjusted HR 0.20; 95% CI 0.10-0.44). CONCLUSIONS: The study provided valuable additional information on the use of CQ/HCQ in patients with COVID-19 and did not show any harmful outcomes of CQ/HCQ + AZ treatment.


Assuntos
COVID-19 , Hidroxicloroquina , Antivirais/uso terapêutico , Azitromicina/efeitos adversos , Burkina Faso/epidemiologia , COVID-19/tratamento farmacológico , Cloroquina/efeitos adversos , Humanos , Hidroxicloroquina/uso terapêutico , Pacientes Internados , Pacientes Ambulatoriais , SARS-CoV-2
11.
Nat Commun ; 13(1): 1501, 2022 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-35314683

RESUMO

The malaria parasite, which is transmitted by several Anopheles mosquito species, requires more time to reach its human-transmissible stage than the average lifespan of mosquito vectors. Monitoring the species-specific age structure of mosquito populations is critical to evaluating the impact of vector control interventions on malaria risk. We present a rapid, cost-effective surveillance method based on deep learning of mid-infrared spectra of mosquito cuticle that simultaneously identifies the species and age class of three main malaria vectors in natural populations. Using spectra from over 40, 000 ecologically and genetically diverse An. gambiae, An. arabiensis, and An. coluzzii females, we develop a deep transfer learning model that learns and predicts the age of new wild populations in Tanzania and Burkina Faso with minimal sampling effort. Additionally, the model is able to detect the impact of simulated control interventions on mosquito populations, measured as a shift in their age structures. In the future, we anticipate our method can be applied to other arthropod vector-borne diseases.


Assuntos
Anopheles , Malária , Animais , Anopheles/parasitologia , Burkina Faso/epidemiologia , Feminino , Humanos , Longevidade , Malária/epidemiologia , Malária/parasitologia , Malária/prevenção & controle , Controle de Mosquitos/métodos , Mosquitos Vetores/parasitologia
12.
BMC Pregnancy Childbirth ; 22(1): 248, 2022 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-35331181

RESUMO

BACKGROUND: Malaria in pregnancy can result in placental infection with fetal implications. This study aimed at assessing placental malaria (PM) prevalence and its associated factors in a cohort of pregnant women with peripheral malaria and their offspring. METHOD: The data were collected in the framework of a clinical trial on treatments for malaria in pregnant women . Placental malaria (PM) was diagnosed by histopathological detection of parasites and/or malaria pigment on placenta biopsies taken at delivery. Factors associated with PM were assessed using logistic regression. RESULTS: Out of 745 biopsies examined, PM was diagnosed in 86.8 % of women. Acute, chronic and past PM were retrieved in 11 (1.5 %), 170 (22.8 %), and 466 (62.6 %) women, respectively. A modifying effect was observed in the association of gravidity or anemia at the study start with pooled PM (presence of parasites and/or malaria pigment). In women under 30, gravidity ≤ 2 was associated with an increased prevalence of pooled PM but in women aged 30 years or more, gravidity was no more associated with pooled PM (OR 6.81, 95 % CI 3.18 - 14.60; and OR 0.52, 95 % CI 0.10 - 2.76, respectively). Anemia was associated with pooled PM in women under 30 (OR 1.96, 95 % CI 1.03 - 3.72) but not in women aged 30 years or more (OR 0.68, 95 % CI 0.31 - 1.49). Similarly, the association of gravidity with past-chronic PM depended also on age. A higher prevalence of active PM was observed in women under 30 presenting with symptomatic malaria (OR 3.79, 95 % CI 1.55 - 9.27), while there was no significant increase in the prevalence of active PM (presence of parasites only) in women with symptomatic malaria when aged 30 years or more (OR 0.42, 95 % CI 0.10 - 1.75). In women with chronic PM, the prevalence of low birth weight or prematurity was the highest (31.2 %) as compared with past PM or no PM. CONCLUSION: Despite the rapid diagnosis and efficacious treatment of peripheral infection, the prevalence of placental malaria remained high in women with P. falciparum peripheral infection in Nanoro, especially in younger women This underlines the importance of preventive measures in this specific group.


Assuntos
Malária Falciparum , Malária , Adulto , Burkina Faso/epidemiologia , Feminino , Número de Gestações , Humanos , Malária/epidemiologia , Malária Falciparum/parasitologia , Placenta/parasitologia , Gravidez
13.
Front Public Health ; 10: 743248, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35252079

RESUMO

BACKGROUND: To limit the spread of COVID-19 due to imported cases, Burkina Faso has set up quarantine measures for arriving passengers. We aimed to determine the incidence and predictors of imported cases of COVID-19 in Burkina Faso. METHODS: A prospective cohort study was performed using data from passengers arriving at the airport from April 9 to August 31, 2020. The data was extracted from the District Health Information Software 2 (DHIS2) platform. Cox regression was used to identify predictors of imported cases of COVID-19. RESULTS: Among 6,332 travelers who arrived in the study period, 173 imported cases (2.7%) were recorded. The incidence rate was 1.9 cases per 1,000 traveler-days (95%CI: 1.6-2.2 per 1,000). Passengers arriving in April (Adjusted hazard ratio [aHR] = 3.56; 95%CI: 1.62-7.81) and May (aHR = 1.92; 95% CI: 1.18-3.12) were more at risk of being tested positive compared to those arriving in August, as well as, passengers presenting with one symptom (aHR = 3.71; 95% CI: 1.63-8.43) and at least two symptoms (aHR = 10.82; 95% CI: 5.24-22,30) compared to asymptomatic travelers. CONCLUSIONS: The incidence of imported cases was relatively low in Burkina Faso between April and August 2020. The period of travel and the presence of symptoms at arrival predicted the risk of being tested positive to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This is essential in the context of the high circulation of virus variants worldwide and the low local capacity to perform genotyping tests to strengthen the surveillance and screening capacities at the points of entry into the country.


Assuntos
COVID-19 , Burkina Faso/epidemiologia , COVID-19/epidemiologia , Humanos , Incidência , Estudos Prospectivos , SARS-CoV-2
14.
BMC Infect Dis ; 22(1): 117, 2022 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-35114959

RESUMO

BACKGROUND: In people living with HIV/AIDS (PLWHA), initiation of antiretroviral therapy (ART) leads to sustained effective suppression of viral replication and increasing CD4 + T cell count. However, a fraction of ART-treated patients still fail to reach adequate CD4 + T cell number despite a suppressed viral load (VL), and this phenomenon is defined as immunovirological discordance (IVD). In Africa, several studies have reported immunovirological outcomes of antiretroviral therapy, but little is known about IVD occurrence in Female sex workers (FSW). This study aimed to assess the prevalence of IVD and associated factors among a cohort of HIV infected FSW in Burkina Faso. METHODS: We conducted a cohort study from December 2003 to October 2016. Immunovirological discordance was defined as CD4 + T cell gain < 100 cells/µL despite a suppressed VL (VL < 1000 copies/mL) 12 months after ART initiation. The CD4 + T cells were counted using BD FACSCount™ System and point of care Pima™ CD4 + Analyzer. HIV-1 RNA was quantified by real-time polymerase-chain-reaction assay with the use of the ABI 7000 system. We conducted a logistic regression to identify factors associated with discordant responses. RESULTS: Among the 123 HIV-1 infected FSW having at least 12 months follow-up on ART, 105 (85.4%) achieved HIV-1 RNA suppression. Among the latter 25 gained less than 100 CD4 + T cells within 12 months follow-up. The IVD rate was 23.8% (95%CI 16.04%-33.11%). After adjustment for age, WHO clinical stage and ART regimen including nucleoside/nucleotide reverse transcriptase inhibitors, only baseline CD4 + T cell count between 200 to 350 cells/µL (adjusted OR: 4.15; 95%CI 1.13-15.22) and 350 to 500 cells/µL (adjusted OR: 17.50; 95%CI 2.68-114.31) remain significantly associated with IVD occurrence. CONCLUSIONS: Immunovirological discordance response was common in FSW with proportions close to those observed in the general population. A diagnosis and personalized follow-up of patients who do not achieve full immune reconstitution would make it possible to avoid complications in terms of morbidity and mortality.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profissionais do Sexo , Fármacos Anti-HIV/uso terapêutico , Burkina Faso/epidemiologia , Contagem de Linfócito CD4 , Estudos de Coortes , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Carga Viral , Organização Mundial da Saúde
15.
Malar J ; 21(1): 59, 2022 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-35193608

RESUMO

BACKGROUND: A recent trial in Burkina Faso and Mali showed that combining seasonal RTS,S/AS01E malaria vaccination with seasonal malaria chemoprevention (SMC) substantially reduced the incidence of uncomplicated and severe malaria in young children compared to either intervention alone. Given the possible negative effect of malaria on nutrition, the study investigated whether these children also experienced lower prevalence of acute and chronic malnutrition. METHODS: In Burkina Faso and Mali 5920 children were randomized to receive either SMC alone, RTS,S/AS01E alone, or SMC combined with RTS,S/AS01E for three malaria transmission seasons (2017-2019). After each transmission season, anthropometric measurements were collected from all study children at a cross-sectional survey and used to derive nutritional status indicators, including the binary variables wasted and stunted (weight-for-height and height-for-age z-scores below - 2, respectively). Binary and continuous outcomes between treatment groups were compared by Poisson and linear regression. RESULTS: In 2017, compared to SMC alone, the combined intervention reduced the prevalence of wasting by approximately 12% [prevalence ratio (PR) = 0.88 (95% CI 0.75, 1.03)], and approximately 21% in 2018 [PR = 0.79 (95% CI 0.62, 1.01)]. Point estimates were similar for comparisons with RTS,S/AS01E, but there was stronger evidence of a difference. There was at least a 30% reduction in the point estimates for the prevalence of severe wasting in the combined group compared to the other two groups in 2017 and 2018. There was no difference in the prevalence of moderate or severe wasting between the groups in 2019. The prevalence of stunting, low-MUAC-for-age or being underweight did not differ between groups for any of the three years. The prevalence of severe stunting was higher in the combined group compared to both other groups in 2018, and compared to RTS,S/AS01E alone in 2017; this observation does not have an obvious explanation and may be a chance finding. Overall, malnutrition was very common in this cohort, but declined over the study as the children became older. CONCLUSIONS: Despite a high burden of malnutrition and malaria in the study populations, and a major reduction in the incidence of malaria in children receiving both interventions, this had only a modest impact on nutritional status. Therefore, other interventions are needed to reduce the high burden of malnutrition in these areas. TRIAL REGISTRATION: https://www.clinicaltrials.gov/ct2/show/NCT03143218 , registered 8th May 2017.


Assuntos
Antimaláricos , Malária , Antimaláricos/uso terapêutico , Burkina Faso/epidemiologia , Quimioprevenção , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Malária/tratamento farmacológico , Malária/epidemiologia , Malária/prevenção & controle , Mali/epidemiologia , Estado Nutricional , Estações do Ano , Vacinação
16.
BMJ Open ; 12(2): e058005, 2022 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-35144955

RESUMO

OBJECTIVES: Lifestyle modifiable risk factors are a leading preventable cause of non-communicable diseases, with alcohol consumption among the most important. Studies characterising the prevalence of alcohol consumption in low-income countries are lacking. This study describes the prevalence of different levels of alcohol consumption in Burkina Faso and its associated factors. DESIGN: Data from the 2013 Burkina Faso WHO STEPwise Approach to Surveillance survey were analysed. The prevalence of alcohol consumption over the last 30 days was recoded into categories according to WHO recommendations: low, mid or abusive alcohol consumption. Multinomial logistic regression analyses identified factors associated with the different levels of alcohol consumption. SETTING: Population-based cross-sectional survey in Burkina Faso. PARTICIPANTS: 4692 participants of both sexes aged 25-64 years were included in the study. RESULTS: In the whole sample, 3559 participants (75.8% (72.5%-78.7%)) were not consuming any alcohol, 614 (12.9% (10.9%-15.3%)) had low alcohol consumption, 399 (8.5% (7.1%-10.1%)) had mid alcohol consumption and 120 (2.7% (2.0%-3.7%)) had abusive consumption. Age was associated with alcohol intake with a gradient effect and older people having a higher level of consumption (adjusted OR (AOR): 2.36, 95% CI (1.59 to 3.51) for low consumption, 2.50 (1.54 to 4.07) for mid consumption and 2.37 (1.01 to 5.92) for abusive consumption in comparison with no consumption). Tobacco consumption was also significantly associated with alcohol intake with a gradient effect, those with higher tobacco consumption being at higher risk of abusive alcohol intake (AOR: 6.08 (2.75 to 13.4) for moderate consumption and 6.58 (1.96 to 22.11) for abusive consumption). CONCLUSION: Our data showed an important burden of alcohol consumption in Burkina Faso, which varied with age and tobacco use. To effectively reduce alcohol consumption in Burkina Faso, comprehensive control and prevention campaigns should consider these associated factors.


Assuntos
Consumo de Bebidas Alcoólicas , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Burkina Faso/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco
17.
BMC Vet Res ; 18(1): 69, 2022 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-35151326

RESUMO

BACKGROUND: African swine fever (ASF) is a viral hemorrhagic disease of domestic and wild swine. ASF has been endemic in Burkina Faso since 2003. In October 2018, substantial pig deaths occurred in Ouagadougou and two neighboring municipalities in central Burkina Faso. Following these mortalities, the veterinary extension services carried out investigations to begin control measures and collect samples. METHODS: We performed real-time PCR for diagnostic confirmation and molecular characterization of the virus based on the partial P72, the complete p54, the partial CD2v, and partial B602L genes. RESULTS: The field study revealed that mortalities started two weeks before our investigations. The real-time PCR results confirmed ASFV DNA in twenty samples out of sixty-two blood samples collected in four different locations. The sequencing and phylogenetic analysis showed that ASFVs causing these outbreaks belong to genotype I and serogroup 4. The study of the CVR showed 4 TRS variants, and that of the CD2v amino acid sequence revealed five variants based on the number of deleted KCPPPK motifs in the C-terminal proline-reach region of the protein. CONCLUSIONS: The existence of multiple variants in these outbreaks shows the importance of molecular characterization to understand the evolution of ASFV isolates and the link between epidemics.


Assuntos
Vírus da Febre Suína Africana , Febre Suína Africana , Doenças dos Suínos , Febre Suína Africana/epidemiologia , Vírus da Febre Suína Africana/genética , Animais , Burkina Faso/epidemiologia , Surtos de Doenças , Genótipo , Filogenia , Análise de Sequência de DNA/veterinária , Suínos , Doenças dos Suínos/epidemiologia
18.
Sci Rep ; 12(1): 1402, 2022 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-35082312

RESUMO

Burkina Faso has one of the highest malaria burdens in sub-Saharan Africa despite the mass deployment of insecticide-treated nets (ITNs) and use of seasonal malaria chemoprevention (SMC) in children aged up to 5 years. Identification of risk factors for Plasmodium falciparum infection in rural Burkina Faso could help to identify and target malaria control measures. A cross-sectional survey of 1,199 children and adults was conducted during the peak malaria transmission season in the Cascades Region of south-west Burkina Faso in 2017. Logistic regression was used to identify risk factors for microscopically confirmed P. falciparum infection. A malaria transmission dynamic model was used to determine the impact on malaria cases averted of administering SMC to children aged 5-15 year old. P. falciparum prevalence was 32.8% in the study population. Children aged 5 to < 10 years old were at 3.74 times the odds (95% CI = 2.68-5.22, P < 0.001) and children aged 10 to 15 years old at 3.14 times the odds (95% CI = 1.20-8.21, P = 0.02) of P. falciparum infection compared to children aged less than 5 years old. Administration of SMC to children aged up to 10 years is predicted to avert an additional 57 malaria cases per 1000 population per year (9.4% reduction) and administration to children aged up to 15 years would avert an additional 89 malaria cases per 1000 population per year (14.6% reduction) in the Cascades Region, assuming current coverage of pyrethroid-piperonyl butoxide ITNs. Malaria infections were high in all age strata, although highest in children aged 5 to 15 years, despite roll out of core malaria control interventions. Given the burden of infection in school-age children, extension of the eligibility criteria for SMC could help reduce the burden of malaria in Burkina Faso and other countries in the region.


Assuntos
Amodiaquina/uso terapêutico , Antimaláricos/uso terapêutico , Malária Falciparum/epidemiologia , Malária Falciparum/prevenção & controle , Plasmodium falciparum/imunologia , Pirimetamina/uso terapêutico , Estações do Ano , Sulfadoxina/uso terapêutico , Adolescente , Adulto , Antígenos de Protozoários/sangue , Antígenos de Protozoários/imunologia , Burkina Faso/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Combinação de Medicamentos , Quimioterapia Combinada/métodos , Feminino , Humanos , Mosquiteiros Tratados com Inseticida , Malária Falciparum/sangue , Malária Falciparum/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium falciparum/isolamento & purificação , Prevalência , Fatores de Risco , População Rural , Resultado do Tratamento , Adulto Jovem
19.
BMC Infect Dis ; 22(1): 15, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983432

RESUMO

BACKGROUND: Nasopharyngeal colonisation with clinically relevant bacterial pathogens is a risk factor for severe infections, such as pneumonia and bacteraemia. In this study, we investigated the determinants of nasopharyngeal carriage in febrile patients in rural Burkina Faso. METHODS: From March 2016 to June 2017, we recruited 924 paediatric and adult patients presenting with fever, hypothermia or suspicion of severe infection to the Centre Medical avec Antenne Chirurgicale Saint Camille de Nanoro, Burkina Faso. We recorded a broad range of clinical data, collected nasopharyngeal swabs and tested them for the presence of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Klebsiella pneumoniae by quantitative polymerase chain reaction. Using logistic regression, we investigated the determinants of carriage and aimed to find correlations with clinical outcome. RESULTS: Nasopharyngeal colonisation with S. pneumoniae, H. influenzae and M. catarrhalis was highly prevalent and strongly dependent on age and season. Females were less likely to be colonised with S. pneumoniae (OR 0.71, p = 0.022, 95% CI 0.53-0.95) and M. catarrhalis (OR 0.73, p = 0.044, 95% CI 0.54-0.99) than males. Colonisation rates were highest in the age groups < 1 year and 1-2 years of age and declined with increasing age. Colonisation also declined towards the end of the rainy season and rose again during the beginning of the dry season. K. pneumoniae prevalence was low and not significantly correlated with age or season. For S. pneumoniae and H. influenzae, we found a positive association between nasopharyngeal carriage and clinical pneumonia [OR 1.75, p = 0.008, 95% CI 1.16-2.63 (S. pneumoniae) and OR 1.90, p = 0.004, 95% CI 1.23-2.92 (H. influenzae)]. S. aureus carriage was correlated with mortality (OR 4.01, p < 0.001, 95% CI 2.06-7.83), independent of bacteraemia caused by this bacterium. CONCLUSIONS: Age, sex and season are important determinants of nasopharyngeal colonisation with S. pneumoniae, H. influenzae and M. catarrhalis in patients with fever in Burkina Faso. S. pneumoniae and H. influenzae carriage is associated with clinical pneumonia and S. aureus carriage is associated with mortality in patients with fever. These findings may help to understand the dynamics of colonisation and the associated transmission of these pathogens. Furthermore, understanding the determinants of nasopharyngeal colonisation and the association with disease could potentially improve the diagnosis of febrile patients.


Assuntos
Portador Sadio , Staphylococcus aureus , Adulto , Burkina Faso/epidemiologia , Portador Sadio/epidemiologia , Criança , Feminino , Haemophilus influenzae , Humanos , Lactente , Masculino , Moraxella catarrhalis , Nasofaringe
20.
J Epidemiol Glob Health ; 12(1): 124-132, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34978709

RESUMO

INTRODUCTION: Long diagnosis delay contributes significantly to the failure to eradicate tuberculosis. The objective of this study was to evaluate the total, patient and system delays in diagnosis of pulmonary bacilliferous in the six tuberculosis Diagnostic and Treatment Centers in the five health districts of the central region in Burkina Faso. METHODS: A descriptive cross-sectional study was conducted among 384 microscopy-positive pulmonary tuberculosis patients in 2018 to address this objective. It concerned the socio-demographic, clinical, microbiological characteristics, and referral location/pathway characteristics of the patients. We then calculated the different delays. The "patient" (time from first symptoms to first consultation), "system" (time from first consultation to first diagnosis) and total (time from first symptoms to diagnosis) median diagnostic delay were estimated. RESULTS: The median "total", "patient" and "system" diagnostic times were 37, 21 and 7 days, respectively. Of the 384 patients surveyed, 158 patients or 41.25% of patients had a long total diagnostic delay (> 45 days). The number of patients with a long system diagnostic delay was 125 patients (32.55%; p < 0.001) and those with a long patient diagnostic delay were 105 patients (27.34%; p < 0.001). CONCLUSION: The total diagnosis delay of pulmonary tuberculosis was long for almost half of the patients. Awareness of the signs of tuberculosis among patients and caregivers, and consultation in a health center must be intensified to help considerably reduce these delays.


Assuntos
Tuberculose Pulmonar , Tuberculose , Burkina Faso/epidemiologia , Estudos Transversais , Diagnóstico Tardio , Humanos , Tuberculose/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia
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