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1.
Zootaxa ; 5087(3): 489-493, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35391276

RESUMO

Geotomus granulosus sp. n. is described from Burundi, and is the third burrower bug species recorded hitherto from this country. This burrower bug resembles species of two Sehirinae genera, i.e. Ochetostethus Fieber, 1860 and Ochetostethomorpha Schumacher, 1913, in its dorsal body habitus. However, all its crucial diagnostic characters (the body chaetotaxy, the shape of evaporatoria and the peritreme, the meso- and metathoracic wings venation, and the shape of spermatheca) demonstrate it represents the genus Geotomus Mulsant et Rey, 1866 (subfamily Cydninae, tribe Geotomini sensu lato).


Assuntos
Hemípteros , Heterópteros , Distribuição Animal , Animais , Burundi
2.
PLoS One ; 17(1): e0256002, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35073332

RESUMO

In Burundi most small-scale farmers still grow traditional cassava landraces that are adapted to local conditions and have been selected for consumer preferred attributes. They tend to be susceptible, in varying degrees, to devastating cassava viral diseases such as Cassava Brown Streak Disease (CBSD) and Cassava Mosaic Disease (CMD) with annual production losses of US$1 billion. For long term resistance to the disease, several breeding strategies have been proposed. A sound basis for a breeding program is to understand the genetic diversity of both landraces and elite introduced breeding cultivars. This will also assist in efforts to conserve landraces ahead of the broad distribution of improved varieties which have the possibility of replacing landraces. Our study aimed at determining the genetic diversity and relationships within and between local landraces and introduced elite germplasm using morphological and single nucleotide polymorphism (SNP) markers. A total of 118 cultivars were characterized for morphological trait variation based on leaf, stem and root traits, and genetic variation using SNP markers. Results of morphological characterization based on Ward's Method revealed three main clusters and five accessions sharing similar characteristics. Molecular characterization identified over 18,000 SNPs and six main clusters and three pairs of duplicates which should be pooled together as one cultivar to avoid redundancy. Results of population genetic analysis showed low genetic distance between populations and between local landraces and elite germplasm. Accessions that shared similar morphological traits were divergent at the molecular level indicating that clustering using morphological traits was inconsistent. Despite the variabilities found within the collection, it was observed that cassava germplasm in Burundi have a narrow genetic base.


Assuntos
Resistência à Doença , Manihot/crescimento & desenvolvimento , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Polimorfismo de Nucleotídeo Único , Burundi , Mapeamento Cromossômico/métodos , Genética Populacional , Genoma de Planta , Manihot/genética , Melhoramento Vegetal , Locos de Características Quantitativas , Sementes/genética , Sementes/crescimento & desenvolvimento
3.
Health Policy Plan ; 37(4): 492-504, 2022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-34871396

RESUMO

The World Health Organization Global Health Observatory Data Repository reports South Africa with 1.52 psychiatrists per 100 000 of the population among other countries in Africa with 0.01 psychiatrists per 100 000 (Chad, Burundi and Niger) to more than 30 per 100 000 for some countries in Europe. The overall situation, while being cognizant that mental health care is not only provided by specialist psychiatrists and that the current treatment gap may have to be addressed by strategies such as appropriate task sharing, suggests that there are actually too few psychiatrists to meet the country's mental health care needs. To address the need to develop a strategy to increase the local specialist training and examination capacity, a situational review of currently practicing psychiatrists was undertaken by the [BLINDED] and the [BLINDED] using the South African Society of Psychiatrists membership database. The number, distribution and attributes of practicing psychiatrists were compared with international figures on the ratio of psychiatrists per 100 000 population. In April 2019, there were 850 qualified psychiatrists actively practicing in the country and based on the national population figure of 55.6 million people (2016 Census), the psychiatrists per 100 000 ratio was 1.53. This indicates no improvement between 2016 to 2019. From the South African Society of Psychiatrists database, we determined that about 80% of psychiatrists are working in the private sector-a much higher proportion than is usually quoted. As the vast majority of psychiatrists are practicing in urban areas in two provinces, Gauteng (n = 350) and Western Cape (n = 292), the ratio of psychiatrists per 100 000 in these areas is relatively higher at 2.6 and 5.0, respectively, whereas rural areas in South Africa are largely without specialist mental health expertise at a rate of 0.03 per 100 000 population. This investigation provides a discipline-specific situational review of the attributes and distribution of the current workforce of specialists in the country.


Assuntos
Psiquiatria , Burundi , Humanos , Setor Privado , África do Sul , Recursos Humanos
4.
Glob Health Sci Pract ; 10(2)2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35487555

RESUMO

INTRODUCTION: Translation of knowledge into policy and practice is important to prevent sexual reproductive health and rights (SRHR)-related morbidity and mortality and ensure access to rights. Existing approaches to knowledge translation are often relatively rigid and implicitly assume linear processes, leading to time-consuming processes that are not tailored to countries' needs. APPROACH: SRHR knowledge platforms designed and implemented a collaborative rapid improvement model for knowledge translation (CRIM-KT) in Burundi, Bangladesh, Indonesia, and Jordan. The approach consisted of learning sessions and action periods aimed at improving policies and practices addressing the prevention of child marriage and teenage pregnancies. To evaluate the approach, a participatory action learning process took place throughout the implementation (September 2017 and January 2019). An end evaluation was conducted using a desk review of project documentation, in-depth interviews, and a focus group discussion to document the process, outcomes, and lessons learned. ACHIEVEMENTS: In Indonesia, a local government policy was changed that aims to prevent child marriage by avoiding misinterpretation of a local cultural practice. In Jordan, the cabinet endorsed a national action plan to prevent child marriage and changes in practice took place. In Burundi, no tangible changes in policy and practice in SRHR were observed. In Bangladesh, practice changed by strengthening coordination for collaboration and exchange among stakeholders to prevent child marriage. In all countries, the approach considerably strengthened participants' knowledge translation capacities. CONCLUSION: The CRIM-KT led to improvements in policy and practice in a relatively short time frame and different contexts. This can be explained by the systematic, structured, and participatory approach, allowing for contextual adaptation and involvement of stakeholders, as well as the cross-learning on 2 levels (international and country collaboration teams). The principles of the CRIM-KT may be further developed and applied in other fields in global health to strengthen knowledge translation processes.


Assuntos
Saúde Reprodutiva , Adolescente , Bangladesh , Burundi , Criança , Feminino , Humanos , Indonésia , Jordânia , Gravidez
5.
PLoS One ; 16(12): e0261218, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34890445

RESUMO

A recent research study on prevalence of tick-borne pathogens in Burundi reported high prevalence and endemicity of Theileria parva, Anaplasma marginale and Babesia bigemina infections in cattle. Detailed information about tick species infesting animals, their distribution and genetic diversity in Burundi is outdated and limited. This study therefore assessed the prevalence and genetic diversity of tick species infesting cattle across agroecological zones (AEZs) in Burundi. A cross-sectional study on the occurrence of tick species was conducted in 24 districts of Burundi between October and December 2017. Differential identification and characterization of ticks collected was conducted using tick morphological keys and molecular tools (cox1 and 12S rRNA gene). Chi-square test was used to test for association between agroecological zones and the prevalence of tick species. Phylogenetic relationships were inferred using bayesian and maximum likelihood algorithms. A total of 483 ticks were collected from the five AEZs sampled. Six tick species comprising of Rhipicephalus appendiculatus, R. sanguineus, R. evertsi evertsi, R. microplus, R. decoloratus and Amblyomma variegatum were observed. Rhipicephalus appendiculatus were the most prevalent ticks (~45%). A total of 138 specimens (28%) were found to be Rhipicephalus microplus, suggesting an emerging threat for cattle farmers. Twelve R. appendiculatus cox1 haplotypes were obtained from 106 specimens that were sequenced. Two cox1 haplotypes of R. microplus which clustered into previously reported Clade A were observed. Rhipicephalus sanguineus and R. evertsi evertsi ticks, the vectors of numerous zoonotic pathogens, were collected from cattle, which constitute a high risk for public health. These findings reveal an overlapping distribution of tick vectors in Burundi. The design of ticks and tick-borne diseases control strategies should consider the distribution of different vectors across the AEZs particularly the presence of the highly invasive R. microplus tick in Burundi and the potential risk of introducing the pathogenic Babesia bovis.


Assuntos
Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/parasitologia , Rhipicephalus/fisiologia , Infestações por Carrapato/veterinária , Animais , Burundi/epidemiologia , Bovinos , Estudos Transversais , Feminino , Filogenia , Prevalência , Infestações por Carrapato/epidemiologia , Infestações por Carrapato/parasitologia
6.
Pan Afr Med J ; 40: 142, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34925677

RESUMO

INTRODUCTION: intimate partner violence (IPV) is a global concern not only among adults but also adolescents. It has been reported that 35% of adolescent women have ever experienced IPV - occuring more so in non-industrialized countries. This study sought to understand the correlates associated with experiencing IPV among adolescent women between the ages 15 and 24 in five East African countries: Burundi, Kenya, Rwanda, Tanzania, and Uganda. METHODS: this was a secondary analysis of Demographic and Health Survey (DHS) data on adolescent women aged 15-24 years in five East African countries. IPV was measured as a composite variable of emotional, physical, and sexual violence. Other sociodemographic, income, maternal, sexual, knowledge, behavioral, and partner-related variables were included in the analysis. RESULTS: the prevalence of ever experiencing IPV was 45.1% (n=2380). A higher proportion of women who reported experiencing IPV had their first sexual encounter when they were less than 18 years of age (p<0.001). The adjusted odds ratio (aOR) of experiencing IPV increased almost two times for women who were aged 18-24 years (aOR: 1.7; CI: 1.3-2.3), almost four times (aOR 3.8; CI: 1.7-8.3) for those who had two or more children, and two-fold for women who had ever terminated a pregnancy compared to those who had not (aOR 2.2; CI: 1.0-4.9). Additionally, there was a higher odds (aOR: 1.5 (1.0-2.3)) of experiencing IPV if the respondent believed their husband/spouse´s abuse was justified. CONCLUSION: raising early awareness and educating both the young males and females appropriately to mitigate contributing factors to IPV could ensure stable, healthy relationships free of domestic violence in the future.


Assuntos
Violência por Parceiro Íntimo , Adolescente , Adulto , Burundi , Criança , Feminino , Humanos , Quênia/epidemiologia , Masculino , Prevalência , Tanzânia/epidemiologia , Adulto Jovem
7.
PLoS One ; 16(12): e0260225, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34898616

RESUMO

INTRODUCTION: Hypertension is a major threat to public health globally. Especially in sub-Saharan African countries, this coexists with high burden of other infectious diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence that well defines the at risk population. In this study, using retrospective data from two referral hospitals in Burundi, we model the risk factors of hypertension in Burundi. MATERIALS AND METHODS: Retrospective data of a sample of 353 randomly selected from a population of 4,380 patients admitted in 2019 in two referral hospitals in Burundi: Military and University teaching hospital of Kamenge. The predictive risk factors were carried out by fixed effect logistic regression. Model performance was assessed with Area under Curve (AUC) method. Model was internally validated using bootstrapping method with 2000 replications. Both data processing and data analysis were done using R software. RESULTS: Overall, 16.7% of the patients were found to be hypertensive. This study didn't showed any significant difference of hypertension's prevalences among women (16%) and men (17.7%). After adjustment of the model for cofounding covariates, associated risk factors found were advanced age (40-59 years) and above 60 years, high education level, chronic kidney failure, high body mass index, familial history of hypertension. In absence of these highlighted risk factors, the risk of hypertension occurrence was about 2 per 1000 persons. This probability is more than 90% in patients with more than three risk factors. CONCLUSION: The relatively high prevalence and associated risk factors of hypertension in Burundi raises a call for concern especially in this context where there exist an equally high burden of infectious diseases, other chronic diseases including chronic malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.


Assuntos
Hipertensão/diagnóstico , Adolescente , Adulto , Fatores Etários , Área Sob a Curva , Índice de Massa Corporal , Burundi/epidemiologia , Escolaridade , Feminino , Hospitais Militares , Hospitais de Ensino , Humanos , Hipertensão/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
8.
BMC Public Health ; 21(1): 2142, 2021 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-34814876

RESUMO

BACKGROUND: Despite the World Health Organization efforts to expand access to the tuberculosis treatment, multidrug resistant tuberculosis (MDR-TB) remains a major threat. MDR-TB represents a challenge for clinicians and staff operating in national tuberculosis (TB) programmes/centres. In sub-Saharan African countries including Burundi, MDR-TB coexists with high burden of other communicable and non-communicable diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence which well defines the at-risk population. In this study, using data from two referral anti-tuberculosis in Burundi, we model the key factors associated with MDR-TB in Burundi. METHODS: A case-control study was conducted from 1stAugust 2019 to 15th January 2020 in Kibumbu Sanatorium and Bujumbura anti-tuberculosis centres for cases and controls respectively. In all, 180 TB patients were selected, comprising of 60 cases and 120 controls using incidence density selection method. The associated factors were carried out by mixed effect logistic regression. Model performance was assessed by the Area under Curve (AUC). Model was internally validated via bootstrapping with 2000 replications. All analysis were done using R Statistical 3.5.0. RESULTS: MDR-TB was more identified among patients who lived in rural areas (51.3%), in patients' residence (69.2%) and among those with a household size of six or more family members (59.5%). Most of the MDR-TB cases had already been under TB treatment (86.4%), had previous contact with an MDR-TR case (85.0%), consumed tobacco (55.5%) and were diabetic (66.6 %). HIV prevalence was 32.3 % in controls and 67.7 % among cases. After modelling using mixed effects, Residence of patients (aOR= 1.31, 95%C: 1.12-1.80), living in houses with more than 6 family members (aOR= 4.15, 95% C: 3.06-5.39), previous close contact with MDR-TB (aOR= 6.03, 95% C: 4.01-8.12), history of TB treatment (aOR= 2.16, 95% C: 1.06-3.42), tobacco consumption (aOR = 3.17 ,95% C: 2.06-5.45) and underlying diabetes' ( aOR= 4.09,95% CI = 2.01-16.79) were significantly associated with MDR-TB. With 2000 stratified bootstrap replicates, the model had an excellent predictive performance, accurately predicting 88.15% (95% C: 82.06%-92.8%) of all observations. The coexistence of risk factors to the same patients increases the risk of MDR-TB occurrence. TB patients with no any risk factors had 17.6% of risk to become MDR-TB. That probability was respectively three times and five times higher among diabetic and close contact MDR-TB patients. CONCLUSION: The relatively high TB's prevalence and MDR-TB occurrence in Burundi raises a cause for concern especially in this context where there exist an equally high burden of chronic diseases including malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.


Assuntos
Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose , Antituberculosos/uso terapêutico , Burundi/epidemiologia , Estudos de Casos e Controles , Humanos , Fatores de Risco , Tuberculose/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
9.
J Trauma Stress ; 34(5): 943-954, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34644415

RESUMO

Studies investigating the associations between histories of childhood maltreatment (CM) in parent-child dyads have primarily involved samples from high-income countries; however, CM rates are higher in low- and middle-income countries. The present study aimed to examine the (a) association between maltreatment in parents and maltreatment of their children through risk (i.e., parent depression) and protective (i.e., parent-child connectedness) factors and (b) associations between CM in children with aggression through posttraumatic stress symptoms (PTSS) and peer/sibling victimization. Participants were 227 parent-child dyads from Burundi, Africa, a low-income country. Parents were 18 years of age or older, and children were 12-18 years (M = 14.76, SD = 1.88, 57.7% female). Among parents, 20.7%-69.5% of participants reported a history of physical and emotional abuse and neglect; among children, the rates of sexual, physical, and emotional abuse ranged from 14.5% to 89.4%. A history of CM in parents was associated with CM in children, B = 0.19, p < .01, and CM in parents was indirectly associated with CM in children through parent-child connectedness, ß = .04, 95% CI [.01, .10], and parental depression, ß = .08, 95% CI [.03, .15]. In children, maltreatment was positively associated with peer/sibling victimization, and CM was associated with aggression, ß = .07, 95% CI [.04, 0.11], through PTSS but not via peer/sibling victimization. Continued efforts to improve CM-related preventive strategies and the accessibility of prevention services are needed to reduce CM in low-income countries such as Burundi.


Assuntos
Maus-Tratos Infantis , Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Agressão , Burundi/epidemiologia , Criança , Depressão/epidemiologia , Feminino , Humanos , Masculino , Relações Pais-Filho , Pais , Transtornos de Estresse Pós-Traumáticos/epidemiologia
10.
Stud Fam Plann ; 52(4): 415-438, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34626481

RESUMO

Examining women's reproductive experiences over time reveals a more dynamic view of women's behaviors and needs than current status measures alone. This study uses sequence and cluster analyses, which are designed for identifying patterns and subgroups in longitudinal data. We apply these methods to contraceptive calendar data in Burundi to identify discrete clusters of women based on contraceptive and pregnancy behaviors over the past 5 years. We identify six unique clusters; three characterized by no use of contraception (85 percent of women) and three by use (16 percent). The Quiet Calendar cluster (42 percent) comprise women who neither experience pregnancy nor use contraception. Family Builder 1 (25 percent) and 2 (18 percent) both include women who experience two pregnancies, but differ in unmet need and lifetime experience with contraception. Modern Mother (8 percent), Consistently Covered Mother (6 percent), and Traditional Mother (2 percent) clusters differ by type of contraception used following pregnancy. Factors associated with cluster membership are need for family planning, lifetime experience with contraception, marital status, pregnancy intention, and age. This clustering approach provides a new, more holistic way to measure the diverse needs across unique subpopulations and can inform the development of multifaceted, adaptable strategies to meet women's dynamic fertility needs over the reproductive life course.


Assuntos
Comportamento Contraceptivo , Anticoncepcionais , Burundi/epidemiologia , Anticoncepção , Demografia , Serviços de Planejamento Familiar , Feminino , Fertilidade , Humanos , Gravidez
11.
BMC Pregnancy Childbirth ; 21(1): 684, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620122

RESUMO

BACKGROUND: Timely and appropriate health care during pregnancy and childbirth are the pillars of better maternal health outcomes. However, factors such as poverty and low education levels, long distances to a health facility, and high costs of health services may present barriers to timely access and utilisation of maternal health services. Despite antenatal care (ANC), delivery and postnatal care being free at the point of use in Burundi, utilisation of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four ANC visits. This study explores the socio-economic determinants that affect utilisation of maternal health services in Burundi. METHODS: We use data from the 2016-2017 Burundi Demographic and Health Survey (DHS) collected from 8941 women who reported a live birth in the five years that preceded the survey. We use multivariate regression analysis to explore which individual-, household-, and community-level factors determine the likelihood that women will seek ANC services from a trained health professional, the number of ANC visits they make, and the choice of assisted childbirth. RESULTS: Occupation, marital status, and wealth increase the likelihood that women will seek ANC services from a trained health professional. The likelihood that a woman consults a trained health professional for ANC services is 18 times and 16 times more for married women and women living in partnership, respectively. More educated women and those who currently live a union or partnership attend more ANC visits than non-educated women and women not in union. At higher birth orders, women tend to not attend ANC visits. The more ANC visits attended, and the wealthier women are; the more likely they are to have assisted childbirth. Women who complete four or more ANC visits are 14 times more likely to have an assisted childbirth. CONCLUSIONS: In Burundi, utilisation of maternal health services is low and is mainly driven by legal union and wealth status. To improve equitable access to maternal health services for vulnerable population groups such as those with lower wealth status and unmarried women, the government should consider certain demand stimulating policy packages targeted at these groups.


Assuntos
Utilização de Instalações e Serviços/estatística & dados numéricos , Serviços de Saúde Materna , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Cuidado Pré-Natal , Fatores Socioeconômicos , Adulto , Burundi , Demografia , Escolaridade , Feminino , Humanos , Renda , Estado Civil , Pessoa de Meia-Idade , Paridade , Gravidez , Adulto Jovem
12.
JMIR Public Health Surveill ; 7(9): e24272, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34591018

RESUMO

BACKGROUND: In Burundi, given the low testing numbers among key populations (KPs), peer-assisted HIV self-testing (HIVST) was initiated for female sex workers (FSWs), men who have sex with men (MSM), and transgender people to provide another testing option. HIVST was provided by existing peer outreach workers who were trained to provide support before, during, and after the administration of the test. People who screened reactive were referred and actively linked to confirmatory testing, and those confirmed positive were linked to treatment. Standard testing included HIV testing by clinical staff either at mobile clinics in the community or in facilities. OBJECTIVE: This study aims to improve access to HIV testing for underserved KPs, improve diagnoses of HIV serostatus among key populations, and link those who were confirmed HIV positive to life-saving treatment for epidemic control. METHODS: A descriptive analysis was conducted using routine programmatic data that were collected during a 9-month implementation period (June 2018 to March 2019) for peer-assisted HIVST among FSWs, MSM, and transgender people in 6 provinces where the US Agency for International Development-and US President's Emergency Plan for AIDS Relief-funded LINKAGES (Linkage across the Continuum of HIV Services for KP Affected by HIV) Burundi project was being implemented. Chi-square tests were used to compare case-finding rates among individuals who were tested through HIVST versus standard testing. Multivariable logistic regression was performed to assess factors that were independently associated with HIV seropositivity among FSWs and MSM who used HIVST kits. RESULTS: A total of 2198 HIVST kits were administered (FSWs: 1791/2198, 81.48%; MSM: 363/2198, 16.52%; transgender people: 44/2198, 2%). HIV seropositivity rates from HIVST were significantly higher than those from standard testing for FSWs and MEM and nonsignificantly higher than those from standard testing for transgender people (FSWs: 257/1791, 14.35% vs 890/9609, 9.26%; P<.001; MSM: 47/363, 12.95% vs 90/2431, 3.7%; P<.001; transgender people: 10/44, 23% vs 6/36, 17%; P=.50). Antiretroviral therapy initiation rates were significantly lower among MSM who were confirmed to be HIV positive through HIVST compared to those among MSM who were confirmed to be HIV positive through standard testing (40/47, 85% vs 89/90, 99%; P<.001). No significant differences in antiretroviral therapy initiation rates were found between the FSW and transgender groups. Multivariable analyses among FSWs who used HIVST kits showed that being aged ≥25 years (adjusted odds ratio 1.9, 95% CI 1.4-2.6) and having >8 clients per week (adjusted odds ratio 1.3, 95% CI 1.0-1.8) were independently associated with HIV seropositivity. CONCLUSIONS: The results demonstrate the potential effectiveness of HIVST in newly diagnosing underserved KPs and linking them to treatment.


Assuntos
Infecções por HIV , Profissionais do Sexo , Minorias Sexuais e de Gênero , Burundi/epidemiologia , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino
13.
Artigo em Inglês | MEDLINE | ID: mdl-34501890

RESUMO

HIV/AIDS stigma is a global issue and a serious problem in African countries. Although prevalence remains high in this region, no detailed study has yet been carried out to determine and characterize this problem in Burundi. Using a qualitative analysis based on an extensive series of 114 interviews, we describe the main characteristics of HIV stigma in the country. The results of our study indicate that the problem of HIV/AIDS stigma is widespread in Burundian society, as all participants in the research reported having experienced some kind of HIV stigma. The seven dimensions of stigma identified in people living with HIV/AIDS (PLWHA) in Burundi are physical violence, verbal violence, marginalization, discrimination, self-stigma, fear and insecurity, and healthcare provider stigma. These dimensions of stigma can be experienced through different manifestations, which have been characterized in this study, revealing that the problem of stigma in PLWHA is still an important issue in Burundi.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/epidemiologia , Burundi/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Pesquisa Qualitativa , Estigma Social
14.
Pan Afr Med J ; 39: 130, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34527146

RESUMO

Economic development in low-income countries has led to a considerable increase in motor vehicles, in particular motorcycles. Traffic accident-related fractures are therefore increasing. The treatment of long bone fractures is, in the majority of cases, based on locked intramedullary nailing, a procedure which is rarely available in countries with poor sanitary conditions. To provide optimal treatment to these countries, the SIGN (Surgical Implant Generation Network) nail was developed in 1999 by Lewis Zirkle. It is currently used free of charge in 53 countries. In return, an international database must be completed in order to assess and develop it. In the light of our experiences in Haiti and Burundi and on the basis of a literature review, we here highlight the conceptual and technical features of SIGN nail whose implant in French-speaking countries is still limited.


Assuntos
Acidentes de Trânsito , Pinos Ortopédicos , Fixação Intramedular de Fraturas/métodos , Burundi , Bases de Dados Factuais , Países em Desenvolvimento , Fixação Intramedular de Fraturas/instrumentação , Haiti , Humanos , Motocicletas
15.
Trop Anim Health Prod ; 53(4): 438, 2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34402985

RESUMO

Several African swine fever (ASF) outbreaks in domestic pigs have been reported in Burundi and Malawi and whole-genome sequences of circulating outbreak viruses in these countries are limited. In the present study, complete genome sequences of ASF viruses (ASFV) that caused the 2018 outbreak in Burundi (BUR/18/Rutana) and the 2019 outbreak in Malawi (MAL/19/Karonga) were produced using Illumina next-generation sequencing (NGS) platform and compared with other previously described ASFV complete genomes. The complete nucleotide sequences of BUR/18/Rutana and MAL/19/Karonga were 176,564 and 183,325 base pairs long with GC content of 38.62 and 38.48%, respectively. The MAL/19/Karonga virus had a total of 186 open reading frames (ORFs) while the BUR/18/Rutana strain had 151 ORFs. After comparative genomic analysis, the MAL/19/Karonga virus showed greater than 99% nucleotide identity with other complete nucleotides sequences of p72 genotype II viruses previously described in Tanzania, Europe and Asia including the Georgia 2007/1 isolate. The Burundian ASFV BUR/18/Rutana exhibited 98.95 to 99.34% nucleotide identity with genotype X ASFV previously described in Kenya and in Democratic Republic of the Congo (DRC). The serotyping results classified the BUR/18/Rutana and MAL/19/Karonga ASFV strains in serogroups 7 and 8, respectively. The results of this study provide insight into the genetic structure and antigenic diversity of ASFV strains circulating in Burundi and Malawi. This is important in order to understand the transmission dynamics and genetic evolution of ASFV in eastern Africa, with an ultimate goal of designing an efficient risk management strategy against ASF transboundary spread.


Assuntos
Vírus da Febre Suína Africana , Febre Suína Africana , Doenças dos Suínos , Febre Suína Africana/epidemiologia , Vírus da Febre Suína Africana/genética , Animais , Burundi/epidemiologia , Surtos de Doenças/veterinária , Malaui/epidemiologia , Filogenia , Sus scrofa , Suínos , Tanzânia
16.
Infect Genet Evol ; 94: 104995, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246798

RESUMO

In the framework of a viral discovery research program using metagenomics, Human Pegivirus-1 reads (HPgV-1, formerly known as GBV-C) were detected in plasma pools of healthy blood donors from seven sub-Saharan African countries. For five of these countries, Mauritania, Mali, Niger, Burundi and Madagascar, no data about HPgV-1 genotypes was reported to date. To confirm our metagenomic findings and further investigate the genotype diversity and distribution of HPgV-1 in Africa, 400 blood donations from these five localities as well as from Cameroon, the Democratic Republic of Congo (DRC) and the Burkina Faso were screened with a RT-nested PCR targeting the viral 5'NCR region. Amplified products were sequenced, and the virus was genotyped by phylogenetic analysis. Out of the 400 plasma samples tested, 65 were positive for HPgV-1 RNA and 61 were successfully genotyped. Among these, 54 strains (88.5%) clustered with genotype 1, six (9.8%) with genotype 2 and one (1.6%) with genotype 5. Genotype 1 was observed in all countries studied, except in Madagascar, genotype 2 was detected in Mauritania and Madagascar, and genotype 5 in DRC. Overall, our results extend the geographic distribution of HPgV-1 in Africa and provide six additional nearly complete genomes. Considering that some HPgV-1 genotypes have been reported as potential predictive indicators of lower disease progression in HIV-1 infected subjects, further investigations should be conducted to better understand the positive impact, if any, of this virus.


Assuntos
Infecções por Flaviviridae/virologia , Vírus GB C/fisiologia , Variação Genética , Genótipo , Hepatite Viral Humana/virologia , Burkina Faso , Burundi , Camarões , República Democrática do Congo , Vírus GB C/genética , Madagáscar , Mali , Mauritânia , Níger
17.
Malar J ; 20(1): 298, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215270

RESUMO

Burundi has experienced an increase in malaria cases since 2000, reaching 843,000 cases per million inhabitants in 2019, a more than twofold increase compared to the early 2000s. Burundi thus contrasts the decreasing number of cases in many other African countries. To evaluate the impact of malaria control on this increase, data on interventions from 2000 to 2019 were compiled. Over this period, the number of health facilities increased threefold, and the number of tests 20-fold. The test positivity rate remained stable at around 50-60% in most years. Artemisinin-based combination therapy was introduced in 2003, initially using artesunate-amodiaquine and changed to artemether-lumefantrine in 2019/2020. Mass distribution campaigns of insecticide-treated bed nets were conducted, and indoor residual spraying and intermittent preventive treatment in pregnancy introduced. Thus, the increase in cases was not the result of faltering control activities. Increased testing was likely a key contributor to higher case numbers. Despite the increase in testing, the test positivity rate remined high, indicating that current case numbers might still underestimate the true burden.


Assuntos
Antimaláricos/administração & dosagem , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Malária Falciparum/prevenção & controle , Burundi/epidemiologia , Humanos , Malária Falciparum/epidemiologia , Malária Falciparum/parasitologia , Malária Falciparum/transmissão
18.
Rev Epidemiol Sante Publique ; 69(4): 183-192, 2021 Aug.
Artigo em Francês | MEDLINE | ID: mdl-34215480

RESUMO

BACKGROUND: The professional identities, profiles and representations of Burundian health workers remain insufficiently explored. Our twofold objective is to identify the different socio-professional profiles of first-line caregivers and to explore their respective representations of health workers and work. METHODS: The first study describes the overall population of the 1047 staff members employed in 2014-2015 in 62 health centers. The second is a cross-sectional survey conducted in April 2014. Using IRAMUTEQ© software, we conducted textology analysis of the structure and contents of 911 respondents' representations via 3 free associations with regard to 6 questions on the "good worker" and the "what renders one capable of doing good work". RESULTS: At the normative level, among all categories of staff, a relational role is a foundation of professional identity, while technical or administrative functions remain marginal. At the positional level, responses differed according to initial qualification level but not as a function of their role with patients or their professional experience. Three socio-professional categories emerged. The most qualified category (one-quarter of the population) consists primarily of male caregivers, with a high turnover rate (4 years) associated with prospects for further training and career development. These persons present the most professionalized representations of the worker and work. The second quarter has an average level of qualification and turnover (10 years), and is mainly composed of female caregivers with limited professional perspectives. This group's representations are less technical and more patient-centered. Finally, the remaining half consists of relatively low-skilled staff members in charge of technical and logistical support, who are likely to spend their entire career in the same center (>20 years). Largely disregarded by the health care system and its funders, they have few opportunities for training or advancement and despite their long experience, maintain profane representations of workers and work. CONCLUSION: Our results shed light on the predicament of unskilled staff members whose expectations are rarely taken into consideration, even though they represent a significant proportion of the workforce, perform tasks essential to quality of care, and serve as bearers of the memory of their hospital center. These results also highlight the compartmentalization of practices and knowledge between categories of workers and underscore the failure of continuous training strategies targeting the unskilled.


Assuntos
Cuidadores , Burundi , Estudos Transversais , Feminino , Humanos , Masculino , Recursos Humanos
19.
Artigo em Inglês | MEDLINE | ID: mdl-34199564

RESUMO

BACKGROUND: Timely initiation of breastfeeding is the first step towards achieving recommended breastfeeding behaviours. Delayed breastfeeding initiation harms neonatal health and survival, including infection associated neonatal mortality. Eighty percent of neonatal deaths occur in the low-and middle-income countries (LMICs), where delayed breastfeeding initiation is the highest. Place and mode of childbirth are important factors determining the time of initiation of breastfeeding. In this study, we report the prevalence of delayed breastfeeding initiation from 58 LMICs and investigate the relationship between place and mode of childbirth and delayed breastfeeding initiation in each country. METHODS: We analysed data from the most recent Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) collected between 2012 and 2017 and reported by 2019. The study sample comprised all women who had a live birth in the 24 months preceding the survey. 'Delayed' initiation of breastfeeding was defined using WHO recommendations as starting breastfeeding after one hour of birth. We coded the stratifying variable for the place and mode of childbirth as "vaginal birth at a facility (VBF)", "caesarean section birth (CSB) ", and "vaginal birth at home (VBH)". We used respondent-level sampling weights to account for individual surveys and de-normalised the standard survey weights to ensure the appropriate contribution of data from each country. We report the prevalence and population attributable fractions with robust standard errors. The population attributable risk identifies the proportion of delayed initiation that we could avert among VBH and CSB if everyone had the same risk of delaying breastfeeding as in VBF. RESULTS: The overall prevalence of delayed initiation of breastfeeding was 53.8% (95% CI 53.3, 54.3), ranging from 15.0% (95% CI 13.8, 16.2) in Burundi to 83.4% (95% CI 80.6, 86.0) in Guinea. The prevalence of delayed initiation of breastfeeding was consistently high among women who experienced caesarean section births; however, there was no direct association with each country's national caesarean section rates. The prevalence of delayed initiation among women who experienced VBF was high in Sub-Saharan Africa and South Asia, even though the CSB rates were low. In some countries, women who give birth vaginally in health facilities were more likely to delay breastfeeding initiation than women who did not. In many places, women who give birth by caesarean section were less likely to delay breastfeeding initiation. Population attributable risk percent for VBH ranged from -28.5% in Ukraine to 22.9% in Moldova, and for CSB, from 10.3% in Guinea to 54.8% in Burundi. On average, across all 58 countries, 24.4% of delayed initiation could be prevented if all women had the same risk of delaying breastfeeding initiation as in VBF. DISCUSSION: In general, women who give birth in a health facility were less likely to experience delayed initiation of breastfeeding. Programs could avert much of the delayed breastfeeding initiation in LMICs if the prevalence of delayed initiation amongst women who experience CSB were the same as amongst women who experience VBF. Crucial reforms of health facilities are required to ensure early breastfeeding practices and to create pro-breastfeeding supportive environments as recommended in intervention packages like the Baby-friendly hospital initiative and Early essential newborn care. The findings from this study will guide program managers to identify countries at varying levels of preparedness to establish and maintain a breastfeeding-friendly environment at health facilities. Thus, governments should prioritise intervention strategies to improve coverage and settings surrounding early initiation of breastfeeding while considering the complex role of place and mode of childbirth.


Assuntos
Aleitamento Materno , Cesárea , África ao Sul do Saara , Ásia , Burundi , Feminino , Inquéritos Epidemiológicos , Humanos , Recém-Nascido , Moldávia , Parto , Gravidez , Inquéritos e Questionários , Ucrânia
20.
JCO Glob Oncol ; 7: 1116-1128, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34264750

RESUMO

PURPOSE: In East Africa, cervical cancer is a leading cause of morbidity and mortality among women diagnosed with cancer. In this study, we describe the burden of risk factors for cervical cancer among women of reproductive age in five East African countries. METHODS: For each country, using STATA13 software and sampling weights, we analyzed the latest Demographic and Health Survey data sets conducted between 2014 and 2017 in Burundi, Kenya, Rwanda, Tanzania, and Uganda. We included women age 15-49 years and considered six risk factors (tobacco use, body mass index, age at first sexual intercourse, age at first birth, number of children, and hormonal contraceptive use). RESULTS: Of the 93,616 women from the five countries, each country had more than half of the women younger than 30 years and lived in rural areas. Pooled proportion of women with at least one risk factor was 89% (95% CI, 87 to 91). Living in a rural area in Burundi (adjusted incidence rate ration 0.94; 95% CI, 0.9 to 0.99; P = .019) and Rwanda (adjusted incidence rate Ration 0.92; 95% CI, 0.88 to 0.96; P < .001) was associated with a lower number of risk factors compared with living in an urban area. In all the countries, women with complete secondary education were associated with a lower number of risk factors compared with those with no education. CONCLUSION: This study reveals a high burden of risk factors for cervical cancer in East Africa, with a high proportion of women exposed to at least one risk factor. There is a need for interventions to reduce the exposure of women to these risk factors.


Assuntos
Neoplasias do Colo do Útero , Adolescente , Adulto , Burundi , Criança , Demografia , Feminino , Inquéritos Epidemiológicos , Humanos , Quênia , Pessoa de Meia-Idade , Fatores de Risco , Ruanda/epidemiologia , Fatores Socioeconômicos , Tanzânia , Uganda , Neoplasias do Colo do Útero/epidemiologia , Adulto Jovem
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