Oncogenic Human Papillomavirus Infection and Genotype Characterization among Women in Orodara, Western Burkina Faso.

BACKGROUND AND OBJECTIVE: Cervical cancer usually occurs several years after persistent infection with oncogenic or high-risk human papillomavirus. The objective of this study was to determine carriage of 14 genotypes of high-risk human papillomavirus among women at Orodara and then characterize the genotypes found in these women. MATERIALS AND METHODS: From June to July 2015, 120 women from the general population were recruited in the health district of Orodara. They voluntarily agreed to participate in the study. Endocervical samples were taken from these women prior to screening for precancerous lesions by visual inspection with acetic acid and lugol's iodine. Identification of high-risk human papillomavirus genotype was done using real-time PCR. RESULTS: High-risk human papillomavirus prevalence was 38.3% and the most common genotypes were HPV 52 (25.4%), HPV 33 (20.6%) and HPV 59 (11.1%). The HPV 66 was also identified with a prevalence of 9.5%. CONCLUSION: The HPV 16 and HPV 18 which are frequently associated with cancer worldwide were not found among the most frequent oncogenic HPV in women in Orodara.

Determination of the insemination time of the Glossina palpalis Robineau Desvoidy, 1830 in the forest belt of Daloa, Côte d'Ivoire.

The observations on the insemination of the Glossina palpalis have been made in the forest belt of Daloa in the Côte d'Ivoire through the test of the spermathecae of females caught in different biotopes. The testing of 8342 Glossina show that the ratio of females with empty spermathecae is low, with a rate of 0.88%. Most of the captured Glossina are tenerals or tsetse flies which have not yet been fed. We did not find a single virgin female among the young parous Glossina above the age of 9 days. However out of 3841 very old Glossina, 0.08% were found with empty spermathecae. Our results suggest that the Glossina's insemination took place earlier within the G. palpalis type, a few days before the adult (between 1 and 3 days).

Diversity of Glossina in the forest belt of Côte d'Ivoire.

Collections of Glossina with a biconical trap have been made for 6 years in the forest area of Daloa in Côte d'Ivoire. Three species of Glossina have been identified in the village of Batéguédéa II as well as in the plantations and gallery forests. They are: G. palpalis, G. pallicera and G. nigrofusca. G. palpalis was predominant in the village in 1984, representing 74% of the collection, while the G. pallicera and G. nigrofusca types are more common in plantations and gallery forest. In 1987, 3 years after the first observation, G. palpalis was the most common species in each of the three biotopes. G. palpalis was even more common in 1990, following a decline in the population of G. pallicera and G. nigrofusca in the village (0.2% for G. pallicera; 0.8% for G. nigrofusca) and the plantations (0.7% for G. pallicera; 1.3% for G. nigrofusca). However, these two species were still found in small numbers in the gallery forest.

[Redistribution of glossina in a forest area of Ivory Coast?]. / Redistribution des glossines dans une zone forestière ivoirienne?

Historically the region of Abengourou is a well-known of sleeping sickness in the forest area of Cote d'Ivoire. However data from epidemiologic studies carried out since 1980 show that this area is currently disease-free. This finding warrants study of glossina vectors to clarify the epidemiology of the disease in this area. Entomologic surveys were carried out over a period of one year. Traps were used to capture glossina in ten natural habitats: villages with or without pigs, coffee, cocoa and rice plantations, grazing lands, camping areas, uncultivated farmlands, trails, forest borderlands and wilderness. Findings documented almost total disappearance of zoophilic glossina (Glossina nigrofusca and Glossina pallicera) which accounted for less than 0.5% of glossina captured only during the rainy season. The apparent trap density (ATD) of Glossina palpalis, the main vector of disease, was low overall. However ATD values tended to be higher in villages with pigs (ATD : 2.07 glossina/trap/day) and forest borderlands (ATD : 2.63 glossina/trap/day) than in other habitants where values were always lower than 1 glossina/trap/day. This almost complete disappearance of Glossina palpalis can be attributed mainly to deforestation in most of the areas studied. This accounts for reduced contact with man. The absence of contact between man and anthropophilic glossins could explain that unlike Daloa and Vavoua sleeping sickness has disappeared from the region of Abengourou.

[A study of the unmet needs for major obstetric interventions: the experience of Burkina Faso]. / Etude des besoins obstétricaux non couverts pour les interventions obstétricales majeures: l'expérience du Burkina Faso.

The fight against maternal mortality requires strategies adapted to every socio-economic and geographic context. To define these strategies, it is essential to have relevant information and to obtain the participation of the various actors involved. One of the indicators which summarizes the maternal mortality level and which it the basis for the mobilization of resources is the maternal mortality ratio. This ratio remains difficult to measure especially in countries with limited resources. Based on the major obstetric interventions for absolute maternal indications, the unmet needs for major obstetric intervention approach is an opportunity for developing countries. We applied this approach in Burkina Faso i) to determine the number of major obstetric interventions for absolute maternal indications carried out in 1998; ii) to quantify the deficit in major obstetric interventions for absolute maternal indications carried out in 1998. In order to do this, we conducted a retrospective study based on files in four sanitary regions. Once the data was collected, we listed 610 major obstetric interventions for absolute maternal indications (IOM/IMA). For the same period, the expected number of IOM/IMA was of 1,470, i.e. a relative global deficit of 58.5%. The analysis per sanitary district revealed disparities with deficits going from 87.5% to 15.5%. The lack of qualified personnel and of surgical infrastructures, the low economic level of the populations and the high cost of the services were identified as factors having favoured these deficits.

[Ecological approach for a better understanding of population-agriculture-environment relations]. / Suivi ecologique pour une meilleure comprehension des relations population-agriculture-environnement.

PIP: In January 1993, representatives from 9 member states of the Permanent Inter-State Committee for the Struggle Against Desertification in the Sahel (CILSS) met to propose potential ecological observation sites for a subnetwork of a vast network covering member countries of the CILSS, the Arab Maghreb Union, and the Intergovernmental Authority Against Desertification for Development. The delegates identified 20 potential sites which represent principle agroecological, socioeconomic, and demographic zones of the Sahel. The identified sites included 8 protected areas, 5 with potential agrico-pastoral development activities, 4 with existing research and experimentation stations to collect scientific data over a long period, 2 with advancing sand, and 1 urban development zone. The ecoclimatic zones were Sahelian (45%), Saharan (30%), Sahelo-Sudanian (15%), and Sudanian (10%). This network will have to put in place an effective coordination mechanism involving all related organizations and to deliver a minimum resource base guaranteeing continuation of guiding activities. Taking in account demographic and socioeconomic aspects integrated with physical aspects will better allow formulation of solutions to identified problems. The blending of data collection and data analysis methods at the heart of the network will constitute an important gain allowing extrapolation of results and the proposition of interregional and international corrective measures. One should avoid duplications which waste these countries' rare resources by strengthening already existing regional and international coordination organizations.^ieng

[Perinatal mortality in Burkina Faso: risk factors in an urban environment of Bobo-Dioulasso]. / La mortinatalité au Burkina Faso: facteurs de risque en milieu urbain de Bobo-Dioulasso.

A total of 96 mothers of stillborn babies (cases) and 402 mothers of live-born babies (controls) were studied between the 1st November 1988 and the 31st July 1989 in an attempt to identify the risk factors for the high number of stillbirths in the Maternity wing of the Hôpital National Sourô SANON in Bobo-Dioulasso, Burkina Faso. From a stratified analysis, eight risk factors emerged as significant predictors of mortality: mother older than 35 years, high parity (five or more), previous history of stillbirth, lack of medical supervision of pregnancy, interval between last consultation and birth longer than 30 days, complications during delivery and birth weight less than 2,500 g. Polygamy was associated with a 51% reduction in the risk of stillbirth. The problem of selection bias which affects the validity of hospital based case-control studies is discussed. Techniques for reducing selection bias in hospital based case-control studies are proposed. Improvements in antenatal care in Bobo-Dioulasso are suggested.

[Morbidity and mortality related to obstetrical referral patients to the hospital of Bobo-Dioulasso, Burkina Faso]. / Morbidité et mortalité liées, aux évacuations sanitaires d'obstétrique à l'hopital de Bobo-Dioulasso, Burkina Faso.

The obstetrical referral patients admitted to the Sanon Souro hospital in Bobo-Dioulasso (Burkina Faso) during 1991 were retrospectively reviewed. During the study period 741 women were admitted. The median distance between the referring centre and Bobo-Dioulasso was 33 km. Median age was 22 years and median parity was 3. Indications for referral were dominated by obstructed labour, haemorrhages and infections. The proportion of maternal mortality in the study was 5.4% and was not related to maternal age or parity. However, there was a linear trend of increasing mortality according to the distance between the referring centre and Bobo-Dioulasso (X2 for trend: 7.56; p = 0.006). The perinatal mortality rate of 420 p. thousand was not related to maternal age, but a parity exceeding 4 was a risk factor for the occurrence of perinatal death (relative risk: 1.4; 95% C.I.: 1.2-1.7). As for maternal mortality, there was a linear increase of perinatal mortality with the distance from the referring centre (X2: 20.8; p = 0.00001). There was no marked seasonal variation in the number of referrals nor in the mortality rates per month.

Early detection and response to meningococcal disease epidemics in sub-Saharan Africa: appraisal of the WHO strategy.

OBJECTIVE: To assess the sensitivity, specificity and predictive value positive of the WHO threshold strategy for detecting meningococcal disease epidemics in sub-Saharan Africa and to estimate the impact of the strategy on an epidemic at district level. METHODS: Data on meningitis cases at the district level were collected weekly from health ministries, WHO country and regional offices, and nongovernmental organizations in countries where there were epidemics of meningococcal disease in 1997. An epidemic was defined as a cumulative district attack rate of at least 100 cases per 100,000 population from January to May, the period of epidemic risk. The sensitivity, specificity and predictive value positive of the WHO threshold rate were calculated, and curves of sensitivity against (1 - specificity) were compared with alternatively defined threshold rates and epidemic sizes. The impact of the WHO strategy on a district epidemic was estimated by comparing the numbers of epidemic cases with cases estimated to have been prevented by vaccination. FINDINGS: An analysis was made of 48 198 cases reported in 174 districts in Benin, Burkina Faso, the Gambia, Ghana, Mali, Niger, and Togo. These cases were 80.3% of those reported from Africa to WHO during the 1997 epidemic period. District populations ranged from 10,298 to 573,908. The threshold rate was crossed during two consecutive weeks in 69 districts (39.7%) and there were epidemics in 66 districts (37.9%). Overall, the sensitivity of the threshold rate for predicting epidemics was 97%, the specificity was 95%, and the predictive value positive was 93%. Taken together, these values were equivalent or better than the sensitivity, specificity and predictive value positive of alternatively defined threshold rates and epidemics, and remained high regardless of district size. The estimated number of potential epidemic cases decreased by nearly 60% in the age group targeted for vaccination in one district where the guidelines were followed in a timely manner. CONCLUSION: The use of the WHO strategy was sensitive and specific for the early detection of meningococcal disease epidemics in countries of sub-Saharan Africa during 1997 and had a substantial impact on a district epidemic. Nevertheless, the burden of meningococcal disease in these countries remains formidable and additional control measures are needed.

Infection placentaire et paludisme urbain a Bobo-Dioulasso; Burkina Faso

L'infestation placentaire par le plasmodium a ete etudiee a Bobo-Dioulasso (Burkina Faso) pendant deux ans; de juillet a decembre chez 342 parturientes au total. Ce travail complete les precedentes enquetes concernant l'etude du paludisme urbain dans la seconde ville du Burkina Faso. Plasmodium falciparum est la seule espece observee. Le taux d'infection placentaire est de 14 pour cent. Il est plus elevee en novembre et decembre que durant les quatre mois precedents. Il est egalement significativement plus eleve chez les femmes habitant a proximite du cours d'eau qui traverse la ville que chez celles habitant les autres quartiers de la ville. Cette etude apparait etre un indicateur sensible de l'infestation palustre au sein d'un milieu urbain globalement peu favorable a la transmission