Socioeconomic and environmental factors associated with malaria hotspots in the Nanoro demographic surveillance area, Burkina Faso.

BACKGROUND: With limited resources and spatio-temporal heterogeneity of malaria in developing countries, it is still difficult to assess the real impact of socioeconomic and environmental factors in order to set up targeted campaigns against malaria at an accurate scale. Our goal was to detect malaria hotspots in rural area and assess the extent to which household socioeconomic status and meteorological recordings may explain the occurrence and evolution of these hotspots. METHODS: Data on malaria cases from 2010 to 2014 and on socioeconomic and meteorological factors were acquired from four health facilities within the Nanoro demographic surveillance area. Statistical cross correlation was used to quantify the temporal association between weekly malaria incidence and meteorological factors. Local spatial autocorrelation analysis was performed and restricted to each transmission period using Kulldorff's elliptic spatial scan statistic. Univariate and multivariable analysis were used to assess the principal socioeconomic and meteorological determinants of malaria hotspots using a Generalized Estimating Equation (GEE) approach. RESULTS: Rainfall and temperature were positively and significantly associated with malaria incidence, with a lag time of 9 and 14 weeks, respectively. Spatial analysis showed a spatial autocorrelation of malaria incidence and significant hotspots which was relatively stable throughout the study period. Furthermore, low socioeconomic status households were strongly associated with malaria hotspots (aOR = 1.21, 95% confidence interval: 1.03-1.40). CONCLUSION: These fine-scale findings highlight a relatively stable spatio-temporal pattern of malaria risk and indicate that social and environmental factors play an important role in malaria incidence. Integrating data on these factors into existing malaria struggle tools would help in the development of sustainable bottleneck strategies adapted to the local context for malaria control.

Setting up a Video Transmission Tool for Teleconsultation and Tele-Expertise in an African Context: Case of Burkina Faso.

Since the COVID-19 health crisis, telemedicine has received a lot of attention around the world. Following attempts to set up a telemedicine system, in particular teleconsultation and teleexpertise, which proved inconclusive in Burkina, we have seen several technologies and tools that could enable the implementation of a telemedicine solution that meets the realities of Burkina Faso. The results of the study of the existing system and interviews with health professionals have made it possible to design a telemedicine platform combining a scalable video-transmission tool adapted to the country's health system.

Design of an Application for the Automatic Assessment of the Quality of Data Produced in an African Context (Burkina Faso) "Package Data Quality Assessment (PackDQA)".

We have developed data quality tool in R language. Our application name is Package-Data-Quality-Assessment (PackDQA)". It developed following five points: Quality dimension approaches identification, design of quality measures, global coefficient design, development of the quality model, test and deployment model. This model test performed on health data in Burkina Faso show 97.69% observations is quality. The current version does not include qualitative data. We will have to improve theme to use all types of data.

Implementation of a Monitoring System for Pregnancy by Tele-Ultrasound in an African Context (Burkina Faso).

Prenatal ultrasound is a radiological examination that allows optimal follow-up of pregnancies. However, its implementation remains limited in poor countries due to a lack of equipment and trained health workers, such as in Burkina Faso. The aim of this work is to set up an ultrasound tele-expertise system. To achieve this objective, we mobilized human, material and IT resources. The design of the tele-expertise application was based on a generic open source software called "MedShakeEHR" that we have adapted to our context. The application runs in a network on a Linux system. It enables ultrasound data exchange and sharing with a remote expert for interpretation using the DICOM protocol. This device thus offers the possibility to pregnant women to carry out their prenatal ultrasound locally. It also allows the constitution of prenatal ultrasound database according security and confidentiality standards.

Design and Implementation of a Unique Patient Identification Model in Information Systems in Burkina Faso.

The implementation of a reliable identity process is the basis of any secure patient information sharing system. Indeed, each individual is unique and should be identified by a unique number (identifier). It is with these issues in mind that we have designed and implemented a unique patient identification method adapted to the context of Burkina Faso. The recommended method is inspired by the French method based on the work of the Group for the Modernization of the Hospital Information System (GMSIH) [1]. The developed model allows to assign a "Unique Identifier" (PatientID) to each patient from his profile of identification features (name, date of birth, gender,…). The patient ID is a sequence of 20 characters plus a security "key" of 2 characters. A reliability test of the model has been performed to take into account identity anomalies (duplicate, collision).

Patient's Unique Identifier for Efficient and Secure Monitoring of Pregnant Women in Burkina Faso.

The objective of this work is to set up a device allowing to identify the pregnant woman in a univocal and reliable way during her pregnancy follow-up. This study is a continuation of a project to improve the electronic monitoring of pregnancy in pregnant women in Burkina Faso. The methodology is based on the scientific work of the GMSIH of France (1). The work has lead to the design and implementation of a model that allows to assign a "Unique Identifier" to each pregnant woman from her first prenatal visit. The Patient ID is developed from the person's identification trait profile. It consists of a sequence of 20 characters and a security "key" of 2 characters. After the design, a reliability test of the model was performed to take into account identity anomalies (duplicates, collisions).

Mobile Monitoring of Diabetic Patients in the Active File of the Medical Center of Do (Burkina Faso).

The care of diabetic patients in peripheral medical centers in Burkina Faso faces many difficulties. This work, which is a new experience, aimed to set up an information system for the care of diabetic patients in the context of Burkina Faso. The system thus conceived consists of a web application (MedshakeEHR), used by the doctor and a mobile application (Glucosio) for the patient. The system has advantages such as remote appointment scheduling, appointment reminder, patient information sharing. The device also makes it possible to store data for the production of statistics and for scientific research. This experience has enabled us to meet certain challenges related in particular to the problem of HIS such as organizational constraints, the creation of a unique identifier, the modeling of the main business processes, etc.

Design and Implementation of a Computerized Management System for Adverse Drug Reactions at the Sourô SANOU University Hospital (CHUSS) in Bobo-Dioulasso, Burkina Faso.

Pharmacovigilance is the science and activities related to the detection, evaluation, understanding and prevention of adverse drug reactions or any other possible drug-related problems. In our tropics, this discipline is in an embryonic state. The availability of a management system capable of responding to pharmacovigilance activities is the main objective of our study. The coding was done on the DJANGO Framework. Signal detection was done using the ROR method. We designed three modules which are the notification module, the analysis module and the statistics module. This study has allowed us to launch the basis for a computerization of the pharmacovigilance information system and partly meets our objective. However, it could lead to the integration of the dictionary of adverse effects such as MedDRA as well as the International Classification of Medicines (ATC, EphMRA).

A Data Warehouse Design for Dangerous Pathogen Monitoring.

Emerging diseases are a major public health problem as illustrated by the current coronavirus disease (COVID-19) pandemic. To make the right decisions, public health departments need a decision-making system. In Africa few IT systems have been put in place to help managers of public health in the analysis of their multidisciplinary data. The majority of digital health solutions are operational databases, as well, focused on surveillance activities that do not include the laboratory component. This paper describes the design model and implementation of data warehouse for dangerous pathogen monitoring in a laboratories network. Talend data integration is used to extract data in Excel sheets, transform it and load it into a MySQL database.

Bioinformatic Analysis of MIRU-VNTR Repeats of Mycobacterium Tuberculosis Strains from Lagos, Nigeria.

The analysis of Mycobacterial Interpersed Repetitive Unit-Variable Number of Tandem Repeat (MIRU-VNTR) discriminates against the species of M. tuberculosis involved in the transmission of the disease. The reference method is the manual method. Our study involved developing a bioinformatics method of interpreting MIRU-VNTR and comparing it to the manual method. For this we used two softwares, namely imagej and Microsoft Excel. Imagej was used to determine the migration distance of the bands and for the measure of size in a base pair. The number of repetitions of 18 markers used was analyzed with Excel macro. The results obtained were: 27% of the results exactly consistent, 16% of outliers generated by the macro and 57% of the results not matching.

Health Metrics Network (HMN-WHO), a Tool to Assess the Quality of the Information System in Burkina Hospitals.

An assessment of the quality of the information system was conducted in the 14 hospitals of Burkina Faso in 2017 using the HMN tool (Health Metrics Network). This evaluation was part of the process of developing a master plan for implementing a HIS for the hospitals in the country, and was aimed at analyzing the sub-components of the existing information system. The results are presented as scores, one per component, evaluated in % and converted into quartiles, ranging from the 1st quartile "Not adequate at all" to the 4th quartile "Highly adequate". The scores are as follows: Resources = Q1 (29%); indicator = Q2 (46%); data sources = Q1 (28%); information production = Q1 (21%); data management = Q2 (47%); dissemination and use = Q3 (55%). In conclusion, overall the system is not adequate (mean score 39%), particularly at the level of information production (score 21%).

Health professionals and patients' perspectives on person-centred maternal and child healthcare in Burkina Faso.

CONTEXT: The person-centred approach (PCA) is a promising avenue for care improvement. However, health professionals in Burkina Faso (hereafter referred to as caregivers) seem unprepared for taking into consideration patients' preferences and values in the context of healthcare provision. OBJECTIVE: To understand the meaning attributed to PCA in the Burkina Faso context of care and to identify the challenges related to its adoption from the perspective of caregivers and women service users (hereafter referred to as patients). METHODS: An ethnographic qualitative research design was used in this study. We conducted 31 semi-directed interviews with caregivers and patients from Koudougou (Burkina Faso) healthcare facilities. We also carried out direct observation of consultations. Data thematic analyses are based on the person-centred approach analysis framework. RESULTS: According to the caregivers and patients interviewed, the PCA in maternal and child healthcare in Burkina Faso includes the following five components used in our analytical framework: i) pregnancy follow-up consultations extend beyond examining physical health issues (biopsychosocial component), ii) healthcare professionals' mood affects the caregiver-patient relationship as well as care delivery (the healthcare professional as a person), iii) patients expect to be well received, listened to, and respected (the patient as a person), iv) healthcare professionals first acknowledge that both themselves and patients have power, rights but also responsibilities (sharing power, rights and responsibilities of professionals and patients), and v) healthcare professionals who are open to involving patients in decision-making about their care and patients asking to have a say in the organization of services (therapeutic alliance). Implementing each of these themes comes with challenges, such as i) talking about health problems in the presence of other women, especially those related to sexuality, even though they are common to parturient women (biopsychosocial component); ii) offering psychotherapy to healthcare professionals (healthcare professional as a person); iii) taking into consideration patients' cultural and linguistic differences (the patient as a person); iv) raising awareness among patients about their right to ask questions and healthcare professionals' duty to answer them (sharing power, and rights and responsibilities of professionals and patients); v) accepting the presence of birth attendants while avoiding traditional practices that are contrary to scientific recommendations (therapeutic alliance). CONCLUSION: Despite some context-specific particularities, the PCA is not new in the context of health care in Burkina Faso. However, its implementation can pose a number of challenges. There is a need to train healthcare professionals with a view to being sensitive to these particularities. This may also require organizational adjustments so as to create the physical and sociocultural environments that are conducive to taking into account the patient's perspective.

Study of the Usability of an Automated Coding Software for Causes of Death in an African Context.

IRIS is an automated coding software for the causes of death. It is used in many European countries for the production of death statistics. The purpose of our work was to study the usability of this software in Africa where the quality of statistics is insufficient. For this, we have developed a device consisting of two software: "collector" and "encoder" cooperating via the same database.

Quality Control of a Health Information System for Causes of Death Statistics in Burkina Faso Using Capture-Recapture Method.

INTRODUCTION: The information system on the causes of death (ISCD), set up in Burkina Faso in January 2014 at the University Hospital Center Souro Sanon (UHCSS) of Bobo-Dioulasso, was evaluated to assess its completeness in terms of death statistics generation. METHOD: The capture-recapture method was used to assess this quality control using the three-sources technique. RESULTS: The cross verification of the three data sources (mortuary, admission department, death certificate) gave the following estimations: number of deaths observed: 735, total estimated deaths: 852 [820-900], i.e. 86% of completeness achieved by the statistics generating system. DISCUSSION: The ISCD is functional and produces easy-to-cross-check quality data. It could be extended to the entire country for the generation of mortality statistics. Nevertheless, it needs to be improved before deploying across the country.

Cause-of-death certification in Africa: analysis of a model implemented at the teaching hospital of Souro Sanou of Bobo-Dioulasso (Burkina Faso).

INTRODUCTION: In Africa, mortality statistics are not reliable due to the low performance of the death registering systems. Our aim is to implement an efficient system. In this article we make a comparison between the existing system model and the new system that will be set up. METHOD: UML has been used as the modeling language based on the 2TUP analysis methods. RESULTS: the new system for registering deaths and their causes was conceived and represented through activities, utilization cases and data model diagrams. DISCUSSION: We have developed a tool for death registration taking into account African hospitals characteristics. The progressive deployment of this system at the CHUSS of Bobo-Dioulasso enables users and actors to appropriate it.