Predictors of severity and prolonged hospital stay of viral acute respiratory infections (ARI) among children under five years in Burkina Faso, 2016-2019

BACKGROUND

Viruses are the leading etiology of acute respiratory infections (ARI) in children. However, there is limited knowledge on drivers of severe acute respiratory infection (SARI) cases involving viruses. We aimed to identify factors associated with severity and prolonged hospitalization of viral SARI among children < 5 years in Burkina Faso.

METHODS

Data were collected from four SARI sentinel surveillance sites during October 2016 through April 2019. A SARI case was a child < 5 years with an acute respiratory infection with history of fever or measured fever ≥ 38 °C and cough with onset within the last ten days, requiring hospitalization. Very severe ARI cases required intensive care or had at least one danger sign. Oropharyngeal/nasopharyngeal specimens were collected and analyzed by multiplex real-time reverse-transcription polymerase chain reaction (rRT-PCR) using FTD-33 Kit. For this analysis, we included only SARI cases with rRT-PCR positive test results for at least one respiratory virus. We used simple and multilevel logistic regression models to assess factors associated with very severe viral ARI and viral SARI with prolonged hospitalization.

RESULTS

Overall, 1159 viral SARI cases were included in the analysis after excluding exclusively bacterial SARI cases (n = 273)very severe viral ARI cases were common among children living in urban areas (AdjOR = 1.3; 95% CI: 1.1-1.6), those < 3 months old (AdjOR = 1.5; 95% CI: 1.1-2.3), and those coinfected with Klebsiella pneumoniae (AdjOR = 1.9; 95% CI: 1.2-2.2). Malnutrition (AdjOR = 2.2; 95% CI: 1.1-4.2), hospitalization during the rainy season (AdjOR = 1.71; 95% CI: 1.2-2.5), and infection with human CoronavirusOC43 (AdjOR = 3; 95% CI: 1.2-8) were significantly associated with prolonged length of hospital stay (> 7 days).

CONCLUSION

Younger age, malnutrition, codetection of Klebsiella pneumoniae, and illness during the rainy season were associated with very severe cases and prolonged hospitalization of SARI involving viruses in children under five years. These findings emphasize the need for preventive actions targeting these factors in young children.

Coinfections with SARS-CoV-2 variants and influenza virus during the 2019 Coronavirus disease pandemic in Burkina Faso: A surveillance study

Background and Aim

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) particularly the variants of concern coinfections with influenza is a public health concern in Africa. We aimed to characterize the SARS-CoV-2 variants and determine the rate of coinfections with influenza in Burkina Faso.

Methods

COVID-19 surveillance study was conducted between August 2021 and January 2022 using reverse transcription polymerase chain reaction (RT-PCR). Positive specimens were further screened for SARS-CoV-2 variants using the multiple variants real-time PCR kits. In addition, influenza virus strains were detected by RT-PCR in SARS-CoV-2 positive specimens using the CDC primers, probes, and protocols.

Results

Of 324 specimens assessed, the Omicron and Delta variants of SARS-CoV-2 were the most prevalent with 27.2% [95% confident interval (CI): 22.5-32.4] and 22.2% [95% CI: 17.9-27.2], respectively. The Beta and Gamma variants were detected in 4.3% [95% CI: 2.4-7.1] and 0.3% [95% CI: 0.0-1.7], respectively. Coinfections of Omicron and Beta variants were reported in 21.3% [95% CI: 17.0-26.2], Omicron and Delta variants in 1.2% [95% CI: 0.3-3.1] of specimens, and the Omicron-Gamma variants' coinfections in 0.6% [95% CI: 0.1-2.2]. One COVID-19 specimen with an undetected SARS-CoV-2 variant was also tested positive for the seasonal influenza A (H₃N₂) virus. No cases of pandemic influenza A (H₁N₁)pdm09, seasonal A/H₁N₁, and influenza B were detected.

Conclusions

The current World Health Organization SARS-CoV-2 variants of concern were prevalent and their coinfections with influenza were uncommon. Continuous surveillance of both pathogens is, however, needed because of their public health implications.

The first study on seroprevalence and risk factors for zoonotic transmission of ovine and caprine brucellosis in the Province of Bam, Burkina Faso

Background and Aim:

Brucellosis is a bacterial disease notorious for its ability to infect a wide range of domestic and wildlife animals, as well as humans. This study aimed to determine the seroprevalence of ovine and caprine brucellosis and the associated risk factors in the Province of Bam in Burkina Faso.

Materials and Methods:

The individual serological status of 300 unvaccinated sheep and 300 unvaccinated goats was determined by Rose Bengal and indirect enzyme-linked immunosorbent assay (iELISA) serological tests used in parallel. The frequency of behaviors conferring risk of developing this zoonotic disease was determined through two epidemiological questionnaires, which identified known risk factors for the transmission of brucellosis between animals and humans.

Results:

Individual seroprevalence was estimated at 6.0% (18/300) in sheep and 4.3% (13/300) in goats. The “herd” prevalence of brucellosis was estimated at 60% in sheep while 40% in goats. Positivity in the iELISA serological test was significantly associated with age, sex, and husbandry system in sheep and goats.

Conclusion:

These results indicate that Brucella melitensis circulates in sheep and goat farms in the Province of Bam in Burkina Faso. As B. melitensis is highly pathogenic to humans, adequate measures must be taken to protect the population against this zoonotic disease.

Prevalence of hepatitis E virus antibodies in cattle in Burkina Faso associated with swine mixed farming

Background

Endemic circulation of human-specific hepatitis E virus (HEV) genotypes 1 and 2 may occult the importance of sporadic zoonotic HEV transmissions in Africa. Increasing numbers of studies reporting anti-HEV antibodies in cattle and the discovery of infectious HEV in cow milk has raised public health concern, but cattle exposure has seldom been investigated in Africa.

Objectives

This study aimed at investigating the role of cows in the epidemiology of HEV in Burkina Faso and farmers habits in terms of dairy product consumption as a prerequisite to estimate the risk of transmission to humans.

Methods

Sera from 475 cattle and 192 pigs were screened for the presence of anti-HEV antibodies while HEV RNA in swine stools was detected by reverse transcription polymerase chain reaction. Data on mixed farming, dairy product consumption and selling habits were gathered through questionnaires.

Results

The overall seroprevalence in cattle was 5.1% and herd seroprevalence reached 32.4% (11/34). Herd seropositivity was not associated with husbandry practice or presence of rabbits on the farms. However, herd seropositivity was associated with on-site presence of pigs, 80.7% of which had anti-HEV antibodies. The majority of farmers reported to preferentially consume raw milk based dairy products.

Conclusions

Concomitant presence of pigs on cattle farms constitutes a risk factor for HEV exposure of cattle. However, the risk of HEV infections associated with raw cow dairy product consumption is currently considered as low.

Factors associated with owned-dogs' vaccination against rabies: A household survey in Bobo Dioulasso, Burkina Faso

Canine vaccination is an effective means for rabies control, a minimum of 70% dog rabies vaccination coverage is required in endemic areas. According to previous investigations, this recommended coverage is always not achieved in Burkina Faso. This study was carried out to investigate reasons for poor vaccination coverage in canine population. Using a structured questionnaires, a cross‐sectional survey was conducted in the city of Bobo Dioulasso to capture data on drivers that affect dog owners’ individual decision to vaccinate or not their dogs. Through a house‐to‐house approach, 239 questionnaires were administrated to dog owners during face to face interviews. The results indicated dog rabies vaccination coverage of 25.9%. Dog breed, origin and confinement status had a significant association with vaccination status (p < 0.05). Owners of exotic and cross‐bred dogs were more likely to adopt vaccination compared to owners of local‐bred dogs. Dogs of bought origin were significantly more likely to be vaccinated among all dogs. Household characteristics including age of owners, level of education, employment status, means of transportation, perception of vaccination cost and level of knowledge about rabies were significantly associated with the vaccination status (p < 0.05). The oldest dog owners, the owners having high level of education, having a car as means of transportation, having good knowledge of rabies and dog rabies vaccination, being employed and perceiving vaccination cost as affordable were more likely to vaccinate their dogs. Combining community awareness and free dog rabies vaccination approaches could improve the vaccination coverage.

Serological evidence of swine exposure to pandemic H1N1/2009 influenza A virus in Burkina Faso

Despite improvement of human and avian influenza surveillance, swine influenza surveillance in sub-Saharan Africa is scarce and pandemic preparedness is still deemed inadequate, including in Burkina Faso. This cross-sectional study therefore aimed to investigate the (past) exposure of pigs to influenza A viruses. Practices of people with occupational contacts with pigs and their knowledge on influenza A were investigated in order to formulate future prevention guidelines. In 2016-2017, pig nasopharyngeal swabs and sera were collected and screened for the presence of influenza virus by RT-PCR or of anti-influenza antibodies by competitive ELISA. Seropositive samples were further characterized in virus microneutralization assays against human and swine H1N1 virus strains. Nasopharyngeal swabs were obtained from people with occupational contact with pigs and screened similarly. Demographic data as well as practices related to their profession were recorded. No influenza A virus was detected in nasopharyngeal swabs in humans (n = 358) or in pigs (n = 600). Seroprevalence in pigs reached 6.8 % (41/600) and seropositive animals were found in 50.0 % of extensive settings (10/20) and 19.0 % of (semi-)intensive farms (4/21). All positive sera reacted against the pandemic H1N1/2009 strain, while seropositivity against two Eurasian avian-like and one American swine H1N1 strains and individual titers were lower. These results suggested exposure to pandemic H1N1/2009 virus and cross-reactivity to other H1N1 strains. Farmers with higher frequency of contact to pigs, absence of protective equipment and lack of knowledge on zoonoses are likely key players in driving human-to-swine virus transmission.

Seroprevalence and factors associated with bovine and swine toxoplasmosis in Bobo-Dioulasso, Burkina Faso

Background and Aim:

Toxoplasmosis is a worldwide zoonosis with major public health importance. To know more about this condition in Burkina Faso, this study was implemented to determine the seroprevalence of Toxoplasma gondii infection among pigs and cattle in intra-urban and peri-urban area of Bobo-Dioulasso (Burkina Faso).

Materials and Methods:

Serum samples were collected from 600 cattle and 600 pigs with 300 samples from each species in intra-urban and peri-urban area of Bobo-Dioulasso. Data about age, sex, and breed of each animal were also noted. Serum samples were analyzed by indirect enzyme-linked immunosorbent assay to look for immunoglobulin G and immunoglobulin M antibodies to T. gondii.

Results:

This study revealed a herd prevalence of 92.5% and 75%, respectively for porcine and bovine toxoplasmosis. At the individual level, we found a prevalence of 29% and 49.2% for cattle and pigs, respectively. For each species, we noticed a significant association between age, sex, breed husbandry system, and the presence of anti-T. gondii antibodies. The prevalence was significantly higher in female, intra-urban system, exotic breed, and animal <2 years old (p<0.05)

Conclusions:

The results provided evidence for the presence of T. gondii in pigs and cattle farms around Bobo-Dioulasso. Hence, in Bobo-Dioulasso, raw or undercooked meat consumption is a risk for T. gondii infection for human. Knowledge of the prevalence of toxoplasmosis will help to target prevention efforts.

Dengue Fever in Burkina Faso, 2016

We report 1,327 probable cases of dengue in Burkina Faso in 2016. Of 35 serum samples tested by a trioplex test, 19 were confirmed dengue virus (DENV)‒positive: 11 DENV-2, 6 DENV-3, 2 nontypeable, and 1 DENV-2/DENV-3 co-infection. Molecular testing should be conducted to correctly identify causative agents in this complex infectious disease landscape.